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
- Behavioral Health (1)
- Blood Thinners (1)
- Cardiovascular Conditions (1)
- Elderly (6)
- Emergency Medical Services (EMS) (1)
- Falls (1)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Costs (5)
- Healthcare Delivery (2)
- Healthcare Utilization (2)
- Health Insurance (2)
- Heart Disease and Health (2)
- (-) Hospitalization (12)
- Hospital Readmissions (1)
- Hospitals (5)
- Injuries and Wounds (1)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (1)
- (-) Medicare (12)
- Medication (1)
- Mortality (2)
- Outcomes (1)
- Policy (1)
- Public Reporting (1)
- Risk (3)
- 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 12 of 12 Research Studies DisplayedWu SS, Bellantoni m, Weiner JP
Geriatric syndrome risk factors among hospitalized postacute Medicare patients.
The purpose of this study was to assess the association of geriatric syndrome risk factors with postacute utilization among hospitalized Medicare patients (both Medicare Advantage [MA] and fee-for-service [FFS] cohorts) and to examine patterns of postacute care for MA and FFS cohorts with high geriatric syndrome risk. The investigators found that geriatric syndrome risk factors not only play a role in postacute care and inpatient utilization in MA and FFS cohorts but also explain different utilizations between MA and FFS cohorts.
AHRQ-funded; HS000029.
Citation: Wu SS, Bellantoni m, Weiner JP .
Geriatric syndrome risk factors among hospitalized postacute Medicare patients.
Am J Manag Care 2020 Oct;26(10):e319-e26. doi: 10.37765/ajmc.2020.88505..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Medicare, Risk, Healthcare Utilization, Hospitalization
Germack HD, Bizhanova Z, Roberts ET
Substantial hospital level variation in all-cause readmission rates among Medicare beneficiaries with serious mental illness.
This study’s purpose was to examine the variation across hospitals in readmissions for patients with serious mental illness (SMI) and differences in the characteristics of hospitals with the highest and lowest readmission rates. A cross-sectional analysis was conducted of pooled inpatient claims from 2013-2016. The 5% sample of fee-for-service Medicare beneficiaries included patients with SMI. The authors identified 2066 hospitals with at least 30 index admissions for Medicare beneficiaries with SMI. Factors most strongly associated with increased risk of readmission included substance use disorder and end stage renal disease. Hospital readmission rates ranged from 7.05% to 15.24%. Hospitals with the lowest adjusted readmission rates were more likely to be teaching hospitals and located in the South or Midwest.
AHRQ-funded; HS026727.
Citation: Germack HD, Bizhanova Z, Roberts ET .
Substantial hospital level variation in all-cause readmission rates among Medicare beneficiaries with serious mental illness.
Healthc 2020 Sep;8(3):100453. doi: 10.1016/j.hjdsi.2020.100453..
Keywords: Elderly, Behavioral Health, Hospital Readmissions, Medicare, Hospitals, Hospitalization
Hoffman GJ, Tinetti ME, Ha J
Prehospital and posthospital fall injuries in older US adults.
Investigators estimated the risk of older adult fall injury within and across discrete periods during a 12-month care episode anchored by an acute hospitalization using national data from 2006 to 2014. Participants in this cohort study included Medicare fee-for-service beneficiaries aged 65 and older from the Health and Retirement Study. The investigators found that an episode-based assessment of fall injury illustrated substantial variability in period-specific risks over an extended period including an anchor hospitalization. Risk transitions between periods included sizable increases just before hospitalization that do not fully subside after hospital discharge. Financial incentives to coordinate hospital and posthospital care for patients at risk for fall injury are needed.
AHRQ-funded; HS025838.
Citation: Hoffman GJ, Tinetti ME, Ha J .
Prehospital and posthospital fall injuries in older US adults.
JAMA Netw Open 2020 Aug 3;3(8):e2013243. doi: 10.1001/jamanetworkopen.2020.13243..
Keywords: Elderly, Falls, Injuries and Wounds, Risk, Hospitalization, Medicare
Carey K, Dor A
Hospital response to CMS public reports of hospital charge information.
