National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
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- Antimicrobial Stewardship (1)
- Blood Clots (1)
- Blood Thinners (1)
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- Case Study (1)
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- (-) Digestive Disease and Health (8)
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- (-) Elderly (8)
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- Medication (4)
- Medication: Safety (1)
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- Surgery (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 8 of 8 Research Studies DisplayedArora S, Fowler ME, Harmon C
Differences in pretreatment frailty across gastrointestinal cancers in older adults: results from the Cancer and Aging Resilience Evaluation registry.
The purpose of this study was to explore differences in pretreatment frailty between colorectal (CRC), hepatobiliary, and pancreatic cancers. The researchers included adults aged 60 years and higher enrolled in the Cancer and Aging Resilience Evaluation registry. A 44-item Cancer and Aging Resilience Evaluation frailty index was utilized to define frailty, which included geriatric assessment impairments of functional status, cognitive complaints, health-related quality of life, comorbidities, polypharmacy, anxiety, depression, malnutrition, falls, ability to walk one block, and interference in social activities. A total of 505 patients were included in the study: 41.8% with CRC, 35.2% with pancreatic cancer, and 116 23.0% with hepatobiliary cancer. The study found the following prevalence of frailty: 40.6% pancreatic, 34.3% hepatobiliary, and 23.3% CRC. Frailty was linked with higher rates of malnutrition and instrumental activities of daily living impairments in patients with pancreatic cancer and higher number of comorbidities in patients with hepatobiliary cancer. The study concluded that adults aged 60 and over with pancreatic and hepatobiliary cancers are at high-risk of pretreatment frailty.
AHRQ-funded; HS013852.
Citation: Arora S, Fowler ME, Harmon C .
Differences in pretreatment frailty across gastrointestinal cancers in older adults: results from the Cancer and Aging Resilience Evaluation registry.
JCO Oncol Pract 2022 Nov;18(11):e1796-e806. doi: 10.1200/op.22.00270..
Keywords: Elderly, Cancer, Digestive Disease and Health
Shah SC, McKinley M, Gupta S
Population-based analysis of differences in gastric cancer incidence among races and ethnicities in individuals age 50 years and older.
There are racial and ethnic differences in the incidence of gastric adenocarcinoma worldwide and in the US. Based on a decision analysis, screening for noncardia gastric adenocarcinoma might be cost-effective for non-White individuals 50 years or older. In this study, the investigators aimed to estimate the differences in gastric adenocarcinoma incidence in specific anatomic sites among races and ethnicities in individuals 50 years or older.
AHRQ-funded; HS026395.
Citation: Shah SC, McKinley M, Gupta S .
Population-based analysis of differences in gastric cancer incidence among races and ethnicities in individuals age 50 years and older.
Gastroenterology 2020 Nov;159(5):1705-14.e2. doi: 10.1053/j.gastro.2020.07.049..
Keywords: Elderly, Cancer, Digestive Disease and Health, Racial and Ethnic Minorities, Disparities
Dos Santos Marques IC, Theiss LM, Baker SJ
Low health literacy exists in the inflammatory bowel disease (IBD) population and is disproportionately prevalent in older African Americans.
This study assessed the prevalence of low health literacy rates among adult patients with inflammatory bowel disease (IBD) in a diverse population and identified risk factors for low health literacy. IBD patients at a single institution from November 2017 to May 2018 were assessed for health literacy using the Newest Vital Sign (NWS). Secondary outcomes were length-of-stay (LOS) and 30-day readmissions after surgery. There were 175 patients surveyed who were 59% female, 23% African Americans, 91% with Crohn’s disease, and mean age was 46. Overall the low health literacy rate was 24%, with African Americans having a higher prevalence (47.5%) versus 17.0% for white IBD patients. Low health literacy was associated with older age and African American race. There were no significant differences between LOS and readmissions rates by health literacy levels.
AHRQ-funded; HS023009.
Citation: Dos Santos Marques IC, Theiss LM, Baker SJ .
Low health literacy exists in the inflammatory bowel disease (IBD) population and is disproportionately prevalent in older African Americans.
Crohns Colitis 360 2020 Oct;2(4). doi: 10.1093/crocol/otaa076..
Keywords: Elderly, Health Literacy, Digestive Disease and Health, Racial and Ethnic Minorities, Chronic Conditions
Abraham NS, Noseworthy PA, Inselman J
Risk of gastrointestinal bleeding increases with combinations of antithrombotic agents and patient age.
