National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Adverse Events (5)
- Alcohol Use (2)
- Ambulatory Care and Surgery (2)
- Behavioral Health (1)
- Cardiovascular Conditions (2)
- Caregiving (1)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Depression (1)
- Education: Patient and Caregiver (1)
- Elderly (6)
- Electronic Health Records (EHRs) (1)
- Emergency Department (4)
- Evidence-Based Practice (1)
- Eye Disease and Health (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (6)
- Healthcare Costs (1)
- Health Information Exchange (HIE) (1)
- Health Information Technology (HIT) (2)
- Heart Disease and Health (9)
- Home Healthcare (2)
- Hospital Discharge (10)
- Hospitalization (8)
- (-) Hospital Readmissions (44)
- Hospitals (7)
- Human Immunodeficiency Virus (HIV) (1)
- Injuries and Wounds (1)
- Intensive Care Unit (ICU) (2)
- Lifestyle Changes (1)
- Low-Income (1)
- Medicaid (2)
- Medicare (8)
- Medication (1)
- Men's Health (1)
- Mortality (2)
- Nursing Homes (2)
- Outcomes (6)
- Palliative Care (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (4)
- Patient Safety (1)
- Pneumonia (1)
- Provider Performance (2)
- Public Reporting (1)
- Quality Improvement (2)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- Quality of Care (2)
- Quality of Life (2)
- Racial and Ethnic Minorities (3)
- Registries (1)
- Rehabilitation (1)
- Respiratory Conditions (3)
- Risk (9)
- Screening (1)
- Social Determinants of Health (2)
- Stroke (1)
- Substance Abuse (1)
- Surgery (5)
- Teams (1)
- Telehealth (2)
- Tobacco Use (1)
- Training (1)
- Transitions of Care (5)
- Vulnerable Populations (1)
- Women (1)
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 25 of 44 Research Studies DisplayedDesai NR, Ross JS, Kwon JY
Association between hospital penalty status under the hospital readmission reduction program and readmission rates for target and nontarget conditions.
This study compared trends in readmission rates for target and nontarget conditions, stratified by hospital penalty status after the announcement of the Hospital Readmission Reduction Program (HRRP). It found that Medicare fee-for-service patients at hospitals subject to penalties under the HRRP had greater reductions in readmission rates compared with those at nonpenalized hospitals. Changes were greater for target vs nontarget conditions for patients at the penalized hospitals but not at the other hospitals.
AHRQ-funded; HS022882; HS023000.
Citation: Desai NR, Ross JS, Kwon JY .
Association between hospital penalty status under the hospital readmission reduction program and readmission rates for target and nontarget conditions.
JAMA 2016 Dec 27;316(24):2647-56. doi: 10.1001/jama.2016.18533.
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Keywords: Heart Disease and Health, Hospital Readmissions, Hospitals, Medicare, Pneumonia
Hollingsworth JM, Funk RJ, Garrison SA
Association between physician teamwork and health system outcomes after coronary artery bypass grafting.
The researchers tested whether teamwork (assessed with the bipartite clustering coefficient) among multiple providers dispersed across many care locations is a determinant of surgical outcomes by examining national Medicare data from patients undergoing CABG. They found that health systems with higher teamwork levels had significantly lower 60-day rates of emergency department visit, readmission, and mortality.
AHRQ-funded; HS020927.
Citation: Hollingsworth JM, Funk RJ, Garrison SA .
Association between physician teamwork and health system outcomes after coronary artery bypass grafting.
Circ Cardiovasc Qual Outcomes 2016 Nov;9(6):641-48. doi: 10.1161/circoutcomes.116.002714.
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Keywords: Teams, Outcomes, Medicare, Surgery, Hospital Readmissions, Cardiovascular Conditions
Pershing S, Morrison DE, Hernandez-Boussard T
Cataract surgery complications and revisit rates among three states.
The authors studied cataract procedures from California, Florida, and New York, to characterize population-based 30-day procedure-related readmissions following surgery. Their results highlight the importance of age as a risk factor for cataract surgery readmissions, and suggest a relationship between black or Hispanic race, Medicaid insurance, and diabetes associated with higher risk for cataract surgery complications.
AHRQ-funded; HS018558.
Citation: Pershing S, Morrison DE, Hernandez-Boussard T .
Cataract surgery complications and revisit rates among three states.
Am J Ophthalmol 2016 Nov;171:130-38. doi: 10.1016/j.ajo.2016.08.036.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Eye Disease and Health, Surgery, Hospital Readmissions, Adverse Events
Wang Y, Pandolfi MM, Fine J
Community level association between home health and nursing home performance on quality and hospital 30-day readmissions for Medicare patients.
