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
- Access to Care (1)
- Adverse Events (3)
- Cardiovascular Conditions (1)
- Children/Adolescents (3)
- Comparative Effectiveness (1)
- Critical Care (2)
- Digestive Disease and Health (2)
- Elderly (2)
- Emergency Department (1)
- Guidelines (1)
- (-) Healthcare Cost and Utilization Project (HCUP) (15)
- Healthcare Costs (3)
- Healthcare Utilization (2)
- Health Insurance (2)
- Hospitalization (2)
- Hospital Readmissions (1)
- Hospitals (3)
- Injuries and Wounds (1)
- Intensive Care Unit (ICU) (1)
- Labor and Delivery (1)
- Medicaid (1)
- Mortality (6)
- Nutrition (1)
- (-) Outcomes (15)
- Patient-Centered Outcomes Research (3)
- Patient Safety (1)
- Pneumonia (1)
- Policy (1)
- Pregnancy (1)
- Respiratory Conditions (1)
- Risk (2)
- Sepsis (2)
- Surgery (8)
- Transitions of Care (1)
- Trauma (1)
- Uninsured (1)
- Women (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 15 of 15 Research Studies DisplayedHenke RM, Karaca Z, Gibson TB
Medicaid Accountable Care Organizations and childbirth outcomes.
This study examined the impact of Accountable Care Organizations (ACOs) to childbirth outcomes. States that use Medicaid ACOs were compared with states that had not adopted ACO. Using HCUP data, the relationship between Medicaid ACO adoption and neonatal and maternal outcomes, and cost per birth was examined. Medicaid ACO implementation was associated with a moderate reduction in hospital costs per birth and decreased cesarean section rates with results varying by state. There was no association with other birth outcomes, including infant inpatient mortality, low birthweight, neonatal intensive care unit utilization and severe maternal morbidity.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Henke RM, Karaca Z, Gibson TB .
Medicaid Accountable Care Organizations and childbirth outcomes.
Med Care Res Rev 2020 Dec;77(6):559-73. doi: 10.1177/1077558718823132..
Keywords: Healthcare Cost and Utilization Project (HCUP), Medicaid, Health Insurance, Healthcare Costs, Labor and Delivery, Pregnancy, Women, Outcomes
Philip JL, Yang DY, Wang X
Effect of transfer status on outcomes of emergency general surgery patients.
This study looked at outcomes of transferred (TRAN) versus directly admitted (DA) emergency general surgery (EGS) patients. Patients with a diagnosis of EGS were identified from the 2008-2011 Nationwide Inpatient Sample (NIS). Outcomes included were in-hospital mortality and morbidity. They identified 274,145 TRAN and 10,456,100 DA encounters. Morbidity and mortality were both higher in TRAN patients than DA. TRAN patients were more likely to have greater comorbidity scores, have Medicare insurance, and reside in an area with a lesser median household income compared to DA patients. Morbidity among TRAN patients were primarily due urinary-, gastrointestinal-, and pulmonary-related complications. Median stay and median cost at the hospital were greater for TRAN patients.
AHRQ-funded; HS025224; HS022694.
Citation: Philip JL, Yang DY, Wang X .
Effect of transfer status on outcomes of emergency general surgery patients.
Surgery 2020 Aug;168(2):280-86. doi: 10.1016/j.surg.2020.01.005..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Transitions of Care, Mortality, Outcomes, Healthcare Costs, Hospitals
Gigli KH, Davis BS, Yabes JG
Pediatric outcomes after regulatory mandates for sepsis care.
The authors used hospital discharge data from 2011 to 2015 to compare changes in pediatric sepsis outcomes in New York and four control states following New York’s 2013 regulations mandating that hospitals develop pediatric-specific protocols for sepsis recognition and treatment. They found that implementation of statewide sepsis regulations was generally associated with improved mortality trends in New York State, particularly in prespecified subpopulations of patients, suggesting that the regulations were successful in affecting sepsis outcomes.
AHRQ-funded; HS025146.
Citation: Gigli KH, Davis BS, Yabes JG .
Pediatric outcomes after regulatory mandates for sepsis care.
