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 Drug Events (ADE) (6)
- (-) Adverse Events (21)
- Ambulatory Care and Surgery (1)
- Antibiotics (1)
- Behavioral Health (1)
- Blood Clots (1)
- Blood Thinners (2)
- Brain Injury (1)
- Cancer (3)
- Cancer: Colorectal Cancer (2)
- Cardiovascular Conditions (3)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Children/Adolescents (3)
- Critical Care (1)
- Depression (1)
- Diagnostic Safety and Quality (1)
- Digestive Disease and Health (1)
- Elderly (3)
- Emergency Department (1)
- Evidence-Based Practice (2)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (5)
- Hospital Discharge (1)
- Hospitalization (2)
- Hospital Readmissions (1)
- Hospitals (2)
- Injuries and Wounds (2)
- Intensive Care Unit (ICU) (2)
- Kidney Disease and Health (1)
- Labor and Delivery (1)
- Long-Term Care (1)
- Medical Devices (1)
- Medical Errors (2)
- Medication (7)
- Medication: Safety (4)
- Mortality (1)
- Nursing Homes (1)
- Obesity (1)
- Obesity: Weight Management (1)
- Opioids (1)
- Outcomes (3)
- Patient-Centered Outcomes Research (3)
- Patient Safety (5)
- Pneumonia (1)
- Pregnancy (1)
- Prevention (2)
- Quality Improvement (2)
- Quality of Care (3)
- (-) Risk (21)
- Surgery (9)
- Tobacco Use (1)
- Urinary Tract Infection (UTI) (2)
- Women (1)
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 21 of 21 Research Studies DisplayedReeder B, Makic MBF, Morrow C
AHRQ Author: Rodrick D
Design and evaluation of low-fidelity visual display prototypes for multiple hospital-acquired conditions.
Hospital-acquired conditions such as catheter-associated urinary tract infection, stage 3 or 4 hospital-acquired pressure injury, and falls with injury are common, costly, and largely preventable. This study used participatory design methods to design and evaluate low-fidelity prototypes of clinical dashboards to inform high-fidelity prototype designs to visualize integrated risks based on patient profiles.
AHRQ-authored; AHRQ-funded; 233201500025I; 23337003T.
Citation: Reeder B, Makic MBF, Morrow C .
Design and evaluation of low-fidelity visual display prototypes for multiple hospital-acquired conditions.
Comput Inform Nurs 2020 Nov;38(11):562-71. doi: 10.1097/cin.0000000000000668..
Keywords: Healthcare-Associated Infections (HAIs), Adverse Events, Risk, Hospitals, Prevention
Guglielminotti J, Li G
Exposure to general anesthesia for cesarean delivery and odds of severe postpartum depression requiring hospitalization.
This retrospective cohort study evaluated the risk of general anesthesia use in cesarean delivery versus neuraxial anesthesia on maternal mental health. Cesarean deliveries performed in New York State hospitals between 2006 and 2013 were included. Exclusion criteria included having more than 1 cesarean delivery during the study period, residing outside of New York State, and having a general anesthetic for other surgery or delivery in the year before or after the index case. The primary outcome looked at was severe postpartum depression (PPD), and secondary outcomes were suicidal ideation, anxiety disorders, and posttraumatic stress disorder (PTSD). The majority of cesareans used neuraxial anesthesia and only 8% (34,356) had general anesthesia. Severe PPD requiring hospitalization occurred in 1158 women with 60% identified during readmission. General anesthesia was found to be associated with a 54% increased odds of PPD, and a 91% increased odds of suicidal ideation or self-inflicted injury. There was insufficient evidence for increased risk of anxiety orders.
AHRQ-funded; HS025787.
Citation: Guglielminotti J, Li G .
Exposure to general anesthesia for cesarean delivery and odds of severe postpartum depression requiring hospitalization.
Anesth Analg 2020 Nov;131(5):1421-29. doi: 10.1213/ane.0000000000004663..
Keywords: Labor and Delivery, Pregnancy, Women, Depression, Behavioral Health, Surgery, Risk, Hospitalization, Medication, Adverse Drug Events (ADE), Adverse Events
Mangrum R, Stewart MD, Gifford DR
Omissions of care in nursing homes: a uniform definition for research and quality improvement.
The goal of this study was to create a uniform definition of omission of care in US nursing homes. Lack of a uniform definition has made efforts to prevent them challenging. Subject matter experts and a broad range of nursing home stakeholders were brought together in iterative rounds of engagement to identify key concepts and aspects of omissions of care and develop a consensus-based definition. The concise definition decided on was: “Omissions of care in nursing homes encompass situations when care–either clinical or nonclinical–is not provided for a resident and results in additional monitoring or intervention or increases the risk of an undesirable or adverse physical, emotional, or psychosocial outcome for the resident."
