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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Antibiotics (3)
- Antimicrobial Stewardship (1)
- Cardiovascular Conditions (2)
- Children/Adolescents (4)
- Clinical Decision Support (CDS) (1)
- Community-Acquired Infections (5)
- Comparative Effectiveness (1)
- COVID-19 (1)
- Critical Care (1)
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- Diagnostic Safety and Quality (2)
- Education: Patient and Caregiver (1)
- Elderly (3)
- Electronic Health Records (EHRs) (1)
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- Healthcare-Associated Infections (HAIs) (5)
- Healthcare Cost and Utilization Project (HCUP) (2)
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- Health Information Technology (HIT) (2)
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- Heart Disease and Health (2)
- Hospitalization (2)
- Hospital Readmissions (1)
- Infectious Diseases (4)
- Influenza (2)
- Long-Term Care (1)
- Medicare (1)
- Medication (3)
- Mortality (1)
- Neurological Disorders (1)
- Newborns/Infants (1)
- Nursing (1)
- Nursing Homes (2)
- Outcomes (1)
- Patient-Centered Outcomes Research (3)
- Patient Safety (3)
- (-) Pneumonia (23)
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- Respiratory Conditions (6)
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- Tobacco Use (1)
- Vaccination (5)
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 23 of 23 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.
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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
Albright K, Hurley LP, Lockhart S
Attitudes about adult vaccines and reminder/recall in a safety net population.
The objective of this study was to determine patient perspectives on adult vaccines generally; attitudes about Tdap, pneumococcal polysaccharide (PPSV-23), and seasonal influenza vaccines specifically; and preferences for adult reminder/recall delivery.
AHRQ-funded; HS022648.
Citation: Albright K, Hurley LP, Lockhart S .
Attitudes about adult vaccines and reminder/recall in a safety net population.
Vaccine 2017 Dec 19;35(52):7292-96. doi: 10.1016/j.vaccine.2017.11.001..
Keywords: Influenza, Pneumonia, Vaccination, Prevention, Respiratory Conditions
Ho V, Ross JS, Steiner CA
AHRQ Author: Steiner CA
A nationwide assessment of the association of smoking bans and cigarette taxes with hospitalizations for acute myocardial infarction, heart failure, and pneumonia.
No national study using complete hospitalization counts by area that accounts for contemporaneous controls including state cigarette taxes has been conducted. This study in 28 states found that smoking bans lowered pneumonia hospitalization rates for persons ages 60 to 74 years and higher cigarette taxes were associated with lower heart failure hospitalizations for all ages and fewer pneumonia hospitalizations for adults aged 60 to 74.
AHRQ-authored.
Citation: Ho V, Ross JS, Steiner CA .
A nationwide assessment of the association of smoking bans and cigarette taxes with hospitalizations for acute myocardial infarction, heart failure, and pneumonia.
Med Care Res Rev 2017 Dec;74(6):687-704. doi: 10.1177/1077558716668646.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Hospitalization, Pneumonia, Tobacco Use
Haessler S, Lagu T, Lindenauer PK
Treatment trends and outcomes in healthcare-associated pneumonia.
This retrospective cohort study assessed changes in hospital rates of concordant antibiotic use over time and their correlation with outcomes related to management of healthcare-associated pneumonia (HCAP). The study concluded that only 1 in 5 patients with risk factors for HCAP received treatment that was fully in accordance with guidelines, and many received community-acquired pneumonia (CAP) therapy instead.
AHRQ-funded; HS018723.
Citation: Haessler S, Lagu T, Lindenauer PK .
Treatment trends and outcomes in healthcare-associated pneumonia.
J Hosp Med 2017 Nov;12(11):886-91. doi: 10.12788/jhm.2877..
Keywords: Antibiotics, Elderly, Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Pneumonia
McFarland M, Szasz TP, Zhou JY
Colonization with 19F and other pneumococcal conjugate vaccine serotypes in children in St. Louis, Missouri, USA.
The primary goal of this study was to determine the vaccine-type (VT) serotype prevalence of nasopharyngeal (NP) pneumococcal colonization of children residing in the St. Louis, MO, USA metropolitan area following introduction of the 13-valent pneumococcal conjugate vaccine in 2010. It concluded that children in St. Louis exhibit a higher prevalence of VT serotypes among pneumococcal carriage isolates than has been reported in other areas in the US.
AHRQ-funded; HS021736; HS024269.
Citation: McFarland M, Szasz TP, Zhou JY .
Colonization with 19F and other pneumococcal conjugate vaccine serotypes in children in St. Louis, Missouri, USA.
Vaccine 2017 Aug 3;35(34):4389-95. doi: 10.1016/j.vaccine.2017.06.047.
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Keywords: Vaccination, Children/Adolescents, Pneumonia, Infectious Diseases
Boltey E, Yakusheva O, Costa DK
5 nursing strategies to prevent ventilator-associated pneumonia.
This article reviews the top five evidence-based nursing practices for reducing ventilator-associated pneumonia (VAP) risk in critically ill adults.
AHRQ-funded; HS024552.
Citation: Boltey E, Yakusheva O, Costa DK .
5 nursing strategies to prevent ventilator-associated pneumonia.
Am Nurse Today 2017 Jun;12(6):42-43..
Keywords: Critical Care, Healthcare-Associated Infections (HAIs), Nursing, Prevention, Pneumonia
Meystre S, Gouripeddi R, Tieder J
Enhancing comparative effectiveness research with automated pediatric pneumonia detection in a multi-institutional clinical repository: a PHIS+ pilot study.
