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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 16 of 16 Research Studies DisplayedShortell SM, Gottlieb DJ, Martinez Camblor P
Hospital-based health systems 20 years later: a taxonomy for policy research and analysis.
Building on the original taxonomy of hospital-based health systems from 20 years ago, the investigators developed a new taxonomy to inform emerging public policy and practice developments. The study design included a cluster analysis of the 2016 AHA Annual Survey data to derive measures of differentiation, centralization, and integration to create categories or types of hospital-based health systems.
AHRQ-funded; HS024075.
Citation: Shortell SM, Gottlieb DJ, Martinez Camblor P .
Hospital-based health systems 20 years later: a taxonomy for policy research and analysis.
Health Serv Res 2021 Jun;56(3):453-63. doi: 10.1111/1475-6773.13621..
Keywords: Hospitals, Health Systems, Health Services Research (HSR), Policy
Everson J, Hollingsworth JM, Adler-Milstein J
Comparing methods of grouping hospitals.
The purpose of this study was to compare the performance of widely used approaches for defining groups of hospitals and a new approach based on network analysis of shared patient volume. Results showed that community detection algorithm-defined hospital groups offer high validity, reliability to different specifications, and generalizability to many uses when compared to approaches in widespread use today. They may offer a better choice for efforts seeking to analyze the behaviors and dynamics of groups of hospitals. Measures of modularity, shared information, inclusivity, and shared behavior can be used to evaluate different approaches to grouping providers.
AHRQ-funded; HS024525; HS024728; HS024454.
Citation: Everson J, Hollingsworth JM, Adler-Milstein J .
Comparing methods of grouping hospitals.
Health Serv Res 2019 Oct;54(5):1090-98. doi: 10.1111/1475-6773.13188..
Keywords: Health Services Research (HSR), Hospitals, Research Methodologies
Hsuan C, Hsia RY, Horwitz JR
Ambulance diversions following public hospital emergency department closures.
The purpose of this study was to examine whether hospitals are more likely to temporarily close their emergency departments to ambulances, through ambulance diversions, if neighboring diverting hospitals are public vs private. Results showed that sample hospitals respond differently to diversions by neighboring public (vs private) hospitals. The authors conclude that these findings suggest that these hospitals might be strategically declaring ambulance diversions to avoid treating low-paying patients served by public hospitals.
AHRQ-funded; HS024247.
Citation: Hsuan C, Hsia RY, Horwitz JR .
Ambulance diversions following public hospital emergency department closures.
Health Serv Res 2019 Aug;54(4):870-79. doi: 10.1111/1475-6773.13147..
Keywords: Access to Care, Emergency Department, Emergency Medical Services (EMS), Health Services Research (HSR), Hospitals
Austin JM, Kirley EM, Rosen MA
A comparison of two structured taxonomic strategies in capturing adverse events in U.S. hospitals.
The purpose of this study was to compare the ability of AHRQ’s Quality and Safety Review System (QSRS) and the proposed triadic structure for the 11th version of the International Classification of Disease (ICD-11) to capture adverse events in U.S. hospitals. One thousand admissions were chosen for this study in a random sample from 3 general, acute care hospitals in Maryland and Washington D.C. and abstracted by two different sets of coding specialists for QSRS and the ICD-11. The results showed less than 20 percent agreement between QSRS and ICD-11 in their ability to identify the same adverse events. The sensitivity of ICD-11 improved when coders were given a list of potential adverse events. The authors conclude that in its draft form, ICD-11 has a limited ability to capture the same types of events as QSRS and that coders may need more training to improve its ability to identify adverse events.
AHRQ-funded; 233201500020I.
Citation: Austin JM, Kirley EM, Rosen MA .
A comparison of two structured taxonomic strategies in capturing adverse events in U.S. hospitals.
Health Serv Res 2019 Jun;54(3):613-22. doi: 10.1111/1475-6773.13090..
Keywords: Adverse Events, Health Services Research (HSR), Hospitals, Patient Safety
Chopra V, Burden M, Jones CD
State of research in adult hospital medicine: results of a national survey.
This study examined the state of research in academic hospital medicine by conducting a survey of members of the Society of Hospital Medicine (SHM). A total of 100 programs were considered eligible and surveys sent to corresponding individuals. Among those programs, 28 completed the survey. There was a total 1,586 faculty members represented with 12% identified as engaging or having obtained extramural funding with 41% as engaging in quality improvement efforts. Most of the programs (61%) received $500,000 or less and 29% received >$1 million in funding. The major federal funders were AHRQ, NIH, and the Veterans Health Administration. Only five programs currently have a research fellow program in hospital medicine, with many programs citing a lack of funding as the major barrier to establishing a program. Almost half of the respondents indicated their faculty were publishing between 11-50 peer-reviewed manuscripts each year.
AHRQ-funded; HS024569.
Citation: Chopra V, Burden M, Jones CD .
