National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Adverse Drug Events (ADE) (1)
- Adverse Events (7)
- Ambulatory Care and Surgery (2)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Behavioral Health (1)
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Caregiving (2)
- Care Management (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- (-) Children/Adolescents (21)
- Decision Making (1)
- Digestive Disease and Health (1)
- Ear Infections (1)
- Evidence-Based Practice (2)
- Healthcare-Associated Infections (HAIs) (4)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Costs (2)
- Healthcare Delivery (1)
- Healthcare Utilization (1)
- Hospital Readmissions (1)
- Hospitals (2)
- Injuries and Wounds (2)
- Low-Income (1)
- Medication (2)
- Mortality (1)
- Neurological Disorders (1)
- Outcomes (3)
- Patient-Centered Outcomes Research (4)
- Patient Experience (1)
- Patient Safety (1)
- Practice Patterns (2)
- Quality Improvement (1)
- Quality Indicators (QIs) (1)
- Racial and Ethnic Minorities (1)
- Registries (2)
- Risk (3)
- Social Determinants of Health (1)
- (-) Surgery (21)
- Transplantation (4)
- Urinary Tract Infection (UTI) (1)
- Vaccination (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 21 of 21 Research Studies DisplayedFeldman AG, Marsh R, Kempe A
Barriers to pretransplant immunization: a qualitative interview study of pediatric solid organ transplant stakeholders.
Investigators described the experiences and beliefs of pediatric transplant stakeholders regarding factors that contribute to low pre-transplant immunization rates. Five central themes emerged: gaps in knowledge about timing and safety of pre-transplant immunizations; lack of communication, coordination, and follow-up between team members; lack of centralized immunization records; subspecialty clinics functioning as the medical home for transplant candidates, but not able to provide all needed immunizations; and differences between organ type in prioritization and completion of pre-transplant immunization. The authors recommended new tools to overcome these barriers and to increase immunization rates in transplant candidates.
AHRQ-funded; HS026510.
Citation: Feldman AG, Marsh R, Kempe A .
Barriers to pretransplant immunization: a qualitative interview study of pediatric solid organ transplant stakeholders.
J Pediatr 2020 Dec;227:60-68. doi: 10.1016/j.jpeds.2020.07.038..
Keywords: Children/Adolescents, Transplantation, Surgery, Healthcare Delivery, Healthcare Utilization
Garrity BM, Singer SJ, Ward E
Parent perspectives on short-term recovery after spinal fusion surgery in children with neuromuscular scoliosis.
This paper evaluates concerns of parents and families of children who had undergone spinal fusion for neuromuscular scoliosis. Semistructured interviews were conducted with 18 families within 3 months after spinal fusion performed August 2017 to January 2019 at a children’s hospital. The interviews were recorded, transcribed, and coded line-by-line by 2 independent reviewers. Five themes emerged among families when reflecting on the postoperative recovery period: 1) communicating and making shared decisions regarding postoperative care in a patient- and family-centered manner, 2) setting hospital discharge goals and being ready for discharge, 3) planning for transportation from hospital to home, 4) acquiring supports for caregiving at home after discharge, and 5) anticipating a long recovery at home.
AHRQ-funded; HS024453.
Citation: Garrity BM, Singer SJ, Ward E .
Parent perspectives on short-term recovery after spinal fusion surgery in children with neuromuscular scoliosis.
J Patient Exp 2020 Dec;7(6):1369-77. doi: 10.1177/2374373520972570..
Keywords: Children/Adolescents, Surgery, Caregiving, Patient Experience
Kemme S, Sundaram SS, Curtis DJ
A community divided: post-transplant live vaccine practices among Society of Pediatric Liver Transplantation (SPLIT) centers.
The goal of this study was to assess current post-transplant live vaccine practices at individual pediatric liver transplant centers following the updated AST guidelines. Using email surveys with a 93% response rate, findings showed that only 29% of centers offered live vaccines post-transplant, with each center using different eligibility criteria for live vaccines. The main reasons for a center not offering post-transplant live vaccines were safety concerns and inability to reach group consensus.
AHRQ-funded; HS026510.
Citation: Kemme S, Sundaram SS, Curtis DJ .
A community divided: post-transplant live vaccine practices among Society of Pediatric Liver Transplantation (SPLIT) centers.
