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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 25 of 25 Research Studies DisplayedWeir RE, Lyttle CS, Meltzer DO
The relative ability of comorbidity ascertainment methodologies to predict in-hospital mortality among hospitalized community-acquired pneumonia patients.
In this observational study, the investigators sought to compare the relative value of several methodologies by which comorbidities may be ascertained. The authors concluded that although comorbidities derived through administrative data did produce an area under the curve greater than chart review, their analyses suggested a coding bias in several comorbidities with a paradoxically protective effect. They assert that chart review, while labor and resource intensive, may be the ideal method for ascertainment of clinically relevant comorbidities.
AHRQ-funded; HS016948; HS010597.
Citation: Weir RE, Lyttle CS, Meltzer DO .
The relative ability of comorbidity ascertainment methodologies to predict in-hospital mortality among hospitalized community-acquired pneumonia patients.
Med Care 2018 Nov;56(11):950-55. doi: 10.1097/mlr.0000000000000989..
Keywords: Community-Acquired Infections, Hospitalization, Mortality, Pneumonia
Desai NR, Ott LS, George EJ
Variation in and hospital characteristics associated with the value of care for Medicare beneficiaries with acute myocardial infarction, heart failure, and pneumonia.
The objectives of this study were to investigate the association between hospital-level 30-day risk-standardized mortality rates (RSMRs) and 30-day risk-standardized payments (RSPs) for acute myocardial infarction (AMI), heart failure (HF), and pneumonia (PNA); to characterize patterns of value in care; and to identify hospital characteristics associated with high-value care (defined by having lower than median RSMRs and RSPs).
AHRQ-funded; HS023000.
Citation: Desai NR, Ott LS, George EJ .
Variation in and hospital characteristics associated with the value of care for Medicare beneficiaries with acute myocardial infarction, heart failure, and pneumonia.
JAMA Netw Open 2018 Oct 5;1(6):e183519. doi: 10.1001/jamanetworkopen.2018.3519..
Keywords: Cardiovascular Conditions, Elderly, Hospitalization, Hospitals, Heart Disease and Health, Inpatient Care, Medicare, Mortality, Pneumonia
Lin MY, Kressin NR, Paasche-Orlow MK
Is 30-day posthospitalization mortality lower among racial/ethnic minorities?: A reexamination.
This study’s objective was to verify other studies that showed that risk-adjusted rates of 30-day mortality after hospitalization for an acute condition was lower among blacks than whites. Inpatient discharge and vital status data was used for patients 18 and older hospitalized in California from January 2010 to June 30, 2011 for a variety of acute conditions. Their analysis verified lower risk of mortality among blacks. Factors for this may be associated with a higher rate of hospitalization with an 80% risk and inpatient mortality was also 30% higher with whites than blacks.
AHRQ-funded; HS022242.
Citation: Lin MY, Kressin NR, Paasche-Orlow MK .
Is 30-day posthospitalization mortality lower among racial/ethnic minorities?: A reexamination.
Med Care 2018 Aug;56(8):665-72. doi: 10.1097/mlr.0000000000000938..
Keywords: Hospitalization, Mortality, Racial and Ethnic Minorities
Kalbaugh CA, Loehr L, Wruck L
Frequency of care and mortality following an incident diagnosis of peripheral artery disease in the inpatient or outpatient setting: the ARIC (Atherosclerosis Risk in Communities) study.
Researchers analyzed frequency of care and mortality date for patients with an initial peripheral artery disease (PAD) diagnosis in the outpatient or inpatient setting. Data was analyzed from the ARIC (Atherosclerosis Risk in Communities) study cohort linked with Centers for Medicare and Medicaid Services fee-for-services claims data for 2002-2012. Patients diagnosed in the outpatient setting had higher follow-up rates with lower hospitalizations and mortality than those diagnosed in the inpatient setting.
AHRQ-funded; HS000032; HS023728.
Citation: Kalbaugh CA, Loehr L, Wruck L .
Frequency of care and mortality following an incident diagnosis of peripheral artery disease in the inpatient or outpatient setting: the ARIC (Atherosclerosis Risk in Communities) study.
J Am Heart Assoc 2018 Apr 13;7(8). doi: 10.1161/jaha.117.007332..
Keywords: Cardiovascular Conditions, Healthcare Utilization, Hospitalization, Mortality, Outcomes
de Cordova PB
Excess mortality associated with weekend hospital admissions may be due to patient-level differences, rather than reduced staffing or services.
