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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results
1 to 21 of 21 Research Studies Displayed
Reiter KL, Jiang HJ, Wang J
Facing the recession: how did safety-net hospitals fare financially compared with their peers?
The authors examined the effect of the recession on the financial performance of safety-net versus non-safety-net hospitals. They concluded that safety-net hospitals may not be disproportionately vulnerable to macro-economic fluctuations, but their significantly lower margins leave less financial cushion to weather sustained financial pressure.
AHRQ-authored.
Citation:
Reiter KL, Jiang HJ, Wang J .
Facing the recession: how did safety-net hospitals fare financially compared with their peers?
Health Serv Res 2014 Dec;49(6):1747-66. doi: 10.1111/1475-6773.12230.
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Keywords:
Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitals, Safety Net
Lorch SA, Martin AE, Ranade R
Lessons for providers and hospitals from Philadelphia's obstetric services closures and consolidations, 1997-2012.
The researchers examined the experience of Philadelphia County, Pennsylvania, where thirteen of nineteen hospital obstetric units closed between 1997 and 2012, and they conducted interviews at eleven hospitals whose obstetric units remained open. Interviewees reported sharp surges in delivery volume and an increase in the proportion of patients with public insurance or no insurance. The authors concluded that their study supports the need for policy makers to anticipate reductions in supply and monitor patient outcomes.
AHRQ-funded; HS018661.
Citation:
Lorch SA, Martin AE, Ranade R .
Lessons for providers and hospitals from Philadelphia's obstetric services closures and consolidations, 1997-2012.
Health Aff 2014 Dec;33(12):2162-9. doi: 10.1377/hlthaff.2014.0136.
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Keywords:
Labor and Delivery, Pregnancy, Hospitals
Rangachari P
Using social knowledge networking technology to enable meaningful use of electronic health record technology in hospitals and health systems.
In this paper, Rangachari (1) reviewed the theoretical literatures on technology use & implementation, and identified a framework for understanding & overcoming unintended adverse consequences of implementing Electronic Health Records; (2) outlined a broad project proposal to test the applicability of the framework in enabling "meaningful use" of Electronic Health Records in a healthcare context; and (3) identified strategies for successful implementation of Electronic Health Records in hospitals & health systems, based on the literature review and application.
AHRQ-funded; HS024335.
Citation:
Rangachari P .
Using social knowledge networking technology to enable meaningful use of electronic health record technology in hospitals and health systems.
J Hosp Adm 2014 Dec;3(6):66-78. doi: 10.5430/jha.v3n6p66.
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Keywords:
Healthcare Systems, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals, Implementation
Thomas KS, Rahman M, Mor V
Influence of hospital and nursing home quality on hospital readmissions.
The authors sought to determine whether the quality of the hospital and of the nursing home (NH) to which a patient was discharged were related to the likelihood of rehospitalization. They found that patients discharged from higher-quality hospitals and patients who received care in higher-quality NHs were less likely to be rehospitalized within 30 days. They concluded that the passage of the Affordable Care Act changed the accountability of hospitals for patients' outcomes after discharge, and that their study highlights the joint accountability of hospitals and NHs for rehospitalization of patients.
AHRQ-funded; HS000011.
Citation:
Thomas KS, Rahman M, Mor V .
Influence of hospital and nursing home quality on hospital readmissions.
Am J Manag Care 2014 Nov;20(11):e523-31.
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Keywords:
Quality of Care, Hospitals, Nursing Homes, Patient-Centered Outcomes Research, Hospital Readmissions
Balamuth F, Weiss SL, Neuman MI
Pediatric severe sepsis in U.S. children's hospitals.
The objective of this study was to compare epidemiological trends in the prevalence, resource utilization, and mortality of pediatric patients with severe sepsis and septic shock. The researchers found that the prevalence of severe sepsis/septic shock has increased in the studied U.S. children’s hospitals between 2004 and 2012, whereas resource utilization and mortality have decreased over that time period.
AHRQ-funded; HS021114
Citation:
Balamuth F, Weiss SL, Neuman MI .
Pediatric severe sepsis in U.S. children's hospitals.
Pediatr Crit Care Med. 2014 Nov;15(9):798-805. doi: 10.1097/pcc.0000000000000225..
Keywords:
Hospitals, Children/Adolescents, Critical Care
Carayon P, Li Y, Kelly MM
Stimulated recall methodology for assessing work system barriers and facilitators in family-centered rounds in a pediatric hospital.
