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.
Results
1 to 25 of 76 Research Studies DisplayedPanupattanapong S, Stwalley DL, White AJ
Epidemiology and outcomes of granulomatosis with polyangiitis in pediatric and working-age adult populations In the United States: analysis of a large national claims database.
This retrospective cohort study examined the epidemiology and outcomes of granulomatosis with polyangiitis (GPA) in pediatric and working-age adult populations in the US. The study used data from the 2006-2014 Truven Health Analytics MarketScan Commercial Claims and Encounters Database. The incidence is rare in children, with a total of 214 (3.8%) out of 5,562 cases identified as pediatric onset. The incidence rate in children was 1.8 cases per 1 million person-years as opposed to 12.8 cases per 1 million person-years in working age adults. Children were more like to have frequent hospitalizations and severe infections including leukopenia, neutropenia, and hypogammaglobulinemia than the non-elderly adults.
AHRQ-funded; HS019455.
Citation: Panupattanapong S, Stwalley DL, White AJ .
Epidemiology and outcomes of granulomatosis with polyangiitis in pediatric and working-age adult populations In the United States: analysis of a large national claims database.
Arthritis Rheumatol 2018 Dec;70(12):2067-76. doi: 10.1002/art.40577..
Keywords: Children/Adolescents, Hospitalization, Respiratory Conditions, Cardiovascular Conditions
Burgermaster M, Murray M, Saiman L
Associations between enteral nutrition and acute respiratory infection among patients in New York metropolitan region pediatric long-term care facilities.
This study investigated the outcomes of children and a subsample of infants in pediatric long-term care facilities are need enteral nutrition (EN). Those patients who need EN had a higher risk of acute pediatric infection (ARI) and a lower odds of discharge than those who did not. Infants had a particular higher risk of comorbidities and infections when they were fed using percutaneous feeding tubes.
AHRQ-funded; HS021470.
Citation: Burgermaster M, Murray M, Saiman L .
Associations between enteral nutrition and acute respiratory infection among patients in New York metropolitan region pediatric long-term care facilities.
Nutr Clin Pract 2018 Dec;33(6):865-71. doi: 10.1002/ncp.10017..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Nutrition, Outcomes, Patient-Centered Outcomes Research, Patient Safety, Respiratory Conditions, Long-Term Care
Kaiser 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
Luthe SK, Hirayama A, Goto T
Association between obesity and acute severity among patients hospitalized for asthma exacerbation.
This study examined the association between obesity and exacerbation of asthma symptoms in hospitalized adults (age 18-54 years). This retrospective cohort study used data from 8 diverse US states from 2010-2013. Among 72,086 patients hospitalized for asthma exacerbation, 24% were considered obese. Obesity was associated with a higher use of mechanical ventilation as well as a longer hospital stay. These findings were consistent among all ages, sex, and race/ethnicity.
AHRQ-funded; HS023305.
Citation: Luthe SK, Hirayama A, Goto T .
Association between obesity and acute severity among patients hospitalized for asthma exacerbation.
J Allergy Clin Immunol Pract 2018 Nov - Dec;6(6):1936-41.e4. doi: 10.1016/j.jaip.2018.02.001..
Keywords: Asthma, Hospitalization, Obesity, Respiratory Conditions
Makam AN, Nguyen OK, Xuan L
Long-term acute care hospital use of non-mechanically ventilated hospitalized older adults.
In this observational cohort study, the investigators sought to determine why non-mechanically ventilated hospitalized older adults are transferred to long-term acute care (LTAC) hospitals rather than remaining in the hospital. The authors found that nearly half of the variation in LTAC use is independent of illness severity and is explained by which hospital and what region the individual was hospitalized in.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Xuan L .
Long-term acute care hospital use of non-mechanically ventilated hospitalized older adults.
J Am Geriatr Soc 2018 Nov;66(11):2112-19. doi: 10.1111/jgs.15564..
Keywords: Elderly, Hospitalization, Long-Term Care, Respiratory Conditions
Mittal M, Wang CE, Goben AH
Proprietary management and higher readmission rates: a correlation.
This study examined readmission rates of patients for six diseases including acute myocardial infarction, heart failure, coronary artery bypass graft, pneumonia, COPD, and total hip or total knee arthroplasty from the Center for Medicare and Medicaid Readmissions Reduction Production (HRRP) for 2012 to 2015. The type of hospital ownership was the variable that was being studied. There were statistically higher readmission rates in proprietary (for profit) hospitals compared to government and non-profit hospitals. This was true regardless of their location.
AHRQ-funded; HS024679.
Citation: Mittal M, Wang CE, Goben AH .
