National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Antibiotics (3)
- Antimicrobial Stewardship (1)
- Cardiovascular Conditions (2)
- Children/Adolescents (2)
- Clinical Decision Support (CDS) (1)
- Community-Acquired Infections (3)
- COVID-19 (1)
- Dental and Oral Health (1)
- Diagnostic Safety and Quality (4)
- Elderly (1)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (3)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Costs (1)
- Heart Disease and Health (1)
- Hospital Readmissions (1)
- Infectious Diseases (3)
- Influenza (2)
- Long-Term Care (1)
- Medicare (2)
- Medication (3)
- Mortality (2)
- Neurological Disorders (1)
- Newborns/Infants (1)
- Nursing Homes (1)
- Outcomes (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (3)
- (-) Pneumonia (17)
- Practice Patterns (1)
- Prevention (3)
- Public Health (1)
- Quality Improvement (1)
- Quality Indicators (QIs) (1)
- Respiratory Conditions (7)
- Risk (1)
- Surgery (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
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 DisplayedHaessler S, Lindenauer PK, Zilberberg MD
Blood cultures versus respiratory cultures: 2 different views of pneumonia.
This study examined characteristics and outcomes of patients with positive cultures for pneumonia by site. The authors compared results from blood and respiratory cultures to see if organisms and resistance patterns differed by site. They studied adult patients discharged from July 2010 to June 2015 with principal diagnoses of pneumonia, respiratory failure, acute respiratory distress syndrome, respiratory arrest, or sepsis with a secondary diagnosis of pneumonia. Out of 138,651 hospitalizations of patients with pneumonia, 9.3% yielded positive cultures with 6438 from respiratory culture and 5992 blood cultures, and 45 both respiratory and blood cultures. Isolates from respiratory samples were often more resistant than were isolates from blood. Patients with positive cultures in both sites had higher case-fatality, longer lengths of stay and higher costs than patients who only had one culture site positive. Among respiratory cultures, the most common pathogens identified were Staphylococcus aureus (34%) and Pseudomonas aeruginosa (17%), whereas blood cultures most commonly grew Streptococcus pneumoniae (33%), followed by S. aureus (22%).
AHRQ-funded; HS024277.
Citation: Haessler S, Lindenauer PK, Zilberberg MD .
Blood cultures versus respiratory cultures: 2 different views of pneumonia.
Clin Infect Dis 2020 Oct 23;71(7):1604-12. doi: 10.1093/cid/ciz1049..
Keywords: Pneumonia, Community-Acquired Infections, Respiratory Conditions, Infectious Diseases
Schimmel JJ, Haessler S, Imrey P
Pneumococcal urinary antigen testing in United States hospitals: a missed opportunity for antimicrobial stewardship.
The Infectious Disease Society of America recommends pneumococcal urinary antigen testing (UAT) when identifying pneumococcal infection would allow for antibiotic de-escalation. However, the frequencies of UAT and subsequent antibiotic de-escalation are unknown. The authors conducted this retrospective cohort study of adult patients admitted with community-acquired or healthcare-associated pneumonia to 170 US hospitals in the Premier database from 2010-2015, to describe variation in UAT use, associations of UAT results with antibiotic de-escalation, and associations of de-escalation with outcomes.
AHRQ-funded; HS024277.
Citation: Schimmel JJ, Haessler S, Imrey P .
Pneumococcal urinary antigen testing in United States hospitals: a missed opportunity for antimicrobial stewardship.
Clin Infect Dis 2020 Sep 12;71(6):1427-34. doi: 10.1093/cid/ciz983..
Keywords: Antimicrobial Stewardship, Community-Acquired Infections, Infectious Diseases, Pneumonia
Strobel RJ, Harrington SD, Hill C
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Pneumonia is the most prevalent healthcare-associated infection after coronary artery bypass grafting (CABG), but the relative effectiveness of strategies to reduce its incidence remains unclear. In this study, the investigators evaluated the relationship between healthcare-associated infection recommendations and risk of pneumonia after CABG. These pneumonia prevention recommendations may serve as effective targets for avoiding postoperative healthcare-associated infections.
AHRQ-funded; HS022535; HS022909.
Citation: Strobel RJ, Harrington SD, Hill C .
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Ann Thorac Surg 2020 Sep;110(3):903-10. doi: 10.1016/j.athoracsur.2019.12.053..