This study examined trends in charge increases for Medicare inpatients treated in approximately 3400 hospitals after the Centers for Medicare and Medicaid Services (CMS) began reporting charges online in 2013 for Medicare inpatients. The investigators applied difference-in-differences analysis to comprehensive inpatient charge data from New York and Florida for the years 2011-2016. After public reporting was implemented the growth in reported charges in New York hospitals was 4-9% lower than unreported diagnosis-related groups and in Florida it was 2-8% lower.
AHRQ-funded; HS025074.
Citation: Carey K, Dor A .
Hospital response to CMS public reports of hospital charge information.
Med Care 2020 Jan;58(1):70-73. doi: 10.1097/mlr.0000000000001232..
Keywords: Hospitals, Healthcare Costs, Public Reporting, Medicare, Hospitalization
Kaye DR, Luckenbaugh AN, Oerline M
Understanding the costs associated with surgical care delivery in the Medicare population.
This study’s objective was to quantify the costs of inpatient and outpatient surgery in the Medicare population. Claims data from a 20% national sample of Medicare beneficiaries was used. Results showed that, while spending on inpatient surgery contributed the most to total surgical payments, it declined over the study period, driven by decreases in index hospitalization and readmissions payments. In contrast, spending on outpatient surgery increased across all sites of care (hospital outpatient department, physician office, and ambulatory surgery center). Ophthalmology and hand surgery witnessed the greatest growth in surgical spending over the study period. Surgical care accounts for half of all Medicare spending.
AHRQ-funded; HS024525; HS024728.
Citation: Kaye DR, Luckenbaugh AN, Oerline M .
Understanding the costs associated with surgical care delivery in the Medicare population.
Ann Surg 2020 Jan;271(1):23-28. doi: 10.1097/sla.0000000000003165..
Keywords: Surgery, Healthcare Delivery, Healthcare Costs, Medicare, Elderly, Hospitalization
Adrion ER, Kocher KE, Nallamothu BK
Rising use of observation care among the commercially insured may lead to total and out-of-pocket cost savings.
Using multipayer commercial claims for the period 2009-13, the investigators evaluated utilization and spending among patients admitted for six conditions that are commonly managed with either observation care or short-stay hospitalizations. In their study period, the use of observation care increased relative to that of short-stay hospitalizations. In addition, total and out-of-pocket spending were substantially lower for observation care, though both grew rapidly--and at rates much higher than spending in the inpatient setting--over the study period.
AHRQ-funded; HS000053.
Citation: Adrion ER, Kocher KE, Nallamothu BK .
Rising use of observation care among the commercially insured may lead to total and out-of-pocket cost savings.
Health Aff 2017 Dec;36(12):2102-09. doi: 10.1377/hlthaff.2017.0774..
Keywords: Health Insurance, Healthcare Costs, Healthcare Delivery, Healthcare Utilization, Hospitalization, Hospitals, Medicare
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.
.
.
Keywords: Emergency Medical Services (EMS), Medicare, Policy, Elderly, Hospitalization
Hines AL, Raetzman SO, Barrett ML
AHRQ Author: Moy E, Andrews RM
Managed care and inpatient mortality in adults: effect of primary payer.
This study provides a comprehensive assessment of the association between managed care and inpatient mortality for Medicare and privately insured patients. Privately insured patients in managed care plans, especially older adults, had better outcomes than those in fee-for-service (FFS) plans. Patients in Medicare managed care had outcomes similar to those in Medicare FFS.
AHRQ-authored.
Citation: Hines AL, Raetzman SO, Barrett ML .
Managed care and inpatient mortality in adults: effect of primary payer.
BMC Health Serv Res 2017 Feb 8;17(1):121. doi: 10.1186/s12913-017-2062-1.
.
.
Keywords: Healthcare Cost and Utilization Project (HCUP), Health Insurance, Inpatient Care, Mortality, Outcomes, Hospitalization, Medicare
Vaughan Sarrazin MS, Jones M, Mazur A
Cost of hospital admissions in Medicare patients with atrial fibrillation taking warfarin, dabigatran, or rivaroxaban.
