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- Adverse Events (5)
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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 16 of 16 Research Studies DisplayedXu X, Lin H, Wright JD
Association between power morcellation and mortality in women with unexpected uterine cancer undergoing hysterectomy or myomectomy.
Despite concerns that power morcellation may adversely affect prognosis of patients with occult uterine cancer, empirical evidence has been limited and inconclusive. In this study, the investigators aimed to determine whether uncontained power morcellation at the time of hysterectomy or myomectomy was associated with increased mortality risk in women with occult uterine cancer.
AHRQ-funded; HS024702.
Citation: Xu X, Lin H, Wright JD .
Association between power morcellation and mortality in women with unexpected uterine cancer undergoing hysterectomy or myomectomy.
J Clin Oncol 2019 Dec 10;37(35):3412-24. doi: 10.1200/jco.19.00562..
Keywords: Cancer, Mortality, Women, Surgery, Risk, Adverse Events
Patel DK, Duncan MS, Shah AS
Association of cardiac rehabilitation with decreased hospitalization and mortality risk after cardiac valve surgery.
Investigators sought to characterize cardiac rehabilitation (CR) enrollment after cardiac valve surgery and its association with outcomes, including hospitalizations and mortality. Subjects were all fee-for-service Medicare beneficiaries undergoing open cardiac valve surgery in 2014, identified by inpatient diagnosis codes for open aortic, mitral, tricuspid, and pulmonary valve surgery. They found that fewer than half of Medicare beneficiaries undergoing cardiac valve surgery enrolled in CR programs, and there were marked racial/ethnic disparities among those who do. They recommend further study on barriers to CR enrollment in this population.
AHRQ-funded; HS022990.
Citation: Patel DK, Duncan MS, Shah AS .
Association of cardiac rehabilitation with decreased hospitalization and mortality risk after cardiac valve surgery.
JAMA Cardiol 2019 Dec;4(12):11887-1301. doi: 10.1001/jamacardio.2019.4032..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Rehabilitation, Hospitalization, Surgery, Mortality, Risk, Elderly
Mehta HB, Yong S, Sura SD
Development of comorbidity score for patients undergoing major surgery.
The goal of this study was to develop and validate a claims-based comorbidity score and compare to established comorbidity scores. The researchers used Medicare data to find adults 65 and older who had undergone major surgery to predict 1-year mortality, and 30-day hospital readmission. The comorbidity score was compared to the Charlson, Elixhauser, and CMC-HCC scores. Their newly developed comorbidity score better predicted outcomes than the established comorbidity score systems in the surgical population.
AHRQ-funded; HS022134.
Citation: Mehta HB, Yong S, Sura SD .
Development of comorbidity score for patients undergoing major surgery.
Health Serv Res 2019 Dec;54(6):1223-32. doi: 10.1111/1475-6773.13209..
Keywords: Surgery, Risk, Mortality
Fritz BA, Cui Z, Zhang M
Deep-learning model for predicting 30-day postoperative mortality.
The currently available prediction tools using summaries of intraoperative data are limited by their inability to reflect shifting risk associated with intraoperative physiological perturbations. In this study the investigators sought to compare similar benchmarks to a deep-learning algorithm predicting postoperative 30-day mortality. They concluded that a deep-learning time-series model improved prediction compared with models with simple summaries of intraoperative data.
AHRQ-funded; HS024581.
Citation: Fritz BA, Cui Z, Zhang M .
Deep-learning model for predicting 30-day postoperative mortality.
Br J Anaesth 2019 Nov;123(5):688-95. doi: 10.1016/j.bja.2019.07.025..
Keywords: Adverse Events, Health Information Technology (HIT), Mortality, Risk, Surgery
Goldstone AB, Chiu P, Baiocchi M
Interfacility transfer of Medicare beneficiaries with acute type a aortic dissection and regionalization of care in the United States.
Researchers investigated the hypothesis that regionalizing care at high-volume hospitals for acute type A aortic dissections will lower mortality. Operative mortality and long-term survival were compared for Medicare beneficiaries diagnosed with an acute type A aortic dissection who were transferred versus not transferred, underwent surgery at high-volume versus low-volume hospitals, and were rerouted versus not rerouted to a high-volume hospital for treatment. The researchers found that, despite delaying surgery, a regionalization policy that transfers patients to high-volume hospitals was associated with a 7.2% absolute risk reduction in operative mortality. They recommended that policymakers evaluate the feasibility and benefits of regionalizing the surgical treatment of acute type A aortic dissection in the United States.
AHRQ-funded; HS022192.
Citation: Goldstone AB, Chiu P, Baiocchi M .
Interfacility transfer of Medicare beneficiaries with acute type a aortic dissection and regionalization of care in the United States.
