National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Caregiving (1)
- Children/Adolescents (5)
- Chronic Conditions (2)
- Electronic Health Records (EHRs) (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Healthcare Delivery (2)
- Health Information Exchange (HIE) (1)
- Health Information Technology (HIT) (2)
- Health Systems (1)
- Heart Disease and Health (1)
- Home Healthcare (1)
- Hospital Discharge (2)
- Hospitalization (4)
- (-) Hospital Readmissions (17)
- (-) Hospitals (17)
- Human Immunodeficiency Virus (HIV) (1)
- Long-Term Care (1)
- Medicare (4)
- Nursing Homes (2)
- Orthopedics (1)
- Patient-Centered Healthcare (1)
- Payment (2)
- Pneumonia (1)
- Primary Care (1)
- Primary Care: Models of Care (1)
- Provider Performance (2)
- Quality Improvement (2)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- Quality of Care (6)
- Racial and Ethnic Minorities (1)
- Surgery (3)
- Transitions of Care (3)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 17 of 17 Research Studies DisplayedSaluja S, Hochman M, Bourgoin A
Primary care: the new frontier for reducing readmissions.
To date, efforts to reduce hospital readmissions have centered largely on hospitals. In a recently published environmental scan, the investigators examined the literature focusing on primary care-based efforts to reduce readmissions. They found that multi-component care transitions programs that are initiated early in the hospitalization and are part of broader primary care practice transformation appear most promising.
AHRQ-funded; 233201500019I.
Citation: Saluja S, Hochman M, Bourgoin A .
Primary care: the new frontier for reducing readmissions.
J Gen Intern Med 2019 Dec;34(12):2894-97. doi: 10.1007/s11606-019-05428-2.
.
.
Keywords: Primary Care, Hospital Readmissions, Hospitals, Transitions of Care, Primary Care: Models of Care, Healthcare Delivery
McWilliams JM, Barnett ML, Roberts ET
Did hospital readmissions fall because per capita admission rates fell?
In this study examining the cause of falling hospital readmission rates, the investigators found that the probability of an admission occurring soon after another was lower when there were fewer admissions per patient. The authors indicate that the reduction in admission rates may explain much of the reduction in readmission rates.
AHRQ-funded; HS026727.
Citation: McWilliams JM, Barnett ML, Roberts ET .
Did hospital readmissions fall because per capita admission rates fell?
Health Aff 2019 Nov;38(11):1840-44. doi: 10.1377/hlthaff.2019.00411..
Keywords: Hospital Readmissions, Hospitals, Hospitalization, Quality of Care, Medicare
Smith AB, Mueller D, Garren B
Using qualitative research to reduce readmissions and optimize perioperative cystectomy care.
This study examined the need for qualitative research on meaningful patient-reported outcomes (PROs) to prevent complications and readmissions after cystectomy. The investigators looked at the potential use of mobile communication devices (mHealth) to capture patients’ experiences and to improve outcomes. Interviews were conducted with 15 readmitted patients and 10 of their partners over 45 semi-structured in-depth interviews. The most common perspectives were that patients and their caregivers were overloaded with cystectomy education; they need to know what are normal post-operative symptoms; and that using mHealth would help with patient and caregiver education.
AHRQ-funded; HS024134.
Citation: Smith AB, Mueller D, Garren B .
Using qualitative research to reduce readmissions and optimize perioperative cystectomy care.
Cancer 2019 Oct 15;125(20):3545-53. doi: 10.1002/cncr.32362..
Keywords: Hospital Readmissions, Surgery, Health Information Technology (HIT), Quality Improvement, Quality of Care, Hospitals, Patient-Centered Healthcare
Vest JR, Unruh MA, Freedman S
Health systems' use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions.
Enterprise health information exchange (HIE) and a single electronic health record (EHR) vendor solution are 2 information exchange approaches to improve performance and increase the quality of care. This study sought to determine the association between adoption of enterprise HIE vs a single vendor environment and changes in unplanned readmissions. The investigators concluded that reductions in the probability of an unplanned readmission after a hospital adopts a single vendor environment suggested that HIE technologies can better support the aim of higher quality care.
AHRQ-funded; HS024717.
Citation: Vest JR, Unruh MA, Freedman S .
Health systems' use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions.
J Am Med Inform Assoc 2019 Oct;26(10):989-98. doi: 10.1093/jamia/ocz116..
