National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Cardiovascular Conditions (2)
- Children/Adolescents (2)
- Communication (1)
- Comparative Effectiveness (1)
- Diagnostic Safety and Quality (1)
- Disparities (1)
- Emergency Department (3)
- Emergency Medical Services (EMS) (1)
- Healthcare-Associated Infections (HAIs) (1)
- (-) Healthcare Cost and Utilization Project (HCUP) (20)
- Healthcare Costs (6)
- Healthcare Delivery (1)
- Healthcare Utilization (1)
- Health Insurance (4)
- Health Services Research (HSR) (1)
- Heart Disease and Health (1)
- Hospital Discharge (1)
- Hospitalization (5)
- Hospital Readmissions (3)
- Hospitals (1)
- Imaging (1)
- Infectious Diseases (1)
- Influenza (1)
- Injuries and Wounds (2)
- Inpatient Care (1)
- Labor and Delivery (1)
- Medicaid (2)
- Mortality (1)
- Newborns/Infants (2)
- Nursing (1)
- Orthopedics (1)
- Outcomes (1)
- Pain (1)
- Patient Safety (2)
- Policy (1)
- Practice Patterns (1)
- Pregnancy (1)
- Primary Care (1)
- Quality of Care (2)
- Racial and Ethnic Minorities (2)
- Risk (1)
- Stroke (1)
- Surgery (4)
- Young Adults (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 20 of 20 Research Studies DisplayedHines AL, Andrews RM, Moy E
AHRQ Author: Andrews RM, Moy E
Disparities in rates of inpatient mortality and adverse events: race/ethnicity and language as independent contributors.
The authors investigated inpatient mortality rates and obstetric trauma for self-reported speakers of English, Spanish, and languages of Asia and the Pacific Islands (API) and compared quality of care by language with patterns by race/ethnicity. They found that speaking a non-English principal language and having a non-White race/ethnicity did not place patients at higher risk for inpatient mortality, except for a higher stroke mortality for Japanese-speaking patients. Patients who spoke API languages or had API race/ethnicity had higher risk for obstetric trauma than English-speaking White patients, while Spanish-speaking Hispanic patients had more obstetric trauma than English-speaking Hispanic patients.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Hines AL, Andrews RM, Moy E .
Disparities in rates of inpatient mortality and adverse events: race/ethnicity and language as independent contributors.
Int J Environ Res Public Health 2014 Dec;11(12):13017-34. doi: 10.3390/ijerph111213017.
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Keywords: Communication, Disparities, Healthcare Cost and Utilization Project (HCUP), Mortality, Racial and Ethnic Minorities
Reiter KL, Jiang HJ, Wang J
AHRQ Author: Jiang HJ
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
Simeone RM, Oster ME, Cassell CH
AHRQ Author: Gray DT
Pediatric inpatient hospital resource use for congenital heart defects.
The authors sought to estimate healthcare costs for infants, children, and adolescents with congenital heart defects (CHDs). Using the 2009 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID), they found that hospitalizations for children with CHDs have disproportionately high hospital costs compared with other pediatric hospitalizations, and the 17% of hospitalizations with critical CHD diagnoses accounted for 27% of CHD hospital costs.
AHRQ-authored.
Citation: Simeone RM, Oster ME, Cassell CH .
Pediatric inpatient hospital resource use for congenital heart defects.
Birth Defects Res A Clin Mol Teratol 2014 Dec;100(12):934-43. doi: 10.1002/bdra.23262.
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Keywords: Cardiovascular Conditions, Children/Adolescents, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitalization
Trudnak Fowler T, Fairbrother G, Owens P
AHRQ Author: Owens P
Trends in complicated newborn hospital stays & costs, 2002-2009: implications for the future.
The researchers used HCUP data to examine trends from 2002 through 2009 in complicated newborn hospital stays, and to explore the relationship between expected sources of payment and reasons for hospitalizations. They concluded that state Medicaid programs are paying for an increasing proportion of births and costly complicated births, and they suggested that policies to prevent common birth complications have the potential to reduce costs for public programs and improve birth outcomes.
AHRQ-authored.
Citation: Trudnak Fowler T, Fairbrother G, Owens P .
Trends in complicated newborn hospital stays & costs, 2002-2009: implications for the future.
Medicare Medicaid Res Rev 2014;4(4). doi: 10.5600/mmrr.004.04.a03.
