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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Cancer (1)
- Cancer: Breast Cancer (1)
- Cancer: Prostate Cancer (1)
- Children/Adolescents (1)
- Comparative Effectiveness (2)
- Data (1)
- Decision Making (1)
- Digestive Disease and Health (1)
- Elderly (3)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (4)
- (-) Healthcare Costs (24)
- Healthcare Delivery (1)
- Healthcare Utilization (2)
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- Hospital Discharge (1)
- Hospital Readmissions (1)
- Hospitals (2)
- Inpatient Care (1)
- Medicare (6)
- Mortality (2)
- Neurological Disorders (1)
- Opioids (1)
- Orthopedics (1)
- Outcomes (2)
- Patient-Centered Outcomes Research (2)
- Patient Safety (3)
- Payment (3)
- Pressure Ulcers (1)
- Provider: Health Personnel (1)
- Provider Performance (1)
- Quality of Life (1)
- Risk (1)
- (-) Surgery (24)
- Tobacco Use (1)
- Treatments (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 24 of 24 Research Studies DisplayedShih YT, Shen C, Hu JC
Do robotic surgical systems improve profit margins? A cross-sectional analysis of California hospitals.
The aim of this study was to examine the association between ownership of robotic surgical systems and hospital profit margins. Hospitals with robotic surgical systems tended to report more favorable profit margins. However, multilevel logistic regression showed that this relationship (an association, not causality) became only marginally significant after controlling for other hospital characteristics.
AHRQ-funded; HS020263; HS024608.
Citation: Shih YT, Shen C, Hu JC .
Do robotic surgical systems improve profit margins? A cross-sectional analysis of California hospitals.
Value Health 2017 Sep;20(8):1221-25. doi: 10.1016/j.jval.2017.05.010.
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Keywords: Healthcare Costs, Hospitals, Surgery
Gaskill CE, Kling CE, Varghese TK, Jr.
Financial benefit of a smoking cessation program prior to elective colorectal surgery.
This study aimed to create an economic evaluation framework to estimate the potential value of preoperative smoking cessation programs for patients undergoing elective colorectal surgery. It concluded that a preoperative smoking cessation program is predicted to be cost-saving over the global postoperative period if the cost of the intervention is below $304 per patient.
AHRQ-funded; HS020025; HS022959.
Citation: Gaskill CE, Kling CE, Varghese TK, Jr. .
Financial benefit of a smoking cessation program prior to elective colorectal surgery.
J Surg Res 2017 Jul;215:183-89. doi: 10.1016/j.jss.2017.03.067.
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Keywords: Tobacco Use, Surgery, Healthcare Costs, Adverse Events
Aliu O, Zhong L, Chetta MD
Comparing health care resource use between implant and autologous reconstruction of the irradiated breast: a national claims-based assessment.
Nationwide data were used to examine health care resource use associated with implant and autologous reconstruction. Thirty-two percent of implant reconstructions failed, compared with 5 percent of autologous cases. In aggregate, failures constituted more than 20 percent of the cumulative costs of implant reconstruction compared with less than 5 percent for autologous reconstruction.
AHRQ-funded; HS023313.
Citation: Aliu O, Zhong L, Chetta MD .
Comparing health care resource use between implant and autologous reconstruction of the irradiated breast: a national claims-based assessment.
Plast Reconstr Surg 2017 Jun;139(6):1224e-31e. doi: 10.1097/prs.0000000000003336.
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Keywords: Cancer: Breast Cancer, Healthcare Costs, Surgery
Jacobs BL, He C, Li BY
Variation in readmission expenditures after high-risk surgery.
The researchers sought to investigate readmission intensity as measured by readmission cost for high-risk surgeries and examine predictors of higher readmission costs. They found that the 30-day readmission rate was 16 percent for major chest and 22 percent for major abdominal surgery. Discharge to a skilled nursing facility was associated with higher readmission costs for both chest and abdominal surgeries.
AHRQ-funded; HS024403; HS023621.
Citation: Jacobs BL, He C, Li BY .
Variation in readmission expenditures after high-risk surgery.
J Surg Res 2017 Jun 1;213:60-68. doi: 10.1016/j.jss.2017.02.017.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Hospital Readmissions, Healthcare Costs, Risk
Regenbogen SE, Cain-Nielsen AH, Norton EC
Costs and consequences of early hospital discharge after major inpatient surgery in older adults.
