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
51 to 75 of 1311 Research Studies DisplayedCaves Sivaraman JJ, Naumann RB
Estimating the association between mental health disorders and suicide: a review of common sources of bias and challenges and opportunities for US-based research.
The purpose of this review was 1) to illuminate prevalent methodological approaches and estimates of association between mental health diagnoses and suicide from the meta-analytic literature; 2) to discuss key internal and external validity concerns with these estimates; and 3) to highlight some of the unique attributes and challenges in US-based suicide research and opportunities to move the evidence base forward. The authors offered methodological considerations for future research and discussed opportunities made possible by the recent expansion of the US National Violent Death Reporting System to a nationwide registry.
AHRQ-funded; HS000032.
Citation: Caves Sivaraman JJ, Naumann RB .
Estimating the association between mental health disorders and suicide: a review of common sources of bias and challenges and opportunities for US-based research.
Curr Epidemiol Rep 2020 Dec;7(4):352-62. doi: 10.1007/s40471-020-00250-5..
Keywords: Behavioral Health, Research Methodologies
Collinsworth AW, Priest EL, Masica AL
Evaluating the cost-effectiveness of the ABCDE bundle: impact of bundle adherence on inpatient and 1-year mortality and costs of care.
This study examined the cost-effectiveness of the Awakening and Breathing Coordination, Delirium monitoring/management, and Early exercise/mobility (ABCDE) bundle intervention to improve short- and long-term clinical outcomes for patients requiring ICU care. A 2-year, prospective, cost-effectiveness study in 12 adult ICUs in six hospitals belonging to a large, integrated healthcare delivery system was conducted. Hospitals in the study included a large, urban center and five community hospitals. ICU types included medical/surgical, trauma, neurologic, and cardiac care units. The cohort included 2,953 adults with an ICU stay greater than 24 hours who were on a ventilator for more than 24 hours and less than 14 days. ICUs with high ABCDE bundle adherence significantly decreased odds of inpatient mortality and had significantly higher costs of inpatient care. The incremental cost-effectiveness ratio of high bundle adherence was $15,077 per life saved, and $1,057 per life-year saved.
AHRQ-funded; HS021459.
Citation: Collinsworth AW, Priest EL, Masica AL .
Evaluating the cost-effectiveness of the ABCDE bundle: impact of bundle adherence on inpatient and 1-year mortality and costs of care.
Crit Care Med 2020 Dec;48(12):1752-59. doi: 10.1097/ccm.0000000000004609..
Keywords: Intensive Care Unit (ICU), Critical Care, Mortality, Healthcare Costs
Frasier LL, Pavuluri Quamme SR, Wiegmann D
Evaluation of intraoperative hand-off frequency, duration, and context: a mixed methods analysis.
The authors sought a better understanding of the coordination and impact of intraoperative hand-offs. They found that intraoperative hand-offs were frequent and not well coordinated with intraoperative events including counts and other hand-offs. Anchoring and announced hand-offs occurred in a small proportion of cases. They recommended that future work focus on optimizing timing, content, and participation in intraoperative hand-offs.
AHRQ-funded; HS022403.
Citation: Frasier LL, Pavuluri Quamme SR, Wiegmann D .
Evaluation of intraoperative hand-off frequency, duration, and context: a mixed methods analysis.
J Surg Res 2020 Dec;256:124-30. doi: 10.1016/j.jss.2020.06.007..
Keywords: Surgery, Transitions of Care, Communication, Teams
Geng F, Mansouri S, Stevenson DG
Evolution of the home health care market: the expansion and quality performance of multi-agency chains.
This study examined the growth and quality performance of multi-agency home health agency (HHA) chains from 2005 to 2018. All Medicare-certified HHAs were included. Over the time period, the number of HHAs increased from 7899 to 10,818 and the number of chain-owned HHAs more than doubled from 903 to 1841. In 2018, for-profit nonchain agencies were still the largest category - both in the number of agencies (67.8%) and number of Medicare enrollees served (40.7%). Non-chain for-profit HHAs served the highest proportion of dual eligible beneficiaries and African Americans among all agency types.
AHRQ-funded; HS024072.
Citation: Geng F, Mansouri S, Stevenson DG .