Using CMS data from 2010 to 2012, the researchers evaluated whether community-level home health agencies and nursing home performance is associated with community-level hospital 30-day all-cause risk-standardized readmission rates for Medicare patients. They found that increasing nursing home performance by one star for all of its 4 measures and home health performance by 10 points for all of its 6 measures is associated with decreases in community-level risk-standardized readmission rates.
AHRQ-funded; HS023000.
Citation: Wang Y, Pandolfi MM, Fine J .
Community level association between home health and nursing home performance on quality and hospital 30-day readmissions for Medicare patients.
Home Health Care Manag Pract 2016 Nov;28(4):201-08. doi: 10.1177/1084822316639032.
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Keywords: Quality of Care, Hospital Readmissions, Home Healthcare, Nursing Homes, Provider Performance
Durstenfeld MS, Ogedegbe O, Katz SD
Racial and ethnic differences in heart failure readmissions and mortality in a large municipal healthcare system.
This study sought to determine whether racial and ethnic differences exist among patients with similar access to care. It examined outcomes after heart failure hospitalization within a large municipal health system and determined that racial and ethnic differences in outcomes were present.
AHRQ-funded; HS023683.
Citation: Durstenfeld MS, Ogedegbe O, Katz SD .
Racial and ethnic differences in heart failure readmissions and mortality in a large municipal healthcare system.
JACC Heart Fail 2016 Nov;4(11):885-93. doi: 10.1016/j.jchf.2016.05.008.
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Keywords: Heart Disease and Health, Hospital Readmissions, Hospitalization, Mortality, Outcomes, Racial and Ethnic Minorities
Thompson MP, Kaplan CM, Cao Y
Reliability of 30-day readmission measures used in the hospital readmission reduction program.
The researchers assessed the reliability of risk-standardized readmission rates (RSRRs) for medical conditions and surgical procedures used in the Hospital Readmission Reduction Program (HRRP). They found that approximately 25 percent of payments for excess readmissions were tied to unreliable RSRRs. Unreliable measures blur the connection between hospital performance and incentives, and threaten the success of the HRRP.
AHRQ-funded; HS023783.
Citation: Thompson MP, Kaplan CM, Cao Y .
Reliability of 30-day readmission measures used in the hospital readmission reduction program.
Health Serv Res 2016 Oct 21;51(6):2095-114. doi: 10.1111/1475-6773.12587.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Hospitals, Elderly, Quality Measures
Nakagawa K, Ahn HJ, Taira DA
Ethnic comparison of 30-day potentially preventable readmissions after stroke in Hawaii.
The authors sought to compare potentially preventable readmissions (PPR) among a multiethnic population in Hawaii. They concluded that the Chinese ethnicity may have a higher risk of 30-day PPR after stroke compared to whites. Other associated factors include mental illness, Medicaid, and Hawaii county.
AHRQ-funded; HS019990.
Citation: Nakagawa K, Ahn HJ, Taira DA .
Ethnic comparison of 30-day potentially preventable readmissions after stroke in Hawaii.
Stroke 2016 Oct;47(10):2611-7. doi: 10.1161/strokeaha.116.013669.
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Keywords: Stroke, Racial and Ethnic Minorities, Hospital Readmissions, Hospitalization, Risk
Carey K, Lin MY
Hospital readmissions reduction program: safety-net hospitals show improvement, modifications to penalty formula still needed.
This study addressed the fundamental question of whether the Medicare's Hospital Readmissions Reduction Program (HRRP) has been an effective tool for reducing thirty-day readmissions in safety-net hospitals. It found that in the first three years of the program, these hospitals reduced readmissions for heart attack by 2.86 percent, heart failure by 2.78 percent, and pneumonia by 1.77 percent.
AHRQ-funded; HS024853.
Citation: Carey K, Lin MY .
Hospital readmissions reduction program: safety-net hospitals show improvement, modifications to penalty formula still needed.
Health Aff 2016 Oct 1;35(10):1918-23. doi: 10.1377/hlthaff.2016.0537.
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Keywords: Hospital Readmissions, Hospitals, Medicare
Morris MS, Graham LA, Richman JS
Postoperative 30-day readmission: time to focus on what happens outside the hospital.
The authors of this study aimed to understand the relative contribution of preoperative patient factors, operative characteristics, and postoperative hospital course on 30-day postoperative readmissions. They found that although postoperative readmissions are difficult to predict at the time of discharge, preoperative factors are the most important.
