National Healthcare Quality and Disparities Report
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Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (3)
- Clinical Decision Support (CDS) (1)
- Electronic Health Records (EHRs) (2)
- Healthcare Cost and Utilization Project (HCUP) (3)
- Healthcare Costs (1)
- Health Information Technology (HIT) (1)
- Hospital Discharge (1)
- Hospitalization (1)
- (-) Hospital Readmissions (11)
- Hospitals (3)
- Medicaid (1)
- Mortality (1)
- Obesity (1)
- Obesity: Weight Management (1)
- Outcomes (1)
- Patient-Centered Outcomes Research (2)
- Quality of Care (1)
- (-) Risk (11)
- Surgery (5)
- Tobacco Use (1)
- Transitions of Care (1)
- Urban Health (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 11 of 11 Research Studies DisplayedMarafino BJ, Schuler A, Liu VX
Predicting preventable hospital readmissions with causal machine learning.
This study’s goal was to assess the feasibility and potential impact of predicting preventable hospital readmissions using causal machine learning applied to data from the implementation of a readmissions prevention intervention called the Transitions Program, which used electronic health records from Kaiser Permanent Northern California (KPNC). A total of 1,539,285 index hospitalizations meeting the inclusion criteria and occurring between June 2010 and December 2010 at 21 KPNC hospitals were analyzed. There was substantial heterogeneity in patients’ response to the intervention, with patients at somewhat lower risk appearing to have the largest predicted effects. The estimates appeared to be well calibrated. The results did suggest a mismatch between risk and treatment effects.
AHRQ-funded; HS022192.
Citation: Marafino BJ, Schuler A, Liu VX .
Predicting preventable hospital readmissions with causal machine learning.
Health Serv Res 2020 Dec;55(6):993-1002. doi: 10.1111/1475-6773.13586..
Keywords: Hospital Readmissions, Hospitals, Clinical Decision Support (CDS), Risk
Saleh SN, Makam AN, Halm EA,
Can we predict early 7-day readmissions using a standard 30-day hospital readmission risk prediction model?
Despite focus on preventing 30-day readmissions, early readmissions (within 7 days of discharge) may be more preventable than later readmissions (8-30 days). In this study, the investigators assessed how well a previously validated 30-day EHR-based readmission model predicted 7-day readmissions and compared differences in strength of predictors. They suggested that improvements in predicting early 7-day readmissions will likely require new risk factors proximal to day of discharge.
AHRQ-funded; HS022418.
Citation: Saleh SN, Makam AN, Halm EA, .
Can we predict early 7-day readmissions using a standard 30-day hospital readmission risk prediction model?
BMC Med Inform Decis Mak 2020 Sep 15;20(1):227. doi: 10.1186/s12911-020-01248-1..
Keywords: Hospital Readmissions, Hospitals, Risk, Transitions of Care, Electronic Health Records (EHRs), Health Information Technology (HIT)
Yuce TK, Khorfan R, Soper NJ
Post-operative complications and readmissions associated with smoking following bariatric surgery.
The link between smoking and poor postoperative outcomes is well established. Despite this, current smokers are still offered bariatric surgery. In this study, the investigators describe the risk of postoperative 30-day complications and readmission following laparoscopic sleeve gastrectomy and laparoscopic Roux-En-Y gastric bypass in smokers. The investigators concluded that smokers undergoing bariatric surgery experienced significantly worse 30-day outcomes when compared with non-smokers.
AHRQ-funded; HS000078.
Citation: Yuce TK, Khorfan R, Soper NJ .
Post-operative complications and readmissions associated with smoking following bariatric surgery.
J Gastrointest Surg 2020 Mar;24(3):525-30. doi: 10.1007/s11605-019-04488-3..
Keywords: Surgery, Tobacco Use, Adverse Events, Hospital Readmissions, Obesity: Weight Management, Obesity, Risk, Outcomes
Longo M, Pennington Z, Gelfand Y
Readmission after spinal epidural abscess management in urban populations: a bi-institutional study.
This study examined 90-day readmission rates and causes after spinal epidural abscess (SEA) occurrence in urban populations. Neurosurgery records from two large urban institutions were reviewed to identify patients who were treated with SEA. Out of 103 patients with identified SEA, 97 were included. The mean age was 57.1 years and 57.7% were male. The 90-readmission rate for all causes was 37.1% with infection being the most common cause. Patients with prior immunocompromised status or hepatic disease had higher odds of 90-day readmission after SEA treatment.
AHRQ-funded; HS026396.
Citation: Longo M, Pennington Z, Gelfand Y .
Readmission after spinal epidural abscess management in urban populations: a bi-institutional study.
J Neurosurg Spine 2020 Mar;32(3):465–72. doi: 10.3171/2019.8.Spine19790..
Keywords: Hospital Readmissions, Urban Health, Surgery, Risk
Moore BJ, White S, Washington R
AHRQ Author: Elixhauser A
Identifying increased risk of readmission and in-hospital mortality using hospital administrative data: the AHRQ Elixhauser Comorbidity Index.
The researchers extended the literature on comorbidity measurement by developing 2 indices, based on the Elixhauser Comorbidity measures, designed to predict 2 frequently reported health outcomes: in-hospital mortality and 30-day readmission in administrative data. The index scores performed as well as using all 29 Elixhauser comorbidity variables separately.
