National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Ambulatory Care and Surgery (1)
- Cardiovascular Conditions (1)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (1)
- Communication (1)
- Comparative Effectiveness (1)
- Cultural Competence (1)
- Elderly (1)
- Electronic Health Records (EHRs) (1)
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- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
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- (-) Hospital Readmissions (11)
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- Obesity: Weight Management (1)
- Outcomes (4)
- Patient-Centered Outcomes Research (1)
- Policy (1)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- Quality of Care (1)
- (-) Risk (11)
- Social Determinants of Health (1)
- Stroke (1)
- Surgery (4)
- 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 DisplayedRogstad TL, Gupta S, Connolly J
Social risk adjustment In the hospital readmissions reduction program: a systematic review and implications for policy.
Investigators reviewed fourteen studies of social risk adjustment in Medicare's Hospital Readmissions Reduction Program (HRRP). They concluded that their findings support the use of social risk adjustment to improve provider payment equity and highlight opportunities to enhance social risk adjustment in value-based payment programs.
AHRQ-funded; HS026727.
Citation: Rogstad TL, Gupta S, Connolly J .
Social risk adjustment In the hospital readmissions reduction program: a systematic review and implications for policy.
Health Aff 2022 Sep;41(9):1307-15. doi: 10.1377/hlthaff.2022.00614..
Keywords: Social Determinants of Health, Hospital Readmissions, Risk, Policy
Squires A, Ma C, Miner S
Assessing the influence of patient language preference on 30 day hospital readmission risk from home health care: a retrospective analysis.
In home health care, language barriers are understudied. Language barriers between patients and providers are known to affect a variety of patient outcomes. How a patient's language preference influences hospital readmission risk from home health care has yet to be determined. The objective of this retrospective cross-sectional study was to determine if home care patients' language preference is associated with their risk for hospital readmission from home health care within 30 days of hospital discharge.
AHRQ-funded; HS023593.
Citation: Squires A, Ma C, Miner S .
Assessing the influence of patient language preference on 30 day hospital readmission risk from home health care: a retrospective analysis.
Int J Nurs Stud 2022 Jan;125:104093. doi: 10.1016/j.ijnurstu.2021.104093..
Keywords: Cultural Competence, Home Healthcare, Hospital Readmissions, Risk, Communication
Boehme AK, Oka M, Cohen B
Readmission rates in stroke patients with and without infections: incidence and risk factors.
Investigators examined whether an infection acquired during the initial stroke admission contributed to increased risk of readmission and infection during readmission. Their a retrospective cohort study incorporated all adult ischemic stroke patients 2006-2016 from three New York City hospitals. They found that, among stroke patients, healthcare-associated infections and infections present on admission were predictors of readmission within 60 days and infection during readmission.
AHRQ-funded; HS024915.
Citation: Boehme AK, Oka M, Cohen B .
Readmission rates in stroke patients with and without infections: incidence and risk factors.
J Stroke Cerebrovasc Dis 2022 Jan;31(1):106172. doi: 10.1016/j.jstrokecerebrovasdis.2021.106172..
Keywords: Stroke, Cardiovascular Conditions, Hospital Readmissions, Risk, Healthcare-Associated Infections (HAIs)
Marafino 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
Paredes AZ, Malik AT, Cluse M
Discharge disposition to skilled nursing facility after emergent general surgery predicts a poor prognosis.
Emergency general surgery can have a profound impact on the functional status of even previously independent patients. In this study, the investigators examined the role and influence of discharging a patient to a skilled nursing facility. They concluded that after accounting for patient severity and perioperative course, discharge to a skilled nursing facility was an independent risk factor for death, readmission, and postdischarge complications.
AHRQ-funded; HS022694.
Citation: Paredes AZ, Malik AT, Cluse M .
Discharge disposition to skilled nursing facility after emergent general surgery predicts a poor prognosis.
Surgery 2019 Oct;166(4):489-95. doi: 10.1016/j.surg.2019.04.034..
Keywords: Nursing Homes, Hospital Discharge, Elderly, Ambulatory Care and Surgery, Emergency Department, Outcomes, Hospital Readmissions, Outcomes, Risk
Nakamura MM, Toomey SL, Zaslavsky AM
Potential impact of initial clinical data on adjustment of pediatric readmission rates.
This study investigated whether the addition of adding initial clinical data to adjust for case-mix (differences in patient populations) improved prediction of pediatric readmissions. Thirty-day readmissions were examined using claims and electronic records for patients aged 18 and younger who were admitted to 3 children’s hospitals from February 2011 to February 2014. The Pediatric All-Condition Readmission Measure was used and started with a model including age, gender, chronic conditions, and primary diagnosis. Initial vital sign and laboratory data was added to see if it improved model performance. Greater readmission risk was found if there was a low red blood cell count and mean corpuscular hemoglobin concentration and high red cell distribution risk. However, it did not provide more than minimal improvement in performance.
AHRQ-funded; HS020513; HS025299.
Citation: Nakamura MM, Toomey SL, Zaslavsky AM .
Potential impact of initial clinical data on adjustment of pediatric readmission rates.
Acad Pediatr 2019 Jul;19(5):589-98. doi: 10.1016/j.acap.2018.09.006..
Keywords: Children/Adolescents, Hospital Readmissions, Risk, Quality Indicators (QIs), Quality Measures, Quality of Care
Bath J, Smith JB, Kruse RL
Cohort study of risk factors for 30-day readmission after abdominal aortic aneurysm repair.
This retrospective cohort study examined 30-day readmission rates for patients who had abdominal aortic aneurysm (AAA) repair comparing two different procedures,. The cohort was selected from inpatients (2009-2016) who had undergone elective AAA repair using the multicenter Cerner Health Facts(R) database and were identified ICD-9 procedure codes. The two procedures compared were 3,101 endovascular aneurysm repairs (EVAR) and 1,622 open procedures. Patients who had EVAR were less likely to be readmitted. Risk factors for readmission included surgical site infection, age, receipt of bronchodilators or steroids, serum potassium > 5.2 mEq/L, and higher Charlson co-morbidity scores. The most common infections causing readmission were pneumonia and urinary tract infection after EVAR.
AHRQ-funded; HS022140.
Citation: Bath J, Smith JB, Kruse RL .
Cohort study of risk factors for 30-day readmission after abdominal aortic aneurysm repair.
Vasa 2019 May;48(3):251-61. doi: 10.1024/0301-1526/a000767..
Keywords: Risk, Hospital Readmissions, Surgery, Outcomes, Comparative Effectiveness, Patient-Centered Outcomes Research
Brauer DG, Lyons SA, Keller MR
Simplified risk prediction indices do not accurately predict 30-day death or readmission after discharge following colorectal surgery.
This study examined the performance of widely used risk prediction indices to predict 30-day death or readmission after discharge following colorectal surgery. The study used a retrospective split-sample cohort of patients discharged after colorectal surgery from inpatient databases of HCUP for the states of New York, California, and Florida from 2006-2014. The commonly used risk prediction model LACE (length of stay, acute admissions, Charlson comorbidity index score, and emergency department visits) was compared with the real outcomes of death or readmission within 30 days after discharge with the cohort. Results showed a poor model fit with LACE and the researchers recommended a better model be developed.
AHRQ-funded; HS019455.
Citation: Brauer DG, Lyons SA, Keller MR .
Simplified risk prediction indices do not accurately predict 30-day death or readmission after discharge following colorectal surgery.
Surgery 2019 May;165(5):882-88. doi: 10.1016/j.surg.2018.12.007..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Surgery, Risk, Adverse Events, Outcomes