National Healthcare Quality and Disparities Report
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Search All Research Studies
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- Adverse Events (4)
- Ambulatory Care and Surgery (1)
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- Comparative Effectiveness (3)
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- (-) Patient-Centered Outcomes Research (22)
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- Public Reporting (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 22 of 22 Research Studies DisplayedHu QL, Livhits MJ, Ko CY MJ, Ko CY
Same-day discharge is not associated with increased readmissions or complications after thyroid operations.
The purpose of this study was to determine whether same-day discharge following thyroid surgery resulted in increased rehospitalization. Data from the American College of Surgeons National Surgical Quality Improvement Program Targeted Thyroidectomy database was used to identify patients who underwent thyroid resections. Results showed that, in a national cohort of patients undergoing thyroid surgery, same-day discharge was not associated with greater rates of readmission or complications when compared with discharge 1 or 2 days after thyroid surgery.
AHRQ-funded; 233201500020I.
Citation: Hu QL, Livhits MJ, Ko CY MJ, Ko CY .
Same-day discharge is not associated with increased readmissions or complications after thyroid operations.
Surgery 2020 Jan;167(1):117-23. doi: 10.1016/j.surg.2019.06.054..
Keywords: Surgery, Ambulatory Care and Surgery, Hospital Readmissions, Hospital Discharge, Adverse Events, Patient-Centered Outcomes Research, Quality Improvement, Quality of Care
Bath J, Smith JB, Kruse RL
Cohort study of risk factors for 30-day readmission after abdominal aortic aneurysm repair.
This retrospective cohort study examined 30-day readmission rates for patients who had abdominal aortic aneurysm (AAA) repair comparing two different procedures,. The cohort was selected from inpatients (2009-2016) who had undergone elective AAA repair using the multicenter Cerner Health Facts(R) database and were identified ICD-9 procedure codes. The two procedures compared were 3,101 endovascular aneurysm repairs (EVAR) and 1,622 open procedures. Patients who had EVAR were less likely to be readmitted. Risk factors for readmission included surgical site infection, age, receipt of bronchodilators or steroids, serum potassium > 5.2 mEq/L, and higher Charlson co-morbidity scores. The most common infections causing readmission were pneumonia and urinary tract infection after EVAR.
AHRQ-funded; HS022140.
Citation: Bath J, Smith JB, Kruse RL .
Cohort study of risk factors for 30-day readmission after abdominal aortic aneurysm repair.
Vasa 2019 May;48(3):251-61. doi: 10.1024/0301-1526/a000767..
Keywords: Risk, Hospital Readmissions, Surgery, Outcomes, Comparative Effectiveness, Patient-Centered Outcomes Research
Ody C, Msall L, Dafny LS
Decreases in readmissions credited to Medicare's program to reduce hospital readmissions have been overstated.
This study examines the assumption that Medicare's Hospital Readmissions Reduction Program (HRRP) can lower risk-adjusted readmission rates at general acute care hospitals for targeted conditions. Prior studies of HRRP have relied upon the control groups' having lower baseline readmission rates, which could falsely create the appearance that readmission rates are changing more in the treatment than in the control group. After adjustment for differences in pre-HRRP readmission rates across samples, the study found that declines for targeted conditions were statistically indistinguishable from declines for two control samples. The authors conclude that either the HRRP had no effect on readmissions, or it has led to a systemwide reduction in readmissions roughly half as large as prior estimates have suggested.
AHRQ-funded; HS024072.
Citation: Ody C, Msall L, Dafny LS .
Decreases in readmissions credited to Medicare's program to reduce hospital readmissions have been overstated.
Health Aff 2019 Jan;38(1):36-43. doi: 10.1377/hlthaff.2018.05178..
Keywords: Hospital Readmissions, Medicare, Patient-Centered Outcomes Research
Lifland B, Wright DR, Mangione-Smith R
The impact of an adolescent depressive disorders clinical pathway on healthcare utilization.
The purpose of this study was to examine the association between level of adherence to an adolescent depressive disorders inpatient clinical pathway with psychiatric patients’ length of stay (LOS), cost, and readmissions. Patients in the high-adherence category were found to have significantly longer LOS and higher costs when compared to those in the low-adherence category. The authors conclude that understanding which of the care processes within the pathway are most cost-effective for improving patient-centered outcomes requires further investigation.
