National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Adverse Events (2)
- (-) Cardiovascular Conditions (9)
- Chronic Conditions (2)
- Decision Making (1)
- Diabetes (1)
- Elderly (1)
- (-) Healthcare Costs (9)
- Healthcare Delivery (1)
- Heart Disease and Health (6)
- Hospitalization (1)
- Kidney Disease and Health (1)
- Medical Expenditure Panel Survey (MEPS) (1)
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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 9 of 9 Research Studies DisplayedMszar R, Grandhi GR, Valero-Elizondo J
Cumulative burden of financial hardship from medical bills across the spectrum of diabetes mellitus and atherosclerotic cardiovascular disease among non-elderly adults in the United States.
This study looked at the rates of financial hardship from medical bills with non-elderly adults diagnosed with diabetes mellitus (DM) and diagnosed with and without atherosclerotic cardiovascular disease (ASCVD). ASCVD with DM accounts for approximately two-thirds of deaths in this patient population. Data from the National Health Interview Survey from 2013 to 2017 was used, with a total study population of 121,672 individuals. Approximately 3.1% of the population had ASCVD, 5.6% had DM, and 1.3% had both. Almost half of individuals with both conditions reported financial hardship from medical bills, with 23% unable to pay medical bills at all, compared to around 28% of those with neither ASCVD and DM reporting financial hardship with 8% being unable to pay at all.
AHRQ-funded; HS023000.
Citation: Mszar R, Grandhi GR, Valero-Elizondo J .
Cumulative burden of financial hardship from medical bills across the spectrum of diabetes mellitus and atherosclerotic cardiovascular disease among non-elderly adults in the United States.
J Am Heart Assoc 2020 May 18;9(10):e015523. doi: 10.1161/jaha.119.015523..
Keywords: Diabetes, Cardiovascular Conditions, Chronic Conditions, Healthcare Costs
Wang Y, Eldridge N, Metersky ML
AHRQ Author: Eldridge N, Rodrick D
Association between Medicare expenditures and adverse events for patients with acute myocardial infarction, heart failure, or pneumonia in the United States.
The purpose of this study was to evaluate whether hospital-specific adverse event rates were associated with hospital-specific risk-standardized 30-day episode-of-care Medicare expenditures for fee-for-service patients discharged with acute myocardial infarction (AMI), heart failure (HF), or pneumonia. Investigators concluded that hospitals with high adverse event rates were more likely to have high 30-day episode-of-care Medicare expenditures for patients discharged with AMI, HF, or pneumonia.
AHRQ-authored; AHRQ-funded; 290201200003C.
Citation: Wang Y, Eldridge N, Metersky ML .
Association between Medicare expenditures and adverse events for patients with acute myocardial infarction, heart failure, or pneumonia in the United States.
JAMA Netw Open 2020 Apr;3(4):e202142. doi: 10.1001/jamanetworkopen.2020.2142..
Keywords: Adverse Events, Patient Safety, Heart Disease and Health, Cardiovascular Conditions, Pneumonia, Medicare, Healthcare Costs
Amin AP, Spertus JA, Kulkarni H
Improving care pathways for acute coronary syndrome: patients undergoing percutaneous coronary intervention.
This study examined ways to improve care pathways for acute coronary syndrome (ACS) patients who are low-risk with no complications. They looked at 434,172 low-risk uncomplicated ACS patients eligible for early discharge from the Premier database and identified ACS care pathways. They compared percutaneous coronary intervention (PCI) types (trans-radial intervention [TRI] vs. transfemoral intervention (TFI) and by length of stay (LOS). Associations with costs and outcomes were tested using hierarchical, mixed-effects regression and projections of cost savings were obtained using modeling. More cost-savings were associated with TRI versus TFI. There was not an increased risk of adverse outcomes with a shorter LOS.
AHRQ-funded; HS022481.
Citation: Amin AP, Spertus JA, Kulkarni H .
Improving care pathways for acute coronary syndrome: patients undergoing percutaneous coronary intervention.
Am J Cardiol 2020 Feb;125(3):354-61. doi: 10.1016/j.amjcard.2019.10.019..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Quality Improvement, Quality of Care, Healthcare Delivery, Registries, Healthcare Costs
Amin AP, McNeely C, Spertus JA
Incremental cost of acute kidney injury after percutaneous coronary intervention in the United States.
This study examined incremental costs of acute kidney injury (AKI) complications from percutaneous coronary intervention (PCI), which is a common and severe complication. Out of a sample of over 1.4 million PCI patients at 518 US hospitals from 2006 to 2015, AKI occurred in 5.73% of PCI patients. Those with AKI had at least double the hospitalization costs and the incremental cost was $9,448. It was also independently associated with an incremental length of stay of 3.6 days. AKI cost burden was extrapolated at 411.3 million US dollars annually.
