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Topics
- Adverse Events (2)
- Alcohol Use (1)
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- Children/Adolescents (2)
- Communication (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Critical Care (1)
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- (-) Hospital Discharge (26)
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- Hospital Readmissions (7)
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- Injuries and Wounds (2)
- Labor and Delivery (1)
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- Medication: Safety (1)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (2)
- Nursing (1)
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- Patient Experience (2)
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- Pregnancy (1)
- Quality Improvement (1)
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- Risk (1)
- Rural Health (1)
- Social Determinants of Health (1)
- Substance Abuse (1)
- Surgery (4)
- Telehealth (1)
- Tools & Toolkits (1)
- Transitions of Care (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 26 Research Studies DisplayedEllimoottil C, Syrjamaki JD, Volt JD
Validation of a claims-based algorithm to characterize episodes of care.
The Michigan Value Collaborative (MVC) developed a claims-based algorithm to provide hospitals with data on events that occur to patients beyond the hospitalization. In this article, the investigators discuss the validation of MVC's claims-based algorithm. They indicate that their findings suggest that the MVC claims-based algorithm identifies and classifies claims with high fidelity and outperforms medical records in the identification of postdischarge events.
AHRQ-funded; HS024193.
Citation: Ellimoottil C, Syrjamaki JD, Volt JD .
Validation of a claims-based algorithm to characterize episodes of care.
Am J Manag Care 2017 Nov;23(11):e382-e86..
Keywords: Hospital Discharge, Hospital Readmissions, Hospitalization, Hospitals, Quality of Care, Quality Improvement
Jones CD, Jones J, RIchard A
"Connecting the Dots": a qualitative study of home health nurse perspectives on coordinating care for recently discharged patients.
This study described home health care (HHC) nurse perspectives about challenges and solutions to coordinating care for recently discharged patients. HHC nurses described challenges and solutions within domains of Accountability, Communication, Assessing Needs & Goals, and Medication Management. One additional domain of Safety, for both patients and HHC nurses, emerged from the analysis.
AHRQ-funded; HS024569.
Citation: Jones CD, Jones J, RIchard A .
"Connecting the Dots": a qualitative study of home health nurse perspectives on coordinating care for recently discharged patients.
J Gen Intern Med 2017 Oct;32(10):1114-21. doi: 10.1007/s11606-017-4104-0.
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Keywords: Care Coordination, Elderly, Home Healthcare, Health Services Research (HSR), Hospital Discharge
Quinn JM, Sparks M, Gephart SM
Discharge criteria for the late preterm infant: a review of the literature.
The purpose of this literature review was to examine differences in late preterm infant (LPI) discharge criteria between the well newborn setting and the NICU by answering the clinical questions, "What are the recommended discharge criteria for the LPI and do they differ if admitted to the well newborn setting versus the NICU?"
AHRQ-funded; HS022908.
Citation: Quinn JM, Sparks M, Gephart SM .
Discharge criteria for the late preterm infant: a review of the literature.
Adv Neonatal Care 2017 Oct;17(5):362-71. doi: 10.1097/anc.0000000000000406..
Keywords: Hospital Discharge, Newborns/Infants, Newborns/Infants
Tedesco D, Asch SM, Curtin C
Opioid abuse and poisoning: trends in inpatient and emergency department discharges.
This study analyzed national trends in inpatient and emergency department (ED) discharges for opioid abuse, dependence, and poisoning using Healthcare Cost and Utilization Project data.
AHRQ-funded; HS024096.
Citation: Tedesco D, Asch SM, Curtin C .
Opioid abuse and poisoning: trends in inpatient and emergency department discharges.
Health Aff 2017 Oct;36(10):1748-53. doi: 10.1377/hlthaff.2017.0260..
Keywords: Emergency Department, Healthcare Cost and Utilization Project (HCUP), Hospital Discharge, Opioids, Substance Abuse
Sobotka SA, Agarwal RK, Msall ME
Prolonged hospital discharge for children with technology dependency: a source of health care disparities.
As the population of children who use medical technology such as long-term ventilation increases, it is important to critically evaluate the systems for preparing families for home life. The authors discuss the complication of hospital discharge and how it contributes to health and developmental disparities. They also describe a hospital-to-home transitional care model, which presents a home-like environment to provide developmental support while focusing on parental training, home nursing, and public-funding arrangements.
