National Healthcare Quality and Disparities Report
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- Ambulatory Care and Surgery (1)
- Cardiovascular Conditions (9)
- Chronic Conditions (2)
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- Diagnostic Safety and Quality (2)
- (-) Emergency Department (11)
- Emergency Medical Services (EMS) (2)
- Healthcare Cost and Utilization Project (HCUP) (3)
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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 11 of 11 Research Studies DisplayedKilaru AS, Illenberger N, Meisel ZF
Incidence of timely outpatient follow-up care after emergency department encounters for acute heart failure.
The purpose of this retrospective cohort study was to explore the incidence of outpatient follow-up care after presentation for acute heart failure at the emergency department (ED), and to present patient characteristics associated with receiving timely follow-up care. Using an administrative claims database from a United States commercial insurer, the researchers reviewed 52,732 adult patients with a mean age of 73.9 years discharged from the ED with the principal diagnosis of acute heart failure. The study found that within 30 days of the ED encounter, 23.2% of patients attended an outpatient clinic visit for heart failure, with 15.9% patients hospitalized before they could obtain an outpatient clinic visit. Patients that were younger, women, reporting non-Hispanic Black race, and had fewer previous clinic visits were less likely to obtain outpatient follow-up care. The study concluded that almost 20% of patients require hospitalization within 30 days of an ED for visit for heart failure, and few obtain timely outpatient follow-up after the initial visit.
AHRQ-funded; HS026372.
Citation: Kilaru AS, Illenberger N, Meisel ZF .
Incidence of timely outpatient follow-up care after emergency department encounters for acute heart failure.
Circ Cardiovasc Qual Outcomes 2022 Sep;15(9):e009001. doi: 10.1161/circoutcomes.122.009001..
Keywords: Ambulatory Care and Surgery, Emergency Department, Heart Disease and Health, Cardiovascular Conditions
Soares WE, Knee A, Gemme SR
SC, et al. A prospective evaluation of Clinical HEART score agreement, accuracy, and adherence in emergency department chest pain patients.
The HEART score is a risk stratification aid that may safely reduce chest pain admissions for emergency department patients. However, differences in interpretation of subjective components potentially alters the performance of the score. In this study, the investigators compared agreement between HEART scores determined during clinical practice with research-generated scores and estimated their accuracy in predicting 30-day major adverse cardiac events.
AHRQ-funded; HS024815.
Citation: Soares WE, Knee A, Gemme SR .
SC, et al. A prospective evaluation of Clinical HEART score agreement, accuracy, and adherence in emergency department chest pain patients.
Ann Emerg Med 2021 Aug;78(2):231-41. doi: 10.1016/j.annemergmed.2021.03.024..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Emergency Department, Diagnostic Safety and Quality, Clinical Decision Support (CDS), Health Information Technology (HIT)
Miller AC, Ward MM, Ullrich F
Emergency department telemedicine consults are associated with faster time-to-electrocardiogram and time-to-fibrinolysis for myocardial infarction patients.
The objective of this study was to evaluate the impact of telemedicine on the timeliness of emergency acute myocardial infarction (AMI) care for patients presenting to rural emergency departments (EDs) with chest pain. Findings showed that, in telemedicine networks, telemedicine consultation during the ED visit was associated with improved timeliness of electrocardiogram evaluation and increased use of fibrinolytic reperfusion therapy for rural AMI patients.
AHRQ-funded; HS025753.
Citation: Miller AC, Ward MM, Ullrich F .
Emergency department telemedicine consults are associated with faster time-to-electrocardiogram and time-to-fibrinolysis for myocardial infarction patients.
Telemed J E Health 2020 Dec;26(12):1440-48. doi: 10.1089/tmj.2019.0273..
Keywords: Telehealth, Health Information Technology (HIT), Emergency Department, Rural Health, Heart Disease and Health, Cardiovascular Conditions
Martsolf GR, Nuckols TK, Fingar KR
AHRQ Author: Stocks C, Owens PL
Nonspecific chest pain and hospital revisits within 7 days of care: variation across emergency department, observation and inpatient visits.
