National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (4)
- Adverse Events (3)
- Antibiotics (2)
- Antimicrobial Stewardship (2)
- Blood Thinners (1)
- Cardiovascular Conditions (1)
- Care Management (1)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (1)
- COVID-19 (1)
- Disparities (2)
- Electronic Health Records (EHRs) (1)
- (-) Healthcare Cost and Utilization Project (HCUP) (17)
- Healthcare Costs (4)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (1)
- Heart Disease and Health (1)
- Hospitalization (6)
- Hospital Readmissions (3)
- Hospitals (3)
- Infectious Diseases (1)
- Inpatient Care (1)
- Labor and Delivery (1)
- Maternal Care (1)
- Medical Errors (1)
- (-) Medication (17)
- Medication: Safety (1)
- Mortality (1)
- Newborns/Infants (4)
- Opioids (7)
- Outcomes (1)
- Patient Safety (2)
- Pregnancy (5)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (1)
- Sepsis (2)
- Social Determinants of Health (1)
- Substance Abuse (6)
- Surgery (1)
- Women (1)
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 17 of 17 Research Studies DisplayedEncinosa W, Moon K, Figueroa J
AHRQ Author: Encinosa W
Complications, adverse drug events, high costs, and disparities in multisystem inflammatory syndrome in children vs COVID-19.
This cross-sectional study’s goal was to determine outcomes from multisystem inflammatory syndrome in children (MIS-C) after COVID-19. Outcomes examined were 50 complications, adverse medication events, costs, and the Social Vulnerability Index. An analysis was conducted using data from the 2021 HCUP in individuals younger than 21 years from 31 states. There were 4107 individuals hospitalized with MIS-C (median age 9 years, 59.5% male, 38.1% White) and 23,686 hospitalizations for COVID-19 without MIS-C (median age 15 years, 54.5% female, 44.1% White). Hospitalization rate for MIS-C was 1.48 per 100,000 children, ranging from 0.97 hospitalizations per 100 for White and 1.99 hospitalizations per 100 for Black children. Outcomes were worse when organ dysfunction increased from 2 to 8 organs, with deaths increasing from less than 1% to 5.8% for MIS-C, and 1% to 17.2% for COVID-19. Median length of stay increased from 4 to 8 days for MIS-C, and 3 to 16 days for COVID-19. Median costs for MIS-C increased from $16,225 to $53 359 and from $6474 to $98,643 for COVID-19. The percentage of MIS-C cases in Black children doubled from 16.2% to 31.7% as organ dysfunction increased, remaining unchanged with COVID-19.
AHRQ-authored.
Citation: Encinosa W, Moon K, Figueroa J .
Complications, adverse drug events, high costs, and disparities in multisystem inflammatory syndrome in children vs COVID-19.
JAMA Netw Open 2023 Jan;6(1):e2244975. doi: 10.1001/jamanetworkopen.2022.44975..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, COVID-19, Medication, Adverse Drug Events (ADE), Adverse Events, Healthcare Costs, Disparities, Racial and Ethnic Minorities
Ko JY, Hirai AH, Owens PL
AHRQ Author: Owens PL
Neonatal abstinence syndrome and maternal opioid-related diagnoses: analysis of ICD-10-CM transition, 2013-2017.
Researchers sought to evaluate whether the transition from ICD-9-CM to ICD-10-CM may have affected surveillance on rates of neonatal abstinence syndrome (NAS), maternal opioid use disorder (OUD), and opioid-related diagnoses. Using HCUP data, they found that the ICD-10-CM transition did not appear to affect NAS. However, coding of maternal OUD alone may not capture the same population across the transition, potentially confounding the interpretation of trend data spanning this time period.
AHRQ-authored.
Citation: Ko JY, Hirai AH, Owens PL .
Neonatal abstinence syndrome and maternal opioid-related diagnoses: analysis of ICD-10-CM transition, 2013-2017.
Hosp Pediatr 2021 Aug;11(8):902-08. doi: 10.1542/hpeds.2021-005845..