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Keywords: Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Newborns/Infants
Henke RM, Wier LM, Marder WD
AHRQ Author: Friedman BS, Wong HS
Geographic variation in cesarean delivery in the United States by payer.
This study aimed (1) to determine whether the geographic variation in cesarean delivery rate is consistent for private insurance and Medicaid, and (2) to identify the patient, population, and market factors associated with cesarean rate and determine if these factors vary by payer. It concluded that factors associated with geographic variation in cesarean delivery, a frequent and high-resource inpatient procedure, vary somewhat by payer.
AHRQ-authored; AHRQ-funded; 290200600009C.
Citation: Henke RM, Wier LM, Marder WD .
Geographic variation in cesarean delivery in the United States by payer.
BMC Pregnancy Childbirth 2014 Nov 19;14:387. doi: 10.1186/s12884-014-0387-x.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Health Insurance, Labor and Delivery, Medicaid, Pregnancy
Martsolf GR, Auerbach D, Benevent R
AHRQ Author: Stocks C, Jiang HJ
Examining the value of inpatient nurse staffing: an assessment of quality and patient care costs.
The authors assessed the effect of nurse staffing on quality of care and inpatient care costs. They found that increases in nurse staffing levels were associated with reductions in nursing-sensitive adverse events and length of stay, while changing skill mix by increasing the number of registered nurses, as a proportion of licensed nursing staff, led to reductions in costs.
AHRQ-authored; AHRQ-funded; 290200600009C.
Citation: Martsolf GR, Auerbach D, Benevent R .
Examining the value of inpatient nurse staffing: an assessment of quality and patient care costs.
Med Care 2014 Nov;52(11):982-8. doi: 10.1097/mlr.0000000000000248.
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Keywords: Healthcare Costs, Quality of Care, Healthcare Cost and Utilization Project (HCUP), Inpatient Care, Nursing
Mutter R, Stocks C
AHRQ Author: Stocks C
Using Healthcare Cost and Utilization Project (HCUP) data for emergency medicine research.
This article mentions Kocher et al., elsewhere in this issue, who use the HCUP Nationwide Inpatient Sample to examine the association between the volume of ED encounters that result in admission and inpatient mortality. It further discusses HCUP strengths, weaknesses, and future.
AHRQ-authored.
Citation: Mutter R, Stocks C .
Using Healthcare Cost and Utilization Project (HCUP) data for emergency medicine research.
Ann Emerg Med 2014 Nov;64(5):458-60. doi: 10.1016/j.annemergmed.2014.09.014.
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Keywords: Emergency Medical Services (EMS), Healthcare Costs, Healthcare Delivery, Health Services Research (HSR), Healthcare Cost and Utilization Project (HCUP)
Maeda JL, Mosher Henke R, Marder WD
AHRQ Author: Karaca Z, Friedman BS, Wong HS
Variation in hospital inpatient prices across small geographic areas.
The authors examined whether market competition may influence the difference in the inpatient price per discharge between public and private payers across small geographic areas. They found greater geographic variation in the inpatient price per discharge among private than public payers for most hospital services, while hospitals in more concentrated markets were associated with a higher price per discharge among knee arthroplasty discharges for both payers. They concluded that hospitals charged significantly higher prices to private than public payers.
AHRQ-authored; AHRQ-funded; 290200600009C.
Citation: Maeda JL, Mosher Henke R, Marder WD .
Variation in hospital inpatient prices across small geographic areas.
Am J Manag Care 2014 Nov;20(11):907-16.
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Keywords: Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Orthopedics, Surgery
Basu J
AHRQ Author: Basu J
Has access to care changed in minority communities? A study of preventable hospitalizations over time in selected States.
Basu assessed the changes in access to care in minority communities by examining the association between preventable hospitalization rates and racial/ethnic composition of the community during 1995-2005. Using HCUP data, the results indicated increases in barriers faced by minority adults in accessing primary care over time, with no similar evidence for the elderly subgroup.
AHRQ-authored.
Citation: Basu J .
Has access to care changed in minority communities? A study of preventable hospitalizations over time in selected States.
J Ambul Care Manage 2014 Oct-Dec;37(4):314-30. doi: 10.1097/jac.0000000000000024.
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Keywords: Access to Care, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Primary Care, Racial and Ethnic Minorities
Curtin CM, Hernandez-Boussard T
Readmissions after treatment of distal radius fractures.