Pediatrics 2020 Jul;146(1). doi: 10.1542/peds.2019-3353.
.
.
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Sepsis, Outcomes, Hospitals
Dworsky JQ, Childers CP, Gornbein J
Hospital experience predicts outcomes after high-risk geriatric surgery.
This study examined if there an association between a hospital’s annual volume of high-risk geriatric surgery and their risk of inpatient mortality, postoperative length of stay, and discharge to nursing facility. Using the 2014 National Inpatient Sample, older adults were identified who had undergone high-risk geriatric surgery. There were an estimated 514,950 hospital encounters at 3,115 hospitals undergoing surgery. A higher proportion of high-risk geriatric surgery patients was associated with decreased mortality and shorter postoperative length of stay. Higher volume hospitals were not associated with mortality but was associated with longer length of stay and decreased discharge to nursing facilities.
AHRQ-funded; HS000046; HS025079.
Citation: Dworsky JQ, Childers CP, Gornbein J .
Hospital experience predicts outcomes after high-risk geriatric surgery.
Surgery 2020 Feb;167(2):468-74. doi: 10.1016/j.surg.2019.07.026..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Surgery, Risk, Hospitals, Outcomes, Mortality
Tignanelli CJ, Sheetz KH, Petersen A
Utilization of intensive care unit nutrition consultation is associated with reduced mortality.
The aim of this project was to investigate the prevalence of nutrition consultation (NC) in U.S. intensive care units (ICUs) and to examine its association with patient outcomes. Data from the Healthcare Cost and Utilization Project's state inpatient databases was utilized from 2010 - 2014. A multilevel logistic regression model was used to evaluate the relationship between NC and clinical outcomes. The investigators concluded that rates of NC were low in critically ill patients.
AHRQ-funded; HS026379.
Citation: Tignanelli CJ, Sheetz KH, Petersen A .
Utilization of intensive care unit nutrition consultation is associated with reduced mortality.
JPEN J Parenter Enteral Nutr 2020 Feb;44(2):213-19. doi: 10.1002/jpen.1534..
Keywords: Healthcare Cost and Utilization Project (HCUP), Intensive Care Unit (ICU), Nutrition, Patient-Centered Outcomes Research, Outcomes, Critical Care, Mortality
Subramanian MP, Liu J, Chapman WC
Utilization trends, outcomes, and cost in minimally invasive lobectomy.
The objective of this study was to compare outcomes and hospitalization costs among patients undergoing open, video-assisted thoracoscopic surgery (VATS) and RATS lobectomy. The investigators concluded that minimally invasive approaches were associated to improved clinical outcomes compared with open lobectomy. However, only robotic-assisted lobectomy has had rapid growth in utilization. Despite additional cost, RATS lobectomy appeared to provide a viable minimally invasive alternative for general thoracic procedures.
AHRQ-funded; HS019455.
Citation: Subramanian MP, Liu J, Chapman WC .
Utilization trends, outcomes, and cost in minimally invasive lobectomy.
Ann Thorac Surg 2019 Dec;108(6):1648-55. doi: 10.1016/j.athoracsur.2019.06.049..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Healthcare Costs, Healthcare Utilization, Outcomes
Dworsky JQ, Childers CP, Copeland T
Geriatric events among older adults undergoing nonelective surgery are associated with poor outcomes.
This study analyzed the rate of geriatric events (GEs): delirium, dehydration, falls/fractures, failure to thrive, and pressure ulcers) with older adults undergoing nonelective surgery. The 2013 to 2014 National Inpatient Sample was used to analyze nonelective admissions for 5 common operations: laparoscopic cholecystectomy, colectomy, soft tissue debridgement, small bowel resection, and laparoscopic appendectomy in adults aged 65 years and older and a younger referent group (aged 55-65 years). Logistic regression estimated the association of age and outcomes with GEs. Having any GE was found to be associated with higher probability of all outcomes including mortality, postoperative complications, prolonged length of stay, and skilled nursing facility discharge.
AHRQ-funded; HS00046; HS025079.
Citation: Dworsky JQ, Childers CP, Copeland T .
