National Healthcare Quality and Disparities Report
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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 16 of 16 Research Studies DisplayedHong I, Goodwin JS, Reistetter TA, I, Goodwin JS, Reistetter TA
Comparison of functional status improvements among patients with stroke receiving postacute care in inpatient rehabilitation vs skilled nursing facilities.
This cohort study compared functional status improvements of poststroke patients who either went to an inpatient rehabilitation facility (IRF) or a skilled nursing facility (SNF). The study used data from Medicare claims for stroke from January 2013 through November 2014. A total of 99,185 patients were studied. Patients admitted to SNFs tended to be older, female, and had a longer hospital length of stay than those admitted to IRFs. Stroke patients admitted to IRFs had larger improvements for mobility score points and for self-care on admission compared with those admitted to SNFs. There was found to be no statistical difference in the odds of 30- to 365-day mortality.
AHRQ-funded; HS024711; HS022134.
Citation: Hong I, Goodwin JS, Reistetter TA, I, Goodwin JS, Reistetter TA .
Comparison of functional status improvements among patients with stroke receiving postacute care in inpatient rehabilitation vs skilled nursing facilities.
JAMA Netw Open 2019 Dec 2;2(12):e1916646. doi: 10.1001/jamanetworkopen.2019.16646..
Keywords: Stroke, Cardiovascular Conditions, Rehabilitation, Health Status, Hospitalization, Nursing Homes
Zachrison KS, Aaronson E, Mahmood S
Resource utilisation among patients transferred for intracerebral haemorrhage.
Patients with intracerebral haemorrhage (ICH) are frequently transferred between hospitals for higher level of care. The investigators aimed to identify factors associated with resource utilisation among patients with ICH admitted to a single academic hospital. They used a prospectively collected registry of consecutive patients with primary ICH at an urban academic hospital between 1 January 2005 and 31 December 2015.
hospital between 1 January 2005 and 31 December 2015.
AHRQ-funded; HS024561.
AHRQ-funded; HS024561.
Citation: Zachrison KS, Aaronson E, Mahmood S .
Resource utilisation among patients transferred for intracerebral haemorrhage.
Stroke Vasc Neurol 2019 Dec;4(4):223-26. doi: 10.1136/svn-2019-000255..
Keywords: Stroke, Cardiovascular Conditions, Healthcare Utilization, Hospitals
Capo-Lugo CE, Askew RL, Naidech A
Patients with greater stroke severity and premorbid disability are less likely to receive therapist consultations and intervention during acute care hospitalization.
The goal of this single-center longitudinal observational study was to estimate the proportion of and factors associated with receipt of therapist consultations and interventions during acute care hospitalization following ischemic and hemorrhagic stroke. Findings showed that approximately 1 in 4 study participants with acute stroke received neither a consultation nor an intervention. The authors conclude that efforts to improve the delivery of acute care therapy services are needed to optimize care for these people.
AHRQ-funded; HS000078.
Citation: Capo-Lugo CE, Askew RL, Naidech A .
Patients with greater stroke severity and premorbid disability are less likely to receive therapist consultations and intervention during acute care hospitalization.
Phys Ther 2019 Nov 25;99(11):1431-42. doi: 10.1093/ptj/pzz116..
Keywords: Disabilities, Stroke, Cardiovascular Conditions, Access to Care
Ellis C, Phillips R, Hill T
Social network structure in young stroke survivors with aphasia: a case series report.
The purpose of this study was to profile the social networks of four young adult stroke survivors with aphasia. Results showed that pre-stroke friendships were dissolved or reduced at the onset of aphasia. The most impaired persons with aphasia spent most of their days in isolation without a consistent communication partner. This study result suggests that young adult stroke survivors with aphasia have significant changes in their social network structure after stroke, but it is unclear if the observed change in social network structure is more related to age or level of communication impairment.
AHRQ-funded; HS025043.
Citation: Ellis C, Phillips R, Hill T .
Social network structure in young stroke survivors with aphasia: a case series report.
Semin Speech Lang 2019 Nov;40(5):359-69. doi: 10.1055/s-0039-1688695..
Keywords: Stroke, Young Adults
Zachrison KS, Dhand A, Schwamm LH
A network approach to stroke systems of care.
This study provided a network analysis of stroke systems of care. Stroke patients are increasing transferred between hospitals to receive higher levels of care, but coordination and triage of these patients remains a challenge. The network analysis provides an understanding of the central hubs, the change of network structure over time, and the dissemination of innovations.
AHRQ-funded; HS024561.
Citation: Zachrison KS, Dhand A, Schwamm LH .
A network approach to stroke systems of care.
Circ Cardiovasc Qual Outcomes 2019 Aug;12(8):e005526. doi: 10.1161/circoutcomes.119.005526..
Keywords: Stroke, Care Coordination, Transitions of Care, Care Management, Cardiovascular Conditions, Hospitals
Mentias A, Shantha G, Adeola O
Role of diabetes and insulin use in the risk of stroke and acute myocardial infarction in patients with atrial fibrillation: a Medicare analysis.