Keywords: Pneumonia, Cardiovascular Conditions, Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Prevention, Evidence-Based Practice, Guidelines, Risk
Joshi RP, Pejaver V, Hammarlund NE
A predictive tool for identification of SARS-CoV-2 PCR-negative emergency department patients using routine test results.
This retrospective case-control study investigated whether the use of a prediction tool based on complete blood count results and patient sex can better allocate testing for SARS-CoV-2 PCR testing in hospital emergency departments. Participants were emergency department patients who had concurrent complete blood counts and SARS-CoV-2 PCR testing in Northern California, Seattle, Washington, Chicago Illinois, and South Korea. A hypothetical scenario of 1000 patients requiring testing was developed, but in this scenario testing resources are limited to 60% of patients. This tool would allow a 33% increase in properly allocated resources.
AHRQ-funded; HS026385.
Citation: Joshi RP, Pejaver V, Hammarlund NE .
A predictive tool for identification of SARS-CoV-2 PCR-negative emergency department patients using routine test results.
J Clin Virol 2020 Aug;129:104502. doi: 10.1016/j.jcv.2020.104502..
Keywords: Emergency Department, COVID-19, Pneumonia, Respiratory Conditions, Diagnostic Safety and Quality, Clinical Decision Support (CDS)
Thomson J, Hall M, Ambroggio L
Antibiotics for aspiration pneumonia in neurologically impaired children.
The objective of the study was to compare hospital outcomes associated with commonly used antibiotic therapies for aspiration pneumonia in children with neurologic impairment (NI). The investigators concluded that anaerobic therapy appeared to be important in the treatment of aspiration pneumonia in children with NI. They suggested that while Gram-negative coverage alone was associated with worse outcomes, its addition to anaerobic therapy may not yield improved outcomes.
AHRQ-funded; HS025138.
Citation: Thomson J, Hall M, Ambroggio L .
Antibiotics for aspiration pneumonia in neurologically impaired children.
J Hosp Med 2020 Jul;15(7):395-402. doi: 10.12788/jhm.3338..
Keywords: Children/Adolescents, Pneumonia, Respiratory Conditions, Neurological Disorders, Antibiotics, Medication, Outcomes
Higgins TL, Deshpande A, Zilberberg MD
Assessment of the accuracy of using ICD-9 diagnosis codes to identify pneumonia etiology in patients hospitalized with pneumonia.
Researchers assessed the validity of ICD-9 organism-specific administrative codes for pneumonia using microbiological data as the criterion standard, using data from 178 US hospitals in the Premier Healthcare Database. They found that, in this study, ICD-9 codes did not reliably capture pneumonia etiology identified by laboratory testing; because of the high specificities of ICD-9 codes, however, administrative data may be useful in identifying risk factors for resistant organisms. The low sensitivities of the diagnosis codes may limit the validity of organism-specific pneumonia prevalence estimates derived from administrative data.
AHRQ-funded; HS024277, HS025026.
Citation: Higgins TL, Deshpande A, Zilberberg MD .
Assessment of the accuracy of using ICD-9 diagnosis codes to identify pneumonia etiology in patients hospitalized with pneumonia.
JAMA Netw Open 2020 Jul;3(7):e207750. doi: 10.1001/jamanetworkopen.2020.7750.
.
.
Keywords: Pneumonia, Respiratory Conditions, Diagnostic Safety and Quality
Abreo A, Wu P, Donovan BM
Infant respiratory syncytial virus bronchiolitis and subsequent risk of pneumonia, otitis media, and antibiotic utilization.
This study looked at infant respiratory syncytial virus (RSV) bronchiolitis and its association with increased odds of pneumonia, otitis media, and antibiotic utilization in infants 7-12 months. The data suggested the potential value of future RSV vaccination programs on subsequent respiratory health.
AHRQ-funded; HS026395.
Citation: Abreo A, Wu P, Donovan BM .
Infant respiratory syncytial virus bronchiolitis and subsequent risk of pneumonia, otitis media, and antibiotic utilization.
Clin Infect Dis 2020 Jun 24;71(1):211-14. doi: 10.1093/cid/ciz1033..
Keywords: Newborns/Infants, Antibiotics, Medication, Respiratory Conditions, Pneumonia
Zimmerman S, Sloane PD, Ward K
Effectiveness of a mouth care program provided by nursing home staff vs standard care on reducing pneumonia incidence: a cluster randomized trial.
