National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (3)
- Blood Clots (1)
- Cancer (1)
- Cardiovascular Conditions (2)
- Children's Health Insurance Program (CHIP) (1)
- Children/Adolescents (3)
- Chronic Conditions (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Decision Making (1)
- Education: Patient and Caregiver (1)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (3)
- Health Insurance (1)
- Heart Disease and Health (1)
- Hospital Discharge (1)
- Hospitalization (3)
- Hospital Readmissions (1)
- Hospitals (6)
- Medicaid (1)
- Medication (1)
- Mortality (2)
- Nursing Homes (4)
- Orthopedics (1)
- Outcomes (3)
- Palliative Care (1)
- Patient-Centered Outcomes Research (2)
- Patient Experience (3)
- Patient Safety (4)
- Payment (2)
- Pneumonia (1)
- Prevention (1)
- Provider Performance (3)
- Public Reporting (2)
- Quality Improvement (1)
- (-) Quality Indicators (QIs) (24)
- Quality Measures (5)
- Quality of Care (15)
- Research Methodologies (3)
- Respiratory Conditions (1)
- Risk (1)
- Surgery (6)
- 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 24 of 24 Research Studies DisplayedPatel HD, Iyoha E, Pierorazio PM
A systematic review of research gaps in the evaluation and management of localized renal masses.
The authors conducted a systematic review to summarize research gaps for the evaluation of composite models for predicting malignancy; use of percutaneous renal sampling for diagnosis; and comparative effectiveness of surgery, thermal ablation, and active surveillance. They recommended incorporation of emerging biomarkers into validated composite models, standardization of biopsy protocols, standard reporting of clinical stage, and performance of prospective studies with objective selection criteria.
AHRQ-funded; 290201200007I.
Citation: Patel HD, Iyoha E, Pierorazio PM .
A systematic review of research gaps in the evaluation and management of localized renal masses.
Urology 2016 Dec;98:14-20. doi: 10.1016/j.urology.2016.08.013.
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Keywords: Cancer, Evidence-Based Practice, Patient-Centered Outcomes Research, Quality Indicators (QIs), Research Methodologies
Mukamel DB, Amin A, Weimer DL
Personalizing nursing home compare and the discharge from hospitals to nursing homes.
This study tested whether use of a personalized report card, Nursing Home Compare Plus (NHCPlus), embedded in a reengineered discharge process, can lead to better outcomes than the usual discharge process from hospitals to nursing homes. It found that about 85 percent of users indicated satisfaction with NHCPlus. Compared to controls, intervention patients were more satisfied with the choice process.
AHRQ-funded; R21 HS021844.
Citation: Mukamel DB, Amin A, Weimer DL .
Personalizing nursing home compare and the discharge from hospitals to nursing homes.
Health Serv Res 2016 Dec;51(6):2076-94. doi: 10.1111/1475-6773.12588.
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Keywords: Hospital Discharge, Hospitals, Nursing Homes, Patient Experience, Quality Indicators (QIs)
Gounder PP, Seeman SM, Holman RC
AHRQ Author: Steiner CA
Potentially preventable hospitalizations for acute and chronic conditions in Alaska, 2010-2012.
The Healthy Alaska 2020 initiative (HA2020) targeted reducing potentially preventable hospitalizations (PPH) for acute and chronic conditions among its health indicators. This study found that among 127,371 total hospitalizations, 4,911 and 6,721 were for acute and chronic PPH conditions, respectively. The overall crude PPH rate was 7.3 (3.1 for acute and 4.2 for chronic conditions).
AHRQ-authored.
Citation: Gounder PP, Seeman SM, Holman RC .
Potentially preventable hospitalizations for acute and chronic conditions in Alaska, 2010-2012.
Prev Med Rep 2016 Dec;4:614-21. doi: 10.1016/j.pmedr.2016.03.017.
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Keywords: Hospitalization, Healthcare Cost and Utilization Project (HCUP), Quality Indicators (QIs), Chronic Conditions, Quality of Care
Pezold ML, Pusic AL, Cohen WA
Defining a research agenda for patient-reported outcomes in surgery: using a Delphi survey of stakeholders.
The authors sought to create a research agenda to help determine future directions and advance cross-disciplinary collaboration on the use of patient-reported outcomes (PROs) in surgery. They concluded that the Patient-Reported Outcomes in Surgery Conference research agenda was created using a modified Delphi survey of stakeholders that will help researchers, surgeons, and funders identify crucial areas of future PROs research in surgery.
AHRQ-funded; HS023357; HS000066.
