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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 15 of 15 Research Studies DisplayedCollinsworth AW, Priest EL, Masica AL
Evaluating the cost-effectiveness of the ABCDE bundle: impact of bundle adherence on inpatient and 1-year mortality and costs of care.
This study examined the cost-effectiveness of the Awakening and Breathing Coordination, Delirium monitoring/management, and Early exercise/mobility (ABCDE) bundle intervention to improve short- and long-term clinical outcomes for patients requiring ICU care. A 2-year, prospective, cost-effectiveness study in 12 adult ICUs in six hospitals belonging to a large, integrated healthcare delivery system was conducted. Hospitals in the study included a large, urban center and five community hospitals. ICU types included medical/surgical, trauma, neurologic, and cardiac care units. The cohort included 2,953 adults with an ICU stay greater than 24 hours who were on a ventilator for more than 24 hours and less than 14 days. ICUs with high ABCDE bundle adherence significantly decreased odds of inpatient mortality and had significantly higher costs of inpatient care. The incremental cost-effectiveness ratio of high bundle adherence was $15,077 per life saved, and $1,057 per life-year saved.
AHRQ-funded; HS021459.
Citation: Collinsworth AW, Priest EL, Masica AL .
Evaluating the cost-effectiveness of the ABCDE bundle: impact of bundle adherence on inpatient and 1-year mortality and costs of care.
Crit Care Med 2020 Dec;48(12):1752-59. doi: 10.1097/ccm.0000000000004609..
Keywords: Intensive Care Unit (ICU), Critical Care, Mortality, Healthcare Costs
Philip JL, Yang DY, Wang X
Effect of transfer status on outcomes of emergency general surgery patients.
This study looked at outcomes of transferred (TRAN) versus directly admitted (DA) emergency general surgery (EGS) patients. Patients with a diagnosis of EGS were identified from the 2008-2011 Nationwide Inpatient Sample (NIS). Outcomes included were in-hospital mortality and morbidity. They identified 274,145 TRAN and 10,456,100 DA encounters. Morbidity and mortality were both higher in TRAN patients than DA. TRAN patients were more likely to have greater comorbidity scores, have Medicare insurance, and reside in an area with a lesser median household income compared to DA patients. Morbidity among TRAN patients were primarily due urinary-, gastrointestinal-, and pulmonary-related complications. Median stay and median cost at the hospital were greater for TRAN patients.
AHRQ-funded; HS025224; HS022694.
Citation: Philip JL, Yang DY, Wang X .
Effect of transfer status on outcomes of emergency general surgery patients.
Surgery 2020 Aug;168(2):280-86. doi: 10.1016/j.surg.2020.01.005..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Transitions of Care, Mortality, Outcomes, Healthcare Costs, Hospitals
Nguyen OK, Vazquez MA, Charles MA
Association of scheduled vs emergency-only dialysis with health outcomes and costs in undocumented immigrants with end-stage renal disease.
This paper discusses costs and mortality associated with undocumented immigrants with end-stage renal disease (ESRD). If the patient has insurance, the costs and mortality rates are much lower than those who receive emergency-only dialysis.
AHRQ-funded; HS022418.
Citation: Nguyen OK, Vazquez MA, Charles MA .
Association of scheduled vs emergency-only dialysis with health outcomes and costs in undocumented immigrants with end-stage renal disease.
JAMA Intern Med 2019 Feb;179(2):175-83. doi: 10.1001/jamainternmed.2018.5866..
Keywords: Dialysis, Kidney Disease and Health, Healthcare Costs, Mortality, Patient-Centered Outcomes Research
Kempker JA, Martin GS
Severity and timing of onset drive economic costs and clinical outcomes with sepsis.
Sepsis disproportionately affects older adults (mean age, 65 yr); is predominantly community acquired (87%); is expensive (mean hospital costs $21,500); and is associated with high hospital mortality (one in eight patients) and high rates of 30-day readmission for survivors (one in eight patients). In this editorial, the authors discuss an article- by Paoli et al, published in 2018 in Volume 46 of Critical Care Medicine- on sepsis epidemiology.
AHRQ-funded; HS025240.
Citation: Kempker JA, Martin GS .
Severity and timing of onset drive economic costs and clinical outcomes with sepsis.
Crit Care Med 2018 Dec;46(12):2043-44. doi: 10.1097/ccm.0000000000003376..
Keywords: Healthcare Costs, Mortality, Outcomes, Sepsis
Bindman AB, Cox DF
AHRQ Author: Bindman AB
Changes in health care costs and mortality associated with transitional care management services after a discharge among Medicare beneficiaries.
