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- Access to Care (1)
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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 8 of 8 Research Studies DisplayedFingar KR, Weiss AJ, Roemer M
AHRQ Author: Roemer M, Reid LD
Effects of the COVID-19 early pandemic on delivery outcomes among women with and without COVID-19 at birth.
This AHRQ-authored paper examined the early pandemic-related changes in birth outcomes for pregnant women with and without a COVID-19 diagnosis at delivery. They compared four delivery outcomes-preterm delivery (PTD), severe maternal morbidity (SMM), stillbirth, and cesarean birth-between 2017 and 2019 (prepandemic) and between April and December 2020 (early pandemic) using interrupted time series models on 11.8 million deliveries, stratified by COVID-19 infection status at birth with entropy weighting for historical controls, from the HCUP across 43 states and the District of Columbia. Relative to 2017-2019, women without COVID-19 at delivery in 2020 had lower odds of PTD (OR = 0.93) and SMM (OR = 0.88) but increased odds of stillbirth (OR = 1.04). COVID-19 deliveries had an excess of each outcome, by factors of 1.07-1.46 for outcomes except SMM at 4.21. The effect for SMM was more pronounced for Asian/Pacific Islander non-Hispanic (API; OR = 10.51) and Hispanic (OR = 5.09) pregnant women than for White non-Hispanic (OR = 3.28) women.
AHRQ-authored; AHRQ-funded; 290201800001C.
Citation: Fingar KR, Weiss AJ, Roemer M .
Effects of the COVID-19 early pandemic on delivery outcomes among women with and without COVID-19 at birth.
Birth 2023 Dec; 50(4):996-1008. doi: 10.1111/birt.12753..
Keywords: Healthcare Cost and Utilization Project (HCUP), COVID-19, Maternal Care, Women, Outcomes
Zondlak AN, Oh EJ, Neiman PU
Association of intellectual disability with delayed presentation and worse outcomes in emergency general surgery.
Individuals with intellectual disabilities may be at higher risk of delayed presentation and worse outcomes for emergency general surgery (EGS) conditions. The purpose of this study was to explore the relationship between intellectual disability and both severity of disease and clinical outcomes in patients presenting with typical EGS conditions. The study found that of 1,317,572 adult EGS admissions, 0.38% of patients had an ICD-9/-10 code consistent with current intellectual disability. EGS patients with intellectual disabilities had 31% greater odds of more severe disease at presentation when compared with neurotypical patients. Intellectual disability was also related with a higher likelihood of complications and mortality, longer lengths of stay, lower rate of discharge to home, and higher inpatient costs.
AHRQ-funded; HS028672; HS027788.
Citation: Zondlak AN, Oh EJ, Neiman PU .
Association of intellectual disability with delayed presentation and worse outcomes in emergency general surgery.
Ann Surg 2023 Nov 1; 278(5):e1118-e22. doi: 10.1097/sla.0000000000005863..
Keywords: Healthcare Cost and Utilization Project (HCUP), Disabilities, Surgery, Outcomes
Ramadan OI, Kelz RR, Sharpe JE
Impact of Medicaid expansion on outcomes after abdominal aortic aneurysm repair.
Researchers sought to assess the association between Medicaid expansion and outcomes after abdominal aortic aneurysm repair using HCUP State Inpatient Databases data from 14 states. They examined data on 8995 adult patients under age 65 from both non-expansion states and Medicaid expansion states. The results indicated that Medicaid expansion was associated with decreased in-hospital mortality after abdominal aortic aneurysm repair among all patients, particularly among patients who were either on Medicaid or were uninsured. The researchers concluded that these results provided support for improved access to care for patients undergoing abdominal aortic aneurysm repair through Medicaid expansion.
AHRQ-funded; HS026116.
Citation: Ramadan OI, Kelz RR, Sharpe JE .
Impact of Medicaid expansion on outcomes after abdominal aortic aneurysm repair.