Citation: Pezold ML, Pusic AL, Cohen WA .
Defining a research agenda for patient-reported outcomes in surgery: using a Delphi survey of stakeholders.
JAMA Surg 2016 Oct;151(10):930-36. doi: 10.1001/jamasurg.2016.1640.
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Keywords: Patient-Centered Outcomes Research, Research Methodologies, Surgery, Quality Indicators (QIs)
Goff SL, Mazor KM, Pekow PS
Patient navigators and parent use of quality data: a randomized trial.
The authors explored the effectiveness of strategies to overcome barriers in vulnerable populations. They found that an intervention to reduce barriers to using publicly reported health care quality data had a modest effect on patient choice, suggesting that factors other than performance on common publicly reported quality metrics have a stronger influence on which pediatric practices women choose.
AHRQ-funded; HS021864.
Citation: Goff SL, Mazor KM, Pekow PS .
Patient navigators and parent use of quality data: a randomized trial.
Pediatrics 2016 Oct;138(4). doi: 10.1542/peds.2016-1140.
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Keywords: Decision Making, Quality of Care, Public Reporting, Quality Indicators (QIs), Vulnerable Populations
Chin DL, Bang H, Manickam RN
Rethinking thirty-day hospital readmissions: shorter intervals might be better indicators of quality of care.
The researchers examined risk-standardized thirty-day risk of unplanned inpatient readmission at the hospital level for Medicare patients ages sixty-five and older in four states and for three conditions: acute myocardial infarction, heart failure, and pneumonia. The hospital-level quality signal captured in readmission risk was highest on the first day after discharge and declined rapidly until it reached a nadir at seven days, as indicated by a decreasing intracluster correlation coefficient.
AHRQ-funded; HS022236.
Citation: Chin DL, Bang H, Manickam RN .
Rethinking thirty-day hospital readmissions: shorter intervals might be better indicators of quality of care.
Health Aff 2016 Oct;35(10):1867-75. doi: 10.1377/hlthaff.2016.0205.
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Keywords: Hospital Readmissions, Quality of Care, Hospitals, Quality Indicators (QIs)
Tedesco D, Hernandez-Boussard T, Carretta E
Evaluating patient safety indicators in orthopedic surgery between Italy and the USA.
The authors compared patient safety in major orthopedic procedures between an orthopedic hospital in Italy and 26 Florida hospitals of similar size. AHRQ Patient Safety Indicators (PSIs) were used to identify inpatient adverse events (AEs). They found that US patients had lower adjusted odds of developing a PSI compared to Italy for pressure ulcers, hemorrhage or hematoma, and physiologic and metabolic derangement. while Italian patients had lower odds of pulmonary embolism/deep vein thrombosis compared to US patients.
AHRQ-funded; HS018558.
Citation: Tedesco D, Hernandez-Boussard T, Carretta E .
Evaluating patient safety indicators in orthopedic surgery between Italy and the USA.
Int J Qual Health Care 2016 Sep;28(4):486-91. doi: 10.1093/intqhc/mzw053.
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Keywords: Adverse Events, Orthopedics, Patient Safety, Quality Indicators (QIs), Surgery
Lau BD, Haut ER, Hobson DB
ICD-9 code-based venous thromboembolism performance targets fail to measure up.
Suboptimal prevention practices have prompted payers to consider hospital-associated Venous thromboembolism (VTE) as a potentially preventable condition for which financial incentives or penalties exist to drive practice improvement. The authors reviewed a subset of hospital-associated VTE that were identified by ICD-9 codes used by a state-run pay-for-performance quality improvement program and discuss their findings.
AHRQ-funded; HS017952.
Citation: Lau BD, Haut ER, Hobson DB .
ICD-9 code-based venous thromboembolism performance targets fail to measure up.
Am J Med Qual 2016 Sep;31(5):448-53. doi: 10.1177/1062860615583547.
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Keywords: Healthcare-Associated Infections (HAIs), Quality Indicators (QIs), Prevention, Hospitals, Quality Improvement, Blood Clots, Payment, Provider Performance
Shah AY, LLanos K, Dougherty D
AHRQ Author: Dougherty D
State challenges to child health quality measure reporting and recommendations for improvement.
The authors sought to assess reporting barriers of the Children's Health Insurance Program (CHIP) and to identify potential opportunities for improvement. They found that low reporting states believed they had inadequate staffing and that data collection and extraction was too time-consuming. They concluded that possible solutions to improve reporting would include funding and staff support, refining the technical assistance provided, and creating venues for state-to-state interaction.