Medicare adopted transitional care management (TCM) payment codes in 2013 to encourage clinicians to furnish TCM services after beneficiaries were discharged to the community from medical facilities. The purpose of this study was to investigate whether the receipt of TCM services was associated with the subsequent health care costs and mortality of the beneficiaries in the month after the service was provided. The study concluded that despite the apparent benefits of TCM services for Medicare beneficiaries, the use of this service remains low.
AHRQ-authored.
Citation: Bindman AB, Cox DF .
Changes in health care costs and mortality associated with transitional care management services after a discharge among Medicare beneficiaries.
JAMA Intern Med 2018 Sep;178(9):1165-71. doi: 10.1001/jamainternmed.2018.2572..
Keywords: Healthcare Costs, Hospital Discharge, Medicare, Mortality, Transitions of Care
Goldberg EM, Trivedi AN, Mor V
Favorable risk selection in Medicare Advantage: trends in mortality and plan exits among nursing home beneficiaries.
This study uses mortality differences, nursing home utilization, and switch rates to assess whether the 2003 Medicare Modernization Act (MMA) successfully decreased risk selection from 2000 to 2012. The study found no decrease in the mortality difference or adjusted difference in nursing home use between plan beneficiaries pre- and post the MMA.
AHRQ-funded; HS000011.
Citation: Goldberg EM, Trivedi AN, Mor V .
Favorable risk selection in Medicare Advantage: trends in mortality and plan exits among nursing home beneficiaries.
Med Care Res Rev 2017 Dec;74(6):736-49. doi: 10.1177/1077558716662565..
Keywords: Healthcare Costs, Medicare, Mortality, Nursing Homes
Schlitz NK, Kaiboriboon K, Koroukian SM
Long-term reduction of health care costs and utilization after epilepsy surgery.
This study assessed long-term direct medical costs, health care utilization, and mortality following resective surgery in persons with uncontrolled epilepsy. It found that the mean direct medical cost difference between the surgical group and control group was $6,806 after risk-set matching. The incidence rate ratio of inpatient, emergency room, and outpatient utilization was lower among the surgical group in both unadjusted and adjusted analyses.
AHRQ-funded; HS000059.
Citation: Schlitz NK, Kaiboriboon K, Koroukian SM .
Long-term reduction of health care costs and utilization after epilepsy surgery.
Epilepsia 2016 Feb;57(2):316-24. doi: 10.1111/epi.13280.
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Keywords: Healthcare Costs, Healthcare Utilization, Mortality, Neurological Disorders, Outcomes, Surgery
Dinan MA, Li Y, Zhang Y
Resource use in the last year of life among patients who died with versus of prostate cancer.
The researchers conducted a retrospective analysis of Surveillance, Epidemiology, and End Results-Medicare data of men with prostate cancer. Patients who died of prostate cancer rather than from other causes had more hospice and outpatient use, less inpatient and ICU use, and lower overall costs. Efforts to shift care toward outpatient settings might provide more efficient and judicious care for patients during the end of life.
AHRQ-funded; HS022189.
Citation: Dinan MA, Li Y, Zhang Y .
Resource use in the last year of life among patients who died with versus of prostate cancer.
Clin Genitourin Cancer 2016 Feb;14(1):28-37.e2. doi: 10.1016/j.clgc.2015.07.006.
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Keywords: Cancer, Cancer: Prostate Cancer, Healthcare Costs, Healthcare Utilization, Men's Health, Mortality, Palliative Care, Patient-Centered Outcomes Research
Newgard CD, Lowe RA
Cost savings in trauma systems: The devil's in the details.
The authors comment on an article in the same issue of Annals by Zocchi et al. They argue that it makes an important contribution to trauma research and health policy by addressing the question: Can we potentially save money in trauma systems without compromising outcomes by redirecting patients with minor to moderate injuries away from major trauma centers?
AHRQ-funded; HS023796.
Citation: Newgard CD, Lowe RA .
Cost savings in trauma systems: The devil's in the details.
Ann Emerg Med 2016 Jan;67(1):68-70. doi: 10.1016/j.annemergmed.2015.06.025..
Keywords: Healthcare Costs, Trauma, Mortality, Care Coordination, Injuries and Wounds
Leung MY, Pollack LM, Colditz GA
Life years lost and lifetime health care expenditures associated with diabetes in the U.S., National Health Interview Survey, 1997-2000.
The authors analyzed the lifetime health care expenditures and life years lost associated with diabetes in the U.S. Their results showed that diabetes is associated with large decreases in life expectancy and large increases in lifetime health care expenditures, with the life years and expenditures depending on age-race-sex-BMI classification groups.
AHRQ-funded; HS022330.
Citation: Leung MY, Pollack LM, Colditz GA .
Life years lost and lifetime health care expenditures associated with diabetes in the U.S., National Health Interview Survey, 1997-2000.