AHRQ-funded; HS023007.
Citation: Sobotka SA, Agarwal RK, Msall ME .
Prolonged hospital discharge for children with technology dependency: a source of health care disparities.
Pediatr Ann 2017 Oct;46(10):e365-e70. doi: 10.3928/19382359-20170919-01.
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Keywords: Children/Adolescents, Disparities, Home Healthcare, Hospital Discharge, Medical Devices
Chavez LJ, Liu CF, Tefft N
The association between unhealthy alcohol use and acute care expenditures in the 30 days following hospital discharge among older Veterans Affairs patients with a medical condition.
Heavy alcohol use could predict increased risk for post-discharge acute care. This study assessed 30-day acute care utilization and expenditures for different categories of alcohol use, using VA and Medicare health care utilization data.
AHRQ-funded; HS022800.
Citation: Chavez LJ, Liu CF, Tefft N .
The association between unhealthy alcohol use and acute care expenditures in the 30 days following hospital discharge among older Veterans Affairs patients with a medical condition.
J Behav Health Serv Res 2017 Oct;44(4):602-24. doi: 10.1007/s11414-016-9529-4..
Keywords: Alcohol Use, Hospital Discharge
Holland DE, Brandt C, Targonski PV
Validating performance of a hospital discharge planning decision tool in community hospitals.
The researchers aimed to determine the predictive performance of the Early Screen for Discharge Planning (ESDP) in a rural regional community hospital practice setting. Patients with high ESDP scores reported more problems after discharge, reported lower quality of life, had longer length of stays, and used post-acute care services more than patients with low ESDP scores.
AHRQ-funded; HS022923.
Citation: Holland DE, Brandt C, Targonski PV .
Validating performance of a hospital discharge planning decision tool in community hospitals.
Prof Case Manag 2017 Sep/Oct;22(5):204-13. doi: 10.1097/ncm.0000000000000233.
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Keywords: Decision Making, Hospital Discharge, Outcomes, Rural Health, Tools & Toolkits
Dharmarajan K, Qin L, Bierlein M
Outcomes after observation stays among older adult Medicare beneficiaries in the USA: retrospective cohort study.
This study characterized rates and trends over time of emergency department treatment-and-discharge stays, repeat observation stays, inpatient stays, any hospital revisit, and death within 30 days of discharge from observation stays. Hospital revisits are common after discharge from observation stays, frequently result in inpatient hospitalizations, and have increased over time among Medicare beneficiaries.
AHRQ-funded; HS023000.
Citation: Dharmarajan K, Qin L, Bierlein M .
Outcomes after observation stays among older adult Medicare beneficiaries in the USA: retrospective cohort study.
BMJ 2017 Jun 20;357:j2616. doi: 10.1136/bmj.j2616.
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Keywords: Elderly, Emergency Department, Hospital Discharge, Hospital Readmissions, Medicare
Henke RM, Karaca Z, Jackson P
AHRQ Author: Karaca Z; Wong HS
Discharge planning and hospital readmissions.
This study examines the association between the quality of hospital discharge planning and all-cause 30-day readmissions and same-hospital readmissions. Discharge-planning quality was associated with (a) lower rates of 30-day hospital readmissions and (b) higher rates of same-hospital readmissions for heart failure, pneumonia, and total hip or joint replacement. These results suggest that by improving inpatient discharge planning, hospitals may be able to influence their 30-day readmissions.
AHRQ-authored; AHRQ-funded.
Citation: Henke RM, Karaca Z, Jackson P .
Discharge planning and hospital readmissions.
Med Care Res Rev 2017 Jun;74(3):345-68. doi: 10.1177/1077558716647652.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospital Discharge, Hospital Readmissions, Hospitals, Hospitalization
Middleton A, Zhou J, Ottenbacher KJ
Hospital variation in rates of new institutionalizations within 6 months of discharge.
The primary objective of this study was to examine the hospital-level variation in rates of new institutionalizations among Medicare beneficiaries. The overall observed rate of new institutionalizations was 3.6 percent (N = 173,998). Older age, white race, Medicaid eligibility, longer hospitalization, and having a skilled nursing facility stay over the 6 months before hospitalization were associated with higher adjusted odds. Observed rates ranged from 0.9 percent to 5.9 percent across states.
AHRQ-funded; HS022134.
