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
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (4)
- Ambulatory Care and Surgery (1)
- Antimicrobial Stewardship (1)
- Communication (1)
- COVID-19 (2)
- Elderly (8)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Falls (5)
- Health Services Research (HSR) (1)
- Hospital Discharge (2)
- Hospitalization (1)
- Hospital Readmissions (1)
- Injuries and Wounds (3)
- Long-Term Care (7)
- Medical Errors (1)
- Medication (2)
- (-) Nursing Homes (14)
- Outcomes (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (3)
- Prevention (2)
- Provider (1)
- Provider: Health Personnel (1)
- Public Health (2)
- Quality Improvement (1)
- Quality of Care (1)
- (-) Risk (14)
- Transitions of Care (2)
- Vulnerable Populations (1)
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 14 of 14 Research Studies DisplayedDube WC, Kellogg JT, Adams C
Quantifying risk for SARS-CoV-2 infection among nursing home workers for the 2020-2021 winter surge of the COVID-19 pandemic in Georgia, USA.
This study’s objective was to estimate incidence of risks for COVID-19 infection among nursing home staff in the state of Georgia during the 2020-2021 Winter surge in the US. Staff at fourteen nursing homes were given a survey and serologic testing at 2 time points with 3-month interval exposure assessment. At the first time point, 203 study eligible contracted or employed staff members from these participating nursing homes were seronegative. At the second time point, 72 (35.5%) had evidence of interval infection. Among unvaccinated staff, infection rates were significantly higher among nurses and certified nursing assistants accounting for race and interval infection incidence in both the community and facility.
AHRQ-funded; HS025987.
Citation: Dube WC, Kellogg JT, Adams C .
Quantifying risk for SARS-CoV-2 infection among nursing home workers for the 2020-2021 winter surge of the COVID-19 pandemic in Georgia, USA.
J Am Med Dir Assoc 2022 Jun;23(6):942-46.e1. doi: 10.1016/j.jamda.2022.02.014..
Keywords: COVID-19, Nursing Homes, Provider: Health Personnel, Risk, Public Health
Temkin-Greener H, Guo W, Mao Y
COVID-19 pandemic in assisted living communities: results from seven states.
The purpose of this observational study was to describe variations in COVID-19 confirmed cases and deaths among assisted living (AL) residents and examine their associations with key AL characteristics. The investigators concluded that ALs with a higher proportion of minorities had more COVID-19 cases. Many of the previously identified individual risk factors were also present in this vulnerable population.
AHRQ-funded; HS024923; HS026893; HS026893.
Citation: Temkin-Greener H, Guo W, Mao Y .
COVID-19 pandemic in assisted living communities: results from seven states.
J Am Geriatr Soc 2020 Dec;68(12):2727-34. doi: 10.1111/jgs.16850..
Keywords: Elderly, Public Health, COVID-19, Nursing Homes, Vulnerable Populations, Risk
Mangrum R, Stewart MD, Gifford DR
Omissions of care in nursing homes: a uniform definition for research and quality improvement.
The goal of this study was to create a uniform definition of omission of care in US nursing homes. Lack of a uniform definition has made efforts to prevent them challenging. Subject matter experts and a broad range of nursing home stakeholders were brought together in iterative rounds of engagement to identify key concepts and aspects of omissions of care and develop a consensus-based definition. The concise definition decided on was: “Omissions of care in nursing homes encompass situations when care–either clinical or nonclinical–is not provided for a resident and results in additional monitoring or intervention or increases the risk of an undesirable or adverse physical, emotional, or psychosocial outcome for the resident."
AHRQ-funded; 233201500014I.
Citation: Mangrum R, Stewart MD, Gifford DR .
Omissions of care in nursing homes: a uniform definition for research and quality improvement.
J Am Med Dir Assoc 2020 Nov;21(11):1587-91.e2. doi: 10.1016/j.jamda.2020.08.016..
Keywords: Elderly, Nursing Homes, Long-Term Care, Quality Improvement, Quality of Care, Medical Errors, Adverse Events, Patient Safety, Risk, Patient-Centered Outcomes Research
Burke RE, Canamucio A, Medvedeva E
External validation of the skilled nursing facility prognosis score for predicting mortality, hospital readmission, and community discharge in veterans.
The goal of this study was to evaluate the Skilled Nursing Facility (SNF) Prognosis Score’s performance in an external validation cohort. Participants were previously community-dwelling veterans who received post-acute care in a SNF; both VA and non-VA hospitals and SNFs were included. Findings showed that the SNF Prognosis Score had reasonable discrimination and calibration, and it was simple to calculate using an admission SNF assessment and a nomogram. Recommendations included future work embedding the score into practice in order to determine real-world feasibility, acceptability, and effectiveness.