This study evaluated the association between early postoperative discharge practices and overall surgical episode spending and expenditures for postdischarge care use and readmissions. It concluded that early routine postoperative discharge after major inpatient surgery is associated with lower total surgical episode payments. There is no evidence that savings from shorter postsurgical hospitalization are offset by higher postdischarge care spending.
AHRQ-funded; HS024698.
Citation: Regenbogen SE, Cain-Nielsen AH, Norton EC .
Costs and consequences of early hospital discharge after major inpatient surgery in older adults.
JAMA Surg 2017 May 17;152(5):e170123. doi: 10.1001/jamasurg.2017.0123.
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Keywords: Elderly, Surgery, Hospital Discharge, Healthcare Costs, Outcomes
Waljee JF, Cron DC, Steiger RM
Effect of preoperative opioid exposure on healthcare utilization and expenditures following elective abdominal surgery.
The researchers examined the extent to which preoperative opioid use is correlated with healthcare utilization and costs following elective surgical procedures. They found that compared with non-users, patients using opioids preoperatively were more likely to have a longer hospital stay and were more likely to be discharged to a rehabilitation facility , adjusting for covariates.
AHRQ-funded; HS023313.
Citation: Waljee JF, Cron DC, Steiger RM .
Effect of preoperative opioid exposure on healthcare utilization and expenditures following elective abdominal surgery.
Ann Surg 2017 Apr;265(4):715-21. doi: 10.1097/sla.0000000000002117.
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Keywords: Opioids, Surgery, Healthcare Delivery, Healthcare Costs, Adverse Drug Events (ADE)
Ellimoottil C, Ryan AM, Hou H
Implications of the definition of an episode of care used in the comprehensive care for joint replacement model.
The researchers compared the Comprehensive Care for Joint Replacement (CJR) program's broad definition of an episode of care with a clinically narrow definition of an episode of care. The 90-day episode payments using the broad definition of the CJR model ranged from $17,349 to $29,465 (mean payment, $22,122). Episode payments were slightly lower (mean payment, $21,670) when the Hospital Compare definition was used.
AHRQ-funded; HS024193; HS018546.
Citation: Ellimoottil C, Ryan AM, Hou H .
Implications of the definition of an episode of care used in the comprehensive care for joint replacement model.
JAMA Surg 2017 Jan;152(1):49-54. doi: 10.1001/jamasurg.2016.3098.
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Keywords: Surgery, Healthcare Costs, Medicare, Payment
Chen LM, Norton EC, Banerjee M
Spending on care after surgery driven by choice of care settings instead of intensity of services.
The rising popularity of episode-based payment models for surgery underscores the need to better understand the drivers of variability in spending on postacute care. Examining postacute care spending for fee-for-service Medicare beneficiaries the researchers found that it varied widely between hospitals in the lowest versus highest spending quintiles but the variation diminished considerably after adjustment for postacute care setting (home health care, outpatient rehabilitation, skilled nursing facility, or inpatient rehabilitation facility).
AHRQ-funded; HS020671.
Citation: Chen LM, Norton EC, Banerjee M .
Spending on care after surgery driven by choice of care settings instead of intensity of services.
Health Aff 2017 Jan;36(1):83-90. doi: 10.1377/hlthaff.2016.0668.
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Keywords: Elderly, Healthcare Costs, Hospitals, Medicare, Surgery
Krakovitz PR, Boss EF
Intraoperative nerve monitoring during thyroidectomy-more complex than cost alone.
This brief invited commentary discussed intraoperative nerve monitoring and surgery.
AHRQ-funded; HS022932.
Citation: Krakovitz PR, Boss EF .
Intraoperative nerve monitoring during thyroidectomy-more complex than cost alone.
JAMA Otolaryngol Head Neck Surg 2016 Dec;142(12):1206-07. doi: 10.1001/jamaoto.2016.3116.
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Keywords: Decision Making, Healthcare Costs, Patient-Centered Outcomes Research, Quality of Life, Surgery
Nathan H, Dimick JB
Opportunities for surgical leadership in managing population health costs.
