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Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (1)
- Alcohol Use (1)
- Arthritis (1)
- Cancer: Breast Cancer (1)
- Cardiovascular Conditions (1)
- Children/Adolescents (5)
- Chronic Conditions (2)
- Clinical Decision Support (CDS) (1)
- Critical Care (1)
- Disparities (1)
- Domestic Violence (1)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Emergency Medical Services (EMS) (1)
- (-) Healthcare Cost and Utilization Project (HCUP) (30)
- (-) Healthcare Costs (30)
- Healthcare Delivery (1)
- Healthcare Utilization (3)
- Health Information Technology (HIT) (1)
- Health Services Research (HSR) (1)
- Health Systems (1)
- Hospitalization (13)
- Hospital Readmissions (1)
- Hospitals (5)
- Human Immunodeficiency Virus (HIV) (1)
- Infectious Diseases (1)
- Influenza (1)
- Inpatient Care (2)
- Medicaid (1)
- Medical Errors (1)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medicare (1)
- Medication (2)
- Mortality (1)
- Neurological Disorders (1)
- Newborns/Infants (1)
- Nursing (1)
- Nutrition (1)
- Orthopedics (2)
- Patient-Centered Outcomes Research (2)
- Patient Safety (1)
- Policy (2)
- Pressure Ulcers (1)
- Quality of Care (2)
- Risk (1)
- Sepsis (1)
- Shared Decision Making (1)
- Skin Conditions (2)
- Stroke (1)
- Surgery (4)
- Trauma (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 25 of 30 Research Studies DisplayedCoupet E, Karp D, Wiebe DJ
Shift in U.S. payer responsibility for the acute care of violent injuries after the Affordable Care Act: Implications for prevention.
In this study, the investigators determined the total annual charges for the acute care of injuries from interpersonal violence and the shift in financial responsibility for these charges after the Medicaid expansion from the Affordable Care Act in 2014. After Medicaid expansion, taxpayers are now accountable for nearly half of the $10.7 billion in annual charges for the acute care of violent injury in the U.S. The investigators suggest that these findings highlight the benefit to state Medicaid programs of preventing interpersonal violence.
AHRQ-funded; HS000028.
Citation: Coupet E, Karp D, Wiebe DJ .
Shift in U.S. payer responsibility for the acute care of violent injuries after the Affordable Care Act: Implications for prevention.
Am J Emerg Med 2018 Dec;36(12):2192-96. doi: 10.1016/j.ajem.2018.03.070..
Keywords: Domestic Violence, Emergency Department, Healthcare Costs, Policy, Healthcare Cost and Utilization Project (HCUP), Medicaid
Williams CN, Piantino J, McEvoy C
The burden of pediatric neurocritical care in the United States.
This article attempts to quantify the burden of pediatric neurocritical care (PNCC) by developing national estimates of disease incidence, evaluating use of critical care interventions (CCI), and examining hospital outcomes. The Kids Inpatient Database (KID) was analyzed to evaluate cohorts with the following conditions: traumatic brain injury, neuro-infection, or inflammatory diseases; status epilepticus; stroke; hypoxic ischemic injury after cardiac arrest; or spinal cord injury.
AHRQ-funded; HS022981.
Citation: Williams CN, Piantino J, McEvoy C .
The burden of pediatric neurocritical care in the United States.
Pediatr Neurol 2018 Dec;89:31-38. doi: 10.1016/j.pediatrneurol.2018.07.013..
Keywords: Children/Adolescents, Critical Care, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Neurological Disorders, Stroke, Trauma
Kwa MC, Silverberg JI, Ardalan K
Inpatient burden of juvenile dermatomyositis among children in the United States.
The purpose of this study was to determine the prevalence and risk factors for hospitalization with juvenile dermatomyositis and assess inpatient burden of juvenile dermatomyositis (JDM). The study authors found that JDM contributes to both increased length of hospitalization and inpatient cost of care. Non-Medicaid government insurance was associated with higher rates of hospitalization for JDM while Hispanic and other non-white racial/ethnic groups demonstrated increased length of stay and cost of care.
AHRQ-funded; HS023011.
Citation: Kwa MC, Silverberg JI, Ardalan K .
Inpatient burden of juvenile dermatomyositis among children in the United States.
Pediatr Rheumatol Online J 2018 Nov 13;16(1):70. doi: 10.1186/s12969-018-0286-1..
Keywords: Children/Adolescents, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Skin Conditions
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
Urish KL, Qin Y, Li BY
Predictors and cost of readmission in total knee arthroplasty.
