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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Behavioral Health (1)
- Cardiovascular Conditions (1)
- Caregiving (1)
- Children/Adolescents (2)
- Depression (1)
- Elderly (7)
- Electronic Health Records (EHRs) (1)
- Emergency Department (10)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Healthcare Utilization (1)
- Heart Disease and Health (2)
- (-) Hospital Discharge (19)
- Hospitalization (5)
- (-) Hospital Readmissions (19)
- Hospitals (3)
- Injuries and Wounds (1)
- Medicare (4)
- Nursing (1)
- Nursing Homes (2)
- Outcomes (4)
- Patient-Centered Outcomes Research (2)
- Primary Care (1)
- Quality Improvement (1)
- Quality of Care (1)
- Rehabilitation (1)
- Risk (1)
- Rural Health (1)
- Social Determinants of Health (1)
- Surgery (2)
- Transitions of Care (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 19 of 19 Research Studies DisplayedParedes AZ, Malik AT, Cluse M
Discharge disposition to skilled nursing facility after emergent general surgery predicts a poor prognosis.
Emergency general surgery can have a profound impact on the functional status of even previously independent patients. In this study, the investigators examined the role and influence of discharging a patient to a skilled nursing facility. They concluded that after accounting for patient severity and perioperative course, discharge to a skilled nursing facility was an independent risk factor for death, readmission, and postdischarge complications.
AHRQ-funded; HS022694.
Citation: Paredes AZ, Malik AT, Cluse M .
Discharge disposition to skilled nursing facility after emergent general surgery predicts a poor prognosis.
Surgery 2019 Oct;166(4):489-95. doi: 10.1016/j.surg.2019.04.034..
Keywords: Nursing Homes, Hospital Discharge, Elderly, Ambulatory Care and Surgery, Emergency Department, Outcomes, Hospital Readmissions, Outcomes, Risk
Statile AM, White CM, Sucharew HJ
Comparison of parent report with administrative data to identify pediatric reutilization following hospital discharge.
Healthcare providers rely on historical data reported by parents to make medical decisions. The Hospital to Home Outcomes (H2O) trial assessed the effects of a onetime home nurse visit following pediatric hospitalization for common conditions. In this study, the investigators sought to compare parent recall of reutilization events two weeks after discharge with administrative records.
AHRQ-funded; HS024735.
Citation: Statile AM, White CM, Sucharew HJ .
Comparison of parent report with administrative data to identify pediatric reutilization following hospital discharge.
J Hosp Med 2019 Jul;14(7):411-14. doi: 10.12788/jhm.3200..
Keywords: Children/Adolescents, Caregiving, Hospital Discharge, Hospital Readmissions, Hospitals
Weerahandi H, Li L, Bao H
Risk of readmission after discharge from skilled nursing facilities following heart failure hospitalization: a retrospective cohort study.
The goal of this study was to examine outcomes for Medicare patients who were hospitalized with heart failure and who had a subsequent skilled nursing facility (SNF) stay of 30 days or less. Patients were categorized by their length of stay in the SNF and followed for the 30 days after their discharge from the SNF to home. Overall, nearly one-quarter of the SNF discharges to home were readmitted within the 30 day follow-up period. The rate of readmission was highest during the first two days home, but this risk was attenuated by a longer SNF length of stay. The authors conclude that interventions to reduce readmissions may be more effective if they incorporate patient transitions from SNF to home.
AHRQ-funded; HS022882.
Citation: Weerahandi H, Li L, Bao H .
Risk of readmission after discharge from skilled nursing facilities following heart failure hospitalization: a retrospective cohort study.
J Am Med Dir Assoc 2019 Apr;20(4):432-37. doi: 10.1016/j.jamda.2019.01.135..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Hospital Discharge, Hospital Readmissions, Hospitalization, Nursing Homes
Markham JL, Richardson T, Hall M
Association of weekend admission and weekend discharge with length of stay and 30-day readmission in children's hospitals.
Worse outcomes among adults presenting for/receiving care on weekends (ie, "the weekend effect") have been observed for many diseases. However, little is known about the overall impact of the weekend effect in hospitalized children. The purpose of this study was to determine the association between 1.) weekend admission and length of stay (LOS) and 2.) weekend discharge and 30-day all-cause readmission.
