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AHRQ Research Studies Date
Topics
- Adverse Events (2)
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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 18 of 18 Research Studies DisplayedJacobs PD, Basu J
AHRQ Author: Jacobs PD, Basu J
Medicare Advantage and postdischarge quality: evidence from hospital readmissions.
This study compared relative readmission rates for beneficiaries enrolled in Medicare Advantage (MA) and traditional Medicare (TM). HCUP State Inpatient Databases data for 4 states was used from 2009 and 2014. The outcome compared was the probability of a hospital readmission within 30 days of an index admission. There were significantly lower all-cause readmission rates among MA enrollees relative to those in TM in both 2009 and 2014, but MA enrollment was not associated with an increased reduction in readmission rates relative to TM during that time period.
AHRQ-authored
Citation: Jacobs PD, Basu J .
Medicare Advantage and postdischarge quality: evidence from hospital readmissions.
Am J Manag Care 2020 Dec;26(12):524-29. doi: 10.37765/ajmc.2020.88540..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Medicare, Hospital Readmissions, Hospitals, Quality of Care, Provider Performance
Boggs KM, Teferi MM, Espinola JA
Consolidating emergency department-specific data to enable linkage with large administrative datasets.
This paper looks at the challenges and opportunities presented by consolidating hospital-level data with patient-level data to create better analyses of hospital-based specialties, units, or departments, and patient outcomes. The American Hospital Association (AHA) has hospital-level data, while the Centers for Medicare & Medicaid Services (CMS) has patient-level data which can be used to study emergency departments (EDs). A distinct database discussed in this paper is the Nationwide Emergency Department Inventory (NEDI). However, the NEDI database lists EDs individually while the AHA and CMS databases list EDs individually or by group if they are part of a larger network. A test set using EDs from New England was conducted using individually matched NEDI EDs with corresponding EDs in the AHA and CMS. A “group match” was assigned when more than one NEDI ED was matched to a single AHA or CMS facility ID number. Of the 195 EDs in the test set, 169 (87%) completed the NEDI survey. Of those, 77% EDs were individually listed in AHA and CMS while 39 were part of groups consisting of 2-3 EDs with one facility ID. The grouped EDs had a larger number of annual visits and beds, were more likely to be freestanding and were less likely to be rural. The consolidated dataset with 171 EDS yielded similar results to the 169 responding EDs which provides a more representative sample for studies.
AHRQ-funded; HS024561.
Citation: Boggs KM, Teferi MM, Espinola JA .
Consolidating emergency department-specific data to enable linkage with large administrative datasets.
West J Emerg Med 2020 Oct 27;21(6):141-45. doi: 10.5811/westjem.2020.8.48305..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Hospitals, Health Information Technology (HIT)
Bourne DS, Davis BS, Gigli KH
Economic analysis of mandated protocolized sepsis care in New York hospitals.
Investigators evaluated the effects of the 2013 New York State sepsis regulations on the costs of care for patients hospitalized with sepsis. They found that mandated protocolized sepsis care was not associated with significant changes in hospital costs in patients hospitalized with sepsis in New York State.
AHRQ-funded; HS025146.
Citation: Bourne DS, Davis BS, Gigli KH .
Economic analysis of mandated protocolized sepsis care in New York hospitals.
Crit Care Med 2020 Oct;48(10):1411-18. doi: 10.1097/ccm.0000000000004514..
Keywords: Healthcare Cost and Utilization Project (HCUP), Sepsis, Healthcare Costs, Hospitalization, Hospitals
Philip JL, Yang DY, Wang X
Effect of transfer status on outcomes of emergency general surgery patients.
This study looked at outcomes of transferred (TRAN) versus directly admitted (DA) emergency general surgery (EGS) patients. Patients with a diagnosis of EGS were identified from the 2008-2011 Nationwide Inpatient Sample (NIS). Outcomes included were in-hospital mortality and morbidity. They identified 274,145 TRAN and 10,456,100 DA encounters. Morbidity and mortality were both higher in TRAN patients than DA. TRAN patients were more likely to have greater comorbidity scores, have Medicare insurance, and reside in an area with a lesser median household income compared to DA patients. Morbidity among TRAN patients were primarily due urinary-, gastrointestinal-, and pulmonary-related complications. Median stay and median cost at the hospital were greater for TRAN patients.
AHRQ-funded; HS025224; HS022694.
Citation: Philip JL, Yang DY, Wang X .
Effect of transfer status on outcomes of emergency general surgery patients.