Keywords: Healthcare Cost and Utilization Project (HCUP), Newborns/Infants, Opioids, Medication, Pregnancy, Substance Abuse
Hirai AH, Ko JY, Owens PL
AHRQ Author: Owens PL, Stocks C
Neonatal abstinence syndrome and maternal opioid-Related diagnoses in the US, 2010-2017.
This study analyzed trends in neonatal abstinence syndrome (NAS) and maternal opioid-Related diagnosis (MOD) in the United States from 2010 to 2017. A cross-sectional analysis was done of the HCUP National Inpatient Sample and State Inpatient Database from 2010 through 2017. Diagnoses of NAS and MOD were found using the ICD-10, CM codes. Significant increases occurred in rates of NAS, from 4.0 to 7.3 per birth hospitalizations and MOD, from 3.5 to 8.2 per 1000 delivery hospitalizations. A census of 47 state databases in 2017 found a large range of NAS rates – from 1.3 per 1000 birth hospitalizations in Nebraska to 53.5 per 1000 hospitalizations in West Virginia with the same ranges found for MOD rates. In all states except Nebraska and Vermont which only had significant MOD increases, NAS and MOD rates rose significantly from 2010 to 2017.
AHRQ-authored; AHRQ-funded; 290201800001C.
Citation: Hirai AH, Ko JY, Owens PL .
Neonatal abstinence syndrome and maternal opioid-Related diagnoses in the US, 2010-2017.
Neonatal abstinence syndrome and maternal opioid-Related diagnoses in the US, 2010-2017..
Keywords: Healthcare Cost and Utilization Project (HCUP), Newborns/Infants, Opioids, Medication, Substance Abuse, Hospitalization, Pregnancy
Kim JH, Fine DR, Li L
Disparities in United States hospitalizations for serious infections in patients with and without opioid use disorder: a nationwide observational study.
This study examined the differences in patients with and without opioid use disorder (OUD) who were hospitalized for serious infections focusing on infective endocarditis, epidural abscess, septic arthritis or osteomyelitis. The authors used the 2016 National Inpatient Sample to examine differences in length of stay (LOS), discharge disposition, and charges. Patients with OUD had a lower probability of discharge at any given LOS, and lower odds of discharge to home with higher odds of discharge to a post-acute care facility. There were no significant differences in average total hospital charges.
AHRQ-funded; HS026215.
Citation: Kim JH, Fine DR, Li L .
Disparities in United States hospitalizations for serious infections in patients with and without opioid use disorder: a nationwide observational study.
PLoS Med 2020 Aug;17(8):e1003247. doi: 10.1371/ournal.pmed.1003247.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Opioids, Substance Abuse, Hospitalization, Medication, Infectious Diseases
Rosenbloom J, Lewkowitz A, Sondgeroth K
Antenatal corticosteroid administration in late-preterm gestations: a cost-effectiveness analysis.
The purpose of this study was to evaluate whether administration of antenatal late-preterm betamethasone was cost-effective in the immediate neonatal period. Cost-effectiveness analysis of late-preterm betamethasone administration with a time horizon of 7.5 days was conducted using a health-system perspective The investigators concluded that administration of betamethasone in the late-preterm period was likely not cost-effective in the short-term.
AHRQ-funded; HS022330.
Citation: Rosenbloom J, Lewkowitz A, Sondgeroth K .
Antenatal corticosteroid administration in late-preterm gestations: a cost-effectiveness analysis.
J Matern Fetal Neonatal Med 2020 Jun;33(12):2109-15. doi: 10.1080/14767058.2018.1540582..
Keywords: Healthcare Cost and Utilization Project (HCUP), Newborns/Infants, Pregnancy, Respiratory Conditions, Medication, Healthcare Costs, Healthcare Utilization
Basu J
AHRQ Author: Basu J
Multilevel risk factors for hospital readmission among patients with opioid use disorder in selected US States: role of socioeconomic characteristics of patients and their community.