J Vasc Surg 2023 Sep; 78(3):648-56.e6. doi: 10.1016/j.jvs.2023.04.029..
Keywords: Healthcare Cost and Utilization Project (HCUP), Medicaid, Outcomes, Access to Care
Lake ET, Staiger D, Smith JG
The association of missed nursing care with very low birthweight infant outcomes.
This study examined the association of missed nursing care and health outcomes of very low birthweight (VLBW) infants in neonatal intensive care units (NICUs). The authors used 2016 hospital administrative discharge abstracts for VLBW newborns (n = 7,595) and NICU registered nurse survey responses (n = 6,963) from the National Database of Nursing Quality Indicators. Mortality, morbidity, and length of stay (LOS) was examined in 190 sample hospitals from 19 states in all regions. There was a significant association between higher odds of bloodstream infection and longer LOS, but not mortality or severe intraventricular hemorrhage and missed nursing care.
AHRQ-funded; HS024918.
Citation: Lake ET, Staiger D, Smith JG .
The association of missed nursing care with very low birthweight infant outcomes.
Med Care Res Rev 2023 Jun; 80(3):293-302. doi: 10.1177/10775587221150950..
Keywords: Healthcare Cost and Utilization Project (HCUP), Quality Indicators (QIs), Nursing, Newborns/Infants, Outcomes, Healthcare Utilization, Quality of Care
Mehta AB, Syeda SN, Bajpayee L
Trends in tracheostomy for mechanically ventilated patients in the United States, 1993-2012.
This study investigated trends in tracheostomy use, timing, and outcomes in the United States. It found that over the past two decades, tracheostomy use rose substantially in the United States until 2008, when use began to decline. In addition, there was an observed dramatic increase in discharge of tracheostomy patients to long-term care facilities.
AHRQ-funded; HS020672.
Citation: Mehta AB, Syeda SN, Bajpayee L .
Trends in tracheostomy for mechanically ventilated patients in the United States, 1993-2012.
Am J Respir Crit Care Med 2015 Aug 15;192(4):446-54. doi: 10.1164/rccm.201502-0239OC..
Keywords: Healthcare Cost and Utilization Project (HCUP), Outcomes, Healthcare Utilization, Respiratory Conditions
Greenberg JK, Ladner TR, Olsen MA
Complications and resource use associated with surgery for Chiari Malformation type 1 in adults: a population perspective.
This study examined the complications and resource use associated with adult CM-1 surgery using administrative data. It concluded that complications after CM-1 surgery are common, and surgical complications are more frequent than medical complications. Also, certain comorbidities and demographic characteristics are associated with increased risk for complications.
AHRQ-funded; H0S19455.
Citation: Greenberg JK, Ladner TR, Olsen MA .
Complications and resource use associated with surgery for Chiari Malformation type 1 in adults: a population perspective.
Neurosurgery 2015 Aug;77(2):261-8. doi: 10.1227/neu.0000000000000777..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Outcomes, Data
Santos CA, Brennan DC, Chapman WC
Delayed-onset cytomegalovirus disease coded during hospital readmission in a multicenter, retrospective cohort of liver transplant recipients.
The researchers sought to determine the risk factors and outcomes of delayed-onset CMV disease among a representative cohort of liver transplant recipients from multiple centers. They found that delayed-onset CMV disease coded during hospital readmission occurred more commonly than early-onset CMV disease and that prior transplant failure or rejection was a risk factor for delayed-onset CMV disease.
AHRQ-funded; HS019455.
Citation: Santos CA, Brennan DC, Chapman WC .
Delayed-onset cytomegalovirus disease coded during hospital readmission in a multicenter, retrospective cohort of liver transplant recipients.
Liver Transpl 2015 May;21(5):581-90. doi: 10.1002/lt.24089..
Keywords: Healthcare Cost and Utilization Project (HCUP), Risk, Transplantation, Outcomes
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)