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
176 to 200 of 323 Research Studies DisplayedYang L, Liu C, Huang C
Patients' perceptions of interactions with hospital staff are associated with hospital readmissions: a national survey of 4535 hospitals.
The researchers examined the extent to which patients' experience with hospital care is related to hospital readmission. Their finding suggests that hospitals with better staff responsiveness were significantly more likely to have lower 30-day readmissions for all conditions. The effect size depended on the baseline readmission rates, with the largest effect on hospitals in the upper 75th quartile.
AHRQ-funded; HS021844.
Citation: Yang L, Liu C, Huang C .
Patients' perceptions of interactions with hospital staff are associated with hospital readmissions: a national survey of 4535 hospitals.
BMC Health Serv Res 2018 Jan 29;18(1):50. doi: 10.1186/s12913-018-2848-9.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Patient Experience, Patient Experience, Hospital Readmissions
Smith LN, Makam AN, Darden D
Acute myocardial infarction readmission risk prediction models: a systematic review of model performance.
The performance of acute myocardial infarction (AMI)-specific readmission risk prediction models is unknown. This review concluded that current AMI-specific readmission risk prediction models have modest predictive ability and uncertain generalizability given methodological limitations. No existing models provide actionable information in real time to enable early identification and risk-stratification of patients with AMI before hospital discharge.
AHRQ-funded; HS022418.
Citation: Smith LN, Makam AN, Darden D .
Acute myocardial infarction readmission risk prediction models: a systematic review of model performance.
Circ Cardiovasc Qual Outcomes 2018 Jan;11(1):e003885. doi: 10.1161/circoutcomes.117.003885.
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Keywords: Heart Disease and Health, Hospital Readmissions, 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
Psoinos CM, Collins CE, Ayturk MD
Post-hospitalization treatment regimen and readmission for C. difficile colitis in Medicare beneficiaries.
C. difficile (CDI) has surpassed methicillin-resistant staph aureus as the most common nosocomial infection with recurrence reaching 30% and the elderly being disproportionately affected. The authors hypothesized that post-discharge antibiotic therapy for continued CDI treatment reduces readmissions. The study concluded that patients discharged with single-drug therapy for CDI had lower readmission rates compared to patients discharged on no ongoing CDI treatment suggesting that short-term monotherapy may be beneficial in inducing eradication and preventing relapse.
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AHRQ-funded; HS022694
Citation: Psoinos CM, Collins CE, Ayturk MD .
Post-hospitalization treatment regimen and readmission for C. difficile colitis in Medicare beneficiaries.
World J Surg 2018 Jan;42(1):246-53. doi: 10.1007/s00268-017-4139-8..
Keywords: Antibiotics, Clostridium difficile Infections, Elderly, Hospital Discharge, Hospital Readmissions
Basu J, Hanchate A, Bierman A
AHRQ Author: Basu J, Bierman A
Racial/ethnic disparities in readmissions in US hospitals: the role of insurance coverage.
This study examined differences in rates of 30-day readmissions across patients by race/ethnicity and the extent to which these differences were moderated by insurance coverage. It found higher readmission risk for non-Hispanic blacks, compared with non-Hispanic whites, among those covered by Medicare and private insurance, but lower risk among uninsured and similar risk among Medicaid.
AHRQ-authored.
Citation: Basu J, Hanchate A, Bierman A .
Racial/ethnic disparities in readmissions in US hospitals: the role of insurance coverage.
Inquiry 2018 Jan-Dec;55:46958018774180. doi: 10.1177/0046958018774180.
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Keywords: Disparities, Health Insurance, Healthcare Cost and Utilization Project (HCUP), Hospitals, Hospital Readmissions
Wheeler KK, Shi J, Nordin AB
U.S. pediatric burn patient 30-day readmissions.
The objectives of the study were to determine unscheduled 30-day readmission rates for pediatric burn patients and to identify readmission reasons. The investigators used the 2013-2014 National Readmission Database to produce 30-day all-cause unscheduled readmission rates by patient and hospital characteristics.
AHRQ-funded; HS024263.
Citation: Wheeler KK, Shi J, Nordin AB .
U.S. pediatric burn patient 30-day readmissions.
J Burn Care Res 2018 Jan;39(1):73-81. doi: 10.1097/bcr.0000000000000596..