The author comments on a study by Walker that explained the weekend effect as arising from differences in patient characteristics among patients who present to the emergency department on the weekend. For staffing, Walker used a proxy measure because staffing information was not available. The author cautions that, although a clear rationale was provided, there should be acknowledgement that use of a proxy, whether for illness severity or staffing, may alter results.
AHRQ-funded; HS024339.
Citation: de Cordova PB .
Excess mortality associated with weekend hospital admissions may be due to patient-level differences, rather than reduced staffing or services.
Evid Based Nurs 2018 Apr;21(2):49. doi: 10.1136/eb-2017-102779.
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Keywords: Healthcare Delivery, Health Services Research (HSR), Hospitalization, Mortality, Provider Performance
Hirayama A, Goto T, Shimada YJ
Association of obesity with severity of heart failure exacerbation: a population-based study.
Researchers investigate the associations of obesity with severity of heart failure exacerbation and in-hospital mortality using population-based data from the State Inpatient Databases. Subjects were adults hospitalized for heart failure exacerbation in seven States from 2012 to 2013. The researchers found that, based on large population-based data sets of patients with heart failure exacerbation, obesity was associated with higher acute severity measures but lower in-hospital mortality.
AHRQ-funded; HS023305.
Citation: Hirayama A, Goto T, Shimada YJ .
Association of obesity with severity of heart failure exacerbation: a population-based study.
J Am Heart Assoc 2018 Mar 15;7(6). doi: 10.1161/jaha.117.008243..
Keywords: Healthcare Cost and Utilization Project (HCUP), Obesity, Heart Disease and Health, Cardiovascular Conditions, Hospitalization, Mortality
Bachmann JM, Duncan MS, Shah AS
Association of cardiac rehabilitation with decreased hospitalizations and mortality after ventricular assist device implantation.
This study examined whether outcomes of cardiac patients who had received ventricular assist device (VAD) implementation had decreased hospitalization and mortality with cardiac rehabilitation (CR). Medicare beneficiaries enrolled for disability or aged 65 years and older in 2014 were included. The investigators identified VAD recipients by diagnosis codes. It was found that each 5-year increase in age was associated with attending an additional 1.6 CR sessions and there was a 23% lower 1-year hospitalization risk and a 47% lower 1-year mortality risk.
AHRQ-funded; HS022990.
Citation: Bachmann JM, Duncan MS, Shah AS .
Association of cardiac rehabilitation with decreased hospitalizations and mortality after ventricular assist device implantation.
JACC Heart Fail 2018 Feb;6(2):130-39. doi: 10.1016/j.jchf.2017.11.002..
Keywords: Cardiovascular Conditions, Rehabilitation, Heart Disease and Health, Medical Devices, Surgery, Patient-Centered Outcomes Research, Outcomes, Mortality, Evidence-Based Practice, Hospitalization
Goodwin JS, Salameh H, Zhou J
Association of hospitalist years of experience with mortality in the hospitalized Medicare population.
The purpose of the study is to describe the association of hospitalist years of experience with 30-day mortality and hospital mortality of their patients. The authors noted that patients cared for by hospitalists in their first year of practice experienced higher mortality. The authors asserted that early-career hospitalists may require additional support to ensure optimal outcomes for their patients.
AHRQ-funded; HS022134.
Citation: Goodwin JS, Salameh H, Zhou J .
Association of hospitalist years of experience with mortality in the hospitalized Medicare population.
JAMA Intern Med 2018 Feb;178(2):196-203. doi: 10.1001/jamainternmed.2017.7049..
Keywords: Hospitalization, Inpatient Care, Medicare, Mortality, Provider
Goto T, Hirayama A, Faridi MK
Obesity and severity of acute exacerbation of chronic obstructive pulmonary disease.
A study was done to determine if there was an increase in severity and mortality with chronic obstructive pulmonary disease (COPD) patients who were also obese. Researchers used data from 2012-2013 State Inpatient Databases data of seven U.S. states. 17% of COPD patients in the database were defined as obese. Obesity was shown to increase use of ventilation, increased hospital stays but not in-hospital mortality.
AHRQ-funded; HS023305.
Citation: Goto T, Hirayama A, Faridi MK .
Obesity and severity of acute exacerbation of chronic obstructive pulmonary disease.
Ann Am Thorac Soc 2018 Feb;15(2):184-91. doi: 10.1513/AnnalsATS.201706-485OC..
Keywords: Chronic Conditions, Respiratory Conditions, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Mortality, Obesity
Edwards ST, Peterson K, Chan B
Effectiveness of intensive primary care interventions: a systematic review.