State of research in adult hospital medicine: results of a national survey.
J Hosp Med 2019 Apr;14(4):207-11. doi: 10.12788/jhm.3136.
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Keywords: Hospitals, Health Services Research (HSR)
Walker DM, Hefner JL, Sieck CJ
Framework for evaluating and implementing inpatient portals: a multi-stakeholder perspective.
Inpatient portals are emerging as an important tool to support patient care and are increasingly being adopted in hospitals. However, best practices concerning the implementation, use, and impact of these portals are poorly understood. To improve evaluation and implementation efforts, this paper develops a logic model that can help researchers and hospital managers in deploying and assessing the impact of inpatient portals.
AHRQ-funded; HS024349; HS024091.
Citation: Walker DM, Hefner JL, Sieck CJ .
Framework for evaluating and implementing inpatient portals: a multi-stakeholder perspective.
J Med Syst 2018 Jul 16;42(9):158. doi: 10.1007/s10916-018-1009-3..
Keywords: Electronic Health Records (EHRs), Health Services Research (HSR), Hospitals, Web-Based
Ly DP, Cutler DM
Factors of U.S. hospitals associated with improved profit margins: an observational study.
The objectives of this study are to determine whether hospitals that became more profitable increased revenues or decreased costs more and to examine characteristics associated with improved financial performance over time. The study concluded that differential price increases have led to improved margins for some hospitals over time.
AHRQ-funded; HS024072.
Citation: Ly DP, Cutler DM .
Factors of U.S. hospitals associated with improved profit margins: an observational study.
J Gen Intern Med 2018 Jul;33(7):1020-27. doi: 10.1007/s11606-018-4347-4..
Keywords: Healthcare Costs, Health Services Research (HSR), Hospitals
Baloh J, Zhu X, Ward MM
Types of internal facilitation activities in hospitals implementing evidence-based interventions.
The aim of the study was to examine internal facilitation activities at 10 critical access hospitals in rural Iowa during their implementation of TeamSTEPPS, a patient safety intervention, and to identify characteristics that distinguish different types of facilitation activities. The investigators concluded that there are four types of facilitation activities that hospitals engage in while implementing evidence-based practices, offering a parsimonious way to characterize facilitation activities.
AHRQ-funded; HS024112; HS018396.
Citation: Baloh J, Zhu X, Ward MM .
Types of internal facilitation activities in hospitals implementing evidence-based interventions.
Health Care Manage Rev 2018 Jul/Sep;43(3):229-37. doi: 10.1097/hmr.0000000000000145..
Keywords: TeamSTEPPS, Implementation, Hospitals, Evidence-Based Practice, Health Services Research (HSR)
Patterson ES, Dewart CM, Stevenson K
A mixed methods approach to tailoring evidence-based guidance for antibiotic stewardship to one medical system.
The purpose of the study is to operationalize a novel antibiotic advisor, called the personalized weighted incidence syndromic combination antibiogram (pWISCA), intended to help physicians with initial antibiotic choice in hospitals. This paper presents findings from applying a mixed methods approach to identifying and prioritizing antibiotic medications and associated contextual data to display in a clinical decision support tailored to the local hospital.
AHRQ-funded; HS024379.
Citation: Patterson ES, Dewart CM, Stevenson K .
A mixed methods approach to tailoring evidence-based guidance for antibiotic stewardship to one medical system.
Proc Int Symp Hum Factors Ergon Healthc 2018 Jun;7(1):224-31. doi: 10.1177/2327857918071053..
Keywords: Antibiotics, Clinical Decision Support (CDS), Evidence-Based Practice, Health Services Research (HSR), Hospitals
Xu X, Lee HC, Lin H
Hospital variation in cost of childbirth and contributing factors: a cross-sectional study.
The purpose of this study was to examine hospital variation in cost of childbirth hospitalizations and identify factors that contribute to the variation. The study concluded that cost of childbirth hospitalizations varied widely among hospitals in California. Institutional characteristics significantly contributed to this variation. Higher-cost hospitals did not have better outcomes, suggesting potential opportunities to enhance value in care.
AHRQ-funded; HS023801.
Citation: Xu X, Lee HC, Lin H .
Hospital variation in cost of childbirth and contributing factors: a cross-sectional study.
BJOG 2018 Jun;125(7):829-39. doi: 10.1111/1471-0528.15007..
Keywords: Healthcare Costs, Health Services Research (HSR), Hospitals, Labor and Delivery, Pregnancy
Hermann LE, Hall M, Kyler K
The pipeline from abstract presentation to publication in pediatric hospital medicine.