The authors assessed the rates and associated diagnoses of readmissions for patients having received an intervention for treatment of distal radius fracture. Using AHRQ data sets, they found that many distal radius fracture patients return to the health care system for pain-related issues, and they recommended implementation of better pain management.
AHRQ-funded; HS018558.
Citation: Curtin CM, Hernandez-Boussard T .
Readmissions after treatment of distal radius fractures.
J Hand Surg Am 2014 Oct;39(10):1926-32. doi: 10.1016/j.jhsa.2014.07.041.
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Keywords: Injuries and Wounds, Quality of Care, Healthcare Cost and Utilization Project (HCUP), Pain, Hospital Readmissions
Jacobs JH, Viboud C, Tchetgen ET
AHRQ Author: Steiner C
The association of meningococcal disease with influenza in the United States, 1989-2009.
The purpose of this paper is to quantify the fraction of meningococcal disease attributable to influenza. The authors found that, over 20 years, 12.8% of meningococcal disease can be attributable to influenza in the preceding weeks with H3N2 accounting for 5.2%, H1N1 4.3%, B 3.0%, and pH1N1 0.2%. They concluded that influenza vaccination could provide protection, particularly in young children where the meningococcal disease vaccine is not recommended or protective against the most common serogroup.
AHRQ-authored.
Citation: Jacobs JH, Viboud C, Tchetgen ET .
The association of meningococcal disease with influenza in the United States, 1989-2009.
PLoS One 2014 Sep 29;9(9):e107486. doi: 10.1371/journal.pone.0107486.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Infectious Diseases, Influenza
Hernandez-Boussard T, Burns CS, Wang NE
The Affordable Care Act reduces emergency department use by young adults: evidence from three States.
The authors tested the impact of the Affordable Care Act (ACA) on how young adults used ED services. They found that the largest relative decreases were found in women and blacks. This relative decrease in ED use implies a total reduction of more than 60,000 visits from young adults across three states in 2011.
AHRQ-funded; HS018558.
Citation: Hernandez-Boussard T, Burns CS, Wang NE .
The Affordable Care Act reduces emergency department use by young adults: evidence from three States.
Health Aff 2014 Sep;33(9):1648-54. doi: 10.1377/hlthaff.2014.0103.
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Keywords: Emergency Department, Health Insurance, Policy, Healthcare Cost and Utilization Project (HCUP), Young Adults
Ellimoottil C, Miller S, Ayanian JZ
Effect of insurance expansion on utilization of inpatient surgery.
The researchers examined the differential effect of the Massachusetts insurance expansion on the use of discretionary vs. nondiscretionary surgical procedures. They found that discretionary surgery increased 9.3 percent while nondiscretionary surgery decreased by 4.5 percent. The greatest increase in discretionary surgery was observed for nonwhite participants.
AHRQ-funded; HS018346.
Citation: Ellimoottil C, Miller S, Ayanian JZ .
Effect of insurance expansion on utilization of inpatient surgery.
JAMA Surg. 2014 Aug;149(8):829-36. doi: 10.1001/jamasurg.2014.857..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Health Insurance, Healthcare Utilization
Schiltz NK, Finkelstein Rosenthal B, Crowley MA
Rehospitalization during the first year of life by insurance status.
The authors assessed the association of insurance status on infant rehospitalization in a population-based setting. They found that Medicaid coverage and being uninsured were strong predictors of rehospitalizations, with Medicaid bearing a disproportionate share of the economic burden. Normal birth weight infants had the lowest risk. They further found that jaundice and acute bronchiolitis were the leading causes of rehospitalization within 30 days and 1 year, respectively.
AHRQ-funded; HS000059.
Citation: Schiltz NK, Finkelstein Rosenthal B, Crowley MA .
Rehospitalization during the first year of life by insurance status.
Clin Pediatr 2014 Aug;53(9):845-53. doi: 10.1177/0009922814536924.
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Keywords: Health Insurance, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Newborns/Infants, Medicaid, Newborns/Infants
Johnson EK, Graham DA, Chow JS
Nationwide emergency department imaging practices for pediatric urolithiasis: room for improvement.
The researchers describe the national use of computed tomography (CT) versus ultrasound imaging for pediatric patients seen at emergency departments (EDs) for suspected urolithiasis (SU) during the period 2006-2010. Use of CT was much higher than use of ultrasound, although it dropped off after 2007. Lowest CT use was seen at EDs that care for more children.
AHRQ-funded; HS019485
Citation: Johnson EK, Graham DA, Chow JS .
