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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 25 of 37 Research Studies DisplayedSwain MJ, Kharrazi H
Feasibility of 30-day hospital readmission prediction modeling based on health information exchange data.
The researchers conducted a semi-systematic review of readmission predictive factors published prior to March 2013. They found that mapping of these variables with common HL7 segments resulted in an 89.2 percent total coverage, with the DG1 (diagnosis) segment having the highest coverage of 39.4 percent. The PID (patient identification) and OBX (observation results) segments cover 13.9 percent and 9.1 percent of the variables.
AHRQ-funded; HS022578.
Citation: Swain MJ, Kharrazi H .
Feasibility of 30-day hospital readmission prediction modeling based on health information exchange data.
Int J Med Inform 2015 Dec;84(12):1048-56. doi: 10.1016/j.ijmedinf.2015.09.003.
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Keywords: Health Information Exchange (HIE), Hospital Readmissions, Health Information Technology (HIT), Data
Rajaram R, Ju MH, Bilimoria KY
National evaluation of hospital readmission after pulmonary resection.
The study’s objectives were to (1) assess readmission rates and timing after pulmonary resection, (2) report the most common reasons for rehospitalization, and (3) identify risk factors for unplanned readmission after pulmonary resection. It found that experiencing a postoperative complication was strongly associated with unplanned readmission.
AHRQ-funded; HS000078.
Citation: Rajaram R, Ju MH, Bilimoria KY .
National evaluation of hospital readmission after pulmonary resection.
J Thorac Cardiovasc Surg 2015 Dec;150(6):1508-14.e2. doi: 10.1016/j.jtcvs.2015.05.047..
Keywords: Hospital Readmissions, Risk, Surgery, Quality Indicators (QIs), Adverse Events
Mitchell SE, Martin JM, Krizman K
Design and rationale for a randomized controlled trial to reduce readmissions among patients with depressive symptoms.
This study aims to examine the effectiveness of RED-D, a modified brief Cognitive behavioral therapy (CBT) protocol delivered as a post-discharge extension of the Re-Engineered Discharge (RED), in reducing 30-day readmissions rates and emergency department use as well as depressive symptoms for medical patients with comorbid depressive symptoms.
AHRQ-funded; HS019700.
Citation: Mitchell SE, Martin JM, Krizman K .
Design and rationale for a randomized controlled trial to reduce readmissions among patients with depressive symptoms.
Contemp Clin Trials 2015 Nov;45(Pt B):151-6. doi: 10.1016/j.cct.2015.08.016.
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Keywords: Depression, Emergency Department, Hospital Discharge, Hospital Readmissions, Behavioral Health
Blecker S, Goldfeld K, Park H
Impact of an intervention to improve weekend hospital care at an academic medical center: an observational study.
The purpose of this study was to evaluate the impact of a weekend hospital intervention on processes of care and clinical outcomes. The multifaceted intervention included expanded weekend diagnostic services, improved weekend discharge processes, and increased physician and care management services on weekends. The intervention was associated with a reduction in length of stay and an increase in weekend discharges.
AHRQ-funded; HS023683.
Citation: Blecker S, Goldfeld K, Park H .
Impact of an intervention to improve weekend hospital care at an academic medical center: an observational study.
J Gen Intern Med 2015 Nov;30(11):1657-64. doi: 10.1007/s11606-015-3330-6.
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Keywords: Quality Improvement, Quality of Care, Hospitals, Hospital Discharge, Hospital Readmissions, Healthcare Delivery, Outcomes, Patient-Centered Outcomes Research
Hu Y, McMurry TL, Stukenborg GJ
Readmission predicts 90-day mortality after esophagectomy: analysis of surveillance, epidemiology, and end results registry linked to Medicare outcomes.
The purpose of this study was to characterize postesophagectomy readmissions and determine their relationship with subsequent 90-day mortality. It found that one in 5 esophagectomy patients are readmitted early after discharge. Readmitted patients have a 5-fold increase in early mortality.
AHRQ-funded; HS018049.
Citation: Hu Y, McMurry TL, Stukenborg GJ .
Readmission predicts 90-day mortality after esophagectomy: analysis of surveillance, epidemiology, and end results registry linked to Medicare outcomes.