Citation: Middleton A, Zhou J, Ottenbacher KJ .
Hospital variation in rates of new institutionalizations within 6 months of discharge.
J Am Geriatr Soc 2017 Jun;65(6):1206-13. doi: 10.1111/jgs.14760.
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Keywords: Hospitalization, Elderly, Nursing Homes, Hospital Discharge
Regenbogen SE, Cain-Nielsen AH, Norton EC
Costs and consequences of early hospital discharge after major inpatient surgery in older adults.
This study evaluated the association between early postoperative discharge practices and overall surgical episode spending and expenditures for postdischarge care use and readmissions. It concluded that early routine postoperative discharge after major inpatient surgery is associated with lower total surgical episode payments. There is no evidence that savings from shorter postsurgical hospitalization are offset by higher postdischarge care spending.
AHRQ-funded; HS024698.
Citation: Regenbogen SE, Cain-Nielsen AH, Norton EC .
Costs and consequences of early hospital discharge after major inpatient surgery in older adults.
JAMA Surg 2017 May 17;152(5):e170123. doi: 10.1001/jamasurg.2017.0123.
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Keywords: Elderly, Surgery, Hospital Discharge, Healthcare Costs, Outcomes
Attanasio LB, Kozhimannil KB, Srinivas SK
Concordance between women's self-reported reasons for cesarean delivery and hospital discharge records.
Researchers compared women's self-reported reasons for cesarean with their hospital discharge records and examined correlates of variability in agreement between sources. Ninety-one percent of women reported a reason for their cesarean that was present in the discharge data. Positive predictive value (PPV), the probability that women's self-reported reasons for cesarean varied by reason for cesarean, with high PPV for dystocia, macrosomia, and cephalopelvic disproportion (91.1 percent), and lower PPV for malposition (81.7 percent).
AHRQ-funded; HS024215.
Citation: Attanasio LB, Kozhimannil KB, Srinivas SK .
Concordance between women's self-reported reasons for cesarean delivery and hospital discharge records.
Womens Health Issues 2017 May - Jun;27(3):329-35. doi: 10.1016/j.whi.2016.12.006.
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Keywords: Hospital Discharge, Labor and Delivery, Pregnancy, Women
Buys DR, Campbell AD, Godfryd A
Meals enhancing nutrition after discharge: findings from a pilot randomized controlled trial.
This pilot study's objective was to evaluate the feasibility of conducting a randomized controlled trial assessing a post-discharge home-delivered meal program's impact on older adults' nutritional intake and hospital readmissions and to assess patient acceptability and satisfaction with the program. It found that participants were overwhelmingly satisfied (82 percent to 100 percent satisfied or very satisfied) with staff performance, meal quality, and delivery processes.
AHRQ-funded; HS013852.
Citation: Buys DR, Campbell AD, Godfryd A .
Meals enhancing nutrition after discharge: findings from a pilot randomized controlled trial.
J Acad Nutr Diet 2017 Apr;117(4):599-608. doi: 10.1016/j.jand.2016.11.005.
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Keywords: Nutrition, Patient Experience, Elderly, Home Healthcare, Hospital Discharge
Unaka NI, Statile A, Haney J
Assessment of readability, understandability, and completeness of pediatric hospital medicine discharge instructions.
A cross-sectional study was conducted at a large urban academic children's hospital to describe readability levels, understandability scores, and completeness of written instructions given to families at hospital discharge. The investigators found that overall, the readability, understandability, and completeness of discharge instructions were subpar. Efforts to improve the content of discharge instructions may promote safe and effective transitions home.
AHRQ-funded; HS023827.
Citation: Unaka NI, Statile A, Haney J .
Assessment of readability, understandability, and completeness of pediatric hospital medicine discharge instructions.
J Hosp Med 2017 Feb;12(2):98-101. doi: 10.12788/jhm.2688..
Keywords: Children/Adolescents, Health Literacy, Hospital Discharge, Children/Adolescents
Nguyen OK, Makam AN, Clark C
Vital signs are still vital: instability on discharge and the risk of post-discharge adverse outcomes.
This study assessed the association between vital sign instability at hospital discharge and post-discharge adverse outcomes. Having two or more vital sign instabilities at discharge had a positive predictive value of 22 percent and positive likelihood ratio of 1.8 for 30-day death or readmission. Vital sign instability on discharge is thus associated with increased risk-adjusted rates of 30-day mortality and readmission.