AHRQ-funded; 233201500014I.
Citation: Mangrum R, Stewart MD, Gifford DR .
Omissions of care in nursing homes: a uniform definition for research and quality improvement.
J Am Med Dir Assoc 2020 Nov;21(11):1587-91.e2. doi: 10.1016/j.jamda.2020.08.016..
Keywords: Elderly, Nursing Homes, Long-Term Care, Quality Improvement, Quality of Care, Medical Errors, Adverse Events, Patient Safety, Risk, Patient-Centered Outcomes Research
Daigle CH, Fiadjoe JE, Laverriere EK
Difficult bag-mask ventilation in critically ill children is independently associated with adverse events.
This study looked at the epidemiology, risk factors, and clinical implications of difficult bag-mask ventilation among critically ill children. The prevalence and risk factors are described as well as its association with adverse tracheal intubation-associated events and oxygen desaturation in PICU patients. This retrospective review used observational data collected from a multicenter tracheal intubation database (National Emergency Airway Registry for Children) from January 2013 to December 2018 from 46 international PICUs. Difficult bag-mask ventilation was reported in 9.5% of 15,810 patients undergoing tracheal intubation with bag-mask ventilation. Difficult bag-mask ventilation was more commonly reported with increasing age, those with a primary respiratory diagnosis/indication for tracheal intubation, presence of difficulty airway features, more experienced provider level, and tracheal intubations without use of neuromuscular blockade. Specific intubation-associated or oxygen desaturation events occurred in 40.2% of patients with reported difficult bag-mask ventilation versus 19.8% in patients without difficult bag-mask ventilation.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Daigle CH, Fiadjoe JE, Laverriere EK .
Difficult bag-mask ventilation in critically ill children is independently associated with adverse events.
Crit Care Med 2020 Sep;48(9):e744-e52. doi: 10.1097/ccm.0000000000004425..
Keywords: Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Adverse Events, Risk
Strobel RJ, Harrington SD, Hill C
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Pneumonia is the most prevalent healthcare-associated infection after coronary artery bypass grafting (CABG), but the relative effectiveness of strategies to reduce its incidence remains unclear. In this study, the investigators evaluated the relationship between healthcare-associated infection recommendations and risk of pneumonia after CABG. These pneumonia prevention recommendations may serve as effective targets for avoiding postoperative healthcare-associated infections.
AHRQ-funded; HS022535; HS022909.
Citation: Strobel RJ, Harrington SD, Hill C .
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Ann Thorac Surg 2020 Sep;110(3):903-10. doi: 10.1016/j.athoracsur.2019.12.053..
Keywords: Pneumonia, Cardiovascular Conditions, Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Prevention, Evidence-Based Practice, Guidelines, Risk
Zachariah P, Sanabria E, Liu J
Novel strategies for predicting healthcare-associated infections at admission: implications for nursing care.
Accurate, real-time models to predict hospital adverse events could facilitate timely and targeted interventions to improve patient outcomes. Advances in computing enable the use of supervised machine learning (SML) techniques to predict hospital-onset infections. The purpose of this study was to trial SML methods to predict urinary tract infections (UTIs) during inpatient hospitalization at the time of admission.
AHRQ-funded; HS024915.
Citation: Zachariah P, Sanabria E, Liu J .
Novel strategies for predicting healthcare-associated infections at admission: implications for nursing care.
Nurs Res 2020 Sep/Oct;69(5):399-403. doi: 10.1097/nnr.0000000000000449..
Keywords: Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Adverse Events, Patient Safety, Risk
Rinke ML, Oyeku SO, Heo M
Pediatric ambulatory catheter-associated urinary tract infections (CAUTIs): incidence, risk factors, and patient outcomes.
Catheter-associated urinary tract infections (CAUTIs) occur frequently in pediatric inpatients, and they are associated with increased morbidity and cost. Few studies have investigated ambulatory CAUTIs, despite at-risk children utilizing home urinary catheterization. This retrospective cohort and case-control study determined incidence, risk factors, and outcomes of pediatric patients with ambulatory CAUTI. The investigators concluded that pediatric ambulatory CAUTIs occurred in 18% of patients with catheters; they were associated with morbidity and healthcare utilization. Ambulatory indwelling catheter CAUTI incidence exceeded national inpatient incidence.
