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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 25 of 62 Research Studies DisplayedWachnik AA, Welch-Coltrane JL, Adams MCB
A standardized emergency department order set decreases admission rates and in-patient length of stay for adults patients with sickle cell disease.
The purpose of this 3-year prospective analysis study was to assess a quality improvement project to standardize Emergency Department (ED) care for patients presenting with pain associated with sickle cell disease (SCD). IN 2019 the researchers implemented an ED order set in to improve care and provide adequate management of analgesia. The primary outcome was the overall hospital admission rate for patients after the intervention, and the secondary outcome measures included ED disposition, rate of return to the ED within 72 hours, ED pain scores at admission and discharge, ED treatment time, in-patient length of stay, non-opioid medication use, and opioid medication use. The study found an overall 67% reduction in the hospital admission rate after implementation of the order set and a significant decrease in the percentage admission rate month over month. Time to the first non-opioid analgesic decreased by 71 minutes and there was no change in time to the first opioid medication. The rate of return to the ED within 72 hours did not change and the ED elopement rate did not change. There were significant increases in the prescribing of orally administered acetaminophen, celecoxib, and tizanidine, and intravenous ketamine and ketorolac. ED pain scores at discharge did not change for hospital-admitted and non-admitted patients. The possible reduction in costs was $193,440 during the 12-month observation period, and the average cost per visit decreased by $792. The researchers concluded that the ED order set decreased the rate of hospital admissions and the timeliness of analgesia administration without having a negative impact on the pain of the patients.
AHRQ-funded; HS028584.
Citation: Wachnik AA, Welch-Coltrane JL, Adams MCB .
A standardized emergency department order set decreases admission rates and in-patient length of stay for adults patients with sickle cell disease.
Pain Med 2022 Dec;23(12):2050-60. doi: 10.1093/pm/pnac096..
Keywords: Sickle Cell Disease, Emergency Department, Hospitalization
Halvorson EE, Thurtle DP, Easter A
Disparities in adverse event reporting for hospitalized children.
The authors compared the adverse event (AE) rate identified by voluntary event reporting (VER) with that identified using the Global Assessment of Pediatric Patient Safety (GAPPS) between hospitalized children by weight category, race, and English proficiency. In the population studied, they identified 288 total AEs, 270 by the GAPPS and 18 by VER. They found a disparity in AE reporting for children with limited English proficiency, with fewer AEs by VER compared with no difference in AEs by GAPPS. They identified no disparities by weight category or race. They concluded that voluntary event reporting may systematically underreport AEs in hospitalized children with limited English proficiency.
AHRQ-funded; HS026038.
Citation: Halvorson EE, Thurtle DP, Easter A .
Disparities in adverse event reporting for hospitalized children.
J Patient Saf 2022 Sep 1;18(6):e928-e33. doi: 10.1097/pts.0000000000001049..
Keywords: Children/Adolescents, Disparities, Adverse Events, Medical Errors, Patient Safety, Hospitals, Hospitalization, Inpatient Care
Saxena FE, Bierman AS, Glazier RH
AHRQ Author: Bierman AS
Association of Early Physician Follow-up With Readmission Among Patients Hospitalized for Acute Myocardial Infarction, Congestive Heart Failure, or Chronic Obstructive Pulmonary Disease.
Investigators assessed whether hospitalized patients with early physician follow-up after discharge had lower rates of overall and condition-specific readmissions within 30 days and 90 days of discharge. Studying adults in Ontario, Canada, with first admission for acute myocardial infarction, congestive heart failure, or chronic obstructive pulmonary disease, the findings suggested that early follow-up in conjunction with a comprehensive transitional care strategy for hospitalized patients with medically complex conditions coupled with ongoing effective chronic disease management may be associated with reduced 90-day readmissions.
AHRQ-authored.
Citation: Saxena FE, Bierman AS, Glazier RH .
Association of Early Physician Follow-up With Readmission Among Patients Hospitalized for Acute Myocardial Infarction, Congestive Heart Failure, or Chronic Obstructive Pulmonary Disease.
JAMA Netw Open 2022 Jul;5(7):e2222056. doi: 10.1001/jamanetworkopen.2022.22056..
