National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (1)
- Cardiovascular Conditions (2)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Complementary and Alternative Medicine (1)
- COVID-19 (1)
- Critical Care (2)
- Elderly (4)
- Electronic Health Records (EHRs) (1)
- Emergency Department (3)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (1)
- Heart Disease and Health (1)
- Hospital Readmissions (2)
- (-) Hospitals (14)
- Infectious Diseases (1)
- Injuries and Wounds (1)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (3)
- Labor and Delivery (1)
- Maternal Care (1)
- Medicare (1)
- (-) Mortality (14)
- Neurological Disorders (1)
- Newborns/Infants (2)
- (-) Outcomes (14)
- Patient-Centered Outcomes Research (3)
- Patient Safety (2)
- Practice Patterns (1)
- Pregnancy (1)
- Quality Improvement (1)
- Quality of Care (3)
- Risk (2)
- Rural Health (1)
- Sepsis (2)
- Stroke (1)
- Surgery (3)
- Transitions of Care (4)
- Urban Health (1)
- Women (1)
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 14 of 14 Research Studies DisplayedGreenwood-Ericksen M, Kamdar N, Lin P
Association of rural and critical access hospital status with patient outcomes after emergency department visits among Medicare beneficiaries.
This study compared 30-day mortality rates after emergency department (ED) visits to rural or critical access hospitals (CAHs) compared to urban hospitals for Medicare beneficiaries. A 20% sample of Medicare beneficiaries was used from January 2011 to October 31, 2015. The primary outcome measured was 30-day mortality. Secondary outcome examined was ED visits with and without rehospitalization. Mortality rates were comparable with both groups, although patients in rural EDs experienced more transfers and less hospitalization.
AHRQ-funded; HS024160.
Citation: Greenwood-Ericksen M, Kamdar N, Lin P .
Association of rural and critical access hospital status with patient outcomes after emergency department visits among Medicare beneficiaries.
JAMA Netw Open 2021 Nov;4(11):e2134980. doi: 10.1001/jamanetworkopen.2021.34980..
Keywords: Hospitals, Rural Health, Urban Health, Emergency Department, Mortality, Outcomes
Anesi GL, Jablonski J, Harhay MO
Characteristics, outcomes, and trends of patients with COVID-19-related critical illness at a learning health system in the United States.
This study’s objective is to describe the epidemiology of COVID-19-related critical illness, including trends in outcomes and care delivery, using five hospitals within the University of Pennsylvania Health System as a setting. Findings showed that, among patients with COVID-19-related critical illness admitted to ICUs of a learning health system in the United States, mortality seemed to decrease over time despite stable patient characteristics. Recommendations included further studies to confirm this result and to investigate causal mechanisms.
AHRQ-funded; HS026372.
Citation: Anesi GL, Jablonski J, Harhay MO .
Characteristics, outcomes, and trends of patients with COVID-19-related critical illness at a learning health system in the United States.
Ann Intern Med 2021 May;174(5):613-21. doi: 10.7326/m20-5327..
Keywords: COVID-19, Critical Care, Intensive Care Unit (ICU), Mortality, Hospitals, Outcomes, Infectious Diseases
Bowman JA, Nuño M, Jurkovich GJ
Association of hospital-level intensive care unit use and outcomes in older patients with isolated rib fractures.
Researchers characterized interhospital variability in intensive care unit (ICU) vs non-ICU admission of older patients with isolated rib fractures and evaluated whether greater hospital-level use of ICU admission is associated with improved outcomes. This study included trauma patients who were admitted to trauma centers participating in the National Trauma Data Bank. The researchers found that admission location of older patients with isolated rib fractures was variable across hospitals, but hospitalization at a center with greater ICU use was associated with improved outcomes. They recommended that hospitals with low ICU use admit more such patients to an ICU.
AHRQ-funded; HS022236.
Citation: Bowman JA, Nuño M, Jurkovich GJ .
