National Healthcare Quality and Disparities Report
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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 25 of 55 Research Studies DisplayedO'Leary KJ, Johnson JK, Williams MV
Effect of complementary interventions to redesign care on teamwork and quality for hospitalized medical patients: a pragmatic controlled trial.
The objective of this pragmatic controlled trial was to evaluate the effect of interventions to redesign hospital care delivery on teamwork and patient outcomes. Survey participants were healthcare professionals and hospitalized medical patients in medical units at four U.S. hospitals. The results showed that the median teamwork climate score was higher after the intervention among nurses, but that interventions to redesign care for hospitalized patients were not associated with improved patient outcomes.
AHRQ-funded; HS02564.
Citation: O'Leary KJ, Johnson JK, Williams MV .
Effect of complementary interventions to redesign care on teamwork and quality for hospitalized medical patients: a pragmatic controlled trial.
Ann Intern Med 2023 Nov; 176(11):1456-64. doi: 10.7326/m23-0953..
Keywords: Teams, Inpatient Care, Hospitals, Quality of Care, Outcomes
Mullens CL, Lussiez A, Scott JW
Association of health professional shortage area hospital designation with surgical outcomes and expenditures among Medicare beneficiaries.
This study’s objective was to compare surgical outcomes and expenditures at hospitals located in Health Professional Shortage Areas to nonshortage area designated hospitals among Medicare beneficiaries. This cross-sectional retrospective study used data from 842,787 Medicare beneficiary patient admissions to hospitals with and without Health Professional Shortage Area designations for common operations including appendectomy, cholecystectomy, colectomy, and hernia repair from 2014 to 2018. Primary outcomes measures were 30-day mortality, hospital readmissions, and 30-day surgical episode payments. Patients (mean age=75.6 years, males=44.4%) undergoing common surgical procedures in shortage area hospitals were less likely to be White (84.6% vs 88.4%) and less likely to have≥2 Elixhauser comorbidities (75.5% vs 78.2%). Patients undergoing surgery at Health Professional Shortage Area hospitals had lower risk-adjusted rates of 30-day mortality (6.05% vs 6.69%) and readmission (14.99% vs 15.74%). Medicare expenditures at Health Professional Shortage Area hospitals were also lower than nonshortage designated hospitals ($28,517 vs $29,685).
AHRQ-funded; HS028606; HS028672.
Citation: Mullens CL, Lussiez A, Scott JW .
Association of health professional shortage area hospital designation with surgical outcomes and expenditures among Medicare beneficiaries.
Ann Surg 2023 Oct 1; 278(4):e733-e39. doi: 10.1097/sla.0000000000005762..
Keywords: Hospitals, Surgery, Medicare, Healthcare Costs, Workforce, Outcomes
Thumma SR, Dualeh SHA, Kunnath NJ
Outcomes for high-risk surgical procedures across high- and low-competition hospital markets.
The purpose of this retrospective study was to assess whether there is a relationship between hospital market competition and outcomes post high-risk surgery. The study included Medicare beneficiaries 65 years and older who electively underwent 1 of 10 high-risk surgical procedures. Procedures included: bariatric surgery, carotid endarterectomy, esophagectomy hip replacement, knee replacement, mitral lung resection valve repair, open aortic aneurysm repair, pancreatectomy, and rectal resection. Hospitals were categorized into high-competition and low-competition markets based on the hospital market Herfindahl-Hirschman index. The primary outcome was 30-day postoperative mortality and readmissions. The study found that when analyzed by procedure, compared with low-competition hospitals, high-competition market hospitals demonstrated higher 30-day mortality for 2 of 10 procedures (mitral valve repair and carotid endarterectomy) and no difference for 5 of 10 procedures (open aortic aneurysm repair, bariatric surgery, esophagectomy, knee replacement, and hip replacement.) High-competition hospitals also demonstrated 30-day readmissions that were higher for 5 of 10 procedures (carotid endarterectomy, knee replacement, mitral valve repair, open aortic aneurysm repair, and rectal resection) and no difference for 3 procedures (bariatric surgery, esophagectomy: and pancreatectomy.) Hospitals in high-competition compared with low-competition markets cared for patients who were older, were more likely to be racial and ethnic minority individuals and had more comorbidities.
AHRQ-funded; HS028963; HS028606.
Citation: Thumma SR, Dualeh SHA, Kunnath NJ .