The aim of this study was to develop an automated, scalable, and accurate method to determine the presence or absence of pneumonia in children using chest imaging reports. It found that, when compared with each of the domain experts manually annotating these reports, the new Natural Language Processing (NLP) application developed by the researchers allowed for significantly higher sensitivity (.71 vs .527) and similar positive predictive value and specificity.
AHRQ-funded; HS019862.
Citation: Meystre S, Gouripeddi R, Tieder J .
Enhancing comparative effectiveness research with automated pediatric pneumonia detection in a multi-institutional clinical repository: a PHIS+ pilot study.
J Med Internet Res 2017 May 15;19(5):e162. doi: 10.2196/jmir.6887.
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Keywords: Children/Adolescents, Community-Acquired Infections, Comparative Effectiveness, Health Information Technology (HIT), Pneumonia
Brown T, Goldman SN, Persell SD
Development and evaluation of a patient education video promoting pneumococcal vaccination.
The researchers aimed to develop and refine a patient education video about pneumococcal polysaccharide vaccination (PPSV23) and to assess patient perceptions regarding video content and receipt of video during a clinic visit. They found that focus group participants had positive reactions to the video but suggested reducing the intensity of messages about pneumonia severity. Participants shown the revised video during a clinic visit perceived it to be easy to understand and informative.
AHRQ-funded; HS021141.
Citation: Brown T, Goldman SN, Persell SD .
Development and evaluation of a patient education video promoting pneumococcal vaccination.
Patient Educ Couns 2017 May;100(5):1024-27. doi: 10.1016/j.pec.2016.12.025.
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Keywords: Education: Patient and Caregiver, Health Promotion, Pneumonia, Vaccination
Iroh Tam PY, Thielen BK, Obaro SK
Childhood pneumococcal disease in Africa - a systematic review and meta-analysis of incidence, serotype distribution, and antimicrobial susceptibility.
This study provided updated estimates of the incidence, serotype distribution, and antimicrobial susceptibility profile of Streptococcus pneumoniae causing disease in Africa. It concluded that, although the incidence of invasive pneumococcal disease (IPD) in young children in Africa is substantial, currently available conjugate vaccines are estimated to cover the majority of invasive disease-causing pneumococcal serotypes.
AHRQ-funded; HS020666.
Citation: Iroh Tam PY, Thielen BK, Obaro SK .
Childhood pneumococcal disease in Africa - a systematic review and meta-analysis of incidence, serotype distribution, and antimicrobial susceptibility.
Vaccine 2017 Apr 4;35(15):1817-27. doi: 10.1016/j.vaccine.2017.02.045.
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Keywords: Children/Adolescents, Infectious Diseases, Medication, Pneumonia, Vaccination
Makam AN, Nguyen OK, Clark C
Predicting 30-day pneumonia readmissions using electronic health record data.
The objective of this study was to develop pneumonia-specific readmission risk-prediction models using EHR data from the first day and from the entire hospital stay ("full stay"). The investigators concluded that EHR data collected from the entire hospitalization can accurately predict readmission risk among patients hospitalized for pneumonia. They suggest that this approach outperforms a first-day pneumonia-specific model, the Centers for Medicare and Medicaid Services pneumonia model, and 2 commonly used pneumonia severity of illness scores.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Clark C .
Predicting 30-day pneumonia readmissions using electronic health record data.
J Hosp Med 2017 Apr;12(4):209-16. doi: 10.12788/jhm.2711..
Keywords: Pneumonia, Hospital Readmissions, Hospitalization, Electronic Health Records (EHRs), Health Information Technology (HIT)
Frei CR, Rehani S, Lee GC
Application of a risk score to identify older adults with community-onset pneumonia most likely to benefit from empiric pseudomonas therapy.
The researchers assessed the impact of empiric Pseudomonas pharmacotherapy on 30-day mortality in hospitalized patients with community-onset pneumonia stratified according to their risk (low, medium, or high) of drug-resistant pathogens. By using a risk score, they found that empiric Pseudomonas therapy was associated with lower 30-day mortality in the high-risk group but not the low- or medium-risk groups.
AHRQ-funded; HS022418.
Citation: Frei CR, Rehani S, Lee GC .
Application of a risk score to identify older adults with community-onset pneumonia most likely to benefit from empiric pseudomonas therapy.
Pharmacotherapy 2017 Feb;37(2):195-203. doi: 10.1002/phar.1891.
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Keywords: Elderly, Community-Acquired Infections, Pneumonia, Patient-Centered Outcomes Research, Risk
Nace DA, Archbald-Pannone LR, Ashraf MS
Pneumococcal vaccination guidance for post-acute and long-term care settings: recommendations from AMDA's infection advisory committee.
Sorting out the indications and timing for 13 pneumococcal serotypes and 23 pneumococcal serotypes administration is complex. The authors discuss the importance of pneumococcal vaccination for older adults, detail AMDA-The Society for Post-Acute and Long-Term Care Medicine (The Society)'s recommendations for pneumococcal vaccination practice and procedures, and offer guidance to postacute and long-term care providers supporting the development and effective implementation of pneumococcal vaccine policies.
AHRQ-funded; HS023779.
Citation: Nace DA, Archbald-Pannone LR, Ashraf MS .
Pneumococcal vaccination guidance for post-acute and long-term care settings: recommendations from AMDA's infection advisory committee.
J Am Med Dir Assoc 2017 Feb;18(2):99-104. doi: 10.1016/j.jamda.2016.11.010.
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Keywords: Elderly, Guidelines, Nursing Homes, Pneumonia, Vaccination
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.
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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.
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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.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Influenza, Pneumonia