Keywords: Hospital Readmissions, Hospitalization, Cardiovascular Conditions, Respiratory Conditions, Transitions of Care
Hirai AH, Owens PL, Reid LD
AHRQ Author: Owens PL, Reid LD
Associations between state-level severe maternal morbidity and other perinatal indicators.
This study used the HCUP State Inpatient Databases (HCUP-SID) to determine the correlation between state-level severe maternal morbidity (SMM) rates and perinatal indicators. HCUP-SID was analyzed from 2017 to 2019 using revised code sets for 20 indicators excluding blood transfusions. Perinatal indicators used included prepregnancy hypertension, prepregnancy diabetes, prepregnancy obesity, low-risk cesarean delivery, preterm birth, infant mortality, and maternal mortality. HCUP-SID data for 10,542,942 maternal deliveries and 11,394,752 live births from the National Vital Statistics System (NVSS) were aggregated for state-level analysis. SMM rates were significantly correlated with 2 of the 7 perinatal indicators: prepregnancy hypertension and low-risk cesarean deliveries. All other perinatal indicators were significantly associated with at least 4 of 7 other indicators, and most correlations were higher in magnitude. Maternity mortality rates were highest in the southeast.
AHRQ-authored.
Citation: Hirai AH, Owens PL, Reid LD .
Associations between state-level severe maternal morbidity and other perinatal indicators.
JAMA Netw Open 2022 Jul;5(7):e2224621. doi: 10.1001/jamanetworkopen.2022.24621..
Keywords: Healthcare Cost and Utilization Project (HCUP), Maternal Care, Pregnancy, Women, Labor and Delivery, Hospitalization
Hirai AH, Owens PL, Reid LD
AHRQ Author: Owens PL, Reid LD
Trends in severe maternal morbidity in the US across the transition to ICD-10-CM/PCS from 2012-2019.
This study evaluated national and state trends in severe maternal morbidity (SMM) rates from 2012 to 2019, and potential disruptions associated with the transition to International Classification of Diseases, 10th Revision, Clinical Modification and Procedure Coding System (ICD-10-CM/PCS) in October 2015. This repeated cross-sectional analysis examined delivery hospitalizations in the HCUP’s National Inpatient Sample and State Inpatient Databases. There were almost 6 million delivery hospitalizations in the national sample representing a weighted total of 29.8 million deliveries with a mean maternal age of 28.6 years. SMM rates increased from 69.5 per 10,000 deliveries to 79.7 per 10,000 in 2019 without a significant change across the ICD-10-CM/PCS transition. OF 20 SMM indicators, rates for 10 indicators increased while 3 significantly decreased with 5 of those changes associated with the ICD-10-CM/PCS transition. Acute kidney failure had the largest increase, from 6.4 to 15.3 per 10,000 delivery hospitalizations, with no change associated with ICD transition. Disseminated intravascular coagulation had the largest decrease from 31.3 to 21.2 per 10,000, with a significant drop associated with ICD transition. State SMM rates significantly decreased for 1 state and significantly increased for 21 states from 2012 to 2019 and with varying associations with ICD transition.
AHRQ-authored.
Citation: Hirai AH, Owens PL, Reid LD .
Trends in severe maternal morbidity in the US across the transition to ICD-10-CM/PCS from 2012-2019.
JAMA Netw Open 2022 Jul;5(7):e2222966. doi: 10.1001/jamanetworkopen.2022.22966..
Keywords: Healthcare Cost and Utilization Project (HCUP), Maternal Care, Pregnancy, Women, Labor and Delivery, Hospitalization
Campbell JI, Dubois MM, Savage TJ
Comorbidities associated with hospitalization and progression among adolescents with symptomatic coronavirus disease 2019.
This study’s objective was to identify subgroups likely to benefit from monoclonal antibody and antiviral therapy to treat COVID-19 by evaluating the relationship between comorbidities and hospitalization among US adolescents aged 12-17 with symptomatic coronavirus disease 2019 (COVID-19). The authors used the Pediatric COVID-19 US registry to identify patients who met their inclusion criteria of comorbidities including obesity, chronic kidney disease (CKD), diabetes, immunosuppressive disease or treatment, sickle cell disease (SCD), heart disease, neurologic disease/neurodevelopmental disorders, and pulmonary disease (excluding patients with mild asthma). Out of 1877 total patients included 284 (15%) were hospitalized within 28 days of their COVID-19 diagnosis. The following comorbidities were associated with increased odds of hospitalization: SCD, immunocompromising condition, obesity, diabetes, neurologic disease, and pulmonary disease (excluding mild asthma).