Proprietary management and higher readmission rates: a correlation.
PLoS One 2018 Sep 18;13(9):e0204272. doi: 10.1371/journal.pone.0204272..
Keywords: Cardiovascular Conditions, Hospital Readmissions, Hospitals, Orthopedics, Respiratory Conditions
Iyer AS, Wells JM, Bhatt SP
Life-space mobility and clinical outcomes in COPD.
Social isolation is a common experience in patients with COPD but is not captured by existing patient-reported outcomes, and its association with clinical outcomes is unknown. In this study, the investigators prospectively enrolled adults with stable COPD who completed a series of assessments. They determined associations between Life-Space mobility and clinical outcomes using regression analyses. They found that Restricted Life-Space mobility predicted severe exacerbations and was associated with reduced exercise tolerance, more severe dyspnea, reduced quality of life, and greater depressive symptoms.
AHRQ-funded; HS023009.
Citation: Iyer AS, Wells JM, Bhatt SP .
Life-space mobility and clinical outcomes in COPD.
Int J Chron Obstruct Pulmon Dis 2018 Sep 4;13:2731-38. doi: 10.2147/copd.s170887..
Keywords: Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research
Hirayama A, Goto T, Shimada YJ
Acute exacerbation of chronic obstructive pulmonary disease and subsequent risk of emergency department visits and hospitalizations for atrial fibrillation.
Although emerging evidence has suggested the relationship of chronic obstructive pulmonary disease with atrial fibrillation (AF), little is known about whether acute exacerbation of chronic obstructive pulmonary disease (AECOPD) increases the risk of repeated AF-related healthcare utilization. The investigators found that among patients with existing AF, AECOPD was associated with a higher risk of AF-related ED visit or hospitalization in the first 90-day post-AECOPD period.
AHRQ-funded; HS023305.
Citation: Hirayama A, Goto T, Shimada YJ .
Acute exacerbation of chronic obstructive pulmonary disease and subsequent risk of emergency department visits and hospitalizations for atrial fibrillation.
Circ Arrhythm Electrophysiol 2018 Sep;11(9):e006322. doi: 10.1161/circep.118.006322..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Respiratory Conditions, Heart Disease and Health, Cardiovascular Conditions, Chronic Conditions, Hospitalization, Risk, Healthcare Utilization
Koziatek CA, Simon E, Horwitz LI
Automated pulmonary embolism risk classification and guideline adherence for computed tomography pulmonary angiography ordering.
The objective of this study was to measure the performance of automated, structured data-only versions of the Wells and revised Geneva risk scores in emergency department encounters during which a computed tomography pulmonary angiography was ordered. The hypothesis was that such an automated method would classify a patient's pulmonary embolism risk with high accuracy compared to manual chart review.
AHRQ-funded; HS024376.
Citation: Koziatek CA, Simon E, Horwitz LI .
Automated pulmonary embolism risk classification and guideline adherence for computed tomography pulmonary angiography ordering.
Acad Emerg Med 2018 Sep;25(9):1053-61. doi: 10.1111/acem.13442..
Keywords: Respiratory Conditions, Risk, Diagnostic Safety and Quality, Emergency Department, Imaging, Guidelines
Goto T, Shimada YJ, Faridi MK
Incidence of acute cardiovascular event after acute exacerbation of COPD.
There is a lack of comprehensive view of the association between acute exacerbation of COPD (AECOPD) and the risk of acute cardiovascular events. The purpose of this study was to determine the association of AECOPD with 30-day and 1-year incidences of acute cardiovascular event. The investigators concluded that AECOPD was associated with increased 30-day and 1-year incidences of acute cardiovascular event.
AHRQ-funded; HS023305.
Citation: Goto T, Shimada YJ, Faridi MK .
Incidence of acute cardiovascular event after acute exacerbation of COPD.
J Gen Intern Med 2018 Sep;33(9):1461-68. doi: 10.1007/s11606-018-4518-3.
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Keywords: Respiratory Conditions, Cardiovascular Conditions, Risk, Chronic Conditions, Heart Disease and Health, Outcomes
Liu TL, Taylor YJ, Mahabaleshwarkar R
Shared decision making and time to exacerbation in children with asthma.
This study examined the use of shared decision making (SDM) to delay exacerbation in children with asthma. A prospective cohort of children at five primary care practices in Charlotte, North Carolina that serve vulnerable population was studied between 2011 and 2013. The cohort included 746 children, with 60.5% male and 54.2% African American with a mean age of 8.6 years. The final analysis included 100 matched pairs of children for use of SDM and normal care. There was a marginally significant difference in the time of exacerbation between the two groups.