The purpose of this study was to examine the impact of anticoagulant choice on inpatient costs in patients with nonvalvular atrial fibrillation (AF). Analysis used 3-way propensity matching to create groups from AF patients taking dabigatran, rivaroxaban, or warfarin, and were plausible candidates for all 3 anticoagulants. Predicted values from two models were multiplied together to estimate expected costs per patient-year. The study concludes from its data that patients with newly diagnosed AF taking 150 mg dabigatran or 20 mg rivaroxaban experience lower annual inpatient costs than patients taking warfarin, due to fewer hospital admissions for stroke, non-gastrointestinal-related hemorrhages, and heart failure events.
AHRQ-funded; HS023104.
Citation: Vaughan Sarrazin MS, Jones M, Mazur A .
Cost of hospital admissions in Medicare patients with atrial fibrillation taking warfarin, dabigatran, or rivaroxaban.
J Am Coll Cardiol 2017 Jan 24;69(3):360-62. doi: 10.1016/j.jacc.2016.11.023..
Keywords: Blood Thinners, Heart Disease and Health, Medication, Healthcare Costs, Medicare, Hospitalization, Cardiovascular Conditions
Admon AJ, Wunsch H, Iwashyna TJ
Hospital contributions to variability in the use of ICUs among elderly Medicare recipients.
Hospitals vary widely in ICU admission rates across numerous medical diagnoses. In This retrospective cohort study examined the extent to which variability in ICU use is specific to individual diagnoses or is a function of the hospital, regardless of disease. The authors concluded that hospitals account for a significant proportion of variation independent of measured patient and hospital characteristics, suggesting the need for further work to evaluate the causes of variation at the hospital level and potential consequences of variation across hospitals.
AHRQ-funded; HS020672.
Citation: Admon AJ, Wunsch H, Iwashyna TJ .
Hospital contributions to variability in the use of ICUs among elderly Medicare recipients.
Crit Care Med 2017 Jan;45(1):75-84. doi: 10.1097/CCM.0000000000002025..
Keywords: Elderly, Hospitalization, Hospitals, Intensive Care Unit (ICU), Medicare
Chaudhry SI, Khan RF, Chen J
National trends in recurrent AMI hospitalizations 1 year after acute myocardial infarction in Medicare beneficiaries: 1999-2010.
The investigators evaluated changes in the incidence of 1-year recurrent acute myocardial infarction (AMI) hospitalization and mortality. In a national sample of Medicare beneficiaries hospitalized for AMI from 1999 to 2010, they found that hospitalization for recurrent AMI decreased, as did subsequent mortality, albeit to a lesser extent. The risk of recurrent AMI hospitalization declined less in black patients than in whites, increasing observed racial disparities by the end of the study period.
AHRQ-funded; HS018781.
Citation: Chaudhry SI, Khan RF, Chen J .
National trends in recurrent AMI hospitalizations 1 year after acute myocardial infarction in Medicare beneficiaries: 1999-2010.
J Am Heart Assoc 2014 Oct;3(5):e001197. doi: 10.1161/jaha.114.001197.
.
.
Keywords: Hospitalization, Medicare, Mortality, Heart Disease and Health, Risk
O'Donnell BE, Schneider KM, Brooks JM
Standardizing Medicare payment information to support examining geographic variation in costs.
This paper describes a method for standardizing claim payments, and demonstrates the difference in actual versus standardized payments by geographic region. It found that without standardization of payments, certain areas of the country are mischaracterized as either high or low healthcare resource-consuming areas.
AHRQ-funded; HS019574; HS019440.
Citation: O'Donnell BE, Schneider KM, Brooks JM .
Standardizing Medicare payment information to support examining geographic variation in costs.
Medicare Medicaid Res Rev 2013 Sep 10;3(3). doi: 10.5600/mmrr.003.03.a06..
Keywords: Medicare, Healthcare Costs, Hospitalization, Hospitals