National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Cancer: Lung Cancer (1)
- Cardiovascular Conditions (4)
- Chronic Conditions (1)
- Elderly (4)
- Evidence-Based Practice (1)
- Heart Disease and Health (5)
- Hospital Discharge (1)
- Hospitalization (1)
- Hospital Readmissions (1)
- Hospitals (4)
- (-) Medicare (9)
- (-) Mortality (9)
- Outcomes (2)
- Patient-Centered Outcomes Research (2)
- Patient Safety (2)
- Provider Performance (1)
- Risk (2)
- Surgery (2)
- Transitions of Care (2)
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 9 of 9 Research Studies DisplayedMueller S, Zheng J, Orav EJ
Inter-hospital transfer and patient outcomes: a retrospective cohort study.
Inter-hospital transfer (IHT, the transfer of patients between hospitals) occurs regularly and exposes patients to risks of discontinuity of care, though outcomes of transferred patients remains largely understudied. The purpose of this retrospective cohort study was to evaluate the association between IHT and healthcare utilisation and clinical outcomes. The investigators concluded that IHT was associated with higher costs, longer LOS and lower odds of discharge home, but was differentially associated with odds of early death and 30 -day mortality depending on patients' disease category.
AHRQ-funded; HS023331.
Citation: Mueller S, Zheng J, Orav EJ .
Inter-hospital transfer and patient outcomes: a retrospective cohort study.
BMJ Qual Saf 2019 Nov;28(11):e1. doi: 10.1136/bmjqs-2018-008087..
Keywords: Transitions of Care, Hospitals, Patient Safety, Elderly, Outcomes, Chronic Conditions, Mortality, Medicare
Goldstone AB, Chiu P, Baiocchi M
Interfacility transfer of Medicare beneficiaries with acute type a aortic dissection and regionalization of care in the United States.
Researchers investigated the hypothesis that regionalizing care at high-volume hospitals for acute type A aortic dissections will lower mortality. Operative mortality and long-term survival were compared for Medicare beneficiaries diagnosed with an acute type A aortic dissection who were transferred versus not transferred, underwent surgery at high-volume versus low-volume hospitals, and were rerouted versus not rerouted to a high-volume hospital for treatment. The researchers found that, despite delaying surgery, a regionalization policy that transfers patients to high-volume hospitals was associated with a 7.2% absolute risk reduction in operative mortality. They recommended that policymakers evaluate the feasibility and benefits of regionalizing the surgical treatment of acute type A aortic dissection in the United States.
AHRQ-funded; HS022192.
Citation: Goldstone AB, Chiu P, Baiocchi M .
Interfacility transfer of Medicare beneficiaries with acute type a aortic dissection and regionalization of care in the United States.
Circulation 2019 Oct 8;140(15):1239-50. doi: 10.1161/circulationaha.118.038867..
Keywords: Transitions of Care, Medicare, Heart Disease and Health, Cardiovascular Conditions, Patient-Centered Outcomes Research, Risk, Evidence-Based Practice, Mortality, Hospitals
Kundi H, Popma JJ, Valsdottir LR
The value of claims-based nontraditional risk factors in predicting long-term mortality after MitraClip procedure.
The goals of this study were to identify nontraditional risk factors coded in administrative claims data and to evaluate their ability to improve prediction of long-term mortality in patients undergoing percutaneous mitral valve repair. Patients undergoing transcatheter mitral valve repair using MitraClip implantation were identified among Medicare fee-for-service beneficiaries; researchers used nested Cox regression models to identify claims codes predictive of long-term mortality. Four groups of variables were introduced: cardiac, noncardiac, and nontraditional risk factors, and presentation characteristics. The authors conclude that risk-prediction models, which include nontraditional risk factors as identified in claims data, can be used to predict long-term mortality risk more accurately in patients who have undergone MitraClip procedures.
AHRQ-funded; HS024520.
Citation: Kundi H, Popma JJ, Valsdottir LR .
The value of claims-based nontraditional risk factors in predicting long-term mortality after MitraClip procedure.
Can J Cardiol 2018 Dec;34(12):1648-54. doi: 10.1016/j.cjca.2018.10.002..
Keywords: Cardiovascular Conditions, Elderly, Mortality, Heart Disease and Health, Medicare, Risk, Surgery
Huckfeldt P, Escarce J, Sood N
Thirty-day postdischarge mortality among black and white patients 65 years and older in the Medicare Hospital Readmissions Reduction Program.
The goal of this cohort study was to determine whether short-term mortality rates increased among black and white adults 65 years and older after initiation of the Medicare Hospital Readmissions Reduction Program (HRRP) and whether trends differed by race. Using an interrupted time-series analysis, the researchers found that short-term post-discharge mortality did not appear to increase for black patients under the HRRP, suggesting that certain value-based payment policies can be implemented without harming black populations. However, mortality seemed to increase for white patients with heart failure; this situation warrants investigation.
AHRQ-funded; HS025394.
Citation: Huckfeldt P, Escarce J, Sood N .
Thirty-day postdischarge mortality among black and white patients 65 years and older in the Medicare Hospital Readmissions Reduction Program.