AHRQ-funded; HS019946.
Citation: Liu TL, Taylor YJ, Mahabaleshwarkar R .
Shared decision making and time to exacerbation in children with asthma.
J Asthma 2018 Sep;55(9):949-55. doi: 10.1080/02770903.2017.1378357..
Keywords: Children/Adolescents, Decision Making, Asthma, Respiratory Conditions, Chronic Conditions, Primary Care
Hirayama A, Goto T, Faridi MK
Association of obstructive sleep apnoea with acute severity of chronic obstructive pulmonary disease exacerbation: a population-based study.
This retrospective cohort study investigated the association of coexistent obstructive sleep apnoea with acute severity markers (i.e. invasive positive pressure ventilation use and hospital length of stay) among adults hospitalised for acute exacerbation of chronic obstructive pulmonary disease.
AHRQ-funded; HS023305.
Citation: Hirayama A, Goto T, Faridi MK .
Association of obstructive sleep apnoea with acute severity of chronic obstructive pulmonary disease exacerbation: a population-based study.
Intern Med J 2018 Sep;48(9):1150-53. doi: 10.1111/imj.14016..
Keywords: Respiratory Conditions, Hospitalization, Sleep Problems, Chronic Conditions
Kline CE, Burke LE, Sereika SM
Bidirectional relationships between weight change and sleep apnea in a behavioral weight loss intervention.
This study examined the relationship between weight change and obstructive sleep apnea (OSA) in the context of behavioral weight loss intervention. A total of 114 adults who were overweight or obese participated in a 12-month behavioral weight loss intervention program from April 2012 to February 2015. Over half (58%) had OSA at the baseline. Those with OSA were found to lose less weight and were less adherent to daily calorie and activity goals. The results suggest that OSA screening should be used before attempting weight loss and also may indicate additional behavioral counseling.
AHRQ-funded; HS022989.
Citation: Kline CE, Burke LE, Sereika SM .
Bidirectional relationships between weight change and sleep apnea in a behavioral weight loss intervention.
Mayo Clin Proc 2018 Sep;93(9):1290-98. doi: 10.1016/j.mayocp.2018.04.026..
Keywords: Sleep Problems, Obesity: Weight Management, Obesity, Lifestyle Changes, Respiratory Conditions
Travers CP, Carlo WA, Nakhmani A
Environmental or nasal cannula supplemental oxygen for preterm infants: a randomized cross-over trial.
The purpose of this study was to test the hypothesis that environmental compared with nasal cannula oxygen decreases episodes of intermittent hypoxemia in preterm infants on supplemental oxygen by providing a more stable hypopharyngeal oxygen concentration. The investigators found that in preterm infants receiving supplemental oxygen, servo-controlled oxygen environment decreased hypoxemia compared with nasal cannula.
AHRQ-funded; HS013852.
Citation: Travers CP, Carlo WA, Nakhmani A .
Environmental or nasal cannula supplemental oxygen for preterm infants: a randomized cross-over trial.
J Pediatr 2018 Sep;200:98-103. doi: 10.1016/j.jpeds.2018.03.010..
Keywords: Newborns/Infants, Newborns/Infants, Respiratory Conditions, Respiratory Conditions
Chaaban MR, Zhang D, Resto V
Factors influencing recurrent emergency department visits for epistaxis in the elderly.
The objective of the study was to determine the risk factors associated with recurrent epistaxis requiring emergency department (ED) visits in the elderly. The investigators concluded that additional ED visits for epistaxis were more common in the elderly and in males. Congestive heart failure, diabetes mellitus and obstructive sleep apnea were found to be independent risk factors.
AHRQ-funded; HS022134.
Citation: Chaaban MR, Zhang D, Resto V .
Factors influencing recurrent emergency department visits for epistaxis in the elderly.
Auris Nasus Larynx 2018 Aug;45(4):760-64. doi: 10.1016/j.anl.2017.11.010..
Keywords: Elderly, Emergency Department, Risk, Respiratory Conditions, Healthcare Utilization
Harris VC, Links AR, Kim JM
Follow-up and time to treatment in an urban cohort of children with sleep-disordered breathing.
The purpose of this study was to evaluate follow-up and timing of sleep-disordered breathing diagnosis and treatment in urban children referred from primary care. Researchers found that half of the children referred for sleep-disordered breathing evaluation are lost to follow-up from primary care. Obstructive sleep apnea severity did not predict follow-up or timeliness of treatment. They conclude that these findings suggest social determinants may pose barriers to care in addition to the clinical burden of sleep-disordered breathing.