AHRQ-funded; HS000063.
Citation: Campbell JI, Dubois MM, Savage TJ .
Comorbidities associated with hospitalization and progression among adolescents with symptomatic coronavirus disease 2019.
J Pediatr 2022 Jun;245:102-10.e2. doi: 10.1016/j.jpeds.2022.02.048..
Keywords: Children/Adolescents, Diabetes, Asthma, Kidney Disease and Health, Hospitalization
Probst MA, Janke AT, Haimovich AD
Development of a novel emergency department quality measure to reduce very low-risk syncope hospitalizations.
The purpose of this study was to develop a new quality measure to apply with very low risk adult emergency department patients under 50 years of age and with no history of heart disease presenting with syncope. The study found that of the 3,292 patients meeting the study criteria, .46% suffered serious adverse events within 30 days after discharge. When the criteria were applied to the 2019 Nationwide Emergency Department Sample (NEDS) to assess its potential effect (assessing for hospital-level factors associated with hospitalization variation), of the 566,031 patients meeting the criteria, 2.7% were hospitalized. The researchers identified factors associated with increased hospitalization rates, which included a yearly ED volume of more than 80,000 and metropolitan teaching status. The study concluded that the novel syncope quality measure developed by the researchers can evaluate variation in low-value hospitalizations for unexplained syncope.
AHRQ-funded; HS022882.
Citation: Probst MA, Janke AT, Haimovich AD .
Development of a novel emergency department quality measure to reduce very low-risk syncope hospitalizations.
Ann Emerg Med 2022 Jun;79(6):509-17. doi: 10.1016/j.annemergmed.2022.03.008..
Keywords: Emergency Department, Quality Measures, Hospitalization, Quality Indicators (QIs), Quality of Care
Valley TS, Schutz A, Peltan ID
Organization of outpatient care after COVID-19 hospitalization.
The purpose of this study was to describe post-discharge care delivery for patients with postacute sequelae of COVID-19 (PASC) across a large network of US academic and community hospitals. Beginning in July, 2021, the researchers surveyed 47 hospitals which were participating in the National Heart, Lung, and Blood Institute Clinical Trials Network for the Prevention and Early Treatment of Acute Lung Injury (PETAL Network.) Surveys were completed by physicians, hospital administrators, social workers, research staff or other clinicians over an 8-week period, and data from the 2019 American Hospital Association annual survey database were used to describe the hospitals. The study found that 79% (37) of the responding hospitals provided COVID-specific discharge information to patients hospitalized with COVID-19. Only 26% of hospitals provided discharge information that included potential symptoms or impairments of postacute sequelae of COVID-19. Seventy percent (33) had a PASC clinic (a postdischarge outpatient clinic designed specifically for patients with COVID). Hospitals without PASC clinics were more likely to be located in a ZIP code with a higher Medicare population and a median annual income lower than $40,000, and were also more likely to be smaller, for-profit hospitals. The researchers identified several core areas for possible improvements in PASC care, including: examining the impact of PASC clinics on patient outcomes; assessing the extent to which the pathophysiology and management of PASC differ from sequelae of other infections and syndromes; and exploring whether an inability to systematically identify patients for PASC care may result in an inability for some patients to receive needed care. The researchers concluded that PASC clinics may offer opportunities to coordinate care and serve as an opportunity for making iterative gains in knowledge about PASC clinics and related models and processes and their effectiveness in improving longer-term patient-centered outcomes for survivors of COVID-19.
AHRQ-funded; HS028038.
Citation: Valley TS, Schutz A, Peltan ID .
Organization of outpatient care after COVID-19 hospitalization.
Chest 2022 Jun;161(6):1485-89. doi: 10.1016/j.chest.2022.01.034..
Keywords: COVID-19, Ambulatory Care and Surgery, Hospitalization, Care Coordination, Healthcare Delivery
Encinosa W, Figueroa J, Elias Y
AHRQ Author: Encinosa W
Severity of hospitalizations from SARS-CoV-2 vs influenza and respiratory syncytial virus infection in children aged 5 to 11 years in 11 US states.