Keywords: Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Injuries and Wounds, Children/Adolescents, Hospital Readmissions
Galbraith AA, Meyers DJ, Ross-Degnan D
Long-term impact of a postdischarge community health worker intervention on health care costs in a safety-net system.
This study evaluated the impact of a patient navigator (PN) intervention on health system costs in the 180 days after discharge for high-risk patients in a safety-net system. Total costs per patient over the 180 days postindex discharge for those aged >/=60 years were significantly lower for PN patients compared to controls ($5,676 vs. $7,640); differences for patients aged <60 ($9,942 vs. $9,046) or for the entire cohort ($7,092 vs. $7,953) were not significant.
AHRQ-funded; HS020628.
Citation: Galbraith AA, Meyers DJ, Ross-Degnan D .
Long-term impact of a postdischarge community health worker intervention on health care costs in a safety-net system.
Health Serv Res 2017 Dec;52(6):2061-78. doi: 10.1111/1475-6773.12790.
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Keywords: Healthcare Costs, Patient Experience, Hospital Readmissions
Ganapathy D, Acharya C, Lachar J
The patient buddy app can potentially prevent hepatic encephalopathy-related readmissions.
The researchers aimed to define the feasibility of using the Patient Buddy App and its impact on 30-day readmissions by engaging and educating cirrhotic inpatients and caregivers in a pilot study. In their proof-of-concept trial, the use of Patient Buddy is feasible in recently discharged patients with cirrhosis and their caregivers. Eight hepatic encephalopathy-related readmissions were potentially avoided after the use of the App.
AHRQ-funded; HS024004.
Citation: Ganapathy D, Acharya C, Lachar J .
The patient buddy app can potentially prevent hepatic encephalopathy-related readmissions.
Liver Int 2017 Dec;37(12):1843-51. doi: 10.1111/liv.13494.
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Keywords: Caregiving, Chronic Conditions, Health Information Technology (HIT), Patient and Family Engagement, Hospital Readmissions
Ellimoottil C, Syrjamaki JD, Volt JD
Validation of a claims-based algorithm to characterize episodes of care.
The Michigan Value Collaborative (MVC) developed a claims-based algorithm to provide hospitals with data on events that occur to patients beyond the hospitalization. In this article, the investigators discuss the validation of MVC's claims-based algorithm. They indicate that their findings suggest that the MVC claims-based algorithm identifies and classifies claims with high fidelity and outperforms medical records in the identification of postdischarge events.
AHRQ-funded; HS024193.
Citation: Ellimoottil C, Syrjamaki JD, Volt JD .
Validation of a claims-based algorithm to characterize episodes of care.
Am J Manag Care 2017 Nov;23(11):e382-e86..
Keywords: Hospital Discharge, Hospital Readmissions, Hospitalization, Hospitals, Quality of Care, Quality Improvement
Platinga LC, King L, Patzer RE
Early hospital readmission among hemodialysis patients in the United States is associated with subsequent mortality.
The researchers examined the timing of readmissions of hemodialysis patients in the United States and its association with mortality among 285,795 prevalent adult Medicare-primary hemodialysis patients from a national registry. They concluded that regardless of timing, patients with readmissions had a higher risk of death within one year, compared to those with no readmissions.
AHRQ-funded; HS025018.
Citation: Platinga LC, King L, Patzer RE .
Early hospital readmission among hemodialysis patients in the United States is associated with subsequent mortality.
Kidney Int 2017 Oct;92(4):934-41. doi: 10.1016/j.kint.2017.03.025.
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Keywords: Kidney Disease and Health, Hospital Readmissions, Mortality
Arbaje AI, Yu Q, Wang J J
Senior services in US hospitals and readmission risk in the Medicare population.
The purpose of this study was to determine whether hospitals' Senior Care Services Scale (SCSS) scores were associated with risk of readmission among Medicare beneficiaries. The study concluded that senior services at the hospital-level represented a modifiable risk factor with important impact. Employing organization-level characteristics in readmission risk prediction tools should be expanded.
AHRQ-funded; HS022916
Citation: Arbaje AI, Yu Q, Wang J J .
Senior services in US hospitals and readmission risk in the Medicare population.
