National Healthcare Quality and Disparities Report
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Topics
- Access to Care (3)
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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 151 Research Studies DisplayedHuerta TR, McAlearney AS, Rizer MK
Introducing a patient portal and electronic tablets to inpatient care.
The researchers implemented a pilot inpatient portal (MyChart Bedside [Epic Systems]) using Android tablets to provide patients and their families and caregivers with an expected care plan each day, a roster of the care team, the ability to exchange secure messages with the care team, a way to write and save notes, and access to health information. They conducted the 90-day pilot program in 15 rooms on 1 patient unit in each of 2 hospitals and gave tablets to 179 patients. They found that patients wanted immediate access to laboratory results, that patients admitted for 1-2 days found the tablets less important, that those readmitted insisted on having a tablet, and that those with their own electronic devices were less likely to accept the tablet.
AHRQ-funded; HS024091.
Citation: Huerta TR, McAlearney AS, Rizer MK .
Introducing a patient portal and electronic tablets to inpatient care.
Ann Intern Med 2017 Dec 5;167(11):816-17. doi: 10.7326/m17-1766.
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Keywords: Health Information Technology (HIT), Hospitalization, Inpatient Care, Web-Based, Electronic Health Records (EHRs)
Ho V, Ross JS, Steiner CA
AHRQ Author: Steiner CA
A nationwide assessment of the association of smoking bans and cigarette taxes with hospitalizations for acute myocardial infarction, heart failure, and pneumonia.
No national study using complete hospitalization counts by area that accounts for contemporaneous controls including state cigarette taxes has been conducted. This study in 28 states found that smoking bans lowered pneumonia hospitalization rates for persons ages 60 to 74 years and higher cigarette taxes were associated with lower heart failure hospitalizations for all ages and fewer pneumonia hospitalizations for adults aged 60 to 74.
AHRQ-authored.
Citation: Ho V, Ross JS, Steiner CA .
A nationwide assessment of the association of smoking bans and cigarette taxes with hospitalizations for acute myocardial infarction, heart failure, and pneumonia.
Med Care Res Rev 2017 Dec;74(6):687-704. doi: 10.1177/1077558716668646.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Hospitalization, Pneumonia, Tobacco Use
Kwa L, Kwa MC, Silverberg JI
Cardiovascular comorbidities of pediatric psoriasis among hospitalized children in the United States.
This study sought to determine if there is an association between pediatric psoriasis and cardiovascular comorbidities. It found that in multivariate survey logistic regression models adjusting for age, sex, and race/ethnicity, pediatric psoriasis was significantly associated with 5 of 10 cardiovascular comorbidities.
AHRQ-funded; HS023011.
Citation: Kwa L, Kwa MC, Silverberg JI .
Cardiovascular comorbidities of pediatric psoriasis among hospitalized children in the United States.
J Am Acad Dermatol 2017 Dec;77(6):1023-29. doi: 10.1016/j.jaad.2017.08.034.
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Keywords: Cardiovascular Conditions, Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Skin Conditions
Stevens JP, Nyweide DJ, Maresh S
Comparison of hospital resource use and outcomes among hospitalists, primary care physicians, and other generalists.
The purpose of this study was to examine differences in the use of health care resources and outcomes among hospitalized patients cared for by hospitalists, their own primary care physicians (PCPs), or other generalists. The investigators found that a PCP's prior experience with a patient may be associated with inpatient use of resources and patient outcomes.
AHRQ-funded; HS024288.
Citation: Stevens JP, Nyweide DJ, Maresh S .
Comparison of hospital resource use and outcomes among hospitalists, primary care physicians, and other generalists.
JAMA Intern Med 2017 Dec;177(12):1781-87. doi: 10.1001/jamainternmed.2017.5824..
Keywords: Healthcare Utilization, Hospitalization, Outcomes, Primary Care
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
Lindenauer PK, Shieh MS, Stefan MS
Hospital procalcitonin testing and antibiotic treatment of patients admitted for chronic obstructive pulmonary disease exacerbation
The purpose of this study was to determine the impact of procalcitonin (PCT) testing on antibiotic treatment of patients hospitalized for exacerbations of chronic obstructive pulmonary disease (COPD) in routine practice. The study conclude that as currently implemented, PCT testing appears to have had little impact on decisions to initiate antibiotic therapy or on duration of treatment for COPD exacerbations.