By the time emergency use authorization had been granted for the Pfizer-BioNTech vaccine in October 2021 in children aged 5 to 11 years, there had been 1.8 million diagnoses of SARS-CoV-2 infection, 8,000 hospitalizations, and 143 deaths in that age group. Very little has been reported on the severity of those hospitalizations relative to the influenza virus and respiratory syncytial virus (RSV) which are the most common childhood viruses. The purpose of this study was to compare hospitalizations of children aged 5 to 11 for SARS-CoV-2 infection and multisystem inflammatory system in children (MIS-C, a sequela of COVID-19 disease) with the hospitalizations of children aged 5 to 11 years who were infected with influenza and RSV. The researchers utilized inpatient data from the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project from the first 11 states with complete first-quarter data as of October 2021, representing 24% of the US population of children aged 5 to 11 years. The researchers examined 46 complications in 7 body systems, total care costs and charges, and data on race and ethnicity. The resulting cross-sectional study included patient data from a total of 2,269 children. The study found that COVID-19 hospitalizations occurred at the rate of 10.8 per 100,000 children, while Influenza and RSV were rare during the first quarter of 2021 with 23 total hospital discharges combined. However, in 2017, which researchers also measured for data on influenza and RSV, influenza and RSV had 17.0 and 6.2 hospitalizations per 100,000 children, respectively. Inpatient death for all viruses was rare. MIS-C had the highest rates of cardiovascular, hematologic, and gastrointestinal complications. Children with RSV ha the highest rate of respiratory complications. Children with COVID-19 (without MISC-C) had the highest rate of neurologic complications, whereas children with influenza had the highest rate of muscoskeletal complications. Children with MIS-C had the longest median length of stay at a median cost of $23,585 per stay compared to children with influenza with a median length of stay of 2 days and a cost of $5,200.
AHRQ-authored.
Citation: Encinosa W, Figueroa J, Elias Y .
Severity of hospitalizations from SARS-CoV-2 vs influenza and respiratory syncytial virus infection in children aged 5 to 11 years in 11 US states.
JAMA Pediatr 2022 May;176(5):520-22. doi: 10.1001/jamapediatrics.2021.6566..
Keywords: Healthcare Cost and Utilization Project (HCUP), COVID-19, Children/Adolescents, Hospitalization, Influenza, Respiratory Conditions
Hobensack M, Ojo M, Barrón Y
Documentation of hospitalization risk factors in electronic health records (EHRs): a qualitative study with home healthcare clinicians.
The objectives of this study were to identify risk factors that home healthcare clinicians associate with patient deterioration and to understand clinicians’ response to and documentation of these risk factors. The authors interviewed multidisciplinary home healthcare clinicians and used directed content analysis to identify risk factors for deterioration. A total of 79 risk factors were identified by the clinicians, who responded most often by communicating with the prescribing provider or following up with patients and caregivers. Clinicians also acknowledged that social factors played a role in deterioration risk. The authors noted that, since most risk factors were documented in clinical notes, methods such as natural language processing are needed to extract them. They concluded that by providing a comprehensive list of risk factors grounded in clinician expertise and mapped to standardized terminologies, the results of their study supported the development of an early warning system for patient deterioration.
AHRQ-funded; HS027742.
Citation: Hobensack M, Ojo M, Barrón Y .
Documentation of hospitalization risk factors in electronic health records (EHRs): a qualitative study with home healthcare clinicians.
J Am Med Inform Assoc 2022 Apr 13;29(5):805-12. doi: 10.1093/jamia/ocac023..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Home Healthcare, Risk, Hospitalization
Khodneva Y, Goyal P, Levitan EB
Depressive symptoms and incident hospitalization for heart failure: findings From the REGARDS Study.
The purpose of this study was to determine whether depressive symptoms are associated with incident heart failure (HF), including hospitalization for HF overall or by subtype: HF with preserved (HFpEF) or reduced ejection fraction (HFrEF). The study found that over a median of 9.2 years of follow-up, there were 872 incident HF hospitalizations, 526 among those without CHD and 334 among those with CHD. The age-adjusted HF hospitalization incidence rates per 1000 person-years were 4.9 for participants with depressive symptoms compared with 3.2 for participants without depressive symptoms. For overall HF, the elevated risk lessened after controlling for covariates. Among those without baseline CHD, when HFpEF was evaluated separately, after controlling for all covariates, depressive symptoms were related with incident hospitalization. In contrast, depressive symptoms were not related with incident HFrEF hospitalizations. The researchers concluded that among individuals without CHD at baseline, depressive symptoms were related with incident hospitalization for HFpEF, but not for those with baseline CHD or HFrEF.
