National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Caregiving (3)
- Decision Making (1)
- (-) Dementia (9)
- Diagnostic Safety and Quality (1)
- Disparities (1)
- Elderly (6)
- Family Health and History (1)
- Healthcare Costs (1)
- Health Information Technology (HIT) (1)
- Hospital Readmissions (2)
- Hospitals (1)
- Long-Term Care (1)
- Medicare (3)
- Medication (2)
- Mortality (1)
- Neurological Disorders (5)
- Nursing Homes (2)
- Outcomes (1)
- Prevention (1)
- Public Reporting (1)
- Racial and Ethnic Minorities (1)
- Stress (1)
- Telehealth (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 9 of 9 Research Studies DisplayedAnderson TS, Marcantonio ER, McCarthy EP
Association of diagnosed dementia with post-discharge mortality and readmission among hospitalized Medicare beneficiaries.
The purpose of this retrospective cohort study was to examine whether patients with dementia have a higher risk of adverse outcomes post-discharge. The researchers included Medicare beneficiaries hospitalized in 2016 and evaluated the co-primary outcomes of mortality and readmission within 30 days of hospital discharge. The final cohort included 1,089,109 hospitalizations of which 19.3% were of patients with diagnosed dementia and 886,411 were of patients without dementia. The study found that at 30 days following discharge, 5.7% of patients with dementia had died compared to 3.1% of patients without dementia. At 30 days following discharge, 17.7% of patients with dementia had been readmitted compared to 13.1% of patients without dementia. Patients with dementia who were discharged to the community had an increased likelihood of being readmitted than those who were discharged to nursing facilities, and, when readmitted, had an increased likelihood of dying during the readmission. The study concluded that diagnosed dementia was related with a substantially increased risk of mortality and a modestly increased risk of readmission within 30 days of discharge.
AHRQ-funded; HS026215.
Citation: Anderson TS, Marcantonio ER, McCarthy EP .
Association of diagnosed dementia with post-discharge mortality and readmission among hospitalized Medicare beneficiaries.
J Gen Intern Med 2022 Dec;37(16):4062-70. doi: 10.1007/s11606-022-07549-7..
Keywords: Dementia, Neurological Disorders, Medicare, Elderly, Hospital Readmissions, Mortality
O'Connell J, Grau L, Goins T
The costs of treating all-cause dementia among American Indians and Alaska native adults who access services through the Indian Health Service and Tribal health programs.
This study analyzed the costs of treatment for all-cause dementia among American Indians and Alaska native (AI/AN) adults who access services through the Indian Health Service (IHS) and Tribal health programs. The authors analyzed fiscal year 2013 IHS/Tribal treatment costs for AI/ANs aged 65 and over with dementia and a matched sample without dementia (n= 1842). Mean total treatment costs for adults with dementia were $5400 higher than for adults without dementia ($13,027 versus $7627). The difference in adjusted total treatment costs was $2943, the majority of which was due to the difference in hospital inpatient costs.
AHRQ-funded; 290200600020I.
Citation: O'Connell J, Grau L, Goins T .
The costs of treating all-cause dementia among American Indians and Alaska native adults who access services through the Indian Health Service and Tribal health programs.
Alzheimers Dement 2022 Nov;18(11):2055-66. doi: 10.1002/alz.12603..
Keywords: Dementia, Racial and Ethnic Minorities, Healthcare Costs, Disparities
Gaugler JE, Rosebush CA, Zmora R
Outcomes of remote activity monitoring for persons living with dementia over an 18-month period.
