National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Behavioral Health (1)
- Cancer (1)
- Children/Adolescents (2)
- Clinician-Patient Communication (1)
- Communication (1)
- Depression (1)
- Elderly (7)
- (-) Emergency Department (25)
- Emergency Medical Services (EMS) (3)
- Healthcare Cost and Utilization Project (HCUP) (3)
- Healthcare Utilization (1)
- Health Information Exchange (HIE) (1)
- Health Information Technology (HIT) (1)
- (-) Hospital Discharge (25)
- Hospitalization (5)
- Hospital Readmissions (15)
- Hospitals (2)
- Imaging (1)
- Medicare (5)
- Medication (1)
- Nursing (1)
- Nursing Homes (1)
- Opioids (2)
- Outcomes (4)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (2)
- Practice Patterns (1)
- Quality of Care (1)
- Quality of Life (1)
- Risk (1)
- Rural Health (1)
- Social Determinants of Health (1)
- Substance Abuse (1)
- Surgery (1)
- Transitions of Care (2)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 25 Research Studies DisplayedCavallaro SC, Michelson KA, D'Ambrosi G
Critical revisits among children after emergency department discharge.
This retrospective study’s objectives were to determine the rate of critical emergency department (ED) revisits among children discharged from the ED and to identify factors associated with critical revisits. Using the HCUP State ED Databases (SEDD) and State Inpatient Databases (SID), researchers examined data from six states, including patients under 21 years old. The findings indicated that critical ED revisits after discharge were uncommon and patient death within three days of ED discharge were rare; patients with complex chronic conditions were more likely to have a critical ED revisit. The researchers concluded that future research should focus on understanding higher risk among patients with asthma or a history of complex chronic conditions.
AHRQ-funded; HS026503.
Citation: Cavallaro SC, Michelson KA, D'Ambrosi G .
Critical revisits among children after emergency department discharge.
Ann Emerg Med 2023 Nov; 82(5):575-82. doi: 10.1016/j.annemergmed.2023.06.006..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Hospital Discharge
Dresden SM, Lo AX, Lindquist LA
The impact of Geriatric Emergency Department Innovations (GEDI) on health services use, health related quality of life, and costs: protocol for a randomized controlled trial.
The objective of this randomized controlled trial is to evaluate the efficacy of the Geriatric Emergency Department Innovations (GEDI) program, an ED nurse-led geriatric assessment and care coordination program, in decreasing unnecessary health services use and improving Health-Related Quality-of-Life (HRQoL) for older adults in the ED. Community-dwelling older adults aged 65 and older who are vulnerable or frail according to the Clinical Frailty Scale during an ED visit will be randomized to either GEDI or to usual ED care. The primary outcome is hospitalization or death within 30 days of the ED visit. Secondary outcomes include health service use outcomes, healthcare costs, and HRQoL outcomes.
AHRQ-funded; HS026489.
Citation: Dresden SM, Lo AX, Lindquist LA .
The impact of Geriatric Emergency Department Innovations (GEDI) on health services use, health related quality of life, and costs: protocol for a randomized controlled trial.
Contemp Clin Trials 2020 Oct;97:106125. doi: 10.1016/j.cct.2020.106125..
Keywords: Elderly, Emergency Department, Quality of Life, Hospitalization, Hospital Discharge
Wentz AE, Wang RRC, Marshall BDL
Variation in opioid analgesia administration and discharge prescribing for emergency department patients with suspected urolithiasis.
Previous research has suggested caution about opioid analgesic usage in the emergency department (ED) setting and raised concerns about variations in prescription opioid analgesic usage, both across institutions and for whom they are prescribed. In this study, the investigators examined opioid analgesic usage in ED patients with suspected urolithiasis across fifteen participating hospitals. They found marked hospital-level differences in opioid analgesic administration and prescribing, as well as associations with education, healthcare insurance, and race/ethnicity groups.
AHRQ-funded; HS019312.
Citation: Wentz AE, Wang RRC, Marshall BDL .
Variation in opioid analgesia administration and discharge prescribing for emergency department patients with suspected urolithiasis.
Am J Emerg Med 2020 Oct;38(10):2119-24. doi: 10.1016/j.ajem.2020.07.016..
