National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
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- Adverse Events (3)
- (-) Cardiovascular Conditions (7)
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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 DisplayedHaddad DN, Shipe ME, Absi TS
Preparing for bundled payments: impact of complications post-coronary artery bypass grafting on costs.
This study examined the impact of complications on bundled payments for coronary artery bypass grafting (CABG) for care provided from admission through 90 days post-discharge. The authors linked clinical and internal cost data for patients undergoing CABG from 2014 to 2017 at a single institution. They performed multivariable linear regression to evaluate drivers of high costs, adjusting for preoperative and intraoperative characteristics and postoperative complications. They reviewed records of 1789 patients undergoing CABG with an average of 2.7 vessels. A large proportion of patients were diabetic and obese. Factors associated with increased adjusted costs were preoperative renal failure, diabetes and body mass index, postoperative stroke, prolonged ventilation, rebleeding requiring reoperation, and renal failure with varying magnitude.
AHRQ-funded; HS026122.
Citation: Haddad DN, Shipe ME, Absi TS .
Preparing for bundled payments: impact of complications post-coronary artery bypass grafting on costs.
Ann Thorac Surg 2021 Apr;111(4):1258-63. doi: 10.1016/j.athoracsur.2020.06.105..
Keywords: Cardiovascular Conditions, Surgery, Adverse Events, Healthcare Costs, Payment
Gold HT, Siman N, Cuthel AM
A practice facilitation-guided intervention in primary care settings to reduce cardiovascular disease risk: a cost analysis.
In this randomized controlled trial, researchers estimated the associated cost of practice facilitation (PF) for guideline adoption in small, private primary care practices. They found that the PF strategy cost approximately $10,000 per practice per quarter for program and practice costs, once implemented and running at highest efficiency. They indicated that whether or not this program is worthwhile to the decision-maker depends on the relative costs and effectiveness of their other options for improving cardiovascular risk reduction.
AHRQ-funded; HS023922.
Citation: Gold HT, Siman N, Cuthel AM .
A practice facilitation-guided intervention in primary care settings to reduce cardiovascular disease risk: a cost analysis.
Implement Sci Commun 2021 Feb 6;2(1):15. doi: 10.1186/s43058-021-00116-x..
Keywords: Primary Care, Cardiovascular Conditions, Guidelines, Prevention, Evidence-Based Practice, Primary Care: Models of Care, Healthcare Costs
Bayliss WS, Bushnell CD, Halladay JR
The cost of implementing and sustaining the COMprehensive Post-Acute Stroke Services model.
This study compares the outcomes of using the COMprehensive Post-Acute Stroke Services (COMPASS) model, a transitional care intervention for stroke patients discharged to home against status quo postacute stroke care in a cluster-randomized trial in 40 hospitals in North Carolina. Hospital-level costs associated with implementing and sustaining COMPASS were examined during a 1-year period. Out of 40 hospitals, 22 hospitals were actively engaged in COMPASS. A 10% higher stroke patient volume was associated with 5.1% lower COMPASS costs per patient. About half of hospitals (N = 10) reported postacute clinic visits as their highest cost activity, while 7 hospitals reported case ascertainment as their highest cost activity. The authors estimated that based on average costs of COMPASS and readmissions, COMPASS could lower net costs if the model can prevent about 6 readmissions per year.
AHRQ-funded; HS025723.
Citation: Bayliss WS, Bushnell CD, Halladay JR .
The cost of implementing and sustaining the COMprehensive Post-Acute Stroke Services model.
Med Care 2021 Feb;59(2):163-68. doi: 10.1097/mlr.0000000000001462..
Keywords: Stroke, Cardiovascular Conditions, Healthcare Costs, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Mszar R, Grandhi GR, Valero-Elizondo J
Cumulative burden of financial hardship from medical bills across the spectrum of diabetes mellitus and atherosclerotic cardiovascular disease among non-elderly adults in the United States.