Evolution of the home health care market: the expansion and quality performance of multi-agency chains.
Health Serv Res 2020 Dec;55(Suppl 3):1073-84. doi: 10.1111/1475-6773.13597..
Keywords: Home Healthcare, Provider Performance, Quality of Care
Patel SA, Krasnow M, Long K
Excess 30-day heart failure readmissions and mortality in black patients increases with neighborhood deprivation.
Researchers examined whether neighborhood environment modifies the disparity in 30-day heart failure (HF) readmissions and mortality between Black and White patients in the Southeastern United States. They created a geocoded retrospective cohort of patients hospitalized for acute HF from 2010-2018 within Emory Healthcare. They found that excess 30-day HF readmissions and mortality were present among Black patients in every neighborhood strata and increased with progressive neighborhood socioeconomic deprivation.
AHRQ-funded; HS026081.
Citation: Patel SA, Krasnow M, Long K .
Excess 30-day heart failure readmissions and mortality in black patients increases with neighborhood deprivation.
Circ Heart Fail 2020 Dec;13(12):e007947. doi: 10.1161/circheartfailure.120.007947..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Hospital Readmissions, Racial and Ethnic Minorities, Mortality, Social Determinants of Health, Low-Income, Disparities
Yankova LC, Neuman MI, Wang ME
Febrile infants ≤60 days old with positive urinalysis results and invasive bacterial infections.
In this study, the investigators aimed to describe the clinical and laboratory characteristics of febrile infants ≤60 days old with positive urinalysis results and invasive bacterial infections (IBI). The investigators concluded that the sensitivity of high-risk PMH, ill appearance, and/or abnormal WBC count was suboptimal for identifying febrile infants with positive urinalysis results at low risk for IBI.
AHRQ-funded; HS026006.
Citation: Yankova LC, Neuman MI, Wang ME .
Febrile infants ≤60 days old with positive urinalysis results and invasive bacterial infections.
Hosp Pediatr 2020 Dec;10(12):1120-25. doi: 10.1542/hpeds.2020-000638..
Keywords: Newborns/Infants, Urinary Tract Infection (UTI), Diagnostic Safety and Quality
Hsu HE, Mathew R, Wang R
Health care-associated infections among critically ill children in the US, 2013-2018.
The purpose of this study was to examine changes over time in CLABSI and CAUTI rates between 2013 and 2018 in neonatal intensive care units (NICUs) and pediatric intensive care units (PICUs) using prospective surveillance data from community hospitals, children's hospitals, and pediatric units within general hospitals. The investigators concluded that recent trends in CLABSI rates noted in this study among critically ill neonates and children in a large cohort of US hospitals indicated that past gains have held, without evidence of further improvements, suggesting novel approaches for CLABSI prevention are needed.
AHRQ-funded; HS025008; HS018414.
Citation: Hsu HE, Mathew R, Wang R .
Health care-associated infections among critically ill children in the US, 2013-2018.
https://www.pubmed.ncbi.nlm.nih.gov/33017011
JAMA Pediatr 2020 Dec;174(12):1176-83. doi: 10.1001/jamapediatrics.2020.3223..
JAMA Pediatr 2020 Dec;174(12):1176-83. doi: 10.1001/jamapediatrics.2020.3223..
Keywords: Children/Adolescents, Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU)
Huth HB, Skeens R, Anders S
Health management in the home: a qualitative study of pregnant women and their caregivers.
This qualitative study examined how pregnant women and their caregivers managed health in their home. Participants filled out sociodemographic surveys and had semi-structured interviews about living situations, information needs, and technology use. The authors identified themes about health management, including the physical home, help at home, community, the virtual home, and largest concerns. Caregivers often did not know how to help expectant mothers and needed to learn new roles. Many expectant families did not trust online advice.
AHRQ-funded; HS021496.
Citation: Huth HB, Skeens R, Anders S .
Health management in the home: a qualitative study of pregnant women and their caregivers.
J Patient Exp 2020 Dec;7(6):1227-33. doi: 10.1177/2374373520948442..
