National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
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- Adverse Events (1)
- Antibiotics (1)
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- Clostridium difficile Infections (1)
- Elderly (4)
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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 11 of 11 Research Studies DisplayedMiddleton A, Kuo YF, Graham JE
Readmission patterns over 90-day episodes of care among Medicare fee-for-service beneficiaries discharged to post-acute care.
This retrospective cohort study’s objective was to examine readmission patterns over 90-day episodes of care in patients discharged from hospitals to skilled nursing facilities (SNFs). Data was used from a national cohort of Medicare fee-for-service beneficiaries discharged from SNF care from July 2013 to July 2014. The cohort studied were adults 65 years and older who were hospitalized for stroke, joint replacement, or hip fracture, and had survived 90 days post-discharge. Patients with hemorrhagic stroke were more likely than those with ischemic stroke to be rehospitalized over the first 30 days after discharge. For patients receiving nonelective joint replacements, readmissions increased from the 30 to 90-day period post-acute discharge.
AHRQ-funded; HS022134.
Citation: Middleton A, Kuo YF, Graham JE .
Readmission patterns over 90-day episodes of care among Medicare fee-for-service beneficiaries discharged to post-acute care.
J Am Med Dir Assoc 2018 Oct;19(10):896-901. doi: 10.1016/j.jamda.2018.03.006..
Keywords: Hospital Readmissions, Hospital Discharge, Medicare, Hospitals, Elderly
Krishnan N, Li B, Jacobs BL
The fate of radical cystectomy patients after hospital discharge: understanding the black box of the pre-readmission interval.
This study looked at reasons why bladder cancer patients who had undergone radical cystectomy surgery were readmitted to the hospital within 30 days. A retrospective cohort study was conducted for patients from 2005 to 2012. Researchers found that fever or difficulty with eating or maintaining their weight had the highest chance of being readmitted. Patients who had a higher pain tolerance or had noninfectious wounds or urinary concerns were less likely to be readmitted.
AHRQ-funded; HS018726.
Citation: Krishnan N, Li B, Jacobs BL .
The fate of radical cystectomy patients after hospital discharge: understanding the black box of the pre-readmission interval.
Eur Urol Focus 2018 Sep;4(5):711-17. doi: 10.1016/j.euf.2016.07.004..
Keywords: Adverse Events, Cancer, Hospital Discharge, Hospital Readmissions, Surgery
Henke RM, Karaca Z, Gibson TB
AHRQ Author: Karaca Z, Wong HS
Medicare Advantage and traditional Medicare hospitalization intensity and readmissions.
This study uses 2013 Healthcare Cost and Utilization Project hospital discharge data from 22 states to compare hospital cost, length of stay, and readmissions for Traditional Medicare and Medicare Advantage. The authors found that Medicare Advantage hospitalizations were substantially less expensive and shorter for mental health stays but costlier and longer for injury and surgical stays.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Henke RM, Karaca Z, Gibson TB .
Medicare Advantage and traditional Medicare hospitalization intensity and readmissions.
Med Care Res Rev 2018 Aug;75(4):434-53. doi: 10.1177/1077558717692103..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Discharge, Hospital Readmissions, Hospitalization, Medicare
Chen LM, Acharya Y, Norton EC
Readmission rates and skilled nursing facility utilization after major inpatient surgery.
The purpose of this observational study was to describe the association between changes in skilled nursing facility (SNF) use and changes in readmission rates after surgery. The investigators looked at fee-for-service Medicare beneficiaries undergoing coronary artery bypass grafting (CABG) or total hip replacement (THR) from 2008 to 2013. They concluded that changes in use of postacute care after THR and CABG were not associated with changes in readmission rates in their study.
AHRQ-funded; HS024698; HS020671.
Citation: Chen LM, Acharya Y, Norton EC .
Readmission rates and skilled nursing facility utilization after major inpatient surgery.
Med Care 2018 Aug;56(8):679-85. doi: 10.1097/mlr.0000000000000941..
Keywords: Hospital Discharge, Hospital Readmissions, Nursing Homes, Surgery
Doupnik SK, Lawlor J, Zima BT
Mental health conditions and unplanned hospital readmissions in children.
Mental health conditions (MHCs) are prevalent among hospitalized children and could influence the success of hospital discharge. The objective of this retrospective cross-sectional study was to assess the relationship between MHCs and 30-day readmissions. The investigators concluded that MHCs were associated with a higher likelihood of hospital readmission in children admitted for medical conditions and procedures. They suggest that understanding the influence of MHCs on readmissions could guide strategic planning to reduce unplanned readmissions for children with co-occurring physical and mental health conditions.
AHRQ-funded; HS023292.
Citation: Doupnik SK, Lawlor J, Zima BT .
Mental health conditions and unplanned hospital readmissions in children.
J Hosp Med 2018 Jul;13(7):445-52. doi: 10.12788/jhm.2910..
Keywords: Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Hospital Discharge, Hospital Readmissions, Hospitalization, Risk, Young Adults
Graham KL, Auerbac AD, Schnipper JL
Preventability of early versus late hospital readmissions in a national cohort of general medicine patients.
The purpose of this study was to determine whether readmissions within 7 days of discharge differed from those between 8 and 30 days after discharge with respect to preventability. The investigators found that early readmissions were more likely to be preventable and amenable to hospital-based interventions. Late readmissions were less likely to be preventable and were more amenable to ambulatory and home-based interventions.
AHRQ-funded; HS022241.
Citation: Graham KL, Auerbac AD, Schnipper JL .