Association of hospital-level intensive care unit use and outcomes in older patients with isolated rib fractures.
JAMA Netw Open 2020 Nov 2;3(11):e2026500. doi: 10.1001/jamanetworkopen.2020.26500..
Keywords: Elderly, Injuries and Wounds, Intensive Care Unit (ICU), Hospitals, Patient-Centered Outcomes Research, Outcomes, Mortality
Philip JL, Yang DY, Wang X
Effect of transfer status on outcomes of emergency general surgery patients.
This study looked at outcomes of transferred (TRAN) versus directly admitted (DA) emergency general surgery (EGS) patients. Patients with a diagnosis of EGS were identified from the 2008-2011 Nationwide Inpatient Sample (NIS). Outcomes included were in-hospital mortality and morbidity. They identified 274,145 TRAN and 10,456,100 DA encounters. Morbidity and mortality were both higher in TRAN patients than DA. TRAN patients were more likely to have greater comorbidity scores, have Medicare insurance, and reside in an area with a lesser median household income compared to DA patients. Morbidity among TRAN patients were primarily due urinary-, gastrointestinal-, and pulmonary-related complications. Median stay and median cost at the hospital were greater for TRAN patients.
AHRQ-funded; HS025224; HS022694.
Citation: Philip JL, Yang DY, Wang X .
Effect of transfer status on outcomes of emergency general surgery patients.
Surgery 2020 Aug;168(2):280-86. doi: 10.1016/j.surg.2020.01.005..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Transitions of Care, Mortality, Outcomes, Healthcare Costs, Hospitals
Arulraja MD, Swanson MB, NM
Double inter-hospital transfer in sepsis patients presenting to the ED does not worsen mortality compared to single inter-hospital transfer.
This study investigated whether double inter-hospital transfer in sepsis patients presenting to the emergency department (ED) worsens mortality compared to single inter-hospital transfer. A retrospective cohort study was conducted using 2005-2014 administrative claims data in Iowa. Hospital length-of-stay and cost data was also collected. Compared to non-transfers, single transfers did not have higher mortality rates than double transfers of Iowa sepsis patients.
AHRQ-funded; HS025753.
Citation: Arulraja MD, Swanson MB, NM .
Double inter-hospital transfer in sepsis patients presenting to the ED does not worsen mortality compared to single inter-hospital transfer.
J Crit Care 2020 Apr;56:49-57. doi: 10.1016/j.jcrc.2019.11.018..
Keywords: Sepsis, Transitions of Care, Mortality, Hospitals, Emergency Department, Outcomes
Dworsky JQ, Childers CP, Gornbein J
Hospital experience predicts outcomes after high-risk geriatric surgery.
This study examined if there an association between a hospital’s annual volume of high-risk geriatric surgery and their risk of inpatient mortality, postoperative length of stay, and discharge to nursing facility. Using the 2014 National Inpatient Sample, older adults were identified who had undergone high-risk geriatric surgery. There were an estimated 514,950 hospital encounters at 3,115 hospitals undergoing surgery. A higher proportion of high-risk geriatric surgery patients was associated with decreased mortality and shorter postoperative length of stay. Higher volume hospitals were not associated with mortality but was associated with longer length of stay and decreased discharge to nursing facilities.
AHRQ-funded; HS000046; HS025079.
Citation: Dworsky JQ, Childers CP, Gornbein J .
Hospital experience predicts outcomes after high-risk geriatric surgery.
Surgery 2020 Feb;167(2):468-74. doi: 10.1016/j.surg.2019.07.026..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Surgery, Risk, Hospitals, Outcomes, Mortality
Williams CN, Eriksson CO, Kirby A
Hospital mortality and functional outcomes in pediatric neurocritical care.