AHRQ-funded; HS024596.
Citation: Lindenauer PK, Shieh MS, Stefan MS .
Hospital procalcitonin testing and antibiotic treatment of patients admitted for chronic obstructive pulmonary disease exacerbation
Ann Am Thorac Soc 2017 Dec;14(12):1779-85. doi: 10.1513/AnnalsATS.201702-133OC..
Keywords: Antibiotics, Respiratory Conditions, Hospitalization, Inpatient Care, Patient-Centered Outcomes Research
Hernandez-Boussard T, Davies S, McDonald K
Interhospital facility transfers in the United States: a nationwide outcomes study.
This study identified and compared characteristics and outcomes of transfer and nontransfer patients. In-hospital adverse events were significantly higher in transfer patients compared with nontransfer patients. Study results suggest that transfer patients have inferior outcomes compared with nontransfer patients.
AHRQ-funded; HS018558.
Citation: Hernandez-Boussard T, Davies S, McDonald K .
Interhospital facility transfers in the United States: a nationwide outcomes study.
J Patient Saf 2017 Dec;13(4):187-91. doi: 10.1097/pts.0000000000000148.
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Keywords: Adverse Events, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Patient Safety, Transitions of Care
Adrion ER, Kocher KE, Nallamothu BK
Rising use of observation care among the commercially insured may lead to total and out-of-pocket cost savings.
Using multipayer commercial claims for the period 2009-13, the investigators evaluated utilization and spending among patients admitted for six conditions that are commonly managed with either observation care or short-stay hospitalizations. In their study period, the use of observation care increased relative to that of short-stay hospitalizations. In addition, total and out-of-pocket spending were substantially lower for observation care, though both grew rapidly--and at rates much higher than spending in the inpatient setting--over the study period.
AHRQ-funded; HS000053.
Citation: Adrion ER, Kocher KE, Nallamothu BK .
Rising use of observation care among the commercially insured may lead to total and out-of-pocket cost savings.
Health Aff 2017 Dec;36(12):2102-09. doi: 10.1377/hlthaff.2017.0774..
Keywords: Health Insurance, Healthcare Costs, Healthcare Delivery, Healthcare Utilization, Hospitalization, Hospitals, Medicare
Saeed MJ, Turner TE, Brown DL
Trends in inferior vena cava filter placement by indication in the United States from 2005 to 2014.
This study examined trends in inpatient inferior vena cava (IVC) filter placement overall and by indication from 2005 to 2014. The IVC filter placement rate per 100 000 hospitalizations increased from 322.1 (n = 99 779) in 2005 to 412.0 (n = 129 026) in 2010, decreased to 374.1 (n = 117 731) in 2011, and continued declining to 321.8 (n = 95 735) in 2014. The percentage of prophylactic IVC filter placement decreased from 28.9 percent in 2005 to 22.6 percent in 2014.
AHRQ-funded; HS019455.
Citation: Saeed MJ, Turner TE, Brown DL .
Trends in inferior vena cava filter placement by indication in the United States from 2005 to 2014.
JAMA Intern Med 2017 Dec;177(12):1861-62. doi: 10.1001/jamainternmed.2017.5960.
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Keywords: Cardiovascular Conditions, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Surgery
Prochaska MT, Newcomb R, Block G
Association between anemia and fatigue in hospitalized patients: does the measure of anemia matter?
This study assessed multiple Hb-based measures of anemia in hospitalized patients and test whether these are associated with fatigue. Mean Hb had a less robust association with fatigue than minimum Hb, and no other measure of Hb was associated with patients' fatigue levels. Minimum Hb is associated with fatigue while hospitalized and may help identify patients for interventions to address anemia-related fatigue.
AHRQ-funded; HS023007.
Citation: Prochaska MT, Newcomb R, Block G .
Association between anemia and fatigue in hospitalized patients: does the measure of anemia matter?
J Hosp Med 2017 Nov;12(11):898-904. doi: 10.12788/jhm.2832.
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Keywords: Hospitalization, Patient-Centered Healthcare, Risk
Masterson Creber R, Chen T, Wei C
Brief report: patient activation among urban hospitalized patients with heart failure.
