National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Ambulatory Care and Surgery (1)
- Cardiovascular Conditions (3)
- Care Coordination (1)
- Chronic Conditions (1)
- Elderly (4)
- Emergency Department (1)
- Health Information Technology (HIT) (1)
- Heart Disease and Health (3)
- Home Healthcare (3)
- Hospital Discharge (4)
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- (-) Hospital Readmissions (15)
- Hospitals (6)
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- Medicare (2)
- (-) Nursing Homes (15)
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- Pneumonia (1)
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- Quality of Care (3)
- Rehabilitation (1)
- Risk (1)
- Surgery (2)
- Telehealth (1)
- Transitions of Care (4)
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 DisplayedManges KA, Ayele R, Leonard C
Differences in transitional care processes among high-performing and low-performing hospital-SNF pairs: a rapid ethnographic approach.
This study’s objective was to explore differences between low- and high-performing hospitals and skilled nursing facilities (SNFs) pairs and postacute care outcomes. The authors used flow maps and thematic analysis to describe the process of hospitals discharging patients to SNFs and to identify differences in subprocesses used by high-performing and low-performing hospitals. Hospitals were classified based on their 30-day readmission rates from SNFs. The final sample included 148 hours of observations with 30 clinicians across four hospitals and five corresponding SNFs. High-performing sites differed in each stage from low-performing sites by focusing on 1) earlier, ongoing, systematic identification of high-risk patients; 2) discussing the decision to go to an SNF as an iterative team-based process and 3) anticipating barriers with knowledge of transitional and SNF care processes.
AHRQ-funded; HS026116.
Citation: Manges KA, Ayele R, Leonard C .
Differences in transitional care processes among high-performing and low-performing hospital-SNF pairs: a rapid ethnographic approach.
BMJ Qual Saf 2021 Aug;30(8):648-57. doi: 10.1136/bmjqs-2020-011204..
Keywords: Transitions of Care, Hospitals, Nursing Homes, Hospital Readmissions, Hospital Discharge
Ryskina KL, Andy AU, Manges KA
Association of online consumer reviews of skilled nursing facilities with patient rehospitalization rates.
The purpose of this study was to: 1.) assess the association between rehospitalization rates and online ratings of skilled nursing facility (SNFs); 2.) Compare the association of rehospitalization with ratings from a review website vs Medicare Nursing Home Compare (NHC) ratings; and 3.) Identify specific topics consistently reported in reviews of SNFs with the highest vs lowest rehospitalization rates using natural language processing.
AHRQ-funded; HS026116.
Citation: Ryskina KL, Andy AU, Manges KA .
Association of online consumer reviews of skilled nursing facilities with patient rehospitalization rates.
JAMA Netw Open 2020 May;3(5):e204682. doi: 10.1001/jamanetworkopen.2020.4682..
Keywords: Nursing Homes, Hospital Readmissions, Provider Performance, Quality of Care, Medicare, Elderly
Weerahandi H, Bao H, Herrin J
Home health care after skilled nursing facility discharge following heart failure hospitalization.
Heart failure (HF) readmission rates have plateaued despite scrutiny of hospital discharge practices. Many HF patients are discharged to skilled nursing facility (SNF) after hospitalization before returning home. Home healthcare (HHC) services received during the additional transition from SNF to home may affect readmission risk. In this study, the investigators examined whether receipt of HHC affects readmission risk during the transition from SNF to home following HF hospitalization.
AHRQ-funded; HS022882.
Citation: Weerahandi H, Bao H, Herrin J .
Home health care after skilled nursing facility discharge following heart failure hospitalization.
J Am Geriatr Soc 2020 Jan;68(1):96-102. doi: 10.1111/jgs.16179..
Keywords: Home Healthcare, Nursing Homes, Heart Disease and Health, Cardiovascular Conditions, Hospitalization, Hospital Readmissions, Transitions of Care, Elderly
Paredes AZ, Malik AT, Cluse M
Discharge disposition to skilled nursing facility after emergent general surgery predicts a poor prognosis.
Emergency general surgery can have a profound impact on the functional status of even previously independent patients. In this study, the investigators examined the role and influence of discharging a patient to a skilled nursing facility. They concluded that after accounting for patient severity and perioperative course, discharge to a skilled nursing facility was an independent risk factor for death, readmission, and postdischarge complications.
AHRQ-funded; HS022694.
Citation: Paredes AZ, Malik AT, Cluse M .