AHRQ-funded; HS024299.
Citation: Lifland B, Wright DR, Mangione-Smith R .
The impact of an adolescent depressive disorders clinical pathway on healthcare utilization.
Adm Policy Ment Health 2018 Nov;45(6):979-87. doi: 10.1007/s10488-018-0878-6..
Keywords: Care Management, Children/Adolescents, Depression, Healthcare Costs, Healthcare Utilization, Hospital Readmissions, Hospitalization, Inpatient Care, Behavioral Health, Outcomes, Patient-Centered Outcomes Research
Vogel TR, Smith JB, Kruse RL
Hospital readmissions after elective lower extremity vascular procedures.
This study evaluated risk factors associated with 30-day readmission after open and endovascular lower extremity revascularization. Factors associated with readmission following lower extremity bypass included heart failure, transfusions, hyponatremia, black race, and bronchodilator use. Risk factors for endovascular readmissions were often chronic conditions including coronary artery disease, kidney disease, hypertension, and hypertensive medications.
AHRQ-funded; HS022140.
Citation: Vogel TR, Smith JB, Kruse RL .
Hospital readmissions after elective lower extremity vascular procedures.
Vascular 2018 Jun;26(3):250-61. doi: 10.1177/1708538117728637.
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Keywords: Hospital Readmissions, Hospitalization, Patient-Centered Outcomes Research, Risk, Surgery
Bachmann JM, Shah AS, Duncan MS
Cardiac rehabilitation and readmissions after heart transplantation.
Cardiac transplant recipients always are referred to cardiac rehabilitation (CR) after transplantation, and is associated with a lower 1-year readmission risk. This study’s objective was to determine rates of CR for heart transplant recipients in the US and also 1-year readmission rates using 2013-2014 Medicare data. Out of the 2,531 heart transplant patients in the US in 2013, about 24% received Medicare coverage and were included in the study. Rates of CR utilization was only, with only 55% participating in the program. Younger transplant patients ages 35 to 49 years were less likely to initiate CR than patients 65 and older. In all groups patients did not attend all 36 prescribed sessions, with a mean of 26.7 sessions attended. The 1-year readmission risk was 29% lower for CR participation patients.
AHRQ-funded; HS022990.
Citation: Bachmann JM, Shah AS, Duncan MS .
Cardiac rehabilitation and readmissions after heart transplantation.
J Heart Lung Transplant 2018 Apr;37(4):467-76. doi: 10.1016/j.healun.2017.0.017.
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Keywords: Transplantation, Surgery, Rehabilitation, Cardiovascular Conditions, Heart Disease and Health, Hospital Readmissions, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Parikh K, Hall M, Kenyon CC
Impact of discharge components on readmission rates for children hospitalized with asthma.
This study described hospital-based asthma-specific discharge components at children's hospitals and determine the association of these discharge components with pediatric asthma readmission rates. No individual or combination discharge components were associated with lower 30-day adjusted readmission rates. The only single-component significantly associated with a lower rate of readmission at 3 months was having comprehensive content of education.
AHRQ-funded; HS024554.
Citation: Parikh K, Hall M, Kenyon CC .
Impact of discharge components on readmission rates for children hospitalized with asthma.
J Pediatr. 2018 Apr;195:175-181.e2. doi: 10.1016/j.jpeds.2017.11.062..
Keywords: Asthma, Children/Adolescents, Hospital Discharge, Hospital Readmissions, Patient-Centered Outcomes Research
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
Makam AN, Nguyen OK, Clark C
Incidence, predictors, and outcomes of hospital-acquired anemia.
This study examined the incidence, predictors, and postdischarge outcomes associated with hospital-acquired anemia (HAA). Most patients with severe HAA (85 percent) underwent a major procedure, had a discharge diagnosis of hemorrhage, and/or a discharge diagnosis of hemorrhagic disorder. Severe HAA is associated with increased odds for 30-day mortality and readmission after discharge; however, it is uncertain whether severe HAA is preventable.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Clark C .
