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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 18 of 18 Research Studies DisplayedMyong C, Hull P, Price M
The impact of funding for federally qualified health centers on utilization and emergency department visits in Massachusetts.
This retrospective study examined the impact of funding for federally qualified health centers (FQHCs) on utilization and emergency department (ED) visits in Massachusetts. The authors theorized that greater funding for FQHCs could increase the local availability of clinic-based care and reduce more costly resource use, such as ED visits. Data from the Massachusetts All Payer Claims Database (APCD) 2010-2013 was used that included enrollees in 559 Massachusetts ZIP codes (2010 numbers 6,173,563). They calculated shift-share predictions of changes in FQHC funding at the ZIP code-level for FQHCs that received Community Health Center funds in any year. They found that a standard deviation increase in prior year FQHC funding (31%) was associated with a 2.3% increase in enrollees with FQHC visits and a 1.3% decrease in enrollees at EDs. However, there were no significant changes in emergent ED visit rates.
AHRQ-funded; HS025378.
Citation: Myong C, Hull P, Price M .
The impact of funding for federally qualified health centers on utilization and emergency department visits in Massachusetts.
PLoS One 2020 Dec 3;15(12):e0243279. doi: 10.1371/journal.pone.0243279..
Keywords: Community-Based Practice, Healthcare Utilization, Emergency Department, Healthcare Costs, Access to Care, Vulnerable Populations, Policy
Ramgopal S, Aronson PL, Marin JR
United States' emergency department visits for fever by young children 2007-2017.
The authors estimated rates of emergency department (ED) visits for fever by children less than 2 years of age and evaluated frequencies of testing and treatment during these visits. They found that, given existing guidelines, blood and urine culture performance was low for infants up to 90 days old. For children 91 days up to 2 years, rates of radiography and antibiotic use were higher in general EDs compared to pediatric EDs. They concluded that their findings suggest opportunities to improve care among febrile young children in the ED.
AHRQ-funded; HS026006.
Citation: Ramgopal S, Aronson PL, Marin JR .
United States' emergency department visits for fever by young children 2007-2017.
West J Emerg Med 2020 Oct 27;21(6):146-51. doi: 10.5811/westjem.2020.8.47455..
Keywords: Children/Adolescents, Emergency Department, Healthcare Utilization
Martsolf GR, Nuckols TK, Fingar KR
AHRQ Author: Stocks C, Owens PL
Nonspecific chest pain and hospital revisits within 7 days of care: variation across emergency department, observation and inpatient visits.
The purpose of this study was to compare the rate at which patients with nonspecific chest pain return to the hospital within 7 days after index observation visits versus after index emergency department and inpatient visits. Findings showed that up to 1 in 10 patients discharged with nonspecific chest pain returned to the hospital within 1week. Compared with emergency department and inpatient care, observation visits were associated with lower revisit rates. Recommendations include further research to refine clinical standards of care for nonspecific chest pain as well as to investigate the healthcare delivery and patient factors that influence 7-day revisit rates.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Martsolf GR, Nuckols TK, Fingar KR .
Nonspecific chest pain and hospital revisits within 7 days of care: variation across emergency department, observation and inpatient visits.
BMC Health Serv Res 2020 Jun 8;20(1):516. doi: 10.1186/s12913-020-05200-x..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Pain, Healthcare Utilization, Hospitals, Heart Disease and Health, Cardiovascular Conditions
Freeman RE, Boggs KM, Zachrison KS
National study of telepsychiatry use in U.S. emergency departments.
This study examined the use of telepsychiatry in US emergency departments (EDs). A survey was conducted of all 5,375 US EDs in 2016. The survey found that about 20% reported receiving telepsychiatry. EDs that utilized telepsychiatry the most tended to have higher annual total visit volumes, rural location, and Critical Access Hospital designation. Autonomous freestanding EDs tended to have a lower likelihood of telepsychiatry use. The majority (59%) reported telepsychiatry as their only form of emergency psychiatric services and 25% received services at least once a day. The most common uses were admission or discharge decisions (80%) and transfer coordination (76%).
AHRQ-funded; HS024561.
Citation: Freeman RE, Boggs KM, Zachrison KS .
National study of telepsychiatry use in U.S. emergency departments.
Psychiatr Serv 2020 Jun;71(6):540-46. doi: 10.1176/appi.ps.201900237..