The purpose of this study was to evaluate whether Remote Activity Monitoring (RAM) technology was associated with reductions in negative health transitions and service utilization for persons with Alzheimer's disease or a related dementia over an 18-month period. The researchers enrolled 88 recipients and their caregivers in a clinical trial, with 88 care recipients and their caregivers in the RAM intervention arm and 91 care recipients and their caregivers in the control arm. The treatment group had the RAM system installed in their home. The attention control group did not receive RAM technology. Baseline and follow-up surveys assessed whether the care recipient had fallen or wandered in the past 6 months (yes/no). Caregivers were also asked whether the care recipient had used any of the following healthcare services in the past 6 months: nursing home stays, assisted living stays other residential care stays, hospital stays, or emergency room visits. The study found that in adjusted models, emergency department visits were almost 50% lower in the intervention group compared with the control group. In addition, the odds of experiencing a higher frequency of falls versus a lower frequency of falls was 0.36 for those in the intervention group compared with controls. The RAM technology did not have a statistically significant effect on any other outcome. The researchers concluded that although RAM did not provide direct support for the management of behaviors for persons with AD/ADRD, the findings imply that this technology may prevent some adverse health events for people living with dementia in the community. The ongoing, unobtrusive monitoring and system alerts of RAM may have resulted in caregivers identifying activity or the lack thereof that may
have prevented falls and wandering events. In turn, emergency room use among persons with dementia may have been avoided.
have prevented falls and wandering events. In turn, emergency room use among persons with dementia may have been avoided.
AHRQ-funded; HS022836.
Citation: Gaugler JE, Rosebush CA, Zmora R .
Outcomes of remote activity monitoring for persons living with dementia over an 18-month period.
J Am Geriatr Soc 2022 Aug;70(8):2439-42. doi: 10.1111/jgs.17839..
Keywords: Elderly, Dementia, Neurological Disorders, Telehealth, Health Information Technology (HIT), Outcomes, Caregiving
Hua CL, Thomas KS, Bunker JN
Dementia diagnosis in the hospital and outcomes among patients with advanced dementia documented in the Minimum Data Set.
This retrospective cohort study examined the association between a dementia diagnosis listed on a hospital claim and patient outcomes among individuals with a Minimum Data Set (MDS) assessment. The cohort was comprised of hospitalized patients aged 66 years and older with advanced dementia noted on an MDS assessment completed within 120 days prior to their first hospitalization in 2017. Among 120,989 patients with advanced dementia and a nursing home stay, 90.6% had a dementia diagnosis on their hospital claims. Documentation of a dementia diagnosis was associated with lower use of intensive care unit or coronary care unit, use of invasive mechanical ventilation, and 30-day mortality. These patients also had a shorter hospital length of stay.
AHRQ-funded; HS000011.
Citation: Hua CL, Thomas KS, Bunker JN .
Dementia diagnosis in the hospital and outcomes among patients with advanced dementia documented in the Minimum Data Set.
J Am Geriatr Soc 2022 Mar;70(3):846-53. doi: 10.1111/jgs.17564..
Keywords: Dementia, Diagnostic Safety and Quality, Medicare, Hospitals, Neurological Disorders
Lee W, Gray SL, Zaslavsky O
Association between having a family member with dementia and perceptions of dementia preventability.
This study examined how having a family history of dementia and caregiving experience are associated with perceptions about and self-efficacy for dementia preventability. Participants were surveyed whether they had a family member with dementia, and if they need whether they served as a caregiver. Of 1,575 respondents, 71% had a family member with dementia, and of those 42% served as a caregiver. People with a family member with dementia were less likely to believe that dementia is preventable and had lower self-efficacy for dementia prevention. Survey participants who were also caregivers had an even lower perception about dementia preventability.
AHRQ-funded; HS022982.
Citation: Lee W, Gray SL, Zaslavsky O .
Association between having a family member with dementia and perceptions of dementia preventability.
Aging Ment Health 2022 Feb;26(2):270-76. doi: 10.1080/13607863.2020.1839866..
Keywords: Dementia, Caregiving, Family Health and History, Prevention, Neurological Disorders
Rosenthal M, Poling J, Wec A
"Medication is just one piece of the whole puzzle": how nursing homes change their use of antipsychotic medications.