Nationwide emergency department imaging practices for pediatric urolithiasis: room for improvement.
J Urol. 2014 Jul;192(1):200-6. doi: 10.1016/j.juro.2014.01.028..
Keywords: Children/Adolescents, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Imaging, Children/Adolescents, Practice Patterns
Newman-Toker DE, Moy E, Valente E
AHRQ Author: Moy E
Missed diagnosis of stroke in the emergency department: a cross-sectional analysis of a large population-based sample.
The authors sought to estimate the frequency of missed stroke and examine associations with patient, emergency department (ED), and hospital characteristics. They estimated 15,000-165,000 misdiagnosed cerebrovascular events annually in US EDs, disproportionately presenting with headache or dizziness. They recommended that physicians evaluating these symptoms be particularly attuned to the possibility of stroke in younger, female, and non-White patients.
AHRQ-authored; AHRQ-funded; HS019252.
Citation: Newman-Toker DE, Moy E, Valente E .
Missed diagnosis of stroke in the emergency department: a cross-sectional analysis of a large population-based sample.
Diagnosis 2014 Jun;1(2):155-66. doi: 10.1515/dx-2013-0038.
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Keywords: Diagnostic Safety and Quality, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Patient Safety, Stroke
Dy CJ, Bozic KJ, Pan TJ
Risk factors for early revision after total hip arthroplasty.
In order to obtain a better understanding of the risk factors for early revision total hip arthroplasty (THA), the researchers used statewide databases to identify a total of 207,256 patients who underwent primary THA. They found a number of identifiable factors, including younger age, Medicaid, and low hospital volume increase the risk of undergoing early revision THA.
AHRQ-funded; HS016075
Citation: Dy CJ, Bozic KJ, Pan TJ .
Risk factors for early revision after total hip arthroplasty.
Arthritis Care Res. 2014 Jun;66(6):907-15. doi: 10.1002/acr.22240..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Risk
Shah TR, Rockman CB, Adelman MA
Nationwide comparative impact of thoracic endovascular aortic repair of acute uncomplicated type B aortic dissections.
The objective of this study was to evaluate the impact of thoracic endovascular aortic repair (TEVAR) on mortality, morbidity, length of stay (LOS), and discharge status on patients with acute uncomplicated Type B aortic dissections (TBAD). It found that TEVAR for acute uncomplicated TBAD was associated with similar in-hospital mortality and renal failure as compared to medical management.
AHRQ-funded; HS019473.
Citation: Shah TR, Rockman CB, Adelman MA .
Nationwide comparative impact of thoracic endovascular aortic repair of acute uncomplicated type B aortic dissections.
Vasc Endovascular Surg. 2014 Apr;48(3):230-3. doi: 10.1177/1538574413518122..
Keywords: Comparative Effectiveness, Outcomes, Cardiovascular Conditions, Healthcare Cost and Utilization Project (HCUP)
Owens PL, Barrett ML, Raetzman S
AHRQ Author: Owens PL, Steiner CA
Surgical site infections following ambulatory surgery procedures.
The authors determined the incidence of clinically significant surgical site infections (CS-SSIs) following low- to moderate-risk ambulatory surgery in patients with low risk for surgical complications. They found that among patients in 8 states undergoing ambulatory surgery, rates of postsurgical visits for CS-SSIs were low relative to all causes but may represent a substantial number of adverse outcomes in aggregate, thus meriting quality improvement efforts to minimize their occurrence.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Owens PL, Barrett ML, Raetzman S .
Surgical site infections following ambulatory surgery procedures.
JAMA 2014 Feb 19;311(7):709-16. doi: 10.1001/jama.2014.4.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare-Associated Infections (HAIs), Injuries and Wounds, Ambulatory Care and Surgery, Surgery, Hospitalization, Patient Safety, Adverse Events
Carey K, Lin MY
Hospital length of stay and readmission: an early investigation.
This study is a retrospective examination of the association between length of stay in an index hospitalization and readmission within 7 days and within 30 days of discharge. It found negative associations between length of stay and readmission probability, particularly for heart attack patients; however, the magnitude of the effect was modest for heart attack.
AHRQ-funded; HS020995.
Citation: Carey K, Lin MY .
Hospital length of stay and readmission: an early investigation.
Med Care Res Rev 2014 Feb;71(1):99-111. doi: 10.1177/1077558713504998..
Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Hospital Readmissions, Hospitalization, Hospital Discharge