AHRQ-funded; HS013852.
Citation: Morris MS, Graham LA, Richman JS .
Postoperative 30-day readmission: time to focus on what happens outside the hospital.
Ann Surg 2016 Oct;264(4):621-31. doi: 10.1097/sla.0000000000001855.
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Keywords: Hospital Readmissions, Surgery, Adverse Events, Risk, Risk
Chin DL, Bang H, Manickam RN
Rethinking thirty-day hospital readmissions: shorter intervals might be better indicators of quality of care.
The researchers examined risk-standardized thirty-day risk of unplanned inpatient readmission at the hospital level for Medicare patients ages sixty-five and older in four states and for three conditions: acute myocardial infarction, heart failure, and pneumonia. The hospital-level quality signal captured in readmission risk was highest on the first day after discharge and declined rapidly until it reached a nadir at seven days, as indicated by a decreasing intracluster correlation coefficient.
AHRQ-funded; HS022236.
Citation: Chin DL, Bang H, Manickam RN .
Rethinking thirty-day hospital readmissions: shorter intervals might be better indicators of quality of care.
Health Aff 2016 Oct;35(10):1867-75. doi: 10.1377/hlthaff.2016.0205.
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Keywords: Hospital Readmissions, Quality of Care, Hospitals, Quality Indicators (QIs)
Saab D, Nisenbaum R, Dhalla I
Hospital readmissions in a community-based sample of homeless adults: a matched-cohort study.
The objective of this study was to compare the hospital readmission rate among individuals experiencing homelessness with that of a low-income matched control group, and to identify risk factors associated with readmission within the group experiencing homelessness. It concluded that homeless patients had nearly four times the odds of being readmitted within 30-days as compared to low-income controls matched on age, sex and primary reason for admission to hospital.
AHRQ-funded; HS014129.
Citation: Saab D, Nisenbaum R, Dhalla I .
Hospital readmissions in a community-based sample of homeless adults: a matched-cohort study.
J Gen Intern Med 2016 Sep;31(9):1011-8. doi: 10.1007/s11606-016-3680-8.
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Keywords: Low-Income, Hospital Readmissions, Vulnerable Populations
Weinreich M, Nguyen OK, Wang D
Predicting the risk of readmission in pneumonia. A systematic review of model performance.
The researchers synthesized the available literature on readmission risk prediction models for adults who are hospitalized because of pneumonia and described their performance. They found a limited number of validated pneumonia-specific readmission models, and their predictive ability was modest. To improve predictive accuracy, future models should include measures of pneumonia illness severity, hospital complications, and stability on discharge.
AHRQ-funded; HS022418.
Citation: Weinreich M, Nguyen OK, Wang D .
Predicting the risk of readmission in pneumonia. A systematic review of model performance.
Ann Am Thorac Soc 2016 Sep;13(9):1607-14. doi: 10.1513/AnnalsATS.201602-135SR.
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Keywords: Hospital Readmissions, Risk, Hospitalization
McLeod L, Flynn J, Erickson M
Variation in 60-day readmission for surgical-site infections (SSIs) and reoperation following spinal fusion operations for neuromuscular scoliosis.
The purpose of this study was to examine variation in hospital performance based on risk-standardized 60-day readmission rates for surgical-site infection (SSIs) and reoperation across 39 US Children's Hospitals. It found that reoperations were associated with an SSI in 70 percent of cases. Across hospitals, SSI and reoperation rates ranged from 1 percent to 11 percent and 1 percent to 12 percent, respectively.
AHRQ-funded; HS022198.
Citation: McLeod L, Flynn J, Erickson M .
Variation in 60-day readmission for surgical-site infections (SSIs) and reoperation following spinal fusion operations for neuromuscular scoliosis.
J Pediatr Orthop 2016 Sep;36(6):634-9. doi: 10.1097/bpo.0000000000000495.
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Keywords: Children/Adolescents, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Hospital Readmissions, Hospitals, Risk
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.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Social Determinants of Health, Hospital Readmissions, Surgery
Jones CE, Hollis RH, Wahl TS
Transitional care interventions and hospital readmissions in surgical populations: a systematic review.
The researchers performed a systematic review of transitional care interventions and their effect on hospital readmissions after surgery. Discharge planning programs reduced readmissions by 11.5 percent , 12.5 percent, and 23 percent . Patient education interventions reduced readmissions by 14 percent and 23.5 percent . Primary care follow-up reduced readmissions by 8.3 percent for patients after high-risk surgeries . Home visits reduced readmissions by 7.7 percent and 4 percent, respectively.
