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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
301 to 325 of 368 Research Studies DisplayedMehta AB, Syeda SN, Bajpayee L
Trends in tracheostomy for mechanically ventilated patients in the United States, 1993-2012.
This study investigated trends in tracheostomy use, timing, and outcomes in the United States. It found that over the past two decades, tracheostomy use rose substantially in the United States until 2008, when use began to decline. In addition, there was an observed dramatic increase in discharge of tracheostomy patients to long-term care facilities.
AHRQ-funded; HS020672.
Citation: Mehta AB, Syeda SN, Bajpayee L .
Trends in tracheostomy for mechanically ventilated patients in the United States, 1993-2012.
Am J Respir Crit Care Med 2015 Aug 15;192(4):446-54. doi: 10.1164/rccm.201502-0239OC..
Keywords: Healthcare Cost and Utilization Project (HCUP), Outcomes, Healthcare Utilization, Respiratory Conditions
Greenberg JK, Ladner TR, Olsen MA
Complications and resource use associated with surgery for Chiari Malformation type 1 in adults: a population perspective.
This study examined the complications and resource use associated with adult CM-1 surgery using administrative data. It concluded that complications after CM-1 surgery are common, and surgical complications are more frequent than medical complications. Also, certain comorbidities and demographic characteristics are associated with increased risk for complications.
AHRQ-funded; H0S19455.
Citation: Greenberg JK, Ladner TR, Olsen MA .
Complications and resource use associated with surgery for Chiari Malformation type 1 in adults: a population perspective.
Neurosurgery 2015 Aug;77(2):261-8. doi: 10.1227/neu.0000000000000777..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Outcomes, Data
Pine M, Kowlessar NM, Salemi JL
Enhancing clinical content and race/ethnicity data in statewide hospital administrative databases: obstacles encountered, strategies adopted, and lessons learned.
Eight grant teams used Agency for Healthcare Research and Quality infrastructure development research grants to enhance the clinical content of and improve race/ethnicity identifiers in statewide all-payer hospital administrative databases. The authors concluded that creation of enhanced administrative databases to support comparative effectiveness research is difficult, particularly in the face of numerous challenges with recruiting data partners such as competing demands on information technology resources.
AHRQ-funded
Citation: Pine M, Kowlessar NM, Salemi JL .
Enhancing clinical content and race/ethnicity data in statewide hospital administrative databases: obstacles encountered, strategies adopted, and lessons learned.
Health Serv Res 2015 Aug;50 Suppl 1:1300-21. doi: 10.1111/1475-6773.12330..
Keywords: Healthcare Cost and Utilization Project (HCUP), Comparative Effectiveness, Patient-Centered Outcomes Research, Data
Andrews RM, Schulman KA
AHRQ Author: Andrews RM
Enhancing the value of Statewide Hospital Discharge Data: improving clinical content and race-ethnicity data.
To foster successful approaches to enhancing state data, AHRQ awarded eight 3-year grants to explore methods to improve the clinical content and race/ethnicity information in these databases. This editorial announces an HSR Special Issue, sponsored by AHRQ, that focuses on the products and lessons learned from these grant projects. Seven articles cover background information on statewide hospital discharge data and the grant program aims, challenges, and lessons learned.
AHRQ-authored.
Citation: Andrews RM, Schulman KA .
Enhancing the value of Statewide Hospital Discharge Data: improving clinical content and race-ethnicity data.
Health Serv Res 2015 Aug;50 Suppl 1:1265-72. doi: 10.1111/1475-6773.12342..
Keywords: Healthcare Cost and Utilization Project (HCUP), Quality Improvement, Racial and Ethnic Minorities
Fingar KR, Smith MW, Davies S
AHRQ Author: Stocks C
Medicaid dental coverage alone may not lower rates of dental emergency department visits.
This study examined county-level rates of ED visits for nontraumatic dental conditions in twenty-nine States in 2010 in relation to dental provider density and Medicaid coverage of nonemergency dental services. It found that county-level Medicaid-funded dental ED visit rates were lower in states where Medicaid covered nonemergency dental services than in other states, although this difference was not significant after other factors were adjusted for.
AHRQ-authored; AHRQ-funded; 290201200003I; HS021700.
Citation: Fingar KR, Smith MW, Davies S .
Medicaid dental coverage alone may not lower rates of dental emergency department visits.
Health Aff 2015 Aug;34(8):1349-57. doi: 10.1377/hlthaff.2015.0223..