Discharge disposition to skilled nursing facility after emergent general surgery predicts a poor prognosis.
Surgery 2019 Oct;166(4):489-95. doi: 10.1016/j.surg.2019.04.034..
Keywords: Nursing Homes, Hospital Discharge, Elderly, Ambulatory Care and Surgery, Emergency Department, Outcomes, Hospital Readmissions, Outcomes, Risk
Popescu I, Sood N, Joshi S
Trends in the use of skilled nursing facility and home health care under the Hospital Readmissions Reduction Program: an interrupted time-series analysis.
Medicare's Hospital Readmission Reduction Program penalizes hospitals with elevated 30-day readmission rates for acute myocardial infarction, heart failure, or pneumonia. The authors investigated if, in order to reduce readmissions, hospitals may have increased referrals to skilled nursing facilities and home health care. They found that hospitals might be shifting to more intensive postacute care to avoid readmissions among seniors with pneumonia. At the same time, penalized hospitals' efforts to prevent readmissions may be keeping higher proportions of their patients in the community.
AHRQ-funded; HS024284; HS025394.
Citation: Popescu I, Sood N, Joshi S .
Trends in the use of skilled nursing facility and home health care under the Hospital Readmissions Reduction Program: an interrupted time-series analysis.
Med Care 2019 Oct;57(10):757-65. doi: 10.1097/mlr.0000000000001184..
Keywords: Home Healthcare, Nursing Homes, Chronic Conditions, Hospital Readmissions, Long-Term Care, Hospitals, Heart Disease and Health, Pneumonia, Cardiovascular Conditions
Kim KL, LI L, Kuang M
Changes in hospital referral patterns to skilled nursing facilities under the Hospital Readmissions Reduction Program.
The objective of this study was to investigate the association between changes in hospital referral patterns to skilled nursing facilities (SNFs) and Hospital Readmissions Reduction Program (HRRP) penalty pressure. Results showed that HRRP did not prompt substantial changes in hospital referral patterns to SNFs, although readmissions for patients referred to SNFs differentially decreased more than for other patients, warranting investigation of other mechanisms underlying readmissions reduction.
AHRQ-funded; HS022882.
Citation: Kim KL, LI L, Kuang M .
Changes in hospital referral patterns to skilled nursing facilities under the Hospital Readmissions Reduction Program.
Med Care 2019 Sep;57(9):695-701. doi: 10.1097/mlr.0000000000001169..
Keywords: Hospitals, Nursing Homes, Hospital Readmissions, Payment, Provider Performance
Weerahandi H, Li L, Bao H
Risk of readmission after discharge from skilled nursing facilities following heart failure hospitalization: a retrospective cohort study.
The goal of this study was to examine outcomes for Medicare patients who were hospitalized with heart failure and who had a subsequent skilled nursing facility (SNF) stay of 30 days or less. Patients were categorized by their length of stay in the SNF and followed for the 30 days after their discharge from the SNF to home. Overall, nearly one-quarter of the SNF discharges to home were readmitted within the 30 day follow-up period. The rate of readmission was highest during the first two days home, but this risk was attenuated by a longer SNF length of stay. The authors conclude that interventions to reduce readmissions may be more effective if they incorporate patient transitions from SNF to home.
AHRQ-funded; HS022882.
Citation: Weerahandi H, Li L, Bao H .
Risk of readmission after discharge from skilled nursing facilities following heart failure hospitalization: a retrospective cohort study.
J Am Med Dir Assoc 2019 Apr;20(4):432-37. doi: 10.1016/j.jamda.2019.01.135..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Hospital Discharge, Hospital Readmissions, Hospitalization, Nursing Homes
Agarwal D, Werner RM
Effect of hospital and post-acute care provider participation in accountable care organizations on patient outcomes and Medicare spending.
The purpose of this study was to test for differences in patient outcomes when hospital and post-acute care (PAC) providers participated in accountable care organizations (ACOs). The investigators concluded that hospital and skilled nursing facilities (SNF) participation in an ACO was associated with lower readmission rates, Medicare spending on SNF, and SNF length of stay.
AHRQ-funded; HS024266.
Citation: Agarwal D, Werner RM .
Effect of hospital and post-acute care provider participation in accountable care organizations on patient outcomes and Medicare spending.
Health Serv Res 2018 Dec;53(6):5035-56. doi: 10.1111/1475-6773.13023..