Int J Qual Health Care 2017 Oct 1;29(6):845-52. doi: 10.1093/intqhc/mzx112..
Keywords: Elderly, Health Services Research (HSR), Hospital Readmissions, Hospitals, Medicare
Goto T, Faridi MK, Gibo K
Sex and racial/ethnic differences in the reason for 30-day readmission after COPD hospitalization.
This retrospective cohort study used 2006-2012 data from the State Inpatient Database of eight geographically-diverse US states (Arkansas, California, Florida, Iowa, Nebraska, New York, Utah, and Washington) to examine 30-day readmissions in patients hospitalized for chronic obstructive pulmonary disease (COPD). In their analysis of all-payer population-based data, the authors found sex and racial/ethnic differences in the reason for 30-day readmission in patients hospitalized for COPD.
AHRQ-funded; HS023305.
Citation: Goto T, Faridi MK, Gibo K .
Sex and racial/ethnic differences in the reason for 30-day readmission after COPD hospitalization.
Respir Med 2017 Oct;131:6-10. doi: 10.1016/j.rmed.2017.07.056..
Keywords: Respiratory Conditions, Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Hospital Readmissions, Sex Factors
Symer MM, Abelson JS, Milsom J
A mobile health application to track patients after gastrointestinal surgery: results from a pilot study.
Many surgical readmissions are preventable. Mobile health technology can identify nascent complications and potentially prevent readmission. The researchers performed a pilot study of a new mobile health application in adults undergoing major abdominal surgery and determined the app can track patient recovery from major abdominal surgery, is easy to use, and has potential to improve outcomes.
AHRQ-funded; HS000066.
Citation: Symer MM, Abelson JS, Milsom J .
A mobile health application to track patients after gastrointestinal surgery: results from a pilot study.
J Gastrointest Surg 2017 Sep;21(9):1500-05. doi: 10.1007/s11605-017-3482-2..
Keywords: Telehealth, Health Information Technology (HIT), Hospital Readmissions, Surgery, Adverse Events, Patient Safety, Digestive Disease and Health, Prevention
Balaban RB, Zhang F, Vialle-Valentin CE
Impact of a patient navigator program on hospital-based and outpatient utilization over 180 days in a safety-net health system.
The objective of this study was to determine the effect of a care transition program using patient navigators (PNs) on health service utilization among high-risk safety-net patients over a 180-day period. The investigators concluded that a PN program serving high-risk safety-net patients differentially impacted patients based on age, and among younger patients, outcomes varied over time. The investigators suggest that their findings highlight the importance for future research to evaluate care transition programs among different subpopulations and over longer time peri
AHRQ-funded; HS020628.
Citation: Balaban RB, Zhang F, Vialle-Valentin CE .
Impact of a patient navigator program on hospital-based and outpatient utilization over 180 days in a safety-net health system.
J Gen Intern Med 2017 Sep;32(9):981-89. doi: 10.1007/s11606-017-4074-2..
Keywords: Care Management, Healthcare Delivery, Healthcare Utilization, Hospital Readmissions, Patient-Centered Healthcare, Transitions of Care
McHugh JP, Foster A, Mor V JP, Foster A, Mor V
Reducing hospital readmissions through preferred networks of skilled nursing facilities.
This study used a concurrent mixed-methods approach to examine changes in rehospitalization rates and differences in practices between hospitals that did and did not develop formal skilled nursing facilities (SNF) networks.
AHRQ-funded; HS023961.
Citation: McHugh JP, Foster A, Mor V JP, Foster A, Mor V .
Reducing hospital readmissions through preferred networks of skilled nursing facilities.
Health Aff 2017 Sep;36(9):1591-98. doi: 10.1377/hlthaff.2017.0211..
Keywords: Care Coordination, Hospital Readmissions, Hospitals, Nursing Homes, Transitions of Care
Hernandez-Boussard T, Graham LA, Desai K
The fifth vital sign: postoperative pain predicts 30-day readmissions and subsequent emergency department visits.
The researchers hypothesized that inpatient postoperative pain trajectories are associated with 30-day inpatient readmission and emergency department (ED) visits. After analyzing National Veterans Affairs Surgical Quality Improvement data on inpatient general, vascular, and orthopedic surgery from 2008 to 2014, they concluded that postoperative pain trajectories identify populations at risk for 30-day readmissions and ED visits, and do not seem to be mediated by postdischarge complications.