In this study, the researchers implemented and evaluated the use of a stimulated recall methodology for collective confrontation in the context of family-centered rounds (FCRs). They concluded that their study demonstrated the value of the stimulated recall methodology to identify a range of work system factors that either positively or negatively influence family engagement during FCRs.
AHRQ-funded; HS018680.
Citation:
Carayon P, Li Y, Kelly MM .
Stimulated recall methodology for assessing work system barriers and facilitators in family-centered rounds in a pediatric hospital.
Appl Ergon 2014 Nov;45(6):1540-6. doi: 10.1016/j.apergo.2014.05.001..
Keywords:
Hospitals, Children/Adolescents, Teams, Research Methodologies
Nembhard IM, Cherian P, Bradley EH
Deliberate learning in health care: the effect of importing best practices and creative problem solving on hospital performance improvement.
The authors examined the effect on quality improvement of two common but distinct approaches to organizational learning, importing best practices and creative problem solving, in hospitals focused on improving treatment time for patients with heart attacks. They found that importing best practices helps hospitals achieve initial phase improvement, after which significant further improvement requires creative problem solving as well.
AHRQ-funded; HS018987.
Citation:
Nembhard IM, Cherian P, Bradley EH .
Deliberate learning in health care: the effect of importing best practices and creative problem solving on hospital performance improvement.
Med Care Res Rev 2014 Oct;71(5):450-71. doi: 10.1177/1077558714536619.
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Keywords:
Quality Improvement, Quality of Care, Hospitals, Organizational Change
Calderwood MS, Kleinman K, Bratzler DW
Medicare claims can be used to identify US hospitals with higher rates of surgical site infection following vascular surgery.
This study found that among Medicare patients who underwent vascular surgery at 2,512 U.S. hospitals, a patient undergoing surgery in a hospital ranked in the worst-performing decile based on claims had a 2.5 times greater likelihood of developing a chart-confirmed surgical site infection relative to a patient characteristics in a hospital in the best-performing decile.
AHRQ-funded; HS018878
Citation:
Calderwood MS, Kleinman K, Bratzler DW .
Medicare claims can be used to identify US hospitals with higher rates of surgical site infection following vascular surgery.
Med Care. 2014 Oct;52(10):918-25. doi: 10.1097/MLR.0000000000000212..
Keywords:
Medicare, Surgery, Healthcare-Associated Infections (HAIs), Patient Safety, Hospitals, Adverse Events
David G, Lindrooth RC, Helmchen LA
Do hospitals cross-subsidize?
The authors used repeated shocks to a profitable service in the market for hospital-based medical care to test for cross-subsidization of unprofitable services. They studied how incumbent hospitals adjusted their provision of three uncontested services that are widely considered to be unprofitable. They estimated that the hospitals most exposed to entry reduced their provision of psychiatric, substance-abuse, and trauma care services at a rate of about one uncontested-service admission for every four cardiac admissions they stood to lose.
AHRQ-funded; HS010730.
Citation:
David G, Lindrooth RC, Helmchen LA .
Do hospitals cross-subsidize?
J Health Econ 2014 Sep;37:198-218. doi: 10.1016/j.jhealeco.2014.06.007.
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Keywords:
Healthcare Costs, Quality of Care, Hospitals, Value
Adler-Milstein J, DesRoches CM, Furukawa MF
More than half of US hospitals have at least a basic EHR, but stage 2 criteria remain challenging for most.
The investigators used American Hospital Association data to assess progress and challenges in EHR adoption. They found that most hospitals are able to meet many of the stage 2 meaningful-use criteria, but only 5.8 percent of hospitals are able to meet them all.
AHRQ-authored.
Citation:
Adler-Milstein J, DesRoches CM, Furukawa MF .
More than half of US hospitals have at least a basic EHR, but stage 2 criteria remain challenging for most.
Health Aff 2014 Sep;33(9):1664-71. doi: 10.1377/hlthaff.2014.0453.
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Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals, Innovations and Emerging Issues
Gomez SL, Lichtensztajn DY, Parikh P
Hospital practices in the collection of patient race, ethnicity, and language data: a statewide survey, California, 2011.