The Comprehensive Care for Joint Replacement bundle was created to decrease total knee arthroplasty (TKA) cost. To help accomplish this, there is a focus on reducing TKA readmissions. The study’s authors used the Nationwide Readmission Database to examine national readmission rates, predictors of readmission, and associated readmission costs for elective TKA procedures.
AHRQ-funded; HS018726.
Citation: Urish KL, Qin Y, Li BY .
Predictors and cost of readmission in total knee arthroplasty.
J Arthroplasty 2018 Sep;33(9):2759-63. doi: 10.1016/j.arth.2018.04.008..
Keywords: Arthritis, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Orthopedics
Rosko M, Wong HS, Mutter R
AHRQ Author: Wong HS Mutter R
Characteristics of high- and low-efficiency hospitals.
Researchers compared the performance, operating characteristics, and market environments of low- and high-efficiency hospitals in the states that supplied inpatient data to HCUP from 2006 to 2010. Their findings indicated that the most efficient hospitals tended to be nonteaching, investor-owned, and members of multihospital systems; these hospitals also tended to have lower average costs and higher labor productivity and profit margins when compared to the least efficient hospitals. High-efficiency hospitals had a higher proportion of Medicaid and Medicare admissions and were usually located in areas with lower health maintenance organization penetration and less competition. The researchers conclude that these results suggest opportunities for public policies that support improved efficiency in the hospital sector.
AHRQ-authored.
Citation: Rosko M, Wong HS, Mutter R .
Characteristics of high- and low-efficiency hospitals.
Med Care Res Rev 2018 Aug;75(4):454-78. doi: 10.1177/1077558716689197..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitals, Healthcare Costs
Richards CA, Rundle AG, Wright JD
Association between hospital financial distress and immediate breast reconstruction surgery after mastectomy among women with ductal carcinoma in situ.
Hospital financial distress may reduce the services a hospital can offer, particularly unprofitable ones. This study examined the association between hospital financial distress (HFD) and receipt of immediate breast reconstruction surgery after mastectomy among women diagnosed with ductal carcinoma in situ (DCIS). It concluded that the financial strength of the hospital where a patient receives treatment is associated with receipt of immediate breast reconstruction surgery.
AHRQ-funded; HS021709.
Citation: Richards CA, Rundle AG, Wright JD .
Association between hospital financial distress and immediate breast reconstruction surgery after mastectomy among women with ductal carcinoma in situ.
JAMA Surg 2018 Apr;153(4):344-51. doi: 10.1001/jamasurg.2017.5018.
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Keywords: Cancer: Breast Cancer, Healthcare Costs, Healthcare Utilization, Healthcare Cost and Utilization Project (HCUP), Surgery
Henke RM, Karaca Z, Gibson TB
AHRQ Author: Karaca Z, Wong HS
Medicare Advantage penetration and hospital costs before and after the Affordable Care Act.
This study investigated the relationship between Medicare Advantage (MA) program growth and inpatient hospital costs and utilization before and after the ACA. Its results suggest that MA enrollment growth is associated with diminished spillover reductions in hospital admission costs after the ACA. Researchers did not observe a strong relationship between MA enrollment and inpatient days per enrollee
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Henke RM, Karaca Z, Gibson TB .
Medicare Advantage penetration and hospital costs before and after the Affordable Care Act.
Med Care 2018 Apr;56(4):321-28. doi: 10.1097/mlr.0000000000000885.
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Keywords: Healthcare Costs, Policy, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Medicare
Valley TS, Nallamothu BK, Heung M
Hospital variation in renal replacement therapy for sepsis in the United States.
This retrospective cohort study estimated the risk- and reliability-adjusted rate of acute renal replacement therapy use for patients with sepsis and acute kidney injury at each hospital sampled by the Nationwide Inpatient Sample in 2011. The investigators examined the association between hospital-specific renal replacement therapy rate and in-hospital mortality and hospital costs after adjusting for patient and hospital characteristics.
AHRQ-funded; HS020672.
Citation: Valley TS, Nallamothu BK, Heung M .
Hospital variation in renal replacement therapy for sepsis in the United States.
Crit Care Med 2018 Feb;46(2):e158-e65. doi: 10.1097/ccm.0000000000002878..
Keywords: Healthcare Costs, Healthcare Utilization, Healthcare Cost and Utilization Project (HCUP), Hospitals, Sepsis
Hsu DY, Shinkai K, Silverberg JI
Epidemiology of eczema herpeticum in hospitalized U.S. children: analysis of a nationwide cohort.