AHRQ-funded; HS026116.
Citation: Burke RE, Canamucio A, Medvedeva E .
External validation of the skilled nursing facility prognosis score for predicting mortality, hospital readmission, and community discharge in veterans.
J Am Geriatr Soc 2020 Sep;68(9):2090-94. doi: 10.1111/jgs.16650..
Keywords: Nursing Homes, Risk, Health Services Research (HSR)
Kapoor A, Field T, Handler S
Characteristics of long-term care residents that predict adverse events after hospitalization.
This study examined the characteristics of long-term care (LTC) residents that predict adverse events (AEs) after discharge from recent hospitalization. This cohort study looked at AEs that occurred at 32 nursing homes from six New England states. AE incidents involving a total of 555 LTC residents with 762 transitions from the hospital back to LTC were reviewed. The association between all AEs and preventable AEs developing in the 45 days following discharge back to LTC was measured. There were 283 discharges with one or more AEs and 212 with preventable AEs. Characteristics independently associated with higher risk of AEs included hospital length of stay (LOS) 9 or more days, 18 or more regularly scheduled medications, and 19 and above on the dependency in activities of daily living (ADL) scale.
AHRQ-funded; HS024422.
Citation: Kapoor A, Field T, Handler S .
Characteristics of long-term care residents that predict adverse events after hospitalization.
J Am Geriatr Soc 2020 Nov;68(11):2551-57. doi: 10.1111/jgs.16770..
Keywords: Elderly, Long-Term Care, Nursing Homes, Hospitalization, Adverse Events, Transitions of Care, Hospital Discharge, Risk
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
Aspinall SL, Springer SP, Zhao X
Central nervous system medication burden and risk of recurrent serious falls and hip fractures in Veterans Affairs nursing home residents.
This study investigated the association between taking central nervous system (CNS) medications with the risk of serious falls and hip fractures. Study participants were residents at a Veterans Health Administration (VHA) Community Living Center (CLC) between July 1, 2005 and June 30, 2009. This was a nested case-control study. The investigators concluded that there was a higher risk in those residents receiving 3.0 or more daily CNS medications.
AHRQ-funded; HS023779.
Citation: Aspinall SL, Springer SP, Zhao X .
Central nervous system medication burden and risk of recurrent serious falls and hip fractures in Veterans Affairs nursing home residents.
J Am Geriatr Soc 2019 Jan;67(1):74-80. doi: 10.1111/jgs.15603..
Keywords: Elderly, Falls, Injuries and Wounds, Long-Term Care, Medication, Nursing Homes, Patient Safety, Risk
Noureldin M, Hass Z, Abrahamson K
Fall risk, supports and services, and falls following a nursing home discharge.
The purpose of this study was to examine whether the presence of supports and services have an impact on the relationship between fall-related risk factors and fall occurrence following a nursing-home discharge. The study sample was comprised of 1459 participants in the Minnesota Return to Community Initiative, who had been assisted in achieving a community discharge; 15 percent of participants fell within 30 days of nursing-home discharge. A structural equation model was used to determine relationship between emerging latent variables and falls. Results indicated that use of high-risk medications and fall concerns/history had a direct, positive effect on falling. Receiving supports/services did not have a direct effect on falls, but the authors note that it reduced the effect of high-risk medication use on falling.
AHRQ-funded; HS020224.
Citation: Noureldin M, Hass Z, Abrahamson K .
Fall risk, supports and services, and falls following a nursing home discharge.
Gerontologist 2018 Nov 3;58(6):1075-84. doi: 10.1093/geront/gnx133..
Keywords: Adverse Events, Elderly, Falls, Nursing Homes, Risk
Berry SD, Zullo AR, Lee Y
Fracture Risk Assessment in Long-term Care (FRAiL): development and validation of a prediction model.
This paper’s objective was to develop and validate a model, Fracture Risk Assessment in Long-term Care (FRAiL) to predict the 2-year risk of hip fracture in nursing home (NH) residents using readily available clinical characteristics. The FRAiL model was developed specifically to identify NH residents at greatest risk for hip fracture, and results identified a different pattern of risk factors compared with community models. This practical model could be used to screen NH residents for fracture risk and to target intervention strategies.
AHRQ-funded; HS022998.
Citation: Berry SD, Zullo AR, Lee Y .
Fracture Risk Assessment in Long-term Care (FRAiL): development and validation of a prediction model.