JAMA Netw Open 2019 Mar;2(3):e190634. doi: 10.1001/jamanetworkopen.2019.0634..
Keywords: Medicare, Elderly, Mortality, Heart Disease and Health, Cardiovascular Conditions, Hospital Discharge
Kim D, Funk RJ, Yan P
Informal clinical integration in Medicare accountable care organizations and mortality following coronary artery bypass graft surgery.
Researchers looked at national Medicare data from 2008-2014 to determine if informal clinical integration in accountable care organizations (ACOs) made a difference in mortality rates in patients undergoing coronary artery bypass grafting (CABG). The cohort used were Medicare beneficiaries age 66 and older undergoing CABG. Results from ACO-participating health systems were compared with nonparticipating systems. Informal clinical integration made a difference in mortality, however there was no difference based on ACO participation for health systems on the low to moderate range.
AHRQ-funded; HS024525; HS024728.
Citation: Kim D, Funk RJ, Yan P .
Informal clinical integration in Medicare accountable care organizations and mortality following coronary artery bypass graft surgery.
Med Care 2019 Mar;57(3):194-201. doi: 10.1097/mlr.0000000000001052..
Keywords: Cardiovascular Conditions, Medicare, Mortality, Outcomes, Surgery
Laccetti AL, Pruitt SL, Xuan L
Prior cancer does not adversely affect survival in locally advanced lung cancer: a national SEER-Medicare analysis.
Researchers identified patients > 65 years of age diagnosed 1992-2009 with locally advanced lung cancer in the Surveillance, Epidemiology, and End Results-Medicare linked dataset. They found that, for patients with locally advanced lung cancer, prior cancer does not adversely impact clinical outcomes. Patients with locally advanced lung cancer and a history of prior cancer should not be excluded from clinical trials.
AHRQ-funded; HS022418.
Citation: Laccetti AL, Pruitt SL, Xuan L .
Prior cancer does not adversely affect survival in locally advanced lung cancer: a national SEER-Medicare analysis.
Lung Cancer 2016 Aug;98:106-13. doi: 10.1016/j.lungcan.2016.05.029.
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Keywords: Elderly, Cancer: Lung Cancer, Medicare, Mortality, Patient-Centered Outcomes Research
Wang Y, Eldridge N, Metersky ML
AHRQ Author: Eldridge N
Association between hospital performance on patient safety and 30-day mortality and unplanned readmission for Medicare fee-for-service patients with acute myocardial infarction.
The researchers studied the relationship between hospital performance on adverse event rates and hospital performance on 30-day mortality and unplanned readmission rates for Medicare fee-for-service patients hospitalized for acute myocardial infarction (AMI). They found that for Medicare fee-for-service patients discharged with AMI, hospitals with poorer patient safety performance were also more likely to have poorer performance on 30-day all-cause mortality and on unplanned readmissions.
AHRQ-authored.
Citation: Wang Y, Eldridge N, Metersky ML .
Association between hospital performance on patient safety and 30-day mortality and unplanned readmission for Medicare fee-for-service patients with acute myocardial infarction.
J Am Heart Assoc 2016 Jul;5(7):pii: e003731. doi: 10.1161/jaha.116.003731.
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Keywords: Adverse Events, Hospital Readmissions, Hospitals, Medicare, Mortality, Heart Disease and Health, Patient Safety, Provider Performance
Chen J, Hsieh AF, Dharmarajan K
National trends in heart failure hospitalization after acute myocardial infarction for Medicare beneficiaries: 1998-2010.
This study used a complete national sample of 2 789 943 AMI hospitalizations of Medicare fee-for-service beneficiaries from 1998 through 2010, we evaluated annual changes in the incidence of subsequent heart failure (HF) hospitalization and mortality using Poisson and survival analysis models. It found that HF hospitalization after AMI decreased from 1998 to 2010, which may indicate improvements in the management of AMI.
AHRQ-funded; HS018781.
Citation: Chen J, Hsieh AF, Dharmarajan K .
National trends in heart failure hospitalization after acute myocardial infarction for Medicare beneficiaries: 1998-2010.
Circulation 2013 Dec 17;128(24):2577-84. doi: 10.1161/circulationaha.113.003668..
Keywords: Hospitalization, Medicare, Heart Disease and Health, Mortality
Silber JH, Satopaa VA, Mukherjee N
Improving Medicare's Hospital Compare mortality model.
The researchers sought to improve the predictions provided by Medicare's Hospital Compare (HC) to facilitate better informed decisions regarding hospital choice by the public. Their model produces very different predictions from the current HC model, with higher predicted mortality rates at hospitals with lower volume and worse characteristics. The expanded model would advise patients against seeking treatment at the smallest hospitals with worse technology and staffing.
AHRQ-funded; HS021854.
Citation: Silber JH, Satopaa VA, Mukherjee N .
Improving Medicare's Hospital Compare mortality model.
Health Serv Res 2016 Jun;51 Suppl 2:1229-47. doi: 10.1111/1475-6773.12478.
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Keywords: Hospitals, Mortality, Medicare