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AHRQ Research Studies Date
Topics
- Cardiovascular Conditions (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Cost and Utilization Project (HCUP) (1)
- (-) Healthcare Costs (13)
- Health Services Research (HSR) (1)
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- (-) Hospitals (13)
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- Urinary Tract Infection (UTI) (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 13 of 13 Research Studies DisplayedEncinosa W, Nguyen P
AHRQ Author: Encinosa W
Is the recent surge in physician-hospital consolidation finally producing cost-savings?
This article revisits earlier integration studies using IBM MarketScan data 2010–2016 to re-examine the relationship between primary care physicians integrated with hospitals and spending under the Affordable Care Act (ACA) during that period. The authors observe an association between physician-hospital integration and overall cost-savings, a reversal of the relationship noted in earlier studies. They recommend that future research examine the precise mechanism of physician-hospital clinical integration in greater detail.
AHRQ-authored.
Citation: Encinosa W, Nguyen P .
Is the recent surge in physician-hospital consolidation finally producing cost-savings?
J Gen Intern Med 2022 Dec;37(16):4289-91. doi: 10.1007/s11606-022-07634-x..
Keywords: Healthcare Costs, Provider: Physician, Hospitals, Primary Care
Likosky DS, Yang G, Zhang M
Interhospital variability in health care-associated infections and payments after durable ventricular assist device implant among Medicare beneficiaries.
The purpose of this study was to examine differences in durable ventricular assist device implantation infection rates and associated costs across hospitals. The researchers utilized clinical data for 8,688 patients who received primary durable ventricular assist devices from the Society of Thoracic Surgeons Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs) hospitals (n = 120) and merged that data with post-implantation 90-day Medicare claims. The primary outcome included infections within 90 days of implantation and Medicare payments. The study found that 27.8% of patients developed 3982 identified infections. The median adjusted incidence of infections (per 100 patient-months) across hospitals was 14.3 and differed according to hospital. Total Medicare payments from implantation to 90 days were 9.0% more in high versus low infection tercile hospitals. The researchers concluded that health-care-associated infection rates post durable ventricular assist device implantation varied according to hospital and were associated with increased 90-day Medicare expenditures.
AHRQ-funded; HS026003.
Citation: Likosky DS, Yang G, Zhang M .
Interhospital variability in health care-associated infections and payments after durable ventricular assist device implant among Medicare beneficiaries.
J Thorac Cardiovasc Surg 2022 Nov;164(5):1561-68. doi: 10.1016/j.jtcvs.2021.04.074..
Keywords: Healthcare-Associated Infections (HAIs), Medical Devices, Medicare, Heart Disease and Health, Cardiovascular Conditions, Hospitals, Payment, Healthcare Costs
Haque W, Ahmadzada M, Janumpally S
Adherence to a federal hospital price transparency rule and associated financial and marketplace factors.
This research letter describes a study that evaluated adherence to the federal Hospital Price Transparency Rule 6 to 9 months after the final rule effective date (January 1, 2021). The rule’s aim is to increase health price transparency and facilitation patient price shopping online. Hospitals were required to post 5 price types: gross charges, discounted prices, payer-specific negotiated prices, minimum and maximum prices in a machine-readable file, and a separate accessible display or price estimator for at least 300 shoppable items. The authors used the Herfindahl-Hirschman Index (HHI) to measure inpatient hospital market concentration. The data was collected for 185 of 929 core-based statistical areas from 2019. HHI is divided into the following categories: unconcentrated, moderately concentrated, or highly or very concentrated. Results showed that out of 5239 total hospitals, 729 (13.9%) had an adherent machine-readable file but no shoppable display, 1542 (29.4%) had an adherent shoppable display but no machine-readable file, and 300 (5.7%) had both. The most adherent hospitals tended to be acute care hospitals with lesser revenue per patient-day, within unconcentrated health care markets, and in urban areas.
AHRQ-funded; HS026980.
Citation: Haque W, Ahmadzada M, Janumpally S .
Adherence to a federal hospital price transparency rule and associated financial and marketplace factors.
JAMA 2022 Jun 7;327(21):2143-45. doi: 10.1001/jama.2022.5363..
Keywords: Policy, Hospitals, Healthcare Costs
McCleskey SG, Shek L, Grein J
Economic evaluation of quality improvement interventions to prevent catheter-associated urinary tract infections in the hospital setting: a systematic review.
This systematic review looked at economic evaluations of quality improvement (QI) interventions to reduce rates of catheter-associated urinary tract infections (CAUTIs). A literature review was conducted for conference abstracts and studies from January 2000 to October 2020. Dual reviewers assessed study design, effectiveness, costs and study quality for eligibility. The reviewers performed a cost-consequence analysis from the hospital perspective, estimating the incidence rate ratio and increment net cost/savings per hospital over 3 years for each eligible study. Fifteen unique economic evaluations were eligible, and 12 studies were amenable to standardization. QI interventions were associated with a 43% decline in infections and wide ranges of net costs relative to usual care.
AHRQ-funded; HS022644.
Citation: McCleskey SG, Shek L, Grein J .
Economic evaluation of quality improvement interventions to prevent catheter-associated urinary tract infections in the hospital setting: a systematic review.
BMJ Qual Saf 2022 Apr;31(4):308-21. doi: 10.1136/bmjqs-2021-013839..
Keywords: Quality Improvement, Quality of Care, Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Hospitals, Healthcare Costs
Grennan M, Kim GH, McConnell KJ
Hospital management practices and medical device costs.