This study examined the association of socioeconomic characteristics of individuals hospitalized with a principal diagnosis of opioid use disorder and their all-cause 30-day readmission risks. Discharge data from the 2014 HCUP Survey was used and was linked to community and hospital characteristics using data from HRSA and the American Hospital Association. Medicare is associated with the highest readmission risk followed by Medicaid covered patients. Self-pay or covered by other payers had a similar risk to private insurance coverage. Urban patients also had a higher readmission rate than rural patients.
AHRQ-authored.
Citation: Basu J .
Multilevel risk factors for hospital readmission among patients with opioid use disorder in selected US States: role of socioeconomic characteristics of patients and their community.
Health Serv Res Manag Epidemiol 2020 Jan-Dec;7:2333392820904240. doi: 10.1177/2333392820904240..
Keywords: Healthcare Cost and Utilization Project (HCUP), Opioids, Medication, Substance Abuse, Hospital Readmissions, Hospitals, Social Determinants of Health
Goldstein E, Olesen SW, Karaca Z
AHRQ Author: Karaca Z
Levels of outpatient prescribing for four major antibiotic classes and rates of septicemia hospitalization in adults in different US states - a statistical analysis.
The authors related state-specific rates of outpatient prescribing overall for oral fluoroquinolones, penicillins, macrolides, and cephalosporins between 2011 and 2012 to state-specific rates of septicemia hospitalization in several age groups of adults. They found positive associations between the rates of prescribing for penicillins and the rates of hospitalization with septicemia in US adults aged 50-84 years and recommended further studies.
AHRQ-authored.
Citation: Goldstein E, Olesen SW, Karaca Z .
Levels of outpatient prescribing for four major antibiotic classes and rates of septicemia hospitalization in adults in different US states - a statistical analysis.
BMC Public Health 2019 Aug 19;19(1):1138. doi: 10.1186/s12889-019-7431-8..
Keywords: Healthcare Cost and Utilization Project (HCUP), Antibiotics, Antimicrobial Stewardship, Sepsis, Medication, Hospitalization
Goldstein E, MacFadden DR, Karaca Z
AHRQ Author: Karaca Z Steiner CA
Antimicrobial resistance prevalence, rates of hospitalization with septicemia and rates of mortality with sepsis in adults in different US states.
Researchers studied the relation between the prevalence of resistance to various antibiotics in different bacteria and rates of sepsis-related outcomes. They found that, among the different combinations of antibiotics/bacteria, prevalence of resistance to fluoroquinolones in E. coli had the strongest association with septicemia hospitalization rates for individuals aged over 50 years, and with sepsis mortality rates for individuals aged 18-84 years. They also found a number of positive correlations between prevalence of resistance for different combinations of antibiotics/bacteria and septicemia hospitalization/sepsis mortality rates in adults.
AHRQ-authored.
Citation: Goldstein E, MacFadden DR, Karaca Z .
Antimicrobial resistance prevalence, rates of hospitalization with septicemia and rates of mortality with sepsis in adults in different US states.
Int J Antimicrob Agents 2019 Jul;54(1):23-34. doi: 10.1016/j.ijantimicag.2019.03.004..
Keywords: Antibiotics, Antimicrobial Stewardship, Healthcare Cost and Utilization Project (HCUP), Hospitals, Hospitalization, Medication, Mortality, Sepsis
Guglielminotti J, Landau R, Li. G
Adverse events and factors associated with potentially avoidable use of general anesthesia in cesarean deliveries.
Compared with neuraxial anesthesia, general anesthesia for cesarean delivery is associated with increased risk of maternal adverse events. Reducing avoidable general anesthetics for cesarean delivery may improve safety of obstetric anesthesia care. This study examined adverse events, trends, and factors associated with potentially avoidable general anesthetics for cesarean delivery. The investigators concluded that compared with neuraxial anesthesia, avoidable general anesthetics are associated with increased risk of adverse maternal outcomes.
