National Healthcare Quality and Disparities Report
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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
51 to 75 of 164 Research Studies DisplayedGeri G, Fahrenbruch C, Meischke H
Effects of bystander CPR following out-of-hospital cardiac arrest on hospital costs and long-term survival.
In this paper, the investigators evaluated bystander cardiopulmonary resuscitation (CPR), hospital-based costs, and long-term survival following out-of-hospital cardiac arrest (OHCA) in order to assess the potential cost-effectiveness of bystander CPR.
AHRQ-funded; HS021658.
Citation: Geri G, Fahrenbruch C, Meischke H .
Effects of bystander CPR following out-of-hospital cardiac arrest on hospital costs and long-term survival.
Resuscitation 2017 Jun;115:129-34. doi: 10.1016/j.resuscitation.2017.04.016..
Keywords: Cardiovascular Conditions, Emergency Medical Services (EMS), Healthcare Costs, Outcomes
Nuckols TK, Fingar KR, Barrett M
AHRQ Author: Steiner CA, Stocks C, Owens PL
The shifting landscape in utilization of inpatient, observation, and emergency department services across payers.
Using data from four states from AHRQ’s Healthcare Cost and Utilization Project, this study compared the payer-specific population-based rates of adults using inpatient, observation, and emergency department (ED) services for 10 common medical conditions in 2009 and in 2013. Inpatient admissions declined, and care shifted toward treat-and-release observation stays and ED visits. The percentage of hospitalizations that began with an observation stay increased.
AHRQ-authored.
Citation: Nuckols TK, Fingar KR, Barrett M .
The shifting landscape in utilization of inpatient, observation, and emergency department services across payers.
J Hosp Med 2017 Jun;12(6):443-46. doi: 10.12788/jhm.2751.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Medical Services (EMS), Healthcare Utilization, Hospitalization, Payment
Benda NC, Fairbanks RJ, Fairbanks RJ
Are you paying attention? Related guidance on how concepts of attention may inform effective time sharing of tasks in emergency medicine.
The authors respond to an earlier article providing a thoughtful introduction to the importance of teaching effective task switching in emergency medicine. Their letter introduces the concept of attention, provides examples of tasks that can be most safely and effectively time shared, and notes that these principles must be considered in designing tools for the time sharing and rapid switching of tasks necessary in the ED environment.
AHRQ-funded; HS022542.
Citation: Benda NC, Fairbanks RJ, Fairbanks RJ .
Are you paying attention? Related guidance on how concepts of attention may inform effective time sharing of tasks in emergency medicine.
Ann Emerg Med 2017 May;69(5):669-70. doi: 10.1016/j.annemergmed.2017.01.027.
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Keywords: Workflow, Emergency Medical Services (EMS), Emergency Department, Patient Safety
Martsolf G, Fingar KR, Coffey R
AHRQ Author: Elixhauser A
Association between the opening of retail clinics and low-acuity emergency department visits.
This study assessed whether the opening of retail clinics near emergency departments (ED) is associated with decreased ED utilization for low-acuity conditions. It concluded that with increased patient demand resulting from the expansion of health insurance coverage, retail clinics may emerge as an important care location, but to date, they have not been associated with a meaningful reduction in low-acuity ED visits.
AHRQ-authored; AHRQ-funded.
Citation: Martsolf G, Fingar KR, Coffey R .
Association between the opening of retail clinics and low-acuity emergency department visits.
Ann Emerg Med 2017 Apr;69(4):397-403.e5. doi: 10.1016/j.annemergmed.2016.08.462.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Utilization, Emergency Medical Services (EMS), Health Services Research (HSR), Ambulatory Care and Surgery
Everson J, Kocher KE, Adler-Milstein J
Health information exchange associated with improved emergency department care through faster accessing of patient information from outside organizations.
This study assessed whether electronic health information exchange (HIE) is associated with improved emergency department (ED) care processes and utilization through more timely clinician viewing of information from outside organizations. It concluded that the relationship between HIE and improved care processes and reduced utilization in the ED is mediated by faster accessing of information from outside organizations.
AHRQ-funded; HS024160.
Citation: Everson J, Kocher KE, Adler-Milstein J .
Health information exchange associated with improved emergency department care through faster accessing of patient information from outside organizations.
