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)
- Antibiotics (2)
- Antimicrobial Stewardship (2)
- Blood Clots (1)
- Community-Acquired Infections (7)
- Diagnostic Safety and Quality (1)
- Elderly (1)
- Healthcare-Associated Infections (HAIs) (1)
- Hospital Discharge (1)
- Hospitalization (1)
- Hospital Readmissions (1)
- Hospitals (2)
- Infectious Diseases (2)
- Influenza (2)
- Inpatient Care (1)
- Medication (3)
- Outcomes (3)
- (-) Pneumonia (10)
- Respiratory Conditions (5)
- Skin Conditions (1)
- Urinary Tract Infection (UTI) (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 10 of 10 Research Studies DisplayedSoper NS, Appukutty AJ, Paje D
Antibiotic overuse after discharge from medical short-stay units.
This study investigated antibiotic overuse after discharge from medical short-stay units (SSUs). This cross-sectional study included patients hospitalized in 2 different medical SSUs with a total of 40 beds at a single academic medical center. Eligible adults were discharged with an oral antibiotic from either SSU from May 2018 to September 2019. Of 100 patients discharged from SSUs with antibiotics, 47 had a skin and soft-tissue infection (SSTI), 22 pneumonia, 21 UTI, and 10 had “other” infections. Overall, 78 cases (78%) were defined as overuse, including 39 of 47 of those treated for SSTI, 17 of 21 for UTI, and 14 of 22 for pneumonia. The most common types of overuse were excess duration and guideline discordant selection. Examples of factors influencing overuse included consultant recommendations, miscalculation of duration, and the need for source control procedure.
AHRQ-funded; HS026530.
Citation: Soper NS, Appukutty AJ, Paje D .
Antibiotic overuse after discharge from medical short-stay units.
Nov;43(11):1689-92. doi: 10.1017/ice.2021.346..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Pneumonia, Skin Conditions, Urinary Tract Infection (UTI), Respiratory Conditions, Hospital Discharge
Lee PT, Krecko LK, Savage S
Which hospital-acquired conditions matter the most in trauma? An evidence-based approach for prioritizing trauma program improvement.
The purpose of this study was to quantify and compare the impacts of six different hospital-acquired conditions (HACs) on early clinical outcomes and resource utilization in hospitalized trauma patients. The researchers included 529,856 adult patients from the 2013 to 2016 American College of Surgeons Trauma Quality Improvement Program Participant Use Data Files with 5 days or longer of hospitalization and had an Injury Severity Score of 9 or higher. The study found the incidences of HACs were: pneumonia, 5.2%; urinary tract infection, 3.4%; venous thromboembolism, 3.3%; surgical site infection, 1.3%; pressure ulcer, 1.3%; and central line-associated blood stream infection, 0.2%. The HAC of pneumonia demonstrated the largest association with in-hospital outcomes and resource utilization. The researchers reported that prevention of pneumonia within the study group would have resulted in estimated reductions of: 22.1% for end organ dysfunction, 8.7% for prolonged hospitalization, 7.8% for mortality, 7.1% for prolonged intensive care unit stay, and 6.8% for need for mechanical ventilation. The researchers concluded that pneumonia prevention should be a priority activity in program improvement efforts.
AHRQ-funded; HS025224.
Citation: Lee PT, Krecko LK, Savage S .
Which hospital-acquired conditions matter the most in trauma? An evidence-based approach for prioritizing trauma program improvement.
J Trauma Acute Care Surg 2022 Oct 1;93(4):446-52. doi: 10.1097/ta.0000000000003645..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Pneumonia, Urinary Tract Infection (UTI), Blood Clots
Deshpande A, Klompas M, Yu PC A, Klompas M, Yu PC
Influenza testing and treatment among patients hospitalized with community-acquired pneumonia.
This study looked at testing rates for influenza in hospitalized patients admitted for community-acquired pneumonia (CAP) and whether it is associated with antiviral treatment and shorter antibiotic courses. The study included patients admitted in 179 US hospitals with pneumonia from 2010 to 2015. The authors assessed influenza testing and compared antimicrobial utilization and the outcomes of test-positive, test-negative, and untested patients. Among 166,268 patients with CAP, 23.3% were tested for influenza, of whom 11.5% tested positive. Testing increased from 15.4% to 35.5% from 2010 to 2015 and was more than triple the rate during flu season (October-May) vs June to September. Patients who tested positive for influenza received antiviral agents more often and antibiotics less often and for shorter courses than patients testing negative. Patients who received early antiviral treatment with oseltamivir experienced lower 14-day in-hospital mortality, lower costs, and shorter length of stay vs patients receiving oseltamivir later or not at all.