AHRQ-funded; HS025787.
Citation: Guglielminotti J, Landau R, Li. G .
Adverse events and factors associated with potentially avoidable use of general anesthesia in cesarean deliveries.
Anesthesiology 2019 Jun;130(6):912-22. doi: 10.1097/aln.0000000000002629..
Keywords: Healthcare Cost and Utilization Project (HCUP), Labor and Delivery, Surgery, Pregnancy, Adverse Drug Events (ADE), Adverse Events, Women, Medication, Medication: Safety, Patient Safety, Maternal Care
Blanchard J, Weiss AJ, Barrett ML
AHRQ Author: Stocks C, Owens PL, Heslin KC
Readmissions following inpatient treatment for opioid-related conditions.
This study analyzed the relationship between hospital admission for inpatient drug detoxification and/or rehabilitation services and subsequent opioid-related readmission. The study used hospital inpatient discharge and emergency department visit data from the AHRQ Healthcare Cost and Utilization Project (HCUP) survey. The sample consisted of 329,037 patients from seven states with an opioid-related index hospitalization from March 2010 to September 2013. A relatively small percentage (19.4%) of patients received treatment for drug use during their hospital stay. Those patients that did receive treatment had a lower 90-day readmission rate than those patients who did not.
AHRQ-authored; AHRQ-funded.
Citation: Blanchard J, Weiss AJ, Barrett ML .
Readmissions following inpatient treatment for opioid-related conditions.
Subst Use Misuse 2019;54(3):473-81. doi: 10.1080/10826084.2018.1517174..
Keywords: Healthcare Cost and Utilization Project (HCUP), Opioids, Hospital Readmissions, Hospitalization, Inpatient Care, Substance Abuse, Medication
Blanchard J, Weiss AJ, Barrett ML
State variation in opioid treatment policies and opioid-related hospital readmissions.
In this study, the investigators used 2013-2015 hospital inpatient discharge data from 13 states from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project to examine the relationship between state opioid treatment policies and 90-day opioid-related readmissions after a stay involving an opioid diagnosis. The concluded that differences in index hospitalization rates suggested that states with opioid treatment policies had a higher level of need for opioid-related intervention, which also may account for higher rates of readmission.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Blanchard J, Weiss AJ, Barrett ML .
State variation in opioid treatment policies and opioid-related hospital readmissions.
BMC Health Serv Res 2018 Dec 17;18(1):971. doi: 10.1186/s12913-018-3703-8..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Medication, Opioids, Substance Abuse
Slight SP, Seger DL, Franz C
The national cost of adverse drug events resulting from inappropriate medication-related alert overrides in the United States.
Investigators worked to determine the national cost of adverse drug events (ADEs) in the United States in 2014. They used three different regression models. They used a random sample of 40,990 adult inpatients at the Brigham and Women’s Hospital in Boston with over 1.6 million medication orders. They extrapolated the medication orders using 2014 National Inpatient Sample (NIS) data. They estimated that out of 78.8 million total medication alerts, 5.5 million medication alerts would have been inappropriately overridden resulting in 196,660 ADEs. They estimated it would have cost between $871 million and $1.8 billion for treating these preventable ADEs in the United States.
AHRQ-funded; HS021094.
Citation: Slight SP, Seger DL, Franz C .
The national cost of adverse drug events resulting from inappropriate medication-related alert overrides in the United States.
J Am Med Inform Assoc 2018 Sep;25(9):1183-88. doi: 10.1093/jamia/ocy066..
Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Drug Events (ADE), Adverse Events, Clinical Decision Support (CDS), Health Information Technology (HIT), Healthcare Costs, Medical Errors, Medication
Turner TE, Saeed MJ, Novak E
Association of inferior vena cava filter placement for venous thromboembolic disease and a contraindication to anticoagulation with 30-day mortality.