This study used data from the Nationwide Inpatient Sample 2002-2012 to determine incidence, risk factors, comorbidities, costs, length of stay, and mortality in hospitalized children with Eczema herpeticum (EH). A higher risk was associated with younger age and non-white ethnicity (Asian in particular). However there was less frequency of hospitalization associated with lower income quartiles. The mortality incidence was 0.1%.
AHRQ-funded; HS023011.
Citation: Hsu DY, Shinkai K, Silverberg JI .
Epidemiology of eczema herpeticum in hospitalized U.S. children: analysis of a nationwide cohort.
J Invest Dermatol 2018 Feb;138(2):265-72. doi: 10.1016/j.jid.2017.08.039..
Keywords: Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Hospitalization, Skin Conditions
Henke RM, Karaca Z, Moore B
AHRQ Author: Karaca Z, Wong HS
Impact of health system affiliation on hospital resource use intensity and quality of care.
This study assessed the impact of hospital affiliation, centralization, and managed care plan ownership on inpatient cost and quality. It found that hospitals affiliated with health systems had a higher cost per discharge and better quality of care compared with independent hospitals. Centralized systems in particular had the highest cost per discharge and longest stays. Independent hospitals with managed care plans had a higher cost per discharge.
AHRQ-authored.
Citation: Henke RM, Karaca Z, Moore B .
Impact of health system affiliation on hospital resource use intensity and quality of care.
Health Serv Res 2018 Feb;53(1):63-86. doi: 10.1111/1475-6773.12631..
Keywords: Healthcare Costs, Quality of Care, Health Systems, Healthcare Cost and Utilization Project (HCUP), Hospitals
Wong H, Karaca Z, Gibson TB
AHRQ Author: Wong H, Karaca Z
A quantitative observational study of physician influence on hospital costs.
Physicians serve as the nexus of treatment decision-making in hospitalized patients; however, little empirical evidence describes the influence of individual physicians on hospital costs. In this study, the extent to which hospital costs vary across physicians and physician characteristics is examined. Among other findings, the investigators observed sizable variation in average costs of hospital inpatient stays across medical specialties.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Wong H, Karaca Z, Gibson TB .
A quantitative observational study of physician influence on hospital costs.
Inquiry 2018 Jan-Dec;55:46958018800906. doi: 10.1177/0046958018800906..
Keywords: Shared Decision Making, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitals
Narla S, Silverberg JI
Association between atopic dermatitis and serious cutaneous, multiorgan and systemic infections in US adults.
This study sought to determine whether adults with atopic dermatitis (AD) have an unusually large number of serious infections and related outcomes. Using data from the 2002 to 2012 National Inpatient Sample Adults, it found that adults with AD had increased cutaneous, respiratory, multiorgan, and systemic infections, which were associated with a considerable cost burden.
AHRQ-funded; HS023011.
Citation: Narla S, Silverberg JI .
Association between atopic dermatitis and serious cutaneous, multiorgan and systemic infections in US adults.
Ann Allergy Asthma Immunol 2018 Jan;120(1):66-72.e11. doi: 10.1016/j.anai.2017.10.019.
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Keywords: Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Infectious Diseases, Patient-Centered Outcomes Research
Spector WD, Limcangco R, Owens PL
AHRQ Author: Spector WD, Limcangco R, Owens PL, Steiner CA
Marginal hospital cost of surgery-related hospital-acquired pressure ulcers.
The researchers estimated the hospital marginal cost of a hospital-acquired pressure ulcer (HAPU) for adults patients who were hospitalized for major surgeries, adjusted for patient characteristics, comorbidities, procedures, and hospital characteristics. They found that 3.5 percent of major surgical patients developed HAPUs and that the HAPUs added approximately $8,200 to the cost of a surgical stay after adjusting for comorbidities, patient characteristics, procedures, and hospital characteristics.
AHRQ-authored.
Citation: Spector WD, Limcangco R, Owens PL .
Marginal hospital cost of surgery-related hospital-acquired pressure ulcers.
Med Care 2016 Sep;54(9):845-51. doi: 10.1097/mlr.0000000000000558.
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Keywords: Pressure Ulcers, Surgery, Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Patient Safety
Hsu DY, Gordon K, Silverberg JI
Serious infections in hospitalized patients with psoriasis in the United States.
The researchers sought to determine rates and predictors of serious infections in hospitalized psoriasis patients and quantify costs of care, length of stay, and mortality. Among patients with psoriasis, rates of serious infections increased over all time intervals analyzed and were significantly higher compared with those without psoriasis across all time intervals.