Pediatr Transplant 2020 Aug 26:e13804. doi: 10.1111/petr.13804..
Keywords: Children/Adolescents, Transplantation, Surgery, Vaccination, Practice Patterns
Rinke ML, Oyeku SO, Ford WJH
Costs of ambulatory pediatric healthcare-associated infections: Central-line-associated bloodstream infection (CLABSIs), catheter-associated urinary tract infection (CAUTIs), and surgical site infections (SSIs).
Ambulatory healthcare-associated infections (HAIs) occur frequently in children and are associated with morbidity. Less is known about ambulatory HAI costs. This retrospective case control study estimated additional costs associated with pediatric ambulatory central-line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTI), and surgical site infections (SSIs) following ambulatory surgery. The authors concluded that ambulatory HAI in pediatric patients were associated with significant additional costs.
AHRQ-funded; HS024432.
Citation: Rinke ML, Oyeku SO, Ford WJH .
Costs of ambulatory pediatric healthcare-associated infections: Central-line-associated bloodstream infection (CLABSIs), catheter-associated urinary tract infection (CAUTIs), and surgical site infections (SSIs).
Infect Control Hosp Epidemiol 2020 Nov;41(11):1292-97. doi: 10.1017/ice.2020.305..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Ambulatory Care and Surgery, Healthcare Costs, Surgery
Ing C, Ma X, Sun M
Exposure to surgery and anesthesia in early childhood and subsequent use of attention deficit hyperactivity disorder medications.
This study examines the association between higher rates of attention deficit hyperactivity disorder (ADHD) diagnosis and exposure to surgery and anesthesia before the age of 5. Longitudinal pharmacy data for children enrolled in Texas and New York Medicaid from 1999 to 2010 were used. They examined the association between a single exposure to anesthesia before age 5 years for 1 of 4 common pediatric surgical procedures: pyloromytomy, inguinal hernia repair, circumcisions outside the perinatal period, and tonsillectomy and/or adenectomy; and persistent ADHD medication use. A total of 213,435 children were included in the study. Children with a single exposure to anesthesia were 37% more likely than unexposed children to persistently use ADHD medication.
AHRQ-funded; HS022941.
Citation: Ing C, Ma X, Sun M .
Exposure to surgery and anesthesia in early childhood and subsequent use of attention deficit hyperactivity disorder medications.
Anesth Analg 2020 Sep;131(3):723-33. doi: 10.1213/ane.0000000000004619..
Keywords: Children/Adolescents, Behavioral Health, Medication, Surgery, Adverse Drug Events (ADE), Adverse Events
Berry JG, Glaspy T, Eagan B
Pediatric complex care and surgery comanagement: preparation for spinal fusion.
This study assessed the impact of preoperative comanagement with complex care pediatricians (CCP) on children with neuromuscular scoliosis undergoing spinal fusion surgery. A chart review of 79 children aged 5-21 years undergoing spinal fusion Jan. 2014-June 2016 was conducted at a children’s hospital. Cerebral palsy (64%) was the most common neuromuscular condition with the mean age of surgery of 14 years. Thirty-nine children had a preoperative CCP evaluation a median 63 days before the preanesthesia visit. More organ systems were affected by coexisting conditions in children with CCP evaluation than those without an evaluation. The rate of last-minute care coordination activities required for surgical clearance as well as last-minute development of new preoperative plans were lower for children with CCP evaluation than those without.
AHRQ-funded; HS024453.
Citation: Berry JG, Glaspy T, Eagan B .
Pediatric complex care and surgery comanagement: preparation for spinal fusion.
J Child Health Care 2020 Sep;24(3):402-10. doi: 10.1177/1367493519864741..
Keywords: Children/Adolescents, Surgery, Care Management, Care Coordination
Mogul DB, Perito ER, Wood N
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
In December 2018, UNOS approved an allocation scheme based on recipients' geographic distance from a deceased donor ("acuity circles"). Previous analyses suggested acuity circles (AC) would reduce waitlist mortality overall, but their impact on pediatric subgroups was not considered. In this study, the investigators applied Scientific Registry of Transplant Recipients data from 2011-2016 towards the Liver Simulated Allocation Model (LSAM) to compare outcomes by age and illness severity for the UNOS-approved AC and the existing Donor Service Area (DSA)/Region-based allocation schemes.
