National Healthcare Quality and Disparities Report
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- Adverse Drug Events (ADE) (1)
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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 7 of 7 Research Studies DisplayedMcGarry BE, Mao Y, Nelson D
Hospital proximity and emergency department use among assisted living residents.
The purpose of this retrospective cohort study was to explore the association between the distance of assisted living (AL) communities to the nearest hospital and AL residents' rates of emergency department (ED) utilization. The researchers hypothesized that when access to an ED is a shorter distance, AL-to-ED transfers are more common, especially for non-emergency conditions. The study found that among 540,944 resident-years from 16,514 AL communities, the median distance to the closest hospital was 2.5 miles. After statistical adjustment, a doubling of distance to the closest hospital was related with 43.5 fewer ED treat-and-release visits per 1000 resident years and no significant difference in the rate of ED visits resulting in an inpatient admission. Among ED treat-and-release visits, a doubling of distance was related with a 3.0% decrease in visits classified as nonemergent, and a 1.6% decrease in visits classified as emergent, not primary care treatable.
AHRQ-funded; HS026893.
Citation: McGarry BE, Mao Y, Nelson D .
Hospital proximity and emergency department use among assisted living residents.
J Am Med Dir Assoc 2023 Sep; 24(9):1349-55.e.5. doi: 10.1016/j.jamda.2023.05.002..
Keywords: Emergency Department, Elderly, Long-Term Care, Medicare, Hospitals
Montoya A, Jenq G, Mills JP
Partnering with local hospitals and public health to manage COVID-19 outbreaks in nursing homes.
In this study, the authors described, among short-term and long-term residents at three nursing homes (NHs) in Michigan, the outbreak identification process, universal testing, point prevalence of COVID-19, and subsequent containment efforts, outcomes, and challenges. They found that proactive and coordinated steps between NH medical directors and administrators, referral hospitals including their laboratories, and local public health officials were necessary to respond rapidly to an outbreak and to limit the transmission of COVID-19. They suggested that this coordinated public health approach may save lives, minimize the burden to the healthcare system, and reduce healthcare costs.
AHRQ-funded; HS025451.
Citation: Montoya A, Jenq G, Mills JP .
Partnering with local hospitals and public health to manage COVID-19 outbreaks in nursing homes.
J Am Geriatr Soc 2021 Jan;69(1):30-36. doi: 10.1111/jgs.16869..
Keywords: Hospitals, Nursing Homes, Long-Term Care, Public Health, COVID-19, Elderly, Infectious Diseases
Makam AN, Nguyen OK, Miller ME
Comparative effectiveness of long-term acute care hospital versus skilled nursing facility transfer.
This study compared the effectiveness of long-term acute care hospital (LTACH) use versus skilled nursing facility (SNF) transfer after hospitalization. Medicare claims linked to electronic health record (EHR) data from six Texas hospitals between 2009 and 2010 were used to conduct a retrospective cohort study of hospitalized patients transferred to either an LTACH or SNF and followed for one year. Out of 3505 patients, 18% were transferred to an LTACH and overall were younger, less likely to be female, and white, but sicker than transfers to an SNF. Patients transferred to an LTACH were less likely to survive (59 vs. 65%) or recover (62.5 vs 66%). Adjusting for demographic and clinical confounders found in Medicare claims and EHR data, transfer location was not significantly associated with differences in mortality but was associated with greater Medicare spending.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Miller ME .
Comparative effectiveness of long-term acute care hospital versus skilled nursing facility transfer.
BMC Health Serv Res 2020 Nov 11;20(1):1032. doi: 10.1186/s12913-020-05847-6..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Long-Term Care, Elderly, Medicare, Transitions of Care, Nursing Homes, Hospitals
Popescu I, Sood N, Joshi S
Trends in the use of skilled nursing facility and home health care under the Hospital Readmissions Reduction Program: an interrupted time-series analysis.
Medicare's Hospital Readmission Reduction Program penalizes hospitals with elevated 30-day readmission rates for acute myocardial infarction, heart failure, or pneumonia. The authors investigated if, in order to reduce readmissions, hospitals may have increased referrals to skilled nursing facilities and home health care. They found that hospitals might be shifting to more intensive postacute care to avoid readmissions among seniors with pneumonia. At the same time, penalized hospitals' efforts to prevent readmissions may be keeping higher proportions of their patients in the community.
AHRQ-funded; HS024284; HS025394.
Citation: Popescu I, Sood N, Joshi S .
Trends in the use of skilled nursing facility and home health care under the Hospital Readmissions Reduction Program: an interrupted time-series analysis.
Med Care 2019 Oct;57(10):757-65. doi: 10.1097/mlr.0000000000001184..
Keywords: Home Healthcare, Nursing Homes, Chronic Conditions, Hospital Readmissions, Long-Term Care, Hospitals, Heart Disease and Health, Pneumonia, Cardiovascular Conditions
Makam AN, Nguyen OK, Kirby B
Effect of site-neutral payment policy on long-term acute care hospital use.
The purpose of this study was to assess the projected effect of the Centers for Medicare and Medicaid Services new site-neutral payment policy, which aims to decrease unnecessary long-term acute care hospital (LTACH) admissions by reducing reimbursements for less-ill individuals by 2020. The investigators concluded that the site-neutral payment policy may limit LTACH access in existing LTAC-scarce markets, with potential adverse implications for recovery of hospitalized older adults.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Kirby B .
Effect of site-neutral payment policy on long-term acute care hospital use.
J Am Geriatr Soc 2018 Nov;66(11):2104-11. doi: 10.1111/jgs.15539..
Keywords: Policy, Hospitalization, Payment, Long-Term Care, Healthcare Costs, Medicare, Elderly, Hospitals
Makam AN, Nguyen OK, Xuan L
Factors associated with variation in long-term acute care hospital vs skilled nursing facility use among hospitalized older adults.
This study examined factors associated with variation in long-term acute care hospitals (LTACs) vs less costly skilled nursing facilities (SNFs) transfer among hospitalized older adults. It concluded that half of the variation in LTAC vs SNF transfer is independent of patients' illness severity or clinical complexity, and is explained by where the patient was hospitalized and in what region, with far greater use in the South.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Xuan L .
Factors associated with variation in long-term acute care hospital vs skilled nursing facility use among hospitalized older adults.
JAMA Intern Med 2018 Mar;178(3):399-405. doi: 10.1001/jamainternmed.2017.8467.
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Keywords: Elderly, Long-Term Care, Hospitals, Nursing Homes, Transitions of Care
Kerstenetzky L, Birschbach MJ, Beach KF
Improving medication information transfer between hospitals, skilled-nursing facilities, and long-term-care pharmacies for hospital discharge transitions of care: a targeted needs assessment using the Intervention Mapping framework.
The authors of this study report on the development of a logic model that will be used to explore methods for minimizing patient care medication delays and errors while further improving handoff communication to skilled nurse facilities and long term care pharmacy staff.
AHRQ-funded; HS021984.
Citation: Kerstenetzky L, Birschbach MJ, Beach KF .
Improving medication information transfer between hospitals, skilled-nursing facilities, and long-term-care pharmacies for hospital discharge transitions of care: a targeted needs assessment using the Intervention Mapping framework.
Res Social Adm Pharm 2018 Feb;14(2):138-45. doi: 10.1016/j.sapharm.2016.12.013..
Keywords: Adverse Drug Events (ADE), Hospital Discharge, Hospitals, Long-Term Care, Medical Errors, Medication, Medication: Safety, Nursing Homes, Patient Safety, Transitions of Care