Keywords: Pregnancy, Women, Home Healthcare, Caregiving
Kranz AM, DeYoreo M, shete-Roesler B
Health system affiliation of physician organizations and quality of care for Medicare beneficiaries who have high needs.
The goal of this study was to test the hypothesis that health systems provide better care to patients with high needs compared to nonaffiliated physician organizations (POs). The 2015 Medicare Data on Provider Practice and Specialty linked physicians’ database was linked to POs Medicare Provider Enrollment, Chain, and Ownership System (PECOS) and IRS Form 990 data to identify health system affiliations. Among 2,323,301 beneficiaries with high needs, 52.3% received care from system-affiliated practices. The emergency department (ED) visit rate was statistically significantly different in system-affiliated POs and nonaffiliated POs. There were small differences for the remaining five of six quality measures examined: continuity of care, follow-up visits, all-cause readmissions, and ambulatory care-sensitive hospitalizations. Within systems there was substantial variation for rates of continuity of care and follow-up after ED visits.
AHRQ-funded; HS024067.
Citation: Kranz AM, DeYoreo M, shete-Roesler B .
Health system affiliation of physician organizations and quality of care for Medicare beneficiaries who have high needs.
Health Serv Res 2020 Dec;55(Suppl 3):1118-28. doi: 10.1111/1475-6773.13570..
Keywords: Health Systems, Medicare, Quality of Care, Healthcare Delivery
Machta RM, Reschovsky JD, Jones DJ
AHRQ Author: Furukawa MF
Health system integration with physician specialties varies across markets and system types.
Data from the AHRQ Compendium of US Health Systems and the IQVIA OneKey database was used to examine the change from 2016 to 2018 in the percentage of physicians in systems, focusing on primary care and the 10 most numerous non-hospital based specialties across 382 metropolitan statistical areas (MSAs) in the US. The authors also categorized systems by ownership, mission, and payment program participation and examined how these characteristics were related to their patterns of physician integration in 2018. Findings were that specialists with lucrative hospital services were the most commonly integrated with systems, including hematology-oncology, cardiology, and general surgery. High market concentration by insurers and hospital-systems was associated with lower rates of physician integration. In addition, systems with academic medical centers (AMCs) and publicly owned systems unrelated to the physicians’ potential contribution to hospital revenue, and investor-owned systems demonstrated more limited physician integration.
AHRQ-authored; AHRQ-funded; 290201600001C.
Citation: Machta RM, Reschovsky JD, Jones DJ .
Health system integration with physician specialties varies across markets and system types.
Health Serv Res 2020 Dec;55(Suppl 3):1062-72. doi: 10.1111/1475-6773.13584..
Keywords: Health Systems, Healthcare Delivery, Primary Care
McKinnell JA, Miller LG, Singh RD
High prevalence of multidrug-resistant organism colonization in 28 nursing homes: an "iceberg effect."
The objective of this study was to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus spp. (VRE), extended-spectrum beta-lactamase producing organisms (ESBLs), and carbapenem-resistant Enterobacteriaceae (CRE) among residents and in the environment of nursing homes (NHs). The investigators concluded that in more than half of the NHs, more than 50% of residents were colonized with MDROs of clinical and public health significance, most commonly MRSA and ESBL. Additionally, the vast majority of resident rooms and common areas were MDRO contaminated.
AHRQ-funded; HS024286.
Citation: McKinnell JA, Miller LG, Singh RD .
High prevalence of multidrug-resistant organism colonization in 28 nursing homes: an "iceberg effect."
J Am Med Dir Assoc 2020 Dec;21(12):1937-43.e2. doi: 10.1016/j.jamda.2020.04.007..
Keywords: Nursing Homes, Long-Term Care, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs)
Nazareno J, Zhang W, Silver B
Home health utilization in assisted living settings.
The authors explored the growth in the delivery of home health agency (HHA) services to Medicare beneficiaries in assisted living (AL) compared with other home settings between 2012 and 2014. Their findings suggested that there was a slight growth in the share of HHA services being delivered in AL. HHA recipients in AL were more likely to have cognitive and activities of daily living impairments than those receiving HHA services in other settings. This study is among the first of those to examine HHA utilization in AL.
AHRQ-funded; HS000011.
Citation: Nazareno J, Zhang W, Silver B .