Keywords: Dental and Oral Health, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Comparative Effectiveness, Medicaid
Berry JG, Zaslavsky AM, Toomey SL
Recognizing differences in hospital quality performance for pediatric inpatient care.
This study was a retrospective analysis of hospital discharges for children aged 0 to 17 years from 3,974 hospitals in 44 states in the 2009 Kids’ Inpatient Database. It found that most children are admitted to hospitals in which all-condition measures of quality have adequate power to show modest differences in performance from average, but most condition-specific measures do not.
AHRQ-funded; HS020513.
Citation: Berry JG, Zaslavsky AM, Toomey SL .
Recognizing differences in hospital quality performance for pediatric inpatient care.
Pediatrics 2015 Aug;136(2):251-62. doi: 10.1542/peds.2014-3131..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Hospitalization, Quality of Care
Andrews RM
AHRQ Author: Andrews RM
Statewide hospital discharge data: Collection, use, limitations, and improvements.
The purpose of the article is to provide background information on statewide hospital discharge data and the context for the other articles in this special issue of HSR that focus on the products and lessons learned by the Enhanced State Data grantees. The author provides an overview of statewide hospital discharge data, including content and coverage, and its evolution and improvement over time.
AHRQ-authored
Citation: Andrews RM .
Statewide hospital discharge data: Collection, use, limitations, and improvements.
Health Serv Res 2015 Aug;50 Suppl 1:1273-99. doi: 10.1111/1475-6773.12343..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Discharge, Data
Peng J, Wheeler K, Shi J
Trauma with Injury Severity Score of 75: are these unsurvivable injuries?
This study aimed to assess the true mortality among patients with an ISS=75, and to examine the characteristics and primary diagnoses of these patients. Its results revealed that at least half of patients with an ISS=75 survived, demonstrating that the rationale for excluding patients with an ISS=75 from analysis is not always justified.
AHRQ-funded; HS022277.
Citation: Peng J, Wheeler K, Shi J .
Trauma with Injury Severity Score of 75: are these unsurvivable injuries?
PLoS One 2015 Jul 31;10(7):e0134821. doi: 10.1371/journal.pone.0134821..
Keywords: Mortality, Healthcare Cost and Utilization Project (HCUP), Trauma, Emergency Medical Services (EMS), Emergency Department
Hicks CW, Hashmi ZG, Hui X
Explaining the paradoxical age-based racial disparities in survival after trauma: The role of the treating facility.
This study sought to determine if differences in outcomes at treating facilities can help explain age-based racial disparities in survival after trauma. For example, among patients older than 65 years, blacks had decreased odds of mortality compared with whites. It found that facility-based differences do not seem to explain this paradoxical age-based racial disparity after trauma observed in the older population.
AHRQ-funded; HS017952.
Citation: Hicks CW, Hashmi ZG, Hui X .
Explaining the paradoxical age-based racial disparities in survival after trauma: The role of the treating facility.
AHRQ-funded; HS017952..
Keywords: Disparities, Comparative Effectiveness, Patient-Centered Outcomes Research, Healthcare Cost and Utilization Project (HCUP)
Meddings J, Reichert H, Rogers MA
Under pressure: Financial effect of the hospital-acquired conditions initiative-a statewide analysis of pressure ulcer development and payment.
This study assessed the financial effect of the 2008 Hospital-Acquired Conditions Initiative (HACI) pressure ulcer payment changes on Medicare, other payers, and hospitals. It found that the total financial effect of the 2008 payment changes for pressure ulcers was negligible. Most payment decreases occurred by removal of comorbidity payments for present-on-admission pressure ulcers other than Stages III and IV.
AHRQ-funded; HS019767; HS018334.
Citation: Meddings J, Reichert H, Rogers MA .
Under pressure: Financial effect of the hospital-acquired conditions initiative-a statewide analysis of pressure ulcer development and payment.
J Am Geriatr Soc 2015 Jul;63(7):1407-12. doi: 10.1111/jgs.13475..
Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare-Associated Infections (HAIs), Pressure Ulcers, Patient Safety, Healthcare-Associated Infections (HAIs)
Leshem E, Tate JE, Steiner CA
AHRQ Author: Steiner CA
Acute gastroenteritis hospitalizations among US children following implementation of the rotavirus vaccine.