AHRQ-funded; HS024735.
Citation: Markham JL, Richardson T, Hall M .
Association of weekend admission and weekend discharge with length of stay and 30-day readmission in children's hospitals.
J Hosp Med 2019 Feb;14(2):75-82. doi: 10.12788/jhm.3085..
Keywords: Children/Adolescents, Hospitals, Hospital Readmissions, Hospital Discharge, Hospitalization
Mitchell SE, Martin JM, Krizman K
Design and rationale for a randomized controlled trial to reduce readmissions among patients with depressive symptoms.
This study aims to examine the effectiveness of RED-D, a modified brief Cognitive behavioral therapy (CBT) protocol delivered as a post-discharge extension of the Re-Engineered Discharge (RED), in reducing 30-day readmissions rates and emergency department use as well as depressive symptoms for medical patients with comorbid depressive symptoms.
AHRQ-funded; HS019700.
Citation: Mitchell SE, Martin JM, Krizman K .
Design and rationale for a randomized controlled trial to reduce readmissions among patients with depressive symptoms.
Contemp Clin Trials 2015 Nov;45(Pt B):151-6. doi: 10.1016/j.cct.2015.08.016.
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Keywords: Depression, Emergency Department, Hospital Discharge, Hospital Readmissions, Behavioral Health
Blecker S, Goldfeld K, Park H
Impact of an intervention to improve weekend hospital care at an academic medical center: an observational study.
The purpose of this study was to evaluate the impact of a weekend hospital intervention on processes of care and clinical outcomes. The multifaceted intervention included expanded weekend diagnostic services, improved weekend discharge processes, and increased physician and care management services on weekends. The intervention was associated with a reduction in length of stay and an increase in weekend discharges.
AHRQ-funded; HS023683.
Citation: Blecker S, Goldfeld K, Park H .
Impact of an intervention to improve weekend hospital care at an academic medical center: an observational study.
J Gen Intern Med 2015 Nov;30(11):1657-64. doi: 10.1007/s11606-015-3330-6.
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Keywords: Quality Improvement, Quality of Care, Hospitals, Hospital Discharge, Hospital Readmissions, Healthcare Delivery, Outcomes, Patient-Centered Outcomes Research
Singh S, Lin YL, Nattinger AB
Variation in readmission rates by emergency departments and emergency department providers caring for patients after discharge.
This study of Texas acute-care hospitals and ED facilities has found that the risk of readmission varies by ED provider caring for patients after discharge. A large part of this variation is explained by the ED facility in which the ED providers practice. Thus, ED provider practices patterns and ED facility systems of care may be a target for interventions to reduce readmissions.
AHRQ-funded; HS022134.
Citation: Singh S, Lin YL, Nattinger AB .
Variation in readmission rates by emergency departments and emergency department providers caring for patients after discharge.
J Hosp Med 2015 Nov;10(11):705-10. doi: 10.1002/jhm.2407.
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Keywords: Emergency Department, Elderly, Hospital Discharge, Hospital Readmissions, Medicare
Leland NE, Gozalo P, Christian TJ
An examination of the first 30 days after patients are discharged to the community from hip fracture postacute care.
This study examined the percentage of PAC patients who remain in the community at least 30 days after discharge (i.e., successful community discharge) after hip fracture rehabilitation and described differences among PAC facilities based on this outcome. It found that between 1999 and 2007, 57 percent of patients achieved successful community discharge. Black were less likely than similar whites to achieve successful community discharge.
AHRQ-funded; HS000011.
Citation: Leland NE, Gozalo P, Christian TJ .
An examination of the first 30 days after patients are discharged to the community from hip fracture postacute care.
Med Care 2015 Oct;53(10):879-87. doi: 10.1097/mlr.0000000000000419..
Keywords: Rehabilitation, Injuries and Wounds, Hospital Discharge, Hospital Readmissions, Outcomes
Acher AW, LeCaire TJ, Hundt AS
Using human factors and systems engineering to evaluate readmission after complex surgery.