Diabetes Care 2015 Mar;38(3):460-8. doi: 10.2337/dc14-1453.
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Keywords: Diabetes, Healthcare Costs, Medical Expenditure Panel Survey (MEPS), Mortality
Turrentine FE, Denlinger CE, Simpson VB
Morbidity, mortality, cost, and survival estimates of gastrointestinal anastomotic leaks.
The aims of this study were to examine the incidence of anastomotic leaks, a potentially deadly postoperative occurrence following gastrointestinal surgery, to identify risk factors predictive of leaks, and to explore the impact of anastomotic leaks on hospital cost and patient survival. The study demonstrates that anastomotic leaks remain a major source of increased morbidity, mortality, and hospital resource use for gastrointestinal surgery.
AHRQ-funded; HS011913.
Citation: Turrentine FE, Denlinger CE, Simpson VB .
Morbidity, mortality, cost, and survival estimates of gastrointestinal anastomotic leaks.
J Am Coll Surg 2015 Feb;220(2):195-206. doi: 10.1016/j.jamcollsurg.2014.11.002..
Keywords: Patient Safety, Surgery, Mortality, Healthcare Costs, Adverse Events
Bartsch SM, Gorham K, Lee BY
The cost of an Ebola case.
The researchers developed a mathematical model to estimate the cost of an Ebola virus disease (EVD) case from the provider and societal perspectives in the three most affected countries of Guinea, Liberia, and Sierra Leone. Their model estimates the total societal cost of an EVD case with full recovery ranges from $480 to $912, while that of an EVD case not surviving ranges from $5,929 to $18,929, varying by age and country.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Gorham K, Lee BY .
The cost of an Ebola case.
Pathog Glob Health 2015 Feb;109(1):4-9. doi: 10.1179/2047773214y.0000000169..
Keywords: Healthcare Costs, Mortality, Public Health, Infectious Diseases
Hockenberry JM, Helmchen LA
The nature of surgeon human capital depreciation.
The authors estimated how temporal breaks affect surgeons' performance of coronary artery bypass grafting (CABG). They found that a surgeon's additional day away from the operating room raised patients' inpatient mortality by up to 0.067 percentage points but reduced total hospitalization costs by up to 0.59 percentage points, and among emergent patients treated by high-volume providers, an additional day away raised mortality risk by 0.398 percentage points but reduced cost by up to 1.4 percentage points. They concluded that their results are consistent with the hypothesis that as temporal distance increases, surgeons are less likely to recognize and address life-threatening complications.
AHRQ-funded; HS019743.
Citation: Hockenberry JM, Helmchen LA .
The nature of surgeon human capital depreciation.
J Health Econ 2014 Sep;37:70-80. doi: 10.1016/j.jhealeco.2014.06.001.
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Keywords: Healthcare Costs, Mortality, Provider Performance, Surgery
Khazeni N, Hutton DW, Collins CI
Health and economic benefits of early vaccination and nonpharmaceutical interventions for a human influenza A (H7N9) pandemic: a modeling study.
In order to determine how quickly vaccination should be completed to reduce infections, deaths, and health care costs in a severe influenza pandemic in a large metropolitan area, researchers used a dynamic transmission model. They found that vaccination in an influenza-A (H7N9) pandemic would need to be completed much faster than in the 2009 pandemic to substantially reduce morbidity, mortality, and health care costs.
AHRQ-funded; HS019816
Citation: Khazeni N, Hutton DW, Collins CI .
Health and economic benefits of early vaccination and nonpharmaceutical interventions for a human influenza A (H7N9) pandemic: a modeling study.
Ann Intern Med. 2014 May 20;160(10):684-94. doi: 10.7326/M13-2071..
Keywords: Vaccination, Influenza, Mortality, Healthcare Costs, Public Health
Steiner CA, Friedman B
AHRQ Author: Steiner CA, Friedman B
Hospital utilization, costs, and mortality for adults with multiple chronic conditions, Nationwide Inpatient Sample, 2009.
The investigators provided a national estimate across all payers of the distribution and cost of selected chronic conditions for hospitalized adults in 2009, stratified by demographic characteristics. They found that there were approximately 28 million adult discharges from US hospitals other than those related to pregnancy and maternity; 39% had 2 to 3 multiple chronic conditions (MCC), and 33% had 4 or more. They concluded that their descriptive analysis of multipayer inpatient data provides a robust national view of the substantial use and costs among adults hospitalized with MCC.
AHRQ-authored.
Citation: Steiner CA, Friedman B .
Hospital utilization, costs, and mortality for adults with multiple chronic conditions, Nationwide Inpatient Sample, 2009.
Prev Chronic Dis 2013 Apr 25;10:E62. doi: 10.5888/pcd10.120292.
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Keywords: Chronic Conditions, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Mortality