Home health utilization in assisted living settings.
Med Care Res Rev 2020 Dec;77(6):620-29. doi: 10.1177/1077558719835049..
Keywords: Elderly, Home Healthcare, Medicare, Healthcare Utilization
Everson J, Adler-Milstein J, Ryan AM
Hospitals strengthened relationships with close partners after joining accountable care organizations.
This study tested the hypothesis that hospitals participating in Medicare Accountable Care Organizations (ACOs) try to influence where their patients receive care in order to achieve quality and cost containment goals. The authors studied hospitals participating in ACO from 2010 to 2014. ACO hospitals shared patients 4.4% more than non-ACO hospitals. This occurred disproportionately at hospitals that already shared a high proportion of their patients prior to participation and among hospitals in ACOs characterized as physician-hospital collaborations.
AHRQ-funded; HS024525; HS024728.
Citation: Everson J, Adler-Milstein J, Ryan AM .
Hospitals strengthened relationships with close partners after joining accountable care organizations.
Med Care Res Rev 2020 Dec;77(6):549-58. doi: 10.1177/1077558718818336..
Keywords: Hospitals, Medicare, Policy, Health Insurance
Sonik RA, Coleman-Jensen A, Parish SL
Household food insufficiency, health status and emergency healthcare utilisation among children with and without special healthcare needs.
The purpose of this study was to compare exposure to household food insufficiency and the relationship between household food insufficiency and both health status and emergency healthcare utilization among children with and without special healthcare needs (SHCN). The investigators concluded that compared with other children, children with SHCN have an elevated risk of exposure to household food insufficiency and experiencing greater reductions in health status when exposed.
AHRQ-funded; HS026317.
Citation: Sonik RA, Coleman-Jensen A, Parish SL .
Household food insufficiency, health status and emergency healthcare utilisation among children with and without special healthcare needs.
Public Health Nutr 2020 Dec;23(17):3204-10. doi: 10.1017/s1368980020000361..
Keywords: Children/Adolescents, Nutrition, Health Status, Emergency Department, Public Health
Sangal RB, Fodeh S, Taylor A
Identification of patients with nontraumatic intracranial hemorrhage using administrative claims data.
Nontraumatic intracranial hemorrhage (ICH) is a neurological emergency of research interest; however, unlike ischemic stroke, has not been well studied in large datasets due to the lack of an established administrative claims-based definition. In this study, the investigators aimed to evaluate both explicit diagnosis codes and machine learning methods to create a claims-based definition for this clinical phenotype.
AHRQ-funded; HS023554.
Citation: Sangal RB, Fodeh S, Taylor A .
Identification of patients with nontraumatic intracranial hemorrhage using administrative claims data.
J Stroke Cerebrovasc Dis 2020 Dec;29(12):105306. doi: 10.1016/j.jstrokecerebrovasdis.2020.105306..
Keywords: Cardiovascular Conditions, Neurological Disorders, Diagnostic Safety and Quality, Data
Liu FF, Lew A, Andes E
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
The objective of this study was to share key strategies that led to successful mental health screening (MHS) implementation in one pediatric cystic fibrosis center and to report implementation and screening outcomes. Results showed that leveraging coproduction to address stakeholder needs led to successful implementation of a sustainable MHS process.
AHRQ-funded; HS026393.
Citation: Liu FF, Lew A, Andes E .
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
Pediatr Pulmonol 2020 Dec;55(12):3328-36. doi: 10.1002/ppul.24951..
Keywords: Children/Adolescents, Respiratory Conditions, Chronic Conditions, Depression, Anxiety, Behavioral Health, Screening, Implementation, Quality Improvement, Quality of Care, Diagnostic Safety and Quality
Joyce NR, Pfeiffer MR, Zullo AR
Individual and geographic variation in driver's license suspensions: evidence of disparities by race, ethnicity and income.
Using data from the New Jersey Safety Health Outcomes data warehouse 2004-2018, the authors compared characteristics of suspended drivers, their residential census tract, as well as access to public transportation and jobs, by reason for the suspension. They found that 91% of license suspensions were for non-driving-related events, with the most common reason for a suspension being failure to pay a fine. Non-driving-related suspended drivers lived in census tracts with a lower household median income, higher proportion of black and Hispanic residents and higher unemployment rates, but also better walkability scores and better access to public transportation and jobs. They recommended additional work to determine what effect this has for the social and economic well-being of suspended drivers.