AHRQ-funded; HS023876.
Citation: Mogul DB, Perito ER, Wood N .
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
Transplantation 2020 Aug;104(8):1627-32. doi: 10.1097/tp.0000000000003079..
Keywords: Children/Adolescents, Transplantation, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Registries, Surgery, Access to Care
Malone SM, Seigel NS, Newland JG
Understanding antibiotic prophylaxis prescribing in pediatric surgical specialties.
The objective of this study was to understand the factors that contribute to pediatric surgeons' decisions regarding the use of perioperative antibiotic prophylaxis. The investigators found that surgeons described a complex set of factors that impacted their antibiotic prescribing in pediatric surgical cases. They reported initial, but not ongoing, training and a use of individual weight of risk and benefit as a major dictator of prescribing practices.
AHRQ-funded; HS026742.
Citation: Malone SM, Seigel NS, Newland JG .
Understanding antibiotic prophylaxis prescribing in pediatric surgical specialties.
Infect Control Hosp Epidemiol 2020 Jun;41(6):666-71. doi: 10.1017/ice.2020.71..
Keywords: Children/Adolescents, Antibiotics, Surgery, Antimicrobial Stewardship, Medication, Practice Patterns
Links AR, Callon W, Wasserman C
Parental role in decision-making for pediatric surgery: perceptions of involvement in consultations for tonsillectomy.
This study examined the parental role in decision-making for pediatric surgery, in particular perceptions of involvement in consultations for tonsillectomy. The investigators analyzed consults between 63 parents and 8 otolaryngologists. Over a third (37%) of clinicians and parent ratings showed inadequate agreement of preferred roles. Parents perceived greater involvement when clinicians discussed reasons to have or not have the surgery. There was less perception of parental involvement when clinicians used jargon, parents trusted clinicians, or experienced greater decisional conflict.
AHRQ-funded; HS022932.
Citation: Links AR, Callon W, Wasserman C .
Parental role in decision-making for pediatric surgery: perceptions of involvement in consultations for tonsillectomy.
Patient Educ Couns 2020 May;103(5):944-51. doi: 10.1016/j.pec.2019.12.012..
Keywords: Children/Adolescents, Decision Making, Surgery, Caregiving
Pruitt LCC, Skarda DE, Rollins MD
Hirschsprung-associated enterocolitis in children treated at US children's hospitals.
The incidence of and risk factors for Hirschsprung's-associated enterocolitis (HAEC) following pull-through have been limited to single institutions studies. In this retrospective cohort study, the investigators characterized the incidence of, risk factors for, and consequences of post-operative HAEC. The investigators concluded that HAEC following pull-through occurs in a large proportion of infants with HD and predicts reoperation. They suggest that multicenter studies are needed to develop prediction models and treatment protocols for HAEC.
AHRQ-funded; HS025776.
Citation: Pruitt LCC, Skarda DE, Rollins MD .
Hirschsprung-associated enterocolitis in children treated at US children's hospitals.
J Pediatr Surg 2020 Mar;55(3):535-40. doi: 10.1016/j.jpedsurg.2019.10.060.
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Keywords: Children/Adolescents, Digestive Disease and Health, Surgery, Adverse Events, Risk, Hospitals
Bowring MG, Massie AB, Chu NM
Projected 20- and 30-year outcomes for pediatric liver transplant recipients in the United States.
Researchers aimed to use national registry data and parametric models to project 20- and 30-year post-transplant outcomes for recently transplanted pediatric liver transplant (LT) recipients. Using Scientific Registry of Transplant Recipients data, they found that projected long-term outcomes for recently transplanted pediatric LT recipients are excellent, reflective of substantial improvements in medical care, and informative for physician-patient education and decision making in the current era.
AHRQ-funded; HS023876.
Citation: Bowring MG, Massie AB, Chu NM .
Projected 20- and 30-year outcomes for pediatric liver transplant recipients in the United States.
J Pediatr Gastroenterol Nutr 2020 Mar;70(3):356-63. doi: 10.1097/mpg.0000000000002592..
Keywords: Children/Adolescents, Transplantation, Patient-Centered Outcomes Research, Outcomes, Surgery, Registries, Evidence-Based Practice
Lander DP, Durakovic N, Kallogjeri D
Incidence of infectious complications following cochlear implantation in children and adults.