Keywords: Emergency Department, Telehealth, Health Information Technology (HIT), Behavioral Health, Healthcare Utilization
Kovalerchik O, Powers E, Holland ML
Differences in frequency of visits to pediatric primary care practices and emergency departments by body mass index.
The purpose of this retrospective study was to examine differences in utilization across health care settings among children by body mass index (BMI) categories to help identify opportunities for interventions. The authors concluded that the children's BMI categories were associated with health care utilization, specifically primary care visits, ED visits, and hospitalizations.
AHRQ-funded; HS024332.
Citation: Kovalerchik O, Powers E, Holland ML .
Differences in frequency of visits to pediatric primary care practices and emergency departments by body mass index.
Acad Pediatr 2020 May-Jun;20(4):532-39. doi: 10.1016/j.acap.2019.12.011..
Keywords: Children/Adolescents, Primary Care, Emergency Department, Obesity, Healthcare Utilization
Melnikow J, Evans E, Xing G
Primary care access to new patient appointments for California Medicaid enrollees: a simulated patient study.
Investigators evaluated variation in the availability of primary care new patient appointments for Medi-Cal (California Medicaid) enrollees in Northern California and its relationship to emergency department (ED) use after Medicaid expansion. Data from the California Health Interview Survey, Medi-Cal enrollment reports, and California hospital discharge records were used. The investigators found that access to primary care in Northern California was limited for new patient Medi-Cal enrollees and varied across counties, despite standard statewide reimbursement rates. Further, counties with more limited access to primary care new patient appointments had higher ED use by Medi-Cal enrollees.
AHRQ-funded; HS022236.
Citation: Melnikow J, Evans E, Xing G .
Primary care access to new patient appointments for California Medicaid enrollees: a simulated patient study.
Ann Fam Med 2020 May;18(3):210-17. doi: 10.1370/afm.2502..
Keywords: Primary Care, Access to Care, Medicaid, Health Insurance, Emergency Department, Healthcare Utilization
Brown CS, Yang J, Meng Z
Trends in emergency department utilization following common operations in New York State, 2005-2014.
Researchers examined emergency department (ED) utilization following three common surgeries: cholecystectomy, appendectomy, and inguinal hernia repair. A longitudinal analysis was conducted using data from the SPARCS New York (NY) administrative database on 746,633 who underwent those procedures from 2005 to 2014. Nearly 1 in 10 patients who underwent cholecystectomy or appendectomy and 1 in 20 patients went to the ED after discharge. Of those, only 9.5% cholecystectomy, 9.1% appendectomy, and 5.1% inguinal hernia repair patients were readmitted indicating possible overutilization of the ED following common operations.
AHRQ-funded; HS025778; HS000053.
Citation: Brown CS, Yang J, Meng Z .
Trends in emergency department utilization following common operations in New York State, 2005-2014.
Surg Endosc 2020 May;34(5):1994-99. doi: 10.1007/s00464-019-06975-9..
Keywords: Emergency Department, Surgery, Healthcare Utilization
Beiser DG, Ward CE, Vu M
Depression in emergency department patients and association with health care utilization.
Depression is one of the most common illnesses in the United States, with increased prevalence among people with lower socioeconomic status and chronic mental illness who often seek care in the emergency department (ED). The investigators sought to estimate the rate and severity of major depressive disorder (MDD) in a nonpsychiatric ED population and its association with subsequent ED visits and hospitalizations.
AHRQ-funded; HS000084; HS025889.
Citation: Beiser DG, Ward CE, Vu M .
Depression in emergency department patients and association with health care utilization.
Acad Emerg Med 2019 Aug;26(8):878-88. doi: 10.1111/acem.13726..
Keywords: Depression, Emergency Department, Healthcare Utilization, Hospitalization, Behavioral Health
Gillespie SM, Wasserman EB, Wood NE
High-intensity telemedicine reduces emergency department use by older adults with dementia in senior living communities.
Individuals with dementia have high rates of emergency department (ED) use for acute illnesses. In this study, the investigators evaluated the effect of a high-intensity telemedicine program that delivered care for acute illnesses on ED use rates for individuals with dementia residing in senior living communities (SLCs; independent and assisted living).
AHRQ-funded; HS018047.
Citation: Gillespie SM, Wasserman EB, Wood NE .
High-intensity telemedicine reduces emergency department use by older adults with dementia in senior living communities.