J Am Med Inform Assoc 2017 Apr 1;24(e1):e103-e10. doi: 10.1093/jamia/ocw116.
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Keywords: Electronic Health Records (EHRs), Emergency Department, Emergency Medical Services (EMS), Quality of Care, Health Information Exchange (HIE)
Venkatesh AK, Mei H, Kocher KE
Identification of emergency department visits in Medicare administrative claims: approaches and implications.
The researchers sought to construct an operational definition for ED visitation using a comprehensive Medicare data set and to compare this definition to existing operational definitions used by researchers and policymakers. They concluded that current operational definitions of ED visitation using administrative claims produce different estimates of ED visitation based on the underlying assumptions applied to billing data and data set availability.
AHRQ-funded; HS024160.
Citation: Venkatesh AK, Mei H, Kocher KE .
Identification of emergency department visits in Medicare administrative claims: approaches and implications.
Acad Emerg Med 2017 Apr;24(4):422-31. doi: 10.1111/acem.13140.
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Keywords: Emergency Medical Services (EMS), Medicare, Policy, Elderly, Hospitalization
Clark LN, Benda NC, Hegde S
Usability evaluation of an emergency department information system prototype designed using cognitive systems engineering techniques.
This article presents an evaluation of novel display concepts for an emergency department information system (EDIS) designed using cognitive systems engineering methods. It concluded that nurse and provider roles had significantly different perceptions of the usability and usefulness of certain EDIS components, suggesting that they have different information needs while working.
AHRQ-funded; HS022542; HS020433.
Citation: Clark LN, Benda NC, Hegde S .
Usability evaluation of an emergency department information system prototype designed using cognitive systems engineering techniques.
Appl Ergon 2017 Apr;60:356-65. doi: 10.1016/j.apergo.2016.12.018.
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Keywords: Health Information Technology (HIT), Emergency Department, Emergency Medical Services (EMS), Health Information Technology (HIT)
Cicero MX, Whitfill T, Munjal K
60 seconds to survival: a pilot study of a disaster triage video game for prehospital providers.
The researchers hypothesized that players of the video game "60 Seconds to Survival" (60S) would have greater improvements in disaster triage accuracy compared to control subjects who did not play 60S. The video game intervention demonstrated a significant improvement in accuracy from baseline to time 2 while the control did not.
AHRQ-funded; HS022837.
Citation: Cicero MX, Whitfill T, Munjal K .
60 seconds to survival: a pilot study of a disaster triage video game for prehospital providers.
Am J Disaster Med 2017 Spring;12(2):75-83. doi: 10.5055/ajdm.2017.0263.
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Keywords: Emergency Medical Services (EMS), Emergency Preparedness, Training
Corrado MM, Shi J, Wheeler KK
Emergency medical services (EMS) versus non-EMS transport among injured children in the United States.
This study assessed the proportions of injured children transported to trauma centers by different transportation modes and evaluated the effect of transportation mode on inter-facility transfer rates using the US national trauma registry. Over one third of US pediatric trauma patients used non-EMS transport to arrive at trauma centers. Moderate to severely injured children benefit from EMS transport and professional field triage.
AHRQ-funded; HS024263.
Citation: Corrado MM, Shi J, Wheeler KK .
Emergency medical services (EMS) versus non-EMS transport among injured children in the United States.
Am J Emerg Med 2017 Mar;35(3):475-78. doi: 10.1016/j.ajem.2016.11.059.
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Keywords: Emergency Medical Services (EMS), Children/Adolescents, Trauma, Critical Care
Ranney ML, Fletcher J, Alter H
A consensus-driven agenda for emergency medicine firearm injury prevention research.
In order to develop an evidence-based research agenda, the researchers identified fifty-nine final emergency medicine-relevant research questions, including questions that cut across all firearm injury topics and questions specific to self-directed violence (suicide and attempted suicide), intimate partner violence, peer (nonpartner) violence, mass violence, and unintentional ("accidental") injury. Some of these questions could be addressed through research conducted in emergency departments; others would require work in other settings.
AHRQ-funded; HS023901.
Citation: Ranney ML, Fletcher J, Alter H .
A consensus-driven agenda for emergency medicine firearm injury prevention research.
Ann Emerg Med 2017 Feb;69(2):227-40. doi: 10.1016/j.annemergmed.2016.08.454.