This article investigated health professionals’ experiences with decision-making during changes under the National Partnership to Improve Dementia Care in Nursing Homes and its companion coalitions. These programs were introduced in 2012 for the purpose of encouraging reductions in antipsychotic use and increasing use of nonpharmacological treatments for dementia. Interviews were conducted with 40 nursing home physicians and staff in seven states. The authors found that reducing antipsychotics is more time and resource-intensive than relying on medication. However, respondents supported reductions in antipsychotic use. They indicated that with supported staffing, effective communications, and training, they could create or implement individualized treatments.
AHRQ-funded; HS023464.
Citation: Rosenthal M, Poling J, Wec A .
"Medication is just one piece of the whole puzzle": how nursing homes change their use of antipsychotic medications.
J Appl Gerontol 2022 Jan;41(1):62-72. doi: 10.1177/0733464820958919..
Keywords: Elderly, Medication, Nursing Homes, Dementia, Neurological Disorders, Long-Term Care, Decision Making
Austrom MG, Lu YY, Perkins AJ
Impact of noncaregiving-related stressors on informal caregiver outcomes.
The researchers studied the most stressful events experienced by spouse caregivers of older adults with Alzheimer s disease during a 6-month period. They found that caregivers reported no stressors 21.5% of the time, 1-2 stressors 25% of the time, and 3 stressors 53% of the time with 318 stressors reported in total. They concluded that their results can be used to develop targeted intervention and support strategies for spouse caregivers experiencing non-caregiving related stressors as well as the traditional challenges with caregiving-related issues.
AHRQ-funded; HS010884.
Citation: Austrom MG, Lu YY, Perkins AJ .
Impact of noncaregiving-related stressors on informal caregiver outcomes.
Am J Alzheimers Dis Other Demen 2014 Aug;29(5):426-32. doi: 10.1177/1533317513518652.
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Keywords: Caregiving, Dementia, Elderly, Stress
Daiello LA, Gardner R, Epstein-Lubow G
Association of dementia with early rehospitalization among Medicare beneficiaries.
This study examined the question of whether dementia was associated with a greater likelihood of Medicare patients being readmitted to the hospital within 30 days. Using a group of 25,839 hospitalizations, including 3,908 admissions of Me.icare beneficiaries with dementia, it found that those with a dementia diagnosis were more likely (17.8 percent vs. 14.5 percent) to be readmitted within 30 days.
AHRQ-funded; HS017735.
Citation: Daiello LA, Gardner R, Epstein-Lubow G .
Association of dementia with early rehospitalization among Medicare beneficiaries.
Arch Gerontol Geriatr. 2014 Jul-Aug;59(1):162-8. doi: 10.1016/j.archger.2014.02.010..
Keywords: Medicare, Elderly, Dementia, Hospital Readmissions
Konetzka RT, Brauner DJ, Shega J
The effects of public reporting on physical restraints and antipsychotic use in nursing home residents with severe cognitive impairment.
The purpose of this paper was to assess whether reductions in physical restraint use associated with quality reporting may have had the unintended consequence of increasing antipsychotic use in nursing home (NH) residents with severe cognitive impairment. Physical restraint use declined significantly from 1999 to 2008 in NH residents with severe cognitive impairment. Correspondingly, antipsychotic use in the same residents increased more in NHs that were subject to public reporting. This analysis suggests that public reporting of physical restraint use had the unintended consequence of increasing use of antipsychotics in NH residents with severe cognitive impairment.
AHRQ-funded; HS018718.
Citation: Konetzka RT, Brauner DJ, Shega J .
The effects of public reporting on physical restraints and antipsychotic use in nursing home residents with severe cognitive impairment.
J Am Geriatr Soc 2014 Mar;62(3):454-61. doi: 10.1111/jgs.12711.
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Keywords: Dementia, Elderly, Medication, Nursing Homes, Public Reporting