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AHRQ Research Studies Date
Topics
- Access to Care (3)
- Brain Injury (1)
- Cardiovascular Conditions (3)
- Comparative Effectiveness (2)
- COVID-19 (1)
- Elderly (5)
- Evidence-Based Practice (1)
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- Patient-Centered Outcomes Research (4)
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- Quality Indicators (QIs) (1)
- (-) Rehabilitation (13)
- Rural Health (1)
- Stroke (2)
- Substance Abuse (1)
- Surgery (1)
- Trauma (1)
- Urban Health (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 DisplayedKittelson AJ, Loyd BJ, Graber J
Examination of exclusion criteria in total knee arthroplasty rehabilitation trials: influence on the application of evidence in day-to-day practice.
This study investigated whether total knee arthroplasty (TKA) patients seen in routine practice who meet common exclusion criteria in clinical trials recover differently compared to research-eligible patients. Postoperative functional outcomes were compared using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Timed Up and Go (TUG). A total of 2,528 participants from 27 trials were compared to 474 patients from the clinical dataset. Research participants were older, with lower BMI than patients in the clinical dataset. There were no differences observed in functional recovery rate between groups, except for patients with diabetes whose TUG recovered more slowly than “eligible” patients.
AHRQ-funded; HS024316.
Citation: Kittelson AJ, Loyd BJ, Graber J .
Examination of exclusion criteria in total knee arthroplasty rehabilitation trials: influence on the application of evidence in day-to-day practice.
J Eval Clin Pract 2021 Dec;27(6):1335-42. doi: 10.1111/jep.13564..
Keywords: Orthopedics, Surgery, Rehabilitation, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Capo-Lugo CE, Askew RL, Boebel M
A comparative approach to quantifying provision of acute therapy services.
This study’s objective was to compare delivery of acute rehabilitation therapy using metrics reflecting distinct aspects of rehabilitation therapy services. Seven general medical-surgical hospitals in Illinois and Indiana prospectively collected de-identified rehabilitation therapy data. The data looked at 35,449 patients who received any type of acute rehabilitation therapy. Metrics recorded by therapists included therapy types, total minutes, and minutes per day (intensity). Extended hospital stay was defined as length of stay (LOS) longer than Medicare’s geometric mean LOS. The odds of an extended hospital stay increased with increased number of minutes, increased number of therapy types, and decreased with increased rehabilitation intensity.
AHRQ-funded; HS000078.
Citation: Capo-Lugo CE, Askew RL, Boebel M .
A comparative approach to quantifying provision of acute therapy services.
Medicine 2021 Oct 8;100(40):e27377. doi: 10.1097/md.0000000000027377.
AHRQ-funded; HS000078..
AHRQ-funded; HS000078..
Keywords: Rehabilitation, Healthcare Delivery
Clair K, Ijadi-Maghsoodi R, Nazinyan M
Veteran perspectives on adaptations to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic.
This paper looks at veterans’ perspectives on adaptations made to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic. Adaptations to services are described within a large residential rehabilitation program for under-resourced veterans; reports veterans’ experiences; and outlines successes and challenges encountered. Data was collected from two focus groups with nine veterans in the program. The groups highlighted experiences of inconsistent communication about residential policies, interruptions to medical and addiction services, and feelings of confinement and social isolation.
AHRQ-funded; HS026407.
Citation: Clair K, Ijadi-Maghsoodi R, Nazinyan M .
Veteran perspectives on adaptations to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic.
Community Ment Health J 2021 Jul;57(5):801-07. doi: 10.1007/s10597-021-00810-z..
Keywords: Substance Abuse, Rehabilitation, COVID-19, Healthcare Delivery, Access to Care, Patient Experience
Anderson MC, Evans E, Zonfrillo MR
Rural/urban differences in discharge from rehabilitation in older adults with traumatic brain injury.
This study compared differences in outcomes for older adults with traumatic brain injury (TBI) in rural and urban settings by 1) comparing the rates of successful community discharge; and 2) reasons for not achieving successful discharge. This retrospective national cohort study looked at skilled nursing facility (SNF) patients aged 66 and older using Medicare inpatient claims with Minimum Data Set assessments. A total of 11,771 SNFs were identified with a total population of 61,021 Medicare beneficiaries discharged to a SNF following hospitalization for TBI between 2011 and 2015. Patients in rural settings had lower rates of successful discharge compared with patients in urban settings (52.1% vs 58.5%). Reasons for unsuccessful discharge differed between rural and urban settings with rural patients less likely to discharged from SNF within 100 days although they were less likely to be rehospitalized within 30 days of SNF discharge.