The purpose of this study was to compare the rate at which patients with nonspecific chest pain return to the hospital within 7 days after index observation visits versus after index emergency department and inpatient visits. Findings showed that up to 1 in 10 patients discharged with nonspecific chest pain returned to the hospital within 1week. Compared with emergency department and inpatient care, observation visits were associated with lower revisit rates. Recommendations include further research to refine clinical standards of care for nonspecific chest pain as well as to investigate the healthcare delivery and patient factors that influence 7-day revisit rates.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Martsolf GR, Nuckols TK, Fingar KR .
Nonspecific chest pain and hospital revisits within 7 days of care: variation across emergency department, observation and inpatient visits.
BMC Health Serv Res 2020 Jun 8;20(1):516. doi: 10.1186/s12913-020-05200-x..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Pain, Healthcare Utilization, Hospitals, Heart Disease and Health, Cardiovascular Conditions
Chen J, Sadasivam R, Blok AC
The association between patient-reported clinical factors and 30-day acute care utilization in chronic heart failure.
The purpose of this study was to identify post-discharge patient-reported clinical factors associated with repeat acute care use. Through phone surveys with patients with chronic heart failure, findings indicated that patient-reported poor health status, pain, and poor appetite were positively associated with 30-day acute care utilization. Recommendations included further study before incorporation into risk prediction to drive quality improvement efforts.
AHRQ-funded; HS017786.
Citation: Chen J, Sadasivam R, Blok AC .
The association between patient-reported clinical factors and 30-day acute care utilization in chronic heart failure.
Med Care 2020 Apr;58(4):336-43. doi: 10.1097/mlr.0000000000001258..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Hospital Readmissions, Emergency Department, Chronic Conditions
Pang PS, Fermann GJ, Hunter BR
TACIT (High Sensitivity Troponin T Rules Out Acute Cardiac Insufficiency Trial).
This study examined the use of high-sensitivity troponin assays to determine whether a patient presenting in the emergency department with chest pains is safe for discharge. An observational study called High Sensitivity Troponin T Rules Out Acute Cardiac Insufficiency Trial (TACIT) explored whether serial high-sensitivity troponin (hsTnT) might aid in making diagnosis of acute heart failure faster. The presence of hsTnT above the 99th percentile usually indicates acute heart failure. Patients in the cohort with hsTnT at or above the 99th percentile were older, more often male, less often black, and more likely to have chronic kidney disease. The study found no difference in risk for 90-day death or rehospitalization or return ED visits in the group with hsTnT above the 99th percentile than those with levels below the 99th percentile so hsTnT would not be considered useful.
AHRQ-funded; HS025411.
Citation: Pang PS, Fermann GJ, Hunter BR .
TACIT (High Sensitivity Troponin T Rules Out Acute Cardiac Insufficiency Trial).
Circ Heart Fail 2019 Jul;12(7):e005931. doi: 10.1161/circheartfailure.119.005931..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Emergency Department, Risk, Shared Decision Making
Russell FM, Ehman RR, Ferre R
Design and rationale of the B-lines lung ultrasound guided emergency department management of acute heart failure (BLUSHED-AHF) pilot trial.
Medical treatment for acute heart failure (AHF) has not changed substantially over the last four decades. Emergency department (ED)-based evidence for treatment is limited. The investigators discuss BLUSHED-AHF, a multicenter, randomized, pilot trial designed to test whether a strategy of care that utilizes a LUS-driven treatment protocol outperforms usual care for reducing pulmonary congestion in the ED.
AHRQ-funded; HS025411.
Citation: Russell FM, Ehman RR, Ferre R .
Design and rationale of the B-lines lung ultrasound guided emergency department management of acute heart failure (BLUSHED-AHF) pilot trial.
Heart Lung 2019 May - Jun;48(3):186-92. doi: 10.1016/j.hrtlng.2018.10.027..
