National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Ambulatory Care and Surgery (1)
- Brain Injury (1)
- Cardiovascular Conditions (1)
- Disparities (1)
- (-) Elderly (14)
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- Nursing Homes (6)
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- Patient Safety (2)
- Payment (1)
- Provider Performance (1)
- Quality of Care (2)
- Racial and Ethnic Minorities (1)
- Rehabilitation (1)
- Risk (2)
- Social Determinants of Health (1)
- Transitions of Care (3)
- Trauma (2)
- Vulnerable Populations (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 14 of 14 Research Studies DisplayedWerner RM, Konetzka RT, Qi M
The impact of Medicare copayments for skilled nursing facilities on length of stay, outcomes, and costs.
The objective of this study was to investigate the impact of Medicare's skilled nursing facility (SNF) copayment policy, with a large increase in the daily copayment rate on the 20th day of a benefit period, on length of stay, patient outcomes, and costs. The investigators concluded that Medicare's SNF copayment policy was associated with shorter lengths of stay and worse patient outcomes, suggesting the copayment policy had unintended and negative effects on patient outcomes.
AHRQ-funded; HS024266.
Citation: Werner RM, Konetzka RT, Qi M .
The impact of Medicare copayments for skilled nursing facilities on length of stay, outcomes, and costs.
Health Serv Res 2019 Dec;54(6):1184-92. doi: 10.1111/1475-6773.13227..
Keywords: Medicare, Nursing Homes, Payment, Long-Term Care, Healthcare Costs, Elderly, Hospitalization, Hospital Discharge
Kapoor A, Field T, Handler S
Characteristics of long-term care residents that predict adverse events after hospitalization.
This study examined the characteristics of long-term care (LTC) residents that predict adverse events (AEs) after discharge from recent hospitalization. This cohort study looked at AEs that occurred at 32 nursing homes from six New England states. AE incidents involving a total of 555 LTC residents with 762 transitions from the hospital back to LTC were reviewed. The association between all AEs and preventable AEs developing in the 45 days following discharge back to LTC was measured. There were 283 discharges with one or more AEs and 212 with preventable AEs. Characteristics independently associated with higher risk of AEs included hospital length of stay (LOS) 9 or more days, 18 or more regularly scheduled medications, and 19 and above on the dependency in activities of daily living (ADL) scale.
AHRQ-funded; HS024422.
Citation: Kapoor A, Field T, Handler S .
Characteristics of long-term care residents that predict adverse events after hospitalization.
J Am Geriatr Soc 2020 Nov;68(11):2551-57. doi: 10.1111/jgs.16770..
Keywords: Elderly, Long-Term Care, Nursing Homes, Hospitalization, Adverse Events, Transitions of Care, Hospital Discharge, Risk
Paredes AZ, Malik AT, Cluse M
Discharge disposition to skilled nursing facility after emergent general surgery predicts a poor prognosis.
Emergency general surgery can have a profound impact on the functional status of even previously independent patients. In this study, the investigators examined the role and influence of discharging a patient to a skilled nursing facility. They concluded that after accounting for patient severity and perioperative course, discharge to a skilled nursing facility was an independent risk factor for death, readmission, and postdischarge complications.
AHRQ-funded; HS022694.
Citation: Paredes AZ, Malik AT, Cluse M .
Discharge disposition to skilled nursing facility after emergent general surgery predicts a poor prognosis.
Surgery 2019 Oct;166(4):489-95. doi: 10.1016/j.surg.2019.04.034..
Keywords: Nursing Homes, Hospital Discharge, Elderly, Ambulatory Care and Surgery, Emergency Department, Outcomes, Hospital Readmissions, Outcomes, Risk
Kapoor A, Field T, Handler S
Adverse events in long-term care residents transitioning from hospital back to nursing home.
This study looked at adverse event rates of long-term care residents transitioning back to their nursing home after hospitalization. A prospective cohort study of LTC residents discharged from hospital back to LTC from March 1, 2016, to December 31, 2017 was conducted, and residents were followed up for 45 days. A random sample of 32 nursing homes located in 6 New England states was used, and 555 LTC residents were selected, contributing 762 transitions from hospital back to the same LTC facility. Most of the cohort were female (65.5%) and non-Hispanic white (93.7%). The study used trained nurse abstractors to review nursing home records to determine if an adverse event occurred. Out of 762 discharges there were 379 adverse events. The most common adverse events were pressure ulcers, skin tears, and falls followed by health care-acquired infections. 145 adverse events were considered less serious, with 28 life-threatening, and 8 were fatal. Most of the adverse events were considered preventable or ameliorable.