AHRQ-funded; HS013852.
Citation: Khodneva Y, Goyal P, Levitan EB .
Depressive symptoms and incident hospitalization for heart failure: findings From the REGARDS Study.
J Am Heart Assoc 2022 Apr 5;11(7):e022818. doi: 10.1161/jaha.121.022818..
Keywords: Depression, Behavioral Health, Heart Disease and Health, Cardiovascular Conditions, Hospitalization, Risk
Fritz CQ, Hall M, Bettenhausen JL
Child Opportunity Index 2.0 and acute care utilization among children with medical complexity.
This cross-sectional, multicenter study examined the association between ZIP code-level opportunity and acute care utilization among children with medical complexity (CMS). The authors assessed associations between the nationally-normed, multi-dimensional ZIP code-level Child Opportunity Index 2.0 (COI) and total utilization days (hospital bed-days + emergency department (ED) discharge encounters). In adjusted analyses, patients in the lowest COI quintile (lowest opportunity) utilized care at 1.22 times the rate of those from the highest COI quintile.
AHRQ-funded; HS026122.
Citation: Fritz CQ, Hall M, Bettenhausen JL .
Child Opportunity Index 2.0 and acute care utilization among children with medical complexity.
J Hosp Med 2022 Apr;17(4):243-51. doi: 10.1002/jhm.12810..
Keywords: Children/Adolescents, Hospitalization, Healthcare Utilization
Álvares-da-Silva MR, Oliveira CP, Fagan A
Interaction of microbiome, diet, and hospitalizations between Brazilian and American patients with cirrhosis.
This study’s objective was to compare cirrhosis patients from the United States with cirrhosis patients from Brazil with respect to diet, microbiota, and impact on hospitalizations. This case-control study had participants undergo dietary recall and provide stool samples for 16S ribosomal RNA sequencing. Demographics and medications/cirrhosis details were also compared. Cirrhosis patients were followed up for 90-day hospitalizations. More Americans were men, had higher hepatic encephalopathy and alcohol/hepatitis C etiology with lower nonalcoholic fatty liver disease than Brazilians. Model for end-stage liver disease (MELD), diabetes, ascites, and albumin were similar. Within participants with cirrhosis, microbial diversity was higher for Brazilians, and among Brazilians high diversity was related to Brazilian origin, age, and cereal intake. High MELD scores and ascites was related to lower diversity. Beneficial taxa and taxa associated with yogurt intake was higher was pathobionts were lower in Brazilians. More Americans were hospitalized than Brazilians.
AHRQ-funded; HS025412; HS024004.
Citation: Álvares-da-Silva MR, Oliveira CP, Fagan A .
Interaction of microbiome, diet, and hospitalizations between Brazilian and American patients with cirrhosis.
Clin Gastroenterol Hepatol 2022 Apr;20(4):930-40. doi: 10.1016/j.cgh.2021.03.045..
Keywords: Hospitalization
Thomson J, Butts B, Camara S
Neighborhood socioeconomic deprivation and health care utilization of medically complex children.
The authors sought to assess the association between neighborhood socioeconomic deprivation and health care utilization in a cohort of children with medical complexity. They found no association between area-level deprivation and emergency department visits, hospitalizations, or inpatient bed-days. However, there was a 13% relative increase in the missed clinic visit rate for every 0.1 unit increase in Deprivation Index. They concluded that a child's socioeconomic context is associated with adherence to patient-centered medical home visits.
AHRQ-funded; HS025138.
Citation: Thomson J, Butts B, Camara S .
Neighborhood socioeconomic deprivation and health care utilization of medically complex children.
Pediatrics 2022 Apr;149(4). doi: 10.1542/peds.2021-052592..
Keywords: Children/Adolescents, Healthcare Utilization, Hospitalization
Remigio RV, Turpin R, Raimann JG, et al.
Assessing proximate intermediates between ambient temperature, hospital admissions, and mortality in hemodialysis patients.
