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AHRQ Research Studies Date
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- Access to Care (1)
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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 7 of 7 Research Studies DisplayedGoldstone AB, Chiu P, Baiocchi M
Interfacility transfer of Medicare beneficiaries with acute type a aortic dissection and regionalization of care in the United States.
Researchers investigated the hypothesis that regionalizing care at high-volume hospitals for acute type A aortic dissections will lower mortality. Operative mortality and long-term survival were compared for Medicare beneficiaries diagnosed with an acute type A aortic dissection who were transferred versus not transferred, underwent surgery at high-volume versus low-volume hospitals, and were rerouted versus not rerouted to a high-volume hospital for treatment. The researchers found that, despite delaying surgery, a regionalization policy that transfers patients to high-volume hospitals was associated with a 7.2% absolute risk reduction in operative mortality. They recommended that policymakers evaluate the feasibility and benefits of regionalizing the surgical treatment of acute type A aortic dissection in the United States.
AHRQ-funded; HS022192.
Citation: Goldstone AB, Chiu P, Baiocchi M .
Interfacility transfer of Medicare beneficiaries with acute type a aortic dissection and regionalization of care in the United States.
Circulation 2019 Oct 8;140(15):1239-50. doi: 10.1161/circulationaha.118.038867..
Keywords: Transitions of Care, Medicare, Heart Disease and Health, Cardiovascular Conditions, Patient-Centered Outcomes Research, Risk, Evidence-Based Practice, Mortality, Hospitals
Hajduk AM, Gurwitz JH, Tabada G
Influence of multimorbidity on burden and appropriateness of implantable cardioverter-defibrillator therapies.
Researchers sought to determine whether burden of multiple chronic conditions (MCCs) influences the risk of receiving inappropriate vs appropriate device therapies. They studied adults with left ventricular systolic dysfunction receiving an implantable cardioverter-defibrillator (ICD) for primary prevention. In these patients, they found that MCC burden was independently associated with an increased risk of inappropriate but not appropriate device therapies. They recommended considering comorbidity burden when engaging patients in shared decision making about ICD implantation.
AHRQ-funded; 290050033.
Citation: Hajduk AM, Gurwitz JH, Tabada G .
Influence of multimorbidity on burden and appropriateness of implantable cardioverter-defibrillator therapies.
J Am Geriatr Soc 2019 Jul;67(7):1370-78. doi: 10.1111/jgs.15839..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Chronic Conditions, Medical Devices, Prevention, Elderly, Risk, Patient-Centered Outcomes Research
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
Arasu VA, Miglioretti DL, Sprague BL
Population-based assessment of the association between magnetic resonance imaging background parenchymal enhancement and future primary breast cancer risk.
The purpose of this study was to evaluate comparative associations of breast magnetic resonance imaging (MRI) background parenchymal enhancement (BPE) and mammographic breast density with subsequent breast cancer risk. The investigators concluded that BPE was associated with future invasive breast cancer risk independent of breast density. They suggest that BPE should be considered for risk prediction models for women undergoing breast MRI.
AHRQ-funded; HS018366.
Citation: Arasu VA, Miglioretti DL, Sprague BL .
Population-based assessment of the association between magnetic resonance imaging background parenchymal enhancement and future primary breast cancer risk.
J Clin Oncol 2019 Apr 20;37(12):954-63. doi: 10.1200/jco.18.00378..
Keywords: Cancer, Cancer: Breast Cancer, Imaging, Patient-Centered Outcomes Research, Risk, Women
Sharma A, Sun JL, Lokhnygina Y
Patient phenotypes, cardiovascular risk, and ezetimibe treatment in patients after acute coronary syndromes (from IMPROVE-IT).
The authors of this article performed a hierarchical cluster analysis to identify acute coronary syndrome (ACS) patients at high risk for adverse clinical events. Post-ACS patients were randomized to ezetimibe+simvastatin or placebo+simvastatin. Ezetimibe's impact on outcomes across clusters; the ability of the cluster analysis to discriminate for outcomes was compared with the Global Registry of Acute Coronary Events (GRACE) score. Outcomes included cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, hospitalization for unstable angina, or coronary revascularization at least 30 days after randomization. Compared with GRACE, cluster analysis did not provide superior outcome discrimination. Consistent ezetimibe treatment effect was identified across clusters. The authors conclude that cluster analysis identified significant difference in risk of outcomes across cluster groups.
AHRQ-funded; HS023000.
Citation: Sharma A, Sun JL, Lokhnygina Y .
Patient phenotypes, cardiovascular risk, and ezetimibe treatment in patients after acute coronary syndromes (from IMPROVE-IT).
Am J Cardiol 2019 Apr 15;123(8):1193-201. doi: 10.1016/j.amjcard.2019.01.034..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Outcomes, Patient-Centered Outcomes Research, Risk
Marcolini EG, Albrecht JS, Sethuraman KN
Gender disparities in trauma care: how sex determines treatment, behavior, and outcome.
This study used US and European trauma database statistics, including the National Trauma Databank, to examine sex disparities in trauma care. Their findings indicate that sex differences in risk-taking behaviors that lead to traumatic injury have been associated with males, with female menstrual cycle timing, and with cortisol levels. Differences in access to services at trauma centers, including triage or transfer and level of medical attention are associated with sex as well race, rural or urban location, and insurance status. Outcomes, such as in-hospital mortality, multiple organ failure, pneumonia, and sepsis are associated with sex disparities in the general trauma patient; outcomes after general trauma and specifically traumatic brain injury show mixed results.
AHRQ-funded; HS024560.
Citation: Marcolini EG, Albrecht JS, Sethuraman KN .
Gender disparities in trauma care: how sex determines treatment, behavior, and outcome.
Anesthesiol Clin 2019 Mar;37(1):107-17. doi: 10.1016/j.anclin.2018.09.007..
Keywords: Access to Care, Disparities, Injuries and Wounds, Outcomes, Patient-Centered Outcomes Research, Risk, Sex Factors, Trauma
Yuo TH, Wallace JR, Fish L
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
This study compared outcomes of different revascularization surgeries among end stage renal disease (ESRD) patients with peripheral arterial disease (PAD). There is a high risk of complications for this surgery. Outcomes of endovascular revascularization (ER) and open surgical revascularisation (OSR) were compared. Outcomes measured included mortality and major amputation. There is a lower mortality risk for ER versus OSR. OSR has better 30-day limb salvage although there are similar long-term outcomes.
AHRQ-funded; HS019486.
Citation: Yuo TH, Wallace JR, Fish L .
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
Eur J Vasc Endovasc Surg 2019 Feb;57(2):248-57. doi: 10.1016/j.ejvs.2018.09.008..
Keywords: Adverse Events, Cardiovascular Conditions, Comparative Effectiveness, Dialysis, Evidence-Based Practice, Kidney Disease and Health, Mortality, Outcomes, Patient-Centered Outcomes Research, Risk, Surgery