Keywords: Health Systems, Health Information Exchange (HIE), Electronic Health Records (EHRs), Health Information Technology (HIT), Hospital Readmissions, Hospitals
Schwarzkopf R, Behery OA, Yu H
Patterns and costs of 90-day readmission for surgical and medical complications following total hip and knee arthroplasty.
Unplanned readmissions following elective total hip (THA) and knee (TKA) arthroplasty as a result of surgical complications likely have different quality improvement targets and cost implications than those for nonsurgical readmissions. In this study, the investigators compared payments, timing, and location of unplanned readmissions with Center for Medicare and Medicaid Services (CMS)-defined surgical complications to readmissions without such complications.
AHRQ-funded; HS022882.
Citation: Schwarzkopf R, Behery OA, Yu H .
Patterns and costs of 90-day readmission for surgical and medical complications following total hip and knee arthroplasty.
J Arthroplasty 2019 Oct;34(10):2304-07. doi: 10.1016/j.arth.2019.05.046..
Keywords: Orthopedics, Surgery, Hospital Readmissions, Adverse Events, Quality Improvement, Quality of Care, Medicare, Hospitals
Auger KA, Harris JM, Gay JC
Progress (?) toward reducing pediatric readmissions.
Investigators sought to determine if pediatric readmission rates have changed over time. Using data from the Inpatient Essentials Database, they found that both all-cause and potentially preventable readmission rates have remained unchanged over six years in spite of significant national efforts to reduce pediatric readmissions.
AHRQ-funded; HS024735.
Citation: Auger KA, Harris JM, Gay JC .
Progress (?) toward reducing pediatric readmissions.
J Hosp Med 2019 Oct;14(10):618-21. doi: 10.12788/jhm.3210..
Keywords: Children/Adolescents, Hospital Readmissions, Hospitals
Popescu I, Sood N, Joshi S
Trends in the use of skilled nursing facility and home health care under the Hospital Readmissions Reduction Program: an interrupted time-series analysis.
Medicare's Hospital Readmission Reduction Program penalizes hospitals with elevated 30-day readmission rates for acute myocardial infarction, heart failure, or pneumonia. The authors investigated if, in order to reduce readmissions, hospitals may have increased referrals to skilled nursing facilities and home health care. They found that hospitals might be shifting to more intensive postacute care to avoid readmissions among seniors with pneumonia. At the same time, penalized hospitals' efforts to prevent readmissions may be keeping higher proportions of their patients in the community.
AHRQ-funded; HS024284; HS025394.
Citation: Popescu I, Sood N, Joshi S .
Trends in the use of skilled nursing facility and home health care under the Hospital Readmissions Reduction Program: an interrupted time-series analysis.
Med Care 2019 Oct;57(10):757-65. doi: 10.1097/mlr.0000000000001184..
Keywords: Home Healthcare, Nursing Homes, Chronic Conditions, Hospital Readmissions, Long-Term Care, Hospitals, Heart Disease and Health, Pneumonia, Cardiovascular Conditions
Montalbano A, Quinonez RA, Hall M
Achievable benchmarks of care for pediatric readmissions.
This study’s objective was to calculate mean readmission rates and the Achievable Benchmarks of Care (ABCs) for pediatric diagnoses by different hospital types: metropolitan teaching, metropolitan nonteaching, and nonmetropolitan hospitals. The authors used a cross-sectional retrospective study of 30-day, all-cause same-hospital readmission of patients less than 18 years of age using the 2014 HCUP National Readmission Database. They calculated mean readmission and corresponding ABCs for the 17 most common readmission diagnosis. They found that sickle cell disease (SCD), bipolar and major depressive disorders were the most common reasons for readmission.
AHRQ-funded; HS024554.
Citation: Montalbano A, Quinonez RA, Hall M .
Achievable benchmarks of care for pediatric readmissions.
J Hosp Med 2019 Sep;14(9):534-40. doi: 10.12788/jhm.3201..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Hospital Readmissions, Hospitals, Quality of Care
Kim KL, LI L, Kuang M
Changes in hospital referral patterns to skilled nursing facilities under the Hospital Readmissions Reduction Program.
The objective of this study was to investigate the association between changes in hospital referral patterns to skilled nursing facilities (SNFs) and Hospital Readmissions Reduction Program (HRRP) penalty pressure. Results showed that HRRP did not prompt substantial changes in hospital referral patterns to SNFs, although readmissions for patients referred to SNFs differentially decreased more than for other patients, warranting investigation of other mechanisms underlying readmissions reduction.
