National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Blood Clots (1)
- Cardiovascular Conditions (1)
- Children/Adolescents (1)
- Disparities (1)
- Elderly (2)
- Electronic Health Records (EHRs) (1)
- Healthcare-Associated Infections (HAIs) (2)
- Health Information Technology (HIT) (1)
- Heart Disease and Health (1)
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- Hospital Readmissions (1)
- Hospitals (5)
- Injuries and Wounds (1)
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- Mortality (1)
- Nursing Homes (1)
- Patient Safety (2)
- Payment (2)
- Pneumonia (1)
- Prevention (1)
- (-) Provider Performance (8)
- Public Reporting (1)
- Quality Improvement (2)
- (-) Quality Indicators (QIs) (8)
- Quality Measures (4)
- Quality of Care (6)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (2)
- Surgery (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 8 of 8 Research Studies DisplayedKaiser SV, Lam R, Joseph GB
Limitations of using pediatric respiratory illness readmissions to compare hospital performance.
Researcher sought to determine if a National Quality Forum (NQF)-endorsed measure for pediatric lower respiratory illness (LRI) 30-day readmission rates can meaningfully identify high- and low-performing hospitals. Subjects were children with LRI (bronchiolitis, influenza, or pneumonia as primary diagnosis, or with an LRI as a secondary diagnosis with a primary diagnosis of respiratory failure, sepsis, bacteremia, or asthma) from all hospital admissions in California from 2012 to 2014. The researchers were unable to identify meaningful variation in hospital performance without broadening the metric definition and merging multiple years of data. They recommend that utilizers of pediatric-quality measures consider modifying metrics to better evaluate the quality of pediatric care at low-volume hospitals.
AHRQ-funded; HS024385; HS022835; HS024592; HS025297.
Citation: Kaiser SV, Lam R, Joseph GB .
Limitations of using pediatric respiratory illness readmissions to compare hospital performance.
J Hosp Med 2018 Nov;13(11):737-42. doi: 10.12788/jhm.2988..
Keywords: Children/Adolescents, Respiratory Conditions, Provider Performance, Hospital Readmissions, Hospitals, Quality Indicators (QIs), Quality Measures, Quality of Care, Quality Improvement
Khoong EC, Cherian R, Rivadeneira NA
Accurate measurement In California's safety-net health systems has gaps and barriers.
The purpose of this study was to measure California’s pay-for-performance program in safety-net hospitals. Results showed both suboptimal performance in aspects of ambulatory safety and questionable reliability in data reporting. Health care systems that lack seamlessly integrated electronic health records and patient registries encountered barriers to reporting reliable ambulatory safety data, precluding accurate performance measurement in many areas. The authors recommended that policymakers and safety advocates support the development of information systems and measures that facilitate the accurate ascertainment of the health systems, patients, and clinical tasks at greatest risk for ambulatory safety failures.
AHRQ-funded; HS024412; HS024426.
Citation: Khoong EC, Cherian R, Rivadeneira NA .
Accurate measurement In California's safety-net health systems has gaps and barriers.
Health Aff 2018 Nov;37(11):1760-69. doi: 10.1377/hlthaff.2018.0709..
Keywords: Ambulatory Care and Surgery, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Provider Performance, Quality Indicators (QIs), Payment
Ryskina KL, Konetzka RT, Werner RM
Association between 5-Star nursing home report card ratings and potentially preventable hospitalizations.
The goal of this study was to test whether the improvements in nursing homes’ 5-star ratings were correlated with reductions in rates of hospitalization; the researchers’ hypothesis was that increased attention to ratings motivated nursing homes to make changes to improve ratings but did not affect hospitalization rate, resulting in a weakened association between ratings and hospitalizations. 2007-2010 Medicare hospital claims and nursing home clinical assessment data were used to compare the correlation between nursing homes’ ratings and hospitalization rates. Correlation weakened slightly after the ratings became publicly available. The researchers conclude that improvements in nursing home ratings after the release of Medicare's 5-star rating system were not accompanied by improvements in a broader measure of outcomes for post-acute care patients and, although this dissociation may be due to additional factors, the 5-star ratings became less meaningful as an indicator of nursing home quality for these patients.
AHRQ-funded; HS021861.
Citation: Ryskina KL, Konetzka RT, Werner RM .
Association between 5-Star nursing home report card ratings and potentially preventable hospitalizations.
Inquiry 2018 Jan-Dec;55:46958018787323. doi: 10.1177/0046958018787323..