Geriatric events among older adults undergoing nonelective surgery are associated with poor outcomes.
Am Surg 2019 Oct;85(10):1089-93..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Surgery, Adverse Events, Outcomes
Kahn JM, Davis BS, Yabes JG
Association between state-mandated protocolized sepsis care and in-hospital mortality among adults with sepsis.
The purpose of this study was to evaluate the association between New York State sepsis regulations and the outcomes of patients hospitalized with sepsis. Results showed that, in New York State, mandated protocolized sepsis care was associated with a greater decrease in sepsis mortality compared with sepsis mortality in control states (Florida, Maryland, Massachusetts, and New Jersey) that did not implement sepsis regulations. The authors add that, because baseline mortality rates differ between New York and the comparison states, it is uncertain whether these findings will be generalizable to other states.
AHRQ-funded; HS025146.
Citation: Kahn JM, Davis BS, Yabes JG .
Association between state-mandated protocolized sepsis care and in-hospital mortality among adults with sepsis.
JAMA 2019 Jul 16;322(3):240-50. doi: 10.1001/jama.2019.9021..
Keywords: Guidelines, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Mortality, Outcomes, Policy, Sepsis
Daniel VT, Rushing AP, Ingraham AM
Association between operating room access and mortality for life-threatening general surgery emergencies.
Few diseases truly require emergency surgery today. In this study, the authors investigated the relationship between access to operating room (OR) and outcomes for patients with life-threatening emergency general surgery (LT-EGS) diseases at US hospitals. The investigators concluded that round-the-clock availability of personnel, specifically emergency general surgeons and recovery room nurses, is associated with decreased mortality.
AHRQ-funded; HS022694.
Citation: Daniel VT, Rushing AP, Ingraham AM .
Association between operating room access and mortality for life-threatening general surgery emergencies.
J Trauma Acute Care Surg 2019 Jul;87(1):35-42. doi: 10.1097/ta.0000000000002267..
Keywords: Access to Care, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Mortality, Outcomes, Surgery
Law AC, Stevens JP, Walkey AJ
Gastrostomy tube use in the critically ill, 1994-2014.
This study used AHRQ’s Healthcare Cost and Utilization Project’s (HCUP’s) National Inpatient Sample to evaluate trends in gastrostomy tube use among critically ill adults from 1994 to 2014. Patients with dementia were excluded from the study. It was found that tube use more than doubled during that time period. Most patients were discharged to long-term care facilities after tube placement. Population-based rates went from 11.9 to 28.8 gastrostomies per 100,000 adults which is an increase of 142%.
AHRQ-funded; HS024288.
Citation: Law AC, Stevens JP, Walkey AJ .
Gastrostomy tube use in the critically ill, 1994-2014.
Ann Am Thorac Soc 2019 Jun;16(6):724-30. doi: 10.1513/AnnalsATS.201809-638OC..
Keywords: Critical Care, Digestive Disease and Health, Healthcare Cost and Utilization Project (HCUP), Outcomes, Patient-Centered Outcomes Research, Surgery
Glick AF, Tomopoulos S, Fierman AH S, Tomopoulos AH
AHRQ Author: Elixhauser A
Association between outdoor air pollution levels and inpatient outcomes in pediatric pneumonia hospitalizations, 2007 to 2008.
Pneumonia is a leading cause of pediatric admissions. Although air pollutants are associated with poor outcomes, few national studies have examined associations between pollutant levels and inpatient pediatric pneumonia outcomes. In this study, the investigators examined the relationship between ozone (O3) and fine particulate matter with a diameter </=2.5 microm (PM2.5) and outcomes related to disease severity. They concluded that greater levels of O3 and PM2.5 were associated with more severe presentations of pneumonia.
AHRQ-authored
Citation: Glick AF, Tomopoulos S, Fierman AH S, Tomopoulos AH .
Association between outdoor air pollution levels and inpatient outcomes in pediatric pneumonia hospitalizations, 2007 to 2008.
Acad Pediatr 2019 May - Jun;19(4):414-20. doi: 10.1016/j.acap.2018.12.001..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Pneumonia, Respiratory Conditions, Hospitalization, Outcomes
Brauer DG, Lyons SA, Keller MR
Simplified risk prediction indices do not accurately predict 30-day death or readmission after discharge following colorectal surgery.