AHRQ-funded; HS022418.
Citation: Nguyen OK, Makam AN, Clark C .
Vital signs are still vital: instability on discharge and the risk of post-discharge adverse outcomes.
J Gen Intern Med 2017 Jan;32(1):42-48. doi: 10.1007/s11606-016-3826-8.
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Keywords: Hospital Discharge, Hospital Readmissions, Patient-Centered Outcomes Research, Risk
Sanger PC, Hartzler A, Han SM
Patient perspectives on post-discharge surgical site infections: towards a patient-centered mobile health solution.
This study explored patient experience of surgical site infections (SSI) and openness to a mobile health (mHealth) wound monitoring ‘‘app’’ as a novel solution to address the problem of patient perceptions about barriers experienced while seeking care for post-discharge SSI. It found that patients are dissatisfied with the current standard post-hospitalization care practice and were accepting of the concept of a patient-centered wound monitoring application.
AHRQ-funded; HS019482.
Citation: Sanger PC, Hartzler A, Han SM .
Patient perspectives on post-discharge surgical site infections: towards a patient-centered mobile health solution.
PLoS One 2014 Dec;9(12):e114016. doi: 10.1371/journal.pone.0114016..
Keywords: Surgery, Health Information Technology (HIT), Adverse Events, Patient Experience, Hospital Discharge
Sanger P, Hartzler A, Lober WB
Design considerations for post-acute care mHealth: patient perspectives.
The authors are developing an mHealth platform to engage patients in wound tracking to identify and manage surgical site infections (SSI) after hospital discharge. Their key design qualities include: meeting basic accessibility, usability and security needs; encouraging patient-centeredness; facilitating better, more predictable communication; and supporting personalized management by providers. In this article, they illustrated their application of these guiding design considerations and proposed a new framework for mHealth design based on illness duration and intensity.
AHRQ-funded; HS019482.
Citation: Sanger P, Hartzler A, Lober WB .
Design considerations for post-acute care mHealth: patient perspectives.
AMIA Annu Symp Proc 2014 Nov 14;2014:1920-9.
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Keywords: Telehealth, Patient Self-Management, Surgery, Injuries and Wounds, Healthcare-Associated Infections (HAIs), Hospital Discharge, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Adverse Events
Albrecht JS, Gruber-Baldini AL, Hirshon JM
Hospital discharge instructions: comprehension and compliance among older adults.
The purpose of this prospective cohort study was to quantify the prevalence of non-comprehension and non-compliance with discharge instructions and to identify associated patient characteristics. The investigators concluded that non-comprehension of discharge instructions among older adults was prevalent, multi-factorial, and varies by domain.
AHRQ-funded; HS021068.
Citation: Albrecht JS, Gruber-Baldini AL, Hirshon JM .
Hospital discharge instructions: comprehension and compliance among older adults.
J Gen Intern Med 2014 Nov;29(11):1491-8. doi: 10.1007/s11606-014-2956-0..
Keywords: Elderly, Health Literacy, Hospital Discharge, Patient Adherence/Compliance
Goldman LE, Sarkar U, Kessell E
Support from hospital to home for elders: a randomized trial.
The researchers studied a peridischarge, nurse-led intervention combined with telephone follow-up designed to reduce readmissions among patients who were 55 or older. They found that the nurse-led, in-hospital discharge support intervention did not show a reduction in readmissions or ED visits among 700 diverse, low-income older adults at a safety-net hospital.
AHRQ-funded; HS018090.
Citation: Goldman LE, Sarkar U, Kessell E .
Support from hospital to home for elders: a randomized trial.
Ann Intern Med 2014 Oct 7;161(7):472-81. doi: 10.7326/m14-0094..
Keywords: Hospital Discharge, Hospital Readmissions, Emergency Department, Elderly, Social Determinants of Health, Nursing
Garfield CF, Lee Y, Kim HN
Paternal and maternal concerns for their very low-birth-weight infants transitioning from the NICU to home.
The authors examined the concerns and coping mechanisms of fathers and mothers of very low-birth-weight neonatal intensive care unit (NICU) infants as they transition to home from the NICU. They found that overriding concerns included pervasive uncertainty, lingering medical concerns, and partner-related adjustment concerns that differed by gender. They concluded that many parental concerns can be addressed with improved discharge information exchanges and anticipatory guidance.
