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AHRQ Research Studies Date
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- Adverse Events (2)
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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 12 of 12 Research Studies DisplayedHaddad DN, Shipe ME, Absi TS
Preparing for bundled payments: impact of complications post-coronary artery bypass grafting on costs.
This study examined the impact of complications on bundled payments for coronary artery bypass grafting (CABG) for care provided from admission through 90 days post-discharge. The authors linked clinical and internal cost data for patients undergoing CABG from 2014 to 2017 at a single institution. They performed multivariable linear regression to evaluate drivers of high costs, adjusting for preoperative and intraoperative characteristics and postoperative complications. They reviewed records of 1789 patients undergoing CABG with an average of 2.7 vessels. A large proportion of patients were diabetic and obese. Factors associated with increased adjusted costs were preoperative renal failure, diabetes and body mass index, postoperative stroke, prolonged ventilation, rebleeding requiring reoperation, and renal failure with varying magnitude.
AHRQ-funded; HS026122.
Citation: Haddad DN, Shipe ME, Absi TS .
Preparing for bundled payments: impact of complications post-coronary artery bypass grafting on costs.
Ann Thorac Surg 2021 Apr;111(4):1258-63. doi: 10.1016/j.athoracsur.2020.06.105..
Keywords: Cardiovascular Conditions, Surgery, Adverse Events, Healthcare Costs, Payment
Gold HT, Siman N, Cuthel AM
A practice facilitation-guided intervention in primary care settings to reduce cardiovascular disease risk: a cost analysis.
In this randomized controlled trial, researchers estimated the associated cost of practice facilitation (PF) for guideline adoption in small, private primary care practices. They found that the PF strategy cost approximately $10,000 per practice per quarter for program and practice costs, once implemented and running at highest efficiency. They indicated that whether or not this program is worthwhile to the decision-maker depends on the relative costs and effectiveness of their other options for improving cardiovascular risk reduction.
AHRQ-funded; HS023922.
Citation: Gold HT, Siman N, Cuthel AM .
A practice facilitation-guided intervention in primary care settings to reduce cardiovascular disease risk: a cost analysis.
Implement Sci Commun 2021 Feb 6;2(1):15. doi: 10.1186/s43058-021-00116-x..
Keywords: Primary Care, Cardiovascular Conditions, Guidelines, Prevention, Evidence-Based Practice, Primary Care: Models of Care, Healthcare Costs
Bayliss WS, Bushnell CD, Halladay JR
The cost of implementing and sustaining the COMprehensive Post-Acute Stroke Services model.
This study compares the outcomes of using the COMprehensive Post-Acute Stroke Services (COMPASS) model, a transitional care intervention for stroke patients discharged to home against status quo postacute stroke care in a cluster-randomized trial in 40 hospitals in North Carolina. Hospital-level costs associated with implementing and sustaining COMPASS were examined during a 1-year period. Out of 40 hospitals, 22 hospitals were actively engaged in COMPASS. A 10% higher stroke patient volume was associated with 5.1% lower COMPASS costs per patient. About half of hospitals (N = 10) reported postacute clinic visits as their highest cost activity, while 7 hospitals reported case ascertainment as their highest cost activity. The authors estimated that based on average costs of COMPASS and readmissions, COMPASS could lower net costs if the model can prevent about 6 readmissions per year.
AHRQ-funded; HS025723.
Citation: Bayliss WS, Bushnell CD, Halladay JR .
The cost of implementing and sustaining the COMprehensive Post-Acute Stroke Services model.
Med Care 2021 Feb;59(2):163-68. doi: 10.1097/mlr.0000000000001462..
Keywords: Stroke, Cardiovascular Conditions, Healthcare Costs, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Amin AP, Miller S, Rahn B
Reversing the "risk-treatment paradox" of bleeding in patients undergoing percutaneous coronary intervention: risk-concordant use of bleeding avoidance strategies is associated with reduced bleeding and lower costs.
Bleeding avoidance strategies (BAS) are effective, but are paradoxically used less often with patients at high risk of bleeding. This article describes the implementation of an intervention in a St. Louis, MO, hospital intended to reverse the bleeding risk-treatment paradox. Temporal trends in BAS use and the association of risk-concordant BAS use with bleeding as well as hospital costs of percutaneous coronary intervention were examined. Patient-centered care that aimed directly toward making treatment-related decisions based on predicted risk of bleeding led to a more risk-concordant use of BAS and a reversal of the risk-treatment paradox. The authors conclude that larger multicentered studies will be needed to corroborate these results.