Despite the absence of data from randomized clinical trials, professional societies recommend inferior vena cava (IVC) filters for patients with venous thromboembolic disease (VTE) and a contraindication to anticoagulation therapy. Prior observational studies of IVC filters have suggested a mortality benefit associated with IVC filter insertion but have often failed to adjust for immortal time bias. The purpose of this study was to determine the association of IVC filter placement with 30-day mortality after adjustment for immortal time bias.
AHRQ-funded; HS019455.
Citation: Turner TE, Saeed MJ, Novak E .
Association of inferior vena cava filter placement for venous thromboembolic disease and a contraindication to anticoagulation with 30-day mortality.
JAMA Netw Open 2018 Jul 6;1(3):e180452. doi: 10.1001/jamanetworkopen.2018.0452.
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Keywords: Blood Thinners, Cardiovascular Conditions, Care Management, Heart Disease and Health, Healthcare Cost and Utilization Project (HCUP), Medication, Outcomes
Weinberger DM, Warren JL, Steiner CA
AHRQ Author: Steiner CA
Reduced-dose schedule of prophylaxis based on local data provides near-optimal protection against respiratory syncytial virus.
The researchers considered whether a reduced- dose schedule tailored to the local RSV season in the continental United States would provide adequate protection. They found that a 4-dose schedule of prophylactic injections timed with local RSV epidemics could provide protection comparable to 5 doses and could be considered as a way to improve the cost-effectiveness of prophylaxis.
AHRQ-authored.
Citation: Weinberger DM, Warren JL, Steiner CA .
Reduced-dose schedule of prophylaxis based on local data provides near-optimal protection against respiratory syncytial virus.
Clin Infect Dis 2015 Aug 15;61(4):506-14. doi: 10.1093/cid/civ331..
Keywords: Healthcare Cost and Utilization Project (HCUP), Newborns/Infants, Newborns/Infants, Medication
Encinosa WE, Bae J
AHRQ Author: Encinosa WE
Meaningful use IT reduces hospital-caused adverse drug events even at challenged hospitals.
The researchers examined the impact of the 5 core meaningful use (MU) medication elements on hospital-caused adverse drug events (ADEs). They found that adopting all 5 core MU elements was associated with a reduction in ADEs. Hospitals reporting costs as the main barrier to MU reduced their ADE rates by 35%; low quality hospitals reduced ADEs by 29 percent, compared to 27 percent at high quality hospitals.
Citation: Encinosa WE, Bae J .
Meaningful use IT reduces hospital-caused adverse drug events even at challenged hospitals.
Healthc 2015 Mar;3(1):12-7. doi: 10.1016/j.hjdsi.2014.07.001..
Keywords: Healthcare Cost and Utilization Project (HCUP), Patient Safety, Hospitals, Medication
Salihu HM, Mogos MF, Salinas-Miranda AA
National trends in maternal use of opioid drugs among pregnancy-related hospitalizations in the United States, 1998 to 2009.
AHRQ-funded; HS019997.
Citation: Salihu HM, Mogos MF, Salinas-Miranda AA .
National trends in maternal use of opioid drugs among pregnancy-related hospitalizations in the United States, 1998 to 2009.
Am J Perinatol 2015 Feb;32(3):289-98. doi: 10.1055/s-0034-1384642..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Medication, Opioids, Pregnancy
Encinosa WE, Bae J
AHRQ Author: Encinosa WE
Will meaningful use electronic medical records reduce hospital costs?
The authors examined what impact the 5 core medication meaningful use (MU) criteria have on hospital-acquired adverse drug events (ADEs) and their costs in 2010, as a baseline for the start of MU implementation in 2011. They developed a quality indicator to track in-hospital ADEs and concluded that the adoption of core medication MU elements will cut ADE rates, with cost savings that recoup 22% of information technology costs.
AHRQ-authored.
Citation: Encinosa WE, Bae J .
Will meaningful use electronic medical records reduce hospital costs?
Am J Manag Care 2013 Nov;19(10 Spec No):eSP19-25.
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Keywords: Adverse Drug Events (ADE), Electronic Health Records (EHRs), Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Medication