AHRQ-funded; HS024277.
Citation: Deshpande A, Klompas M, Yu PC A, Klompas M, Yu PC .
Influenza testing and treatment among patients hospitalized with community-acquired pneumonia.
Chest 2022 Sep;162(3):543-55. doi: 10.1016/j.chest.2022.01.053..
Keywords: Influenza, Pneumonia, Community-Acquired Infections, Outcomes, Medication, Inpatient Care
Vaughn VM, Gandhi TN, Hofer TP
A statewide collaborative quality initiative to improve antibiotic duration and outcomes in patients hospitalized with uncomplicated community-acquired pneumonia.
Researchers sought to improve antibiotic duration for community-acquired pneumonia (CAP) across 41 hospitals participating in the Michigan Hospital Medicine Safety Consortium (HMS). They found that, across diverse hospitals, HMS participation was associated with more appropriate use of short-course therapy and fewer adverse events in hospitalized patients with uncomplicated CAP.
AHRQ-funded; HS026530.
Citation: Vaughn VM, Gandhi TN, Hofer TP .
A statewide collaborative quality initiative to improve antibiotic duration and outcomes in patients hospitalized with uncomplicated community-acquired pneumonia.
Clin Infect Dis 2022 Aug 31;75(3):460-67. doi: 10.1093/cid/ciab950..
Keywords: Community-Acquired Infections, Pneumonia, Antibiotics, Antimicrobial Stewardship, Medication, Respiratory Conditions
Rothberg MB, Imrey PB, Guo N MB, Imrey PB, Guo N
A risk model to identify Legionella among patients admitted with community-acquired pneumonia: a retrospective cohort study.
This study’s goal was to derive and externally validate a model to predict a positive Legionella test among adult inpatients diagnosed with pneumonia. The study used data from 177 US hospitals in the Premier Healthcare Database and 12 Cleveland Clinic Health System (CCHS) hospitals. Of 166,689 patients hospitalized for pneumonia, out of 43,070 tested for Legionella 642 (1.5%) tested positive. The strongest predictors of a positive test were a local outbreak, June-October occurrence, hyponatremia, smoking and diarrhea. A negative test was associated with prior admission within 6 months and chronic pulmonary disease.
AHRQ-funded; HS024277.
Citation: Rothberg MB, Imrey PB, Guo N MB, Imrey PB, Guo N .
A risk model to identify Legionella among patients admitted with community-acquired pneumonia: a retrospective cohort study.
J Hosp Med 2022 Aug;17(8):624-32. doi: 10.1002/jhm.12919..
Keywords: Pneumonia, Community-Acquired Infections, Infectious Diseases, Respiratory Conditions
Haessler S, Guo N, Deshpande A
Etiology, treatments, and outcomes of patients with severe community-acquired pneumonia in a large U.S. sample.
This study compared the clinical practice and outcomes in severe community-acquired pneumonia (sCAP) patients to those in non-sCAP patients using guideline-defined criteria for sCAP. The definition for sCAP includes a principal diagnosis of pneumonia or a secondary pneumonia diagnosis paired with a principal diagnosis of sepsis or respiratory failure. One-hundred seventy-seven US hospitals within the Premier Healthcare Database were used to identify 154,799 patients with pneumonia, with 14.1% meeting criteria for sCAP. The sCAP patients had higher organ failure scores and inpatient mortality, longer lengths of stay, and higher costs than those with nonsevere disease. Patients with sCAP had twice the rate of positive blood cultures and respiratory cultures and more often had isolates resistant to first-line community-acquired pneumonia antibiotics. The most common pathogen acquired from blood cultures was Streptococcus pneumoniae and from the respiratory tract Staphylococcus aureus and Pseudomonas species. The most common antibiotics prescribed were vancomycin (65%) and piperacillin-tazobactam (42.8%), regardless of cultures positive for a resistant organism.
AHRQ-funded; HS024277.
Citation: Haessler S, Guo N, Deshpande A .
Etiology, treatments, and outcomes of patients with severe community-acquired pneumonia in a large U.S. sample.
Crit Care Med 2022 Jul;50(7):1063-71. doi: 10.1097/ccm.0000000000005498..
Keywords: Community-Acquired Infections, Pneumonia, Respiratory Conditions, Outcomes
Wang Y, Eldridge N, Metersky ML
AHRQ Author: Eldridge N, Rodrick D
Analysis of hospital-level readmission rates and variation in adverse events among patients with pneumonia in the United States.