AHRQ-funded; HS024096.
Citation: Hernandez-Boussard T, Graham LA, Desai K .
The fifth vital sign: postoperative pain predicts 30-day readmissions and subsequent emergency department visits.
Ann Surg 2017 Sep;266(3):516-24. doi: 10.1097/sla.0000000000002372.
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Keywords: Emergency Department, Hospital Readmissions, Pain
Goto T, Faridi MK, Gibo K
Trends in 30-day readmission rates after COPD hospitalization, 2006-2012.
This study investigated trends in 30-day readmission rates after chronic obstructive pulmonary disease (COPD)-related hospitalization. Overall, the 30-day readmission rate for COPD-related hospitalization decreased modestly from 20.0 percent in 2006 to 19.2 percent in 2012. Similar to the overall population, the readmission rate over the 7-year period remained persistently high in most of AHRQ-defined priority populations.
AHRQ-funded; HS023305.
Citation: Goto T, Faridi MK, Gibo K .
Trends in 30-day readmission rates after COPD hospitalization, 2006-2012.
Respir Med 2017 Sep;130:92-97. doi: 10.1016/j.rmed.2017.07.058.
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Keywords: Respiratory Conditions, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Social Determinants of Health, Vulnerable Populations
Goldberg EM, Morphis B, Youssef R
An analysis of diagnoses that drive readmission: what can we learn from the hospitals in Southern New England with the highest and lowest readmission performance?
This study examined the most common diagnoses driving readmissions among fee-for-service Medicare beneficiaries in the hospitals with the highest and lowest readmission performance in Southern New England from 2014 to 2016. It found that the lowest-performing hospitals readmitted higher percentages of patients for sepsis and complications of device, implant, or graft, compared to highest-performing hospitals.
AHRQ-funded; HS000011.
Citation: Goldberg EM, Morphis B, Youssef R .
An analysis of diagnoses that drive readmission: what can we learn from the hospitals in Southern New England with the highest and lowest readmission performance?
R I Med J 2017 Aug;100(8):23-28.
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Keywords: Adverse Events, Diagnostic Safety and Quality, Hospital Readmissions, Hospitals, Quality Indicators (QIs)
Clark B, Baron K, Tynan-McKiernan K
Perspectives of clinicians at skilled nursing facilities on 30-day hospital readmissions: a qualitative study.
The purpose of this paper was to understand the perspectives of clinicians working at skilled nursing facilities (SNFs) regarding factors contributing to readmissions. SNF clinicians identified a broad range of factors that contributed to readmissions. The investigators suggest that addressing these factors may mitigate patients' risk of readmission from SNFs to acute care hospitals.
AHRQ-funded; HS023554.
Citation: Clark B, Baron K, Tynan-McKiernan K .
Perspectives of clinicians at skilled nursing facilities on 30-day hospital readmissions: a qualitative study.
J Hosp Med 2017 Aug;12(8):632-38. doi: 10.12788/jhm.2785..
Keywords: Hospital Readmissions, Nursing Homes, Quality Improvement, Transitions of Care
Murtaugh CM, Deb P, Zhu C
Reducing readmissions among heart failure patients discharged to home health care: effectiveness of early and intensive nursing services and early physician follow-up.
This study compared the effectiveness of two "treatments"-early, intensive home health nursing and physician follow-up within a week-versus less intense and later postacute care in reducing readmissions among heart failure patients discharged to home health care. Neither treatment by itself had a statistically significant effect on hospital readmission. In combination, however, they reduced the probability of readmission by roughly 8 percentage points.
AHRQ-funded; HS020257.
Citation: Murtaugh CM, Deb P, Zhu C .
Reducing readmissions among heart failure patients discharged to home health care: effectiveness of early and intensive nursing services and early physician follow-up.
Health Serv Res 2017 Aug;52(4):1445-72. doi: 10.1111/1475-6773.12537.
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Keywords: Comparative Effectiveness, Heart Disease and Health, Home Healthcare, Hospital Readmissions, Patient-Centered Outcomes Research
D'Apuzzo M, Westrich G, Hidaka C
All-cause versus complication-specific readmission following total knee arthroplasty.