The authors reported on a sruvey of general acute care hospitals in California to elucidate practices regarding collection and auditing of patient race, ethnicity, and primary spoken language (REL). They found that the majority of hospitals used standardized forms for collection, and 75% audited patient information for completeness. They concluded that California hospitals are collecting information on patient REL as mandated, but variation in data collection exists, and hospitals may benefit from standardized data collection and auditing practices.
AHRQ-funded; HS019963.
Citation:
Gomez SL, Lichtensztajn DY, Parikh P .
Hospital practices in the collection of patient race, ethnicity, and language data: a statewide survey, California, 2011.
J Health Care Poor Underserved 2014 Aug;25(3):1384-96. doi: 10.1353/hpu.2014.0126.
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Keywords:
Data, Hospitals, Racial / Ethnic Minorities, Social Determinants of Health
Ryan AM, Mushlin AI
The Affordable Care Act's payment reforms and the future of hospitals.
The author places likely hospital responses to the Affordable Care Act’s payment reforms in the historical context of their previous responses to such reforms as price controls, certificate-of-need laws, and prospective payment systems. He then discusses possible hospital responses to counter readmission penalties, revenue reductions, bundled payment strategies, and accountable care organizations.
AHRQ-funded; HS018546
Citation:
Ryan AM, Mushlin AI .
The Affordable Care Act's payment reforms and the future of hospitals.
Ann Intern Med. 2014 May 20;160(10):729-30. doi: 10.7326/M13-2033..
Keywords:
Healthcare Costs, Payment, Value, Hospitals, Policy
Bazzoli GJ, Fareed N, Waters TM
Hospital financial performance in the recent recession and implications for institutions that remain financially weak.
This study of 2,971 private short-term general medical or surgical hospitals found that hospitals that were financially weak before the recession remained so during and after the recession. The total margins of nonprofit hospitals declined in 2008 but returned to pre-recession levels by 2011. The recession did not create additional fiscal pressure on hospitals that were previously financially weak or in safety-net roles.
AHRQ-funded; HS020627
Citation:
Bazzoli GJ, Fareed N, Waters TM .
Hospital financial performance in the recent recession and implications for institutions that remain financially weak.
Health Aff. 2014 May;33(5):739-45. doi: 10.1377/hlthaff.2013.0988..
Keywords:
Healthcare Costs, Payment, Hospitals, Safety Net
Glance LG, Mukamel DB, Osler TM
Ranking trauma center quality: can past performance predict future performance?
This study investigated whether hospital quality metrics based on prior years of data reliably predict future performance. It found that although the future performance of individual trauma centers can be predicted using 2-year-old data, the performance of individual trauma centers cannot be reliably predicted using performance reports based on data that is 3, 4, or 5 years old.
AHRQ-funded; HS016737.
Citation:
Glance LG, Mukamel DB, Osler TM .
Ranking trauma center quality: can past performance predict future performance?
Ann Surg 2014 Apr;259(4):682-6. doi: 10.1097/sla.0000000000000334..
Keywords:
Quality Improvement, Quality Measures, Hospitals
Weissman JS, López L, Schneider EC
The association of hospital quality ratings with adverse events.
The researchers used a survey of 2,582 patients hospitalized at 16 acute care Massachusetts hospitals to understand how patient-reported quality is related to adverse events (AEs). Although patients with AEs rated hospital quality lower than others, patients with AEs who experienced ‘service recovery’ rated their quality of care at levels similar to those not experiencing AEs.
AHRQ-funded
Citation:
Weissman JS, López L, Schneider EC .
The association of hospital quality ratings with adverse events.
Int J Qual Health Care. 2014 Apr;26(2):129-35. doi: 10.1093/intqhc/mzt092..
Keywords:
Adverse Events, Quality of Care, Hospitals, Patient Experience, Patient Safety, Quality Indicators (QIs), Quality Measures
Chopra V, McMahon LF
Redesigning hospital alarms for patient safety: alarmed and potentially dangerous.
In this paper, the authors discuss redesigning hospital alarms for patient safety. They note the benefits and dangers of patient safety alarms and outline potential solutions to make patient safety alarms more effective. The investigators suggest that the scope and design of alarm systems must shift from the status quo to a biologically valid, clinically relevant, patient-centered model. They assert that existing technology allows integration and intelligent assessment of patient data to create advanced alarm systems.
AHRQ-funded; HS022835.
Citation:
Chopra V, McMahon LF .
Redesigning hospital alarms for patient safety: alarmed and potentially dangerous.