J Am Med Dir Assoc 2019 Aug;20(8):942-46. doi: 10.1016/j.jamda.2019.03.024..
Keywords: Elderly, Telehealth, Health Information Technology (HIT), Dementia, Neurological Disorders, Healthcare Delivery, Chronic Conditions, Emergency Department, Healthcare Utilization
Durojaiye AB, Levin S, Toerper M
Evaluation of multidisciplinary collaboration in pediatric trauma care using EHR data.
This study electronic health record (EHR) data to compare usage patterns from pediatric trauma patients with minor injuries at a Level I pediatric trauma center. The data was used to compare demographics, clinical and network characteristics, and emergency department (ED) length of stay (LOS). Three distinct groups were compared: fully connected, partially connected, and disconnected. The fully connected group had a decreased ED LOS compared with the partially connected group.
AHRQ-funded; HS023837.
Citation: Durojaiye AB, Levin S, Toerper M .
Evaluation of multidisciplinary collaboration in pediatric trauma care using EHR data.
J Am Med Inform Assoc 2019 Jun;26(6):506-15. doi: 10.1093/jamia/ocy184..
Keywords: Children/Adolescents, Trauma, Electronic Health Records (EHRs), Health Information Technology (HIT), Emergency Department, Healthcare Utilization
Hongs S AS, Froehlich T, Clayton Hobbs S
Impact of a cancer urgent care clinic on regional emergency department visits.
In this study, the researchers investigated whether the creation of an urgent care clinic specifically for patients with cancer affected emergency department visits among adults newly diagnosed with cancer? They concluded that although only one in eight emergency department-visiting patients also used the urgent care clinic, the growth rate of emergency department visits fell by half after the urgent care clinic was established.
AHRQ-funded; HS022418.
Citation: Hongs S AS, Froehlich T, Clayton Hobbs S .
Impact of a cancer urgent care clinic on regional emergency department visits.
J Oncol Pract 2019 Jun;15(6):e501-e09. doi: 10.1200/jop.18.00743..
Keywords: Cancer, Emergency Department, Hospitalization, Healthcare Utilization, Ambulatory Care and Surgery
Vogel JA, Gannon Sungar W, Boatright D
Denver ED Trauma Organ Failure Score predicts healthcare resource utilization in adult trauma patients.
This study examined the success of the Denver Emergency Department (ED) Trauma Organ Failure (TOF) Score and the need for specialized healthcare resources for trauma patients. Outcomes measured included intensive care unit (ICU) length of stay (LOS), hospital LOS, procedures and costs. They included 3000 patients with 71% of them male, a median age of 42, and median injury severity score of 9 (IQR 5-16). Of that total, 46% were admitted to the ICU and 4% died. The tool was found to successfully predict healthcare resource utilization and can be used to identify patients early after injury that will require specialized trauma care.
AHRQ-funded; HS023901.
Citation: Vogel JA, Gannon Sungar W, Boatright D .
Denver ED Trauma Organ Failure Score predicts healthcare resource utilization in adult trauma patients.
Am J Emerg Med 2019 Jun;37(6):1108-13. doi: 10.1016/j.ajem.2018.08.073..
Keywords: Emergency Department, Healthcare Utilization, Outcomes, Trauma
Hanchate AD, Dyer KS, Paasche-Orlow MK
Disparities in emergency department visits among collocated racial/ethnic Medicare enrollees.
In this retrospective cohort study, the investigators estimated emergency department (ED) use differences across Medicare enrollees of different race/ethnicity who were residing in the same zip codes. The investigators found that among Medicare enrollees, blacks and Hispanics had higher ED use rates than whites overall and among subgroups by demographics and socioeconomic status.
AHRQ-funded; HS022242.
Citation: Hanchate AD, Dyer KS, Paasche-Orlow MK .
Disparities in emergency department visits among collocated racial/ethnic Medicare enrollees.
Ann Emerg Med 2019 Mar;73(3):225-35. doi: 10.1016/j.annemergmed.2018.09.007..
Keywords: Disparities, Emergency Department, Healthcare Utilization, Medicare, Racial and Ethnic Minorities
Burgdorf J, Mulcahy J, Amjad H
Family caregiver factors associated with emergency department utilization among community-living older adults with disabilities.