The authors sought to determine whether the variation in prices paid for cardiac medical devices was associated with management practices in cardiac units. Unit prices on management practice scores and other hospital characteristics were regressed for the 11 top-spending cardiac device categories. The authors found that better management practices were associated with lower device prices. They noted that this modest magnitude was similar to other events expected to lower input prices, such as transparency in the form of benchmarking information and hospital mergers.
AHRQ-funded; HS018466.
Citation: Grennan M, Kim GH, McConnell KJ .
Hospital management practices and medical device costs.
Health Serv Res 2022 Apr;57(2):227-36. doi: 10.1111/1475-6773.13898..
Keywords: Medical Devices, Hospitals, Healthcare Costs
Eliason EL, MacDougall H, Peterson L
Understanding the aggressive practices of nonprofit hospitals in pursuit of patient debt.
This study examined the prevalence of extraordinary collection actions (ECAs) and characteristics of nonprofit hospitals that reported this behavior from 2010 to 2016. The authors used Community Benefit Insight data to compare these hospitals with ones that did not report these practices. ECAs include reporting patient debt to credit and collection agencies, filing lawsuits, placing liens on residences, and issuing civil arrest. Hospitals that reported ECAs significantly differed in total revenue, system membership, bed size, urban location, financial assistance policy use, and use of poverty guidelines for discounted care. Lower total hospital revenue was a significant predictor of ECAs.
AHRQ-funded; HS000084.
Citation: Eliason EL, MacDougall H, Peterson L .
Understanding the aggressive practices of nonprofit hospitals in pursuit of patient debt.
Health Soc Work 2022 Jan 31;47(1):36-44. doi: 10.1093/hsw/hlab034..
Keywords: Hospitals, Healthcare Costs, Policy
Herb J, Williams B, Stitzenberg K
Hospital price transparency rules are inadequate to inform patients needing major gastrointestinal cancer operations.
This cross-sectional descriptive study evaluated the hospital price transparency web pages, machine-readable files, and online out-of-pocket cost estimators (OOPCEs) for all National Cancer Institute Designated Clinical Cancer Centers. Findings showed that hospital charges were readily available and the availability of consumer-friendly OOPCEs had improved with the updated price transparency policy. However, the utility of the available information for cancer patients who need a major gastrointestinal operation was limited. Although chargemasters were available for nearly all hospitals, using these to determine what a patient may pay would be very difficult, if not impossible.
AHRQ-funded; HS000032.
Citation: Herb J, Williams B, Stitzenberg K .
Hospital price transparency rules are inadequate to inform patients needing major gastrointestinal cancer operations.
Ann Surg Oncol 2022 Jan;29(1):45-46. doi: 10.1245/s10434-021-10244-2..
Keywords: Hospitals, Healthcare Costs, Surgery
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
David G, Lindrooth RC, Helmchen LA
Do hospitals cross-subsidize?
The authors used repeated shocks to a profitable service in the market for hospital-based medical care to test for cross-subsidization of unprofitable services. They studied how incumbent hospitals adjusted their provision of three uncontested services that are widely considered to be unprofitable. They estimated that the hospitals most exposed to entry reduced their provision of psychiatric, substance-abuse, and trauma care services at a rate of about one uncontested-service admission for every four cardiac admissions they stood to lose.
AHRQ-funded; HS010730.
Citation: David G, Lindrooth RC, Helmchen LA .
Do hospitals cross-subsidize?
J Health Econ 2014 Sep;37:198-218. doi: 10.1016/j.jhealeco.2014.06.007.
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Keywords: Healthcare Costs, Quality of Care, Hospitals
Ryan AM, Mushlin AI
The Affordable Care Act's payment reforms and the future of hospitals.
The author places likely hospital responses to the Affordable Care Act’s payment reforms in the historical context of their previous responses to such reforms as price controls, certificate-of-need laws, and prospective payment systems. He then discusses possible hospital responses to counter readmission penalties, revenue reductions, bundled payment strategies, and accountable care organizations.
AHRQ-funded; HS018546
Citation: Ryan AM, Mushlin AI .
The Affordable Care Act's payment reforms and the future of hospitals.
Ann Intern Med. 2014 May 20;160(10):729-30. doi: 10.7326/M13-2033..
Keywords: Healthcare Costs, Payment, Hospitals, Policy
Bazzoli GJ, Fareed N, Waters TM
Hospital financial performance in the recent recession and implications for institutions that remain financially weak.
This study of 2,971 private short-term general medical or surgical hospitals found that hospitals that were financially weak before the recession remained so during and after the recession. The total margins of nonprofit hospitals declined in 2008 but returned to pre-recession levels by 2011. The recession did not create additional fiscal pressure on hospitals that were previously financially weak or in safety-net roles.
AHRQ-funded; HS020627
Citation: Bazzoli GJ, Fareed N, Waters TM .
Hospital financial performance in the recent recession and implications for institutions that remain financially weak.
Health Aff. 2014 May;33(5):739-45. doi: 10.1377/hlthaff.2013.0988..
Keywords: Healthcare Costs, Hospitals
Ederhof M, Chen LM
Critical access hospitals and cost shifting.
In the context of ongoing discussion about critical access hospital (CAH) reimbursement, it is important to better understand how health care providers currently utilize funds from the CAH Programs. This study found that among hospitals converted to CAH designation while part of a hospital system, the relative proportion of costs that reflect shared services provided by the parent organization is significantly higher than would be expected in the post-conversion period.
AHRQ-funded; HS020671.
Citation: Ederhof M, Chen LM .
Critical access hospitals and cost shifting.
JAMA Intern Med 2014 Jan;174(1):143-4. doi: 10.1001/jamainternmed.2013.11901..
Keywords: Hospitals, Healthcare Costs, Health Services Research (HSR)
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