AHRQ-funded; HS022998.
Citation: Joyce NR, Pfeiffer MR, Zullo AR .
Individual and geographic variation in driver's license suspensions: evidence of disparities by race, ethnicity and income.
J Transp Health 2020 Dec;19. doi: 10.1016/j.jth.2020.100933..
Keywords: Racial and Ethnic Minorities, Disparities, Low-Income, Vulnerable Populations, Social Determinants of Health
Gonzalez CM, Walker SA, Rodriguez N
It can be done! A skills-based elective in implicit bias recognition and management for preclinical medical students.
This paper describes a skill-based elective designed to recognize and manage implicit bias for preclinical medical students. From 2017 to 2019, nine 1.5-hour sessions were delivered to 15 first-year medical students. A program evaluation based on focus groups with students and data from notes taken by the investigative team was conducted. Three themes were identified from the program evaluation: 1) Student engagement can be enhanced, 2) Instruction is empowering, and 3) Addressing bias in one’s own and witnessed encounters can be done.
AHRQ-funded; HS023199.
Citation: Gonzalez CM, Walker SA, Rodriguez N .
It can be done! A skills-based elective in implicit bias recognition and management for preclinical medical students.
Acad Med 2020 Dec;95(12S):S150-s55. doi: 10.1097/acm.0000000000003697..
Keywords: Education: Continuing Medical Education, Education: Academic
Henke RM, Karaca Z, Gibson TB
Medicaid Accountable Care Organizations and childbirth outcomes.
This study examined the impact of Accountable Care Organizations (ACOs) to childbirth outcomes. States that use Medicaid ACOs were compared with states that had not adopted ACO. Using HCUP data, the relationship between Medicaid ACO adoption and neonatal and maternal outcomes, and cost per birth was examined. Medicaid ACO implementation was associated with a moderate reduction in hospital costs per birth and decreased cesarean section rates with results varying by state. There was no association with other birth outcomes, including infant inpatient mortality, low birthweight, neonatal intensive care unit utilization and severe maternal morbidity.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Henke RM, Karaca Z, Gibson TB .
Medicaid Accountable Care Organizations and childbirth outcomes.
Med Care Res Rev 2020 Dec;77(6):559-73. doi: 10.1177/1077558718823132..
Keywords: Healthcare Cost and Utilization Project (HCUP), Medicaid, Health Insurance, Healthcare Costs, Labor and Delivery, Pregnancy, Women, Outcomes
Jacobs 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
Bajaj JS, Duarte-Rojo A, Xie JJ
Minimal hepatic encephalopathy and mild cognitive impairment worsen quality of life in elderly patients with cirrhosis.
Researchers investigated the performance of elderly patients with cirrhosis on tests for minimal hepatic encephalopathy (MHE) and predementia mild cognitive impairment (MCI) and their effects on quality of life (QOL). They found that, in a multicenter study of elderly patients with cirrhosis and controls, the presence of MHE, regardless of MCI, was associated with poor cognition and QOL. They created adjusted norms that defined the high sensitivity of EncephalApp for the detection of MHE in older individuals and validated it in a separate cohort.
AHRQ-funded; HS025412.
Citation: Bajaj JS, Duarte-Rojo A, Xie JJ .
Minimal hepatic encephalopathy and mild cognitive impairment worsen quality of life in elderly patients with cirrhosis.
Clin Gastroenterol Hepatol 2020 Dec;18(13):3008-16.e2. doi: 10.1016/j.cgh.2020.03.033..
Keywords: Elderly, Chronic Conditions, Quality of Life, Dementia, Neurological Disorders
Gelfand JM, Armstrong AW, Bell S
National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Vversion 1.
