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
- Access to Care (1)
- Behavioral Health (2)
- Cardiovascular Conditions (1)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Disabilities (1)
- Disparities (1)
- Elderly (1)
- Emergency Department (1)
- Healthcare Cost and Utilization Project (HCUP) (4)
- Heart Disease and Health (1)
- Hospital Discharge (2)
- Hospitalization (1)
- (-) Hospital Readmissions (13)
- Hospitals (1)
- Low-Income (2)
- Medicaid (2)
- Medication (1)
- Mortality (1)
- Nursing (1)
- Opioids (1)
- Outcomes (1)
- Patient Safety (1)
- Policy (1)
- Racial and Ethnic Minorities (3)
- Respiratory Conditions (2)
- Risk (2)
- (-) Social Determinants of Health (13)
- Substance Abuse (2)
- Surgery (1)
- Vulnerable Populations (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 13 of 13 Research Studies DisplayedRyus CR, Janke AT, Kunnath N
Association of hospital discharge against medical advice and coded housing instability in the US.
This study examined the relationship between discharge type and housing instability, then identified primary reasons for hospitalization among self-discharged patients with housing instability. This cross-sectional, retrospective study analyzed the National Inpatient Sample between January 2017 and December 2019, available from the Agency for Healthcare Research and Quality’s Healthcare Cost and Utilization Project. Among 85,402,831 hospitalizations analyzed, 1.6% resulted in self-discharge. Compared to admissions with planned discharges, self-discharges were more likely to have coded housing instability. Among hospitalizations resulting in self-discharge, admissions with coded housing instability were more likely to result in self-discharge than those without coded housing instability. Relationships between housing instability and self-discharges were found among major medical conditions: septicemia, acute myocardial infarction, and respiratory failure. Alcohol-related disorders and opioid-related disorders were among the highest self-discharge volumes, but relationships were minimal.
AHRQ-funded; HS028963.
Citation: Ryus CR, Janke AT, Kunnath N .
Association of hospital discharge against medical advice and coded housing instability in the US.
J Gen Intern Med 2023 Oct; 38(13):3082-85. doi: 10.1007/s11606-023-08240-1..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Discharge, Social Determinants of Health, Vulnerable Populations, Hospital Readmissions
Rogstad TL, Gupta S, Connolly J
Social risk adjustment In the hospital readmissions reduction program: a systematic review and implications for policy.
Investigators reviewed fourteen studies of social risk adjustment in Medicare's Hospital Readmissions Reduction Program (HRRP). They concluded that their findings support the use of social risk adjustment to improve provider payment equity and highlight opportunities to enhance social risk adjustment in value-based payment programs.
AHRQ-funded; HS026727.
Citation: Rogstad TL, Gupta S, Connolly J .
Social risk adjustment In the hospital readmissions reduction program: a systematic review and implications for policy.
Health Aff 2022 Sep;41(9):1307-15. doi: 10.1377/hlthaff.2022.00614..
Keywords: Social Determinants of Health, Hospital Readmissions, Risk, Policy
Carroll AR, Hall M, Brown CM
Association of race/ethnicity and social determinants with rehospitalization for mental health conditions at acute care children's hospitals.
This retrospective cohort study evaluated the associations of race/ethnicity and social determinants with 90-day rehospitalization of children with mental health conditions to acute non-psychiatric children’s hospitals. Children included were aged 5 to 18 years at 32 freestanding U.S. children’s hospitals from 2016-2018 using the Children’s Hospital Association’s Pediatric Health Information System (PHIS) database to assess the association of race/ethnicity and social determinants (insurance payer, neighborhood median household income, and rurality of patient home location) with 90-day rehospitalization. Among 23,556 index hospitalizations, 5.9% (n = 1382) were rehospitalized for mental health within 90 days. Non-Hispanic Black children were 26% more likely to be rehospitalized than non-Hispanic White children. Those with government insurance were 18% more likely to rehospitalized than those with private insurance. Those living in a suburban location were 22% less likely to be rehospitalized than those living in an urban location.
AHRQ-funded; HS026122.
Citation: Carroll AR, Hall M, Brown CM .
Association of race/ethnicity and social determinants with rehospitalization for mental health conditions at acute care children's hospitals.
J Pediatr 2022 Jan;240:228-34.e1. doi: 10.1016/j.jpeds.2021.08.078..