Pediatric neurocritical care (PNCC) outcomes research is scarce. In this study, the investigators aimed to expand knowledge about outcomes in PNCC by evaluating death and changes in Functional Status Scale (FSS) from baseline among PNCC diagnoses. The investigators concluded that PNCC patients had high rates of death and new disability at discharge, varying significantly between PNCC diagnoses. Multiple domains of disability were affected, underscoring the ongoing multidisciplinary health care needs of survivors.
AHRQ-funded; HS022981.
Citation: Williams CN, Eriksson CO, Kirby A .
Hospital mortality and functional outcomes in pediatric neurocritical care.
Hosp Pediatr 2019 Dec;9(12):958-66. doi: 10.1542/hpeds.2019-0173..
Keywords: Children/Adolescents, Newborns/Infants, Intensive Care Unit (ICU), Critical Care, Neurological Disorders, Mortality, Hospitals, Inpatient Care, Outcomes, Patient-Centered Outcomes Research
Mueller S, Zheng J, Orav EJ
Inter-hospital transfer and patient outcomes: a retrospective cohort study.
Inter-hospital transfer (IHT, the transfer of patients between hospitals) occurs regularly and exposes patients to risks of discontinuity of care, though outcomes of transferred patients remains largely understudied. The purpose of this retrospective cohort study was to evaluate the association between IHT and healthcare utilisation and clinical outcomes. The investigators concluded that IHT was associated with higher costs, longer LOS and lower odds of discharge home, but was differentially associated with odds of early death and 30 -day mortality depending on patients' disease category.
AHRQ-funded; HS023331.
Citation: Mueller S, Zheng J, Orav EJ .
Inter-hospital transfer and patient outcomes: a retrospective cohort study.
BMJ Qual Saf 2019 Nov;28(11):e1. doi: 10.1136/bmjqs-2018-008087..
Keywords: Transitions of Care, Hospitals, Patient Safety, Elderly, Outcomes, Chronic Conditions, Mortality, Medicare
Vanderlaan J, Rochat R, Williams B
Associations between hospital maternal service level and delivery outcomes.
This study explored the associations between delivery hospital self-reported level of maternal service, as defined by the American Hospital Association, and both maternal and neonatal outcomes among women at high maternal risk, as defined by the Obstetric Comorbidity Index. The investigators concluded that for the group of pregnant women in need of maternal transfer, delivery hospital self-reported level of maternal care was not associated with the odds of poor maternal or neonatal outcomes.
AHRQ-funded; HS024655.
Citation: Vanderlaan J, Rochat R, Williams B .
Associations between hospital maternal service level and delivery outcomes.
Womens Health Issues 2019 May - Jun;29(3):252-58. doi: 10.1016/j.whi.2019.02.004..
Keywords: Maternal Care, Labor and Delivery, Pregnancy, Women, Outcomes, Hospitals, Quality of Care, Newborns/Infants, Mortality
Shah S, Xian Y, Sheng S
Use, temporal trends, and outcomes of endovascular therapy after interhospital transfer in the United States.
This study examined the use, trends and outcomes of endovascular therapy (EVT) after interhospital transfer in the United Sates. This cohort study analyzed trends from over 1.8 million patients with ischemic stroke admitted to 2143 Get With The Guidelines-Stroke participating hospitals between 2012 and 2017. There were differences in mortality for interhospital transfer patients, although those differences disappeared after adjusting for delay in EVT initiation.
AHRQ-funded; HS024561.
Citation: Shah S, Xian Y, Sheng S .
Use, temporal trends, and outcomes of endovascular therapy after interhospital transfer in the United States.
Circulation 2019 Mar 26;139(13):1568-77. doi: 10.1161/circulationaha.118.036509..
Keywords: Stroke, Cardiovascular Conditions, Transitions of Care, Outcomes, Healthcare Delivery, Hospitals, Mortality, Quality of Care
Austrian JS, Jamin CT, Doty GR
Impact of an emergency department electronic sepsis surveillance system on patient mortality and length of stay.