Keywords: Opioids, Medication, Emergency Department, Practice Patterns, Hospital Discharge
Rising KL, Powell RE, Cameron KA
Development of the uncertainty communication checklist: a patient-centered approach to patient discharge from the emergency department.
Acad Med 2020 Jul;95(7):1026-34. doi: 10.1097/acm.0000000000003231.
AHRQ-funded; HS025651.
Citation: Rising KL, Powell RE, Cameron KA .
Development of the uncertainty communication checklist: a patient-centered approach to patient discharge from the emergency department.
Acad Med 2020 Jul;95(7):1026-34. doi: 10.1097/acm.0000000000003231..
Keywords: Patient-Centered Healthcare, Hospital Discharge, Emergency Department, Clinician-Patient Communication, Communication
Hsuan C, Carr BG, Hsia RY
Assessment of hospital readmissions from the emergency department after implementation of Medicare's hospital readmissions reduction program.
The purpose of this study was to examine whether the Medicare Hospital Readmissions Reduction Program (HRRP) was associated with changes in the probability of readmission at emergency department (ED) visits after hospital discharge (ED revisits) overall and depending on whether admission is typically indicated for the patient's condition at the ED revisit. Using hospital and ED discharge data from California, Florida, and New York, findings suggested that implementation of the HRRP was associated with a lower likelihood of readmission for recently discharged patients presenting to the ED, specifically for congestive heart failure. These findings highlighted the critical role of the ED in readmission reduction under the HRRP and suggested that patient outcomes after HRRP implementation merit further study.
AHRQ-funded; HS025838.
Citation: Hsuan C, Carr BG, Hsia RY .
Assessment of hospital readmissions from the emergency department after implementation of Medicare's hospital readmissions reduction program.
JAMA Netw Open 2020 May;3(5):e203857. doi: 10.1001/jamanetworkopen.2020.3857..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Hospital Readmissions, Hospital Discharge, Hospitals, Medicare
Paredes AZ, Malik AT, Cluse M
Discharge disposition to skilled nursing facility after emergent general surgery predicts a poor prognosis.
Emergency general surgery can have a profound impact on the functional status of even previously independent patients. In this study, the investigators examined the role and influence of discharging a patient to a skilled nursing facility. They concluded that after accounting for patient severity and perioperative course, discharge to a skilled nursing facility was an independent risk factor for death, readmission, and postdischarge complications.
AHRQ-funded; HS022694.
Citation: Paredes AZ, Malik AT, Cluse M .
Discharge disposition to skilled nursing facility after emergent general surgery predicts a poor prognosis.
Surgery 2019 Oct;166(4):489-95. doi: 10.1016/j.surg.2019.04.034..
Keywords: Nursing Homes, Hospital Discharge, Elderly, Ambulatory Care and Surgery, Emergency Department, Outcomes, Hospital Readmissions, Outcomes, Risk
Hong AS, Sadeghi N, Harvey V
Characteristics of emergency department visits and select predictors of hospitalization for adults with newly diagnosed cancer in a safety-net health system.
There is little description of emergency department (ED) visits and subsequent hospitalizations among a safety-net cancer population. In this study, the investigators characterized patterns of ED visits and explored nonclinical predictors of subsequent hospitalization, including time of ED arrival. They concluded that ED visits are common among safety-net patients with newly diagnosed cancer, and hospitalizations may be influenced by nonclinical factors.
AHRQ-funded; HS022418.
Citation: Hong AS, Sadeghi N, Harvey V .
Characteristics of emergency department visits and select predictors of hospitalization for adults with newly diagnosed cancer in a safety-net health system.
J Oncol Pract 2019 Jun;15(6):e490-e500. doi: 10.1200/jop.18.00614..
Keywords: Cancer, Emergency Department, Hospitalization, Hospital Discharge
Gupta A, Lacson R, Balthazar PC
Assessing documentation of critical imaging result follow-up recommendations in emergency department discharge instructions.
The purpose of this study was to facilitate follow-up of critical test results across transitions in patient care settings, the investigators implemented an electronic discharge module that enabled care providers to include follow-up recommendations in the discharge instructions. Implementation of a discharge module was associated with increased documentation of critical imaging finding follow-up recommendations in ED discharge instructions. However, one in four patients still did not receive adequate follow-up recommendations, suggesting further opportunities for performance improvement exist.
AHRQ-funded; HS022586.