AHRQ-funded; HS020316.
Citation: Garfield CF, Lee Y, Kim HN .
Paternal and maternal concerns for their very low-birth-weight infants transitioning from the NICU to home.
J Perinat Neonatal Nurs 2014 Oct-Dec;28(4):305-12. doi: 10.1097/jpn.0000000000000021.
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Keywords: Care Coordination, Hospital Discharge, Neonatal Intensive Care Unit (NICU), Newborns/Infants, Transitions of Care
Mixon AS, Neal E, Bell S
Care transitions: a leverage point for safe and effective medication use in older adults--a mini-review.
The authors discuss medication adherence in older adults across the continuum of care, describing reasons for nonadherence, methods to assess adherence, and tools to improve adherence, with particular focus on emerging techniques and technologies.
AHRQ-funded; HS019598.
Citation: Mixon AS, Neal E, Bell S .
Care transitions: a leverage point for safe and effective medication use in older adults--a mini-review.
Gerontology 2015;61(1):32-40. doi: 10.1159/000363765.
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Keywords: Elderly, Hospital Discharge, Medication: Safety, Medication, Patient Adherence/Compliance
Gadzinski AJ, Dimick JB, Ye Z
Transfer rates and use of post-acute care after surgery at critical access vs non-critical access hospitals.
This study evaluated discharge practice patterns and use of post-acute care after surgical admissions at critical access hospitals (CAHs). It found that for each of six common surgical procedures, a greater proportion of patients was transferred to another hospital. However, the proportion of patients at CAHs using post-acute care is equal to or less than that of patients treated in non-CAHs.
AHRQ-funded; HS018346
Citation: Gadzinski AJ, Dimick JB, Ye Z .
Transfer rates and use of post-acute care after surgery at critical access vs non-critical access hospitals.
JAMA Surg. 2014 Jul;149(7):671-7. doi: 10.1001/jamasurg.2013.5694..
Keywords: Surgery, Critical Care, Hospital Discharge, Quality of Care
Wang CY, Graham JE, Karmarkar AM
FIM motor scores for classifying community discharge after inpatient rehabilitation for hip fracture.
A major goal of this study was to identify which discharge functional independence measure (FIM)--total, motor, or cognition--best discriminates community versus institutional discharges. It found that the FIM motor scale yields the best overall discrimination of patients discharged to the community versus those discharged to an institution after inpatient rehabilitation for hip fracture.
AHRQ-funded; HS022134.
Citation: Wang CY, Graham JE, Karmarkar AM .
FIM motor scores for classifying community discharge after inpatient rehabilitation for hip fracture.
PM & R 2014 Jun; 6(6):493-7. doi: 10.1016/j.pmrj.2013.12.008..
Keywords: Hospital Discharge, Injuries and Wounds, Elderly
Liao JM, Roy CL, Eibensteiner K
Lost in transition: discrepancies in how physicians perceive the actionability of the results of tests pending at discharge.
Effective communication of pending hospital test results between inpatient and primary care physicians is sometimes challenging or nonexistent. This communication is essential for safe, quality transactions at discharge. Health information technology (such as email and fax) is an effective strategy for improving and reporting test-result management.
AHRQ-funded; HS018229
Citation: Liao JM, Roy CL, Eibensteiner K .
Lost in transition: discrepancies in how physicians perceive the actionability of the results of tests pending at discharge.
J Hospital Med. 2014 Jun;9(6):407-9. doi: 10.1002/jhm.2177..
Keywords: Communication, Care Coordination, Health Information Technology (HIT), Hospital Discharge, Patient Safety
Carey K, Lin MY
Hospital length of stay and readmission: an early investigation.
This study is a retrospective examination of the association between length of stay in an index hospitalization and readmission within 7 days and within 30 days of discharge. It found negative associations between length of stay and readmission probability, particularly for heart attack patients; however, the magnitude of the effect was modest for heart attack.
AHRQ-funded; HS020995.
Citation: Carey K, Lin MY .
Hospital length of stay and readmission: an early investigation.
Med Care Res Rev 2014 Feb;71(1):99-111. doi: 10.1177/1077558713504998..
Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Hospital Readmissions, Hospitalization, Hospital Discharge