Because laboratory testing and coding for rotavirus are not routinely performed for patients with diarrhea, the researchers examined both all-cause acute gastroenteritis and rotavirus-coded hospitalizations among children younger than 5 years from 2000 through 2012. They found that, in 2012, when vaccine coverage was highest, the greatest reductions were observed for all-cause acute gastroenteritis (55 percent) and rotavirus-coded (94 percent) hospitalizations.
AHRQ-authored.
Citation: Leshem E, Tate JE, Steiner CA .
Acute gastroenteritis hospitalizations among US children following implementation of the rotavirus vaccine.
JAMA 2015 Jun 9;313(22):2282-4. doi: 10.1001/jama.2015.5571..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Vaccination, Children/Adolescents, Adverse Events
Duseja R, Bardach NS, Lin GA
Revisit rates and associated costs after an emergency department encounter: a multistate analysis.
This study describes revisit rates, variation in revisit rates by diagnosis and state, and associated costs. It found that revisits after an index ED encounter are more frequent than previously reported, in part because many occur outside the index institution. Among ED patients in Florida, more resources are spent on revisits than on index ED visits.
AHRQ-funded; HS020667.
Citation: Duseja R, Bardach NS, Lin GA .
Revisit rates and associated costs after an emergency department encounter: a multistate analysis.
Ann Intern Med 2015 Jun 2;162(11):750-6. doi: 10.7326/m14-1616..
Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Emergency Department, Hospitalization, Hospital Readmissions
Geissler KH, Holmes GM
Emergency department use in the US-Mexico border region and violence in Mexico: is there a relationship?
This study assessed the association between homicide rates in northern Mexico and potentially avoidable use of emergency departments (ED) in the US-Mexico border region. It concluded that a substantial majority of ED encounters in the US-Mexico border region were potentially avoidable. However, there was not a strong relationship between homicide rates in northern Mexico and the distribution of ED discharges in Arizona and California.
AHRQ-funded; HS021074.
Citation: Geissler KH, Holmes GM .
Emergency department use in the US-Mexico border region and violence in Mexico: is there a relationship?
J Rural Health 2015 Summer;31(3):316-25. doi: 10.1111/jrh.12109.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Medical Services (EMS), Healthcare Utilization, Access to Care, Vulnerable Populations
Spector WD, Limcangco R, Mutter RL
AHRQ Author: Spector WD, Mutter RL, Owens P
Inpatient admissions from the ED for adults with injuries: the role of clinical and nonclinical factors.
The study objective was to explore the association of clinical and nonclinical factors with the decision to admit ED patients with injury. It found that injury location, type, and mechanism and comorbidities had large effects on hospitalization rates as expected. We found higher inpatient admission rates by level of trauma center designation and hospital size, but findings differed by age and type of injury.
AHRQ-authored.
Citation: Spector WD, Limcangco R, Mutter RL .
Inpatient admissions from the ED for adults with injuries: the role of clinical and nonclinical factors.
Am J Emerg Med 2015 Jun;33(6):764-9. doi: 10.1016/j.ajem.2015.02.045..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Emergency Department
Cavazos-Rehg PA, Krauss MJ, Spitznagel EL
Maternal age and risk of labor and delivery complications.
The researchers examined associations between maternal age and prevalence of maternal morbidity during complications of labor and delivery. Using HCUP data, they found that complications with the highest odds among women 11-18 years of age included preterm delivery, chorioamnionitis, endometritis, and mild preeclampsia. Pregnant women 15-19 years old had greater odds for severe preeclampsia, eclampsia, postpartum hemorrhage, poor fetal growth, and fetal distress. Pregnant women 35 and older had greater odds for preterm delivery, hypertension, superimposed preeclampsia, severe preeclampsia, and decreased risk for chorioamnionitis. Women over 40 had increased odds for mild preeclampsia, fetal distress, and poor fetal growth.
AHRQ-funded; HS019455.
Citation: Cavazos-Rehg PA, Krauss MJ, Spitznagel EL .
Maternal age and risk of labor and delivery complications.
Matern Child Health J 2015 Jun;19(6):1202-11. doi: 10.1007/s10995-014-1624-7.
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Keywords: Adverse Events, Healthcare Cost and Utilization Project (HCUP), Labor and Delivery, Pregnancy, Risk
Saeed MJ, Dubberke ER, Fraser VJ
Procedure-specific surgical site infection incidence varies widely within certain National Healthcare Safety Network surgery groups.