This study examined the performance of widely used risk prediction indices to predict 30-day death or readmission after discharge following colorectal surgery. The study used a retrospective split-sample cohort of patients discharged after colorectal surgery from inpatient databases of HCUP for the states of New York, California, and Florida from 2006-2014. The commonly used risk prediction model LACE (length of stay, acute admissions, Charlson comorbidity index score, and emergency department visits) was compared with the real outcomes of death or readmission within 30 days after discharge with the cohort. Results showed a poor model fit with LACE and the researchers recommended a better model be developed.
AHRQ-funded; HS019455.
Citation: Brauer DG, Lyons SA, Keller MR .
Simplified risk prediction indices do not accurately predict 30-day death or readmission after discharge following colorectal surgery.
Surgery 2019 May;165(5):882-88. doi: 10.1016/j.surg.2018.12.007..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Surgery, Risk, Adverse Events, Outcomes
Daniel VT, Ayturk D, Ward DV
The influence of payor status on outcomes associated with surgical repair of upper gastrointestinal perforations due to peptic ulcer disease in the United States.
An association between lack of insurance and inferior outcomes has been well described for a number of surgical emergencies, yet little is known about the relationship of payor status and outcomes of patients undergoing emergent surgical repair for upper gastrointestinal (UGI) perforations. In this study, the investigators evaluated the association of payor status and in-hospital mortality for patients undergoing emergency surgery for UGI perforations in the United States.
AHRQ-funded; HS022694.
Citation: Daniel VT, Ayturk D, Ward DV .
The influence of payor status on outcomes associated with surgical repair of upper gastrointestinal perforations due to peptic ulcer disease in the United States.
Am J Surg 2019 Jan;217(1):121-25. doi: 10.1016/j.amjsurg.2018.06.025..
Keywords: Adverse Events, Digestive Disease and Health, Health Insurance, Healthcare Cost and Utilization Project (HCUP), Mortality, Outcomes, Patient Safety, Surgery, Uninsured
Myers SR, Branas CC, French B
A national analysis of pediatric trauma care utilization and outcomes in the United States.
The goal of this study was to provide the first national description of the proportion of injured children treated at pediatric trauma centers, and to clarify the presumed benefit of pediatric trauma center verification by comparing injury mortality across hospital types. The study used data from the 2006 Healthcare Cost and Utilization Project Kids Inpatient Database combined with national trauma center inventories. The results of the study may provide evidence that treatment of injured children at verified pediatric trauma centers may improve outcomes.
AHRQ-funded; HS017960; HS018604.
Citation: Myers SR, Branas CC, French B .
A national analysis of pediatric trauma care utilization and outcomes in the United States.
Pediatr Emerg Care 2019 Jan;35(1):1-7. doi: 10.1097/pec.0000000000000902..
Keywords: Children/Adolescents, Healthcare Utilization, Healthcare Cost and Utilization Project (HCUP), Injuries and Wounds, Outcomes, Patient-Centered Outcomes Research, Trauma
Shah TR, Rockman CB, Adelman MA
Nationwide comparative impact of thoracic endovascular aortic repair of acute uncomplicated type B aortic dissections.
The objective of this study was to evaluate the impact of thoracic endovascular aortic repair (TEVAR) on mortality, morbidity, length of stay (LOS), and discharge status on patients with acute uncomplicated Type B aortic dissections (TBAD). It found that TEVAR for acute uncomplicated TBAD was associated with similar in-hospital mortality and renal failure as compared to medical management.
AHRQ-funded; HS019473.
Citation: Shah TR, Rockman CB, Adelman MA .
Nationwide comparative impact of thoracic endovascular aortic repair of acute uncomplicated type B aortic dissections.
Vasc Endovascular Surg. 2014 Apr;48(3):230-3. doi: 10.1177/1538574413518122..
Keywords: Comparative Effectiveness, Outcomes, Cardiovascular Conditions, Healthcare Cost and Utilization Project (HCUP)