This study examined the role of diabetes and insulin use in the risk of stroke and acute myocardial infarction (AMI) in patients with atrial fibrillation (AF). A cohort of Medicare beneficiaries newly diagnoses with AF from 2011 to 2013 were identified. The cohort was divided into those with diabetes requiring insulin (6.7%), those with diabetes not requiring insulin (31.3%) and non-diabetics (62%). Diabetics requiring insulin were at the greatest risk of stroke and AMI, and diabetics not requiring insulin were at slightly lower risk, but non-diabetics had the lowest risk.
AHRQ-funded; HS023104.
Citation: Mentias A, Shantha G, Adeola O .
Role of diabetes and insulin use in the risk of stroke and acute myocardial infarction in patients with atrial fibrillation: a Medicare analysis.
Am Heart J 2019 Aug;214:158-66. doi: 10.1016/j.ahj.2019.05.003..
Keywords: Diabetes, Stroke, Heart Disease and Health, Cardiovascular Conditions, Risk, Chronic Conditions, Elderly
Gadhia R, Schwamm LH, Viswanathan A
Evaluation of the experience of spoke hospitals in an academic telestroke network.
Implementation of telestroke has been associated with improved thrombolysis rates and clinical outcomes in remote or neurologically underserved spoke hospitals. Yet, the experience of spoke hospitals using telestroke has not been well described. In this study, the investigators sought to characterize spoke hospitals' perceptions of telestroke to understand perceived advantages, challenges, and barriers to use.
AHRQ-funded; HS024561.
Citation: Gadhia R, Schwamm LH, Viswanathan A .
Evaluation of the experience of spoke hospitals in an academic telestroke network.
Telemed J E Health 2019 Jul;25(7):584-90. doi: 10.1089/tmj.2018.0133..
Keywords: Telehealth, Health Information Technology (HIT), Hospitals, Stroke, Cardiovascular Conditions
Krishnan S, Hay CC, Pappadis MR
Stroke survivors' perspectives on post-acute rehabilitation options, goals, satisfaction, and transition to home.
This study analyzed stroke survivors’ perspectives on post-acute rehabilitation involvement with their care during discharge planning. Researchers interviewed eighteen stroke survivors who were sent to inpatient rehabilitation facilities after a stroke. They were surveyed about their involvement in decisions made in the selection of their rehabilitation facilities, and more than half were not. About two-thirds of patients were not involved in rehabilitation goal setting. However, most patients were satisfied with their rehabilitation stay.
AHRQ-funded; HS022134; HS024711.
Citation: Krishnan S, Hay CC, Pappadis MR .
Stroke survivors' perspectives on post-acute rehabilitation options, goals, satisfaction, and transition to home.
J Neurol Phys Ther 2019 Jul;43(3):160-67. doi: 10.1097/npt.0000000000000281..
Keywords: Hospital Discharge, Rehabilitation, Stroke, Transitions of Care
Shah S, Xian Y, Olson DM
Home-time is a patient-centered outcome variable for stroke: an executive summary.
An outcome measure to assess functional recovery after stroke that is easily obtainable and meaningful to the patient can be very useful for assessing risks and benefits of therapeutic strategies. Home-time, which is defined as the total number of days spent alive by the patient at home, outside healthcare institutions after discharge from an index stroke event, is such a measure, and is discussed in this paper.
AHRQ-funded.
Citation: Shah S, Xian Y, Olson DM .
Home-time is a patient-centered outcome variable for stroke: an executive summary.
J Neurosci Nurs 2019 Jun;51(3):110-12. doi: 10.1097/jnn.0000000000000437..
Keywords: Patient-Centered Outcomes Research, Stroke, Cardiovascular Conditions, Outcomes
Colla CH, Lewis VA, Stachowski C
Changes in use of postacute care associated with accountable care organizations in hip fracture, stroke, and pneumonia hospitalized cohorts.
In this study, researchers examined changes in more and less discretionary condition-specific postacute care use associated with Medicare accountable care organization (ACO) implementation. They found that ACOs decreased spending on postacute care by decreasing use of discretionary services. In addition, ACO implementation was associated with reduced length of stay in skilled nursing facilities, while hip fracture patients used institutional postacute settings at higher rates. The authors also observed decreases in spending, readmission days, and mortality among pneumonia patients.
AHRQ-funded; HS024698.
Citation: Colla CH, Lewis VA, Stachowski C .
Changes in use of postacute care associated with accountable care organizations in hip fracture, stroke, and pneumonia hospitalized cohorts.
Med Care 2019 Jun;57(6):444-52. doi: 10.1097/mlr.0000000000001121..
Keywords: Injuries and Wounds, Healthcare Costs, Healthcare Utilization, Hospitalization, Medicare, Pneumonia, Stroke
Kempker JA, Panwar B, Judd SE
Plasma 25-hydroxyvitamin d and the longitudinal risk of sepsis in the REGARDS cohort..