This study systematically reviewed the impact of intensive primary care programs on all-cause mortality, hospitalization, and emergency department use. The authors found that intensive primary care interventions demonstrated varying effectiveness in reducing hospitalizations, and noted there was limited evidence that these interventions were associated with changes in mortality.
AHRQ-funded; HS022981.
Citation: Edwards ST, Peterson K, Chan B .
Effectiveness of intensive primary care interventions: a systematic review.
J Gen Intern Med 2017 Dec;32(12):1377-86. doi: 10.1007/s11606-017-4174-z..
Keywords: Hospitalization, Mortality, Patient-Centered Outcomes Research, Primary Care
Hines AL, Raetzman SO, Barrett ML
AHRQ Author: Moy E, Andrews RM
Managed care and inpatient mortality in adults: effect of primary payer.
This study provides a comprehensive assessment of the association between managed care and inpatient mortality for Medicare and privately insured patients. Privately insured patients in managed care plans, especially older adults, had better outcomes than those in fee-for-service (FFS) plans. Patients in Medicare managed care had outcomes similar to those in Medicare FFS.
AHRQ-authored.
Citation: Hines AL, Raetzman SO, Barrett ML .
Managed care and inpatient mortality in adults: effect of primary payer.
BMC Health Serv Res 2017 Feb 8;17(1):121. doi: 10.1186/s12913-017-2062-1.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Health Insurance, Inpatient Care, Mortality, Outcomes, Hospitalization, Medicare
Brown JR, Rezaee ME, Marshall EJ
Hospital mortality in the United States following acute kidney injury.
This review discusses the epidemiology of acute kidney injury (AKI) and its association with in-hospital mortality in the United States. Also discussed is the importance of the 71 percent reduction in AKI-related mortality among hospitalized patients in the United States and whether or not this is a phenomenon of hospital billing (coding) or improvements to the management of AKI.
AHRQ-funded; HS018443.
Citation: Brown JR, Rezaee ME, Marshall EJ .
Hospital mortality in the United States following acute kidney injury.
Biomed Res Int 2016;2016:4278579. doi: 10.1155/2016/4278579.
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Keywords: Mortality, Hospitalization, Adverse Events, Patient Safety
Durstenfeld MS, Ogedegbe O, Katz SD
Racial and ethnic differences in heart failure readmissions and mortality in a large municipal healthcare system.
This study sought to determine whether racial and ethnic differences exist among patients with similar access to care. It examined outcomes after heart failure hospitalization within a large municipal health system and determined that racial and ethnic differences in outcomes were present.
AHRQ-funded; HS023683.
Citation: Durstenfeld MS, Ogedegbe O, Katz SD .
Racial and ethnic differences in heart failure readmissions and mortality in a large municipal healthcare system.
JACC Heart Fail 2016 Nov;4(11):885-93. doi: 10.1016/j.jchf.2016.05.008.
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Keywords: Heart Disease and Health, Hospital Readmissions, Hospitalization, Mortality, Outcomes, Racial and Ethnic Minorities
Donnelly JP, Locke JE, MacLennan PA
Inpatient mortality among solid organ transplant recipients hospitalized for sepsis and severe sepsis.
The researchers investigated the impact of solid organ transplant (SOT) on outcomes following sepsis. They found that among patients hospitalized for severe sepsis or sepsis, those with SOT had lower inpatient mortality than those without SOT.
AHRQ-funded; HS013852.
Citation: Donnelly JP, Locke JE, MacLennan PA .
Inpatient mortality among solid organ transplant recipients hospitalized for sepsis and severe sepsis.
Clin Infect Dis 2016 Jul 15;63(2):186-94. doi: 10.1093/cid/ciw295.
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Keywords: Transplantation, Mortality, Sepsis, Hospitalization, Patient-Centered Outcomes Research
Wilkes JJ, Hennessy S, Xiao R
Volume-outcome relationships in pediatric acute lymphoblastic leukemia: association between hospital pediatric and pediatric oncology volume with mortality and intensive care resources during initial therapy.
Researchers investigated if inpatient hospital volume influences outcomes. The objective of their study was to evaluate the relationship between inpatient pediatric and pediatric oncology volume and mortality and intensive care resources (ICU care). It concluded that induction mortality was low and that there was no inverse relationship between volume and mortality or ICU care.
AHRQ-funded; HS023419.
Citation: Wilkes JJ, Hennessy S, Xiao R .