The goal of this study was to determine if an electronic health record (EHR) based sepsis alert system could improve quality of care and clinical outcomes for patients with sepsis. A patient-level, interrupted time series study of emergency department patients with severe sepsis or septic shock was conducted, with an intervention introduced at the approximate mid-point--a system of interruptive sepsis alerts triggered by abnormal vital signs or laboratory results. Mean length of stay for patients with sepsis decreased significantly following the introduction of the alert, but the alert system had no effect on mortality or other clinical or process measures. The researchers conclude that a more sophisticated algorithm for sepsis identification is needed to improve outcomes.
AHRQ-funded; HS023683.
Citation: Austrian JS, Jamin CT, Doty GR .
Impact of an emergency department electronic sepsis surveillance system on patient mortality and length of stay.
J Am Med Inform Assoc 2018 May;25(5):523-29. doi: 10.1093/jamia/ocx072..
Keywords: Electronic Health Records (EHRs), Emergency Department, Health Information Technology (HIT), Hospitals, Mortality, Outcomes, Quality Improvement, Quality of Care, Sepsis
Spatz ES, Wang Y, Beckman AL
Traditional Chinese medicine for acute myocardial infarction in western medicine hospitals in China.
This study examined the use of traditional Chinese medicine (TCM) in patients admitted for acute myocardial infarction (AMI) in China during the first 24 hours of hospitalization. The data came from the China Patient-centered Evaluative Assessment of Cardiac Events Retrospective Study of Acute Myocardial Infarction. A chart review was done of randomly sampled patients in 2001, 2006 and 2011 in 162 Western medicine hospitals across China. Nearly all (99%) hospitals used some form of TCM, with Salvia miltiorrhiza being the most commonly prescribed. This TCM treatment (and others) was used intravenously and use has increased over the span of the study, despite lack of evidence of benefit or harm.
AHRQ-funded; HS023000.
Citation: Spatz ES, Wang Y, Beckman AL .
Traditional Chinese medicine for acute myocardial infarction in western medicine hospitals in China.
Circ Cardiovasc Qual Outcomes 2018 Mar;11(3):e004190. doi: 10.1161/circoutcomes.117.004190..
Keywords: Adverse Events, Cardiovascular Conditions, Complementary and Alternative Medicine, Heart Disease and Health, Hospitals, Mortality, Outcomes, Patient-Centered Outcomes Research, Patient Safety, Practice Patterns, Risk
Burke RE, Jones CD, Hosokawa P
Influence of nonindex hospital readmission on length of stay and mortality.
The purpose of this study was to describe the prevalence of nonindex 30-day readmissions in a nationally representative sample of all payers and associations with outcomes. The investigators conclude that nonindex readmissions are common and associated with worse outcomes; the common findings across cohorts highlighted the importance for hospitals and care systems participating in value-based payment models.
AHRQ-funded; HS024569.
Citation: Burke RE, Jones CD, Hosokawa P .
Influence of nonindex hospital readmission on length of stay and mortality.
Med Care 2018 Jan;56(1):85-90. doi: 10.1097/mlr.0000000000000829..
Keywords: Hospitals, Mortality, Outcomes, Hospital Readmissions
Brooke BS, Goodney PP, Kraiss LW
Readmission destination and risk of mortality after major surgery: an observational cohort study.
This study examined the association between readmission destination and mortality risk in the USA in Medicare beneficiaries after a range of common operations. It found that patients who are readmitted to hospital after various major operations consistently achieve improved survival if they return to the hospital where their surgery took place.
AHRQ-funded; HS021581.
Citation: Brooke BS, Goodney PP, Kraiss LW .
Readmission destination and risk of mortality after major surgery: an observational cohort study.
Lancet 2015 Aug 29;386(9996):884-95. doi: 10.1016/s0140-6736(15)60087-3..
Keywords: Hospital Readmissions, Mortality, Surgery, Elderly, Outcomes, Hospitals