The goal of this study was to determine the incidence and timing of infectious complications following cochlear implantation. Results showed low rates of infectious complications in cochlear implant recipients, and meningitis was exceedingly rare. Children aged 1 and 2 years experienced infectious complications more frequently than older children, with benefits of early implantation on language development outweighing the risk. Recommendations included increased vigilance by physicians when caring for young children early after implantation and children with prior implant infections.
AHRQ-funded; HS019455.
Citation: Lander DP, Durakovic N, Kallogjeri D .
Incidence of infectious complications following cochlear implantation in children and adults.
JAMA 2020 Jan 14;323(2):182-83. doi: 10.1001/jama.2019.18611..
Keywords: Children/Adolescents, Adverse Events, Surgery, Healthcare-Associated Infections (HAIs)
Nieman CL, Tunkel DE, Boss EF
Do race/ethnicity or socioeconomic status affect why we place ear tubes in children?
The study’s objective was to analyze the association of patient- and neighborhood-level demographics and SES with clinical indications for tympanostomy tube (TT). It found that among children receiving tubes, those from high poverty areas were more likely than those from low poverty neighborhoods to receive tubes for the indication of chronic otitis media with effusion (OME) as opposed to recurrent acute otitis media (RAOM).
AHRQ-funded; HS022932.
Citation: Nieman CL, Tunkel DE, Boss EF .
Do race/ethnicity or socioeconomic status affect why we place ear tubes in children?
Int J Pediatr Otorhinolaryngol 2016 Sep;88:98-103. doi: 10.1016/j.ijporl.2016.06.029.
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Keywords: Children/Adolescents, Ear Infections, Racial and Ethnic Minorities, Social Determinants of Health, Surgery, Low-Income
McLeod L, Flynn J, Erickson M
Variation in 60-day readmission for surgical-site infections (SSIs) and reoperation following spinal fusion operations for neuromuscular scoliosis.
The purpose of this study was to examine variation in hospital performance based on risk-standardized 60-day readmission rates for surgical-site infection (SSIs) and reoperation across 39 US Children's Hospitals. It found that reoperations were associated with an SSI in 70 percent of cases. Across hospitals, SSI and reoperation rates ranged from 1 percent to 11 percent and 1 percent to 12 percent, respectively.
AHRQ-funded; HS022198.
Citation: McLeod L, Flynn J, Erickson M .
Variation in 60-day readmission for surgical-site infections (SSIs) and reoperation following spinal fusion operations for neuromuscular scoliosis.
J Pediatr Orthop 2016 Sep;36(6):634-9. doi: 10.1097/bpo.0000000000000495.
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Keywords: Children/Adolescents, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Hospital Readmissions, Hospitals, Risk
Rinke ML, Jan D, Nassim J
Surgical site infections following pediatric ambulatory surgery: an epidemiologic analysis.
The authors identified surgical site infection (SSI) rates following pediatric ambulatory surgery, SSI outcomes and risk factors, and sensitivity and specificity of SSI administrative billing codes. They concluded that SSI following pediatric ambulatory surgery occurs at an appreciable rate and conveys morbidity on children.
AHRQ-funded; HS021282.
Citation: Rinke ML, Jan D, Nassim J .
Surgical site infections following pediatric ambulatory surgery: an epidemiologic analysis.
Infect Control Hosp Epidemiol 2016 Aug;37(8):931-8. doi: 10.1017/ice.2016.98.
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Keywords: Children/Adolescents, Ambulatory Care and Surgery, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Risk
Ladner TR, Greenberg JK, Guerrero N
Chiari malformation type I surgery in pediatric patients. part 1: validation of an ICD-9-CM code search algorithm.
The researchers sought to validate two ICD-9-CM code algorithms using hospital billing data to identify pediatric patients undergoing Chiari malformation Type I (CM-I) decompression surgery. They found that an ICD-9-CM algorithm requiring a primary diagnosis of CM-I has excellent positive predictive value and very good sensitivity for identifying CM-I decompression surgery in pediatric patients. They concluded that these results establish a basis for utilizing administrative billing data to assess pediatric CM-I treatment outcomes.
AHRQ-funded; HS019455.