AHRQ-funded; HS024596.
Citation: Kapoor A, Field T, Handler S .
Adverse events in long-term care residents transitioning from hospital back to nursing home.
JAMA Intern Med 2019 Sep;179(9):1254-61. doi: 10.1001/jamainternmed.2019.2005..
Keywords: Adverse Events, Long-Term Care, Nursing Homes, Transitions of Care, Elderly, Patient Safety, Hospital Discharge, Hospitalization
Vadlamani A, Perry JA, McCunn M
Racial differences in discharge location after a traumatic brain injury among older adults.
The purpose of this retrospective cohort study was to determine if there were racial differences in discharge location among older adults treated for traumatic brain injury (TBI) at a level 1 trauma center. The authors concluded that in this group of Medicare-eligible older adults, blacks were more likely to be discharged to inpatient rehabilitation compared to whites.
AHRQ-funded; HS024560.
Citation: Vadlamani A, Perry JA, McCunn M .
Racial differences in discharge location after a traumatic brain injury among older adults.
Arch Phys Med Rehabil 2019 Sep;100(9):1622-28. doi: 10.1016/j.apmr.2019.03.008.
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Keywords: Racial and Ethnic Minorities, Brain Injury, Trauma, Elderly, Hospital Discharge, Rehabilitation, Medicare
Albrecht JS, Al Kibria GM, Greene CR
Post-discharge mortality of older adults with traumatic brain injury or other trauma.
This study examined post-discharge mortality of older adults with traumatic brain injury (TBI) or non-TBI trauma compared with the general population. A retrospective cohort study of adults 65 years and older was conducted using data from an urban trauma center from 1997 to 2008. The data was then linked to the National Death Index through 2008 to obtain date and cause of death. A higher rate of death was associated with both cohorts after moderate to severe injury from accidents than for older adults without TBI or non-TBI trauma.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Al Kibria GM, Greene CR .
Post-discharge mortality of older adults with traumatic brain injury or other trauma.
J Am Geriatr Soc 2019 Jul 25;67(11):2382-86. doi: 10.1111/jgs.16098..
Keywords: Elderly, Hospital Discharge, Injuries and Wounds, Mortality, Trauma
Bain AM, Werner RM, Yuan Y
Do hospitals participating in accountable care organizations discharge patients to higher quality nursing homes?
This study examined whether hospitals participating in Medicare's Shared Saving Program increased use of highly rated skilled nursing facilities (SNFs) or decreased the use of low-rated SNFs after initiation of accountable care organization (ACO) contracts, compared with non-ACO hospitals. The findings indicate that, after joining an ACO, the percentage of hospital discharges going to a high-quality SNF increased slightly; the probability of discharge from ACO-participating hospitals to low-quality SNFs did not change significantly in comparison with non-ACO hospitals.
AHRQ-funded; HS024266.
Citation: Bain AM, Werner RM, Yuan Y .
Do hospitals participating in accountable care organizations discharge patients to higher quality nursing homes?
J Hosp Med 2019 May;14(5):288-89. doi: 10.12788/jhm.3147..
Keywords: Elderly, Hospital Discharge, Hospitals, Medicare, Nursing Homes, Quality of Care
Huckfeldt P, Escarce J, Sood N
Thirty-day postdischarge mortality among black and white patients 65 years and older in the Medicare Hospital Readmissions Reduction Program.
The goal of this cohort study was to determine whether short-term mortality rates increased among black and white adults 65 years and older after initiation of the Medicare Hospital Readmissions Reduction Program (HRRP) and whether trends differed by race. Using an interrupted time-series analysis, the researchers found that short-term post-discharge mortality did not appear to increase for black patients under the HRRP, suggesting that certain value-based payment policies can be implemented without harming black populations. However, mortality seemed to increase for white patients with heart failure; this situation warrants investigation.
AHRQ-funded; HS025394.
Citation: Huckfeldt P, Escarce J, Sood N .
Thirty-day postdischarge mortality among black and white patients 65 years and older in the Medicare Hospital Readmissions Reduction Program.
JAMA Netw Open 2019 Mar;2(3):e190634. doi: 10.1001/jamanetworkopen.2019.0634..