Preventability of early versus late hospital readmissions in a national cohort of general medicine patients.
Ann Intern Med 2018 Jun 5;168(11):766-74. doi: 10.7326/m17-1724..
Keywords: Hospital Discharge, Hospital Readmissions, Hospitals, Hospitalization, Prevention
Middleton A, Graham JE, Ottenbacher KJ
Functional status is associated with 30-day potentially preventable hospital readmissions after inpatient rehabilitation among aged Medicare fee-for-service beneficiaries.
This study has two purposes: Determine the association between functional status of patients at discharge following inpatient rehabilitation and their potentially preventable readmission; Examine conditions that result in potentially preventable readmissions. The study examined inpatient rehabilitation facilities that submitted claims to Medicare, and concluded that functional status is associated with readmission and this may help to identify at-risk patients.
AHRQ-funded; HS022134.
Citation: Middleton A, Graham JE, Ottenbacher KJ .
Functional status is associated with 30-day potentially preventable hospital readmissions after inpatient rehabilitation among aged Medicare fee-for-service beneficiaries.
Arch Phys Med Rehabil 2018 Jun;99(6):1067-76. doi: 10.1016/j.apmr.2017.05.001..
Keywords: Elderly, Quality of Care, Hospital Discharge, Hospital Readmissions, Medicare
Middleton A, Downer B, Haas A
Functional status is associated with 30-day potentially preventable readmissions following skilled nursing facility discharge among Medicare beneficiaries.
This retrospective cohort study’s objective was to determine the association between patients’ functional status at discharge from skilled nursing facility (SNF) care and 30-day potentially preventable readmissions. Data was used from a national cohort of Medicare fee-for-service beneficiaries discharged from SNF care from July 2013 to July 2014. The average age was 81.4 years, 67% were women, and 86.3% non-Hispanic white. Functional data used from the Minimum Data Set was self-care, mobility, and cognition domains. The overall rate of 30-day potentially preventable readmissions was 5.7%. The 5 most common conditions for readmissions were congestive heart failure, septicemia, urinary tract infection, bacterial pneumonia, and renal failure. Mobility was the most dependent category followed by self-care and cognition.
AHRQ-funded; HS022134.
Citation: Middleton A, Downer B, Haas A .
Functional status is associated with 30-day potentially preventable readmissions following skilled nursing facility discharge among Medicare beneficiaries.
J Am Med Dir Assoc 2018 Apr;19(4):348-54.e4. doi: 10.1016/j.jamda.2017.12.003..
Keywords: Hospital Readmissions, Hospital Discharge, Hospitals, Medicare, Elderly
Parikh K, Hall M, Kenyon CC
Impact of discharge components on readmission rates for children hospitalized with asthma.
This study described hospital-based asthma-specific discharge components at children's hospitals and determine the association of these discharge components with pediatric asthma readmission rates. No individual or combination discharge components were associated with lower 30-day adjusted readmission rates. The only single-component significantly associated with a lower rate of readmission at 3 months was having comprehensive content of education.
AHRQ-funded; HS024554.
Citation: Parikh K, Hall M, Kenyon CC .
Impact of discharge components on readmission rates for children hospitalized with asthma.
J Pediatr. 2018 Apr;195:175-181.e2. doi: 10.1016/j.jpeds.2017.11.062..
Keywords: Asthma, Children/Adolescents, Hospital Discharge, Hospital Readmissions, Patient-Centered Outcomes Research
Sills MR, Macy ML, Kocher KE
Return visit admissions may not indicate quality of emergency department care for children.
The goal of this retrospective analysis was to test the hypothesis that in-hospital outcomes are worse among children admitted during a return ED visit than among those admitted during an index visit. Children who were hospitalized in Florida and New York hospitals during a return visit within 7 days were classified as "ED return admissions" or "readmissions"; in-hospital outcomes for ED return admissions and readmissions were compared to "index admissions without return admission". The results indicate that children who are initially discharged from the ED and then have a return admission had lower severity but similar cost in comparison with children who experienced an index admission without a return admission. The authors conclude that this suggests that ED return visit admissions do not involve worse outcomes than index admissions.
AHRQ-funded; HS024160; HS016418.
Citation: Sills MR, Macy ML, Kocher KE .
Return visit admissions may not indicate quality of emergency department care for children.
Acad Emerg Med 2018 Mar;25(3):283-92. doi: 10.1111/acem.13324..
Keywords: Children/Adolescents, Emergency Department, Hospital Discharge, Hospital Readmissions, Hospitals, Quality of Care, Outcomes
Psoinos CM, Collins CE, Ayturk MD
Post-hospitalization treatment regimen and readmission for C. difficile colitis in Medicare beneficiaries.
C. difficile (CDI) has surpassed methicillin-resistant staph aureus as the most common nosocomial infection with recurrence reaching 30% and the elderly being disproportionately affected. The authors hypothesized that post-discharge antibiotic therapy for continued CDI treatment reduces readmissions. The study concluded that patients discharged with single-drug therapy for CDI had lower readmission rates compared to patients discharged on no ongoing CDI treatment suggesting that short-term monotherapy may be beneficial in inducing eradication and preventing relapse.
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AHRQ-funded; HS022694
Citation: Psoinos CM, Collins CE, Ayturk MD .
Post-hospitalization treatment regimen and readmission for C. difficile colitis in Medicare beneficiaries.
World J Surg 2018 Jan;42(1):246-53. doi: 10.1007/s00268-017-4139-8..
Keywords: Antibiotics, Clostridium difficile Infections, Elderly, Hospital Discharge, Hospital Readmissions