AHRQ-funded; HS000011.
Citation: Anderson MC, Evans E, Zonfrillo MR .
Rural/urban differences in discharge from rehabilitation in older adults with traumatic brain injury.
J Am Geriatr Soc 2021 Jun;69(6):1601-08. doi: 10.1111/jgs.17065..
Keywords: Elderly, Brain Injury, Trauma, Rural Health, Urban Health, Rehabilitation, Nursing Homes
Reistetter TA, Eschbach K K, Prochaska J
Understanding variation in postacute care: developing rehabilitation service areas through geographic mapping.
This study’s goal was to demonstrate a method for developing rehabilitation service areas for post-acute care. A secondary analysis of 2013-2014 Medicare records for older patients in Texas (n = 469,172) was conducted. The analysis included admission records for inpatient rehabilitation facilities, skilled nursing facilities, and long-term care hospitals. The authors used Ward’s algorithm to cluster patient ZIP code tabulation areas based on which facilities patients were admitted to for rehabilitation. They set the number of rehabilitation clusters to 22 to allow for comparison to the 22 hospital referral regions. Interclass Correlation Coefficient (ICC) and variance in the number of rehabilitation beds across areas were the methods used to evaluate rehabilitation service areas. The service areas had a higher ICC and variance in beds than the hospital referral regions.
AHRQ-funded; HS024711.
Citation: Reistetter TA, Eschbach K K, Prochaska J .
Understanding variation in postacute care: developing rehabilitation service areas through geographic mapping.
Am J Phys Med Rehabil 2021 May;100(5):465-72. doi: 10.1097/phm.0000000000001577..
Keywords: Elderly, Rehabilitation, Medicare, Nursing Homes, Long-Term Care, Home Healthcare, Access to Care
Bush M, Kucharska-Newton A, Simpson RJ
Effect of initiating cardiac rehabilitation after myocardial infarction on subsequent hospitalization in older adults.
Outpatient cardiac rehabilitation (CR) participation after myocardial infarction (MI) reduces all-cause mortality; however, less is known about effects of CR on post-MI hospitalization. The objective of this study was to investigate effects of CR on hospitalization following acute MI among older adults. The investigators concluded that this study provided evidence that CR could reduce the 1-yr risk of cardiovascular and all-cause hospital admissions in Medicare aged MI survivors.
AHRQ-funded; HS000032.
Citation: Bush M, Kucharska-Newton A, Simpson RJ .
Effect of initiating cardiac rehabilitation after myocardial infarction on subsequent hospitalization in older adults.
J Cardiopulm Rehabil Prev 2020 Mar;40(2):87-93. doi: 10.1097/hcr.0000000000000452..
Keywords: Elderly, Rehabilitation, Heart Disease and Health, Cardiovascular Conditions, Hospitalization
Dean JM, Hreha K, Hong I
Post-acute care use patterns among hospital service areas by older adults in the United States: a cross-sectional study.
This study examined post-stroke acute care patterns across Hospital Service Areas among a national stroke cohort of Medicare beneficiaries to determine drivers of variation in post-acute care service utilization. Data was extracted from 2013 to 2014 (174,498 total records across 3232 Hospital Service Areas). Patients’ residence ZIP codes were linked to the facility ZIP code where care was received. Patients were considered a “traveler” if they did not live in the Hospital Service Area where they received care. Only 23.5% of all patients received care in skilled nursing-only Hospital Service Areas although 73.4% of all Hospital Service Areas were skilled nursing-only. Thirty-five percent of all patients traveled to a different Hospital Service Area from their residence. Patients living in skilled nursing-only Hospital Service Areas had more than 5 times the odds of traveling compared to those living in Hospital Service Areas with skilled nursing, inpatient rehabilitation, and long-term care hospital services.
AHRQ-funded; HS026133; HS024711.
Citation: Dean JM, Hreha K, Hong I .
Post-acute care use patterns among hospital service areas by older adults in the United States: a cross-sectional study.
BMC Health Serv Res 2021 Feb 25;21(1):176. doi: 10.1186/s12913-021-06159-z..
Keywords: Elderly, Hospitals, Access to Care, Stroke, Cardiovascular Conditions, Healthcare Utilization, Rehabilitation, Nursing Homes
Thompson MP, Yaser JM, Hou H
Determinants of hospital variation in cardiac rehabilitation enrollment during coronary artery disease episodes of care.