AHRQ-funded; HS022882.
Citation: Kim KL, LI L, Kuang M .
Changes in hospital referral patterns to skilled nursing facilities under the Hospital Readmissions Reduction Program.
Med Care 2019 Sep;57(9):695-701. doi: 10.1097/mlr.0000000000001169..
Keywords: Hospitals, Nursing Homes, Hospital Readmissions, Payment, Provider Performance
Auger KA, Shah SS, Huang B
Discharge medical complexity, change in medical complexity and pediatric 30-day readmission.
Investigators conducted a five-year retrospective, case-control study of pediatric hospitalizations at a tertiary care children's hospital and estimated odds of 30-day unplanned readmission using adjusted conditional logistic regression. They found that polypharmacy and use of technology at discharge pose a substantial readmission risk for children, but added technology and new complex chronic conditions do not increase risk when accounting for length of stay.
AHRQ-funded; HS204735.
Citation: Auger KA, Shah SS, Huang B .
Discharge medical complexity, change in medical complexity and pediatric 30-day readmission.
J Hosp Med 2019 Aug;14(8):474-81. doi: 10.12788/jhm.3222..
Keywords: Children/Adolescents, Chronic Conditions, Hospital Readmissions, Hospitalization, Hospitals
Statile AM, White CM, Sucharew HJ
Comparison of parent report with administrative data to identify pediatric reutilization following hospital discharge.
Healthcare providers rely on historical data reported by parents to make medical decisions. The Hospital to Home Outcomes (H2O) trial assessed the effects of a onetime home nurse visit following pediatric hospitalization for common conditions. In this study, the investigators sought to compare parent recall of reutilization events two weeks after discharge with administrative records.
AHRQ-funded; HS024735.
Citation: Statile AM, White CM, Sucharew HJ .
Comparison of parent report with administrative data to identify pediatric reutilization following hospital discharge.
J Hosp Med 2019 Jul;14(7):411-14. doi: 10.12788/jhm.3200..
Keywords: Children/Adolescents, Caregiving, Hospital Discharge, Hospital Readmissions, Hospitals
Kaplan CM, Thompson MP, Waters TM
How have 30-day readmission penalties affected racial disparities in readmissions?: an analysis from 2007 to 2014 in five US states.
The purpose of this study was to examine changes in Black-White disparities in 30-day readmissions for acute myocardial infarction (AMI), congestive heart failure (CHF), or pneumonia following the passage and implementation of the Hospital Readmission Reduction Program (HRRP), and to compare disparities across safety-net and non-safety-net hospitals. Prior to the passage of HRRP, Black and White readmission rates and disparities in readmissions were decreasing, with largest reductions at safety-net hospitals. Findings showed that improvements in readmissions have not reversed following the implementation of HRRP. In contrast, disparities continue to persist at non-safety-net hospitals.
AHRQ-funded; HS023783.
Citation: Kaplan CM, Thompson MP, Waters TM .
How have 30-day readmission penalties affected racial disparities in readmissions?: an analysis from 2007 to 2014 in five US states.
J Gen Intern Med 2019 Jun;34(6):878-83. doi: 10.1007/s11606-019-04841-x..
Keywords: Hospital Readmissions, Racial and Ethnic Minorities, Hospitals, Medicare, Payment
Borza T, Oerline MK, Skolarus TA
Association between hospital participation in Medicare Shared Savings Program Accountable Care Organizations and readmission following major surgery.
Accountable Care Organizations (ACOs) and readmission rates following major surgery. A retrospective cohort study was conducted using a 20% national Medicare sample to identify beneficiaries undergoing 1 of 7 common surgical procedures: abdominal aortic aneurysm repair, colectomy, cystectomy, prostatectomy, lung resection, total knee arthroplasty, and total hip arthroplasty between 2010 and 2014. Thirty-day risk-adjusted readmission rates was the primary outcome studied. Out of 2974 hospitals in the study, 389 were ACO affiliated. While rates fell for both cohorts, ACO hospitals had a higher decrease in hospitalizations over the same time period.
AHRQ-funded; HS024728; HS024525.
Citation: Borza T, Oerline MK, Skolarus TA .
Association between hospital participation in Medicare Shared Savings Program Accountable Care Organizations and readmission following major surgery.