In this paper, researchers studied low baseline plasma 25-hydroxyvitamin D (25(OH)D) and its association with long-term risk of sepsis. Data from the Reasons for Geographic and Racial Differences in Stroke study was used. Findings reveals that, among community-dwelling US adults, low plasma 25(OH)D measured at a time of relative health was independently associated with increased risk of sepsis.
AHRQ-funded; HS025240.
Citation: Kempker JA, Panwar B, Judd SE .
Plasma 25-hydroxyvitamin d and the longitudinal risk of sepsis in the REGARDS cohort..
Clin Infect Dis 2019 May 17;68(11):1926-31. doi: 10.1093/cid/ciy794..
Keywords: Community-Acquired Infections, Racial and Ethnic Minorities, Risk, Sepsis, Stroke
Simon KC, Munson R, Ong A
Design and implementation of structured clinical documentation support tools for treating stroke patients.
This article describes the development of a customized structured clinical documentation toolkit that standardizes patient data collection to conform to Best Practices for treating patients with stroke. The toolkit collects demographic information for patients, relevant score test measures, and information on disability, treatment, and outcomes. Basic descriptive data gathered via the toolkits is provided and their utility in collecting patient data in a manner that supports both quality clinical care and research initiatives demonstrated. Quality improvement projects and current research initiatives using the toolkit are also discussed.
AHRQ-funded; HS024057.
Citation: Simon KC, Munson R, Ong A .
Design and implementation of structured clinical documentation support tools for treating stroke patients.
J Stroke Cerebrovasc Dis 2019 May;28(5):1229-35. doi: 10.1016/j.jstrokecerebrovasdis.2019.01.011..
Keywords: Electronic Health Records (EHRs), Evidence-Based Practice, Guidelines, Health Information Technology (HIT), Stroke, Tools & Toolkits
Mahalingam M, Moore Jx, Donnelly JP
Frailty syndrome and risk of sepsis in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
This study examined the association between frailty (weakness, exhaustion, and low physical activity) and the risk of sepsis in stroke patients. Data from the cohort study Reasons for Geographic and Racial Differences in Stroke (REGARDS) was used. There was an associated increase in sepsis hospitalizations and 30-day case fatalities from sepsis in stroke patients with more frailty indicators.
AHRQ-funded; HS013852.
Citation: Mahalingam M, Moore Jx, Donnelly JP .
Frailty syndrome and risk of sepsis in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
J Intensive Care Med 2019 Apr;34(4):292-300. doi: 10.1177/0885066617715251..
Keywords: Elderly, Racial and Ethnic Minorities, Risk, Sepsis, Stroke
Shah S, Xian Y, Sheng S
Use, temporal trends, and outcomes of endovascular therapy after interhospital transfer in the United States.
This study examined the use, trends and outcomes of endovascular therapy (EVT) after interhospital transfer in the United Sates. This cohort study analyzed trends from over 1.8 million patients with ischemic stroke admitted to 2143 Get With The Guidelines-Stroke participating hospitals between 2012 and 2017. There were differences in mortality for interhospital transfer patients, although those differences disappeared after adjusting for delay in EVT initiation.
AHRQ-funded; HS024561.
Citation: Shah S, Xian Y, Sheng S .
Use, temporal trends, and outcomes of endovascular therapy after interhospital transfer in the United States.
Circulation 2019 Mar 26;139(13):1568-77. doi: 10.1161/circulationaha.118.036509..
Keywords: Stroke, Cardiovascular Conditions, Transitions of Care, Outcomes, Healthcare Delivery, Hospitals, Mortality, Quality of Care
Trent SA, Morse EA, Ginde AA
Barriers to prompt presentation to emergency departments in Colorado after onset of stroke symptoms.
Despite significant morbidity and mortality from stroke, patient delays to emergency department (ED) presentation following the onset of stroke symptoms are one of the main contraindications to treatment for acute ischemic stroke (AIS). The objective of this study was to identify patient and environmental factors associated with delayed presentations to the ED after onset of stroke symptoms.
AHRQ-funded; HS022400.
Citation: Trent SA, Morse EA, Ginde AA .
Barriers to prompt presentation to emergency departments in Colorado after onset of stroke symptoms.
West J Emerg Med 2019 Mar;20(2):237-43. doi: 10.5811/westjem.2018.10.38731..
Keywords: Emergency Department, Stroke, Cardiovascular Conditions, Healthcare Delivery
O'Brien EC, Holmes DN, Thomas L
Incremental prognostic value of renal function for stroke prediction in atrial fibrillation.
This study investigated whether renal function predicted stroke in patients diagnosed with atrial fibrillation (AF). Data from the Outcomes Registry for Better Informed Treatment (ORBIT-AF) was used. Investigators concluded that renal dysfunction was not independently associated with embolic risk in either treated or untreated patients.
AHRQ-funded; HS021092.
Citation: O'Brien EC, Holmes DN, Thomas L .
Incremental prognostic value of renal function for stroke prediction in atrial fibrillation.
Int J Cardiol 2019 Jan 1;274:152-57. doi: 10.1016/j.ijcard.2018.07.113..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Risk, Stroke