Circulation 2019 Oct 8;140(15):1239-50. doi: 10.1161/circulationaha.118.038867..
Keywords: Transitions of Care, Medicare, Heart Disease and Health, Cardiovascular Conditions, Patient-Centered Outcomes Research, Risk, Evidence-Based Practice, Mortality, Hospitals
Kundi H, Popma JJ, Valsdottir LR
The value of claims-based nontraditional risk factors in predicting long-term mortality after MitraClip procedure.
The goals of this study were to identify nontraditional risk factors coded in administrative claims data and to evaluate their ability to improve prediction of long-term mortality in patients undergoing percutaneous mitral valve repair. Patients undergoing transcatheter mitral valve repair using MitraClip implantation were identified among Medicare fee-for-service beneficiaries; researchers used nested Cox regression models to identify claims codes predictive of long-term mortality. Four groups of variables were introduced: cardiac, noncardiac, and nontraditional risk factors, and presentation characteristics. The authors conclude that risk-prediction models, which include nontraditional risk factors as identified in claims data, can be used to predict long-term mortality risk more accurately in patients who have undergone MitraClip procedures.
AHRQ-funded; HS024520.
Citation: Kundi H, Popma JJ, Valsdottir LR .
The value of claims-based nontraditional risk factors in predicting long-term mortality after MitraClip procedure.
Can J Cardiol 2018 Dec;34(12):1648-54. doi: 10.1016/j.cjca.2018.10.002..
Keywords: Cardiovascular Conditions, Elderly, Mortality, Heart Disease and Health, Medicare, Risk, Surgery
Reeder HT, Shen C, Buxton AE
Joint shock/death risk prediction model for patients considering implantable cardioverter-defibrillators.
This study’s goal was to develop a joint shock/death risk prediction tool for patients who received implantable cardioverter-defibrillators (ICDs). Secondary analysis of patients was conducted as part of the SCD-HeFT trial (Sudden Cardiac Death in Heart Failure Trial). An illness-death regression model was applied for both ICD shocks and deaths. Among 803 ICD recipients, 430 (53.5%) did not receive an ICD shock or die, 206 (25.7%) received at least 1 shock but did not die, 113 (14.1%) died before receiving a shock, and 54 (6.7%) received at least 1 shock but still died. This predictive performance can be used as a tool for individualized counseling for patients contemplating an ICD.
AHRQ-funded; HS024520.
Citation: Reeder HT, Shen C, Buxton AE .
Joint shock/death risk prediction model for patients considering implantable cardioverter-defibrillators.
Circ Cardiovasc Qual Outcomes 2019 Aug;12(8):e005675. doi: 10.1161/circoutcomes.119.005675..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Medical Devices, Risk, Decision Making, Mortality
Liu J, Larson E, Hessels A
Comparison of measures to predict mortality and length of stay in hospitalized patients.
This study compared performance of five measures in order to predict mortality and length of stay (LOS) in hospitalized adults using claims data; the measures included three comorbidity composite scores, 3 M risk of mortality, and 3 M severity of illness subclasses. Binary logistic and zero-truncated negative binomial regression models were applied to a 2-year retrospective dataset of adult inpatient admissions from a large hospital system in New York City. All five measures demonstrated a good to strong model fit for predicting in-hospital mortality. The authors conclude that these measures can guide nurse managers in assigning nursing care and coordinating patient services, as well as administrators in supporting optimal nursing care more effectively and efficiently.
AHRQ-funded; HS024915.
Citation: Liu J, Larson E, Hessels A .
Comparison of measures to predict mortality and length of stay in hospitalized patients.
Nurs Res 2019 May/Jun;68(3):200-09. doi: 10.1097/nnr.0000000000000350..
Keywords: Hospitalization, Mortality, Nursing, Patient Safety, Risk
Hannan EL, Barrett SC, Samadashvili Z
Retooling of paper-based outcome measures to electronic format: comparison of the NY State public risk model and EHR-derived risk models for CABG mortality.
This study assessed the feasibility of retooling the paper-based New York State coronary artery bypass graft (CABG) surgery statistical model for mortality and readmission into a model for electronic health records (EHRs). Researchers found that only 6 data elements could be extracted from the EHR, and outlier hospitals differed for readmission but was usable for mortality. They concluded that the EHR model was inferior to the NYS model, and that simplifying the EHR risk model couldn’t capture most of the risk factors in the NYS model.
AHRQ-funded; HS022647.
Citation: Hannan EL, Barrett SC, Samadashvili Z .
Retooling of paper-based outcome measures to electronic format: comparison of the NY State public risk model and EHR-derived risk models for CABG mortality.