Citation: Gupta A, Lacson R, Balthazar PC .
Assessing documentation of critical imaging result follow-up recommendations in emergency department discharge instructions.
J Digit Imaging 2018 Aug;31(4):562-67. doi: 10.1007/s10278-017-0039-6..
Keywords: Emergency Department, Health Information Technology (HIT), Hospital Discharge, Imaging, Transitions of Care
Sills MR, Macy ML, Kocher KE
Return visit admissions may not indicate quality of emergency department care for children.
The goal of this retrospective analysis was to test the hypothesis that in-hospital outcomes are worse among children admitted during a return ED visit than among those admitted during an index visit. Children who were hospitalized in Florida and New York hospitals during a return visit within 7 days were classified as "ED return admissions" or "readmissions"; in-hospital outcomes for ED return admissions and readmissions were compared to "index admissions without return admission". The results indicate that children who are initially discharged from the ED and then have a return admission had lower severity but similar cost in comparison with children who experienced an index admission without a return admission. The authors conclude that this suggests that ED return visit admissions do not involve worse outcomes than index admissions.
AHRQ-funded; HS024160; HS016418.
Citation: Sills MR, Macy ML, Kocher KE .
Return visit admissions may not indicate quality of emergency department care for children.
Acad Emerg Med 2018 Mar;25(3):283-92. doi: 10.1111/acem.13324..
Keywords: Children/Adolescents, Emergency Department, Hospital Discharge, Hospital Readmissions, Hospitals, Quality of Care, Outcomes
Tedesco D, Asch SM, Curtin C
Opioid abuse and poisoning: trends in inpatient and emergency department discharges.
This study analyzed national trends in inpatient and emergency department (ED) discharges for opioid abuse, dependence, and poisoning using Healthcare Cost and Utilization Project data.
AHRQ-funded; HS024096.
Citation: Tedesco D, Asch SM, Curtin C .
Opioid abuse and poisoning: trends in inpatient and emergency department discharges.
Health Aff 2017 Oct;36(10):1748-53. doi: 10.1377/hlthaff.2017.0260..
Keywords: Emergency Department, Healthcare Cost and Utilization Project (HCUP), Hospital Discharge, Opioids, Substance Abuse
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.
.
.
Keywords: Elderly, Emergency Department, Hospital Discharge, Hospital Readmissions, Medicare
Blecker S, Gavin NP, Park H
Observation units as substitutes for hospitalization or home discharge.
The purpose of this study is to determine the effect of the availability of observation units on hospitalizations and discharges to home for emergency department (ED) patients. The authors concluded that half of ED visits for chest pain that resulted in an observation unit admission were made by patients who may have been discharged home had the observation unit not been available.
AHRQ-funded; HS023683.
Citation: Blecker S, Gavin NP, Park H .
Observation units as substitutes for hospitalization or home discharge.
Ann Emerg Med 2016 Jun;67(6):706-13.e2. doi: 10.1016/j.annemergmed.2015.10.025.
.
.
Keywords: Hospitalization, Hospital Discharge, Emergency Department, Emergency Medical Services (EMS)
Shy BD, Kim EY, Genes NG
Increased identification of emergency department 72-hour returns using multihospital health information exchange.
The authors tested the use of a health information exchange (HIE) to improve identification of 72-hour return visits compared to individual hospitals' site-specific data. They found that HIE increased the identification ability of 72-hour ED return analyses by a mean of 11.16% compared with site-specific (no HIE) analyses. They concluded that their analysis demonstrates incremental improvements in the ability to identify early ED returns using increasing levels of HIE data aggregation.
AHRQ-funded; HS021261.
Citation: Shy BD, Kim EY, Genes NG .
Increased identification of emergency department 72-hour returns using multihospital health information exchange.
Acad Emerg Med 2016 May;23(5):645-9. doi: 10.1111/acem.12954.
.
.
Keywords: Emergency Department, Health Information Exchange (HIE), Hospital Discharge, Hospital Readmissions
Mitchell SE, Martin JM, Krizman K
Design and rationale for a randomized controlled trial to reduce readmissions among patients with depressive symptoms.
This study aims to examine the effectiveness of RED-D, a modified brief Cognitive behavioral therapy (CBT) protocol delivered as a post-discharge extension of the Re-Engineered Discharge (RED), in reducing 30-day readmissions rates and emergency department use as well as depressive symptoms for medical patients with comorbid depressive symptoms.