This article describes the process that was used to create the first version of a guidance document for management of psoriatic disease during the COVID-19 pandemic developed by the National Psoriasis Foundation. A task force of 18 physician voting members with expertise in dermatology, rheumatology, epidemiology, infectious diseases, and critical care was created with supplementation by nonvoting members. A Delphi process was created, out of which 22 guidance statements were approved. All guidance statements were recommended, with 9 of them high consensus, and the remaining 13 were moderate consensus. Topics covered included how COVID-19 can impact patients, how medical care can be optimized during the pandemic, and what patients can do to lower their risk of getting infected with COVID-19. This guidance will be updated by the TF as new data emerges.
AHRQ-funded; HS026372.
Citation: Gelfand JM, Armstrong AW, Bell S .
National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Vversion 1.
J Am Acad Dermatol 2020 Dec;83(6):1704-16. doi: 10.1016/j.jaad.2020.09.001..
Keywords: Skin Conditions, Chronic Conditions, Care Management, Evidence-Based Practice, Guidelines, COVID-19
Qureshi N, Quigley DD, Hays RD
Nationwide qualitative study of practice leader perspectives on what it takes to transform into a patient-centered medical home.
The purpose of this study was to examine reasons practices obtained and maintained patient-centered medical home (PCMH) recognition and what resources were needed. The investigators concluded that PCMH efforts necessitated support and assistance to frontline, on-site practice leaders leading care delivery changes. They suggested that change efforts should include financial incentives (e.g., direct payment or additional reimbursement), leadership direction and support, and internal or external staff with experience with the PCMH application process, implementation changes, and QI expertise in monitoring process and outcome data.
AHRQ-funded; HS016980.
Citation: Qureshi N, Quigley DD, Hays RD .
Nationwide qualitative study of practice leader perspectives on what it takes to transform into a patient-centered medical home.
J Gen Intern Med 2020 Dec;35(12):3501-09. doi: 10.1007/s11606-020-06052-1..
Keywords: Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Quality Improvement, Quality of Care, Healthcare Delivery
Colla C, Yang W, Mainor AJ
Organizational integration, practice capabilities, and outcomes in clinically complex Medicare beneficiaries.
This study examines the association between clinical integration and financial integration, quality-focused care delivery processes, and beneficiary utilization and outcomes. Data was used from multiphysician practices in the 2017-2018 National Survey of Healthcare Organizations and Systems and 2017 Medicare claims data. Out of 1.6M fee-for-service Medicare beneficiaries aged 66 or older attributed to 2113 practices, 414,209 were considered clinically complex (frailty or 2 or more chronic conditions). Financial and clinical integration were weakly correlated. Clinical integration was significantly associated with greater adoption of quality-focused care delivery processes, while financial integration was associated with the opposite. Integration was not associated with reduced utilization or better beneficiary-level health-related outcomes, but both integration types were associated with lower spending.
AHRQ-funded; HS024075.
Citation: Colla C, Yang W, Mainor AJ .
Organizational integration, practice capabilities, and outcomes in clinically complex Medicare beneficiaries.
Health Serv Res 2020 Dec;55(Suppl 3):1085-97. doi: 10.1111/1475-6773.13580..
Keywords: Medicare, Health Systems, Healthcare Delivery
Konetzka RT, Jung DH, Gorges RJ
Outcomes of Medicaid home- and community-based long-term services relative to nursing home care among dual eligibles.
This study measured the outcomes of dual-eligible recipients of Medicaid home- and community-based long-term services (HCBS) compared to nursing home residents. The authors used the 2005 and 2012 Medicaid Analytic eXtract (MAX) database, a national compilation of Medicaid claims which merges Medicare claims to identify hospital admissions. A cohort of 1,312,498 older adults dually enrolled in Medicaid and Medicare and using long-term care was tracked. HCBS users were found to have 10 percent points higher annual rates of hospitalization than their nursing home counterparts when selection bias is addressed. The differences persisted across races, dementia status, and intensity of HCBS spending.
AHRQ-funded; HS000084.
Citation: Konetzka RT, Jung DH, Gorges RJ .
Outcomes of Medicaid home- and community-based long-term services relative to nursing home care among dual eligibles.
Health Serv Res 2020 Dec;55(6):973-82. doi: 10.1111/1475-6773.13573..
Keywords: Elderly, Long-Term Care, Nursing Homes, Medicaid, Medicare, Outcomes