This study investigated whether pre-dialysis systolic blood pressure (preSBP) and interdialytic weight gain (IDWG) in individuals with end-stage kidney disease (ESKD) can independently mediate the association between ambient temperature, all-cause hospital admissions (ACHA), and all-cause mortality (ACM). The study population consisted of 1981 ESKD patients receiving hemodialysis treatments at Fresenius Medical Care facilities in Philadelphia County, PA, from 2011 to 2019. Within a time-to-event framework, the authors estimated the association between daily maximum dry-bulb temperature (TMAX) and, as separate models, ACHA and ACM during warmer calendar months. Based on Lag 2- Lag 1 temporal ordering, and a 1 °C increase in daily maximum dry-bulb temperature (TMAX), the authors found an increased hazard of ACHA by 1.4% and ACM 7.5%. Short-term lag exposures to 1 °C increase in temperature predicted mean reductions in IDWG and preSBP by 0.013-0.015% and 0.168-0.229 mmHg.
AHRQ-funded; HS027716.
Citation: Remigio RV, Turpin R, Raimann JG, et al..
Assessing proximate intermediates between ambient temperature, hospital admissions, and mortality in hemodialysis patients.
Environ Res 2022 Mar;204(Pt B):112127. doi: 10.1016/j.envres.2021.112127..
Keywords: Kidney Disease and Health, Chronic Conditions, Hospitalization
Kamran F, Tang S, Otles E
Early identification of patients admitted to hospital for covid-19 at risk of clinical deterioration: model development and multisite external validation study.
The authors sought to create and validate a simple and transferable machine learning model from electronic health record data to accurately predict clinical deterioration in patients with COVID-19 across institutions, through use of a novel paradigm for model development and code sharing. They determined that a model to predict clinical deterioration was developed rapidly in response to the COVID-19 pandemic at a single hospital, was applied externally without the sharing of data, and performed well across multiple medical centers, patient subgroups, and time periods, showing its potential as a tool for use in optimizing healthcare resources.
AHRQ-funded; HS028038.
Citation: Kamran F, Tang S, Otles E .
Early identification of patients admitted to hospital for covid-19 at risk of clinical deterioration: model development and multisite external validation study.
BMJ 2022 Feb 17;376:e068576. doi: 10.1136/bmj-2021-068576..
Keywords: COVID-19, Hospitalization, Risk, Electronic Health Records (EHRs), Health Information Technology (HIT)
Tucher E, Keeney T, Bélanger E
Leveraging survey and claims data to identify high-need Medicare beneficiaries in the National Health and Aging Trends Study.
The purpose of this retrospective cohort study was to compare the performance of existing survey and claims-based definitions in identifying high-need (HN) Medicare population beneficiaries and predicting poor outcomes among a community-dwelling population. The researchers utilized Round 5 (2015) of the National Health and Aging Trends Study (NHATS) linked with Medicare claims and applied HN definitions from prior studies to the current study cohort. The study found that the percentage of NHATS respondents categorized as HN differed greatly across definitions. HN respondents had significantly higher mortality and hospitalization rates in 2016. The researchers report that although all the definitions utilized had good specificity, none were sufficiently accurate in their ability to predict outcomes in the following year.
AHRQ-funded; HS000011.
Citation: Tucher E, Keeney T, Bélanger E .
Leveraging survey and claims data to identify high-need Medicare beneficiaries in the National Health and Aging Trends Study.
J Am Geriatr Soc 2022 Feb; 70(2):522-30. doi: 10.1111/jgs.17517..
Keywords: Medicare, Elderly, Hospitalization
Bronstein JM, Huang L, Shelley JP
Primary care visits and ambulatory care sensitive diabetes hospitalizations among adult Alabama Medicaid beneficiaries.
This retrospective cohort study described patterns of care use for Alabama Medicaid adult beneficiaries with diabetes and the association of primary care utilization and ambulatory care sensitive (ACS) diabetes hospitalizations. Alabama Medicaid claims data from January 2010 to April 2018 for 52, 549 covered adults aged 19-64 with diabetes was analyzed. Individuals were categorized by demographics, comorbidities, and health care use. Characteristics of the cohort with and without ACS hospitalization was reported. One third of the cohort had at least one ACS diabetes hospitalization over the observed periods. Hospital users tended to have multiple ACS hospitalizations as well as more comorbidities and pharmaceutical and other types of care use than those with no ACS hospitalizations. Having a primary care visit in one year was significantly associated with a reduced likelihood of ACS hospitalization in the following year.