The study objective was to use a human factors and systems engineering approach to understand contributors to surgical readmissions from a patient and provider perspective. Patients and clinician providers identified a number of factors during the transition of care that may have contributed to readmission, including poor patient and caregiver understanding; inadequate discharge preparation for home care; insufficient educational process and materials.
AHRQ-funded; HS022446.
Citation: Acher AW, LeCaire TJ, Hundt AS .
Using human factors and systems engineering to evaluate readmission after complex surgery.
J Am Coll Surg 2015 Oct;221(4):810-20. doi: 10.1016/j.jamcollsurg.2015.06.014..
Keywords: Surgery, Hospital Readmissions, Hospital Discharge, Transitions of Care, Electronic Health Records (EHRs)
Toth M, Holmes M, Van Houtven C
Rural Medicare beneficiaries have fewer follow-up visits and greater emergency department use postdischarge.
This study tested whether rural Medicare beneficiaries have a lower likelihood of follow-up care and greater likelihood of a readmission and ED visit within 30 days postdischarge, compared with urban beneficiaries. The results provide evidence of lower quality postdischarge care for Medicare beneficiaries in rural settings.
AHRQ-funded; HS000032.
Citation: Toth M, Holmes M, Van Houtven C .
Rural Medicare beneficiaries have fewer follow-up visits and greater emergency department use postdischarge.
Med Care 2015 Sep;53(9):800-8. doi: 10.1097/mlr.0000000000000401..
Keywords: Rural Health, Elderly, Medicare, Hospital Readmissions, Emergency Department, Hospital Discharge
Williams TP, Dimou FM, Adhikari D
Hospital readmission after emergency room visit for cholelithiasis.
This study evaluated the surgical follow-up and outcomes in patients seen in the emergency department (ED) for an episode of symptomatic cholelithiasis and discharged home for elective follow-up. It found that the failure to achieve a timely surgical follow-up leads to multiple ED readmissions and emergent gallstone-related hospitalizations, including emergency cholecystectomy.
AHRQ-funded; HS022134.
Citation: Williams TP, Dimou FM, Adhikari D .
Hospital readmission after emergency room visit for cholelithiasis.
J Surg Res 2015 Aug;197(2):318-23. doi: 10.1016/j.jss.2015.04.032..
Keywords: Hospital Readmissions, Patient-Centered Outcomes Research, Emergency Department, Hospital Discharge, Surgery
Carey K
Measuring the hospital length of stay/readmission cost trade-off under a bundled payment mechanism.
This paper investigates the relationship between length of stay and readmission within 30 days of discharge from an acute care hospitalization. It found that the cost of an additional day of stay was offset by expected cost savings from an avoided readmission in the range of 15 to 65 percent.
AHRQ-funded; HS020995.
Citation: Carey K .
Measuring the hospital length of stay/readmission cost trade-off under a bundled payment mechanism.
Health Econ 2015 Jul;24(7):790-802. doi: 10.1002/hec.3061..
Keywords: Hospital Readmissions, Hospitalization, Elderly, Hospital Discharge, Medicare
Field TS, Ogarek J, Garber L
Association of early post-discharge follow-up by a primary care physician and 30-day rehospitalization among older adults.
The researchers aimed to determine whether an office visit with a primary care physician within 7 days after discharge is associated with 30-day rehospitalization. Of 3,661 patients discharged to home during the study year, 1,808 received an office visit within 7 days and of these, 1,000 were with a primary care physician. No protective effect for office visits within 7 days was found.
AHRQ-funded; HS017203.
Citation: Field TS, Ogarek J, Garber L .
Association of early post-discharge follow-up by a primary care physician and 30-day rehospitalization among older adults.
J Gen Intern Med 2015 May;30(5):565-71. doi: 10.1007/s11606-014-3106-4..
Keywords: Hospital Readmissions, Primary Care, Hospital Discharge, Elderly, Healthcare Costs
Hinami K, Smith J, Deamant CD
When do patient-reported outcome measures inform readmission risk?
The study sought was to characterize changes in patient-reported outcome measures from hospital discharge to assess when they best inform risk of utilization as defined by readmissions or emergency department use. It concluded that routine measurement of patient-reported outcomes can help identify patients at higher risk for utilizations. For example, in-hospital assessments revealing high symptom burden and poor health status predicted 14-day reutilization.