Incidence, predictors, and outcomes of hospital-acquired anemia.
J Hosp Med 2017 May;12(5):317-22. doi: 10.12788/jhm.2723
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Keywords: Electronic Health Records (EHRs), Hospital Readmissions, Hospitalization, Patient-Centered Outcomes Research, Risk
Francis DO, Fonnesbeck C, Sathe N
Postoperative bleeding and associated utilization following tonsillectomy in children.
This review assessed posttonsillectomy hemorrhage (PTH), associated nonoperative readmissions/revisits, and reoperations in children. It concluded that PTH occurred in roughly 4 percent of tonsillectomies. Although studies typically did not report bleeding severity or amount, relatively few episodes of PTH necessitated reoperation for hemostasis. Frequency of PTH across techniques was similar; thus, it cannot be concluded that a given technique is superior.
AHRQ-funded; 290201500003I.
Citation: Francis DO, Fonnesbeck C, Sathe N .
Postoperative bleeding and associated utilization following tonsillectomy in children.
Otolaryngol Head Neck Surg 2017 Mar;156(3):442-55. doi: 10.1177/0194599816683915.
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Keywords: Children/Adolescents, Surgery, Adverse Events, Hospital Readmissions, Patient-Centered Outcomes Research
Fish DR, Mancuso CA, Garcia-Aguilar JE
Readmission after ileostomy creation: retrospective review of a common and significant event.
This study evaluated the causes and predictors of readmission after new ileostomy creation. It concluded that Readmissions are most commonly caused by dehydration, and are predicted by serious complications, comorbidity burden, loop stoma, shorter length of stay, and age. Readmissions in older patients are easier to predict, representing an important target for improvement.
AHRQ-funded; HS000066.
Citation: Fish DR, Mancuso CA, Garcia-Aguilar JE .
Readmission after ileostomy creation: retrospective review of a common and significant event.
Ann Surg 2017 Feb;265(2):379-87. doi: 10.1097/sla.0000000000001683.
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Keywords: Patient-Centered Outcomes Research, Surgery, Hospital Readmissions, Adverse Events
Nguyen OK, Makam AN, Clark C
Vital signs are still vital: instability on discharge and the risk of post-discharge adverse outcomes.
This study assessed the association between vital sign instability at hospital discharge and post-discharge adverse outcomes. Having two or more vital sign instabilities at discharge had a positive predictive value of 22 percent and positive likelihood ratio of 1.8 for 30-day death or readmission. Vital sign instability on discharge is thus associated with increased risk-adjusted rates of 30-day mortality and readmission.
AHRQ-funded; HS022418.
Citation: Nguyen OK, Makam AN, Clark C .
Vital signs are still vital: instability on discharge and the risk of post-discharge adverse outcomes.
J Gen Intern Med 2017 Jan;32(1):42-48. doi: 10.1007/s11606-016-3826-8.
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Keywords: Hospital Discharge, Hospital Readmissions, Patient-Centered Outcomes Research, Risk
Baillargeon J, Deer RR, Kuo YF
Androgen therapy and rehospitalization in older men with testosterone deficiency.
This study assessed whether the receipt of androgen therapy is associated with a reduced 30-day rehospitalization rate among older men with testosterone deficiency. It concluded that androgen therapy may reduce the risk of rehospitalization in older men with testosterone deficiency.
AHRQ-funded; HS022134.
Citation: Baillargeon J, Deer RR, Kuo YF .
Androgen therapy and rehospitalization in older men with testosterone deficiency.
Mayo Clin Proc 2016 May;91(5):587-95. doi: 10.1016/j.mayocp.2016.03.016.
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Keywords: Elderly, Hospital Readmissions, Medication, Men's Health, Patient-Centered Outcomes Research
Vora AN, Peterson ED, Hellkamp AS
Care transitions after acute myocardial infarction for transferred-in versus direct-arrival patients.
Many patients in the United States require transfer from one hospital to another for acute myocardial infarction (MI) care. How well these transferred-in patients are transitioned back to their local community is unknown. This study found that transferred-in patients with acute MI are less likely to have outpatient clinic follow-up within 30 days and more likely to be readmitted within the first 30 days post discharge compared with direct-arrival patients.
