National Healthcare Quality and Disparities Report
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 6 of 6 Research Studies DisplayedEverson 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
Ibrahim AM, Nuliyalu U, Lawton EJ
Evaluation of US hospital episode spending for acute inpatient conditions after the Patient Protection and Affordable Care Act.
This study evaluated the association between enactment of Affordable Care Act (ACA) reforms and 30-day price standardized hospital episode spending for Medicare patients. Reforms to reduce spending were targeted to acute care hospitals and often focused on specific diagnoses such as acute myocardial infarction, heart failure, and pneumonia. The policy evaluation included index discharges between January 2008 and August 31, 2015 from a random 20% sample of Medicare beneficiaries. Three different estimation approaches were used to evaluate the association between reforms and episode spending: difference-in-difference (DID) analysis among acute care hospitals; a DID analysis comparing acute care hospitals and critical care hospitals; and a generalized synthetic control analysis, comparing acute care and critical access hospitals. A total of 7,634,242 index discharges were included. All 3 approaches found that ACA-associated spending reforms were associated with a significant reduction in episode spending.
AHRQ-funded; HS024525; HS024728.
Citation: Ibrahim AM, Nuliyalu U, Lawton EJ .
Evaluation of US hospital episode spending for acute inpatient conditions after the Patient Protection and Affordable Care Act.
JAMA Netw Open 2020 Nov 2;3(11):e2023926. doi: 10.1001/jamanetworkopen.2020.23926..
Keywords: Elderly, Policy, Hospitals, Medicare, Healthcare Costs
de Cordova PB, Jones T, Riman KA
Staffing trends in magnet and non-magnet hospitals after state legislation.
This study examined whether there was a difference in staffing of registered nurses in Magnet and non-Magnet hospitals using unit-level, publicly available data in New Jersey. This secondary analysis of longitudinal RN staffing data was conducted using 64 hospitals representing 12 nursing specialties during the time span of 2008 to 2015. There was a slight increase in staffing at Magnet hospitals compared to non-Magnet hospitals, but RN staffing improved in all hospitals. No meaningful difference in staffing for all 12 specialties was found.
AHRQ-funded; HS024339.
Citation: de Cordova PB, Jones T, Riman KA .
Staffing trends in magnet and non-magnet hospitals after state legislation.
J Nurs Care Qual 2020 Oct/Dec;35(4):323-28. doi: 10.1097/ncq.0000000000000479..
Keywords: Hospitals, Policy, Healthcare Delivery, Workforce
Terp S, Seabury SA, Axeen S
The association between hospital characteristics and Emergency Medical Treatment and Labor Act citation events.
The Emergency Medical Treatment and Labor Act (EMTALA) is a federal law enacted in 1986 prohibiting patient dumping (refusing or transferring patients with emergency medical conditions without appropriate stabilization), and discrimination based upon ability to pay. In this study, the investigators evaluated hospital-level features associated with citation for EMTALA violation. They concluded that for-profit ownership was associated with increased odds of EMTALA citations after adjusting for other characteristics.
AHRQ-funded; HS025281.
Citation: Terp S, Seabury SA, Axeen S .
The association between hospital characteristics and Emergency Medical Treatment and Labor Act citation events.
Med Care 2020 Sep;58(9):793-99. doi: 10.1097/mlr.0000000000001360..
Keywords: Emergency Department, Hospitals, Policy, Transitions of Care
Yakusheva O, Hoffman GJ
Does a reduction in readmissions result in net savings for most hospitals? An examination of Medicare's hospital readmissions reduction program.
This study aimed (1) to estimate the impact of an incremental reduction in excess readmissions on a hospital's Medicare reimbursement revenue, for hospitals subject to penalties under the Medicare's Hospital Readmissions Reduction Program and (2) to evaluate the economic case for an investment in a readmission reduction program.
AHRQ-funded; HS025838.
Citation: Yakusheva O, Hoffman GJ .
Does a reduction in readmissions result in net savings for most hospitals? An examination of Medicare's hospital readmissions reduction program.
Med Care Res Rev 2020 Aug;77(4):334-44. doi: 10.1177/1077558718795745..
Keywords: Medicare, Hospital Readmissions, Hospitals, Healthcare Costs, Policy
Kunz SN, Phibbs CS, Profit J
The changing landscape of perinatal regionalization.
This article discusses the need for consistent perinatal regionalization policies across regions and between countries to reduce neonatal morbidity and mortality. Regionalization emphasizes matching patient needs with the capabilities of the hospital in which care is provided. The need to account for geographic and other regional differences when determining the feasibility of regionalization for a specific regions is emphasized.
AHRQ-funded; HS025749.
Citation: Kunz SN, Phibbs CS, Profit J .
The changing landscape of perinatal regionalization.
Semin Perinatol 2020 Jun;44(4):151241. doi: 10.1016/j.semperi.2020.151241..
Keywords: Pregnancy, Maternal Care, Women, Policy, Hospitals