Outcomes for high-risk surgical procedures across high- and low-competition hospital markets.
JAMA Surg 2023 Oct; 158(10):1041-48. doi: 10.1001/jamasurg.2023.3221..
Keywords: Surgery, Outcomes, Hospitals
Mullens CL, Lussiez A, Scott JW
High-risk surgery among Medicare beneficiaries living in health professional shortage areas.
This study’s objective was to compare high-risk surgical outcomes at hospitals located in Health Professional Shortage Areas to nonshortage area designated hospitals among Medicare beneficiaries. The authors performed a retrospective review of Medicare beneficiaries living in health professional shortage areas and nonshortage areas who underwent abdominal aortic aneurysm repair, coronary artery bypass graft, esophagectomy, liver resection, pancreatectomy, or rectal resection between 2014 and 2018. They compared rates of postoperative complications and 30-day mortality between the patient cohorts. They used beneficiary and hospital ZIP codes to quantify travel time to obtain care. Compared with patients living in nonshortage areas, patients living in health professional shortage areas traveled longer (median 60.0 vs 28.0 minutes). There were no differences in risk-adjusted rates of complications (28.5% vs 28.6%) and small differences in rates of 30-day mortality (4.2% vs 4.4%) between beneficiaries living in shortage areas versus those not in shortage areas, respectively.
AHRQ-funded; HS028606; HS028672; HS027788.
Citation: Mullens CL, Lussiez A, Scott JW .
High-risk surgery among Medicare beneficiaries living in health professional shortage areas.
J Rural Health 2023 Sep; 39(4):824-32. doi: 10.1111/jrh.12748..
Keywords: Surgery, Hospitals, Workforce, Medicare, Outcomes
Nguyen JK, P P
Comparison of survival outcomes among older adults with major trauma after trauma center versus non-trauma center care in the United States.
This study’s objective was to compare level 1 and 2 trauma centers with similarly sized non-trauma centers on survival after major trauma among older adults. The authors used claims of 100% of 2012-2017 Medicare fee-for-service beneficiaries who received hospital care after major trauma. They assessed the roles of prehospital care, hospital quality, and volume. Thirty-day mortality was higher overall at level 1 versus non-trauma centers by 2.2 percentage points (pp). Thirty-day mortality was higher at level 1 versus non-trauma centers by 2.3 pp for falls and 2.3 pp for motor vehicle crashes. Outcomes were similar at level 1 and 2 trauma centers. The difference was not explained by hospital quality and volume. There were also no statistical differences in the ambulance-transported group, after adjusting for prehospital variables.
AHRQ-funded; HS025720.
Citation: Nguyen JK, P P .
Comparison of survival outcomes among older adults with major trauma after trauma center versus non-trauma center care in the United States.
Health Serv Res 2023 Aug; 58(4):817-27. doi: 10.1111/1475-6773.14148..
Keywords: Elderly, Trauma, Outcomes, Injuries and Wounds, Emergency Department, Hospitals
Silver CM, Yang AD, Shan Y
Changes in surgical outcomes in a Statewide Quality Improvement Collaborative with introduction of simultaneous, comprehensive interventions.
Researchers investigated whether a comprehensive quality improvement program implemented simultaneously across hospitals at the formation of a quality improvement collaborative (QIC) would improve patient outcomes. They analyzed risk-adjusted rates of postoperative morbidity and mortality for patients who had undergone surgery at hospitals in the Illinois Surgical Quality Improvement Collaborative (ISQIC); analyses compared ISQIC hospitals with hospitals in the NSQIP Participant Use File (PUF). Although complication rates decreased at both ISQIC and PUF hospitals, findings showed that participation in ISQIC was associated with a significantly greater improvement in death or serious morbidity. The researchers concluded that these results emphasize the potential of QICs to improve patient outcomes.
AHRQ-funded; HS024516.
Citation: Silver CM, Yang AD, Shan Y .
Changes in surgical outcomes in a Statewide Quality Improvement Collaborative with introduction of simultaneous, comprehensive interventions.
J Am Coll Surg 2023 Jul 1; 237(1):128-38. doi: 10.1097/xcs.0000000000000679..
Keywords: Surgery, Outcomes, Quality Improvement, Quality of Care, Hospitals
Taylor K, Diaz A, Nuliyalu U
Association of dual Medicare and Medicaid eligibility with outcomes and spending for cancer surgery in high-quality hospitals.