This study examined characteristics of family caregivers of older community-living adults with disabilities that use emergency departments (EDs). They found in their sample of 2521 community-living older adults that have visited the ED one or more times within 12 months of their interview that the primary caregivers provided greater than 40 hours of care per week, helped with health care tasks, or experienced physical strain.
AHRQ-funded; HS000029.
Citation: Burgdorf J, Mulcahy J, Amjad H .
Family caregiver factors associated with emergency department utilization among community-living older adults with disabilities.
J Prim Care Community Health 2019 Jan-Dec;10:2150132719875636. doi: 10.1177/2150132719875636..
Keywords: Elderly, Emergency Department, Disabilities, Healthcare Utilization, Caregiving
Meyers DJ, Chien AT, Nguyen KH
Association of team-based primary care with health care utilization and costs among chronically ill patients.
This study analyzed the value of team-based care practice on the treatment of patients, especially those with multiple chronic conditions. A large study was conducted using data from 18 academically affiliated primary care practices in the Boston, Massachusetts, area between 2011 and 2015. The study included 83,953 patients total with 19% of patients being younger than 18 years and the rest from 19-64 years of age. For patients with multiple chronic conditions, there was a statistically significant reduction in hospitalizations and emergency department visits. Among patients with less than 2 comorbidities, there was an increase in outpatient visits, hospitalizations and ambulatory care hospitalizations.
AHRQ-funded; HS000011.
Citation: Meyers DJ, Chien AT, Nguyen KH .
Association of team-based primary care with health care utilization and costs among chronically ill patients.
JAMA Intern Med 2019 Jan;179(1):54-61. doi: 10.1001/jamainternmed.2018.5118..
Keywords: Chronic Conditions, Emergency Department, Healthcare Costs, Healthcare Utilization, Primary Care, Teams
Hwang SW, Chambers C, Chiu S
A comprehensive assessment of health care utilization among homeless adults under a system of universal health insurance.
The researchers comprehensively assessed health care utilization in a population-based sample of homeless adults and matched controls under a universal health insurance system. They found that homeless people had substantially higher rates of ED and hospital use than general population controls; these rates were largely driven by a subset of homeless persons with extremely high-intensity usage of health services.
AHRQ-funded; HS014129.
Citation: Hwang SW, Chambers C, Chiu S .
A comprehensive assessment of health care utilization among homeless adults under a system of universal health insurance.
Am J Public Health 2013 Dec;103 Suppl 2:S294-301. doi: 10.2105/ajph.2013.301369..
Keywords: Healthcare Utilization, Social Determinants of Health, Emergency Department, Emergency Medical Services (EMS)
Shapiro JS, Johnson SA, Angiollilo J
Health information exchange improves identification of frequent emergency department users.
The goal of the project was to measure the incremental increase in the number of frequent ED users who were identified when data
from all EDs participating in an health information exchange were compared with site-specific data. When the researchers analyzed HIE-wide data instead of site-specific data, they identified 20.3 percent more frequent ED users and 16.0 percent more visits by them to the ED.
from all EDs participating in an health information exchange were compared with site-specific data. When the researchers analyzed HIE-wide data instead of site-specific data, they identified 20.3 percent more frequent ED users and 16.0 percent more visits by them to the ED.
AHRQ-funded; HS021261.
Citation: Shapiro JS, Johnson SA, Angiollilo J .
Health information exchange improves identification of frequent emergency department users.
Health Aff 2013 Dec;32(12):2193-8. doi: 10.1377/hlthaff.2013.0167..
Keywords: Data, Emergency Department, Healthcare Utilization, Health Information Exchange (HIE), Health Information Technology (HIT)
Chambers C, Chiu S, Katic M
High utilizers of emergency health services in a population-based cohort of homeless adults.
This study identified predictors of frequent emergency department (ED) use among a population-based sample of homeless adults in Toronto, Ontario. It found that among homeless adults with universal health insurance, a small subgroup accounted for the majority of visits to emergency services. Frequent use was driven by multiple predisposing, enabling, and need factors.
AHRQ-funded; HS014129.
Citation: Chambers C, Chiu S, Katic M .
High utilizers of emergency health services in a population-based cohort of homeless adults.
Am J Public Health 2013 Dec;103 Suppl 2:S302-10. doi: 10.2105/ajph.2013.301397..
Keywords: Emergency Department, Social Determinants of Health, Health Insurance, Healthcare Utilization