Citation: Ladner TR, Greenberg JK, Guerrero N .
Chiari malformation type I surgery in pediatric patients. part 1: validation of an ICD-9-CM code search algorithm.
J Neurosurg Pediatr 2016 May;17(5):519-24. doi: 10.3171/2015.10.peds15370.
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Keywords: Children/Adolescents, Neurological Disorders, Surgery
Greenberg JK, Olsen MA, Yarbrough CK
Chiari malformation type I surgery in pediatric patients. Part 2: complications and the influence of comorbid disease in California, Florida, and New York.
The objective of this study was to investigate Chiari malformation Type I (CM-I) surgical outcomes using population-level administrative billing data. It concluded that approximately 1 in 8 pediatric CM-I patients experienced a surgical complication, whereas medical complications were rare. Although complex chronic conditions were common in pediatric CM-I patients, only hydrocephalus was independently associated with increased risk of surgical events.
AHRQ-funded; HS019455.
Citation: Greenberg JK, Olsen MA, Yarbrough CK .
Chiari malformation type I surgery in pediatric patients. Part 2: complications and the influence of comorbid disease in California, Florida, and New York.
J Neurosurg Pediatr 2016 May;17(5):525-32. doi: 10.3171/2015.10.peds15369.
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Keywords: Adverse Events, Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Surgery
Jenkins KJ, Koch Kupiec J, Owens PL
AHRQ Author: Owens PL
Development and validation of an Agency for Healthcare Research and Quality indicator for mortality after congenital heart surgery harmonized with risk adjustment for congenital heart surgery (RACHS-1) methodology.
The National Quality Forum previously approved a quality indicator for mortality after congenital heart surgery developed by AHRQ. Several parameters of the validated Risk Adjustment for Congenital Heart Surgery (RACHS-1) method were included, but others differed. As part of the National Quality Forum endorsement maintenance process, developers were asked to harmonize the 2 methodologies.
AHRQ-authored.
Citation: Jenkins KJ, Koch Kupiec J, Owens PL .
Development and validation of an Agency for Healthcare Research and Quality indicator for mortality after congenital heart surgery harmonized with risk adjustment for congenital heart surgery (RACHS-1) methodology.
J Am Heart Assoc 2016 May;5(5):pii: e003028. doi: 10.1161/jaha.115.003028.
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Keywords: Surgery, Mortality, Quality Indicators (QIs), Children/Adolescents, Cardiovascular Conditions
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
Shah RK, Stey AM, Jantana KR
Identification of opportunities for quality improvement and outcome measurement in pediatric otolaryngology.
This study evaluated perioperative outcomes in pediatric otolaryngology through analysis of records residing in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (ACS-NSQIP) database. It found that although the overall rate of major postoperative morbidity in pediatric otolaryngology is low, the following areas may be targeted for targeted quality-improvement interventions: tracheostomy, airway reconstruction, mastoidectomy, and abscess drainage.
AHRQ-funded; HS022932
Citation: Shah RK, Stey AM, Jantana KR .
Identification of opportunities for quality improvement and outcome measurement in pediatric otolaryngology.
JAMA Otolaryngol Head Neck Surg. 2014 Nov;140(11):1019-26. doi: 10.1001/jamaoto.2014.2067..
Keywords: Surgery, Children/Adolescents, Quality Improvement, Outcomes, Patient-Centered Outcomes Research
Nguyen C, Hernandez-Boussard T, Davies SM
Cleft palate surgery: an evaluation of length of stay, complications, and costs by hospital type.
The purpose of this study was to assess length of stay (LOS), complication rates, costs, and charges of cleft palate repair by various hospital types. Results showed that pediatric hospitals had higher comorbidities yet shorter LOS. Pediatric resources significantly decreased the relative rate of LOS greater than 2 days, and median costs and charges increased by 41% with LOS greater than 2 days.
AHRQ-funded; HS018558.
Citation: Nguyen C, Hernandez-Boussard T, Davies SM .
Cleft palate surgery: an evaluation of length of stay, complications, and costs by hospital type.
Cleft Palate Craniofac J 2014 Jul;51(4):412-9. doi: 10.1597/12-150.
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Keywords: Adverse Events, Children/Adolescents, Patient Safety, Children/Adolescents, Surgery