AHRQ-funded; HS021092.
Citation: Vora AN, Peterson ED, Hellkamp AS .
Care transitions after acute myocardial infarction for transferred-in versus direct-arrival patients.
Circ Cardiovasc Qual Outcomes 2016 Mar;9(2):109-16. doi: 10.1161/circoutcomes.115.002108.
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Keywords: Transitions of Care, Hospital Readmissions, Cardiovascular Conditions, Patient-Centered Outcomes Research, Hospital Discharge
DeVore AD, Hammill BG, Hardy NC
Has public reporting of hospital readmission rates affected patient outcomes?: Analysis of Medicare claims data.
Following the implementation of Centers for Medicare & Medicaid Services (CMS) public reporting, this study assessed trends of 30-day readmission rates and post-discharge care for patients discharged with acute myocardial infarction (MI), heart failure (HF), or pneumonia. It found that the release of the CMS public reporting of hospital readmission rates did not change 30-day readmission trends for MI, HF, or pneumonia, but it was associated with less hospital-based acute care for HF.
AHRQ-funded; HS021092.
Citation: DeVore AD, Hammill BG, Hardy NC .
Has public reporting of hospital readmission rates affected patient outcomes?: Analysis of Medicare claims data.
J Am Coll Cardiol 2016 Mar 1;67(8):963-72. doi: 10.1016/j.jacc.2015.12.037.
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Keywords: Public Reporting, Hospital Readmissions, Outcomes, Medicare, Patient-Centered Outcomes Research
Sabbatini AK, Kocher KE, Basu A
In-hospital outcomes and costs among patients hospitalized during a return visit to the emergency department.
This study examined in-hospital clinical outcomes and resource use among patients who are hospitalized during an unscheduled return visit to the ED.It found that, compared with adult patients who were hospitalized during the index ED visit and did not have a return visit to the ED, patients who were initially discharged during an ED visit and admitted during a return visit to the ED had lower in-hospital mortality.
AHRQ-funded; HS024160; HS022982.
Citation: Sabbatini AK, Kocher KE, Basu A .
In-hospital outcomes and costs among patients hospitalized during a return visit to the emergency department.
JAMA 2016 Feb 16;315(7):663-71. doi: 10.1001/jama.2016.0649.
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Keywords: Patient-Centered Outcomes Research, Hospital Readmissions, Emergency Department, Hospitalization
Blecker S, Goldfeld K, Park H
Impact of an intervention to improve weekend hospital care at an academic medical center: an observational study.
The purpose of this study was to evaluate the impact of a weekend hospital intervention on processes of care and clinical outcomes. The multifaceted intervention included expanded weekend diagnostic services, improved weekend discharge processes, and increased physician and care management services on weekends. The intervention was associated with a reduction in length of stay and an increase in weekend discharges.
AHRQ-funded; HS023683.
Citation: Blecker S, Goldfeld K, Park H .
Impact of an intervention to improve weekend hospital care at an academic medical center: an observational study.
J Gen Intern Med 2015 Nov;30(11):1657-64. doi: 10.1007/s11606-015-3330-6.
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Keywords: Quality Improvement, Quality of Care, Hospitals, Hospital Discharge, Hospital Readmissions, Healthcare Delivery, Outcomes, Patient-Centered Outcomes Research
Nijhawan AE, Kitchell E, Etherton SS
Half of 30-day hospital readmissions among HIV-infected patients are potentially preventable.
The researchers assessed whether readmissions among HIV-infected patients were potentially preventable using both published criteria and detailed chart review, how readmissions might have been prevented, and the phase of care deemed suboptimal (inpatient care, discharge planning, post-discharge). They found that among 130 individuals experiencing 30-day readmissions, about half were determined to be potentially preventable using published criteria (53 percent) or implicit chart review (48 percent).
AHRQ-funded; HS022418.
Citation: Nijhawan AE, Kitchell E, Etherton SS .
Half of 30-day hospital readmissions among HIV-infected patients are potentially preventable.
AIDS Patient Care STDS 2015 Sep;29(9):465-73. doi: 10.1089/apc.2015.0096..