AHRQ-funded; HS022481.
Citation: Amin AP, McNeely C, Spertus JA .
Incremental cost of acute kidney injury after percutaneous coronary intervention in the United States.
Am J Cardiol 2020 Jan;125(1):29-33. doi: 10.1016/j.amjcard.2019.09.042..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Adverse Events, Healthcare Costs, Kidney Disease and Health, Patient Safety, Registries
Bernard D, Fang Z
AHRQ Author: Bernard D
Financial burdens and barriers to care among nonelderly adults with heart disease: 2010-2015.
Researchers examined the prevalence of high burdens and barriers to care among adults with heart disease treatment. Using MEPS data, they found that public insurance provides protection against high burdens but not against forgoing or delaying care. They recommended that future research investigate whether, and to what extent, barriers to care are associated with worse health outcomes and higher costs in the long term.
AHRQ-authored.
Citation: Bernard D, Fang Z .
Financial burdens and barriers to care among nonelderly adults with heart disease: 2010-2015.
J Am Heart Assoc 2019 Dec 17;8(24):e008831. doi: 10.1161/jaha.118.008831..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Heart Disease and Health, Cardiovascular Conditions, Access to Care
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
Nuti SV, Li SX, Xu X
Association of in-hospital resource utilization with post-acute spending in Medicare beneficiaries hospitalized for acute myocardial infarction: a cross-sectional study.
This study compared costs among Medicare fee-for-service beneficiaries aged 65 and over hospitalized with acute myocardial infarction (AMI) from 2010 to 2013 in the Premiere Healthcare Database. The association of in-hospital and post-acute care resource utilization and outcomes was examined. Researchers concluded that greater resource utilization during hospitalization was not associated with meaning differences in costs or mortality rates after hospitalization.
AHRQ-funded; HS023000.
Citation: Nuti SV, Li SX, Xu X .
Association of in-hospital resource utilization with post-acute spending in Medicare beneficiaries hospitalized for acute myocardial infarction: a cross-sectional study.
BMC Health Serv Res 2019 Mar 25;19(1):190. doi: 10.1186/s12913-019-4018-0..
Keywords: Cardiovascular Conditions, Elderly, Healthcare Costs, Hospitalization, Medicare
Valero-Elizondo J, Khera R, Saxena A
Financial hardship from medical bills among nonelderly U.S. Adults with atherosclerotic cardiovascular disease.
This study assessed the national burden of financial hardship from medical bills among individuals with atherosclerotic cardiovascular disease (ASCVD) in a representative sample of nonelderly U.S. adults with ASCVD. The relationship with potential consequences such as financial distress, food insecurity, and cost-related medication nonadherence was also considered. Data from the National Health Interview Survey (NHIS) was used. The authors conclude that the current health care system fails to protect a significant proportion of nonelderly ASCVD patients from financial hardship and its consequences.
AHRQ-funded; HS023000.
Citation: Valero-Elizondo J, Khera R, Saxena A .
Financial hardship from medical bills among nonelderly U.S. Adults with atherosclerotic cardiovascular disease.
J Am Coll Cardiol 2019 Feb 19;73(6):727-32. doi: 10.1016/j.jacc.2018.12.004..
Keywords: Cardiovascular Conditions, Healthcare Costs
Smith GH, Shore S, Allen LA
Discussing out-of-pocket costs with patients: shared decision making for sacubitril-valsartan in heart failure.
This study examined how prescription costs can greatly impact decision-making in patients with serious medical conditions. Forty-nine patients with heart failure with reduced ejection fracture were recruited and interviewed about a drug sacrubitril-valsartan. The drug is considered effective but can be costly. Most patients (45/49) said they would take the medicine if the out-of-pocket cost was only $5 per month more than their current medication. But if the costs increased to $100 more per month then only 43% would switch to sacrubritil-valsartan. Only 20% of participants said their physician had discussed medication costs in the past year.
AHRQ-funded; HS026081.
Citation: Smith GH, Shore S, Allen LA .
Discussing out-of-pocket costs with patients: shared decision making for sacubitril-valsartan in heart failure.
J Am Heart Assoc 2019 Jan 8;8(1):e010635. doi: 10.1161/jaha.118.010635..
Keywords: Healthcare Costs, Decision Making, Heart Disease and Health, Cardiovascular Conditions, Medication, Chronic Conditions