AHRQ-funded; HS019700.
Citation: Mitchell SE, Martin JM, Krizman K .
Design and rationale for a randomized controlled trial to reduce readmissions among patients with depressive symptoms.
Contemp Clin Trials 2015 Nov;45(Pt B):151-6. doi: 10.1016/j.cct.2015.08.016.
.
.
Keywords: Depression, Emergency Department, Hospital Discharge, Hospital Readmissions, Behavioral Health
Gabayan GZ, Derose SF, Chiu VY
Emergency department crowding and outcomes after emergency department discharge.
The researchers assess whether a panel of emergency department (ED) crowding measures, including 2 reported by the Centers for Medicare & Medicaid Services (CMS), is associated with inpatient admission and death within 7 days of ED discharge. Their findings suggest that ED length of stay is a proxy for unmeasured differences in case mix and challenge the validity of the CMS metric as a safety measure for discharged patients.
AHRQ-funded; HS018098.
Citation: Gabayan GZ, Derose SF, Chiu VY .
Emergency department crowding and outcomes after emergency department discharge.
.
Keywords: Emergency Department, Emergency Medical Services (EMS), Hospital Discharge, Outcomes, Hospitalization
Singh S, Lin YL, Nattinger AB
Variation in readmission rates by emergency departments and emergency department providers caring for patients after discharge.
This study of Texas acute-care hospitals and ED facilities has found that the risk of readmission varies by ED provider caring for patients after discharge. A large part of this variation is explained by the ED facility in which the ED providers practice. Thus, ED provider practices patterns and ED facility systems of care may be a target for interventions to reduce readmissions.
AHRQ-funded; HS022134.
Citation: Singh S, Lin YL, Nattinger AB .
Variation in readmission rates by emergency departments and emergency department providers caring for patients after discharge.
J Hosp Med 2015 Nov;10(11):705-10. doi: 10.1002/jhm.2407.
.
.
Keywords: Emergency Department, Elderly, Hospital Discharge, Hospital Readmissions, Medicare
Toth M, Holmes M, Van Houtven C
Rural Medicare beneficiaries have fewer follow-up visits and greater emergency department use postdischarge.
This study tested whether rural Medicare beneficiaries have a lower likelihood of follow-up care and greater likelihood of a readmission and ED visit within 30 days postdischarge, compared with urban beneficiaries. The results provide evidence of lower quality postdischarge care for Medicare beneficiaries in rural settings.
AHRQ-funded; HS000032.
Citation: Toth M, Holmes M, Van Houtven C .
Rural Medicare beneficiaries have fewer follow-up visits and greater emergency department use postdischarge.
Med Care 2015 Sep;53(9):800-8. doi: 10.1097/mlr.0000000000000401..
Keywords: Rural Health, Elderly, Medicare, Hospital Readmissions, Emergency Department, Hospital Discharge
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
Hinami K, Smith J, Deamant CD
When do patient-reported outcome measures inform readmission risk?
The study sought was to characterize changes in patient-reported outcome measures from hospital discharge to assess when they best inform risk of utilization as defined by readmissions or emergency department use. It concluded that routine measurement of patient-reported outcomes can help identify patients at higher risk for utilizations. For example, in-hospital assessments revealing high symptom burden and poor health status predicted 14-day reutilization.
AHRQ-funded; HS019481.
Citation: Hinami K, Smith J, Deamant CD .
When do patient-reported outcome measures inform readmission risk?
J Hosp Med 2015 May;10(5):294-300. doi: 10.1002/jhm.2366..
Keywords: Emergency Department, Healthcare Utilization, Hospital Discharge, Hospital Readmissions, Outcomes
Desai AD, Popalisky J, Simon TD
The effectiveness of family-centered transition processes from hospital settings to home: a review of the literature.
The objective of this study was to conduct a targeted literature review of studies examining the effectiveness of family-centered transition processes from hospital-and emergency department (ED)-to-home for improving patient health outcomes and health care utilization. It determined that patient-tailored discharge education is associated with improved patient health outcomes in pediatric ED patients.
AHRQ-funded; HS020506.
Citation: Desai AD, Popalisky J, Simon TD .