AHRQ-funded; HS024432.
Citation: Rinke ML, Oyeku SO, Heo M .
Pediatric ambulatory catheter-associated urinary tract infections (CAUTIs): incidence, risk factors, and patient outcomes.
Infect Control Hosp Epidemiol 2020 Aug;41(8):891-99. doi: 10.1017/ice.2020.204..
Keywords: Children/Adolescents, Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Risk, Ambulatory Care and Surgery, Adverse Events
Griffey RT, Schneider RM, Todorov AA
The emergency department trigger tool: a novel approach to screening for quality and safety events.
The goal of this study was to develop an automated version of a previously developed emergency department (ED) trigger tool to track the likelihood of an adverse event. Thirty triggers were associated with risk of harm. The authors identified 1,726 records out of 76,894 ED visits with greater than or equal to 1 trigger. They compared the results of the automated tool to the previous version and found it performed well. They began with a broad set of candidate triggers and validated a computerized query that eliminates the need for manual screening of triggers and also identified a refined set of triggers associated with adverse events in the ED.
AHRQ-funded; HS025052.
Citation: Griffey RT, Schneider RM, Todorov AA .
The emergency department trigger tool: a novel approach to screening for quality and safety events.
Ann Emerg Med 2020 Aug;76(2):230-40. doi: 10.1016/j.annemergmed.2019.07.032..
Keywords: Emergency Department, Patient Safety, Adverse Events, Medical Errors, Quality of Care, Risk
Assimon MM, Wang L, Pun PH
Use of QT prolonging medications by hemodialysis patients and individuals without end-stage kidney disease.
Investigators characterized the extent and patterns of QT-interval prolonging medication use by adult hemodialysis patients and individuals without end-stage kidney disease annually from 2012 to 2016. They found that hemodialysis patients used QT prolonging medications with known torsades de pointes risk more extensively than individuals without end-stage kidney disease. They recommended future studies evaluating the cardiac safety of these drugs in the hemodialysis population.
AHRQ-funded; HS026801.
Citation: Assimon MM, Wang L, Pun PH .
Use of QT prolonging medications by hemodialysis patients and individuals without end-stage kidney disease.
J Am Heart Assoc 2020 Jul 7;9(13):e015969. doi: 10.1161/jaha.120.015969..
Keywords: Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Kidney Disease and Health, Risk
Villa Zapata L, Hansten PD, Panic J
Risk of bleeding with exposure to warfarin and nonsteroidal anti-inflammatory drugs: a systematic review and meta-analysis.
Warfarin use can trigger the occurrence of bleeding independently or as a result of a drug-drug interaction when used in combination with nonsteroidal anti-inflammatory drugs (NSAIDs). This article examines the risk of bleeding in individuals exposed to concomitant warfarin and NSAID compared with those taking warfarin alone. The investigators concluded that risk of bleeding was significantly increased among persons taking warfarin and a NSAID or COX-2 inhibitor together as compared with taking warfarin alone.
AHRQ-funded; HS025984.
Citation: Villa Zapata L, Hansten PD, Panic J .
Risk of bleeding with exposure to warfarin and nonsteroidal anti-inflammatory drugs: a systematic review and meta-analysis.
Thromb Haemost 2020 Jul;120(7):1066-74. doi: 10.1055/s-0040-1710592..
Keywords: Blood Thinners, Medication, Medication: Safety, Risk, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Stone CA, Stollings JL, Lindsell CJ
Risk-stratified management to remove low-risk penicillin allergy labels in the ICU.
Patients admitted to a medical ICU (MICU) often have chronic illnesses or altered immunity, increasing their need for immediate antibiotic use. In this study, the investigators sought to determine whether MICU patients with low-risk penicillin allergy history could be challenged directly with amoxicillin to have their allergy label safely removed during an acute inpatient stay.
Citation: Stone CA, Stollings JL, Lindsell CJ .
Risk-stratified management to remove low-risk penicillin allergy labels in the ICU.
Am J Respir Crit Care Med 2020 Jun 15;201(12):1572-75. doi: 10.1164/rccm.202001-0089LE..
Keywords: Intensive Care Unit (ICU), Antibiotics, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Risk, Diagnostic Safety and Quality
Khaneki S, Bronsert MR, Henderson WG
Comparison of accuracy of prediction of postoperative mortality and morbidity between a new, parsimonious risk calculator (SURPAS) and the ACS Surgical Risk Calculator.