The concept of population health management—long a mainstay in primary care and chronic disease management—is taking root in surgery. The 2010 Affordable Care Act (ACA) ushered in the implementation of several innovative payment models that shift accountability for population costs to health systems and providers. The authors discuss the implications of th trends for the surgical profession.
AHRQ-funded; HS024763.
Citation: Nathan H, Dimick JB .
Opportunities for surgical leadership in managing population health costs.
Ann Surg 2016 Dec;264(6):909-10. doi: 10.1097/sla.0000000000001759.
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Keywords: Healthcare Costs, Payment, Provider: Health Personnel, Surgery
Pradarelli JC, Healy MA, Osborne NH
Variation in Medicare expenditures for treating perioperative complications: the cost of rescue.
The researchers evaluated differences across hospitals in the costs of care for patients surviving perioperative complications after major inpatient surgery. After 4 selected inpatient operations, substantial variation was observed across hospitals regarding Medicare episode payments for patients rescued from perioperative complications. Notably, higher Medicare payments were not associated with improved clinical performance.
AHRQ-funded; HS017765.
Citation: Pradarelli JC, Healy MA, Osborne NH .
Variation in Medicare expenditures for treating perioperative complications: the cost of rescue.
JAMA Surg 2016 Oct 5:e163340. doi: 10.1001/jamasurg.2016.3340.
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Keywords: Medicare, Adverse Events, Surgery, Healthcare Costs, Patient Safety
Spector WD, Limcangco R, Owens PL
AHRQ Author: Spector WD, Limcangco R, Owens PL, Steiner CA
Marginal hospital cost of surgery-related hospital-acquired pressure ulcers.
The researchers estimated the hospital marginal cost of a hospital-acquired pressure ulcer (HAPU) for adults patients who were hospitalized for major surgeries, adjusted for patient characteristics, comorbidities, procedures, and hospital characteristics. They found that 3.5 percent of major surgical patients developed HAPUs and that the HAPUs added approximately $8,200 to the cost of a surgical stay after adjusting for comorbidities, patient characteristics, procedures, and hospital characteristics.
AHRQ-authored.
Citation: Spector WD, Limcangco R, Owens PL .
Marginal hospital cost of surgery-related hospital-acquired pressure ulcers.
Med Care 2016 Sep;54(9):845-51. doi: 10.1097/mlr.0000000000000558.
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Keywords: Pressure Ulcers, Surgery, Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Patient Safety
Ehlers AP, Simianu VV, Bastawrous AL
Alvimopan use, outcomes, and costs: a report from the Surgical Care and Outcomes Assessment Program Comparative Effectiveness Research Translation Network Collaborative.
The researchers investigated the effectiveness of alvimopan in routine clinical practice and its impact on hospital costs. They found that when used in routine clinical practice, alvimopan was associated with a shorter length of stay and limited but significant hospital cost savings. They concluded that both efficacy and effectiveness data support the use of alvimopan in routine clinical practice, and its use could be measured as a marker of higher quality care.
AHRQ-funded; HS020025.
Citation: Ehlers AP, Simianu VV, Bastawrous AL .
Alvimopan use, outcomes, and costs: a report from the Surgical Care and Outcomes Assessment Program Comparative Effectiveness Research Translation Network Collaborative.
J Am Coll Surg 2016 May;222(5):870-7. doi: 10.1016/j.jamcollsurg.2016.01.051.
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Keywords: Comparative Effectiveness, Surgery, Digestive Disease and Health, Healthcare Costs
Chen LM, Norton EC, Birkmeyer JD
Comparing approaches to controlling Medicare spending.
For 3 common surgical procedures (coronary artery bypass grafting (CABG), prostatectomy, and hip replacement), the researchers compared the relative influence of procedure rates versus episode payments (among those with procedures) on total Medicare expenditures. Using complete Part A and B Medicare claims data, they found that reducing procedure rates lowers total Medicare spending substantially more than reducing episode payments.
AHRQ-funded; HS020671.
Citation: Chen LM, Norton EC, Birkmeyer JD .
Comparing approaches to controlling Medicare spending.
J Hosp Med 2016 Mar;11(3):215-6. doi: 10.1002/jhm.2527.
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Keywords: Medicare, Healthcare Costs, Surgery
Raol N, Zogg CK, Boss EF
Inpatient pediatric tonsillectomy: Does hospital type affect cost and outcomes of care?