The purpose of this study was to identify whether patient activation is associated with patient-reported health outcomes in an urban and racially diverse inpatient sample of patients with heart failure. The study concluded that patient activation can be easily measured in hospitalized patients with heart failure and is associated with clinically meaningful patient-reported health outcomes.
AHRQ-funded; HS021816.
Citation: Masterson Creber R, Chen T, Wei C .
Brief report: patient activation among urban hospitalized patients with heart failure.
J Card Fail 2017 Nov;23(11):817-20. doi: 10.1016/j.cardfail.2017.08.452..
Keywords: Heart Disease and Health, Hospitalization, Patient and Family Engagement, Patient Self-Management, Urban Health
Albrecht JS, Slejko JF, Stein DM
Treatment charges for traumatic brain injury among older adults at a trauma center.
The objective of this study was to provide charge estimates of treatment for traumatic brain injury (TBI), including both hospital and physician charges, among adults 65 years and older treated at a trauma center. The study provided the first estimates of hospital and physician charges associated with hospitalization for TBI among older adults at a trauma center that will aid in resource allocation, triage decisions, and healthcare policy.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Slejko JF, Stein DM .
Treatment charges for traumatic brain injury among older adults at a trauma center.
J Head Trauma Rehabil 2017 Nov/Dec;32(6):E45-e53. doi: 10.1097/htr.0000000000000297..
Keywords: Brain Injury, Elderly, Healthcare Costs, Hospitalization, Patient-Centered Outcomes Research
Heslin KC, Owens PL, Karaca Z
AHRQ Author: Heslin KC; Owens PL; Karaca Z; Elixhauser A
Trends in opioid-related inpatient stays shifted after the US transitioned to ICD-10-CM diagnosis coding in 2015.
This study examines how trend analyses of inpatient stays involving opioid diagnoses were affected by the transition to ICD-10-CM. It found a sharp increase in opioid-related stays overall during the transition to ICD-10-CM. This may indicate that the new classification system is capturing stays that were missed by ICD-9-CM data.
AHRQ-authored.
Citation: Heslin KC, Owens PL, Karaca Z .
Trends in opioid-related inpatient stays shifted after the US transitioned to ICD-10-CM diagnosis coding in 2015.
Med Care 2017 Nov;55(11):918-23. doi: 10.1097/mlr.0000000000000805.
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Keywords: Critical Care, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Opioids, Substance Abuse
Ellimoottil C, Syrjamaki JD, Volt JD
Validation of a claims-based algorithm to characterize episodes of care.
The Michigan Value Collaborative (MVC) developed a claims-based algorithm to provide hospitals with data on events that occur to patients beyond the hospitalization. In this article, the investigators discuss the validation of MVC's claims-based algorithm. They indicate that their findings suggest that the MVC claims-based algorithm identifies and classifies claims with high fidelity and outperforms medical records in the identification of postdischarge events.
AHRQ-funded; HS024193.
Citation: Ellimoottil C, Syrjamaki JD, Volt JD .
Validation of a claims-based algorithm to characterize episodes of care.
Am J Manag Care 2017 Nov;23(11):e382-e86..
Keywords: Hospital Discharge, Hospital Readmissions, Hospitalization, Hospitals, Quality of Care, Quality Improvement
Badawy J, Nguyen OK, Clark C
Is everyone really breathing 20 times a minute? Assessing epidemiology and variation in recorded respiratory rate in hospitalised adults.
The researchers sought to assess the potential accuracy of respiratory rate (RR) by analyzing the distribution and variation as a proxy, since RR should be normally distributed if recorded accurately. The observed patterns suggest that RR is inaccurately recorded, even among those with cardiopulmonary compromise, and represents a 'spot' estimate with values of 18 and 20 breaths per minute representing 'normal.’
AHRQ-funded; HS022418.
Citation: Badawy J, Nguyen OK, Clark C .
Is everyone really breathing 20 times a minute? Assessing epidemiology and variation in recorded respiratory rate in hospitalised adults.
BMJ Qual Saf 2017 Oct;26(10):832-36. doi: 10.1136/bmjqs-2017-006671.
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Keywords: Hospitalization, Inpatient Care, Patient Safety, Quality Improvement, Respiratory Conditions
Davidov DM, Davis SM, Zhu M
AHRQ Author: Stocks C
Intimate partner violence-related hospitalizations in Appalachia and the non-Appalachian United States.