JAMA 2014 Mar 26;311(12):1199-200. doi: 10.1001/jama.2014.710..
Keywords:
Adverse Events, Hospitals, Patient Safety
Dahlke AR, Chung JW, Holl JL
Evaluation of initial participation in public reporting of American College of Surgeons NSQIP surgical outcomes on Medicare's Hospital Compare website.
The objective of this paper was to compare CMS-National Surgical Quality Improvement Program (CMS-NSQIP) participating hospitals with American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) hospitals that elected not to participate in Hospital Compare. The researchers found few measurable differences between CMS-NSQIP participating and nonparticipating hospitals.
AHRQ-funded; HS021857.
Citation:
Dahlke AR, Chung JW, Holl JL .
Evaluation of initial participation in public reporting of American College of Surgeons NSQIP surgical outcomes on Medicare's Hospital Compare website.
J Am Coll Surg 2014 Mar;218(3):374-80, 80.e1-5. doi: 10.1016/j.jamcollsurg.2013.11.022.
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Keywords:
Hospitals, Outcomes, Public Reporting, Quality Improvement, Surgery
Enayati M, Banerjee T, Popescu M
A novel web-based depth video rewind approach toward fall preventive interventions in hospitals.
The purpose of this study was to implement a web-based application to provide the ability to rewind and review depth videos captured in hospital rooms to investigate the event chains that led to patient’s fall at a specific time. It proposes a novel web application to ease the process of search and review of the videos by means of new visualization techniques to highlight video frames that contain potential risk of fall based on our previous research.
AHRQ-funded; HS018477.
Citation:
Enayati M, Banerjee T, Popescu M .
A novel web-based depth video rewind approach toward fall preventive interventions in hospitals.
Conf Proc IEEE Eng Med Biol Soc 2014;2014:4511-4. doi: 10.1109/embc.2014.6944626..
Keywords:
Health Information Technology (HIT), Web-Based, Falls, Hospitals
Dimick JB, Birkmeyer NJ, Finks JF
Composite measures for profiling hospitals on bariatric surgery performance.
The study objective was to develop a novel composite measure for profiling hospital performance with bariatric surgery. Composite measures are much better at explaining hospital-level variation in serious complications and predicting future performance than other approaches. This study provides preliminary data that empirically weighted composite outcomes measures may be better than existing alternatives for selective referral and outcomes feedback programs.
AHRQ-funded; HS017765.
Citation:
Dimick JB, Birkmeyer NJ, Finks JF .
Composite measures for profiling hospitals on bariatric surgery performance.
JAMA Surg 2014 Jan;149(1):10-6. doi: 10.1001/jamasurg.2013.4109..
Keywords:
Adverse Events, Quality of Care, Hospitals
Ederhof M, Chen LM
Critical access hospitals and cost shifting.
In the context of ongoing discussion about critical access hospital (CAH) reimbursement, it is important to better understand how health care providers currently utilize funds from the CAH Programs. This study found that among hospitals converted to CAH designation while part of a hospital system, the relative proportion of costs that reflect shared services provided by the parent organization is significantly higher than would be expected in the post-conversion period.
AHRQ-funded; HS020671.
Citation:
Ederhof M, Chen LM .
Critical access hospitals and cost shifting.
JAMA Intern Med 2014 Jan;174(1):143-4. doi: 10.1001/jamainternmed.2013.11901..
Keywords:
Hospitals, Healthcare Costs, Health Services Research (HSR)
Barbash GI, Friedman B, Glied SA
Factors associated with adoption of robotic surgical technology in US hospitals and relationship to radical prostatectomy procedure volume.
The authors aimed to identify the factors associated with hospitals' decisions to adopt robotic technology and the consequences of these decisions. They found that hospitals in areas where a higher proportion of other hospitals had already acquired a robot were more likely to acquire one, as were those with more than 300 beds and teaching hospitals. They also found a significant association between years with a robot and the change in the number of radical prostatectomies. They concluded that local area robot competition was associated with the rapid spread of robot technology in the United States.
AHRQ-authored.
Citation:
Barbash GI, Friedman B, Glied SA .
Factors associated with adoption of robotic surgical technology in US hospitals and relationship to radical prostatectomy procedure volume.
Ann Surg 2014 Jan;259(1):1-6. doi: 10.1097/SLA.0b013e3182a5c8b8.
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Keywords:
Hospitals, Cancer: Prostate Cancer, Surgery