Ann Surg 2019 May;269(5):873-78. doi: 10.1097/sla.0000000000002737..
Keywords: Hospitals, Surgery, Hospital Readmissions, Medicare, Healthcare Costs, Healthcare Delivery
Markham JL, Richardson T, Hall M
Association of weekend admission and weekend discharge with length of stay and 30-day readmission in children's hospitals.
Worse outcomes among adults presenting for/receiving care on weekends (ie, "the weekend effect") have been observed for many diseases. However, little is known about the overall impact of the weekend effect in hospitalized children. The purpose of this study was to determine the association between 1.) weekend admission and length of stay (LOS) and 2.) weekend discharge and 30-day all-cause readmission.
AHRQ-funded; HS024735.
Citation: Markham JL, Richardson T, Hall M .
Association of weekend admission and weekend discharge with length of stay and 30-day readmission in children's hospitals.
J Hosp Med 2019 Feb;14(2):75-82. doi: 10.12788/jhm.3085..
Keywords: Children/Adolescents, Hospitals, Hospital Readmissions, Hospital Discharge, Hospitalization
Nijhawan AE, Higashi RT, Marks EG
Patient and provider perspectives on 30-day readmissions, preventability, and strategies for improving transitions of care for patients with HIV at a safety net hospital.
Researchers assessed perceived causes of 30-day hospital readmissions, factors associated with preventability, and strategies to reduce preventable readmissions and improve continuity of care for HIV-positive individuals. Using semi-structured interviews, they found that the 30-day metric should be adjusted for safety net institutions and patients with AIDS; that participants disagreed about preventability; and that various stakeholders proposed readmission reduction strategies that spanned the inpatient to outpatient care continuum. They then outlined multiple interventions which could substantially decrease hospital readmissions in this underserved population.
AHRQ-funded; HS022418.
Citation: Nijhawan AE, Higashi RT, Marks EG .
Patient and provider perspectives on 30-day readmissions, preventability, and strategies for improving transitions of care for patients with HIV at a safety net hospital.
J Int Assoc Provid AIDS Care 2019 Jan-Dec;18:2325958219827615. doi: 10.1177/2325958219827615..
Keywords: Human Immunodeficiency Virus (HIV), Transitions of Care, Hospital Readmissions, Hospitals
Chukmaitov A, Harless DW, Bazzoli GJ
Preventable hospital admissions and 30-day all-cause readmissions: does hospital participation in accountable care organizations improve quality of care?
This study evaluates quality performance of hospitals participating in Medicare Shared Savings and Pioneer Accountable Care Organization (ACO) programs relative to nonparticipating hospitals. The authors studied preventable hospitalizations for conditions sensitive to high-quality ambulatory care and 30-day all-cause readmissions potentially influenced by hospital care. A decrease was found in preventable hospitalizations for COPD and asthma and for diabetes complications for ACO participating hospitals, but no significant differences for preventable chronic heart failure hospitalizations and 30-day readmissions.
AHRQ-funded; HS023332.
Citation: Chukmaitov A, Harless DW, Bazzoli GJ .
Preventable hospital admissions and 30-day all-cause readmissions: does hospital participation in accountable care organizations improve quality of care?
Am J Med Qual 2019 Jan/Feb;34(1):14-22. doi: 10.1177/1062860618778786..
Keywords: Hospital Readmissions, Hospitals, Quality of Care, Provider Performance, Hospitalization
Gupta S, Zengul FD, Davlyatov GK
Reduction in hospitals' readmission rates: role of hospital-based skilled nursing facilities.
The purpose of this study was to examine the association between hospital-based skilled nursing facilities (HBSNFs) and hospitals' readmission rates. Data sources included the American Hospital Association Annual Survey, Area Health Resources Files, CMS Medicare cost reports and Hospital Compare. Results showed that the presence of HBSNFs was associated with lower readmission rates for acute myocardial infarction and pneumonia. Further, higher skilled nursing facilities to hospitals ratio were associated with lower readmission rates.
AHRQ-funded; HS023345.
Citation: Gupta S, Zengul FD, Davlyatov GK .
Reduction in hospitals' readmission rates: role of hospital-based skilled nursing facilities.
Inquiry 2019 Jan-Dec;56:46958018817994. doi: 10.1177/0046958018817994..
Keywords: Hospital Readmissions, Transitions of Care, Care Coordination, Hospitals, Quality Indicators (QIs), Quality Measures, Quality of Care