National Healthcare Quality and Disparities Report
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 4 of 4 Research Studies DisplayedEverhart AO
Time to publication of cost-effectiveness analyses for medical devices.
This study examined the availability of cost-effectiveness analyses for medical devices, in terms of both the number of studies and when studies are published. The longer the time between FDA approval/clearance and publication of cost-effectiveness analyses of medical devices, the longer that decision makers will not have the evidence they and their patients need when making initial decisions related to newly available medical devices. An analysis was conducted using the Tufts University Cost-Effectiveness Analysis Registry to identify studies of medical devices that were linked to FDA databases. The years between FDA approval/clearance and publication of cost-effectiveness analyses were calculated. The authors identified a total of 218 cost-effectiveness analyses of medical devices in the United States published between 2002 and 2020. Of those studies, 39.4% were linked to FDA databases. Studies examining devices approved via premarket approval were published a mean of 6.0 years after the device received FDA approval, whereas studies examining devices that were cleared via the 510(k) process were published a mean of 6.5 years after the device received FDA clearance.
AHRQ-funded; HS027522.
Citation: Everhart AO .
Time to publication of cost-effectiveness analyses for medical devices.
Am J Manag Care 2023 May; 29(5):265-68. doi: 10.37765/ajmc.2023.89359..
Keywords: Medical Devices, Healthcare Costs
Likosky DS, Yang G, Zhang M
Interhospital variability in health care-associated infections and payments after durable ventricular assist device implant among Medicare beneficiaries.
The purpose of this study was to examine differences in durable ventricular assist device implantation infection rates and associated costs across hospitals. The researchers utilized clinical data for 8,688 patients who received primary durable ventricular assist devices from the Society of Thoracic Surgeons Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs) hospitals (n = 120) and merged that data with post-implantation 90-day Medicare claims. The primary outcome included infections within 90 days of implantation and Medicare payments. The study found that 27.8% of patients developed 3982 identified infections. The median adjusted incidence of infections (per 100 patient-months) across hospitals was 14.3 and differed according to hospital. Total Medicare payments from implantation to 90 days were 9.0% more in high versus low infection tercile hospitals. The researchers concluded that health-care-associated infection rates post durable ventricular assist device implantation varied according to hospital and were associated with increased 90-day Medicare expenditures.
AHRQ-funded; HS026003.
Citation: Likosky DS, Yang G, Zhang M .
Interhospital variability in health care-associated infections and payments after durable ventricular assist device implant among Medicare beneficiaries.
J Thorac Cardiovasc Surg 2022 Nov;164(5):1561-68. doi: 10.1016/j.jtcvs.2021.04.074..
Keywords: Healthcare-Associated Infections (HAIs), Medical Devices, Medicare, Heart Disease and Health, Cardiovascular Conditions, Hospitals, Payment, Healthcare Costs
Kim KD, Funk RJ, Hou H
Association between care fragmentation and total spending after durable left ventricular device implant: a mediation analysis of health care-associated infections within a national Medicare-Society of Thoracic Surgeons INTERMACS linked dataset.
The purpose of this study was to examine the relationship between care fragmentation and total spending for durable left ventricular assisted device (LVAD) implant, and whether this relationship is mediated by infections. The researchers developed a measure of care fragmentation based on the number of shared medical professionals providing care to 4,987 Medicare beneficiaries undergoing LVAD implantation. The study found that the indirect effect of care fragmentation, through infections, was positive and statistically significant. The researchers concluded that higher care fragmentation associated with durable LVAD implantation is related with a greater incidence of infections and higher Medicare beneficiary payments.
AHRQ-funded; HS026003.
Citation: Kim KD, Funk RJ, Hou H .
Association between care fragmentation and total spending after durable left ventricular device implant: a mediation analysis of health care-associated infections within a national Medicare-Society of Thoracic Surgeons INTERMACS linked dataset.
Circ Cardiovasc Qual Outcomes 2022 Sep;15(9):e008592. doi: 10.1161/circoutcomes.121.008592..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Healthcare Costs, Healthcare-Associated Infections (HAIs), Medicare, Medical Devices, Healthcare Delivery
Grennan M, Kim GH, McConnell KJ
Hospital management practices and medical device costs.
The authors sought to determine whether the variation in prices paid for cardiac medical devices was associated with management practices in cardiac units. Unit prices on management practice scores and other hospital characteristics were regressed for the 11 top-spending cardiac device categories. The authors found that better management practices were associated with lower device prices. They noted that this modest magnitude was similar to other events expected to lower input prices, such as transparency in the form of benchmarking information and hospital mergers.
AHRQ-funded; HS018466.
Citation: Grennan M, Kim GH, McConnell KJ .
Hospital management practices and medical device costs.
Health Serv Res 2022 Apr;57(2):227-36. doi: 10.1111/1475-6773.13898..
Keywords: Medical Devices, Hospitals, Healthcare Costs