AHRQ-funded; HS013852.
Citation: Jones CE, Hollis RH, Wahl TS .
Transitional care interventions and hospital readmissions in surgical populations: a systematic review.
Am J Surg 2016 Aug;212(2):327-35. doi: 10.1016/j.amjsurg.2016.04.004.
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Keywords: Education: Patient and Caregiver, Hospital Discharge, Hospital Readmissions, Transitions of Care
Kavalieratos D, Rollman BL, Arnold RM
Homeward Bound, not hospital rebound: how transitional palliative care can reduce readmission.
Comment on a study concerning heart failure palliative care interventions.
AHRQ-funded; HS022989.
Citation: Kavalieratos D, Rollman BL, Arnold RM .
Homeward Bound, not hospital rebound: how transitional palliative care can reduce readmission.
Heart 2016 Jul 15;102(14):1079-80. doi: 10.1136/heartjnl-2016-309385.
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Keywords: Heart Disease and Health, Hospital Discharge, Hospital Readmissions, Palliative Care
Clark BJ, Rubinsky AD, Ho PM
Alcohol screening scores and the risk of intensive care unit admission and hospital readmission.
This study sought to determine whether alcohol misuse was associated with admission to an intensive care unit (ICU) among patients receiving outpatient care. Among 486,115 veterans receiving outpatient care, the adjusted probability of ICU admission within 1 year was 2.0 percent for abstinent patients, 1.6 percent for patients with lower-risk alcohol use, 1.8 percent for patients with moderate alcohol misuse, and 2.5 percent for patients with severe alcohol misuse.
AHRQ-funded; HS022800.
Citation: Clark BJ, Rubinsky AD, Ho PM .
Alcohol screening scores and the risk of intensive care unit admission and hospital readmission.
Subst Abus 2016 Jul-Sep;37(3):466-73. doi: 10.1080/08897077.2015.1137259.
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Keywords: Alcohol Use, Hospital Readmissions, Intensive Care Unit (ICU), Ambulatory Care and Surgery, Screening, Substance Abuse
Wang Y, Eldridge N, Metersky ML
AHRQ Author: Eldridge N
Association between hospital performance on patient safety and 30-day mortality and unplanned readmission for Medicare fee-for-service patients with acute myocardial infarction.
The researchers studied the relationship between hospital performance on adverse event rates and hospital performance on 30-day mortality and unplanned readmission rates for Medicare fee-for-service patients hospitalized for acute myocardial infarction (AMI). They found that for Medicare fee-for-service patients discharged with AMI, hospitals with poorer patient safety performance were also more likely to have poorer performance on 30-day all-cause mortality and on unplanned readmissions.
AHRQ-authored.
Citation: Wang Y, Eldridge N, Metersky ML .
Association between hospital performance on patient safety and 30-day mortality and unplanned readmission for Medicare fee-for-service patients with acute myocardial infarction.
J Am Heart Assoc 2016 Jul;5(7):pii: e003731. doi: 10.1161/jaha.116.003731.
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Keywords: Adverse Events, Hospital Readmissions, Hospitals, Medicare, Mortality, Heart Disease and Health, Patient Safety, Provider Performance
Nguyen OK, Makam AN, Clark C
Predicting all-cause readmissions using electronic health record data from the entire hospitalization: model development and comparison.
The purpose of this study was to develop an all-cause readmissions risk-prediction model incorporating electronic health record (EHR) data from the full hospital stay, and to compare "full-stay" model performance to a "first day" and 2 other validated models. It found that incorporating clinically granular EHR data from the full hospital stay modestly improves prediction of 30-day readmissions.
AHRQ-funded; HS022418.
Citation: Nguyen OK, Makam AN, Clark C .
Predicting all-cause readmissions using electronic health record data from the entire hospitalization: model development and comparison.
J Hosp Med 2016 Jul;11(7):473-80. doi: 10.1002/jhm.2568.
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Keywords: Electronic Health Records (EHRs), Hospital Readmissions, Hospitalization, Risk
Basu J, Avila R, Ricciardi R
AHRQ Author: Basu J, Ricciardi R
Hospital readmission rates in U.S. states: are readmissions higher where more patients with multiple chronic conditions cluster?
This study examines small area variations in readmission rates to assess whether higher readmission rate in an area is associated with higher clusters of patients with multiple chronic conditions. It found that areas with higher concentration of patients with increased comorbid conditions are more likely to have higher readmission rates.
AHRQ-authored.
Citation: Basu J, Avila R, Ricciardi R .