Keywords: Children/Adolescents, Hospital Readmissions, Behavioral Health, Social Determinants of Health, Racial and Ethnic Minorities
Patel SA, Krasnow M, Long K
Excess 30-day heart failure readmissions and mortality in black patients increases with neighborhood deprivation.
Researchers examined whether neighborhood environment modifies the disparity in 30-day heart failure (HF) readmissions and mortality between Black and White patients in the Southeastern United States. They created a geocoded retrospective cohort of patients hospitalized for acute HF from 2010-2018 within Emory Healthcare. They found that excess 30-day HF readmissions and mortality were present among Black patients in every neighborhood strata and increased with progressive neighborhood socioeconomic deprivation.
AHRQ-funded; HS026081.
Citation: Patel SA, Krasnow M, Long K .
Excess 30-day heart failure readmissions and mortality in black patients increases with neighborhood deprivation.
Circ Heart Fail 2020 Dec;13(12):e007947. doi: 10.1161/circheartfailure.120.007947..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Hospital Readmissions, Racial and Ethnic Minorities, Mortality, Social Determinants of Health, Low-Income, Disparities
Basu J
AHRQ Author: Basu J
Multilevel risk factors for hospital readmission among patients with opioid use disorder in selected US States: role of socioeconomic characteristics of patients and their community.
This study examined the association of socioeconomic characteristics of individuals hospitalized with a principal diagnosis of opioid use disorder and their all-cause 30-day readmission risks. Discharge data from the 2014 HCUP Survey was used and was linked to community and hospital characteristics using data from HRSA and the American Hospital Association. Medicare is associated with the highest readmission risk followed by Medicaid covered patients. Self-pay or covered by other payers had a similar risk to private insurance coverage. Urban patients also had a higher readmission rate than rural patients.
AHRQ-authored.
Citation: Basu J .
Multilevel risk factors for hospital readmission among patients with opioid use disorder in selected US States: role of socioeconomic characteristics of patients and their community.
Health Serv Res Manag Epidemiol 2020 Jan-Dec;7:2333392820904240. doi: 10.1177/2333392820904240..
Keywords: Healthcare Cost and Utilization Project (HCUP), Opioids, Medication, Substance Abuse, Hospital Readmissions, Hospitals, Social Determinants of Health
Goto T, Yoshida K, Faridi MK
Contribution of social factors to readmissions within 30 days after hospitalization for COPD exacerbation.
This study examined whether adding social factors improved the predictive ability for 30-day hospital readmissions for COPD. Social factors include educational level and marital status. Out of 905 hospitalizations identified in the Medicare Current Beneficiary Survey from 2006 through 2012, 18.5% were readmitted within 30 days. The optimized model including social factors for prediction improved for early readmissions but not for late readmissions.
AHRQ-funded; HS023305.
Citation: Goto T, Yoshida K, Faridi MK .
Contribution of social factors to readmissions within 30 days after hospitalization for COPD exacerbation.
BMC Pulm Med 2020 Apr 29;20(1):107. doi: 10.1186/s12890-020-1136-8..
Keywords: Respiratory Conditions, Hospital Readmissions, Hospitalization, Social Determinants of Health, Chronic Conditions
Goto T, Faridi MK, Gibo K
Trends in 30-day readmission rates after COPD hospitalization, 2006-2012.
This study investigated trends in 30-day readmission rates after chronic obstructive pulmonary disease (COPD)-related hospitalization. Overall, the 30-day readmission rate for COPD-related hospitalization decreased modestly from 20.0 percent in 2006 to 19.2 percent in 2012. Similar to the overall population, the readmission rate over the 7-year period remained persistently high in most of AHRQ-defined priority populations.
AHRQ-funded; HS023305.
Citation: Goto T, Faridi MK, Gibo K .
Trends in 30-day readmission rates after COPD hospitalization, 2006-2012.
Respir Med 2017 Sep;130:92-97. doi: 10.1016/j.rmed.2017.07.058.
.
.
Keywords: Respiratory Conditions, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Social Determinants of Health, Vulnerable Populations
Meddings J, Reichert H, Smith SN
The impact of disability and social determinants of health on condition-specific readmissions beyond Medicare risk adjustments: a cohort study.