The purpose of this study was to assess whether treatment at high-quality hospitals mitigates dual-eligibility-associated disparities in outcomes and spending for cancer surgery. Medicare beneficiaries 65 years or older who underwent colectomy, rectal resection, lung resection, or pancreatectomy were evaluated. The findings indicate that, even among the highest-quality hospitals, dual-eligibility patients had poorer outcomes and higher spending. Dually eligible patients were more likely to be discharged to a facility and thus incurred higher post-acute care costs. Although treatment at high-quality hospitals is associated with reduced differences in outcomes, dual-eligibility patients remain at high risk for adverse post-operative outcomes as well as increased readmissions and post-acute care use.
AHRQ-funded; HS024763.
Citation: Taylor K, Diaz A, Nuliyalu U .
Association of dual Medicare and Medicaid eligibility with outcomes and spending for cancer surgery in high-quality hospitals.
JAMA Surg 2022 Apr;157(4):e217586. doi: 10.1001/jamasurg.2021.7586..
Keywords: Cancer, Surgery, Medicare, Medicaid, Outcomes, Hospitals
Bergman ZR, Usher M, Olson A
Comparison of outcomes and process of care for patients treated at hospitals dedicated for COVID-19 care vs other hospitals.
The purpose of this study was to analyze the mortality rate and complications associated with treatment at the COVID-19-dedicated hospitals. Findings showed that, in this cohort study, COVID-19-dedicated hospitals in Minnesota had multiple benefits, including providing high-volume repetitive treatment and isolating patients with the infection. This experience suggests improved in-hospital mortality for patients treated at dedicated hospitals.
AHRQ-funded; HS026732; HS026379.
Citation: Bergman ZR, Usher M, Olson A .
Comparison of outcomes and process of care for patients treated at hospitals dedicated for COVID-19 care vs other hospitals.
JAMA Netw Open 2022 Mar;5(3):e220873. doi: 10.1001/jamanetworkopen.2022.0873..
Keywords: COVID-19, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes, Healthcare Delivery, Hospitals
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.
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
Thompson MP, Yaser JM, Hou H
Determinants of hospital variation in cardiac rehabilitation enrollment during coronary artery disease episodes of care.
Cardiac rehabilitation (CR) is associated with improved outcomes for patients with coronary artery disease (CAD). However, CR enrollment remains low and there is a dearth of real-world data on hospital-level variation in CR enrollment. In this study, the investigators sought to explore determinants of hospital variability in CR enrollment during CAD episodes of care: medical management of acute myocardial infarction (AMI-MM), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG).
AHRQ-funded; HS026003.
Citation: Thompson MP, Yaser JM, Hou H .
Determinants of hospital variation in cardiac rehabilitation enrollment during coronary artery disease episodes of care.
Circ Cardiovasc Qual Outcomes 2021 Feb;14(2):e007144. doi: 10.1161/circoutcomes.120.007144..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Rehabilitation, Outcomes, Patient-Centered Outcomes Research, Hospitals
Kohn R, Harhay MO, Bayes B
Influence of bedspacing on outcomes of hospitalised medicine service patients: a retrospective cohort study.
The objective of this cohort study was to assess the association of bedspacing with patient-centered outcomes among United States patients admitted to general medicine services. The study compared internal medicine, family medicine and geriatric service patients who were bedspaced versus cohorted for the entirety of their hospital stay within three large, urban hospitals. Findings showed that bedspacing was associated with adverse patient-centered outcomes. Recommendations for future work included a need to confirm these findings, to understand mechanisms contributing to adverse outcomes, and to identify factors that mitigate these adverse effects in order to provide high-value, patient-centered care to hospitalized patients.
AHRQ-funded; HS026372.
Citation: Kohn R, Harhay MO, Bayes B .
Influence of bedspacing on outcomes of hospitalised medicine service patients: a retrospective cohort study.
BMJ Qual Saf 2021 Feb;30(2):116-22. doi: 10.1136/bmjqs-2019-010675..
Keywords: Patient-Centered Outcomes Research, Outcomes, Inpatient Care, Hospitals, Healthcare Delivery, Care Management, Adverse Events
Anesi GL, Chelluri J, Qasim ZA
Association of an emergency department-embedded critical care unit with hospital outcomes and intensive care unit use.