J Thorac Cardiovasc Surg 2015 Nov;150(5):1254-60. doi: 10.1016/j.jtcvs.2015.08.071..
Keywords: Hospital Readmissions, Mortality, Outcomes, Registries, Surgery
Singh S, Lin YL, Nattinger AB
Variation in readmission rates by emergency departments and emergency department providers caring for patients after discharge.
This study of Texas acute-care hospitals and ED facilities has found that the risk of readmission varies by ED provider caring for patients after discharge. A large part of this variation is explained by the ED facility in which the ED providers practice. Thus, ED provider practices patterns and ED facility systems of care may be a target for interventions to reduce readmissions.
AHRQ-funded; HS022134.
Citation: Singh S, Lin YL, Nattinger AB .
Variation in readmission rates by emergency departments and emergency department providers caring for patients after discharge.
J Hosp Med 2015 Nov;10(11):705-10. doi: 10.1002/jhm.2407.
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Keywords: Emergency Department, Elderly, Hospital Discharge, Hospital Readmissions, Medicare
Leland NE, Gozalo P, Christian TJ
An examination of the first 30 days after patients are discharged to the community from hip fracture postacute care.
This study examined the percentage of PAC patients who remain in the community at least 30 days after discharge (i.e., successful community discharge) after hip fracture rehabilitation and described differences among PAC facilities based on this outcome. It found that between 1999 and 2007, 57 percent of patients achieved successful community discharge. Black were less likely than similar whites to achieve successful community discharge.
AHRQ-funded; HS000011.
Citation: Leland NE, Gozalo P, Christian TJ .
An examination of the first 30 days after patients are discharged to the community from hip fracture postacute care.
Med Care 2015 Oct;53(10):879-87. doi: 10.1097/mlr.0000000000000419..
Keywords: Rehabilitation, Injuries and Wounds, Hospital Discharge, Hospital Readmissions, Outcomes
Jung HY, Trivedi AN, Grabowski DC
Integrated Medicare and Medicaid managed care and rehospitalization of dual eligibles.
The objective of this study was to conduct an early evaluation of an innovative program that coordinates benefits for elderly dual eligibles. The authors found no statistically significant effect of senior care options on rehospitalization. They concluded that coordinating the financing and delivery of services through an integrated managed program may not sufficiently address the problems of inefficiency and fragmentation in care for hospitalized dual eligible enrollees.
AHRQ-funded; HS020756.
Citation: Jung HY, Trivedi AN, Grabowski DC .
Integrated Medicare and Medicaid managed care and rehospitalization of dual eligibles.
Am J Manag Care 2015 Oct;21(10):711-7.
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Keywords: Healthcare Delivery, Care Management, Medicaid, Medicare, Hospital Readmissions
Khan A, Nakamura MM, Zaslavsky AM
Same-hospital readmission rates as a measure of pediatric quality of care.
This study determined the prevalence of 30-day pediatric different hospital readmission (DHRs); to assess the effect of DHR on readmission performance; and to identify patient and hospital characteristics associated with DHR. It concluded that DHRs differentially affect hospitals’ pediatric readmission rates and anticipated performance, making same-hospital readmissions an incomplete surrogate for all-hospital readmissions—particularly for certain hospital types.
AHRQ-funded; HS000063; HS020513.
Citation: Khan A, Nakamura MM, Zaslavsky AM .
Same-hospital readmission rates as a measure of pediatric quality of care.
JAMA Pediatr 2015 Oct;169(10):905-12. doi: 10.1001/jamapediatrics.2015.1129..
Keywords: Children/Adolescents, Quality of Care, Hospital Readmissions, Quality Indicators (QIs), Children/Adolescents
Acher AW, LeCaire TJ, Hundt AS
Using human factors and systems engineering to evaluate readmission after complex surgery.
The study objective was to use a human factors and systems engineering approach to understand contributors to surgical readmissions from a patient and provider perspective. Patients and clinician providers identified a number of factors during the transition of care that may have contributed to readmission, including poor patient and caregiver understanding; inadequate discharge preparation for home care; insufficient educational process and materials.
AHRQ-funded; HS022446.