The purpose of this AHRQ-authored cross-sectional study was to assess whether patients with pneumonia who were admitted to hospitals with higher risk-standardized readmission rates had a higher risk of in-hospital adverse events. The researchers linked patient-level adverse events data from the Medicare Patient Safety Monitoring System (MPSMS) to the hospital-level pneumonia-specific all-cause readmissions data from the Centers for Medicare & Medicaid Services. The MPSMS data included 46,047 patients with pneumonia across 2,590 hospitals discharged from July 1, 2010, through December 31, 2019. For data from 2010 to 2017, analysis was completed from October 2019 through July 2020, and for data from 2018 to 2019 analysis was completed from March through April 2022. The study concluded that readmission rates are associated with the quality of hospital care for pneumonia; patients with pneumonia admitted to hospitals with high all-cause readmission rates had a higher likelihood of developing adverse events during the initial hospitalization.
AHRQ-authored; AHRQ-funded; 290201800005C.
Citation: Wang Y, Eldridge N, Metersky ML .
Analysis of hospital-level readmission rates and variation in adverse events among patients with pneumonia in the United States.
JAMA Netw Open 2022 May 2;5(5):e2214586. doi: 10.1001/jamanetworkopen.2022.14586..
Keywords: Hospital Readmissions, Hospitals, Adverse Events, Pneumonia, Respiratory Conditions
Gupta A, Petty L, Gandhi T
Overdiagnosis of urinary tract infection linked to overdiagnosis of pneumonia: a multihospital cohort study.
This study’s goal was to determine if there is a correlation between overdiagnosis of urinary tract infection (UTI) and overdiagnosis of community-acquired pneumonia (CAP) in hospitals, resulting in unnecessary antibiotic use and diagnostic delays. The authors first determined the proportion of hospitalized patients treated for CAP or UTI at 46 hospitals in Michigan who were overdiagnosed according to national guideline definitions. Then they used Pearson's correlation coefficient to compare hospital proportions of overdiagnosis of CAP and UTI. They included 14,085 patients treated for CAP and 10,398 patients treated for UTI. There was a moderate correlation within hospitals of the proportion of patients overdiagnosed with UTI and those overdiagnosed with CAP.
AHRQ-funded; HS026530.
Citation: Gupta A, Petty L, Gandhi T .
Overdiagnosis of urinary tract infection linked to overdiagnosis of pneumonia: a multihospital cohort study.
BMJ Qual Saf 2022 May;31(5):383-86. doi: 10.1136/bmjqs-2021-013565..
Keywords: Urinary Tract Infection (UTI), Pneumonia, Community-Acquired Infections, Diagnostic Safety and Quality
Bartley PS, Deshpande A, Yu PC
Bacterial coinfection in influenza pneumonia: rates, pathogens, and outcomes.
Among patients hospitalized for influenza pneumonia, the researchers reported the rate of coinfection and distribution of pathogens and also compared outcomes of patients with and without bacterial coinfection. They found that, in a large US inpatient sample hospitalized with influenza and community-acquired pneumonia, Staphylococcus aureus was the most frequent cause of bacterial coinfection. Coinfection was associated with worse outcomes and higher costs.
AHRQ-funded; HS024277.
Citation: Bartley PS, Deshpande A, Yu PC .
Bacterial coinfection in influenza pneumonia: rates, pathogens, and outcomes.
Infect Control Hosp Epidemiol 2022 Feb;43(2):212-17. doi: 10.1017/ice.2021.96..
Keywords: Influenza, Pneumonia, Infectious Diseases, Community-Acquired Infections
Rastogi R, Yu PC, Deshpande A
Treatment and outcomes among patients ≥85 years hospitalized with community-acquired pneumonia.
This retrospective cohort study’s objective was to describe community-acquired pneumonia (CAP) among patients ≥85 years and compare them to patients aged 65-74. Findings showed that patients aged 85 and over have different comorbidities and etiologies of CAP, receive less intense treatment, and have greater mortality than patients between 65 and 75 years.
AHRQ-funded; HS024277.
Citation: Rastogi R, Yu PC, Deshpande A .
Treatment and outcomes among patients ≥85 years hospitalized with community-acquired pneumonia.
J Investig Med 2022 Feb;70(2):376-82. doi: 10.1136/jim-2021-002078..
Keywords: Elderly, Community-Acquired Infections, Pneumonia, Outcomes, Hospitalization