Pneumonia affects more than 250 000 nursing home (NH) residents annually. A strategy to reduce pneumonia is to provide daily mouth care, especially to residents with dementia. The objective of this study was to evaluate the effectiveness of Mouth Care Without a Battle, a program that increases staff knowledge and attitudes regarding oral hygiene, changes mouth care, and improves oral hygiene, in reducing the incidence of pneumonia among NH residents.
AHRQ-funded; HS022298.
Citation: Zimmerman S, Sloane PD, Ward K .
Effectiveness of a mouth care program provided by nursing home staff vs standard care on reducing pneumonia incidence: a cluster randomized trial.
JAMA Netw Open 2020 Jun;3(6):e204321. doi: 10.1001/jamanetworkopen.2020.4321..
Keywords: Pneumonia, Nursing Homes, Long-Term Care, Dental and Oral Health, Prevention, Patient Safety
Wang Y, Eldridge N, Metersky ML
AHRQ Author: Eldridge N, Rodrick D
Association between Medicare expenditures and adverse events for patients with acute myocardial infarction, heart failure, or pneumonia in the United States.
The purpose of this study was to evaluate whether hospital-specific adverse event rates were associated with hospital-specific risk-standardized 30-day episode-of-care Medicare expenditures for fee-for-service patients discharged with acute myocardial infarction (AMI), heart failure (HF), or pneumonia. Investigators concluded that hospitals with high adverse event rates were more likely to have high 30-day episode-of-care Medicare expenditures for patients discharged with AMI, HF, or pneumonia.
AHRQ-authored; AHRQ-funded; 290201200003C.
Citation: Wang Y, Eldridge N, Metersky ML .
Association between Medicare expenditures and adverse events for patients with acute myocardial infarction, heart failure, or pneumonia in the United States.
JAMA Netw Open 2020 Apr;3(4):e202142. doi: 10.1001/jamanetworkopen.2020.2142..
Keywords: Adverse Events, Patient Safety, Heart Disease and Health, Cardiovascular Conditions, Pneumonia, Medicare, Healthcare Costs
Shrestha S, Foxman B, Berus J
AHRQ Author: Steiner C
The role of influenza in the epidemiology of pneumonia.
The researchers used longitudinal influenza and pneumonia incidence data, at different spatial resolutions and across different epidemiological periods, to infer the nature, timing and the intensity of influenza-pneumonia interaction. They concluded that influenza infection substantially enhances the risk of pneumonia, though only for a short period.
AHRQ-authored.
Citation: Shrestha S, Foxman B, Berus J .
The role of influenza in the epidemiology of pneumonia.
Sci Rep 2015 Oct 21;5:15314. doi: 10.1038/srep15314.
.
.
Keywords: Healthcare Cost and Utilization Project (HCUP), Influenza, Pneumonia
Kelly MS, Smieja M, Luinstra K
Association of respiratory viruses with outcomes of severe childhood pneumonia in Botswana.
The authors examined whether detection of respiratory viruses predicts acute lower respiratory tract infection (ALRI) outcomes in low- and middle-income countries. They found that respiratory viruses were detected from most children hospitalized with ALRI in Botswana, but only respiratory syncytial virus (RSV) and human metapneumovirus were more frequent than among children without ALRI. Further, detection of RSV from children with ALRI predicted a protracted illness course but lower mortality compared with non-RSV viruses.
AHRQ-funded; HS020939.
Citation: Kelly MS, Smieja M, Luinstra K .
Association of respiratory viruses with outcomes of severe childhood pneumonia in Botswana.
PLoS One 2015 May 14;10(5):e0126593. doi: 10.1371/journal.pone.0126593.
.
.
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Pneumonia, Respiratory Conditions
Sjoding MW, Iwashyna TJ, Dimick JB
Gaming hospital-level pneumonia 30-day mortality and readmission measures by legitimate changes to diagnostic coding.
The researchers sought to determine the degree to which hospitals can game mortality or readmission measures and change their rankings by recoding patients with pneumonia. They concluded that hospitals can improve apparent pneumonia mortality and readmission rates by recoding pneumonia patients. Centers for Medicare and Medicaid Services should consider changes to their methods used to calculate hospital-level pneumonia outcome measures.
AHRQ-funded; HS020672.
Citation: Sjoding MW, Iwashyna TJ, Dimick JB .
Gaming hospital-level pneumonia 30-day mortality and readmission measures by legitimate changes to diagnostic coding.
Crit Care Med 2015 May;43(5):989-95. doi: 10.1097/ccm.0000000000000862..