The objective of this study was to estimate the rate of intimate partner violence -related hospitalizations in Appalachia and the non-Appalachian United States for 2007-2011 and compare hospitalizations in each region by clinical and sociodemographic factors.. After adjusting for age and rurality, Appalachian counties had a 22 percent higher hospitalization rate than non-Appalachian counties.
AHRQ-authored.
Citation: Davidov DM, Davis SM, Zhu M .
Intimate partner violence-related hospitalizations in Appalachia and the non-Appalachian United States.
PLoS One 2017 Sep 8;12(9):e0184222. doi: 10.1371/journal.pone.0184222.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Domestic Violence, Hospitalization, Social Determinants of Health, Rural Health
Khan A, Furtak SL, Melvin P
Parent-provider miscommunications in hospitalized children.
The objectives of this study were to: (1) examine characteristics of parent-provider miscommunications about hospitalized children; (2) describe associations among parent-provider miscommunications, parent-reported errors, and hospital experience; and (3) compare parent and attending physician reports of parent-provider miscommunications. The investigators found that parent-provider miscommunications were associated with parent-reported errors and suboptimal hospital experience. Parents reported parent-provider miscommunications more often than attending physicians did.
AHRQ-funded; HS022986; HS000063.
Citation: Khan A, Furtak SL, Melvin P .
Parent-provider miscommunications in hospitalized children.
Hosp Pediatr 2017 Sep;7(9):505-15. doi: 10.1542/hpeds.2016-0190..
Keywords: Adverse Events, Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Hospitalization, Hospitals, Medical Errors, Patient Safety
Wang SY, Dang W, Aldridge MD
Associations of hospice disenrollment and hospitalization with continuous home care provision.
The researchers examined rates of hospice disenrollment and posthospice hospitalization among patients who are enrolled in hospices that provide continuous home care (CHC) (CHC hospices) compared with patients who are enrolled in hospices that do not offer CHC (non-CHC hospices). They concluded that CHC hospices had significantly lower rates of hospice disenrollment and posthospice hospitalization, suggesting CHC service available may enable higher quality of end-of-life care.
AHRQ-funded; HS023900.
Citation: Wang SY, Dang W, Aldridge MD .
Associations of hospice disenrollment and hospitalization with continuous home care provision.
Med Care 2017 Sep;55(9):848-55. doi: 10.1097/mlr.0000000000000776.
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Keywords: Elderly, Home Healthcare, Hospitalization, Palliative Care
Kwa MC, Ardalan K, Laumann AE
Predictors of hospitalization, length of stay and costs of care among adults with dermatomyositis in the United States.
The researchers sought to determine the prevalence and risk factors for hospitalization with dermatomyositis and to assess inpatient burden of dermatomyositis. They concluded that there is a significant and increasing inpatient burden for dermatomyositis in the US. Also, there appear to be racial differences as non-whites have higher prevalence of admission, increased length of stay and cost of care.
AHRQ-funded; HS023011.
Citation: Kwa MC, Ardalan K, Laumann AE .
Predictors of hospitalization, length of stay and costs of care among adults with dermatomyositis in the United States.
Arthritis Care Res 2017 Sep;69(9):1391-99. doi: 10.1002/acr.23190.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Health Insurance, Skin Conditions
Spector WD, Limcangco R, Furukawa MF
AHRQ Author: Spector WD, Limcangco R, Furukawa MF, Encinosa WE
The marginal costs of adverse drug events associated with exposures to anticoagulants and hypoglycemic agents during hospitalization.
The researchers estimated the marginal cost of care associated with anticoagulants and hypoglycemic agents for adults in 5 patient groups during their hospital stay and the total annual ADE costs for all patients exposed to these drugs during their stay. The 2013 hospital cost estimates for adverse drug events associated with anticoagulants and hypoglycemic agents were >$2.5 billion for each drug class.
AHRQ-authored.
Citation: Spector WD, Limcangco R, Furukawa MF .
The marginal costs of adverse drug events associated with exposures to anticoagulants and hypoglycemic agents during hospitalization.