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Keywords: Emergency Medical Services (EMS), Prevention, Health Services Research (HSR), Injuries and Wounds
Musey PI, Jr., Kline JA
Do gender and race make a difference in acute coronary syndrome pretest probabilities in the emergency department?
The objective was to test for significant differences in subjective and objective pretest probabilities for acute coronary syndrome (ACS) in chest pain patients. Despite consistently estimating the risk for ACS to be lower for both females and minorities concordantly with calculated objective pretest assessments, there does not appear to have been any significant decrease in subsequent evaluation of these perceived lower-risk groups when radiation exposure and costs are taken into account.
AHRQ-funded; HS018519.
Citation: Musey PI, Jr., Kline JA .
Do gender and race make a difference in acute coronary syndrome pretest probabilities in the emergency department?
Acad Emerg Med 2017 Feb;24(2):142-51. doi: 10.1111/acem.13131.
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Keywords: Sex Factors, Racial and Ethnic Minorities, Cardiovascular Conditions, Emergency Medical Services (EMS)
de Cordova PB, Johansen ML, Martinez ME
Emergency department weekend presentation and mortality in patients with acute myocardial infarction.
The purpose of this research was to determine if weekend and holiday presentation is associated with increased mortality in EDs among patients with acute myocardial infarction (AMI) in New Jersey. It found that weekend/holiday presentation to the ED for AMI was associated with increased mortality. The effect may be related to the limited availability of resources on weekend/holidays compared to weekdays.
AHRQ-funded; HS024339.
Citation: de Cordova PB, Johansen ML, Martinez ME .
Emergency department weekend presentation and mortality in patients with acute myocardial infarction.
Nurs Res 2017 Jan/Feb;66(1):20-27. doi: 10.1097/nnr.0000000000000196.
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Keywords: Emergency Medical Services (EMS), Emergency Department, Mortality, Heart Disease and Health, Risk
Michelson KA, Bachur RG, Levy JA
The impact of critically ill children on paediatric ED medication timeliness.
The presence of critically ill patients may impact care for other ED patients. The researchers evaluated whether the presence of a critically ill child was associated with the time to (1) receipt of the first medication among other patients, and (2) administration of diagnosis-specific medications. They concluded that the presence of critically ill patients was associated with a delay in medication administration to others.
AHRQ-funded; HS000063.
Citation: Michelson KA, Bachur RG, Levy JA .
The impact of critically ill children on paediatric ED medication timeliness.
Emerg Med J 2017 Jan;34(1):8-12. doi: 10.1136/emermed-2016-205989.
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Keywords: Children/Adolescents, Critical Care, Medication, Emergency Medical Services (EMS), Healthcare Delivery
Melnick ER, Probst MA, Schoenfeld E
Development and testing of shared decision making interventions for use in emergency care: a research agenda.
This article provides background on decision aids and the conclusions of the 2016 Academic Emergency Medicine consensus conference SDM in practice work group regarding "Shared Decision Making in the Emergency Department: Development of a Policy-Relevant, Patient-Centered Research Agenda."
AHRQ-funded; HS021271; HS024311.
Citation: Melnick ER, Probst MA, Schoenfeld E .
Development and testing of shared decision making interventions for use in emergency care: a research agenda.
Acad Emerg Med 2016 Dec;23(12):1346-53. doi: 10.1111/acem.13045.
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Keywords: Shared Decision Making, Emergency Department, Emergency Medical Services (EMS), Patient-Centered Healthcare, Policy
Kessler R, Stowell JR, Vogel JA
Effect of interventional program on the utilization of PACS in point-of-care ultrasound.
The study’s objective was to determine if a simple interventional program would influence the utilization of Picture Archiving and Communication Systems (PACS) in point-of-care ultrasound. It concluded that a simple interventional program for emergency physicians can significantly increase and sustain the utilization of PACS for point-of-care ultrasound.
AHRQ-funded; HS023901.
Citation: Kessler R, Stowell JR, Vogel JA .
Effect of interventional program on the utilization of PACS in point-of-care ultrasound.
J Digit Imaging 2016 Dec;29(6):701-05. doi: 10.1007/s10278-016-9893-x.