Citation: Acher AW, LeCaire TJ, Hundt AS .
Using human factors and systems engineering to evaluate readmission after complex surgery.
J Am Coll Surg 2015 Oct;221(4):810-20. doi: 10.1016/j.jamcollsurg.2015.06.014..
Keywords: Surgery, Hospital Readmissions, Hospital Discharge, Transitions of Care, Electronic Health Records (EHRs)
Nijhawan AE, Kitchell E, Etherton SS
Half of 30-day hospital readmissions among HIV-infected patients are potentially preventable.
The researchers assessed whether readmissions among HIV-infected patients were potentially preventable using both published criteria and detailed chart review, how readmissions might have been prevented, and the phase of care deemed suboptimal (inpatient care, discharge planning, post-discharge). They found that among 130 individuals experiencing 30-day readmissions, about half were determined to be potentially preventable using published criteria (53 percent) or implicit chart review (48 percent).
AHRQ-funded; HS022418.
Citation: Nijhawan AE, Kitchell E, Etherton SS .
Half of 30-day hospital readmissions among HIV-infected patients are potentially preventable.
AIDS Patient Care STDS 2015 Sep;29(9):465-73. doi: 10.1089/apc.2015.0096..
Keywords: Human Immunodeficiency Virus (HIV), Hospital Readmissions, Electronic Health Records (EHRs), Patient-Centered Outcomes Research, Prevention
Toth M, Holmes M, Van Houtven C
Rural Medicare beneficiaries have fewer follow-up visits and greater emergency department use postdischarge.
This study tested whether rural Medicare beneficiaries have a lower likelihood of follow-up care and greater likelihood of a readmission and ED visit within 30 days postdischarge, compared with urban beneficiaries. The results provide evidence of lower quality postdischarge care for Medicare beneficiaries in rural settings.
AHRQ-funded; HS000032.
Citation: Toth M, Holmes M, Van Houtven C .
Rural Medicare beneficiaries have fewer follow-up visits and greater emergency department use postdischarge.
Med Care 2015 Sep;53(9):800-8. doi: 10.1097/mlr.0000000000000401..
Keywords: Rural Health, Elderly, Medicare, Hospital Readmissions, Emergency Department, Hospital Discharge
Donnelly JP, Hohmann SF, Wang HE
Unplanned readmissions after hospitalization for severe sepsis at academic medical center-affiliated hospitals.
The researchers sought to characterize 7- and 30-day readmission rates following hospital admission for severe sepsis as well as institutional variations in readmission. They concluded that severe sepsis readmission places a substantial burden on the healthcare system, with one in 15 and one in five severe sepsis discharges readmitted within 7 and 30 days, respectively.
AHRQ-funded; HS013852.
Citation: Donnelly JP, Hohmann SF, Wang HE .
Unplanned readmissions after hospitalization for severe sepsis at academic medical center-affiliated hospitals.
Crit Care Med 2015 Sep;43(9):1916-27. doi: 10.1097/ccm.0000000000001147..
Keywords: Hospital Readmissions, Hospitals, Risk, Sepsis
Brooke BS, Goodney PP, Kraiss LW
Readmission destination and risk of mortality after major surgery: an observational cohort study.
This study examined the association between readmission destination and mortality risk in the USA in Medicare beneficiaries after a range of common operations. It found that patients who are readmitted to hospital after various major operations consistently achieve improved survival if they return to the hospital where their surgery took place.
AHRQ-funded; HS021581.
Citation: Brooke BS, Goodney PP, Kraiss LW .
Readmission destination and risk of mortality after major surgery: an observational cohort study.
Lancet 2015 Aug 29;386(9996):884-95. doi: 10.1016/s0140-6736(15)60087-3..
Keywords: Hospital Readmissions, Mortality, Surgery, Elderly, Outcomes, Hospitals
McElroy LM, Schmidt KA, Richards CT
Early postoperative emergency department care of abdominal transplant recipients.
The goal of this study was to describe early postoperative ED care of transplant recipients. It found that transplant recipients have a high frequency of ED visits in the first post transplantation year and high rates of subsequent hospital admission.
AHRQ-funded; HS000078.