Keywords: Elderly, Hospital Readmissions, Medicare, Mortality, Pneumonia, Quality Indicators (QIs)
Linder JA
Sore throat: avoid overcomplicating the uncomplicated.
In this editorial, the author described issues involving sore throat diagnosis and delineated various points concerning an article within the same journal issue, concluding that physicians should remember that the prevalence of group A streptococcus in adults with a sore throat is approximately 10%; and that they should use the Centor scoring criteria; selectively use rapid antigen-detection testing; limit antibiotic treatment to patients most likely to have group A streptococcus; and most of the time when prescribing antibiotics, use penicillin.
AHRQ-funded; HS018419.
Citation: Linder JA .
Sore throat: avoid overcomplicating the uncomplicated.
Ann Intern Med 2015 Feb 17;162(4):311-2. doi: 10.7326/m14-2899.
.
.
Keywords: Antibiotics, Diagnostic Safety and Quality, Infectious Diseases, Medication, Pneumonia, Respiratory Conditions, Practice Patterns
Pitts SI, Apostolou A, DasGupta S
Serotype 10A in case patients with invasive pneumococcal disease: a pilot study of PCR-based serotyping in New Jersey.
This study used the existing infrastructure for surveillance of invasive S. pneumoniae in New Jersey to conduct state-based serotype surveillance using nucleic acid amplification. It revealed that an unusual serotype, 10A, represented 25% of invasive pneumococcal disease cases in New Jersey during the study period.
AHRQ-funded; HS019488.
Citation: Pitts SI, Apostolou A, DasGupta S .
Serotype 10A in case patients with invasive pneumococcal disease: a pilot study of PCR-based serotyping in New Jersey.
Public Health Rep 2015 Jan-Feb;130(1):54-9..
Keywords: Pneumonia, Public Health
Ali KJ, Farley DO, Speck K
Measurement of implementation components and contextual factors in a two-state healthcare quality initiative to reduce ventilator-associated pneumonia.
The authors sought to develop and field test an implementation assessment tool for assessing progress of hospital units in implementing improvements for the prevention of ventilator-associated pneumonia (VAP) in a two-state collaborative. They found that a relatively small number of barriers were found to have important negative effects on implementation progress, including barriers related to workload and time issues. They modified coaching provided to the unit teams to reinforce training in weak spots that the interviews identified.
AHRQ-funded; 290201000027I.
Citation: Ali KJ, Farley DO, Speck K .
Measurement of implementation components and contextual factors in a two-state healthcare quality initiative to reduce ventilator-associated pneumonia.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S116-23. doi: 10.1086/677832.
.
.
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Pneumonia, Prevention, Quality Improvement
Rothberg MB, Haessler S, Lagu T
Outcomes of patients with healthcare-associated pneumonia: worse disease or sicker patients?
The researchers sought to determine the contribution of healthcare-associated pneumonia (HCAP) criteria to case-fatality rate. They found that, after adjustment for differences in patient characteristics, HCAP was associated with greater case-fatality rate than community-acquired pneumonia, possibly due to HCAP organisms or to HCAP criteria themselves.
AHRQ-funded; HS018723.
Citation: Rothberg MB, Haessler S, Lagu T .
Outcomes of patients with healthcare-associated pneumonia: worse disease or sicker patients?
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S107-15. doi: 10.1086/677829.
.
.
Keywords: Community-Acquired Infections, Healthcare-Associated Infections (HAIs), Mortality, Patient-Centered Outcomes Research, Pneumonia
Shrestha S, Foxman B, Weinberger DM
AHRQ Author: Steiner C
Identifying the interaction between influenza and pneumococcal pneumonia using incidence data.
The authors integrated weekly incidence reports and a mechanistic transmission model within a likelihood-based inference framework to characterize the nature, timing, and magnitude of the interaction between influenza and pneumococcal pneumonia. They found support for a strong but short-lived interaction, with influenza infection increasing susceptibility to pneumococcal pneumonia ~100-fold. They inferred modest population-level impacts arising from strong processes at the level of an individual.
AHRQ-authored.
Citation: Shrestha S, Foxman B, Weinberger DM .
Identifying the interaction between influenza and pneumococcal pneumonia using incidence data.
Sci Transl Med 2013 Jun 26;5(191):191ra84. doi: 10.1126/scitranslmed.3005982.
.
.
Keywords: Healthcare Cost and Utilization Project (HCUP), Influenza, Pneumonia