AHRQ-authored; AHRQ-funded.
Citation: Moore BJ, White S, Washington R .
Identifying increased risk of readmission and in-hospital mortality using hospital administrative data: the AHRQ Elixhauser Comorbidity Index.
Med Care 2017 Jul;55(7):698-705. doi: 10.1097/mlr.0000000000000735.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Mortality, Risk
Macht R, Cassidy R, Cabral H
Evaluating organizational factors associated with postoperative bariatric surgery readmissions.
This study evaluated the association between readmissions and several organizational factors, including compliance with best practices to reduce unplanned hospital visits, major complication rates, and the emergency department-sourced readmission rate. It concluded that bariatric centers with higher rates of major complications and sites with emergency departments that are less likely to treat and discharge patients are more likely to have higher readmission rates.
AHRQ-funded; HS023621.
Citation: Macht R, Cassidy R, Cabral H .
Evaluating organizational factors associated with postoperative bariatric surgery readmissions.
Surg Obes Relat Dis 2017 Jun;13(6):1004-09. doi: 10.1016/j.soard.2016.12.029.
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Keywords: Adverse Events, Surgery, Hospital Readmissions, Risk
Jacobs BL, He C, Li BY
Variation in readmission expenditures after high-risk surgery.
The researchers sought to investigate readmission intensity as measured by readmission cost for high-risk surgeries and examine predictors of higher readmission costs. They found that the 30-day readmission rate was 16 percent for major chest and 22 percent for major abdominal surgery. Discharge to a skilled nursing facility was associated with higher readmission costs for both chest and abdominal surgeries.
AHRQ-funded; HS024403; HS023621.
Citation: Jacobs BL, He C, Li BY .
Variation in readmission expenditures after high-risk surgery.
J Surg Res 2017 Jun 1;213:60-68. doi: 10.1016/j.jss.2017.02.017.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Hospital Readmissions, Healthcare Costs, Risk
Horwitz LI, Bernheim SM, Ross JS
Hospital characteristics associated with risk-standardized readmission rates.
This national study using Medicare data examined the independent association of 8 hospital characteristics with hospital-wide 30-day risk-standardized readmission rate (RSRR). Overall, larger, urban, academic facilities had modestly higher RSRRs than smaller, suburban, community hospitals, although there was a wide range of performance. The strong regional effect suggests that local practice patterns are an important influence.
AHRQ-funded; HS022882.
Citation: Horwitz LI, Bernheim SM, Ross JS .
Hospital characteristics associated with risk-standardized readmission rates.
Med Care 2017 May;55(5):528-34. doi: 10.1097/mlr.0000000000000713.
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Keywords: Hospitals, Hospital Readmissions, Medicaid, Risk, Quality of Care
Makam AN, Nguyen OK, Clark C
Incidence, predictors, and outcomes of hospital-acquired anemia.
This study examined the incidence, predictors, and postdischarge outcomes associated with hospital-acquired anemia (HAA). Most patients with severe HAA (85 percent) underwent a major procedure, had a discharge diagnosis of hemorrhage, and/or a discharge diagnosis of hemorrhagic disorder. Severe HAA is associated with increased odds for 30-day mortality and readmission after discharge; however, it is uncertain whether severe HAA is preventable.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Clark C .
Incidence, predictors, and outcomes of hospital-acquired anemia.
J Hosp Med 2017 May;12(5):317-22. doi: 10.12788/jhm.2723
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Keywords: Electronic Health Records (EHRs), Hospital Readmissions, Hospitalization, Patient-Centered Outcomes Research, Risk
Graboyes EM, Kallogjeri D, Saeed MJ
30-day hospital readmission following otolaryngology surgery: analysis of a state inpatient database.
Researchers sought to determine patient and hospital-level risk factors associated with 30-day readmission for patients undergoing inpatient otolaryngologic surgery. Approximately one out of 12 patients undergoing otolaryngologic surgery had a 30-day readmission. Readmissions occur across a variety of types of procedures and hospitals. Most of the variability was driven by patient-specific factors, not structural hospital characteristics.
AHRQ-funded; HS019455.
Citation: Graboyes EM, Kallogjeri D, Saeed MJ .
30-day hospital readmission following otolaryngology surgery: analysis of a state inpatient database.
Laryngoscope 2017 Feb;127(2):337-45. doi: 10.1002/lary.25997.
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Keywords: Adverse Events, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Risk, Surgery
Nguyen OK, Makam AN, Clark C
Vital signs are still vital: instability on discharge and the risk of post-discharge adverse outcomes.
This study assessed the association between vital sign instability at hospital discharge and post-discharge adverse outcomes. Having two or more vital sign instabilities at discharge had a positive predictive value of 22 percent and positive likelihood ratio of 1.8 for 30-day death or readmission. Vital sign instability on discharge is thus associated with increased risk-adjusted rates of 30-day mortality and readmission.
AHRQ-funded; HS022418.
Citation: Nguyen OK, Makam AN, Clark C .
Vital signs are still vital: instability on discharge and the risk of post-discharge adverse outcomes.
J Gen Intern Med 2017 Jan;32(1):42-48. doi: 10.1007/s11606-016-3826-8.
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Keywords: Hospital Discharge, Hospital Readmissions, Patient-Centered Outcomes Research, Risk