Med Care 2017 Sep;55(9):856-63. doi: 10.1097/mlr.0000000000000780.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Drug Events (ADE), Blood Thinners, Hospitalization, Healthcare Costs
Neuman MI, Hall M, Lipsett SC
Utility of blood culture among children hospitalized with community-acquired pneumonia.
The researchers sought to determine the prevalence of bacteremia and characterize the microbiology and penicillin-susceptibility patterns of positive blood culture results among children hospitalized with community-acquired pneumonia (CAP). Among children without comorbidities hospitalized with CAP in a non-ICU setting, the rate of bacteremia was low, and isolated pathogens were usually susceptible to penicillin. Blood cultures may not be needed for most children hospitalized with CAP.
AHRQ-funded; HS022342; HS019862.
Citation: Neuman MI, Hall M, Lipsett SC .
Utility of blood culture among children hospitalized with community-acquired pneumonia.
Pediatrics 2017 Sep;140(3):pii: e20171013. doi: 10.1542/peds.2017-1013.
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Keywords: Hospitalization, Children/Adolescents, Children/Adolescents, Medication
Chhatre S, Cook R, Mallik E
Trends in substance use admissions among older adults.
Researchers sought to analyze the trends in admissions for substance abuse treatment among older adults (aged 55 and older). Substantial changes in the demographic, substance use pattern, and treatment characteristics for the older adult admissions were noted. The proportion of admissions for following primary substances showed increase: cocaine/crack, marijuana/hashish, heroin, non-prescription methadone, and other opiates and synthetics.
AHRQ-funded; HS024106.
Citation: Chhatre S, Cook R, Mallik E .
Trends in substance use admissions among older adults.
BMC Health Serv Res 2017 Aug 22;17(1):584. doi: 10.1186/s12913-017-2538-z.
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Keywords: Behavioral Health, Elderly, Hospitalization, Opioids, Substance Abuse
Leshem E, Tate JE, Steiner CA
AHRQ Author: Steiner. CA
National estimates of reductions in acute gastroenteritis-related hospitalizations and associated costs in US children after implementation of rotavirus vaccines.
The study compared acute gastroenteritis (AGE)-related hospitalization rates among children <5 years of age during the pre-rotavirus vaccine (2000-2006) and post-rotavirus vaccine (2008-2013) periods to estimate national reductions in AGE-related hospitalizations and associated costs.
AHRQ-authored
Citation: Leshem E, Tate JE, Steiner CA .
National estimates of reductions in acute gastroenteritis-related hospitalizations and associated costs in US children after implementation of rotavirus vaccines.
J Pediatric Infect Dis Soc 2017 Aug 17;7(3):257-60. doi: 10.1093/jpids/pix057..
Keywords: Children/Adolescents, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Vaccination
Nahhas GJ, Wilson D, Talbot V
Feasibility of implementing a hospital-based "opt-out" tobacco-cessation service.
This study assessed the feasibility and outcomes of implementing a hospital-based "opt-out" tobacco-cessation service. The service consisted of a bedside consult and phone follow-up 3, 14, and 30 days after hospital discharge using interactive-voice-response. Findings from this study suggest that an inpatient smoking-cessation service with an "opt-out" approach can positively impact short-term cessation outcomes.
AHRQ-funded; HS023863.
Citation: Nahhas GJ, Wilson D, Talbot V .
Feasibility of implementing a hospital-based "opt-out" tobacco-cessation service.
Nicotine Tob Res 2017 Aug;19(8):937-43. doi: 10.1093/ntr/ntw312.
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Keywords: Health Information Technology (HIT), Hospitalization, Tobacco Use, Outcomes
Berry J, Wilson K, Dumas H
Use of post-acute facility care in children hospitalized with acute respiratory illness.
In this retrospective analysis, the investigators assessed which children hospitalized with respiratory illness (RI) were the most likely to use post-acute facility care (PAC) for recovery. The investigators found that children with RI who were most likely to use PAC had a high prevalence of multiple chronic conditions, multiple medications, and medical technology.
AHRQ-funded; HS023092.
Citation: Berry J, Wilson K, Dumas H .
Use of post-acute facility care in children hospitalized with acute respiratory illness.
J Hosp Med 2017 Aug;12(8):626-31. doi: 10.12788/jhm.2780..
Keywords: Children/Adolescents, Hospitalization, Respiratory Conditions, Transitions of Care