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Keywords: Emergency Medical Services (EMS), Imaging, Healthcare Utilization, Health Information Technology (HIT)
Dodd KW, Berman A, Brown J
Funding research in emergency department shared decision making: a summary of the 2016 Academic Emergency Medicine Consensus Conference Panel Discussion.
This article summarizes a panel discussion of funding priorities and examples of successfully funded projects related to shared decision making in emergency medicine. The discussion was part of the 2016 Academic Emergency Medicine Consensus Conference, "Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda."
AHRQ-funded; HS024172.
Citation: Dodd KW, Berman A, Brown J .
Funding research in emergency department shared decision making: a summary of the 2016 Academic Emergency Medicine Consensus Conference Panel Discussion.
Acad Emerg Med 2016 Dec;23(12):1340-45. doi: 10.1111/acem.13063.
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Keywords: Emergency Department, Shared Decision Making, Emergency Medical Services (EMS), Health Services Research (HSR)
Mueller LR, Donnelly JP, Jacobson KE
National characteristics of emergency medical services in frontier and remote areas.
This study sought to describe the national characteristics and outcomes of EMS care provided in frontier and remote (FAR) areas in the continental United States (US). It found that FAR responses were more likely to be of American Indian or Alaska Native race. Age, ethnicity, location type, and clinical impressions were similar between FAR and non-FAR responses. On-scene death was more likely in FAR than non-FAR responses.
AHRQ-funded; HS013852.
Citation: Mueller LR, Donnelly JP, Jacobson KE .
National characteristics of emergency medical services in frontier and remote areas.
Prehosp Emerg Care 2016;20(2):191-9. doi: 10.3109/10903127.2015.1086846.
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Keywords: Emergency Medical Services (EMS), Rural Health, Provider: Health Personnel, Health Services Research (HSR), Outcomes
Jarman MP, Castillo RC
Rural risk: geographic disparities in trauma mortality.
The authors sought to quantify differences in injury mortality comparing rural and nonrural residents with traumatic injuries. They concluded that rural residents are significantly more likely than nonrural residents to die after traumatic injury, a disparity that varies by trauma center designation, injury severity, and US Census region.
AHRQ-funded; HS000029.
Citation: Jarman MP, Castillo RC .
Rural risk: geographic disparities in trauma mortality.
Surgery 2016 Dec;160(6):1551-59. doi: 10.1016/j.surg.2016.06.020.
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Keywords: Access to Care, Disparities, Emergency Medical Services (EMS), Healthcare Cost and Utilization Project (HCUP), Rural Health
Grudzen CR, Anderson JR, Carpenter CR
The 2016 Academic Emergency Medicine Consensus Conference, Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda May 10, 2016, New Orleans, LA.
The authors described the current state of shared decision making in the emergency department context and provided an overview of the conference. They explained that the results of the conference published in the same journal issue provided an essential summary of the future research priorities for shared decision making to increase quality of care and patient-centered outcomes.
AHRQ-funded; HS024172.
Citation: Grudzen CR, Anderson JR, Carpenter CR .
The 2016 Academic Emergency Medicine Consensus Conference, Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda May 10, 2016, New Orleans, LA.
Acad Emerg Med 2016 Dec;23(12):1313-19. doi: 10.1111/acem.13047.
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Keywords: Shared Decision Making, Emergency Department, Emergency Medical Services (EMS), Patient-Centered Healthcare, Policy
O'Malley JP, O'Keeffe-Rosetti M, Lowe RA
Health care utilization rates after Oregon's 2008 Medicaid expansion: within-group and between-group differences over time among new, returning, and continuously insured enrollees.
The authors sought to assess changes in emergency department, primary care, mental and behavioral health care, and specialist care visit rates among individuals gaining Medicaid over 24 months postinsurance gain and also to evaluate the association of previous insurance with utilization. They found that primary care visit rates in both newly and returning insured individuals significantly exceeded those of the continuously insured in months 4 through 12, but were not significantly elevated in the second year. In contrast, emergency department utilization rates were significantly higher in returning insured compared with newly or continuously insured individuals and remained elevated over time. New visits to primary and specialist care were higher among those who gained Medicaid compared with the continuously insured throughout the study period. They concluded that expansion evaluations should allow for rate stabilization.
AHRQ-funded; HS021522.
Citation: O'Malley JP, O'Keeffe-Rosetti M, Lowe RA .
