National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Ambulatory Care and Surgery (1)
- Antibiotics (5)
- (-) Antimicrobial Stewardship (7)
- Caregiving (1)
- (-) Children/Adolescents (7)
- Critical Care (1)
- Emergency Department (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Costs (1)
- Home Healthcare (1)
- Intensive Care Unit (ICU) (1)
- Medicaid (1)
- Medication (4)
- Patient Safety (2)
- Practice Patterns (2)
- Respiratory Conditions (1)
- Shared Decision Making (1)
- Surgery (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 7 of 7 Research Studies DisplayedMalone SM, Seigel NS, Newland JG
Understanding antibiotic prophylaxis prescribing in pediatric surgical specialties.
The objective of this study was to understand the factors that contribute to pediatric surgeons' decisions regarding the use of perioperative antibiotic prophylaxis. The investigators found that surgeons described a complex set of factors that impacted their antibiotic prescribing in pediatric surgical cases. They reported initial, but not ongoing, training and a use of individual weight of risk and benefit as a major dictator of prescribing practices.
AHRQ-funded; HS026742.
Citation: Malone SM, Seigel NS, Newland JG .
Understanding antibiotic prophylaxis prescribing in pediatric surgical specialties.
Infect Control Hosp Epidemiol 2020 Jun;41(6):666-71. doi: 10.1017/ice.2020.71..
Keywords: Children/Adolescents, Antibiotics, Surgery, Antimicrobial Stewardship, Medication, Practice Patterns
Fischer MA, Mahesri M, Lii J
Non-Infection-related and non-visit-based antibiotic prescribing is common among Medicaid patients.
This study examined antibiotic prescribing by clinicians when there was no visit or without clear indications for use. The authors discuss the fact that current ambulatory antibiotic stewardship policies do not capture prescribing outside of clinician visits or clear indications for use. They measured the frequency for all filled antibiotic prescriptions in Medicaid patients in the period 2004-2013. They found that out of 298 million antibiotic fills for 53 million patients (62% for children), 55% were for clinician visits with an infection-related diagnosis, 17% were for visits without an infection-related diagnosis, and 28% were not associated with a visit.
AHRQ-funded; HS024930; HS023236; HS024651; HS026506; 2332015000201.
Citation: Fischer MA, Mahesri M, Lii J .
Non-Infection-related and non-visit-based antibiotic prescribing is common among Medicaid patients.
Health Aff 2020 Feb;39(2):280-88. doi: 10.1377/hlthaff.2019.00545..
Keywords: Antimicrobial Stewardship, Medicaid, Antibiotics, Medication, Practice Patterns, Children/Adolescents
Woods-Hill CZ, Koontz DW, King AF
Practices, perceptions, and attitudes in the evaluation of critically ill children for bacteremia: a national survey.
Sending blood cultures in children at low risk of bacteremia can contribute to a cascade of unnecessary antibiotic exposure, adverse effects, and increased costs. In this study, the investigators aimed to describe practice variation, clinician beliefs, and attitudes about blood culture testing in critically ill children. They concluded that there is variation in blood culture practices in the pediatric ICU. Fear and reflexive habits are common drivers of cultures. These practices may contribute to over-testing for bacteremia.
AHRQ-funded; HS025642.
Citation: Woods-Hill CZ, Koontz DW, King AF .
Practices, perceptions, and attitudes in the evaluation of critically ill children for bacteremia: a national survey.
Pediatr Crit Care Med 2020 Jan;21(1):e23-e29. doi: 10.1097/pcc.0000000000002176..
Keywords: Children/Adolescents, Critical Care, Antimicrobial Stewardship, Antibiotics, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Intensive Care Unit (ICU), Shared Decision Making
Krah NM, Bardsley T, Nelson R
Economic burden of home antimicrobial therapy: OPAT versus oral therapy.
There is increasing evidence that outpatient parenteral antimicrobial therapy (OPAT) is overused for children and that outcomes with oral therapy are equivalent. The objective of this study was to compare economic burden between OPAT and oral therapy, accounting for direct and indirect costs and caregiver quality of life (QoL). The investigators concluded that the overall burden of OPAT was substantially higher than that of oral therapy, including higher direct and indirect costs and greater impact on caregiver QoL.
AHRQ-funded; HS023320.
Citation: Krah NM, Bardsley T, Nelson R .
Economic burden of home antimicrobial therapy: OPAT versus oral therapy.
Hosp Pediatr 2019 Apr;9(4):234-40. doi: 10.1542/hpeds.201-0193.
.
.
Keywords: Healthcare Costs, Children/Adolescents, Caregiving, Home Healthcare, Antimicrobial Stewardship, Antibiotics, Medication
Mistry RD, May LS, Pulia MS
Improving antimicrobial stewardship in pediatric emergency care: a pathway forward.
In this commentary, the authors discuss a study in this same issue. Recent multidisciplinary teams have used novel methods to successfully engage with and intervene in urgent care, pediatric, and general–emergency department antibiotic prescribing. Antibiotic stewardship programs are recommended, as well as emergency department experts continuing to collaborate and formulate thoughtful solutions to this important patient-safety and public-health issue.
AHRQ-funded; HS024342.
Citation: Mistry RD, May LS, Pulia MS .
Improving antimicrobial stewardship in pediatric emergency care: a pathway forward.
Pediatrics 2019 Feb;143(2). doi: 10.1542/peds.2018-2972..
Keywords: Antimicrobial Stewardship, Antibiotics, Children/Adolescents, Emergency Department, Medication, Patient Safety
Karandikar MV, Coffin SE, Priebe GP
Variability in antimicrobial use in pediatric ventilator-associated events.
This article describes a study which assesses variability in antimicrobial use and associations with infection testing in pediatric ventilator-associated events (VAEs). 192 patients with ventilator-associated conditions were identified in neonatal, pediatric, and cardiac ICUs in six hospitals. Type and duration of antimicrobial use varied by ICU type. The authors conclude that antimicrobial use is common in pediatric ventilator-associated conditions, but pediatric VAP is uncommon; prolonged usage of antimicrobials in spite of low pediatric VAP rates or positive laboratory testing for infection suggests that pediatric ventilator-associated conditions with antimicrobial use for >/= 4 days may provide a lever for antimicrobial stewardship programs to improve utilization.
AHRQ-funded; HS021636.
Citation: Karandikar MV, Coffin SE, Priebe GP .
Variability in antimicrobial use in pediatric ventilator-associated events.
Infect Control Hosp Epidemiol 2019 Jan;40(1):32-39. doi: 10.1017/ice.2018.264..
Keywords: Adverse Events, Antimicrobial Stewardship, Children/Adolescents, Healthcare-Associated Infections (HAIs), Respiratory Conditions
Knackstedt ED, Stockmann C, Davis CR
Outpatient parenteral antimicrobial therapy in pediatrics: an opportunity to expand antimicrobial stewardship.
The researchers reviewed patient discharges with outpatient parenteral antimicrobial therapy (OPAT) to determine whether OPAT was modifiable or unnecessary at a large tertiary care children’s hospital. At least one modification definitely or possibly would have been recommended for 78 percent of episodes. For more than 40 percent of episodes, OPAT was potentially not indicated.
AHRQ-funded; HS023320.
Citation: Knackstedt ED, Stockmann C, Davis CR .
Outpatient parenteral antimicrobial therapy in pediatrics: an opportunity to expand antimicrobial stewardship.
Infect Control Hosp Epidemiol 2015 Feb;36(2):222-4. doi: 10.1017/ice.2014.27..
Keywords: Antimicrobial Stewardship, Children/Adolescents, Ambulatory Care and Surgery