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Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Cardiovascular Conditions (7)
- Disparities (1)
- Elderly (4)
- Evidence-Based Practice (1)
- Healthcare Costs (1)
- (-) Heart Disease and Health (12)
- Hospital Discharge (1)
- Hospitalization (2)
- Hospital Readmissions (3)
- Hospitals (3)
- Medicaid (1)
- (-) Medicare (12)
- Medication (3)
- Mortality (5)
- Outcomes (2)
- Patient-Centered Outcomes Research (1)
- Patient Adherence/Compliance (2)
- Patient Safety (1)
- Pneumonia (1)
- Policy (1)
- Provider Performance (1)
- Quality of Care (1)
- Research Methodologies (1)
- Risk (2)
- Surgery (1)
- Transitions of Care (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 12 of 12 Research Studies DisplayedGoldstone 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
Sukul D, Ryan AM, Yan P
Cardiologist participation in accountable care organizations and changes in spending and quality for Medicare patients with cardiovascular disease.
Despite widespread adoption of Medicare accountable care organizations (ACOs), healthcare spending reductions have been modest. This may relate to variable participation in ACOs by specialist physicians, who disproportionately drive spending. In this study, the investigators analyzed national Medicare data to examine whether specialist participation in Medicare ACOs was associated with changes in healthcare spending and clinical quality.
AHRQ-funded; HS024728; HS025615; HS024525.
Citation: Sukul D, Ryan AM, Yan P .
Cardiologist participation in accountable care organizations and changes in spending and quality for Medicare patients with cardiovascular disease.
Circ Cardiovasc Qual Outcomes 2019 Sep;12(9):e005438. doi: 10.1161/circoutcomes.118.005438..
Keywords: Cardiovascular Conditions, Healthcare Costs, Heart Disease and Health, Medicare, Quality of Care
Blecker S, Herrin J, Li L
Trends in hospital readmission of Medicare-covered patients with heart failure.
This study sought to compare trends in Medicare risk-adjusted, 30-day readmissions following principal heart failure (HF) hospitalizations and other hospitalizations with HF. The investigators found that patients with HF are often hospitalized for other causes, and these hospitalizations have high readmission rates. Policy changes led to decreases in readmission rates for both principal and secondary HF hospitalizations. Readmission rates in both groups remained high, suggesting that initiatives targeting all hospitalized patients with HF continue to be warranted.
AHRQ-funded; HS022882; HS023683.
Citation: Blecker S, Herrin J, Li L .
Trends in hospital readmission of Medicare-covered patients with heart failure.
J Am Coll Cardiol 2019 Mar 12;73(9):1004-12. doi: 10.1016/j.jacc.2018.12.040..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Hospital Readmissions, Hospitalization, Medicare, Policy
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
Doll JA, Hellkamp AS, Thomas L
The association of pre- and posthospital medication adherence in myocardial infarction patients.
Nonadherence to optimal medical therapy following myocardial infarction (MI) is associated with adverse clinical outcomes such as stent thrombosis, recurrent cardiovascular events, and death. Whether adherence to medications prior to MI predicts post-MI medication adherence is unknown. In this study, the investigators assessed adherence to P2Y12 inhibitors and statins before and after admission for MI among 8,147 MI patients who had Medicare insurance with Part D prescription coverage.
AHRQ-funded; HS021092.
Citation: Doll JA, Hellkamp AS, Thomas L .
The association of pre- and posthospital medication adherence in myocardial infarction patients.
Am Heart J 2019 Feb;208:74-80. doi: 10.1016/j.ahj.2018.11.004..
Keywords: Cardiovascular Conditions, Elderly, Heart Disease and Health, Medicare, Medication, Patient Adherence/Compliance
Desai NR, Ross JS, Kwon JY
Association between hospital penalty status under the hospital readmission reduction program and readmission rates for target and nontarget conditions.
This study compared trends in readmission rates for target and nontarget conditions, stratified by hospital penalty status after the announcement of the Hospital Readmission Reduction Program (HRRP). It found that Medicare fee-for-service patients at hospitals subject to penalties under the HRRP had greater reductions in readmission rates compared with those at nonpenalized hospitals. Changes were greater for target vs nontarget conditions for patients at the penalized hospitals but not at the other hospitals.
AHRQ-funded; HS022882; HS023000.
Citation: Desai NR, Ross JS, Kwon JY .
Association between hospital penalty status under the hospital readmission reduction program and readmission rates for target and nontarget conditions.
JAMA 2016 Dec 27;316(24):2647-56. doi: 10.1001/jama.2016.18533.
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Keywords: Heart Disease and Health, Hospital Readmissions, Hospitals, Medicare, Pneumonia
Doll JA, Hellkamp AS, Goyal A
Treatment, outcomes, and adherence to medication regimens among dual Medicare-Medicaid-eligible adults with myocardial infarction.
The purpose of the study was to examine the association of dual-eligible status with clinical outcomes and adherence to medication regimens among older adults after MI. The investigators found that compared with Medicare-only patients, older adults with dual Medicare-Medicaid eligibility presenting with MI had superior rates of medication adherence but higher rates of postdischarge readmission and adverse cardiovascular outcomes.
AHRQ-funded; HS021092.
Citation: Doll JA, Hellkamp AS, Goyal A .
Treatment, outcomes, and adherence to medication regimens among dual Medicare-Medicaid-eligible adults with myocardial infarction.
JAMA Cardiol 2016 Oct 1;1(7):787-94. doi: 10.1001/jamacardio.2016.2724..
Keywords: Elderly, Medicaid, Medicare, Medication, Heart Disease and Health, Outcomes, Patient Adherence/Compliance
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
Goedken AM, Lund BC, Cook EA
Application of a framework for determining number of drugs.
The purpose of the study was to propose a framework and illustrate how that framework can be used to create and succinctly describe various approaches to counting the number of drugs used by patients and to examine the impact of varying individual components of the framework on the resulting drug count.
AHRQ-funded; HS018381.
Citation: Goedken AM, Lund BC, Cook EA .
Application of a framework for determining number of drugs.
BMC Res Notes 2016 May 13;9:272. doi: 10.1186/s13104-016-2076-5.
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Keywords: Medication, Research Methodologies, Heart Disease and Health, Medicare
Wallaert JB, Nolan BW, Stone DH
Physician specialty and variation in carotid revascularization technique selected for Medicare patients.
The researchers investigated whether the choice of carotid artery stenting (CAS) vs. carotid endarterectomy (CEA) varies as a function of treating physician specialty, which would result in regional variation in the relative use of these treatment types They found that the proportion of all carotid revascularization procedures performed as CAS varies markedly by geographic region, and regions with the highest proportion of cardiologists perform the most CAS procedures.
AHRQ-funded; HS021581.
Citation: Wallaert JB, Nolan BW, Stone DH .
Physician specialty and variation in carotid revascularization technique selected for Medicare patients.
J Vasc Surg 2016 Jan;63(1):89-97. doi: 10.1016/j.jvs.2015.08.068.
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Keywords: Heart Disease and Health, Medicare, Cardiovascular Conditions, Disparities, Outcomes