The objective of this study was to determine surgical site infection (SSI) incidence for clinically defined subgroups within 5 heterogeneous National Healthcare Safety Network surgery categories (amputation; bile duct, liver or pancreas; breast; colon; and hernia) in community hospitals in California, Florida, and New York. The 90-day SSI rates varied significantly within each of the 5 subgroups.
AHRQ-funded; HS019455.
Citation: Saeed MJ, Dubberke ER, Fraser VJ .
Procedure-specific surgical site infection incidence varies widely within certain National Healthcare Safety Network surgery groups.
Am J Infect Control 2015 Jun;43(6):617-23. doi: 10.1016/j.ajic.2015.02.012..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Patient Safety, Adverse Events
Seitz AE, Adjemian J, Steiner CA
AHRQ Author: Steiner CA
Spatial epidemiology of blastomycosis hospitalizations: detecting clusters and identifying environmental risk factors.
The researchers used a single, multi-state dataset with standard methodology throughout the endemic area to provide new insights into the epidemiology of blastomycosis. They found that the odds of a county being part of a high-risk cluster was associated with increasing percentage of population over age 65, decreasing maximum temperature, increasing mercury, and decreasing copper soil content.
AHRQ-authored.
Citation: Seitz AE, Adjemian J, Steiner CA .
Spatial epidemiology of blastomycosis hospitalizations: detecting clusters and identifying environmental risk factors.
Med Mycol 2015 Jun;53(5):447-54. doi: 10.1093/mmy/myv014..
Keywords: Risk, Hospitalization, Elderly, Healthcare Cost and Utilization Project (HCUP)
Sentell TL, Ahn HJ, Miyamura J
Cost burden of potentially preventable hospitalizations for cardiovascular disease and diabetes for Asian Americans, Pacific Islanders, and Whites in Hawai'i.
The authors compared the cost burdens of potentially preventable hospitalizations for cardiovascular disease and diabetes for Asian Americans, Pacific Islanders, and Whites using Hawai'i statewide 2007-2012 inpatient data. They found that costs for preventable diabetes-related amputations were significantly higher for Native Hawaiians, Japanese, and other Pacific Islanders compared with Whites.
AHRQ-funded; HS019990.
Citation: Sentell TL, Ahn HJ, Miyamura J .
Cost burden of potentially preventable hospitalizations for cardiovascular disease and diabetes for Asian Americans, Pacific Islanders, and Whites in Hawai'i.
J Health Care Poor Underserved 2015 May;26(2 Suppl):63-82. doi: 10.1353/hpu.2015.0068.
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Keywords: Cardiovascular Conditions, Diabetes, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities
Santos CA, Brennan DC, Chapman WC
Delayed-onset cytomegalovirus disease coded during hospital readmission in a multicenter, retrospective cohort of liver transplant recipients.
The researchers sought to determine the risk factors and outcomes of delayed-onset CMV disease among a representative cohort of liver transplant recipients from multiple centers. They found that delayed-onset CMV disease coded during hospital readmission occurred more commonly than early-onset CMV disease and that prior transplant failure or rejection was a risk factor for delayed-onset CMV disease.
AHRQ-funded; HS019455.
Citation: Santos CA, Brennan DC, Chapman WC .
Delayed-onset cytomegalovirus disease coded during hospital readmission in a multicenter, retrospective cohort of liver transplant recipients.
Liver Transpl 2015 May;21(5):581-90. doi: 10.1002/lt.24089..
Keywords: Healthcare Cost and Utilization Project (HCUP), Risk, Transplantation, Outcomes
Singh JA, Ramachandran R
Does hospital volume predict outcomes and complications after total shoulder arthroplasty in the US?
The researchers assessed the association of hospital procedure volume for total shoulder arthroplasty (TSA) with patient outcomes and complications. They found that, compared to low volume hospitals (<5, 5–9, or 10–14 procedures annually), patients receiving TSA at higher volume hospitals (15–24 or ‡25 procedures annually) had significantly lower likelihood of being discharged to an inpatient medical facility.
AHRQ-funded; HS021110.
Citation: Singh JA, Ramachandran R .
Does hospital volume predict outcomes and complications after total shoulder arthroplasty in the US?
Arthritis Care Res 2015 May;67(6):885-90. doi: 10.1002/acr.22507..
Keywords: Patient-Centered Outcomes Research, Adverse Events, Patient Safety, Quality of Care, Healthcare Cost and Utilization Project (HCUP)
Hernandez-Boussard T, McDonald KM, Rhoads KF
Patient safety in plastic surgery: identifying areas for quality improvement efforts.