The researchers ascertained whether hospital type is associated with differences in total cost and outcomes for inpatient tonsillectomy. They found that significant differences in costs, outcomes, and patient factors exist for inpatient tonsillectomy based on hospital type. Reasons for these differences are not discernable using isolated claims data.
AHRQ-funded; HS022932.
Citation: Raol N, Zogg CK, Boss EF .
Inpatient pediatric tonsillectomy: Does hospital type affect cost and outcomes of care?
Otolaryngol Head Neck Surg 2016 Mar;154(3):486-93. doi: 10.1177/0194599815621739..
Keywords: Healthcare Cost and Utilization Project (HCUP), Patient-Centered Outcomes Research, Healthcare Costs, Surgery, Children/Adolescents
Schlitz NK, Kaiboriboon K, Koroukian SM
Long-term reduction of health care costs and utilization after epilepsy surgery.
This study assessed long-term direct medical costs, health care utilization, and mortality following resective surgery in persons with uncontrolled epilepsy. It found that the mean direct medical cost difference between the surgical group and control group was $6,806 after risk-set matching. The incidence rate ratio of inpatient, emergency room, and outpatient utilization was lower among the surgical group in both unadjusted and adjusted analyses.
AHRQ-funded; HS000059.
Citation: Schlitz NK, Kaiboriboon K, Koroukian SM .
Long-term reduction of health care costs and utilization after epilepsy surgery.
Epilepsia 2016 Feb;57(2):316-24. doi: 10.1111/epi.13280.
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Keywords: Healthcare Costs, Healthcare Utilization, Mortality, Neurological Disorders, Outcomes, Surgery
Grenda TR, Krell RW, Dimick JB
Reliability of hospital cost profiles in inpatient surgery.
This study sought to discover whether Medicare payments for surgery can reliably compare hospital costs. It found that episode payments for inpatient surgery are a reliable measure of hospital costs for commonly performed procedures, but are less reliable for lower volume operations. These findings suggest that hospital cost profiles based on Medicare claims data may be used to benchmark efficiency, especially for more common procedures.
AHRQ-funded; HS000053.
Citation: Grenda TR, Krell RW, Dimick JB .
Reliability of hospital cost profiles in inpatient surgery.
Surgery 2016 Feb;159(2):375-80. doi: 10.1016/j.surg.2015.06.043..
Keywords: Inpatient Care, Surgery, Healthcare Costs, Medicare, Data
Shen C, Tina Shih YC
Therapeutic substitutions in the midst of new technology diffusion: the case of treatment for localized prostate cancer.
The authors studied the impact of the fast diffusion of robotic surgical systems on the overall treatment pattern of localized prostate cancer. They found that the density of robotic systems at state-level had a significantly positive impact on the rate of surgery and a significantly negative impact on the rate of radiation therapy. They concluded that part of the increase in the rate of surgery was driven by substitution across treatment types with a large proportion originating from the younger population.
AHRQ-funded; HS018535; HS020263.
Citation: Shen C, Tina Shih YC .
Therapeutic substitutions in the midst of new technology diffusion: the case of treatment for localized prostate cancer.
Soc Sci Med 2016 Feb;151:110-20. doi: 10.1016/j.socscimed.2016.01.016.
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Keywords: Surgery, Cancer: Prostate Cancer, Cancer, Healthcare Costs, Treatments
Hawken SR, Ryan AM, Miller DC
Surgery and Medicare shared savings program accountable care organizations.
The researchers investigated the degree to which surgeons and other specialists are participating in Medicare Shared Savings Programs, and whether such specialist integration influences accountable care organization (ACO) performance. They found that participation by surgeons and other specialists in Medicare ACO programs is highly variable. Some ACOs include many specialists who are tightly integrated with primary care physicians, while others consist solely of primary care physicians.
AHRQ-funded; HS018546.
Citation: Hawken SR, Ryan AM, Miller DC .
Surgery and Medicare shared savings program accountable care organizations.
JAMA Surg 2016 Jan;151(1):5-6. doi: 10.1001/jamasurg.2015.2772.
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Keywords: Surgery, Medicare, Payment, Healthcare Costs
Maeda JL, Mosher Henke R, Marder WD
AHRQ Author: Karaca Z, Friedman BS, Wong HS
Variation in hospital inpatient prices across small geographic areas.