AHRQ-funded; HS023009.
Citation: Bronstein JM, Huang L, Shelley JP .
Primary care visits and ambulatory care sensitive diabetes hospitalizations among adult Alabama Medicaid beneficiaries.
Prim Care Diabetes 2022 Feb;16(1):116-21. doi: 10.1016/j.pcd.2021.10.005..
Keywords: Diabetes, Hospitalization, Medicaid, Primary Care
Rastogi R, Yu PC, Deshpande A
Treatment and outcomes among patients ≥85 years hospitalized with community-acquired pneumonia.
This retrospective cohort study’s objective was to describe community-acquired pneumonia (CAP) among patients ≥85 years and compare them to patients aged 65-74. Findings showed that patients aged 85 and over have different comorbidities and etiologies of CAP, receive less intense treatment, and have greater mortality than patients between 65 and 75 years.
AHRQ-funded; HS024277.
Citation: Rastogi R, Yu PC, Deshpande A .
Treatment and outcomes among patients ≥85 years hospitalized with community-acquired pneumonia.
J Investig Med 2022 Feb;70(2):376-82. doi: 10.1136/jim-2021-002078..
Keywords: Elderly, Community-Acquired Infections, Pneumonia, Outcomes, Hospitalization
Wickwire EM, Bailey MD, Somers VK
CPAP adherence is associated with reduced inpatient utilization among older adult Medicare beneficiaries with pre-existing cardiovascular disease.
The purpose of this study was to examine the impact of adherence to continuous positive airway pressure (CPAP) therapy on health care utilization among a nationally representative and sample of older adults with multiple morbidities and pre-existing cardiovascular disease and subsequently diagnosed with obstructive sleep apnea in the United States. The investigators concluded that in this nationally representative sample of older Medicare beneficiaries with multiple morbidities and relative to low adherers, high adherers demonstrated reduced inpatient utilization.
AHRQ-funded; HS024560.
Citation: Wickwire EM, Bailey MD, Somers VK .
CPAP adherence is associated with reduced inpatient utilization among older adult Medicare beneficiaries with pre-existing cardiovascular disease.
J Clin Sleep Med 2022 Jan;18(1):39-45. doi: 10.5664/jcsm.9478..
Keywords: Elderly, Medicare, Sleep Problems, Cardiovascular Conditions, Patient Adherence/Compliance, Hospitalization, Healthcare Utilization, Respiratory Conditions
Song Zhang, Zhang X, Patterson LJ
Racial and ethnic disparities in hospitalization outcomes among Medicare beneficiaries during the COVID-19 pandemic.
This study assessed assess racial and ethnic differences in hospitalization outcomes during the COVID-19 pandemic among Medicare beneficiaries. Medicare claims from the Social Security Administration was used to determine in-hospital mortality and mortality inclusive of discharges to hospice and discharges to postacute care. Over 31 million Medicare recipients in the database were analyzed with over 14 million hospitalizations from January 2019 to February 2021. There was a decline in non-COVID-19 and an emergence of COVID-19 hospitalizations among beneficiaries of different racial and ethnic minority groups through February 2021. In-hospital mortality was not significantly different among Black patients relative to White patients but was 3.5 percentage points higher among Hispanic patients and other racial and ethnic minority groups. There were disparities in discharges to hospice and postacute care as well.
AHRQ-funded; HS024072.
Citation: Song Zhang, Zhang X, Patterson LJ .
Racial and ethnic disparities in hospitalization outcomes among Medicare beneficiaries during the COVID-19 pandemic.
JAMA Health Forum 2021 Dec 23;2(12):e214223. doi: 10.1001/jamahealthforum.2021.4223..
Keywords: COVID-19, Racial and Ethnic Minorities, Disparities, Medicare, Hospitalization, Outcomes, Mortality
Williams D, Stout MJ, Rosenbloom JI
Preeclampsia predicts risk of hospitalization for heart failure with preserved ejection fraction.
Preeclampsia is associated with increased risk of future heart failure (HF), but the relationship between preeclampsia and HF subtypes are not well-established. The objective of this analysis was to identify the risk of HF with preserved ejection fraction (HFpEF) following a delivery complicated by preeclampsia/eclampsia. The investigators concluded that preeclampsia/eclampsia was an independent risk factor for future hospitalizations for HFpEF.