Hospital readmission rates in U.S. states: are readmissions higher where more patients with multiple chronic conditions cluster?
Health Serv Res 2016 Jun;51(3):1135-51. doi: 10.1111/1475-6773.12401..
Keywords: Chronic Conditions, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Hospitals
Driessen J, Bonhomme A, Chang W
Nursing home provider perceptions of telemedicine for reducing potentially avoidable hospitalizations.
The goal of this study was to survey a nationally representative sample of nursing home physicians and advanced practice providers to quantify provider perceptions and desired functionality of telemedicine in nursing homes to reduce potentially avoidable hospitalizations. The authors found that there is a high degree of confidence in the potential for a telemedicine solution and concrete views about its features, concluding that further research is needed to study the impact of successful implementations.
AHRQ-funded; HS018721; HS022989; HS022465; HS023779.
Citation: Driessen J, Bonhomme A, Chang W .
Nursing home provider perceptions of telemedicine for reducing potentially avoidable hospitalizations.
J Am Med Dir Assoc 2016 Jun;17(6):519-24. doi: 10.1016/j.jamda.2016.02.004.
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Keywords: Health Information Technology (HIT), Hospital Readmissions, Hospitalization, Nursing Homes, Telehealth
Bergethon KE, Ju C, DeVore AD
Trends in 30-day readmission rates for patients hospitalized with heart failure: findings from the Get With The Guidelines-Heart Failure Registry.
The researchers analyzed data from the Heart Failure registry linked to Medicare claims between 2009 and 2012 to describe trends and relative reduction of rates of 30-day all-cause readmission among patients with heart failure. They concluded that although there has been slight improvement in 30-day all-cause readmission rates during the past 4 years in patients with heart failure, few hospitals have seen large success.
AHRQ-funded; HS021092.
Citation: Bergethon KE, Ju C, DeVore AD .
Trends in 30-day readmission rates for patients hospitalized with heart failure: findings from the Get With The Guidelines-Heart Failure Registry.
Circ Heart Fail 2016 Jun;9(6). doi: 10.1161/circheartfailure.115.002594.
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Keywords: Guidelines, Heart Disease and Health, Hospital Readmissions, Hospitalization, Registries
Baillargeon J, Deer RR, Kuo YF
Androgen therapy and rehospitalization in older men with testosterone deficiency.
This study assessed whether the receipt of androgen therapy is associated with a reduced 30-day rehospitalization rate among older men with testosterone deficiency. It concluded that androgen therapy may reduce the risk of rehospitalization in older men with testosterone deficiency.
AHRQ-funded; HS022134.
Citation: Baillargeon J, Deer RR, Kuo YF .
Androgen therapy and rehospitalization in older men with testosterone deficiency.
Mayo Clin Proc 2016 May;91(5):587-95. doi: 10.1016/j.mayocp.2016.03.016.
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Keywords: Elderly, Hospital Readmissions, Medication, Men's Health, Patient-Centered Outcomes Research
Shy BD, Kim EY, Genes NG
Increased identification of emergency department 72-hour returns using multihospital health information exchange.
The authors tested the use of a health information exchange (HIE) to improve identification of 72-hour return visits compared to individual hospitals' site-specific data. They found that HIE increased the identification ability of 72-hour ED return analyses by a mean of 11.16% compared with site-specific (no HIE) analyses. They concluded that their analysis demonstrates incremental improvements in the ability to identify early ED returns using increasing levels of HIE data aggregation.
AHRQ-funded; HS021261.
Citation: Shy BD, Kim EY, Genes NG .
Increased identification of emergency department 72-hour returns using multihospital health information exchange.
Acad Emerg Med 2016 May;23(5):645-9. doi: 10.1111/acem.12954.
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Keywords: Emergency Department, Health Information Exchange (HIE), Hospital Discharge, Hospital Readmissions
Hasegawa K, Camargo CA, Jr.
Prevalence of blood eosinophilia in hospitalized patients with acute exacerbation of COPD.
In this first study to investigate the prevalence of eosinophilia among inpatients with acute exacerbation of COPD, the authors found that 17% had blood eosinophilia, and that such patients had higher frequency of readmission during a one-year follow-up period.
AHRQ-funded; HS023305.
Citation: Hasegawa K, Camargo CA, Jr. .
Prevalence of blood eosinophilia in hospitalized patients with acute exacerbation of COPD.
Respirology 2016 May;21(4):761-4. doi: 10.1111/resp.12724.
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Keywords: Respiratory Conditions, Elderly, Hospitalization, Outcomes, Hospital Readmissions