The purpose of this study was to compare the accuracy of the Surgical Risk Preoperative Assessment System (SURPAS) to that of the American College of Surgeons Surgical Risk Calculator (ACS-SRC). Data from 1006 selected ACS National Surgical Quality Improvement Program (NSQIP) patients with known outcomes were used to calculate predicted risk of postoperative mortality and morbidity. Findings showed that the SURPAS risk predictions were more accurate than the ACS-SRC's for overall morbidity, particularly for high risk patients.
AHRQ-funded; HS024124.
Citation: Khaneki S, Bronsert MR, Henderson WG .
Comparison of accuracy of prediction of postoperative mortality and morbidity between a new, parsimonious risk calculator (SURPAS) and the ACS Surgical Risk Calculator.
Am J Surg 2020 Jun;219(6):1065-72. doi: 10.1016/j.amjsurg.2019.07.036..
Keywords: Surgery, Risk, Adverse Events, Quality Improvement, Quality of Care
Pruitt LCC, Skarda DE, Rollins MD
Hirschsprung-associated enterocolitis in children treated at US children's hospitals.
The incidence of and risk factors for Hirschsprung's-associated enterocolitis (HAEC) following pull-through have been limited to single institutions studies. In this retrospective cohort study, the investigators characterized the incidence of, risk factors for, and consequences of post-operative HAEC. The investigators concluded that HAEC following pull-through occurs in a large proportion of infants with HD and predicts reoperation. They suggest that multicenter studies are needed to develop prediction models and treatment protocols for HAEC.
AHRQ-funded; HS025776.
Citation: Pruitt LCC, Skarda DE, Rollins MD .
Hirschsprung-associated enterocolitis in children treated at US children's hospitals.
J Pediatr Surg 2020 Mar;55(3):535-40. doi: 10.1016/j.jpedsurg.2019.10.060.
.
.
Keywords: Children/Adolescents, Digestive Disease and Health, Surgery, Adverse Events, Risk, Hospitals
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
Probst MA, Gupta M, Hendey GW
Prevalence of intracranial injury in adult patients with blunt head trauma with and without anticoagulant or antiplatelet use.
In this study, the investigators determined the prevalence of significant intracranial injury among adults with blunt head trauma who are receiving preinjury anticoagulant or antiplatelet medications. The investigators concluded that patients receiving preinjury warfarin or a combination of aspirin and clopidogrel were at increased risk for significant intracranial injury, but not those receiving aspirin alone. They suggested that clinicians should have a low threshold for neuroimaging when evaluating patients receiving warfarin or a combination of aspirin and clopidogrel.
AHRQ-funded; HS009699.
Citation: Probst MA, Gupta M, Hendey GW .
Prevalence of intracranial injury in adult patients with blunt head trauma with and without anticoagulant or antiplatelet use.
Ann Emerg Med 2020 Mar;75(3):354-64. doi: 10.1016/j.annemergmed.2019.10.004..
Keywords: Brain Injury, Injuries and Wounds, Blood Thinners, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Risk
Fakhri B, Fiala MA, Shah N
Measuring cardiopulmonary complications of carfilzomib treatment and associated risk factors using the SEER-Medicare database.
This study’s goal was to measure rates of cardiopulmonary complications from carfilzomib treatment in patients with recurrent myeloma. Myeloma case data was extracted from the SEER-Medicare linked database from 2000 to 2013, and corresponding claims through 2014. There were 635 patients identified as being treated with carfilzomib. Of these, median age was 72 years, 55% were male, and 79% were white. Median duration of treatment was 58 days. Overall, 66% of patients had codes identifying cardiac or pulmonary adverse events. Cardiac adverse events included hypertension, peripheral edema and heart failure. Pulmonary adverse events included dyspnea, cough, and pneumonia.
AHRQ-funded; HS019455.
Citation: Fakhri B, Fiala MA, Shah N .
Measuring cardiopulmonary complications of carfilzomib treatment and associated risk factors using the SEER-Medicare database.
Cancer 2020 Feb 15;128(4):808-13. doi: 10.1002/cncr.32601..
Keywords: Adverse Events, Medication, Cardiovascular Conditions, Risk, Cancer, Patient Safety
McIsaac DI, Taljaard M, Bryson GL
Frailty as a predictor of death or new disability after surgery: a prospective cohort study.
The purpose of this study was to compare the accuracy of the modified Fried Index (mFI) and the Clinical Frailty Scale (CFS) to predict death or patient-reported new disability 90 days after major elective surgery. Results showed that older people with frailty are significantly more likely to die or experience a new patient-reported disability after surgery and that although accuracy was similar, the CFS, compared to the mFI, was easier to use and feasibility was higher.