The purpose of this study was to evaluate the potential impact of an emergency department-embedded critical care unit (CCU) at the Hospital of the University of Pennsylvania among patients with sepsis and acute respiratory failure (ARF) admitted from the emergency department to a medical ward or ICU from January 2016 to December 2017. Findings showed that the emergency department-embedded CCU was not associated with clinical outcomes among patients admitted with sepsis or ARF. Among less sick patients with sepsis, the emergency department-embedded CCU was initially associated with reduced rates of direct ICU admission from the emergency department. Further research was recommended to further evaluate the impact and utility of the emergency department-embedded CCU model.
AHRQ-funded; HS026372.
Citation: Anesi GL, Chelluri J, Qasim ZA .
Association of an emergency department-embedded critical care unit with hospital outcomes and intensive care unit use.
Ann Am Thorac Soc 2020 Dec;17(12):1599-609. doi: 10.1513/AnnalsATS.201912-912OC..
Keywords: Emergency Department, Critical Care, Intensive Care Unit (ICU), Hospitals, Sepsis, Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research, Healthcare Delivery
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
Hall KK, Lim A, Gale B
The use of rapid response teams to reduce failure to rescue events: a systematic review.
This systematic review looked at studies on the evidence on the impact of rapid response teams (RRTs) on failure to rescue events. Articles from 2008 to 2018 were found on the impact of RRTs on failure to rescue events, including hospital mortality and in-hospital cardiac arrest events. Ten articles were identified for inclusion. Patient outcomes included hospital mortality (8 studies), in-hospital cardiac arrests (9 studies) and ICU transfer rates (5 studies). Moderate evidence was found linking the implementation of RRTs with decreased mortality and non-ICU cardiac arrest rates. Results linking RRTs to ICU transfer rates were inconclusive. Benefits of RRTs may take some time after implementation to be realized.
AHRQ-funded; 233201500013I.
Citation: Hall KK, Lim A, Gale B .
The use of rapid response teams to reduce failure to rescue events: a systematic review.
J Patient Saf 2020 Sep;16(3S Suppl 1):S3-s7. doi: 10.1097/pts.0000000000000748..
Keywords: Teams, Inpatient Care, Hospitals, Evidence-Based Practice, Outcomes, Patient-Centered Outcomes Research
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
Gigli KH, Davis BS, Yabes JG
Pediatric outcomes after regulatory mandates for sepsis care.
The authors used hospital discharge data from 2011 to 2015 to compare changes in pediatric sepsis outcomes in New York and four control states following New York’s 2013 regulations mandating that hospitals develop pediatric-specific protocols for sepsis recognition and treatment. They found that implementation of statewide sepsis regulations was generally associated with improved mortality trends in New York State, particularly in prespecified subpopulations of patients, suggesting that the regulations were successful in affecting sepsis outcomes.
AHRQ-funded; HS025146.
Citation: Gigli KH, Davis BS, Yabes JG .
Pediatric outcomes after regulatory mandates for sepsis care.
Pediatrics 2020 Jul;146(1). doi: 10.1542/peds.2019-3353.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Sepsis, Outcomes, Hospitals
Smith ME, Shubeck SP, Nuliyalu U
Local referral of high-risk patients to high-quality hospitals: surgical outcomes, cost savings, and travel burdens.
In this study, the investigators sought to assess the potential changes in Medicare payments and clinical outcomes of referring high-risk surgical patients to local high-quality hospitals within small geographic areas. The investigators concluded that complication rates and Medicare payments were significantly lower for high-risk patients treated at local high-quality hospitals. The investigators suggest that triaging high-risk patients to local high-quality hospitals within small geographic areas may serve as a template for improving the value of surgical care.
AHRQ-funded; HS024763.
Citation: Smith ME, Shubeck SP, Nuliyalu U .
Local referral of high-risk patients to high-quality hospitals: surgical outcomes, cost savings, and travel burdens.
Ann Surg 2020 Jun;271(6):1065-71. doi: 10.1097/sla.0000000000003208..
Keywords: Surgery, Healthcare Costs, Hospitals, Medicare, Outcomes
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
Smith ME, Nuliyalu U, Dimick JB
Local referral of high-risk pancreatectomy patients to improve surgical outcomes and minimize travel burden.
Referring patients to high-quality hospitals for complex procedures may improve outcomes. This is most feasible within small geographic areas. However, access to specialized surgical procedures may be an implementation barrier. In this study, the investigators sought to determine the availability of high-quality hospitals performing pancreatectomy and the potential benefit and travel burden of referral within small geographic areas.