The effectiveness of family-centered transition processes from hospital settings to home: a review of the literature.
Hosp Pediatr 2015 Apr;5(4):219-31. doi: 10.1542/hpeds.2014-0097..
Keywords: Patient-Centered Outcomes Research, Hospital Discharge, Emergency Department, Emergency Medical Services (EMS), Transitions of Care
Shy BD, Shapiro JS, Shearer PL
A conceptual framework for improved analyses of 72-hour return cases.
The researchers describe the potential importance and limitations of reviewing cases where patients return to emergency departments (EDs) within 72-hours of discharge. They outline a novel framework for carrying out this practice. Within this framework, they describe the selection, training, and monitoring of QA reviewers, the attention reviewers should give to returning ED patients who are subsequently admitted, as well as several other topics.
AHRQ-funded; HS021261.
Citation: Shy BD, Shapiro JS, Shearer PL .
A conceptual framework for improved analyses of 72-hour return cases.
Am J Emerg Med 2015 Jan;33(1):104-7. doi: 10.1016/j.ajem.2014.08.005..
Keywords: Emergency Department, Hospital Discharge, Hospital Readmissions
Gabayan GZ, Sarkisian CA, Liang LJ
Predictors of admission after emergency department discharge in older adults.
The objective of this study was to identify the incidence and predictors of admissions to nonfederal California hospitals within 7 days of ED discharge of older Medicare beneficiaries. It found that five percent of older Medicare beneficiaries have a hospital inpatient admission after discharge from the ED, with chronic disease such as renal disease and heart failure being associated with the greatest odds of admission.
AHRQ-funded; HS18098.
Citation: Gabayan GZ, Sarkisian CA, Liang LJ .
Predictors of admission after emergency department discharge in older adults.
J Am Geriatr Soc 2015 Jan;63(1):39-45. doi: 10.1111/jgs.13185..
Keywords: Elderly, Emergency Department, Hospital Discharge, Hospital Readmissions, Medicare
Goldman LE, Sarkar U, Kessell E
Support from hospital to home for elders: a randomized trial.
The researchers studied a peridischarge, nurse-led intervention combined with telephone follow-up designed to reduce readmissions among patients who were 55 or older. They found that the nurse-led, in-hospital discharge support intervention did not show a reduction in readmissions or ED visits among 700 diverse, low-income older adults at a safety-net hospital.
AHRQ-funded; HS018090.
Citation: Goldman LE, Sarkar U, Kessell E .
Support from hospital to home for elders: a randomized trial.
Ann Intern Med 2014 Oct 7;161(7):472-81. doi: 10.7326/m14-0094..
Keywords: Hospital Discharge, Hospital Readmissions, Emergency Department, Elderly, Social Determinants of Health, Nursing
Mitchell SE, Gardiner PM, Sadikova E
Patient activation and 30-day post-discharge hospital utilization.
This study examining the role of patient activation in the rate of hospital readmission within 30 days of discharge found that adult medical patients in an urban academic safety net hospital with lower levels of patient activation had a higher rate of post-discharge 30-day hospital utilization.
AHRQ-funded; HS019771.
Citation: Mitchell SE, Gardiner PM, Sadikova E .
Patient activation and 30-day post-discharge hospital utilization.
J Gen Intern Med. 2014 Feb;29(2):349-55. doi: 10.1007/s11606-013-2647-2..
Keywords: Emergency Department, Hospital Discharge, Hospital Readmissions, Hospitalization
Gabayan GZ, Asch SM, Hsia RY
Factors associated with short-term bounce-back admissions after emergency department discharge.
The researchers describe the prevalence, characteristics, and predictors of 7-day bounce-back admissions after ED discharge in a cohort of California hospitals. They found that older white men and patients with a disposition of eloped or having left against medical advice especially at risk for a bounce-back admission. They also found that use of Medicaid or Medicare was associated with higher rates of bounce-back admission.
AHRQ-funded; HS018098.
Citation: Gabayan GZ, Asch SM, Hsia RY .
Factors associated with short-term bounce-back admissions after emergency department discharge.
Ann Emerg Med 2013 Aug;62(2):136-44.e1. doi: 10.1016/j.annemergmed.2013.01.017..
Keywords: Emergency Department, Hospital Discharge, Hospital Readmissions