AHRQ-authored.
Citation: Shah AY, LLanos K, Dougherty D .
State challenges to child health quality measure reporting and recommendations for improvement.
Healthc 2016 Sep;4(3):217-24. doi: 10.1016/j.hjdsi.2016.03.001.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Quality of Care, Medicaid, Quality Indicators (QIs)
Pradarelli JC, Varban OA, Dimick JB
Hospital variation in rates of acid-reducing medication use after laparoscopic sleeve gastrectomy.
This study assessed variation in hospital performance with laparoscopic sleeve gastrectomy using rates of acid-reducing medication use at postoperative 1 year. It concluded that across Michigan hospitals, rates of new acid-reducing medication use at 1 year after laparoscopic sleeve gastrectomy varied widely and did not correlate with traditional quality indicators.
AHRQ-funded; R01 HS023597.
Citation: Pradarelli JC, Varban OA, Dimick JB .
Hospital variation in rates of acid-reducing medication use after laparoscopic sleeve gastrectomy.
Surg Obes Relat Dis 2016 Aug;12(7):1382-89. doi: 10.1016/j.soard.2015.11.016.
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Keywords: Hospitals, Medication, Surgery, Quality Indicators (QIs), Outcomes
Werner RM, Konetzka RT, Polsky D
Changes in consumer demand following public reporting of summary quality ratings: an evaluation in nursing homes.
The study’s objective was to evaluate consumer response to summary measures in the setting of nursing homes. It found that the star rating system was associated with a significant change in consumer demand for low- and high-scoring facilities. After the star-based rating system was released, 1-star facilities typically lost 8 percent of their market share and 5-star facilities gained over 6 percent of their market share.
AHRQ-funded; HS021861.
Citation: Werner RM, Konetzka RT, Polsky D .
Changes in consumer demand following public reporting of summary quality ratings: an evaluation in nursing homes.
Health Serv Res 2016 Jun;51 Suppl 2:1291-309. doi: 10.1111/1475-6773.12459.
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Keywords: Nursing Homes, Quality Indicators (QIs), Education: Patient and Caregiver
Schapira MM, Shea JA, Duey KA
The Nursing Home Compare report card: perceptions of residents and caregivers regarding quality ratings and nursing home choice.
The researchers evaluated the perceived usefulness of publicly reported nursing home quality indicators. They found that star ratings, clinical quality measures, and benchmarking information were salient to decision making, with preferred formats varying across participants. Participants desired additional information on the source of quality data. Confusion was evident regarding the relationship between domain-specific and overall star quality ratings.
AHRQ-funded; HS02861.
Citation: Schapira MM, Shea JA, Duey KA .
The Nursing Home Compare report card: perceptions of residents and caregivers regarding quality ratings and nursing home choice.
Health Serv Res 2016 Jun;51 Suppl 2:1212-28. doi: 10.1111/1475-6773.12458.
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Keywords: Nursing Homes, Quality Indicators (QIs), Patient Experience, Patient Experience, Quality of Care
Hernandez-Boussard TM, McDonald KM, Morrison DE
Risks of adverse events in colorectal patients: population-based study.
The authors sought to assess adverse events in colorectal surgical patients. They found important differential rates of adverse events by diagnostic category, with the highest odds ratio occurring in patients undergoing surgery for ischemic colitis.
AHRQ-funded; HS018558.
Citation: Hernandez-Boussard TM, McDonald KM, Morrison DE .
Risks of adverse events in colorectal patients: population-based study.
J Surg Res 2016 May 15;202(2):328-34. doi: 10.1016/j.jss.2016.01.013.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Surgery, Patient Safety, Risk, Quality Indicators (QIs), Quality of Care, Quality Measures
Wahl ER, Yazdany J
Challenges and opportunities in using patient-reported outcomes in quality measurement in rheumatology.
This article reviews the use of patient-reported outcomes (PROs) in assessing health care quality, and highlights challenges and opportunities specific to their use in rheumatology quality measurement. It describes the current use of PROs as quality measures in rheumatology, and frames an agenda for future work supporting development of meaningful quality measures based on PROs.
AHRQ-funded; HS024412.
Citation: Wahl ER, Yazdany J .
Challenges and opportunities in using patient-reported outcomes in quality measurement in rheumatology.
Rheum Dis Clin North Am 2016 May;42(2):363-75. doi: 10.1016/j.rdc.2016.01.008.