Keywords: Elderly, Nursing Homes, Medicare, Quality Indicators (QIs), Provider Performance, Quality Measures, Hospitalization, Quality of Care
Lewis VA, Fraze T, Fisher ES
ACOs serving high proportions of racial and ethnic minorities lag in quality performance.
Researchers analyzed racial and ethnic disparities in health care outcomes among accountable care organizations (ACOs). Their findings suggest that ACOs with a high share of minority patients may struggle with quality performance under ACO contracts, especially during their early years of participation-maintaining or potentially exacerbating current inequities.
AHRQ-funded; HS024075.
Citation: Lewis VA, Fraze T, Fisher ES .
ACOs serving high proportions of racial and ethnic minorities lag in quality performance.
Health Aff 2017 Jan;36(1):57-66. doi: 10.1377/hlthaff.2016.0626.
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Keywords: Disparities, Racial and Ethnic Minorities, Provider Performance, Quality Indicators (QIs), Quality of Care
Calderwood MS, Kleinman K, Huang SS
Surgical site infections: volume-outcome relationship and year-to-year stability of performance rankings.
The researchers evaluated the volume-outcome relationship as well as the year-to-year stability of performance rankings following coronary artery bypass graft (CABG) surgery and hip arthroplasty. They concluded that aggregate surgical site infection risk is highest in hospitals with low annual procedure volumes. Even for higher volume hospitals, year-to-year random variation makes past experience an unreliable estimator of current performance.
AHRQ-funded; HS021424.
Citation: Calderwood MS, Kleinman K, Huang SS .
Surgical site infections: volume-outcome relationship and year-to-year stability of performance rankings.
Med Care 2017 Jan;55(1):79-85. doi: 10.1097/mlr.0000000000000620.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Injuries and Wounds, Hospitals, Provider Performance, Quality Indicators (QIs), Quality of Care, Patient Safety, Elderly
Lau BD, Haut ER, Hobson DB
ICD-9 code-based venous thromboembolism performance targets fail to measure up.
Suboptimal prevention practices have prompted payers to consider hospital-associated Venous thromboembolism (VTE) as a potentially preventable condition for which financial incentives or penalties exist to drive practice improvement. The authors reviewed a subset of hospital-associated VTE that were identified by ICD-9 codes used by a state-run pay-for-performance quality improvement program and discuss their findings.
AHRQ-funded; HS017952.
Citation: Lau BD, Haut ER, Hobson DB .
ICD-9 code-based venous thromboembolism performance targets fail to measure up.
Am J Med Qual 2016 Sep;31(5):448-53. doi: 10.1177/1062860615583547.
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Keywords: Healthcare-Associated Infections (HAIs), Quality Indicators (QIs), Prevention, Hospitals, Quality Improvement, Blood Clots, Payment, Provider Performance
McConnell KJ, Lindrooth RC, Wholey DR
Modern management practices and hospital admissions.
The researchers investigated whether the modern management practices and publicly reported performance measures are associated with choice of hospital for patients with acute myocardial infarction (AMI). They found that, overall, a one standard deviation change in management practice scores is associated with an 8% increase in AMI admissions.
AHRQ-funded; HS018466.
Citation: McConnell KJ, Lindrooth RC, Wholey DR .
Modern management practices and hospital admissions.
Health Econ 2016 Apr;25(4):470-85. doi: 10.1002/hec.3171.
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Keywords: Hospitals, Heart Disease and Health, Cardiovascular Conditions, Quality Indicators (QIs), Quality Measures, Quality of Care, Public Reporting, Provider Performance
Walkey AJ, Weinberg J, Wiener RS
Association of do-not-resuscitate orders and hospital mortality rate among patients with pneumonia.
The researchers evaluated the effect of analytic approaches accounting for do-not-resuscitate (DNR) status on risk-adjusted hospital mortality rates and performance rankings. They found that after accounting for patient DNR status and between-hospital variation in the association between DNR status and mortality, hospitals with higher DNR rates had lower mortality.
AHRQ-funded; HS020672.
Citation: Walkey AJ, Weinberg J, Wiener RS .
Association of do-not-resuscitate orders and hospital mortality rate among patients with pneumonia.
JAMA Intern Med 2016 Jan;176(1):97-104. doi: 10.1001/jamainternmed.2015.6324.
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Keywords: Hospitals, Mortality, Quality of Care, Quality Indicators (QIs), Quality Measures, Pneumonia, Provider Performance, Respiratory Conditions