Keywords: Human Immunodeficiency Virus (HIV), Hospital Readmissions, Electronic Health Records (EHRs), Patient-Centered Outcomes Research, Prevention
Williams TP, Dimou FM, Adhikari D
Hospital readmission after emergency room visit for cholelithiasis.
This study evaluated the surgical follow-up and outcomes in patients seen in the emergency department (ED) for an episode of symptomatic cholelithiasis and discharged home for elective follow-up. It found that the failure to achieve a timely surgical follow-up leads to multiple ED readmissions and emergent gallstone-related hospitalizations, including emergency cholecystectomy.
AHRQ-funded; HS022134.
Citation: Williams TP, Dimou FM, Adhikari D .
Hospital readmission after emergency room visit for cholelithiasis.
J Surg Res 2015 Aug;197(2):318-23. doi: 10.1016/j.jss.2015.04.032..
Keywords: Hospital Readmissions, Patient-Centered Outcomes Research, Emergency Department, Hospital Discharge, Surgery
Chin DL, Wilson MH, Bang H
Comparing patient outcomes of academician-preceptors, hospitalist-preceptors, and hospitalists on internal medicine services in an academic medical center.
The aim of this study was to compare patient outcomes between hospitalist-preceptors and hospitalists working alone, and between hospitalist-preceptors and academician-preceptors. The researchers found that preceptor-led medicine services were associated with more readmissions within 30 days, shorter lengths of stay, and lower index admission-associated costs. However, they also found that when considering cumulative hospitalization costs, patients discharged by academician-preceptors incurred the highest cost and hospitalist-preceptors incurred the lowest cost.
AHRQ-funded; HS022236.
Citation: Chin DL, Wilson MH, Bang H .
Comparing patient outcomes of academician-preceptors, hospitalist-preceptors, and hospitalists on internal medicine services in an academic medical center.
J Gen Intern Med 2014 Dec;29(12):1672-8. doi: 10.1007/s11606-014-2982-y.
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Keywords: Comparative Effectiveness, Hospital Readmissions, Patient-Centered Outcomes Research, Teams
Thomas KS, Rahman M, Mor V
Influence of hospital and nursing home quality on hospital readmissions.
The authors sought to determine whether the quality of the hospital and of the nursing home (NH) to which a patient was discharged were related to the likelihood of rehospitalization. They found that patients discharged from higher-quality hospitals and patients who received care in higher-quality NHs were less likely to be rehospitalized within 30 days. They concluded that the passage of the Affordable Care Act changed the accountability of hospitals for patients' outcomes after discharge, and that their study highlights the joint accountability of hospitals and NHs for rehospitalization of patients.
AHRQ-funded; HS000011.
Citation: Thomas KS, Rahman M, Mor V .
Influence of hospital and nursing home quality on hospital readmissions.
Am J Manag Care 2014 Nov;20(11):e523-31.
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Keywords: Quality of Care, Hospitals, Nursing Homes, Patient-Centered Outcomes Research, Hospital Readmissions
Goode AP, Richardson WJ, Schectman RM
Complications, revision fusions, readmissions, and utilization over a 1-year period after bone morphogenetic protein use during primary cervical spine fusions.
The authors sought to determine the 1-year risk of complications, cervical revision fusions, hospital readmissions, and health care services utilization after bone morphogenetic protein (BMP) use with cervical spine fusions. They found that patients receiving BMP were 29% more likely to have a complication and a nervous system complication; cervical revision fusions were more likely among patients receiving BMP; the risk of 30-day readmission was greater with BMP use; and readmission occurred 27.4% sooner on an average. Additionally, patients receiving BMP were more likely to receive computed tomography scans and epidurals with anterior surgical approaches.
AHRQ-funded; HS019479.
Citation: Goode AP, Richardson WJ, Schectman RM .
Complications, revision fusions, readmissions, and utilization over a 1-year period after bone morphogenetic protein use during primary cervical spine fusions.
Spine J 2014 Sep;14(9):2051-9. doi: 10.1016/j.spinee.2013.11.042.
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Keywords: Adverse Events, Hospital Readmissions, Patient Safety, Outcomes, Patient-Centered Outcomes Research, Surgery, Treatments