Keywords: Hospital Readmissions, Hospitals, Medicare, Nursing Homes, Outcomes
Chen LM, Acharya Y, Norton EC
Readmission rates and skilled nursing facility utilization after major inpatient surgery.
The purpose of this observational study was to describe the association between changes in skilled nursing facility (SNF) use and changes in readmission rates after surgery. The investigators looked at fee-for-service Medicare beneficiaries undergoing coronary artery bypass grafting (CABG) or total hip replacement (THR) from 2008 to 2013. They concluded that changes in use of postacute care after THR and CABG were not associated with changes in readmission rates in their study.
AHRQ-funded; HS024698; HS020671.
Citation: Chen LM, Acharya Y, Norton EC .
Readmission rates and skilled nursing facility utilization after major inpatient surgery.
Med Care 2018 Aug;56(8):679-85. doi: 10.1097/mlr.0000000000000941..
Keywords: Hospital Discharge, Hospital Readmissions, Nursing Homes, Surgery
McHugh JP, Foster A, Mor V JP, Foster A, Mor V
Reducing hospital readmissions through preferred networks of skilled nursing facilities.
This study used a concurrent mixed-methods approach to examine changes in rehospitalization rates and differences in practices between hospitals that did and did not develop formal skilled nursing facilities (SNF) networks.
AHRQ-funded; HS023961.
Citation: McHugh JP, Foster A, Mor V JP, Foster A, Mor V .
Reducing hospital readmissions through preferred networks of skilled nursing facilities.
Health Aff 2017 Sep;36(9):1591-98. doi: 10.1377/hlthaff.2017.0211..
Keywords: Care Coordination, Hospital Readmissions, Hospitals, Nursing Homes, Transitions of Care
Clark B, Baron K, Tynan-McKiernan K
Perspectives of clinicians at skilled nursing facilities on 30-day hospital readmissions: a qualitative study.
The purpose of this paper was to understand the perspectives of clinicians working at skilled nursing facilities (SNFs) regarding factors contributing to readmissions. SNF clinicians identified a broad range of factors that contributed to readmissions. The investigators suggest that addressing these factors may mitigate patients' risk of readmission from SNFs to acute care hospitals.
AHRQ-funded; HS023554.
Citation: Clark B, Baron K, Tynan-McKiernan K .
Perspectives of clinicians at skilled nursing facilities on 30-day hospital readmissions: a qualitative study.
J Hosp Med 2017 Aug;12(8):632-38. doi: 10.12788/jhm.2785..
Keywords: Hospital Readmissions, Nursing Homes, Quality Improvement, Transitions of Care
Welsh RL, Graham JE, Karmarkar AM
Effects of postacute settings on readmission rates and reasons for readmission following total knee arthroplasty.
This study examined the effects of postacute discharge setting on unplanned hospital readmissions following total knee arthroplasty (TKA) in older adults. Inpatient rehabilitation facility (IRF), skilled nursing facility (SNF) concluded that patients discharged to either inpatient rehabilitation facility (IRF) or skilled nursing facility (SNF), in comparison with those discharged to the community, had greater likelihood of readmission within 30 and 90 days.
AHRQ-funded; HS022907.
Citation: Welsh RL, Graham JE, Karmarkar AM .
Effects of postacute settings on readmission rates and reasons for readmission following total knee arthroplasty.
J Am Med Dir Assoc 2017 Apr;18(4):367.e1-67.e10. doi: 10.1016/j.jamda.2016.12.068.
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Keywords: Elderly, Nursing Homes, Hospital Readmissions, Rehabilitation, Surgery
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
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
Thomas KS, Rahman M, Mor V
Influence of hospital and nursing home quality on hospital readmissions.
The authors sought to determine whether the quality of the hospital and of the nursing home (NH) to which a patient was discharged were related to the likelihood of rehospitalization. They found that patients discharged from higher-quality hospitals and patients who received care in higher-quality NHs were less likely to be rehospitalized within 30 days. They concluded that the passage of the Affordable Care Act changed the accountability of hospitals for patients' outcomes after discharge, and that their study highlights the joint accountability of hospitals and NHs for rehospitalization of patients.
AHRQ-funded; HS000011.
Citation: Thomas KS, Rahman M, Mor V .
Influence of hospital and nursing home quality on hospital readmissions.
Am J Manag Care 2014 Nov;20(11):e523-31.
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Keywords: Quality of Care, Hospitals, Nursing Homes, Patient-Centered Outcomes Research, Hospital Readmissions