Keywords: Emergency Department, Heart Disease and Health, Cardiovascular Conditions, Imaging, Respiratory Conditions
Hirayama A, Goto T, Shimada YJ
Acute exacerbation of chronic obstructive pulmonary disease and subsequent risk of emergency department visits and hospitalizations for atrial fibrillation.
Although emerging evidence has suggested the relationship of chronic obstructive pulmonary disease with atrial fibrillation (AF), little is known about whether acute exacerbation of chronic obstructive pulmonary disease (AECOPD) increases the risk of repeated AF-related healthcare utilization. The investigators found that among patients with existing AF, AECOPD was associated with a higher risk of AF-related ED visit or hospitalization in the first 90-day post-AECOPD period.
AHRQ-funded; HS023305.
Citation: Hirayama A, Goto T, Shimada YJ .
Acute exacerbation of chronic obstructive pulmonary disease and subsequent risk of emergency department visits and hospitalizations for atrial fibrillation.
Circ Arrhythm Electrophysiol 2018 Sep;11(9):e006322. doi: 10.1161/circep.118.006322..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Respiratory Conditions, Heart Disease and Health, Cardiovascular Conditions, Chronic Conditions, Hospitalization, Risk, Healthcare Utilization
de Cordova PB, Johansen ML, Martinez ME
Emergency department weekend presentation and mortality in patients with acute myocardial infarction.
The purpose of this research was to determine if weekend and holiday presentation is associated with increased mortality in EDs among patients with acute myocardial infarction (AMI) in New Jersey. It found that weekend/holiday presentation to the ED for AMI was associated with increased mortality. The effect may be related to the limited availability of resources on weekend/holidays compared to weekdays.
AHRQ-funded; HS024339.
Citation: de Cordova PB, Johansen ML, Martinez ME .
Emergency department weekend presentation and mortality in patients with acute myocardial infarction.
Nurs Res 2017 Jan/Feb;66(1):20-27. doi: 10.1097/nnr.0000000000000196.
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Keywords: Emergency Medical Services (EMS), Emergency Department, Mortality, Heart Disease and Health, Risk
Moy E, Barrett M, Coffey R
AHRQ Author: Moy E
Missed diagnoses of acute myocardial infarction in the emergency department: variation by patient and facility characteristics.
The purpose of this study is to estimate the frequency of missed heart attacks or their precursors (e.g., unstable angina) in the emergency department (ED) by examining use of EDs in the week prior to hospitalization for heart attack. This study of 111,973 patients found an overall rate of 0.9 percent for missed diagnoses of heart attacks.
AHRQ-authored; AHRQ-funded; 290201300002C
Citation: Moy E, Barrett M, Coffey R .
Missed diagnoses of acute myocardial infarction in the emergency department: variation by patient and facility characteristics.
Diagn. 2015 Feb;2(1):29-40..
Keywords: Diagnostic Safety and Quality, Heart Disease and Health, Emergency Department, Emergency Medical Services (EMS), Healthcare Cost and Utilization Project (HCUP)
Blecker S, Ladapo JA, Doran KM
Emergency department visits for heart failure and subsequent hospitalization or observation unit admission.
The purpose of this study was to examine trends in ED visits for heart failure and disposition following such visits. The investigators found that the number of ED visits for heart failure and the high proportion of ED visits with subsequent inpatient hospitalization have not changed in the last decade. They suggest that opportunities may exist to reduce hospitalizations by increasing short-term management of heart failure in the ED or observation unit.
AHRQ-funded; HS023683.
Citation: Blecker S, Ladapo JA, Doran KM .
Emergency department visits for heart failure and subsequent hospitalization or observation unit admission.
Am Heart J 2014 Dec;168(6):901-8.e1. doi: 10.1016/j.ahj.2014.08.002..
Keywords: Cardiovascular Conditions, Emergency Department, Heart Disease and Health, Hospitalization