AHRQ-funded; HS024763.
Citation: Smith ME, Nuliyalu U, Dimick JB .
Local referral of high-risk pancreatectomy patients to improve surgical outcomes and minimize travel burden.
J Gastrointest Surg 2020 Apr;24(4):882-89. doi: 10.1007/s11605-019-04245-6..
Keywords: Surgery, Hospitals, Outcomes, Quality of Care
Colton K, Richards CT, Pruitt PB
Early stroke recognition and time-based emergency care performance metrics for intracerebral hemorrhage.
This study compared time for early stroke recognition for intracerebral hemorrhage for hospitals with and without stroke teams. An observational cohort study was conducted at an urban comprehensive stroke center from 2009 to 2017 with 204 cases included. Stroke team activation resulted in faster emergency care compared to no activation. This process resulted in shorter onset-to-arrival times, higher NIH Stroke Scale scores, and higher Glasgow Coma Scale scores.
AHRQ-funded; HS023437.
Citation: Colton K, Richards CT, Pruitt PB .
Early stroke recognition and time-based emergency care performance metrics for intracerebral hemorrhage.
J Stroke Cerebrovasc Dis 2020 Feb;29(2):104552. doi: 10.1016/j.jstrokecerebrovasdis.2019.104552..
Keywords: Stroke, Emergency Department, Provider Performance, Diagnostic Safety and Quality, Quality Improvement, Quality Indicators (QIs), Patient-Centered Outcomes Research, Outcomes, Quality of Care, Evidence-Based Practice, Hospitals
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
Yu K, Westbrook M, Brodie S
Gaps in treatment and surveillance: head and neck cancer care in a safety-net hospital.
Treatment delays and suboptimal adherence to posttreatment surveillance may adversely affect head and neck cancer (HNC) outcomes. Such challenges can be exacerbated in safety-net settings that struggle with limited resources and serve a disproportionate number of patients vulnerable to gaps in care. This study aimed to characterize treatment delays and adherence with posttreatment surveillance in HNC care at an urban tertiary care public hospital in San Francisco.
AHRQ-funded; HS023558.
Citation: Yu K, Westbrook M, Brodie S .
Gaps in treatment and surveillance: head and neck cancer care in a safety-net hospital.
OTO Open 2020 Jan-Mar;4(1):2473974x19900761. doi: 10.1177/2473974x19900761..
Keywords: Cancer, Hospitals, Outcomes
Carey K, Morgan JR, Lin MY
Patient outcomes following total joint replacement surgery: a comparison of hospitals and ambulatory surgery centers.
This study used a large claims database of non-Medicare patients to examine inpatient and outpatient total knee replacement and total hip replacement surgery performed on a near-elderly population during 2014-2016. Findings support the argument that outpatient total joint replacement is appropriate for select patients treated in both hospital outpatient departments and ambulatory surgery centers, although in the commercially insured population, the latter services may come at a cost. Until further study of outpatient total joint replacement in the Medicare population becomes available, how this will extrapolate to the Medicare population is unknown.
AHRQ-funded; HS022242.
Citation: Carey K, Morgan JR, Lin MY .
Patient outcomes following total joint replacement surgery: a comparison of hospitals and ambulatory surgery centers.
J Arthroplasty 2020 Jan;35(1):7-11. doi: 10.1016/j.arth.2019.08.041..
Keywords: Orthopedics, Surgery, Ambulatory Care and Surgery, Hospitals, Outcomes
Sheetz KH, Dimick JB, Nathan H
Centralization of high-risk cancer surgery within existing hospital systems.
Centralization is often proposed as a strategy to improve the quality of certain high-risk health care services. In this study, the investigators evaluated the extent to which existing hospital systems centralize high-risk cancer surgery and whether centralization is associated with short-term clinical outcomes. The investigators concluded that greater centralization of complex cancer surgery within existing hospital systems was associated with better outcomes.
AHRQ-funded; HS023597.
Citation: Sheetz KH, Dimick JB, Nathan H .
Centralization of high-risk cancer surgery within existing hospital systems.
J Clin Oncol 2019 Dec 1;37(34):3234-42. doi: 10.1200/jco.18.02035..
Keywords: Surgery, Cancer, Risk, Hospitals, Health Systems, Quality Improvement, Quality Indicators (QIs), Quality of Care, Outcomes