The authors of this article identified the publication rate of abstracts submitted to the 2014 Pediatric Hospital Medicine (PHM) conference and determined whether presentation format was associated with subsequent journal publication or time to publication. They found that abstracts accepted for oral presentation had more than 7-fold greater odds of publication and a 4-fold greater likelihood of publication at each month compared with rejected abstracts. Median journal impact factor was significantly higher for oral presentations than for other presentation formats. They concluded that abstract reviewers may be able to identify methodologically sound studies for presentation; however, the low overall publication rate may indicate that presented results are preliminary or signify a need for increased mentorship and resources for research development in PHM.
AHRQ-funded; 2337002T; 233201500016I.
Citation: Hermann LE, Hall M, Kyler K .
The pipeline from abstract presentation to publication in pediatric hospital medicine.
J Hosp Med 2018 Feb;13(2):90-95. doi: 10.12788/jhm.2853..
Keywords: Children/Adolescents, Health Services Research (HSR), Hospitals
Baker LC, Bundorf MK, Devlin AM
Hospital ownership of physicians: hospital versus physician perspectives.
There has been significant interest from health services researchers and policy makers about recent trends in hospitals' ownership of physician practices, however, few studies have investigated the strengths and weaknesses of available data sources. In this article, the investigators compare results from two national surveys that have been used to assess ownership patterns, one of hospitals (the American Hospital Association survey) and one of physicians (the SK&A survey).
AHRQ-funded; HS024535.
Citation: Baker LC, Bundorf MK, Devlin AM .
Hospital ownership of physicians: hospital versus physician perspectives.
Med Care Res Rev 2018 Feb;75(1):88-99. doi: 10.1177/1077558716676018..
Keywords: Health Services Research (HSR), Hospitals, Provider
Arbaje AI, Yu Q, Wang J J
Senior services in US hospitals and readmission risk in the Medicare population.
The purpose of this study was to determine whether hospitals' Senior Care Services Scale (SCSS) scores were associated with risk of readmission among Medicare beneficiaries. The study concluded that senior services at the hospital-level represented a modifiable risk factor with important impact. Employing organization-level characteristics in readmission risk prediction tools should be expanded.
AHRQ-funded; HS022916
Citation: Arbaje AI, Yu Q, Wang J J .
Senior services in US hospitals and readmission risk in the Medicare population.
Int J Qual Health Care 2017 Oct 1;29(6):845-52. doi: 10.1093/intqhc/mzx112..
Keywords: Elderly, Health Services Research (HSR), Hospital Readmissions, Hospitals, Medicare
Zingmond DS, Parikh P, Louie R
Improving hospital reporting of patient race and ethnicity--approaches to data auditing.
This study investigated new metrics to improve the reporting of patient race and ethnicity (R/E) by hospitals. It examined agreement between hospital reported R/E versus self-report among mothers delivering babies and a cancer cohort in California. It concluded that comparison between reported R/E and R/E estimates using zip code level data may be a reasonable first approach to evaluate and track hospital R/E reporting.
AHRQ-funded; HS019963.
Citation: Zingmond DS, Parikh P, Louie R .
Improving hospital reporting of patient race and ethnicity--approaches to data auditing.
Health Serv Res 2015 Aug;50 Suppl 1:1372-89. doi: 10.1111/1475-6773.12324..
Keywords: Racial and Ethnic Minorities, Hospitals, Hospital Discharge, Health Services Research (HSR), Registries, Quality Improvement, Quality of Care, Data
Nembhard IM, Labao I, Savage S
Breaking the silence: determinants of voice for quality improvement in hospitals.
The researchers examined the drivers of “voice” for health professionals in hospitals. “Voice” is understood as the discretionary communication of ideas, suggestions, concerns, or opinions about work-related issues with the intent to improve organizational or unit functioning. They found that factors related to individuals (e.g., tenure), work (e.g., work configuration), organizational context (e.g., culture), data (e.g., benchmarking), and the external environment (e.g., attention) influenced health professionals’ voice.
AHRQ-funded; HS018987.
Citation: Nembhard IM, Labao I, Savage S .
Breaking the silence: determinants of voice for quality improvement in hospitals.
Health Care Manage Rev 2015 Jul-Sep;40(3):225-36. doi: 10.1097/hmr.0000000000000028..
Keywords: Hospitals, Quality Improvement, Quality of Care, Communication, Organizational Change, Health Services Research (HSR)
Ederhof M, Chen LM
Critical access hospitals and cost shifting.
In the context of ongoing discussion about critical access hospital (CAH) reimbursement, it is important to better understand how health care providers currently utilize funds from the CAH Programs. This study found that among hospitals converted to CAH designation while part of a hospital system, the relative proportion of costs that reflect shared services provided by the parent organization is significantly higher than would be expected in the post-conversion period.
AHRQ-funded; HS020671.
Citation: Ederhof M, Chen LM .
Critical access hospitals and cost shifting.
JAMA Intern Med 2014 Jan;174(1):143-4. doi: 10.1001/jamainternmed.2013.11901..
Keywords: Hospitals, Healthcare Costs, Health Services Research (HSR)