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Keywords: Quality of Care, Outcomes, Quality Indicators (QIs), Quality Measures
Jenkins KJ, Koch Kupiec J, Owens PL
AHRQ Author: Owens PL
Development and validation of an Agency for Healthcare Research and Quality indicator for mortality after congenital heart surgery harmonized with risk adjustment for congenital heart surgery (RACHS-1) methodology.
The National Quality Forum previously approved a quality indicator for mortality after congenital heart surgery developed by AHRQ. Several parameters of the validated Risk Adjustment for Congenital Heart Surgery (RACHS-1) method were included, but others differed. As part of the National Quality Forum endorsement maintenance process, developers were asked to harmonize the 2 methodologies.
AHRQ-authored.
Citation: Jenkins KJ, Koch Kupiec J, Owens PL .
Development and validation of an Agency for Healthcare Research and Quality indicator for mortality after congenital heart surgery harmonized with risk adjustment for congenital heart surgery (RACHS-1) methodology.
J Am Heart Assoc 2016 May;5(5):pii: e003028. doi: 10.1161/jaha.115.003028.
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Keywords: Surgery, Mortality, Quality Indicators (QIs), Children/Adolescents, Cardiovascular Conditions
McConnell KJ, Lindrooth RC, Wholey DR
Modern management practices and hospital admissions.
The researchers investigated whether the modern management practices and publicly reported performance measures are associated with choice of hospital for patients with acute myocardial infarction (AMI). They found that, overall, a one standard deviation change in management practice scores is associated with an 8% increase in AMI admissions.
AHRQ-funded; HS018466.
Citation: McConnell KJ, Lindrooth RC, Wholey DR .
Modern management practices and hospital admissions.
Health Econ 2016 Apr;25(4):470-85. doi: 10.1002/hec.3171.
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Keywords: Hospitals, Heart Disease and Health, Cardiovascular Conditions, Quality Indicators (QIs), Quality Measures, Quality of Care, Public Reporting, Provider Performance
Moghavem N, McDonald K, Ratliff JK
Performance measures in neurosurgical patient care: differing applications of patient safety indicators.
The researchers sought to determine how Patient Safety Indicator (PSI) rates and their impact on other outcomes in patients undergoing cranial neurosurgery compared with other surgeries.. They found that procedure indication was strongly associated with PSI development. The neurosurgical population had significantly higher risk-adjusted ratios of most PSIs evaluated compared with other surgical patients. Development of a PSI was strongly associated with increased length of stay and hospital cost.
AHRQ-funded; HS018558.
Citation: Moghavem N, McDonald K, Ratliff JK .
Performance measures in neurosurgical patient care: differing applications of patient safety indicators.
Med Care 2016 Apr;54(4):359-64. doi: 10.1097/mlr.0000000000000490.
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Keywords: Quality Indicators (QIs), Surgery, Hospitalization, Outcomes, Quality of Care
Mukamel DB, Amin A, Weimer DL
When patients customize nursing home ratings, choices and rankings differ from the government's version.
Report cards currently published by the Centers for Medicare and Medicaid Services (CMS) offer composite quality measures, such as the one featured on the Nursing Home Compare website. Nursing Home Compare Plus is an alternative that allows patients and their families to create their own composite scores based on their own preferences and medical needs. When comparing Nursing Home Compare Plus to Medicare's five-star ratings, we found only minimal agreement on ranking of nursing homes.
AHRQ-funded; HS021844.
Citation: Mukamel DB, Amin A, Weimer DL .
When patients customize nursing home ratings, choices and rankings differ from the government's version.
Health Aff 2016 Apr;35(4):714-9. doi: 10.1377/hlthaff.2015.1340.
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Keywords: Nursing Homes, Quality of Care, Quality Indicators (QIs), Patient Experience, Consumer Assessment of Healthcare Providers and Systems (CAHPS)
Chien AT, Schiavoni KH, Sprecher E
How accountable care organizations responded to pediatric incentives in the alternative quality contract.
The authors characterized the pediatric infrastructure of adult-oriented accountable care organizations (ACOs) and obtained leaders' perspectives on their ACOs' response to pediatric incentives. They found that most ACOs augmented their pediatric quality improvement and spending reduction efforts when faced with pediatric incentives.
AHRQ-funded; HS017146.
Citation: Chien AT, Schiavoni KH, Sprecher E .
How accountable care organizations responded to pediatric incentives in the alternative quality contract.
Acad Pediatr 2016 Mar;16(2):200-7. doi: 10.1016/j.acap.2015.10.008.