This study investigated whether age of patient and time frame increased the risk of gastrointestinal bleeding (GIB) in elderly patients being treated with anticoagulants, antiplatelets, or a combination of both therapies. This retrospective analysis used nationwide claims data from privately insured and Medicare Advantage enrollees who received anticoagulant and/or antiplatelet agents from October 1, 2010, through May 31, 2017. The final cohort included 311,211 patients who had a primary diagnosis of atrial fibrillation, ischemic heart disease, or venous thromboembolism. There was no significant different in the proportion of patients with GIB after anticoagulant or antiplatelet monotherapy, but combination therapy increased GIB risk. Advancing age was also associated with increasing 1-year probability of FIB, especially patients older than 75 years taking combination therapy.
AHRQ-funded; HS025402.
Citation: Abraham NS, Noseworthy PA, Inselman J .
Risk of gastrointestinal bleeding increases with combinations of antithrombotic agents and patient age.
Clin Gastroenterol Hepatol 2020 Feb;18(2):337-46.e19. doi: 10.1016/j.cgh.2019.05.017..
Keywords: Adverse Drug Events (ADE), Medication, Adverse Events, Medication: Safety, Elderly, Blood Thinners, Blood Clots, Digestive Disease and Health
D'Agata EMC, Varu A, Geffert SF
Acquisition of multidrug-resistant organisms in the absence of antimicrobials.
This nested case-control study was conducted among 137 nursing home residents who did not receive antimicrobials, with 44 acquiring a multi-drug resistant organism. Risk factors identified included receiving gastrointestinal medication that affected the gut microbiome, the number of visits from healthcare workers, pressure ulcers, and not residing in a dementia unit.
AHRQ-funded; HS021666.
Citation: D'Agata EMC, Varu A, Geffert SF .
Acquisition of multidrug-resistant organisms in the absence of antimicrobials.
Clin Infect Dis 2018 Oct 15;67(9):1437-40. doi: 10.1093/cid/ciy358..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Nursing Homes, Long-Term Care, Elderly, Digestive Disease and Health, Case Study
Dimou FM, Adhikari D, Mehta HB
Incidence of hepaticojejunostomy stricture after hepaticojejunostomy.
The authors aimed to determine the timing, incidence, and management of stricture after biliary-enteric anastomosis. They found that younger age was associated with a decreased likelihood of stricture formation and that the presence of an endostent predicted stricture formation. They concluded that biliary-enteric anastomotic strictures occur with significant frequency after a biliary-enteric anastomosis, and that while many patients are managed nonoperatively, stricture diagnosis remains burdensome.
AHRQ-funded; HS022134.
Citation: Dimou FM, Adhikari D, Mehta HB .
Incidence of hepaticojejunostomy stricture after hepaticojejunostomy.
Surgery 2016 Sep;160(3):691-8. doi: 10.1016/j.surg.2016.05.021.
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Keywords: Surgery, Adverse Events, Digestive Disease and Health, Elderly, Patient-Centered Outcomes Research
Govani SM, Wiitala WL, Stidham RW
Age disparities in the use of steroid-sparing therapy for inflammatory bowel disease.
The investigators compared the use of steroids and steroid-sparing therapies and rates of complications among elderly and younger patients in a national cohort of veterans with inflammatory bowel disease (IBD). They found that, after starting steroids, fracture rates increased in the elderly patients with IBD, whereas increases in venous thromboembolism and infections after starting steroids affected both age groups. Additonally, elderly veterans were less likely to receive steroids and steroid-sparing medications than younger veterans.
AHRQ-funded; HS024122.
Citation: Govani SM, Wiitala WL, Stidham RW .
Age disparities in the use of steroid-sparing therapy for inflammatory bowel disease.
Inflamm Bowel Dis 2016 Aug;22(8):1923-8. doi: 10.1097/mib.0000000000000817.
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Keywords: Digestive Disease and Health, Disparities, Elderly, Medication, Practice Patterns
Johnson SL, Bartels CM, Palta M
Biological and steroid use in relationship to quality measures in older patients with inflammatory bowel disease: a US Medicare cohort study.
The researchers examined the frequency and predictors of antitumour necrosis factor (TNF) use, among US patients with inflammatory bowel disease (IBD) aged 65 years and older prior to the publication of a new Medicare quality measure calling for the use of anti-TNFs and other steroid-sparing agents. They found that anti-TNF use was very low in this population of older patients with IBD.
AHRQ-funded; HS022786.
Citation: Johnson SL, Bartels CM, Palta M .
Biological and steroid use in relationship to quality measures in older patients with inflammatory bowel disease: a US Medicare cohort study.
BMJ Open 2015 Sep 07;5(9):e008597. doi: 10.1136/bmjopen-2015-008597.
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Keywords: Elderly, Digestive Disease and Health, Medication, Quality Measures