Surgery 2020 Aug;168(2):280-86. doi: 10.1016/j.surg.2020.01.005..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Transitions of Care, Mortality, Outcomes, Healthcare Costs, Hospitals
Oslock WM, Ricci KB, Ingraham AM
Role of interprofessional teams in emergency general surgery patient outcomes.
This paper discusses the results of a 2015 survey of acute care hospitals, which asked whether residents and advanced practice providers participate in emergency general surgery care. The data was then linked to patient data from 17 State Inpatient Databases using American Hospital Association identifiers to determine if that was associated with better management of patients, mortality, or complications. Eighty-three hospitals and 49,271 unique emergency general surgery admissions were included in the dataset. Hospitals with residents had reduced odds of systemic complications compared with hospitals without them or other clinical support. Hospitals with only residents had the lowest odds of operative complication.
AHRQ-funded; HS022694.
Citation: Oslock WM, Ricci KB, Ingraham AM .
Role of interprofessional teams in emergency general surgery patient outcomes.
Surgery 2020 Aug;168(2):347-53. doi: 10.1016/j.surg.2020.04.046..
Keywords: Healthcare Cost and Utilization Project (HCUP), Teams, Surgery, Adverse Events, Hospitals, Healthcare Delivery
Bucholz EM,, Schuster MA, Toomey SL
Trends in 30-day readmission for Medicaid and privately insured pediatric patients: 2010-2017.
This study examined trends in 30-day readmission rates for Medicaid and privately insured pediatric patients from 2010 to 2017. The HCUP Nationwide Readmissions Database was used to compare hospital-level risk-adjusted readmission rates. Higher readmission rates were found for Medicaid beneficiaires compared to privately insured pediatric patients during the time period.
AHRQ-funded; HS020513; HS025299.
Citation: Bucholz EM,, Schuster MA, Toomey SL .
Trends in 30-day readmission for Medicaid and privately insured pediatric patients: 2010-2017.
Pediatrics 2020 Aug;146(2). doi: 10.1542/peds.2020-0270..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Hospital Readmissions, Health Insurance, Medicaid, Hospitals
Gigli KH, Davis BS, Yabes JG
Pediatric outcomes after regulatory mandates for sepsis care.
The authors used hospital discharge data from 2011 to 2015 to compare changes in pediatric sepsis outcomes in New York and four control states following New York’s 2013 regulations mandating that hospitals develop pediatric-specific protocols for sepsis recognition and treatment. They found that implementation of statewide sepsis regulations was generally associated with improved mortality trends in New York State, particularly in prespecified subpopulations of patients, suggesting that the regulations were successful in affecting sepsis outcomes.
AHRQ-funded; HS025146.
Citation: Gigli KH, Davis BS, Yabes JG .
Pediatric outcomes after regulatory mandates for sepsis care.
Pediatrics 2020 Jul;146(1). doi: 10.1542/peds.2019-3353.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Sepsis, Outcomes, Hospitals
Martsolf GR, Nuckols TK, Fingar KR
AHRQ Author: Stocks C, Owens PL
Nonspecific chest pain and hospital revisits within 7 days of care: variation across emergency department, observation and inpatient visits.
The purpose of this study was to compare the rate at which patients with nonspecific chest pain return to the hospital within 7 days after index observation visits versus after index emergency department and inpatient visits. Findings showed that up to 1 in 10 patients discharged with nonspecific chest pain returned to the hospital within 1week. Compared with emergency department and inpatient care, observation visits were associated with lower revisit rates. Recommendations include further research to refine clinical standards of care for nonspecific chest pain as well as to investigate the healthcare delivery and patient factors that influence 7-day revisit rates.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Martsolf GR, Nuckols TK, Fingar KR .
Nonspecific chest pain and hospital revisits within 7 days of care: variation across emergency department, observation and inpatient visits.
BMC Health Serv Res 2020 Jun 8;20(1):516. doi: 10.1186/s12913-020-05200-x..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Pain, Healthcare Utilization, Hospitals, Heart Disease and Health, Cardiovascular Conditions
Basu J
AHRQ Author: Basu J
Multilevel risk factors for hospital readmission among patients with opioid use disorder in selected US States: role of socioeconomic characteristics of patients and their community.