Citation: McElroy LM, Schmidt KA, Richards CT .
Early postoperative emergency department care of abdominal transplant recipients.
Transplantation 2015 Aug;99(8):1652-7. doi: 10.1097/tp.0000000000000781..
Keywords: Emergency Department, Transplantation, Hospital Readmissions, Hospitals
Williams TP, Dimou FM, Adhikari D
Hospital readmission after emergency room visit for cholelithiasis.
This study evaluated the surgical follow-up and outcomes in patients seen in the emergency department (ED) for an episode of symptomatic cholelithiasis and discharged home for elective follow-up. It found that the failure to achieve a timely surgical follow-up leads to multiple ED readmissions and emergent gallstone-related hospitalizations, including emergency cholecystectomy.
AHRQ-funded; HS022134.
Citation: Williams TP, Dimou FM, Adhikari D .
Hospital readmission after emergency room visit for cholelithiasis.
J Surg Res 2015 Aug;197(2):318-23. doi: 10.1016/j.jss.2015.04.032..
Keywords: Hospital Readmissions, Patient-Centered Outcomes Research, Emergency Department, Hospital Discharge, Surgery
Balaban RB, Galbraith AA, Burns ME
A patient navigator intervention to reduce hospital readmissions among high-risk safety-net patients: a randomized controlled trial.
The researchers sough to determine if an intervention by patient navigators, hospital-based Community Health Workers, reduces readmissions among high risk, low socioeconomic status patients. They found that, overall, 30-day readmission rates did not differ between intervention and control patients.
AHRQ-funded; HS020628.
Citation: Balaban RB, Galbraith AA, Burns ME .
A patient navigator intervention to reduce hospital readmissions among high-risk safety-net patients: a randomized controlled trial.
J Gen Intern Med 2015 Jul;30(7):907-15. doi: 10.1007/s11606-015-3185-x..
Keywords: Hospital Readmissions, Low-Income, Social Determinants of Health, Patient Safety
Moghavem N, Morrison D, Ratliff JK
Cranial neurosurgical 30-day readmissions by clinical indication.
The objects of this study were to determine population-level, 30-day, all-cause readmission rates for cranial neurosurgery and identify factors associated with readmission. It fund that the frequency of 30-day readmission rates for patients undergoing cranial neurosurgery varied by diagnosis between 14% and 24%. Important patient characteristics and comorbidities that were associated with an increased readmission risk were identified.
AHRQ-funded; HS018558.
Citation: Moghavem N, Morrison D, Ratliff JK .
Cranial neurosurgical 30-day readmissions by clinical indication.
J Neurosurg 2015 Jul;123(1):189-97. doi: 10.3171/2014.12.jns14447..
Keywords: Hospital Readmissions, Surgery, Patient Safety, Outcomes
Holden TR, Smith MA, Bartels CM
Hospice enrollment, local hospice utilization patterns, and rehospitalization in Medicare patients.
The study objective was to examine the association between hospice enrollment, local hospice utilization patterns and 30-day rehospitalization in Medicare patients. It found that area-level hospice utilization is inversely proportional to rehospitalization rates. This relationship is not fully explained by direct hospice enrollment, and may reflect a spillover effect of the benefits of hospice extending to nonenrollees.
AHRQ-funded; HS000083.
Citation: Holden TR, Smith MA, Bartels CM .
Hospice enrollment, local hospice utilization patterns, and rehospitalization in Medicare patients.
J Palliat Med 2015 Jul;18(7):601-12. doi: 10.1089/jpm.2014.0395..
Keywords: Long-Term Care, Palliative Care, Hospital Readmissions, Medicare, Healthcare Utilization
Carey K
Measuring the hospital length of stay/readmission cost trade-off under a bundled payment mechanism.
This paper investigates the relationship between length of stay and readmission within 30 days of discharge from an acute care hospitalization. It found that the cost of an additional day of stay was offset by expected cost savings from an avoided readmission in the range of 15 to 65 percent.
AHRQ-funded; HS020995.
Citation: Carey K .
Measuring the hospital length of stay/readmission cost trade-off under a bundled payment mechanism.
Health Econ 2015 Jul;24(7):790-802. doi: 10.1002/hec.3061..
