National Healthcare Quality and Disparities Report
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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.
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1 to 3 of 3 Research Studies DisplayedCongdon M, Rauch B, Carroll B
Opportunities for diagnostic improvement among pediatric hospital readmissions.
The purpose of this retrospective cohort study was to: 1) identify and describe diagnostic errors, termed "missed opportunities for improving diagnosis" (MOIDs) in general pediatric patients who experienced hospital readmission, 2) outline improvement opportunities, and 3) explore factors associated with increased risk of MOID. The researchers included unplanned readmissions within 15 days of discharge from a freestanding children's hospital between October 2018 and September 2020. Health records were reviewed and discussed by practicing inpatient physicians to identify MOIDs using SaferDx, an established instrument. MOIDs were evaluated using a diagnostic-specific tool to identify improvement opportunities within the diagnostic process. The study found that MOIDs were identified in 6.3% of 348 readmissions. Opportunities for improvement included: delay in considering the correct diagnosis (50%) and failure to order needed test (45%). Patients with MOIDs were older than patients without MOIDs but similar in gender, primary language, race, ethnicity, and insurance type. The researchers did not identify conditions related with higher risk of MOID. Lower respiratory tract infections accounted for 26% of admission diagnoses but only 1 (4.5%) case of MOID.
AHRQ-funded; HS028682.
Citation: Congdon M, Rauch B, Carroll B .
Opportunities for diagnostic improvement among pediatric hospital readmissions.
Hosp Pediatr 2023 Jul; 13(7):563-71. doi: 10.1542/hpeds.2023-007157..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Hospitals, Hospital Readmissions
Odeh Couvertier V, Patterson Patterson, Zayas-Cabán G
Association between advanced image ordered in the emergency department on subsequent imaging for abdominal pain patients.
The purpose of this retrospective, observational study was to evaluate abdominal pain patients discharged from the ED to determine the association between advanced emergency department (ED) imaging on subsequent outpatient imaging and on revisits. The researchers utilized the electronic health records of Medicare patients who presented with a complaint of abdominal pain at a United States academic emergency department. The study found that participants who were not imaged at the ED had significantly higher adjusted odds of being imaged outside of the ED within 7, 14, and 28 days of being discharged, and had a significantly higher adjusted odds of returning to the study ED and visiting any ED within 30 days of being discharged. The study concluded that receiving abdominal imaging services in the ED was related with significantly lower imaging use after discharge.
AHRQ-funded; HS024558.
Citation: Odeh Couvertier V, Patterson Patterson, Zayas-Cabán G .
Association between advanced image ordered in the emergency department on subsequent imaging for abdominal pain patients.
Acad Emerg Med 2022 Sep;29(9):1078-83. doi: 10.1111/acem.14541..
Keywords: Imaging, Emergency Department, Diagnostic Safety and Quality, Hospital Readmissions
Goldberg EM, Morphis B, Youssef R
An analysis of diagnoses that drive readmission: what can we learn from the hospitals in Southern New England with the highest and lowest readmission performance?
This study examined the most common diagnoses driving readmissions among fee-for-service Medicare beneficiaries in the hospitals with the highest and lowest readmission performance in Southern New England from 2014 to 2016. It found that the lowest-performing hospitals readmitted higher percentages of patients for sepsis and complications of device, implant, or graft, compared to highest-performing hospitals.
AHRQ-funded; HS000011.
Citation: Goldberg EM, Morphis B, Youssef R .
An analysis of diagnoses that drive readmission: what can we learn from the hospitals in Southern New England with the highest and lowest readmission performance?
R I Med J 2017 Aug;100(8):23-28.
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Keywords: Adverse Events, Diagnostic Safety and Quality, Hospital Readmissions, Hospitals, Quality Indicators (QIs)