AHRQ-funded; HS023011.
Citation: Hsu DY, Gordon K, Silverberg JI .
Serious infections in hospitalized patients with psoriasis in the United States.
J Am Acad Dermatol 2016 Aug;75(2):287-96. doi: 10.1016/j.jaad.2016.04.005..
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Healthcare Costs, Inpatient Care
Hsu D, Brieva J, Silverberg JI
Costs of care for hospitalization for pemphigus in the United States.
The purpose of this study was to determine the incidence of and risk factors for hospitalization with pemphigus and cost of care. It concluded that there is a significant inpatient burden for pemphigus in the United States. Moreover, there appear to be racial/ethnic and health care disparities with respect to pemphigus, such that poor, nonwhite, and/or uninsured or underinsured patients have higher odds of hospitalization.
AHRQ-funded; HS023011.
Citation: Hsu D, Brieva J, Silverberg JI .
Costs of care for hospitalization for pemphigus in the United States.
JAMA Dermatol 2016 Jun;152(6):645-54. doi: 10.1001/jamadermatol.2015.5240..
Keywords: Healthcare Costs, Hospitalization, Disparities, Healthcare Cost and Utilization Project (HCUP), Risk
Hellinger FJ
AHRQ Author: Hellinger FJ
Hospital use by persons with HIV in the 21st century: a 5-state study.
The purpose of this study was to determine whether reductions in hospital utilization observed immediately after the availability of highly active antiretroviral therapy (between 1995 and 2000) have persisted into the 21st century. It found that the total number of hospitalizations by persons with HIV in the 5 study states fell by one third between 2000 and 2013 even though the number of persons living with HIV increased by >50%.
AHRQ-authored.
Citation: Hellinger FJ .
Hospital use by persons with HIV in the 21st century: a 5-state study.
Med Care 2016 Jun;54(6):639-44. doi: 10.1097/mlr.0000000000000526.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Human Immunodeficiency Virus (HIV), Hospitalization, Healthcare Costs
Heslin KC, Elixhauser A, Steiner CA
AHRQ Author: Heslin KC, Elixhauser A, Steiner CA
Identifying in-patient costs attributable to the clinical sequelae and comorbidities of alcoholic liver disease in a national hospital database.
The aim of this study was to compare the average costs of hospitalizations with alcoholic liver disease (ALD) and the costs of hospitalizations with other alcohol-related diagnoses that do not involve the liver. It found that costs of hospital care for patients with ALD are higher than those for patients with other alcohol-related diagnoses.
AHRQ-authored.
Citation: Heslin KC, Elixhauser A, Steiner CA .
Identifying in-patient costs attributable to the clinical sequelae and comorbidities of alcoholic liver disease in a national hospital database.
Addiction 2016 May;112(5):782-91. doi: 10.1111/add.13702.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Alcohol Use, Healthcare Costs, Nutrition, Hospitalization
Raol N, Zogg CK, Boss EF
Inpatient pediatric tonsillectomy: Does hospital type affect cost and outcomes of care?
The researchers ascertained whether hospital type is associated with differences in total cost and outcomes for inpatient tonsillectomy. They found that significant differences in costs, outcomes, and patient factors exist for inpatient tonsillectomy based on hospital type. Reasons for these differences are not discernable using isolated claims data.
AHRQ-funded; HS022932.
Citation: Raol N, Zogg CK, Boss EF .
Inpatient pediatric tonsillectomy: Does hospital type affect cost and outcomes of care?
Otolaryngol Head Neck Surg 2016 Mar;154(3):486-93. doi: 10.1177/0194599815621739..
Keywords: Healthcare Cost and Utilization Project (HCUP), Patient-Centered Outcomes Research, Healthcare Costs, Surgery, Children/Adolescents
Skinner HG, Coffey R, Jones J
AHRQ Author: Heslin KC, Moy E
The effects of multiple chronic conditions on hospitalization costs and utilization for ambulatory care sensitive conditions in the United States: a nationally representative cross-sectional study.
A purpose of this study was to evaluate how multiple chronic conditions relate to inpatient hospitalization costs. It found that compared with costs for patients with 0 or 1 chronic condition, hospitalization costs per stay for overall ambulatory care sensitive conditions were 19 percent higher for those with 2 or 3 , 32 percent higher for those with 4 or 5, and 31 percent higher for those with 6+ conditions.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Skinner HG, Coffey R, Jones J .