Volume-outcome relationships in pediatric acute lymphoblastic leukemia: association between hospital pediatric and pediatric oncology volume with mortality and intensive care resources during initial therapy.
Clin Lymphoma Myeloma Leuk 2016 Jul;16(7):404-10.e1. doi: 10.1016/j.clml.2016.04.016.
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Keywords: Cancer, Children/Adolescents, Hospitalization, Mortality, Outcomes
Chen J, Hsieh AF, Dharmarajan K
National trends in heart failure hospitalization after acute myocardial infarction for Medicare beneficiaries: 1998-2010.
This study used a complete national sample of 2 789 943 AMI hospitalizations of Medicare fee-for-service beneficiaries from 1998 through 2010, we evaluated annual changes in the incidence of subsequent heart failure (HF) hospitalization and mortality using Poisson and survival analysis models. It found that HF hospitalization after AMI decreased from 1998 to 2010, which may indicate improvements in the management of AMI.
AHRQ-funded; HS018781.
Citation: Chen J, Hsieh AF, Dharmarajan K .
National trends in heart failure hospitalization after acute myocardial infarction for Medicare beneficiaries: 1998-2010.
Circulation 2013 Dec 17;128(24):2577-84. doi: 10.1161/circulationaha.113.003668..
Keywords: Hospitalization, Medicare, Heart Disease and Health, Mortality
Spatz ES, Beckman AL, Wang Y
Geographic variation in trends and disparities in acute myocardial infarction hospitalization and mortality by income levels, 1999-2013.
The researchers sought to determine whether trends in US county-level, risk-standardized acute myocardial infarction (AMI) hospitalization and mortality rates varied by county-based median income level. They concluded that hospitalization and mortality rates of AMI declined among counties of all income levels, although hospitalization rates among low-income counties lag behind those of the higher income groups.
AHRQ-funded; HS023000.
Citation: Spatz ES, Beckman AL, Wang Y .
Geographic variation in trends and disparities in acute myocardial infarction hospitalization and mortality by income levels, 1999-2013.
JAMA Cardiol 2016 Jun 1;1(3):255-65. doi: 10.1001/jamacardio.2016.0382.
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Keywords: Disparities, Hospitalization, Heart Disease and Health, Mortality, Social Determinants of Health
Blecker S, Park H, Katz SD
Association of HbA1c with hospitalization and mortality among patients with heart failure and diabetes.
Comorbid diabetes is common in heart failure and associated with increased hospitalization and mortality. Nonetheless, the association between glycemic control and outcomes among patients with heart failure and diabetes remains poorly characterized, particularly among low income and minority patients. This study found that among a cohort of primarily minority and low income patients with heart failure and diabetes, an increased risk of hospitalization was observed.
AHRQ-funded; HS023683.
Citation: Blecker S, Park H, Katz SD .
Association of HbA1c with hospitalization and mortality among patients with heart failure and diabetes.
BMC Cardiovasc Disord 2016 May 20;16:99. doi: 10.1186/s12872-016-0275-6.
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Keywords: Diabetes, Heart Disease and Health, Mortality, Hospitalization, Racial and Ethnic Minorities
Hakkarainen TW, Arbabi S, Willis MM
Outcomes of patients discharged to skilled nursing facilities after acute care hospitalizations.
This study evaluated previously independent older patients discharged to skilled nursing facilities (SNFs) and identified risk factors for failure to return home and death and development of a predictive tool to determine likelihood of adverse outcome. It found that a large proportion of older patients discharging to SNFs never return home.
AHRQ-funded; HS020025.
Citation: Hakkarainen TW, Arbabi S, Willis MM .
Outcomes of patients discharged to skilled nursing facilities after acute care hospitalizations.
Ann Surg 2016 Feb;263(2):280-5. doi: 10.1097/sla.0000000000001367..
Keywords: Critical Care, Hospitalization, Risk, Elderly, Mortality
Nagendran M, Dimick JB, Gonzalez AA
Mortality among older adults before versus after hospital transition to intensivist staffing.
The researchers sought to determine whether hospitals can reduce their mortality by adopting an intensivist staffing model. Adoption of an intensivist staffing model was not associated with improved mortality in Medicare beneficiaries. These findings suggest that the lower mortality rates previously observed at hospitals with intensivist staffing may be attributable to other factors.
AHRQ-funded; HS023621; HS024403.
Citation: Nagendran M, Dimick JB, Gonzalez AA .
Mortality among older adults before versus after hospital transition to intensivist staffing.
Med Care 2016 Jan;54(1):67-73. doi: 10.1097/mlr.0000000000000446.