The purpose of this study was to determine (1) the frequency of and (2) risk factors for readmissions for all causes or procedure-specific complications within 30 days after total knee arthroplasty (TKA) as well as (3) the association between hospital volume and readmission rate. It found that the frequency of readmissions for TKA-specific complications was low relative to the frequency of all-cause readmissions. Reasons for hospital readmission are multifactorial.
AHRQ-funded; HS016075.
Citation: D'Apuzzo M, Westrich G, Hidaka C .
All-cause versus complication-specific readmission following total knee arthroplasty.
J Bone Joint Surg Am 2017 Jul 5;99(13):1093-103. doi: 10.2106/jbjs.16.00874.
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Keywords: Adverse Events, Hospital Readmissions, Surgery
Rinne ST, Castaneda J, Lindenauer PK
Chronic obstructive pulmonary disease readmissions and other measures of hospital quality.
This study examined the association between COPD readmissions and other quality measures. There were modest correlations between COPD readmission rates and readmission rates for other medical conditions, including heart failure , acute myocardial infarction, pneumonia, and stroke . In contrast, it also found low correlations between COPD readmission rates and readmission rates for surgical conditions, as well as mortality rates for all measured conditions.
AHRQ-funded; HS016978.
Citation: Rinne ST, Castaneda J, Lindenauer PK .
Chronic obstructive pulmonary disease readmissions and other measures of hospital quality.
Am J Respir Crit Care Med 2017 Jul 1;196(1):47-55. doi: 10.1164/rccm.201609-1944OC.
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Keywords: Respiratory Conditions, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Hospital Readmissions, Hospitals
Nuckols TK, Keeler E, Morton S
Economic evaluation of quality improvement interventions designed to prevent hospital readmission: a systematic review and meta-analysis.
The researchers conducted a systematic review of economic evaluations of quality improvement (QI) interventions designed to reduce readmissions. They concluded that multicomponent QI interventions can be effective at reducing readmissions relative to the status quo, but net costs vary. Interventions that engage general populations of patients and their caregivers may offer greater value to the health system, but the implications for patients and caregivers are unknown.
AHRQ-funded; HS022644.
Citation: Nuckols TK, Keeler E, Morton S .
Economic evaluation of quality improvement interventions designed to prevent hospital readmission: a systematic review and meta-analysis.
JAMA Intern Med 2017 Jul;177(7):975-85. doi: 10.1001/jamainternmed.2017.1136.
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Keywords: Hospital Readmissions, Hospitals, Quality Improvement
Moore BJ, White S, Washington R
AHRQ Author: Elixhauser A
Identifying increased risk of readmission and in-hospital mortality using hospital administrative data: the AHRQ Elixhauser Comorbidity Index.
The researchers extended the literature on comorbidity measurement by developing 2 indices, based on the Elixhauser Comorbidity measures, designed to predict 2 frequently reported health outcomes: in-hospital mortality and 30-day readmission in administrative data. The index scores performed as well as using all 29 Elixhauser comorbidity variables separately.
AHRQ-authored; AHRQ-funded.
Citation: Moore BJ, White S, Washington R .
Identifying increased risk of readmission and in-hospital mortality using hospital administrative data: the AHRQ Elixhauser Comorbidity Index.
Med Care 2017 Jul;55(7):698-705. doi: 10.1097/mlr.0000000000000735.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Mortality, Risk
Dharmarajan K, Qin L, Bierlein M
Outcomes after observation stays among older adult Medicare beneficiaries in the USA: retrospective cohort study.
This study characterized rates and trends over time of emergency department treatment-and-discharge stays, repeat observation stays, inpatient stays, any hospital revisit, and death within 30 days of discharge from observation stays. Hospital revisits are common after discharge from observation stays, frequently result in inpatient hospitalizations, and have increased over time among Medicare beneficiaries.
AHRQ-funded; HS023000.
Citation: Dharmarajan K, Qin L, Bierlein M .
Outcomes after observation stays among older adult Medicare beneficiaries in the USA: retrospective cohort study.
BMJ 2017 Jun 20;357:j2616. doi: 10.1136/bmj.j2616.
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Keywords: Elderly, Emergency Department, Hospital Discharge, Hospital Readmissions, Medicare