Med Care 2019 May;57(5):377-84. doi: 10.1097/mlr.0000000000001104..
Keywords: Surgery, Electronic Health Records (EHRs), Health Information Technology (HIT), Mortality, Outcomes, Risk, Cardiovascular Conditions
Wey A, Salkowski N, Kasiske BL
Comparing Scientific Registry of Transplant Recipients posttransplant program-specific outcome ratings at listing with subsequent recipient outcomes after transplant.
To improve accessibility of program-specific reports to patients, the Scientific Registry of Transplant Recipients released a 5-tier system for categorizing 1-year posttransplant program evaluations. Whether this system predicts subsequent posttransplant outcomes at the time patients are waitlisted has been questioned. IN this study, researchers investigated the association of tier at listing and the corresponding continuous score used for tier assignment, which ranges from 0 (poor outcomes) to 1 (good outcomes), with eventual 1-year posttransplant graft survival.
AHRQ-funded; HS024527.
Citation: Wey A, Salkowski N, Kasiske BL .
Comparing Scientific Registry of Transplant Recipients posttransplant program-specific outcome ratings at listing with subsequent recipient outcomes after transplant.
Am J Transplant 2019 Feb;19(2):391-98. doi: 10.1111/ajt.15038..
Keywords: Transplantation, Surgery, Mortality, Registries, Adverse Events, Risk
Yuo TH, Wallace JR, Fish L
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
This study compared outcomes of different revascularization surgeries among end stage renal disease (ESRD) patients with peripheral arterial disease (PAD). There is a high risk of complications for this surgery. Outcomes of endovascular revascularization (ER) and open surgical revascularisation (OSR) were compared. Outcomes measured included mortality and major amputation. There is a lower mortality risk for ER versus OSR. OSR has better 30-day limb salvage although there are similar long-term outcomes.
AHRQ-funded; HS019486.
Citation: Yuo TH, Wallace JR, Fish L .
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
Eur J Vasc Endovasc Surg 2019 Feb;57(2):248-57. doi: 10.1016/j.ejvs.2018.09.008..
Keywords: Adverse Events, Cardiovascular Conditions, Comparative Effectiveness, Dialysis, Evidence-Based Practice, Kidney Disease and Health, Mortality, Outcomes, Patient-Centered Outcomes Research, Risk, Surgery
Albrecht JS, Al Kibria G, Gruber-Baldini A
Risk of mortality in individuals with hip fracture and traumatic brain injury.
Researchers estimated the prevalence of TBI (traumatic brain injury) with individuals hospitalized with hip fracture and their all-cause mortality. The population studied were Medicare beneficiaries aged 65 and older from 2006 to 2010. They concluded that there was a higher risk of death with individuals who had TBI than those who had only a hip fracture.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Al Kibria G, Gruber-Baldini A .
Risk of mortality in individuals with hip fracture and traumatic brain injury.
J Am Geriatr Soc 2019 Jan;67(1):124-27. doi: 10.1111/jgs.15661..
Keywords: Brain Injury, Injuries and Wounds, Mortality, Risk, Trauma
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
Huesch MD
The impact of short breaks from cardiac surgery on mortality and stay length in California.
In this small, exploratory study, the researchers sought to investigate potential surgical “forgetting” among cardiac surgeons taking a break from performing isolated coronary artery bypass graft (CABG) surgery in a large state-wide study in California. Patients operated on by surgeons who had not performed isolated CABG in the prior calendar month stayed in hospital 0.5 day longer.
AHRQ-funded; HS021868.
Citation: Huesch MD .
The impact of short breaks from cardiac surgery on mortality and stay length in California.
J Healthc Qual 2014 Sep-Oct;36(5):42-9. doi: 10.1111/jhq.12018..
Keywords: Surgery, Outcomes, Mortality, Risk
Arkin N, Lee PH, McDonald K
Association of Nurse-to-Patient Ratio with mortality and preventable complications following aortic valve replacement.
The purpose of this study was to examine hospital resources associated with patient outcomes for aortic valve replacement (AVR), including inpatient adverse events and mortality. The investigators found that the hospital volume-outcomes relationship was associated with mortality outcomes but not postoperative complications. They identified structural differences in hospital size, nurses-to-patient ratio, and nursing skill level indicative of high quality outcomes.
AHRQ-funded; HS018558.
Citation: Arkin N, Lee PH, McDonald K .
Association of Nurse-to-Patient Ratio with mortality and preventable complications following aortic valve replacement.
J Card Surg 2014 Mar;29(2):141-8. doi: 10.1111/jocs.12284..
Keywords: Adverse Events, Cardiovascular Conditions, Quality of Care, Mortality, Risk
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