Keywords: Hospital Readmissions, Hospitalization, Elderly, Hospital Discharge, Medicare
Gonzalez AA, Abdelsattar ZM, Dimick JB
Time-to-readmission and mortality after high-risk surgery.
This study used 5 years of data on Medicare beneficiaries undergoing high-risk surgical procedures to investigate whether postdischarge mortality varies by time to readmission. It found that surgical readmissions within 10 days of discharge are disproportionately common and associated with increased mortality independent of index complications.
AHRQ-funded; HS017765; HS000053.
Citation: Gonzalez AA, Abdelsattar ZM, Dimick JB .
Time-to-readmission and mortality after high-risk surgery.
Ann Surg 2015 Jul;262(1):53-9. doi: 10.1097/sla.0000000000000912..
Keywords: Patient Safety, Mortality, Hospital Readmissions, Adverse Events, Surgery
Duseja R, Bardach NS, Lin GA
Revisit rates and associated costs after an emergency department encounter: a multistate analysis.
This study describes revisit rates, variation in revisit rates by diagnosis and state, and associated costs. It found that revisits after an index ED encounter are more frequent than previously reported, in part because many occur outside the index institution. Among ED patients in Florida, more resources are spent on revisits than on index ED visits.
AHRQ-funded; HS020667.
Citation: Duseja R, Bardach NS, Lin GA .
Revisit rates and associated costs after an emergency department encounter: a multistate analysis.
Ann Intern Med 2015 Jun 2;162(11):750-6. doi: 10.7326/m14-1616..
Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Emergency Department, Hospitalization, Hospital Readmissions
Lopes RD, Gharacholou SM, Holmes DN
Cumulative incidence of death and rehospitalization among the elderly in the first year after NSTEMI.
The researchers evaluated mortality and cause-specific rehospitalization rates in elderly non-ST-segment elevation myocardial infarction survivors with ischemic heart disease. They found that rehospitalization rates do not rise substantially with advancing age, and rehospitalization is often for noncardiac diagnoses.
AHRQ-funded; HS021092.
Citation: Lopes RD, Gharacholou SM, Holmes DN .
Cumulative incidence of death and rehospitalization among the elderly in the first year after NSTEMI.
Am J Med 2015 Jun;128(6):582-90. doi: 10.1016/j.amjmed.2014.12.032.
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Keywords: Elderly, Mortality, Heart Disease and Health, Cardiovascular Conditions, Hospital Readmissions
Shih T, Ryan AM, Gonzalez AA
Medicare's hospital readmissions reduction program in surgery may disproportionately affect minority-serving hospitals.
The authors aimed to project readmission penalties for hospitals performing cardiac surgery and examine how these penalties will affect minority-serving hospitals. They found that minority-serving hospitals would disproportionately bear the burden of readmission penalties if expanded to include cardiac surgery.
AHRQ-funded; HS018546.
Citation: Shih T, Ryan AM, Gonzalez AA .
Medicare's hospital readmissions reduction program in surgery may disproportionately affect minority-serving hospitals.
Ann Surg 2015 Jun;261(6):1027-31. doi: 10.1097/sla.0000000000000778.
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Keywords: Hospitals, Medicare, Racial and Ethnic Minorities, Hospital Readmissions, Surgery
Amarasingham R, Velasco F, Xie B
Electronic medical record-based multicondition models to predict the risk of 30 day readmission or death among adult medicine patients: validation and comparison to existing models.
The purpose of this study was to evaluate the degree to which electronic medical record-based risk models for 30-day readmission or mortality accurately identify high risk patients and to compare these models with published claims-based models. The researchers found that a new electronic multicondition model based on information derived from the electronic medical record predicted mortality and readmission at 30 days, and was superior to previously published claims-based models
AHRQ-funded; HS022418.
Citation: Amarasingham R, Velasco F, Xie B .
Electronic medical record-based multicondition models to predict the risk of 30 day readmission or death among adult medicine patients: validation and comparison to existing models.
BMC Med Inform Decis Mak 2015 May 20;15:39. doi: 10.1186/s12911-015-0162-6.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Mortality, Hospital Readmissions, Risk