AHRQ-funded; HS019481.
Citation: Hinami K, Smith J, Deamant CD .
When do patient-reported outcome measures inform readmission risk?
J Hosp Med 2015 May;10(5):294-300. doi: 10.1002/jhm.2366..
Keywords: Emergency Department, Healthcare Utilization, Hospital Discharge, Hospital Readmissions, Outcomes
Shy BD, Shapiro JS, Shearer PL
A conceptual framework for improved analyses of 72-hour return cases.
The researchers describe the potential importance and limitations of reviewing cases where patients return to emergency departments (EDs) within 72-hours of discharge. They outline a novel framework for carrying out this practice. Within this framework, they describe the selection, training, and monitoring of QA reviewers, the attention reviewers should give to returning ED patients who are subsequently admitted, as well as several other topics.
AHRQ-funded; HS021261.
Citation: Shy BD, Shapiro JS, Shearer PL .
A conceptual framework for improved analyses of 72-hour return cases.
Am J Emerg Med 2015 Jan;33(1):104-7. doi: 10.1016/j.ajem.2014.08.005..
Keywords: Emergency Department, Hospital Discharge, Hospital Readmissions
Gabayan GZ, Sarkisian CA, Liang LJ
Predictors of admission after emergency department discharge in older adults.
The objective of this study was to identify the incidence and predictors of admissions to nonfederal California hospitals within 7 days of ED discharge of older Medicare beneficiaries. It found that five percent of older Medicare beneficiaries have a hospital inpatient admission after discharge from the ED, with chronic disease such as renal disease and heart failure being associated with the greatest odds of admission.
AHRQ-funded; HS18098.
Citation: Gabayan GZ, Sarkisian CA, Liang LJ .
Predictors of admission after emergency department discharge in older adults.
J Am Geriatr Soc 2015 Jan;63(1):39-45. doi: 10.1111/jgs.13185..
Keywords: Elderly, Emergency Department, Hospital Discharge, Hospital Readmissions, Medicare
Goldman LE, Sarkar U, Kessell E
Support from hospital to home for elders: a randomized trial.
The researchers studied a peridischarge, nurse-led intervention combined with telephone follow-up designed to reduce readmissions among patients who were 55 or older. They found that the nurse-led, in-hospital discharge support intervention did not show a reduction in readmissions or ED visits among 700 diverse, low-income older adults at a safety-net hospital.
AHRQ-funded; HS018090.
Citation: Goldman LE, Sarkar U, Kessell E .
Support from hospital to home for elders: a randomized trial.
Ann Intern Med 2014 Oct 7;161(7):472-81. doi: 10.7326/m14-0094..
Keywords: Hospital Discharge, Hospital Readmissions, Emergency Department, Elderly, Social Determinants of Health, Nursing
Carey K, Lin MY
Hospital length of stay and readmission: an early investigation.
This study is a retrospective examination of the association between length of stay in an index hospitalization and readmission within 7 days and within 30 days of discharge. It found negative associations between length of stay and readmission probability, particularly for heart attack patients; however, the magnitude of the effect was modest for heart attack.
AHRQ-funded; HS020995.
Citation: Carey K, Lin MY .
Hospital length of stay and readmission: an early investigation.
Med Care Res Rev 2014 Feb;71(1):99-111. doi: 10.1177/1077558713504998..
Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Hospital Readmissions, Hospitalization, Hospital Discharge
Mitchell SE, Gardiner PM, Sadikova E
Patient activation and 30-day post-discharge hospital utilization.
This study examining the role of patient activation in the rate of hospital readmission within 30 days of discharge found that adult medical patients in an urban academic safety net hospital with lower levels of patient activation had a higher rate of post-discharge 30-day hospital utilization.
AHRQ-funded; HS019771.
Citation: Mitchell SE, Gardiner PM, Sadikova E .
Patient activation and 30-day post-discharge hospital utilization.
J Gen Intern Med. 2014 Feb;29(2):349-55. doi: 10.1007/s11606-013-2647-2..
Keywords: Emergency Department, Hospital Discharge, Hospital Readmissions, Hospitalization