The effects of multiple chronic conditions on hospitalization costs and utilization for ambulatory care sensitive conditions in the United States: a nationally representative cross-sectional study.
BMC Health Serv Res 2016 Mar 1;16:77. doi: 10.1186/s12913-016-1304-y.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Chronic Conditions, Hospitalization, Healthcare Utilization, Healthcare Costs
Reiter KL, Jiang HJ, Wang J
AHRQ Author: Jiang HJ
Facing the recession: how did safety-net hospitals fare financially compared with their peers?
The authors examined the effect of the recession on the financial performance of safety-net versus non-safety-net hospitals. They concluded that safety-net hospitals may not be disproportionately vulnerable to macro-economic fluctuations, but their significantly lower margins leave less financial cushion to weather sustained financial pressure.
AHRQ-authored.
Citation: Reiter KL, Jiang HJ, Wang J .
Facing the recession: how did safety-net hospitals fare financially compared with their peers?
Health Serv Res 2014 Dec;49(6):1747-66. doi: 10.1111/1475-6773.12230.
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Keywords: Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitals
Simeone RM, Oster ME, Cassell CH
AHRQ Author: Gray DT
Pediatric inpatient hospital resource use for congenital heart defects.
The authors sought to estimate healthcare costs for infants, children, and adolescents with congenital heart defects (CHDs). Using the 2009 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID), they found that hospitalizations for children with CHDs have disproportionately high hospital costs compared with other pediatric hospitalizations, and the 17% of hospitalizations with critical CHD diagnoses accounted for 27% of CHD hospital costs.
AHRQ-authored.
Citation: Simeone RM, Oster ME, Cassell CH .
Pediatric inpatient hospital resource use for congenital heart defects.
Birth Defects Res A Clin Mol Teratol 2014 Dec;100(12):934-43. doi: 10.1002/bdra.23262.
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Keywords: Cardiovascular Conditions, Children/Adolescents, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitalization
Trudnak Fowler T, Fairbrother G, Owens P
AHRQ Author: Owens P
Trends in complicated newborn hospital stays & costs, 2002-2009: implications for the future.
The researchers used HCUP data to examine trends from 2002 through 2009 in complicated newborn hospital stays, and to explore the relationship between expected sources of payment and reasons for hospitalizations. They concluded that state Medicaid programs are paying for an increasing proportion of births and costly complicated births, and they suggested that policies to prevent common birth complications have the potential to reduce costs for public programs and improve birth outcomes.
AHRQ-authored.
Citation: Trudnak Fowler T, Fairbrother G, Owens P .
Trends in complicated newborn hospital stays & costs, 2002-2009: implications for the future.
Medicare Medicaid Res Rev 2014;4(4). doi: 10.5600/mmrr.004.04.a03.
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Keywords: Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Newborns/Infants
Martsolf GR, Auerbach D, Benevent R
AHRQ Author: Stocks C, Jiang HJ
Examining the value of inpatient nurse staffing: an assessment of quality and patient care costs.
The authors assessed the effect of nurse staffing on quality of care and inpatient care costs. They found that increases in nurse staffing levels were associated with reductions in nursing-sensitive adverse events and length of stay, while changing skill mix by increasing the number of registered nurses, as a proportion of licensed nursing staff, led to reductions in costs.
AHRQ-authored; AHRQ-funded; 290200600009C.
Citation: Martsolf GR, Auerbach D, Benevent R .
Examining the value of inpatient nurse staffing: an assessment of quality and patient care costs.
Med Care 2014 Nov;52(11):982-8. doi: 10.1097/mlr.0000000000000248.
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Keywords: Healthcare Costs, Quality of Care, Healthcare Cost and Utilization Project (HCUP), Inpatient Care, Nursing
Mutter R, Stocks C
AHRQ Author: Stocks C
Using Healthcare Cost and Utilization Project (HCUP) data for emergency medicine research.
This article mentions Kocher et al., elsewhere in this issue, who use the HCUP Nationwide Inpatient Sample to examine the association between the volume of ED encounters that result in admission and inpatient mortality. It further discusses HCUP strengths, weaknesses, and future.
AHRQ-authored.
Citation: Mutter R, Stocks C .
Using Healthcare Cost and Utilization Project (HCUP) data for emergency medicine research.
Ann Emerg Med 2014 Nov;64(5):458-60. doi: 10.1016/j.annemergmed.2014.09.014.
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Keywords: Emergency Medical Services (EMS), Healthcare Costs, Healthcare Delivery, Health Services Research (HSR), Healthcare Cost and Utilization Project (HCUP)