AHRQ-funded; HS023313.
Citation: McIsaac DI, Taljaard M, Bryson GL .
Frailty as a predictor of death or new disability after surgery: a prospective cohort study.
Ann Surg 2020 Feb;271(2):283-89. doi: 10.1097/sla.0000000000002967..
Keywords: Elderly, Patient-Centered Outcomes Research, Surgery, Mortality, Adverse Events, Risk, Outcomes
Herzig SJ, Stefan MS, Pekow PS
Risk factors for severe opioid-related adverse events in a national cohort of medical hospitalizations.
The objective of this study was to identify independent risk factors for severe opioid-related adverse drug events (ORADEs) in hospitalized patients. This retrospective cohort study used data from medical patients hospitalized at US non-federal and acute care facilities with at least one pharmacy charge. They excluded patients with metastatic, hospice, or palliative care billing codes. Out of 731,208 hospitalizations there was a severe ORADE in 2727 (0.4%) of patients. Independent risk factors included advanced age, female gender, comorbidities, organ failures on admission, medication co-administrations, and characteristics of the opioids themselves. These risk factors can be used to inform physician decision-making and conversations with patients about risk.
AHRQ-funded; HS026215.
Citation: Herzig SJ, Stefan MS, Pekow PS .
Risk factors for severe opioid-related adverse events in a national cohort of medical hospitalizations.
J Gen Intern Med 2020 Feb;35(2):538-45. doi: 10.1007/s11606-019-05490-w..
Keywords: Opioids, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Hospitalization
De Roo AC, Li Y, Abrahamse PH
Long-term functional decline after high-risk elective colorectal surgery in older adults.
This study examined the long-term risks of functional decline after elective colorectal surgery in older adults. This retrospective matched cohort study used data from the Health and Retirement Study, a nationally representative, longitudinal survey of adults >50 years of age. This survey collected data on functional status, cognition, and demographics, among other topics. The survey was linked with Medicare claims and National Death Index data from 1992 to 2012 and used patients 65 years and older. Surgery patients did experience a greater likelihood of functional decline with or without complications compared to control subjects. The older the patient, the more likelihood of a functional decline occurring after surgery.
AHRQ-funded; HS000053.
Citation: De Roo AC, Li Y, Abrahamse PH .
Long-term functional decline after high-risk elective colorectal surgery in older adults.
Dis Colon Rectum 2020 Jan;63(1):75-83. doi: 10.1097/dcr.0000000000001541..
Keywords: Elderly, Cancer: Colorectal Cancer, Cancer, Surgery, Adverse Events, Risk
Schlick CJR, Liu JY, Yang AD
Pre-operative, intra-operative, and post-operative factors associated with post-discharge venous thromboembolism following colorectal cancer resection.
Venous thromboembolism (VTE) is the most common preventable cause of 30-day post-operative mortality, with many events occurring after hospital discharge. High-level evidence supports post-discharge VTE chemoprophylaxis following abdominal/pelvic cancer resection; however, some studies support a more tailored approach. The objectives of this study were to (1) identify risk factors associated with post-discharge VTE in a large cohort of patients undergoing colorectal cancer resection and (2) develop a post-discharge VTE risk calculator.
AHRQ-funded; HS024516; HS026385.
Citation: Schlick CJR, Liu JY, Yang AD .
Pre-operative, intra-operative, and post-operative factors associated with post-discharge venous thromboembolism following colorectal cancer resection.
J Gastrointest Surg 2020 Jan;24(1):144-54. doi: 10.1007/s11605-019-04354-2..
Keywords: Cancer: Colorectal Cancer, Cancer, Surgery, Blood Clots, Adverse Events, Risk, Hospital Discharge
Song J, Tark A, Larson EL
The relationship between pocket hematoma and risk of wound infection among patients with a cardiovascular implantable electronic device: an integrative review.
Pocket hematoma is a common adverse event following the insertion of cardiovascular implantable electronic devices (CIEDs), but the risk of wound infections associated with a pocket hematoma is unclear. The objective of this integrative review was to examine the relationship between pocket hematoma and risk of wound infection in a CIED population.
AHRQ-funded; HS024915.
Citation: Song J, Tark A, Larson EL .
The relationship between pocket hematoma and risk of wound infection among patients with a cardiovascular implantable electronic device: an integrative review.
Heart Lung 2020 Jan-Feb;49(1):92-98. doi: 10.1016/j.hrtlng.2019.09.009..
Keywords: Medical Devices, Cardiovascular Conditions, Surgery, Adverse Events, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Risk