Keywords: Medicare, Elderly, Mortality, Heart Disease and Health, Cardiovascular Conditions, Hospital Discharge
Arbaje AI, Hughes A, Werner N
Information management goals and process failures during home visits for middle-aged and older adults receiving skilled home healthcare services after hospital discharge: a multisite, qualitative study.
The goal of this study was to identify information management (IM) process failures made during home health visits to middle-aged and older adults after hospital discharge. Communication risks included information overload, information underload, information scatter, information conflict, and erroneous information.
AHRQ-funded; HS022916.
Citation: Arbaje AI, Hughes A, Werner N .
Information management goals and process failures during home visits for middle-aged and older adults receiving skilled home healthcare services after hospital discharge: a multisite, qualitative study.
BMJ Qual Saf 2019 Feb;28(2):111-20. doi: 10.1136/bmjqs-2018-008163..
Keywords: Elderly, Home Healthcare, Hospital Discharge, Patient Safety, Transitions of Care
Zuckerman RB, Wu S, Chen LM
The five-star skilled nursing facility rating system and care of disadvantaged populations.
AHRQ-funded; HS000029.
Citation: Zuckerman RB, Wu S, Chen LM .
The five-star skilled nursing facility rating system and care of disadvantaged populations.
J Am Geriatr Soc 2019 Jan;67(1):108-14. doi: 10.1111/jgs.15629..
Keywords: Nursing Homes, Vulnerable Populations, Medicare, Elderly, Provider Performance, Quality of Care, Hospital Discharge, Disparities
Albrecht JS, Gruber-Baldini AL, Hirshon JM
Hospital discharge instructions: comprehension and compliance among older adults.
The purpose of this prospective cohort study was to quantify the prevalence of non-comprehension and non-compliance with discharge instructions and to identify associated patient characteristics. The investigators concluded that non-comprehension of discharge instructions among older adults was prevalent, multi-factorial, and varies by domain.
AHRQ-funded; HS021068.
Citation: Albrecht JS, Gruber-Baldini AL, Hirshon JM .
Hospital discharge instructions: comprehension and compliance among older adults.
J Gen Intern Med 2014 Nov;29(11):1491-8. doi: 10.1007/s11606-014-2956-0..
Keywords: Elderly, Health Literacy, Hospital Discharge, Patient Adherence/Compliance
Goldman LE, Sarkar U, Kessell E
Support from hospital to home for elders: a randomized trial.
The researchers studied a peridischarge, nurse-led intervention combined with telephone follow-up designed to reduce readmissions among patients who were 55 or older. They found that the nurse-led, in-hospital discharge support intervention did not show a reduction in readmissions or ED visits among 700 diverse, low-income older adults at a safety-net hospital.
AHRQ-funded; HS018090.
Citation: Goldman LE, Sarkar U, Kessell E .
Support from hospital to home for elders: a randomized trial.
Ann Intern Med 2014 Oct 7;161(7):472-81. doi: 10.7326/m14-0094..
Keywords: Hospital Discharge, Hospital Readmissions, Emergency Department, Elderly, Social Determinants of Health, Nursing
Mixon AS, Neal E, Bell S
Care transitions: a leverage point for safe and effective medication use in older adults--a mini-review.
The authors discuss medication adherence in older adults across the continuum of care, describing reasons for nonadherence, methods to assess adherence, and tools to improve adherence, with particular focus on emerging techniques and technologies.
AHRQ-funded; HS019598.
Citation: Mixon AS, Neal E, Bell S .
Care transitions: a leverage point for safe and effective medication use in older adults--a mini-review.
Gerontology 2015;61(1):32-40. doi: 10.1159/000363765.
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Keywords: Elderly, Hospital Discharge, Medication: Safety, Medication, Patient Adherence/Compliance
Wang CY, Graham JE, Karmarkar AM
FIM motor scores for classifying community discharge after inpatient rehabilitation for hip fracture.
A major goal of this study was to identify which discharge functional independence measure (FIM)--total, motor, or cognition--best discriminates community versus institutional discharges. It found that the FIM motor scale yields the best overall discrimination of patients discharged to the community versus those discharged to an institution after inpatient rehabilitation for hip fracture.
AHRQ-funded; HS022134.
Citation: Wang CY, Graham JE, Karmarkar AM .
FIM motor scores for classifying community discharge after inpatient rehabilitation for hip fracture.
PM & R 2014 Jun; 6(6):493-7. doi: 10.1016/j.pmrj.2013.12.008..
Keywords: Hospital Discharge, Injuries and Wounds, Elderly