AHRQ-funded; HS019455.
Citation: Williams D, Stout MJ, Rosenbloom JI .
Preeclampsia predicts risk of hospitalization for heart failure with preserved ejection fraction.
J Am Coll Cardiol 2021 Dec 7;78(23):2281-90. doi: 10.1016/j.jacc.2021.09.1360..
Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Cardiovascular Conditions, Hospitalization, Risk, Labor and Delivery, Pregnancy, Women
Alrawashdeh M, Klompas M, Kimmel S
Epidemiology, outcomes, and trends of patients with sepsis and opioid-related hospitalizations in U.S. hospitals.
This study examined the epidemiology, outcomes, and trends of patients with sepsis and opioid-related hospitalizations in U.S. hospitals from January 2009 to September 2015. This retrospective cohort study looked at about 373 hospitals with a total of 6,715,286 hospitalizations. Using ICD-9 CM codes, 5.6% had sepsis, 1.9% had opioid-related hospitalizations, and 0.1% had both. Patients hospitalized with both diagnoses were younger and healthier, had more bloodstream infections from Gram-positive and fungal pathogens, and had lower in-hospital mortality rates. Of 1,803 patients with opioid-related hospitalizations who died in-hospital, 51.5% had sepsis. From 2009 to 2015, the proportion of sepsis hospitalizations that were opioid-related increased by 77%.
AHRQ-funded; HS025008.
Citation: Alrawashdeh M, Klompas M, Kimmel S .
Epidemiology, outcomes, and trends of patients with sepsis and opioid-related hospitalizations in U.S. hospitals.
Crit Care Med 2021 Dec;49(12):2102-11. doi: 10.1097/ccm.0000000000005141..
Keywords: Sepsis, Opioids, Hospitalization
Mueller SK, Shannon E, Dalal A
Patient and physician experience with interhospital transfer: a qualitative study.
This qualitative study explored patients’ and involved physicians’ experience with interhospital transfer (IHT) to understand specific factors that may impact the quality and safety of this care transition. Individual interviews were conducted with adult patients transferred to cardiology, general medicine, and oncology services at a tertiary care academic medical center, as well as their transferring physician, accepting attending physician, and accepting/admitting resident physician. Participants included 10 adults (6 cardiology, 2 medicine, and 2 oncology), 9 accepting attending physicians, 12 accepting and/or admitting resident physicians, and 5 transferring physicians. Emergent themes demonstrated that participants held a shared understanding for the reason for the transfer and relayed a general dissatisfaction regarding the timing and lack of advanced notification of transfer. The authors found distinct differences in IHT experience by stakeholder group - with physicians relaying discontent on intrahospital chains of communication and interhospital information exchange, and patient participants focused more readily on the physical aspects of IHT.
AHRQ-funded; HS023331.
Citation: Mueller SK, Shannon E, Dalal A .
Patient and physician experience with interhospital transfer: a qualitative study.
J Patient Saf 2021 Dec 1;17(8):e752-e57. doi: 10.1097/pts.0000000000000501..
Keywords: Transitions of Care, Hospitals, Hospitalization, Provider: Physician, Patient Experience
Tandan M, Zimmerman S, Sloane PD
Which nursing home residents with pneumonia are managed on-site and which are hospitalized? Results from 2 years' surveillance in 14 US homes.
Pneumonia is a frequent cause of hospitalization among nursing home (NH) residents, but little information is available as to how clinical presentation and other characteristics relate to hospitalization, and the differential use of antimicrobials based on hospitalization status. This study examined how hospitalized and nonhospitalized NH residents with pneumonia differ. The investigators concluded that respiratory rate was associated with hospitalization but was not documented for more than a quarter of residents.
AHRQ-funded; HS022298.
Citation: Tandan M, Zimmerman S, Sloane PD .
Which nursing home residents with pneumonia are managed on-site and which are hospitalized? Results from 2 years' surveillance in 14 US homes.
J Am Med Dir Assoc 2020 Dec;21(12):1862-68.e3. doi: 10.1016/j.jamda.2020.07.028..
Keywords: Elderly, Nursing Homes, Pneumonia, Respiratory Conditions, Hospitalization