Cardiac rehabilitation (CR) is associated with improved outcomes for patients with coronary artery disease (CAD). However, CR enrollment remains low and there is a dearth of real-world data on hospital-level variation in CR enrollment. In this study, the investigators sought to explore determinants of hospital variability in CR enrollment during CAD episodes of care: medical management of acute myocardial infarction (AMI-MM), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG).
AHRQ-funded; HS026003.
Citation: Thompson MP, Yaser JM, Hou H .
Determinants of hospital variation in cardiac rehabilitation enrollment during coronary artery disease episodes of care.
Circ Cardiovasc Qual Outcomes 2021 Feb;14(2):e007144. doi: 10.1161/circoutcomes.120.007144..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Rehabilitation, Outcomes, Patient-Centered Outcomes Research, Hospitals
Roberts AC, Rafferty MR, Wu SS
Patterns and predictors of referrals to allied health services for individuals with Parkinson's disease: a Parkinson's foundation (PF) QII study.
Rehabilitation therapies are critical for optimizing quality-of-life and daily functions for individuals living with Parkinson's disease (PD). Thus, understanding the patterns of and under what conditions physicians make rehabilitation referrals is important for optimizing care. In this study, the investigators analyzed data from 5020 participants (4 countries) collected from 1/3/2016 to 4/20/2018 as part of the Parkinson's Foundation Quality Improvement Initiative (PF QII).
AHRQ-funded; HS025077.
Citation: Roberts AC, Rafferty MR, Wu SS .
Patterns and predictors of referrals to allied health services for individuals with Parkinson's disease: a Parkinson's foundation (PF) QII study.
Parkinsonism Relat Disord 2021 Feb;83:115-22. doi: 10.1016/j.parkreldis.2020.11.024..
Keywords: Neurological Disorders, Rehabilitation
Rundell SD, Goode AP, Friedly JL
Role of health services research in producing high-value rehabilitation care.
The overall purpose of this article is to present a framework to help clinicians, researchers, educators, and policy makers better understand the role of health services research in developing and evaluating evidence on value in rehabilitation. The authors believe that rehabilitation professionals have a great opportunity to increase their engagement in describing, evaluating, delivering, and disseminating high-value care, but there are several barriers they need to consider to be most successful.
AHRQ-Funded HS022982.
Citation: Rundell SD, Goode AP, Friedly JL .
Role of health services research in producing high-value rehabilitation care.
Phys Ther 2015 Dec;95(12):1703-11. doi: 10.2522/ptj.20150033..
Keywords: Health Services Research (HSR), Rehabilitation, Patient-Centered Outcomes Research, Comparative Effectiveness
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
Ottenbacher KJ, Karmarkar A, Graham JE
Thirty-day hospital readmission following discharge from postacute rehabilitation in fee-for-service Medicare patients.
This study sought to determine 30-day readmission rates and factors related to readmission for patients receiving postacute inpatient rehabilitation. It found that among postacute rehabilitation facilities providing services to Medicare fee-for-service beneficiaries, 30-day readmission rates ranged from 5.8 percent to 18.8 percent for selected impairment groups.
AHRQ-funded; HS022134.
Citation: Ottenbacher KJ, Karmarkar A, Graham JE .
Thirty-day hospital readmission following discharge from postacute rehabilitation in fee-for-service Medicare patients.
JAMA 2014 Feb 12;311(6):604-14. doi: 10.1001/jama.2014.8..
Keywords: Hospital Readmissions, Medicare, Rehabilitation, Elderly, Quality Indicators (QIs)
Stineman MG, Xie D, Kurichi JE
Comprehensive versus consultative rehabilitation services postacute stroke: outcomes differ.
The researchers compared outcomes of veteran patients provided with comprehensive rehabilitation with those provided with consultative rehabilitation services after acute stroke using propensity scores. They found that comprehensive rehabilitation services are associated with greater recovery of physical and cognitive independence, improved home discharge likelihood, and improved 1 yr. survival.
AHRQ-funded; HS018540.
Citation: Stineman MG, Xie D, Kurichi JE .
Comprehensive versus consultative rehabilitation services postacute stroke: outcomes differ.
J Rehabil Res Dev 2014;51(7):1143-54. doi: 10.1682/jrrd.2014.03.0084..
Keywords: Comparative Effectiveness, Rehabilitation, Stroke, Patient-Centered Outcomes Research