AHRQ-funded; HS022481.
Citation: Amin AP, Miller S, Rahn B .
Reversing the "risk-treatment paradox" of bleeding in patients undergoing percutaneous coronary intervention: risk-concordant use of bleeding avoidance strategies is associated with reduced bleeding and lower costs.
J Am Heart Assoc 2018 Nov 6;7(21):e008551. doi: 10.1161/jaha.118.008551..
Keywords: Adverse Events, Patient Safety, Heart Disease and Health, Risk, Surgery, Cardiovascular Conditions, Healthcare Costs
Annapureddy A, Valero-Elizondo J, Khera R
Association between financial burden, quality of life, and mental health among those with atherosclerotic cardiovascular disease in the United States.
Currently, there is little information about the relationship between the financial burden of healthcare for patients with atherosclerotic cardiovascular disease (ASCVD) and their health-related quality of life (HRQoL), well-being, and psychological health. Accordingly, the authors of this study, determined the relationship between healthcare financial burden and patient-reported HRQoL, self-perception of health, psychological distress, and risk of depression in a nationally representative US adult population with established ASCVD.
AHRQ-funded; HS023000.
Citation: Annapureddy A, Valero-Elizondo J, Khera R .
Association between financial burden, quality of life, and mental health among those with atherosclerotic cardiovascular disease in the United States.
Circ Cardiovasc Qual Outcomes 2018 Nov;11(11):e005180. doi: 10.1161/circoutcomes.118.005180..
Keywords: Cardiovascular Conditions, Healthcare Costs, Behavioral Health, Quality of Life
Thompson MP, Cabrera L, Strobel RJ
Association between postoperative pneumonia and 90-day episode payments and outcomes among Medicare beneficiaries undergoing cardiac surgery.
Postoperative pneumonia is the most common healthcare-associated infection in cardiac surgical patients, yet their impact across a 90-day episode of care remains unknown. The objective of this study was to examine the relationship between pneumonia and 90-day episode payments and outcomes among Medicare beneficiaries undergoing cardiac surgery. The investigators concluded that postoperative pneumonia was associated with significantly higher 90-day episode payments and inferior outcomes at the patient and hospital level.
AHRQ-funded; HS022535.
Citation: Thompson MP, Cabrera L, Strobel RJ .
Association between postoperative pneumonia and 90-day episode payments and outcomes among Medicare beneficiaries undergoing cardiac surgery.
Circ Cardiovasc Qual Outcomes 2018 Sep;11(9):e004818. doi: 10.1161/circoutcomes.118.004818..
Keywords: Elderly, Surgery, Medicare, Cardiovascular Conditions, Heart Disease and Health, Pneumonia, Payment, Healthcare Costs, Outcomes, Healthcare-Associated Infections (HAIs), Health Insurance
Ngo-Metzger Q, Zuvekas SH, Bierman AS
AHRQ Author: Ngo-Metzger Q, Zuvekas SH, Bierman AS
Estimated impact of US Preventive Services Task Force Recommendations on use and cost of statins for cardiovascular disease prevention.
The purpose of the study was to assess the US population meeting criteria for statin use and factors associated with use, and calculate associated costs. The study concluded that new USPSTF recommendations may result in decreased out-of-pocket costs and expanded access to statins. Previous research has shown that eliminating copayments increased adherence and decreased rates of ASCVD events without increasing overall healthcare costs.
AHRQ-authored.
Citation: Ngo-Metzger Q, Zuvekas SH, Bierman AS .
Estimated impact of US Preventive Services Task Force Recommendations on use and cost of statins for cardiovascular disease prevention.
J Gen Intern Med 2018 Aug;33(8):1317-23. doi: 10.1007/s11606-018-4497-4..
Keywords: Cardiovascular Conditions, Healthcare Costs, Medication, Prevention, U.S. Preventive Services Task Force (USPSTF)
Singh J, Valero-Elizondo J, Salami JA
Favorable modifiable cardiovascular risk profile is associated with lower healthcare costs among cancer patients: the 2012-2013 Medical Expenditure Panel Survey.
Atherosclerotic cardiovascular disease (ASCVD) and cancer are among the leading causes of economic burden, morbidity, and mortality in the United States. In this study, the investigators aimed to quantify the overall impact of cardiovascular modifiable risk factor (CRF) profile on healthcare expenditures among those with and without ASCVD and/or cancer. The investigators concluded that in a nationally representative US adult population, absence of ASCVD and a favorable CRF profile were associated with significantly lower medical expenditure among cancer patients.