This study examined the association of socioeconomic characteristics of individuals hospitalized with a principal diagnosis of opioid use disorder and their all-cause 30-day readmission risks. Discharge data from the 2014 HCUP Survey was used and was linked to community and hospital characteristics using data from HRSA and the American Hospital Association. Medicare is associated with the highest readmission risk followed by Medicaid covered patients. Self-pay or covered by other payers had a similar risk to private insurance coverage. Urban patients also had a higher readmission rate than rural patients.
AHRQ-authored.
Citation: Basu J .
Multilevel risk factors for hospital readmission among patients with opioid use disorder in selected US States: role of socioeconomic characteristics of patients and their community.
Health Serv Res Manag Epidemiol 2020 Jan-Dec;7:2333392820904240. doi: 10.1177/2333392820904240..
Keywords: Healthcare Cost and Utilization Project (HCUP), Opioids, Medication, Substance Abuse, Hospital Readmissions, Hospitals, Social Determinants of Health
Hsuan C, Carr BG, Hsia RY
Assessment of hospital readmissions from the emergency department after implementation of Medicare's hospital readmissions reduction program.
The purpose of this study was to examine whether the Medicare Hospital Readmissions Reduction Program (HRRP) was associated with changes in the probability of readmission at emergency department (ED) visits after hospital discharge (ED revisits) overall and depending on whether admission is typically indicated for the patient's condition at the ED revisit. Using hospital and ED discharge data from California, Florida, and New York, findings suggested that implementation of the HRRP was associated with a lower likelihood of readmission for recently discharged patients presenting to the ED, specifically for congestive heart failure. These findings highlighted the critical role of the ED in readmission reduction under the HRRP and suggested that patient outcomes after HRRP implementation merit further study.
AHRQ-funded; HS025838.
Citation: Hsuan C, Carr BG, Hsia RY .
Assessment of hospital readmissions from the emergency department after implementation of Medicare's hospital readmissions reduction program.
JAMA Netw Open 2020 May;3(5):e203857. doi: 10.1001/jamanetworkopen.2020.3857..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Hospital Readmissions, Hospital Discharge, Hospitals, Medicare
Dworsky JQ, Childers CP, Gornbein J
Hospital experience predicts outcomes after high-risk geriatric surgery.
This study examined if there an association between a hospital’s annual volume of high-risk geriatric surgery and their risk of inpatient mortality, postoperative length of stay, and discharge to nursing facility. Using the 2014 National Inpatient Sample, older adults were identified who had undergone high-risk geriatric surgery. There were an estimated 514,950 hospital encounters at 3,115 hospitals undergoing surgery. A higher proportion of high-risk geriatric surgery patients was associated with decreased mortality and shorter postoperative length of stay. Higher volume hospitals were not associated with mortality but was associated with longer length of stay and decreased discharge to nursing facilities.
AHRQ-funded; HS000046; HS025079.
Citation: Dworsky JQ, Childers CP, Gornbein J .
Hospital experience predicts outcomes after high-risk geriatric surgery.
Surgery 2020 Feb;167(2):468-74. doi: 10.1016/j.surg.2019.07.026..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Surgery, Risk, Hospitals, Outcomes, Mortality
Strobel RJ, Likosky DS, Brescia AA
The effect of hospital market competition on the adoption of transcatheter aortic valve replacement.
The use of transcatheter aortic valve replacement (TAVR) has grown rapidly. The purpose of this study was to assess whether hospital market competition was associated with the use of TAVR. The investigators concluded that market competition was positively associated with a hospital's adoption of TAVR and indicated that future studies should further examine the impact of competition on quality and appropriateness.
AHRQ-funded; HS026003.
Citation: Strobel RJ, Likosky DS, Brescia AA .
The effect of hospital market competition on the adoption of transcatheter aortic valve replacement.
Ann Thorac Surg 2020 Feb;109(2):473-79. doi: 10.1016/j.athoracsur.2019.06.025..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitals, Cardiovascular Conditions, Heart Disease and Health, Surgery
Leyenaar JK, Ralston SL, Shieh MS
Epidemiology of pediatric hospitalizations at general hospitals and freestanding children's hospitals in the United States.
Researchers described the volume and characteristics of pediatric hospitalizations at acute care general and freestanding children's hospitals in the United States. They found that, in 2012, more than 70 percent of pediatric hospitalizations occurred at general hospitals in the United States. Although the most common reasons for hospitalization were similar, the most costly conditions differed.
AHRQ-funded; HS024133.
Citation: Leyenaar JK, Ralston SL, Shieh MS .
Epidemiology of pediatric hospitalizations at general hospitals and freestanding children's hospitals in the United States.
