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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 6 of 6 Research Studies DisplayedBrauer DG, Wu N, Keller MR
Care fragmentation and mortality in readmission after surgery for hepatopancreatobiliary and gastric cancer: a patient-level and hospital-level analysis of the Healthcare Cost and Utilization Project administrative database.
This study investigates patient-level and hospital-level variables associated with the mortality difference at referral centers and, postoperatively, outside hospitals, in patients undergoing hepatopancreatobiliary (HPB) and gastric oncologic surgeries. Using HCUP data, findings showed that, for readmissions following HPB and gastric oncologic surgery, travel distance and timing were major determinants of care fragmentation. However, these variables were not associated with mortality, nor was annual hospital surgical volume after risk-adjustment.
AHRQ-funded; HS019455.
Citation: Brauer DG, Wu N, Keller MR .
Care fragmentation and mortality in readmission after surgery for hepatopancreatobiliary and gastric cancer: a patient-level and hospital-level analysis of the Healthcare Cost and Utilization Project administrative database.
J Am Coll Surg 2021 Jun;232(6):921-32. doi: 10.1016/j.jamcollsurg.2021.03.017..
Keywords: Healthcare Cost and Utilization Project (HCUP), Cancer, Surgery, Hospital Readmissions, Mortality
Langston DM, Oslock WM, Paredes AZ
Hospital location and socioeconomic disadvantage of emergency general surgery patients.
This study’s purpose was to test the hypothesis that a hospital’s neighborhood disadvantage is associated with vulnerability of its emergency general surgery (EGS) patients. An area deprivation index (ADI), which is a neighborhood-level measure of disadvantage, and key characteristics of 724 hospitals in 14 states were linked to patient-level data in State Inpatient Databases. Hospitals in more disadvantaged areas disproportionately serve underserved EGS patient populations but are less likely to have robust resources for EGS care or train future EGS surgeons.
AHRQ-funded; HS022694.
Citation: Langston DM, Oslock WM, Paredes AZ .
Hospital location and socioeconomic disadvantage of emergency general surgery patients.
J Surg Res 2021 May;261:376-84. doi: 10.1016/j.jss.2020.12.028..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Social Determinants of Health, Vulnerable Populations, Critical Care
Dy CJ, Salter A, Barker A
Increased utilization of total joint arthroplasty after Medicaid expansion.
This study examined prior analyses that greater utilization of total hip arthroplasty (THA) and total knee arthroplasty (TKA) was to be expected after Medicaid expansion in 2014. Using 2012-2015 data from the HCUP Database, 9 expansion states (Arkansas, Arizona, Colorado, Iowa, Massachusetts, Maryland, Nevada, New York, and Vermont) were compared to 2 states that did not expand Medicaid (Florida and Missouri). After adjusting for community characteristics, THA and TKA increased 15% in 2014 and 23% in 2015 within expansion states compared to 2013. In non-expansion states, compared to 2013, there were significant decreases of 18% in 2014 and 11% in 2015.
AHRQ-funded; HS019455.
Citation: Dy CJ, Salter A, Barker A .
Increased utilization of total joint arthroplasty after Medicaid expansion.
J Bone Joint Surg Am 2021 Mar 17;103(6):524-31. doi: 10.2106/jbjs.20.00303..
Keywords: Healthcare Cost and Utilization Project (HCUP), Medicaid, Orthopedics, Surgery, Healthcare Utilization, Access to Care
Dworsky JQ, Shellito AD, Childers CP
Association of geriatric events with perioperative outcomes after elective inpatient surgery.
Researchers investigated the prevalence and association of geriatric events (GEs) with clinical outcomes after elective surgery. Using National Inpatient Sample data, they found that, compared to admissions with no GEs, one or more GEs were associated with higher probability of worse outcomes including mortality, postoperative complications, prolonged length of stay, and discharge to a skilled nursing facility. They recommended efforts focusing on mutable factors responsible for GEs in order to optimize surgical care for older adults.
AHRQ-funded; HS000046.
Citation: Dworsky JQ, Shellito AD, Childers CP .
Association of geriatric events with perioperative outcomes after elective inpatient surgery.
J Surg Res 2021 Mar;259:192-99. doi: 10.1016/j.jss.2020.11.011..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Surgery, Adverse Events, Outcomes
Fernandes-Taylor S, Yang DY, Schumacher J
Factors associated with Interhospital transfers of emergency general surgery patients from emergency departments.
This study looked at the factors contributing to transfer of emergency general surgery (EGS) patients to another hospital. Data from the AHRQ Nationwide Emergency Department Sample (NEDS) from 2010-2014 was analyzed. The transfer rate during that time was 1.9%. Patients with Medicare or other insurance had higher odds of transfer compared to patients with private health insurance. Odds of transfer increased with a greater number of comorbid conditions as well as resuscitation, intestinal obstruction, and conditions of the upper gastrointestinal tract. Transfers were more likely to originate from rural hospitals or Level I or II trauma centers.
AHRQ-funded; HS025224.
Citation: Fernandes-Taylor S, Yang DY, Schumacher J .
Factors associated with Interhospital transfers of emergency general surgery patients from emergency departments.
Am J Emerg Med 2021 Feb;40:83-88. doi: 10.1016/j.ajem.2020.12.012..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Emergency Department, Transitions of Care, Hospitals, Healthcare Delivery
Diaz A, Ricci KB, Rushing AP
Re-examining "never letting the sun rise or set on a bowel obstruction" in the era of acute care surgery.
This study looked at factors linked to emergency surgery practices for small bowel obstruction (SBO) as opposed to non-operative treatment. Data from adult SBO patients from 17 Statewide Inpatient Databases (SIDS) was linked to the authors’ 2015 survey on emergency general surgery (EGS) practices including queries on operating room (OR) availability and surgical staffing. Of the 32,422 SBO patients identified, 83% were treated non-operatively. Operative patients tended to be older, had more comorbidities (53% vs. 46% with 3 or greater), and experienced more systemic complications (36% vs. 23%), higher mortality (2.8% vs. 1.4%), and longer length of stay (median 10 vs. 4 days). Patients had higher odds of operation if they were treated at hospitals with surgeons sometimes or rarely/never covering EGS at more than one location compared to always.
AHRQ-funded; HS022694.
Citation: Diaz A, Ricci KB, Rushing AP .
Re-examining "never letting the sun rise or set on a bowel obstruction" in the era of acute care surgery.
J Gastrointest Surg 2021 Feb;25(2):512-22. doi: 10.1007/s11605-019-04496-3..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Digestive Disease and Health