AHRQ-funded; HS022932.
Citation: Harris VC, Links AR, Kim JM .
Follow-up and time to treatment in an urban cohort of children with sleep-disordered breathing.
Otolaryngol Head Neck Surg 2018 Aug;159(2):371-78. doi: 10.1177/0194599818772035..
Keywords: Access to Care, Children/Adolescents, Disparities, Healthcare Delivery, Patient-Centered Healthcare, Quality of Care, Respiratory Conditions, Sleep Problems, Urban Health
Goto T, Faridi MK, Camargo CA
Time-varying readmission diagnoses during 30 days after hospitalization for COPD exacerbation.
The purpose of this study was to investigate the longitudinal changes in principal readmission diagnoses within 30 days after hospitalization for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The investigators found that the proportions of principal discharge diagnosis of readmission changed significantly at around postdischarge day 7.
AHRQ-funded; HS023305.
Citation: Goto T, Faridi MK, Camargo CA .
Time-varying readmission diagnoses during 30 days after hospitalization for COPD exacerbation.
Med Care 2018 Aug;56(8):673-78. doi: 10.1097/mlr.0000000000000940..
Keywords: Respiratory Conditions, Hospital Readmissions, Hospitalization
Iyer AS, Benzo RP, Bakitas MA
Easing the tension between palliative care and intensive care in chronic obstructive pulmonary disease.
This editorial discusses palliative care and intensive care in chronic obstructive pulmonary disease and comments on an article by Shen, et al., published, in 2018, in the Journal of Palliative Care, entitled “Life-sustaining procedures, palliative care consultation, and do-not resuscitate status in dying patients with COPD in US hospitals: 2010-2014.”
AHRQ-funded; HS023009.
Citation: Iyer AS, Benzo RP, Bakitas MA .
Easing the tension between palliative care and intensive care in chronic obstructive pulmonary disease.
J Palliat Care 2018 Jul;33(3):123-24. doi: 10.1177/0825859718782505..
Keywords: Chronic Conditions, Respiratory Conditions, Critical Care, Elderly, Palliative Care, Quality of Care
Wu P, Escobar GJ, Gebretsadik T
Effectiveness of respiratory syncytial virus immunoprophylaxis in reducing bronchiolitis hospitalizations among high-risk infants.
This retrospective cohort study examined the effectiveness of respiratory syncytial virus (RSV) prophylaxis for infants born between 1996 and 2008. The infants were enrolled in the Kaiser Permanente Northern California integrated health system. Infants who ever received RSV immunoprophylaxis had a 32% decreased risk of bronchiolitis hospitalization and finants with chronic lung disease (CLD) had a 52% decreased risk. The 2014 American Academy of Pediatrics (AAP) guidelines changed recommendations for RSV immunoprophylaxis which made 48% of infants no longer eligible but nearly all infants with CLD would remain eligible.
AHRQ-funded; HS018454.
Citation: Wu P, Escobar GJ, Gebretsadik T .
Effectiveness of respiratory syncytial virus immunoprophylaxis in reducing bronchiolitis hospitalizations among high-risk infants.
Am J Epidemiol 2018 Jul;187(7):1490-500. doi: 10.1093/aje/kwy008..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Hospitalization, Newborns/Infants, Outcomes, Patient-Centered Outcomes Research, Prevention, Respiratory Conditions, Risk
Taylor YJ, Tapp H, Shade LE
Impact of shared decision making on asthma quality of life and asthma control among children.
This study evaluated the impact of shared decision making (SDM) on quality of life and symptom control in children with asthma. The investigators found that implementation of SDM within clinical practices using a standardized toolkit was associated with improved asthma quality of life and asthma control for low-income children with asthma when compared to usual care with decision support.
AHRQ-funded; HS019946.
Citation: Taylor YJ, Tapp H, Shade LE .
Impact of shared decision making on asthma quality of life and asthma control among children.
J Asthma 2018 Jun;55(6):675-83. doi: 10.1080/02770903.2017.1362423..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Chronic Conditions, Decision Making, Quality of Life
Kojima T, Harwayne-Gidansky I, Shenoi AN
Cricoid pressure during induction for tracheal intubation in critically ill children: a report from National Emergency Airway Registry for Children.
The objective of this retrospective cohort study was to evaluate the association between cricoid pressure use and the occurrence of regurgitation during tracheal intubation for critically ill children in pediatric intensive care unit (PICU). The investigators found that cricoid pressure during induction and mask ventilation before tracheal intubation in the current ICU practice was not associated with a lower regurgitation rate after adjusting for previously reported confounders.
AHRQ-funded; HS024511.