This study looked at the rates of financial hardship from medical bills with non-elderly adults diagnosed with diabetes mellitus (DM) and diagnosed with and without atherosclerotic cardiovascular disease (ASCVD). ASCVD with DM accounts for approximately two-thirds of deaths in this patient population. Data from the National Health Interview Survey from 2013 to 2017 was used, with a total study population of 121,672 individuals. Approximately 3.1% of the population had ASCVD, 5.6% had DM, and 1.3% had both. Almost half of individuals with both conditions reported financial hardship from medical bills, with 23% unable to pay medical bills at all, compared to around 28% of those with neither ASCVD and DM reporting financial hardship with 8% being unable to pay at all.
AHRQ-funded; HS023000.
Citation: Mszar R, Grandhi GR, Valero-Elizondo J .
Cumulative burden of financial hardship from medical bills across the spectrum of diabetes mellitus and atherosclerotic cardiovascular disease among non-elderly adults in the United States.
J Am Heart Assoc 2020 May 18;9(10):e015523. doi: 10.1161/jaha.119.015523..
Keywords: Diabetes, Cardiovascular Conditions, Chronic Conditions, Healthcare Costs
Wang Y, Eldridge N, Metersky ML
AHRQ Author: Eldridge N, Rodrick D
Association between Medicare expenditures and adverse events for patients with acute myocardial infarction, heart failure, or pneumonia in the United States.
The purpose of this study was to evaluate whether hospital-specific adverse event rates were associated with hospital-specific risk-standardized 30-day episode-of-care Medicare expenditures for fee-for-service patients discharged with acute myocardial infarction (AMI), heart failure (HF), or pneumonia. Investigators concluded that hospitals with high adverse event rates were more likely to have high 30-day episode-of-care Medicare expenditures for patients discharged with AMI, HF, or pneumonia.
AHRQ-authored; AHRQ-funded; 290201200003C.
Citation: Wang Y, Eldridge N, Metersky ML .
Association between Medicare expenditures and adverse events for patients with acute myocardial infarction, heart failure, or pneumonia in the United States.
JAMA Netw Open 2020 Apr;3(4):e202142. doi: 10.1001/jamanetworkopen.2020.2142..
Keywords: Adverse Events, Patient Safety, Heart Disease and Health, Cardiovascular Conditions, Pneumonia, Medicare, Healthcare Costs
Amin AP, Spertus JA, Kulkarni H
Improving care pathways for acute coronary syndrome: patients undergoing percutaneous coronary intervention.
This study examined ways to improve care pathways for acute coronary syndrome (ACS) patients who are low-risk with no complications. They looked at 434,172 low-risk uncomplicated ACS patients eligible for early discharge from the Premier database and identified ACS care pathways. They compared percutaneous coronary intervention (PCI) types (trans-radial intervention [TRI] vs. transfemoral intervention (TFI) and by length of stay (LOS). Associations with costs and outcomes were tested using hierarchical, mixed-effects regression and projections of cost savings were obtained using modeling. More cost-savings were associated with TRI versus TFI. There was not an increased risk of adverse outcomes with a shorter LOS.
AHRQ-funded; HS022481.
Citation: Amin AP, Spertus JA, Kulkarni H .
Improving care pathways for acute coronary syndrome: patients undergoing percutaneous coronary intervention.
Am J Cardiol 2020 Feb;125(3):354-61. doi: 10.1016/j.amjcard.2019.10.019..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Quality Improvement, Quality of Care, Healthcare Delivery, Registries, Healthcare Costs
Amin AP, McNeely C, Spertus JA
Incremental cost of acute kidney injury after percutaneous coronary intervention in the United States.
This study examined incremental costs of acute kidney injury (AKI) complications from percutaneous coronary intervention (PCI), which is a common and severe complication. Out of a sample of over 1.4 million PCI patients at 518 US hospitals from 2006 to 2015, AKI occurred in 5.73% of PCI patients. Those with AKI had at least double the hospitalization costs and the incremental cost was $9,448. It was also independently associated with an incremental length of stay of 3.6 days. AKI cost burden was extrapolated at 411.3 million US dollars annually.
AHRQ-funded; HS022481.
Citation: Amin AP, McNeely C, Spertus JA .
Incremental cost of acute kidney injury after percutaneous coronary intervention in the United States.
Am J Cardiol 2020 Jan;125(1):29-33. doi: 10.1016/j.amjcard.2019.09.042..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Adverse Events, Healthcare Costs, Kidney Disease and Health, Patient Safety, Registries