J Gerontol A Biol Sci Med Sci 2018 May 9;73(6):763-69. doi: 10.1093/gerona/glx147.
.
.
Keywords: Elderly, Injuries and Wounds, Long-Term Care, Nursing Homes, Risk
Dore DD, Zullo AR, Mor V
Age, sex, and dose effects of nonbenzodiazepine hypnotics on hip fracture in nursing home residents.
This study examined the rate of hip fracture in nursing home residents prescribed nonbenzodiazepine hypnotics. A sample of nursing home residents was used and linked to Medicare and Minimum Data Set (2007-2008) data. The rate of hip fracture was higher in residents aged 90 and above, and lower in residents 70 or below. There was no different by sex.
AHRQ-funded; HS022998.
Citation: Dore DD, Zullo AR, Mor V .
Age, sex, and dose effects of nonbenzodiazepine hypnotics on hip fracture in nursing home residents.
J Am Med Dir Assoc 2018 Apr;19(4):328-32.e2. doi: 10.1016/j.jamda.2017.09.015..
Keywords: Injuries and Wounds, Medication, Nursing Homes, Long-Term Care, Adverse Drug Events (ADE), Adverse Events, Falls, Risk, Patient Safety
Cary MP, Hall RK, Anderson AL
Management team perceptions of risks and strategies for preventing falls among short-stay patients in nursing homes.
This study sought to understand and describe strategies reported by members of the nursing home management team used to prevent falls in short-stay nursing home patients. The authors propose interventions that might reduce falls for short-stay patients and could be tested in future research.
AHRQ-funded; HS022134.
Citation: Cary MP, Hall RK, Anderson AL .
Management team perceptions of risks and strategies for preventing falls among short-stay patients in nursing homes.
Health Care Manag 2018 Jan/Mar;37(1):76-85. doi: 10.1097/hcm.0000000000000192..
Keywords: Falls, Nursing Homes, Prevention, Provider, Risk
Britton MC, Ouellet GM, Minges KE
Care transitions between hospitals and skilled nursing facilities: perspectives of sending and receiving providers.
This study was conducted to identify the perspectives of sending and receiving providers regarding care transitions between the hospital and skilled nursing facilities. Four main themes emerged: increasing patient complexity, identifying an optimal care setting, rising financial pressure, and barriers to effective communication. The investigators indicated that the data highlighted hospital and SNF providers' shared concerns about patient-level risk factors and escalating costs of care.
AHRQ-funded; HS023554.
Citation: Britton MC, Ouellet GM, Minges KE .
Care transitions between hospitals and skilled nursing facilities: perspectives of sending and receiving providers.
.
Keywords: Communication, Long-Term Care, Nursing Homes, Risk, Transitions of Care
Marier A, Olsho LE, Rhodes W
AHRQ Author: Spector WD
Improving prediction of fall risk among nursing home residents using electronic medical records.
To identify individuals at highest risk for falls, the authors applied a repeated events survival model to analyze The Minimum Data Set ( MDS 3.0 and EMR data for 5129 residents in 13 nursing homes within a single large California chain. They found that incorporating EMR data improves ability to identify those at highest risk for falls relative to prediction using MDS data alone.
AHRQ-funded; AHRQ-authored; 290201000031I.
Citation: Marier A, Olsho LE, Rhodes W .
Improving prediction of fall risk among nursing home residents using electronic medical records.
J Am Med Inform Assoc 2016 Mar;23(2):276-82. doi: 10.1093/jamia/ocv061..
Keywords: Falls, Electronic Health Records (EHRs), Risk, Nursing Homes, Prevention
Min L, Galecki A, Mody L
Functional disability and nursing resource use are predictive of antimicrobial resistance in nursing homes.
This study used a simple measure of activities of daily living, wounds, and indwelling devices (urinary catheter, feeding tube) to predict prevalent, new, and intermittent multidrug-resistant organism (MDRO) acquisition in nursing home (NH) residents. It found that MDRO acquisition is common in community NHs. The need for nursing care predicts new MDRO acquisition in NHs, suggesting potential mechanisms for MDRO acquisition and strategies for future interventions for high-risk individuals.
AHRQ-funded; HS019979.
Citation: Min L, Galecki A, Mody L .
Functional disability and nursing resource use are predictive of antimicrobial resistance in nursing homes.
J Am Geriatr Soc 2015 Apr;63(4):659-66. doi: 10.1111/jgs.13353..
Keywords: Nursing Homes, Antimicrobial Stewardship, Elderly, Long-Term Care, Risk