The authors examined whether market competition may influence the difference in the inpatient price per discharge between public and private payers across small geographic areas. They found greater geographic variation in the inpatient price per discharge among private than public payers for most hospital services, while hospitals in more concentrated markets were associated with a higher price per discharge among knee arthroplasty discharges for both payers. They concluded that hospitals charged significantly higher prices to private than public payers.
AHRQ-authored; AHRQ-funded; 290200600009C.
Citation: Maeda JL, Mosher Henke R, Marder WD .
Variation in hospital inpatient prices across small geographic areas.
Am J Manag Care 2014 Nov;20(11):907-16.
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Keywords: Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Orthopedics, Surgery
Parmar AD, Coutin MD, Vargas GM
Cost-effectiveness of elective laparoscopic cholecystectomy versus observation in older patients presenting with mild biliary disease.
The objective was to determine the threshold for probability of recurrent symptoms at which elective cholecystectomy became the most effective and cost-effective options for older patients with mild biliary disease. This procedure was more effective than observation when the probability of continued symptoms exceeded 45.3 percent; when the probability exceeded 82.7 percent, the procedure became more cost-effective as well.
AHRQ-funded; HS022134
Citation: Parmar AD, Coutin MD, Vargas GM .
Cost-effectiveness of elective laparoscopic cholecystectomy versus observation in older patients presenting with mild biliary disease.
J Gastrointest Surg. 2014 Sep;18(9):1616-22. doi: 10.1007/s11605-014-2570-9..
Keywords: Comparative Effectiveness, Healthcare Costs, Elderly, Surgery
Hockenberry JM, Helmchen LA
The nature of surgeon human capital depreciation.
The authors estimated how temporal breaks affect surgeons' performance of coronary artery bypass grafting (CABG). They found that a surgeon's additional day away from the operating room raised patients' inpatient mortality by up to 0.067 percentage points but reduced total hospitalization costs by up to 0.59 percentage points, and among emergent patients treated by high-volume providers, an additional day away raised mortality risk by 0.398 percentage points but reduced cost by up to 1.4 percentage points. They concluded that their results are consistent with the hypothesis that as temporal distance increases, surgeons are less likely to recognize and address life-threatening complications.
AHRQ-funded; HS019743.
Citation: Hockenberry JM, Helmchen LA .
The nature of surgeon human capital depreciation.
J Health Econ 2014 Sep;37:70-80. doi: 10.1016/j.jhealeco.2014.06.001.
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Keywords: Healthcare Costs, Mortality, Provider Performance, Surgery
Martin BI, Franklin GM, Deyo RA
How do coverage policies influence practice patterns, safety, and cost of initial lumbar fusion surgery? A population-based comparison of workers' compensation systems.
In response to increasing use of lumbar fusion for improving back pain, despite unclear efficacy, particularly among injured workers, this study compared the use of complex fusion techniques, adverse outcomes within 3 months, and costs for California and Washington State with workers’ compensation policies that differed in their coverage restrictions. The researchers found that California’s broader coverage policy was associated with more aggressive practice, higher rates of reoperation, readmission and other complications.
AHRQ-funded; HS018405
Citation: Martin BI, Franklin GM, Deyo RA .
How do coverage policies influence practice patterns, safety, and cost of initial lumbar fusion surgery? A population-based comparison of workers' compensation systems.
Spine J. 2014 Jul;14(7):1237-46. doi: 10.1016/j.spinee.2013.08..
Keywords: Health Insurance, Surgery, Healthcare Costs, Healthcare Utilization
Schweizer ML, Cullen JJ, Perencevich EN
Costs associated with surgical site infections in Veterans Affairs hospitals.
This study evaluated surgical site infections(SSIs) in 1,756 Veterans Administration patients to determine the excess costs associated with total, deep, and superficial SSIs. It found that the highest risk-adjusted costs occurred with deep SSIs and SSIs associated with neurosurgery patients.
AHRQ-funded; HS021992
Citation: Schweizer ML, Cullen JJ, Perencevich EN .
Costs associated with surgical site infections in Veterans Affairs hospitals.
JAMA Surg. 2014 Jun;149(6):575-581. doi:10.1001/jamasurg.2013.4663..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Patient Safety, Healthcare Costs