Health care utilization rates after Oregon's 2008 Medicaid expansion: within-group and between-group differences over time among new, returning, and continuously insured enrollees.
Med Care 2016 Nov;54(11):984-91. doi: 10.1097/mlr.0000000000000600.
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Keywords: Medicaid, Healthcare Delivery, Healthcare Utilization, Emergency Department, Emergency Medical Services (EMS)
Johnson SA, Shi J, Groner JI
Inter-facility transfer of pediatric burn patients from U.S. Emergency Departments.
This study described the epidemiology of pediatric burn patients seen in U.S. emergency departments (EDs) in order to determine factors associated with inter-facility transfer. It concluded that over 90 percent of pediatric burn ED patients meet ABA burn referral criteria but are not transferred from low volume hospitals.
AHRQ-funded; HS022277.
Citation: Johnson SA, Shi J, Groner JI .
Inter-facility transfer of pediatric burn patients from U.S. Emergency Departments.
Burns 2016 Nov;42(7):1413-22. doi: 10.1016/j.burns.2016.06.024.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Transitions of Care, Children/Adolescents, Emergency Medical Services (EMS), Guidelines
Goss FR, Zhou L, Weiner SG
Incidence of speech recognition errors in the emergency department.
The study’s aim was to determine the incidence and types of speech recognition (SR) errors introduced by computerized SR technology in the emergency department (ED). It found that SR errors occur commonly with annunciation errors being the most frequent. Error rates were comparable if not lower than previous studies. Fifteen percent of errors were deemed critical, potentially leading to miscommunication that could affect patient care.
AHRQ-funded; HS024264.
Citation: Goss FR, Zhou L, Weiner SG .
Incidence of speech recognition errors in the emergency department.
Int J Med Inform 2016 Sep;93:70-3. doi: 10.1016/j.ijmedinf.2016.05.005.
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Keywords: Communication, Emergency Medical Services (EMS), Health Information Technology (HIT), Patient Safety
Fleischman W, Ross JS, Melnick ER
Financial ties between emergency physicians and industry: insights from open payments data.
The authors sought to describe nonresearch, nonroyalty Open Payments made to emergency physicians in the United States. They found that nearly a third of emergency physicians received such payments from industry in 2014, and that most payments were of small monetary value and for activities related to the marketing of antithrombotic drugs.
AHRQ-funded; HS021271.
Citation: Fleischman W, Ross JS, Melnick ER .
Financial ties between emergency physicians and industry: insights from open payments data.
Ann Emerg Med 2016 Aug;68(2):153-58.e4. doi: 10.1016/j.annemergmed.2016.01.014.
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Keywords: Emergency Medical Services (EMS), Medication, Policy, Practice Patterns, Provider: Physician
Bonafide CP, Roland D, Brady PW
Rapid response systems 20 years later: new approaches, old challenges.
In this article, the authors propose a set of recommendations for a research agenda aimed at pursuing the work of optimizing the identification of deteriorating children. They recommend that the second generation of pediatric rapid response systems continue to build on past achievements while further optimizing use of the data, tools, and people available at the bedside to take the next leap forward.
AHRQ-funded; HS023827.
Citation: Bonafide CP, Roland D, Brady PW .
Rapid response systems 20 years later: new approaches, old challenges.
JAMA Pediatr 2016 Aug;170(8):729-30. doi: 10.1001/jamapediatrics.2016.0398.
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Keywords: Children/Adolescents, Clinical Decision Support (CDS), Shared Decision Making, Emergency Medical Services (EMS), Hospitals
Melnick ER, O'Brien EG, Kovalerchik O
The association between physician empathy and variation in imaging use.
This paper's objective was to describe empathy in a cohort of emergency physicians and evaluate its association with CT utilization. The authors found that, on the four psychometric scales used, performance was not predictive of risk-adjusted CT utilization in the emergency department. They concluded that the underlying physician-based factors that mediate interphysician variation remain to be clearly identified.
AHRQ-funded; HS021271.
Citation: Melnick ER, O'Brien EG, Kovalerchik O .
The association between physician empathy and variation in imaging use.
Acad Emerg Med 2016 Aug;23(8):895-904. doi: 10.1111/acem.13017.
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Keywords: Shared Decision Making, Emergency Medical Services (EMS), Healthcare Utilization, Imaging, Practice Patterns