This study assessed the impact of disability and social determinants of health on condition-specific readmissions beyond current risk adjustment. Outcomes measured were readmissions </=30 days after hospitalizations for pneumonia, heart failure, or acute myocardial infarction. The study concluded that disability and social determinants of health influence readmission risk when added to the current Medicare risk adjustment models, but the effect varies by condition.
AHRQ-funded; HS018334.
Citation: Meddings J, Reichert H, Smith SN .
The impact of disability and social determinants of health on condition-specific readmissions beyond Medicare risk adjustments: a cohort study.
J Gen Intern Med 2017 Jan;32(1):71-80. doi: 10.1007/s11606-016-3869-x.
.
.
Keywords: Disabilities, Hospital Readmissions, Outcomes, Social Determinants of Health
Martsolf GR, Barrett ML, Weiss AJ
AHRQ Author: Steiner CA, Coffey R
Impact of race/ethnicity and socioeconomic status on risk-adjusted hospital readmission rates following hip and knee arthroplasty.
This study examined the extent to which risk-adjusting for race/ethnicity and socioeconomic status affected hospital performance in terms of readmission rates following total hip arthroplasty (THA) and total knee arthroplasty (TKA). It found that inclusion of race/ethnicity and socioeconomic status in the risk-adjustment algorithm led to a relative-performance change in readmission rates following THA and TKA at less than 3 percent of the hospitals.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Martsolf GR, Barrett ML, Weiss AJ .
Impact of race/ethnicity and socioeconomic status on risk-adjusted hospital readmission rates following hip and knee arthroplasty.
J Bone Joint Surg Am 2016 Aug 17;98(16):1385-91. doi: 10.2106/jbjs.15.00884.
.
.
Keywords: Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Social Determinants of Health, Hospital Readmissions, Surgery
Jiang HJ, Boutwell AE, Maxwell J
AHRQ Author: Jiang HJ
Understanding patient, provider, and system factors related to Medicaid readmissions.
This study was undertaken to understand the complexity of Medicaid readmission issues at the patient, provider, and system levels. It found that significant risk factors for Medicaid readmissions included financial stress, high prevalence of mental health and substance abuse disorders, medication nonadherence, and housing instability. Lacking awareness on Medicaid patients' high risk, a sufficient business case, and proven strategies for reducing readmissions were primary barriers for providers.
AHRQ-authored; AHRQ-funded; 290201000034I; 290201000030I.
Citation: Jiang HJ, Boutwell AE, Maxwell J .
Understanding patient, provider, and system factors related to Medicaid readmissions.
Jt Comm J Qual Patient Saf 2016 Mar;42(3):115-21.
.
.
Keywords: Medicaid, Hospital Readmissions, Access to Care, Social Determinants of Health, Risk
Balaban RB, Galbraith AA, Burns ME
A patient navigator intervention to reduce hospital readmissions among high-risk safety-net patients: a randomized controlled trial.
The researchers sough to determine if an intervention by patient navigators, hospital-based Community Health Workers, reduces readmissions among high risk, low socioeconomic status patients. They found that, overall, 30-day readmission rates did not differ between intervention and control patients.
AHRQ-funded; HS020628.
Citation: Balaban RB, Galbraith AA, Burns ME .
A patient navigator intervention to reduce hospital readmissions among high-risk safety-net patients: a randomized controlled trial.
J Gen Intern Med 2015 Jul;30(7):907-15. doi: 10.1007/s11606-015-3185-x..
Keywords: Hospital Readmissions, Low-Income, Social Determinants of Health, Patient Safety
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
Regenstein M, Andres E
Reducing hospital readmissions among Medicaid patients: a review of the literature.
This review aims to identify factors related to readmissions that are unique to Medicaid populations to inform efforts to reduce Medicaid readmissions. It concluded that much of the Medicaid readmissions literature focuses on patients with mental health or substance abuse issues, who are often high utilizers of health care within the Medicaid population.
AHRQ-funded; 290202010000301.
Citation: Regenstein M, Andres E .
Reducing hospital readmissions among Medicaid patients: a review of the literature.
Qual Manag Health Care 2014 Oct-Dec;23(4):203-25. doi: 10.1097/qmh.0000000000000043..
Keywords: Hospital Readmissions, Medicaid, Behavioral Health, Substance Abuse, Social Determinants of Health