AHRQ-funded; HS023000.
Citation: Singh J, Valero-Elizondo J, Salami JA .
Favorable modifiable cardiovascular risk profile is associated with lower healthcare costs among cancer patients: the 2012-2013 Medical Expenditure Panel Survey.
J Am Heart Assoc 2018 Apr 23;7(9). doi: 10.1161/jaha.117.007874..
Keywords: Medical Expenditure Panel Survey (MEPS), Cardiovascular Conditions, Risk, Healthcare Costs, Cancer
Geri G, Fahrenbruch C, Meischke H
Effects of bystander CPR following out-of-hospital cardiac arrest on hospital costs and long-term survival.
In this paper, the investigators evaluated bystander cardiopulmonary resuscitation (CPR), hospital-based costs, and long-term survival following out-of-hospital cardiac arrest (OHCA) in order to assess the potential cost-effectiveness of bystander CPR.
AHRQ-funded; HS021658.
Citation: Geri G, Fahrenbruch C, Meischke H .
Effects of bystander CPR following out-of-hospital cardiac arrest on hospital costs and long-term survival.
Resuscitation 2017 Jun;115:129-34. doi: 10.1016/j.resuscitation.2017.04.016..
Keywords: Cardiovascular Conditions, Emergency Medical Services (EMS), Healthcare Costs, Outcomes
Allen NB, Zhao L, Liu L
Favorable cardiovascular health, compression of morbidity, and healthcare costs: forty-year follow-up of the CHA Study (Chicago Heart Association Detection Project in Industry).
The researchers examined the association of cardiovascular health at younger ages with the proportion of life lived free of morbidity, the cumulative burden of morbidity, and average healthcare costs at older ages. They found that individuals in favorable cardiovascular health in early middle age live a longer, healthier life free of all types of morbidity.
AHRQ-funded; HS020263.
Citation: Allen NB, Zhao L, Liu L .
Favorable cardiovascular health, compression of morbidity, and healthcare costs: forty-year follow-up of the CHA Study (Chicago Heart Association Detection Project in Industry).
Circulation 2017 May 2;135(18):1693-701. doi: 10.1161/circulationaha.116.026252.
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Keywords: Healthcare Costs, Cardiovascular Conditions, Health Status
Vaughan Sarrazin MS, Jones M, Mazur A
Cost of hospital admissions in Medicare patients with atrial fibrillation taking warfarin, dabigatran, or rivaroxaban.
The purpose of this study was to examine the impact of anticoagulant choice on inpatient costs in patients with nonvalvular atrial fibrillation (AF). Analysis used 3-way propensity matching to create groups from AF patients taking dabigatran, rivaroxaban, or warfarin, and were plausible candidates for all 3 anticoagulants. Predicted values from two models were multiplied together to estimate expected costs per patient-year. The study concludes from its data that patients with newly diagnosed AF taking 150 mg dabigatran or 20 mg rivaroxaban experience lower annual inpatient costs than patients taking warfarin, due to fewer hospital admissions for stroke, non-gastrointestinal-related hemorrhages, and heart failure events.
AHRQ-funded; HS023104.
Citation: Vaughan Sarrazin MS, Jones M, Mazur A .
Cost of hospital admissions in Medicare patients with atrial fibrillation taking warfarin, dabigatran, or rivaroxaban.
J Am Coll Cardiol 2017 Jan 24;69(3):360-62. doi: 10.1016/j.jacc.2016.11.023..
Keywords: Blood Thinners, Heart Disease and Health, Medication, Healthcare Costs, Medicare, Hospitalization, Cardiovascular Conditions
Webb M, Fahimi S, Singh GM
Cost effectiveness of a government supported policy strategy to decrease sodium intake: global analysis across 183 nations.
This study quantified the cost effectiveness of a government policy combining targeted industry agreements and public education to reduce sodium intake in 183 countries worldwide. It concluded that a government "soft regulation" strategy combining targeted industry agreements and public education to reduce dietary sodium is projected to be highly cost effective worldwide, even without accounting for potential healthcare savings.
AHRQ-funded; HS000062.
Citation: Webb M, Fahimi S, Singh GM .
Cost effectiveness of a government supported policy strategy to decrease sodium intake: global analysis across 183 nations.
BMJ 2017 Jan 10;356:i6699. doi: 10.1136/bmj.i6699.
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Keywords: Healthcare Costs, Nutrition, Cardiovascular Conditions, Blood Pressure, Policy