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Keywords: Mortality, Elderly, Intensive Care Unit (ICU), Hospitalization, Critical Care
Arvold ND, Wang Y, Zigler C
Hospitalization burden and survival among older glioblastoma patients.
The researchers performed a retrospective cohort study among patients aged 65 years and older with glioblastoma diagnosed between 1999 and 2007. They found that higher comorbidity score and black race were associated with an increased risk of being hospitalized for at least 25% of remaining life, whereas radiation, temozolomide, and extensive surgery were associated with a decreased risk.
AHRQ-funded; HS021991.
Citation: Arvold ND, Wang Y, Zigler C .
Hospitalization burden and survival among older glioblastoma patients.
Neuro Oncol 2014 Nov;16(11):1530-40. doi: 10.1093/neuonc/nou060.
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Keywords: Cancer, Elderly, Hospitalization, Mortality, Quality of Life
Chaudhry SI, Khan RF, Chen J
National trends in recurrent AMI hospitalizations 1 year after acute myocardial infarction in Medicare beneficiaries: 1999-2010.
The investigators evaluated changes in the incidence of 1-year recurrent acute myocardial infarction (AMI) hospitalization and mortality. In a national sample of Medicare beneficiaries hospitalized for AMI from 1999 to 2010, they found that hospitalization for recurrent AMI decreased, as did subsequent mortality, albeit to a lesser extent. The risk of recurrent AMI hospitalization declined less in black patients than in whites, increasing observed racial disparities by the end of the study period.
AHRQ-funded; HS018781.
Citation: Chaudhry SI, Khan RF, Chen J .
National trends in recurrent AMI hospitalizations 1 year after acute myocardial infarction in Medicare beneficiaries: 1999-2010.
J Am Heart Assoc 2014 Oct;3(5):e001197. doi: 10.1161/jaha.114.001197.
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Keywords: Hospitalization, Medicare, Mortality, Heart Disease and Health, Risk
Buys DR, Roth DL, Ritchie CS
Nutritional risk and body mass index predict hospitalization, nursing home admissions, and mortality in community-dwelling older adults: results from the UAB Study of Aging with 8.5 years of follow-up.
This study finds that nutritional risk was prospectively associated with all-cause and nonsurgical hospitalizations and with nursing home admission and mortality in unadjusted models. After adjusting for other risk factors, the association between high nutritional risk and all-cause and nonsurgical hospitalizations remained significant.
AHRQ-funded; HS013852
Citation: Buys DR, Roth DL, Ritchie CS .
Nutritional risk and body mass index predict hospitalization, nursing home admissions, and mortality in community-dwelling older adults: results from the UAB Study of Aging with 8.5 years of follow-up.
J Gerontol A Biol Sci Med Sci. 2014 Sep;69(9):1146-53. doi: 10.1093/gerona/glu024..
Keywords: Nutrition, Hospitalization, Elderly, Long-Term Care, Mortality
Bates BE, Xie D, Kwong PL
One-year all-cause mortality after stroke: a prediction model.
Using data from Department of Veterans Affairs (VA) national databases, the researchers present and internally validate a 1-year all-cause mortality prediction index after hospitalization for acute stroke. They conclude that a simple index using readily available data that stratifies stroke patients at the time of discharge according to low, moderate, high, and highest likelihood of all-cause 1-year mortality is feasible.
AHRQ-funded; HS018540.
Citation: Bates BE, Xie D, Kwong PL .
One-year all-cause mortality after stroke: a prediction model.
PM R 2014 Jun;6(6):473-83. doi: 10.1016/j.pmrj.2013.11.006..
Keywords: Stroke, Mortality, Hospitalization
Patel RB, Mathur MB, Gould M
Demographic and clinical predictors of mortality from highly pathogenic avian influenza A (H5N1) virus infection: CART analysis of international cases.
The researchers for this international study sought to model individuals at highest risk of mortality from HPAI N5N1 virus infection in order to inform preventive and therapeutic interventions. They found that age, health expenditure, delay from symptom onset to hospitalization and country are significant predictors of mortality.
AHRQ-funded; HS019816
Citation: Patel RB, Mathur MB, Gould M .
Demographic and clinical predictors of mortality from highly pathogenic avian influenza A (H5N1) virus infection: CART analysis of international cases.
PLoS One. 2014 Mar 25;9(3):e91630. doi: 10.1371/journal.pone.0091630..
Keywords: Influenza, Mortality, Critical Care, Hospitalization, Risk