Citation: Kojima T, Harwayne-Gidansky I, Shenoi AN .
Cricoid pressure during induction for tracheal intubation in critically ill children: a report from National Emergency Airway Registry for Children.
Pediatr Crit Care Med 2018 Jun;19(6):528-37. doi: 10.1097/pcc.0000000000001531.
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Keywords: Children/Adolescents, Critical Care, Children/Adolescents, Registries, Respiratory Conditions
Semenkovich TR, Olsen MA, Puri V
Current state of empyema management.
The goal of this study was to examine current treatment practices and outcomes for inpatient treatment of empyema. A comprehensive, longitudinal data set from the New York State Inpatient Database, encompassing an entire state cohort of hospitalized patients, was used. The cohort included 4,095 patients who were undergoing intervention for primary empyema and were discharged 2009 to 2014 with chest tube, video-assisted thoracoscopic surgery (VATS) decortication and drainage, or open drainage and decortication. Patients were categorized into these three groups by definitive treatment during their initial hospitalization. The findings indicate that patients who were managed with chest tubes showed higher readmission and reintervention rates, suggesting that some of these patients may benefit from earlier definitive surgical intervention.
AHRQ-funded; HS019455.
Citation: Semenkovich TR, Olsen MA, Puri V .
Current state of empyema management.
Ann Thorac Surg 2018 Jun;105(6):1589-96. doi: 10.1016/j.athoracsur.2018.02.027..
Keywords: Care Management, Healthcare Cost and Utilization Project (HCUP), Inpatient Care, Outcomes, Respiratory Conditions
Blecker S, Kwon JY, Herrin J
Seasonal variation in readmission risk for patients hospitalized with cardiopulmonary conditions.
The purpose of this retrospective study was to examine whether seasonal differences in risk were related to variations in reason for admission or due to seasonal variations in risk strata. The investigators observed significant increases in hospitalizations during winter months for heart failure, pneumonia, chronic obstructive pulmonary disease, and other cardiopulmonary conditions.
AHRQ-funded; HS023683; HS022882.
Citation: Blecker S, Kwon JY, Herrin J .
Seasonal variation in readmission risk for patients hospitalized with cardiopulmonary conditions.
J Gen Intern Med 2018 May;33(5):599-601. doi: 10.1007/s11606-017-4299-0..
Keywords: Cardiovascular Conditions, Hospitalization, Respiratory Conditions, Risk
Sobieraj DM, Weeda ER, Nguyen E
Association of inhaled corticosteroids and long-acting beta-agonists as controller and quick relief therapy with exacerbations and symptom control in persistent asthma: a systematic review and meta-analysis.
The authors conducted a systematic review and meta-analysis of the effects of single maintenance and reliever therapy (SMART) in patients with persistent asthma. They found that in patients with persistent asthma, the use of single maintenance and reliever therapy compared with inhaled corticosteroids as the controller therapy (with or without a long-acting beta-agonist) and short-acting beta-agonists as the relief therapy was associated with a lower risk of asthma exacerbations.
AHRQ-funded; 290201500012I.
Citation: Sobieraj DM, Weeda ER, Nguyen E .
Association of inhaled corticosteroids and long-acting beta-agonists as controller and quick relief therapy with exacerbations and symptom control in persistent asthma: a systematic review and meta-analysis.
JAMA 2018 Apr 10;319(14):1485-96. doi: 10.1001/jama.2018.2769.
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Keywords: Asthma, Comparative Effectiveness, Medication, Patient-Centered Outcomes Research, Respiratory Conditions
Sobieraj DM, Baker WL, Nguyen E
Association of inhaled corticosteroids and long-acting muscarinic antagonists with asthma control in patients with uncontrolled, persistent asthma: a systematic review and meta-analysis.
The authors conducted a systematic review and meta-analysis of the effects associated with long-acting muscarinic antagonists (LAMAs) vs placebo or vs other controllers as an add-on therapy to inhaled corticosteroids. They concluded that use of LAMA compared with placebo as add-on therapy to inhaled corticosteroids was associated with a lower risk of asthma exacerbations.
AHRQ-funded; 290201500012I.
Citation: Sobieraj DM, Baker WL, Nguyen E .
Association of inhaled corticosteroids and long-acting muscarinic antagonists with asthma control in patients with uncontrolled, persistent asthma: a systematic review and meta-analysis.
JAMA 2018 Apr 10;319(14):1473-84. doi: 10.1001/jama.2018.2757.
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Keywords: Asthma, Evidence-Based Practice, Medication, Patient-Centered Outcomes Research, Respiratory Conditions