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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 3 of 3 Research Studies DisplayedRoemer M, Schaefer MB, Pickens GT
AHRQ Author: Roemer M
Estimating state-specific population-based hospitalization rates from in-state hospital discharge data.
The purpose of this study was to develop weights to estimate state population-based hospitalization rates for all residents of a state using only data from in-state hospitals. The researchers utilized Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases (SID), for data from 2018-2019, including 47 states plus Washington D.C. and excluding residents treated in other states. SID were based on administrative billing records collected by hospitals, shared with statewide data organizations, and provided to HCUP. The study found that of 34,186,766 discharged patients in 2018, 4.2% were movers. A greater share of movers (vs. stayers) lived in state border and rural counties; a lower share had discharges billed to Medicaid or were hospitalized for maternal/neonatal services. The difference between 2019 observed and estimated total discharges for all included states and D.C. was 9,402. The researchers reported an overestimation of discharges with an expected payer of Medicaid, from the lowest income communities, and for maternal/neonatal care. The researchers reported an underestimation of discharges with an expected payer of private insurance, from the highest income communities, and with injury diagnoses and surgical services. Estimates for the majority of subsets were reported to be not within a 95% confidence interval, attributed to factors such as hospital closures/openings, shifting consumer preferences, and other issues impossible to account for.
AHRQ-authored; AHRQ-funded; 290201800001C.
Citation: Roemer M, Schaefer MB, Pickens GT .
Estimating state-specific population-based hospitalization rates from in-state hospital discharge data.
Health Serv Res 2023 Dec; 58(6):1314-27. doi: 10.1111/1475-6773.14216..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Hospital Discharge
Piniella NR, Fuller TE, Smith L
Early expected discharge date accuracy during hospitalization: a multivariable analysis.
The purpose of this study was to assess the level at which accurate estimation of an expected discharge date (EDD) early during hospitalization impacts clinical operations and discharge planning. The researchers conducted a retrospective study of patients discharged from six general medicine units at an academic medical center in Boston, MA from January 2017 to June 2018. All EDD entries and patient, encounter, unit, and provider data were extracted from the electronic health record (EHR), and public weather data. The study found that of 3917 eligible hospitalizations 22.7% had at least one accurate early EDD entry. Clinician-entered EDD, admit day and discharge day during the work week, and teaching clinical units were the factors significantly positively associated with an accurate early EDD. An Elixhauser Comorbidity Index of 11 or more and length of stay of two or more days were the factors significantly negatively associated with an accurate early EDD. The researchers concluded that EDDs entered within the first 24 hours of admission were frequently inaccurate. Few of the factors associated with accurate early EDD entries would be useful for prospective prediction.
AHRQ-funded; HS024751.
Citation: Piniella NR, Fuller TE, Smith L .
Early expected discharge date accuracy during hospitalization: a multivariable analysis.
J Med Syst 2023 May 12; 47(1):63. doi: 10.1007/s10916-023-01952-1..
Keywords: Hospital Discharge, Hospitalization
Skains RM, Zhang Y, Osborne JD
Hospital-associated disability due to avoidable hospitalizations among older adults.
A frequent complication during the course of acute care hospitalizations in older adults is Hospital-associated disability (HAD). Numerous admissions are for ambulatory care sensitive conditions (ACSCs), which are considered potentially avoidable hospitalizations-conditions that may be able to be treated in outpatient settings to prevent hospitalization and HAD. The purpose of this study was to compare the incidence of HAD between older adults hospitalized for ACSCs versus those hospitalized for other diagnoses. The researchers conducted a retrospective cohort study of 38,960 older adults 65 years of age or older admitted to inpatient (non-ICU) medical and surgical units of a large southeastern regional academic medical center. The primary study outcome was HAD. The study found that 10% of older adults were admitted for an ACSC, with rates of HAD in those admitted for ACSCs lower than those admitted for other conditions. Age, comorbidity, admission functional status, and admission cognitive impairment were significant predictors for development of HAD. Compared with admissions for other conditions, ACSC admissions to medical and medical/surgical services had decreased odds of HAD, with no significant differences between ACSC and non-ACSC admissions to surgical services.
AHRQ-funded; HS013852.
Citation: Skains RM, Zhang Y, Osborne JD .
Hospital-associated disability due to avoidable hospitalizations among older adults.
J Am Geriatr Soc 2023 May; 71(5):1395-405. doi: 10.1111/jgs.18238..
Keywords: Elderly, Hospitalization, Hospital Discharge