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Keywords: Children/Adolescents, Health Insurance, Quality of Care, Payment, Quality Indicators (QIs)
Southern DA, Pincus HA, Romano PS
Enhanced capture of healthcare-related harms and injuries in the 11th revision of the International Classification of Diseases (ICD-11).
The authors presented recommendations made to the World Health Organization (WHO) by the ICD revision's Quality and Safety Topic Advisory Group (Q&S TAG) for a new conceptual approach to capturing healthcare-related harms and injuries in ICD-coded data. They concluded that this new framework for coding healthcare-related harm has great potential to improve the clinical detail of adverse event descriptions and the overall quality of coded health data.
AHRQ-funded; HS020543.
Citation: Southern DA, Pincus HA, Romano PS .
Enhanced capture of healthcare-related harms and injuries in the 11th revision of the International Classification of Diseases (ICD-11).
Int J Qual Health Care 2016 Feb;28(1):136-42. doi: 10.1093/intqhc/mzv099.
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Keywords: Adverse Events, Quality of Care, Patient Safety, Quality Indicators (QIs)
Dy SM, Herr K, Bernacki RE
Methodological research priorities in palliative care and hospice quality measurement.
The authors describe three key priorities: 1) defining the population of interest for palliative care quality indicators, 2) developing methods to measure quality from different data sources, and 3) conducting research to advance the development of patient/family-reported indicators. They apply these concepts to the key quality domain of advance care planning and address relevance to implementation of indicators in improving care in order to facilitate improved quality measurement across all populations with serious illness and care for patients and families.
AHRQ-funded; HS023681.
Citation: Dy SM, Herr K, Bernacki RE .
Methodological research priorities in palliative care and hospice quality measurement.
J Pain Symptom Manage 2016 Feb;51(2):155-62. doi: 10.1016/j.jpainsymman.2015.10.019.
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Keywords: Research Methodologies, Palliative Care, Quality Measures, Quality Indicators (QIs), Quality of Care
Southern DA, Hall M, White DE
Opportunities and challenges for quality and safety applications in ICD-11: an international survey of users of coded health data.
The authors identified opportunities and challenges in improving the utility of ICD-11 for quality and safety applications. The 246 online survey respondents specified desires for the ICD revision: more code content for adverse events/complications; a desire for code clustering mechanisms; the need for diagnosis timing information; and the addition of better code definitions to reference materials. The authors concluded that the World Health Organization's ICD revision process is addressing each of these desires.
AHRQ-funded; HS020543.
Citation: Southern DA, Hall M, White DE .
Opportunities and challenges for quality and safety applications in ICD-11: an international survey of users of coded health data.
Int J Qual Health Care 2016 Feb;28(1):129-35. doi: 10.1093/intqhc/mzv096.
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Keywords: Quality of Care, Patient Safety, Quality Indicators (QIs)
Dresden SM, Feinglass JM, Kang R
Ambulatory care sensitive hospitalizations through the emergency department by payer: comparing 2003 and 2009.
This study compared rates of ED ambulatory care sensitive hospitalizations (ACSHs) for 2003 and 2009 among patients 18 to 64 years of age with private insurance, Medicaid, or no insurance.It found that an increase in the uninsured population was associated with an increase in the rate of ED ACSH for uninsured patients.
AHRQ-funded; HS000078.
Citation: Dresden SM, Feinglass JM, Kang R .
Ambulatory care sensitive hospitalizations through the emergency department by payer: comparing 2003 and 2009.
J Emerg Med 2016 Jan;50(1):135-42. doi: 10.1016/j.jemermed.2015.02.047.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Quality Indicators (QIs), Hospitalization, Emergency Medical Services (EMS)
Walkey AJ, Weinberg J, Wiener RS
Association of do-not-resuscitate orders and hospital mortality rate among patients with pneumonia.
The researchers evaluated the effect of analytic approaches accounting for do-not-resuscitate (DNR) status on risk-adjusted hospital mortality rates and performance rankings. They found that after accounting for patient DNR status and between-hospital variation in the association between DNR status and mortality, hospitals with higher DNR rates had lower mortality.
AHRQ-funded; HS020672.
Citation: Walkey AJ, Weinberg J, Wiener RS .
Association of do-not-resuscitate orders and hospital mortality rate among patients with pneumonia.
JAMA Intern Med 2016 Jan;176(1):97-104. doi: 10.1001/jamainternmed.2015.6324.
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Keywords: Hospitals, Mortality, Quality of Care, Quality Indicators (QIs), Quality Measures, Pneumonia, Provider Performance, Respiratory Conditions