The study’s aim was to assess risk-adjusted rates of inpatient adverse events (AEs) for general reconstructive soft tissue procedures using established measures. It found that plastic surgery patients had a significantly lower risk-adjusted rate compared to other surgical inpatients for all events evaluated except for failure to rescue and postoperative hemorrhage or hematoma.
AHRQ-funded; HS018558.
Citation: Hernandez-Boussard T, McDonald KM, Rhoads KF .
Patient safety in plastic surgery: identifying areas for quality improvement efforts.
Ann Plast Surg 2015 May;74(5):597-602. doi: 10.1097/SAP.0b013e318297791e..
Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Inpatient Care, Hospitalization, Patient Safety
King JT, Perkal MF, Rosenthal RA
Thirty-day postoperative mortality among individuals with HIV infection receiving antiretroviral therapy and procedure-matched, uninfected comparators.
The researchers explored the current relationship between perioperative mortality and indicators of immune function, anemia, and hypoalbuminemia among HIV-infected and uninfected individuals. Among HIV-infected patients receiving antiretroviral therapy, modern postoperative mortality rates are low and lower CD4 cell counts are associated with increased mortality, but characteristics other than HIV status, such as age and hypoalbuminemia, are also important determinants of outcome.
AHRQ-funded; HS021112.
Citation: King JT, Perkal MF, Rosenthal RA .
Thirty-day postoperative mortality among individuals with HIV infection receiving antiretroviral therapy and procedure-matched, uninfected comparators.
JAMA Surg 2015 Apr;150(4):343-51. doi: 10.1001/jamasurg.2014.2257..
Keywords: Healthcare Cost and Utilization Project (HCUP), Mortality, Human Immunodeficiency Virus (HIV), Hospitalization, Surgery
Martin BI, Lurie JD, Tosteson AN
Use of bone morphogenetic protein among patients undergoing fusion for degenerative diagnoses in the United States, 2002 to 2012.
The authors examined whether published concerns about the safety of bone morphogenetic protein (BMP) altered clinical practice. They found that use of BMP in spinal fusion surgery declined subsequent to published safety concerns and revelations of financial conflicts of interest for investigators involved in the pivotal clinical trials.
AHRQ-funded; HS021695.
Citation: Martin BI, Lurie JD, Tosteson AN .
Use of bone morphogenetic protein among patients undergoing fusion for degenerative diagnoses in the United States, 2002 to 2012.
Spine J 2015 Apr;15(4):692-9. doi: 10.1016/j.spinee.2014.12.010.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Patient Safety, Patient-Centered Outcomes Research, Practice Patterns, Surgery
Encinosa WE, Bae J
AHRQ Author: Encinosa WE
Meaningful use IT reduces hospital-caused adverse drug events even at challenged hospitals.
The researchers examined the impact of the 5 core meaningful use (MU) medication elements on hospital-caused adverse drug events (ADEs). They found that adopting all 5 core MU elements was associated with a reduction in ADEs. Hospitals reporting costs as the main barrier to MU reduced their ADE rates by 35%; low quality hospitals reduced ADEs by 29 percent, compared to 27 percent at high quality hospitals.
Citation: Encinosa WE, Bae J .
Meaningful use IT reduces hospital-caused adverse drug events even at challenged hospitals.
Healthc 2015 Mar;3(1):12-7. doi: 10.1016/j.hjdsi.2014.07.001..
Keywords: Healthcare Cost and Utilization Project (HCUP), Patient Safety, Hospitals, Medication
Dresden SM, O'Connor LM, Pearce CG
National trends in the use of postcardiac arrest therapeutic hypothermia and hospital factors influencing its use.
The goal of this study is to use population-based national hospital discharge data to examine trends in the use of therapeutic hypothermia (TH) in both in- and out-of-hospital cardiac arrest patients after implementation of the 2005 American Heart Association guidelines. Its findings demonstrate that while TH use is increasing, the overall utilization of TH relative to all cardiac arrests remains very low.
AHRQ-funded; HS000078.
Citation: Dresden SM, O'Connor LM, Pearce CG .
National trends in the use of postcardiac arrest therapeutic hypothermia and hospital factors influencing its use.
Ther Hypothermia Temp Manag 2015 Mar;5(1):48-54. doi: 10.1089/ther.2014.0023..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitals, Cardiovascular Conditions, Healthcare Utilization