J Hosp Med 2016 Nov;11(11):743-49. doi: 10.1002/jhm.2624.
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Keywords: Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Hospitals, Children/Adolescents
Thompson MP, Kaplan CM, Cao Y
Reliability of 30-day readmission measures used in the hospital readmission reduction program.
The researchers assessed the reliability of risk-standardized readmission rates (RSRRs) for medical conditions and surgical procedures used in the Hospital Readmission Reduction Program (HRRP). They found that approximately 25 percent of payments for excess readmissions were tied to unreliable RSRRs. Unreliable measures blur the connection between hospital performance and incentives, and threaten the success of the HRRP.
AHRQ-funded; HS023783.
Citation: Thompson MP, Kaplan CM, Cao Y .
Reliability of 30-day readmission measures used in the hospital readmission reduction program.
Health Serv Res 2016 Oct 21;51(6):2095-114. doi: 10.1111/1475-6773.12587.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Hospitals, Elderly, Quality Measures
Jiang HJ, Reiter KL, Wang J
AHRQ Author: Jiang HJ
Measuring mortality performance: How did safety-net hospitals compare with other hospitals?
This study assessed mortality performance of safety-net hospitals (SNHs) using all-payer databases and measures for a broad range of conditions and procedures. It found small differences in risk-adjusted mortality rates between SNHs and non-SNHs only among teaching hospitals. After controlling for hospital factors, these differences were substantially reduced and remained significant only for surgical mortality rates.
AHRQ-authored.
Citation: Jiang HJ, Reiter KL, Wang J .
Measuring mortality performance: How did safety-net hospitals compare with other hospitals?
Med Care 2016 Jul;54(7):648-56. doi: 10.1097/mlr.0000000000000540.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitals, Mortality, Provider Performance
Basu J, Avila R, Ricciardi R
AHRQ Author: Basu J, Ricciardi R
Hospital readmission rates in U.S. states: are readmissions higher where more patients with multiple chronic conditions cluster?
This study examines small area variations in readmission rates to assess whether higher readmission rate in an area is associated with higher clusters of patients with multiple chronic conditions. It found that areas with higher concentration of patients with increased comorbid conditions are more likely to have higher readmission rates.
AHRQ-authored.
Citation: Basu J, Avila R, Ricciardi R .
Hospital readmission rates in U.S. states: are readmissions higher where more patients with multiple chronic conditions cluster?
Health Serv Res 2016 Jun;51(3):1135-51. doi: 10.1111/1475-6773.12401..
Keywords: Chronic Conditions, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Hospitals
Yanamadala S, Morrison D, Curtin C
Electronic health records and quality of care: an observational study modeling impact on mortality, readmissions, and complications.
The authors assessed the relationship between electronic health records (EHR) adoption and patient outcomes. Their results indicate that patients receiving medical and surgical care at hospitals with no EHR system have similar outcomes compared to patients seeking care at hospitals with a full EHR system. They concluded that EHRs may play a smaller role than expected in patient outcomes and overall quality of care.
AHRQ-funded; HS024096.
Citation: Yanamadala S, Morrison D, Curtin C .
Electronic health records and quality of care: an observational study modeling impact on mortality, readmissions, and complications.
Medicine (Baltimore) 2016 May;95(19):e3332. doi: 10.1097/md.0000000000003332.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Electronic Health Records (EHRs), Quality of Care, Mortality, Hospitals
Brown JR, Rezaee ME, Nichols EL
Incidence and in-hospital mortality of acute kidney injury (AKI) and dialysis-requiring AKI (AKI-D) after cardiac catheterization in the National Inpatient Sample.
This study examined cardiac catheterization or percutaneous coronary intervention (PCI) hospital discharges from the nationally representative National Inpatient Sample to determine annual population incidence rates for AKI and AKI-D in the United States from 2001 to 2011. It found that the incidence of AKI among cardiac catheterization and PCI patients has increased sharply in the United States; however, mortality has significantly declined.
AHRQ-funded; HS018443.
Citation: Brown JR, Rezaee ME, Nichols EL .
Incidence and in-hospital mortality of acute kidney injury (AKI) and dialysis-requiring AKI (AKI-D) after cardiac catheterization in the National Inpatient Sample.
J Am Heart Assoc 2016 Mar 15;5(3):e002739. doi: 10.1161/jaha.115.002739.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Mortality, Patient Safety, Surgery, Heart Disease and Health, Cardiovascular Conditions, Kidney Disease and Health, Dialysis, Hospitals