National Healthcare Quality and Disparities Report
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- Adverse Events (6)
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- Cardiovascular Conditions (4)
- Children/Adolescents (2)
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- Healthcare-Associated Infections (HAIs) (1)
- (-) Healthcare Cost and Utilization Project (HCUP) (29)
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- Pregnancy (5)
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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 29 Research Studies DisplayedInterrante JD, Tuttle MS, Admon LK
Severe maternal morbidity and mortality risk at the intersection of rurality, race and ethnicity, and Medicaid.
Using maternal discharge records from childbirth hospitalizations in the HCUP National Inpatient Sample, 2007-15, researchers examined differences in rates of severe maternal morbidity and mortality by rural or urban geography, race and ethnicity, and clinical factors among Medicaid-funded births and privately insured hospital births. The highest rate of severe maternal morbidity and mortality occurred among rural Indigenous Medicaid-funded births; births among Black rural and urban residents and among Hispanic urban residents also experienced elevated rates. The researchers concluded that heightened rates of severe maternal morbidity and mortality among Medicaid-funded births indicate an opportunity for state and federal policy responses to address the maternal health challenges faced by Medicaid beneficiaries, including Black, Indigenous, and rural residents
AHRQ-funded; HS027640.
Citation: Interrante JD, Tuttle MS, Admon LK .
Severe maternal morbidity and mortality risk at the intersection of rurality, race and ethnicity, and Medicaid.
Womens Health Issues 2022 Nov-Dec;32(6):540-49. doi: 10.1016/j.whi.2022.05.003..
Keywords: Healthcare Cost and Utilization Project (HCUP), Maternal Care, Women, Pregnancy, Mortality, Risk, Racial and Ethnic Minorities, Medicaid
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
Shaheen MS, Silverberg JI
Association of inflammatory skin diseases with venous thromboembolism in US adults.
Patients with certain inflammatory skin diseases have multiple risk factors for venous thromboembolism (VTE). The objective of the study was to determine whether atopic dermatitis (AD), psoriasis, pemphigus, pemphigoid and/or hidradenitis was associated with VTE in US adults. Data were analyzed from the 2002-2012 Nationwide Inpatient Sample, a representative cohort of US hospitalizations.
AHRQ-funded; HS023011.
Citation: Shaheen MS, Silverberg JI .
Association of inflammatory skin diseases with venous thromboembolism in US adults.
Arch Dermatol Res 2021 May;313(4):281-89. doi: 10.1007/s00403-020-02099-6..
Keywords: Healthcare Cost and Utilization Project (HCUP), Skin Conditions, Blood Clots, Risk
Wu SS, Bellantoni m, Weiner JP
Geriatric syndrome risk factors among hospitalized postacute Medicare patients.
The purpose of this study was to assess the association of geriatric syndrome risk factors with postacute utilization among hospitalized Medicare patients (both Medicare Advantage [MA] and fee-for-service [FFS] cohorts) and to examine patterns of postacute care for MA and FFS cohorts with high geriatric syndrome risk. The investigators found that geriatric syndrome risk factors not only play a role in postacute care and inpatient utilization in MA and FFS cohorts but also explain different utilizations between MA and FFS cohorts.
AHRQ-funded; HS000029.
Citation: Wu SS, Bellantoni m, Weiner JP .
Geriatric syndrome risk factors among hospitalized postacute Medicare patients.
Am J Manag Care 2020 Oct;26(10):e319-e26. doi: 10.37765/ajmc.2020.88505..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Medicare, Risk, Healthcare Utilization, Hospitalization
Dworsky JQ, Childers CP, Gornbein J
Hospital experience predicts outcomes after high-risk geriatric surgery.
This study examined if there an association between a hospital’s annual volume of high-risk geriatric surgery and their risk of inpatient mortality, postoperative length of stay, and discharge to nursing facility. Using the 2014 National Inpatient Sample, older adults were identified who had undergone high-risk geriatric surgery. There were an estimated 514,950 hospital encounters at 3,115 hospitals undergoing surgery. A higher proportion of high-risk geriatric surgery patients was associated with decreased mortality and shorter postoperative length of stay. Higher volume hospitals were not associated with mortality but was associated with longer length of stay and decreased discharge to nursing facilities.
AHRQ-funded; HS000046; HS025079.
Citation: Dworsky JQ, Childers CP, Gornbein J .
Hospital experience predicts outcomes after high-risk geriatric surgery.
Surgery 2020 Feb;167(2):468-74. doi: 10.1016/j.surg.2019.07.026..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Surgery, Risk, Hospitals, Outcomes, Mortality
Qi AC, Peacock K, Luke AA
Associations between social risk factors and surgical site infections after colectomy and abdominal hysterectomy.
The purpose of this study was to determine whether social risk factors, including race/ethnicity, insurance status, and neighborhood income, were associated with higher rates of surgical site infections (SSI) after colectomy or abdominal hysterectomy, 2 surgical procedures for which SSI rates are publicly reported and included in pay-for-performance programs by Medicare and other groups. The investigators report that inconsistent associations between social risk factors and SSIs were found.
AHRQ-funded; HS019455.
Citation: Qi AC, Peacock K, Luke AA .
Associations between social risk factors and surgical site infections after colectomy and abdominal hysterectomy.
JAMA Netw Open 2019 Oct 2;2(10):e1912339. doi: 10.1001/jamanetworkopen.2019.12339..
Keywords: Healthcare Cost and Utilization Project (HCUP), Risk, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Social Determinants of Health
Lewkowitz AK, Rosenbloom JI , Keller M
Association between severe maternal morbidity and psychiatric illness within 1 year of hospital discharge after delivery.
The purpose of this study was to estimate whether severe maternal morbidity is associated with increased risk of psychiatric illness in the year after delivery hospital discharge. Results showed that although absolute numbers were modest, severe maternal morbidity was associated with increased risk of severe postpartum psychiatric morbidity and substance use disorder. The highest period of risk extended to 4 months after hospital discharge.
AHRQ-funded; HS019455.
Citation: Lewkowitz AK, Rosenbloom JI , Keller M .
Association between severe maternal morbidity and psychiatric illness within 1 year of hospital discharge after delivery.
Obstet Gynecol 2019 Oct;134(4):695-707. doi: 10.1097/aog.0000000000003434..
Keywords: Healthcare Cost and Utilization Project (HCUP), Maternal Care, Pregnancy, Behavioral Health, Hospital Discharge, Risk, Women
Ren Z, Laumann AE, Silverberg JI
Association of dermatomyositis with systemic and opportunistic infections in the United States.
This study examined whether dermatomyositis is associated with opportunistic and antibiotic-resistant infections. Data was analyzed from the Nationwide Inpatient Sample from 2002 to 2012 with a cross-sectional representative 20% sample of all hospitalizations in the US. There was an association found with serious infections in adults and children, with more associated with adults. Infections were found in the skin, bone, joints, brain, heart, lungs, and gastrointestinal system. Predictors of infections included non-white race/ethnicity, insurance status, history of long-term corticosteroid usage, Cushing’s syndrome, diabetes and cancer. This in turn caused higher odds, costs, and inpatient mortality from these infections.
AHRQ-funded; HS023011.
Citation: Ren Z, Laumann AE, Silverberg JI .
Association of dermatomyositis with systemic and opportunistic infections in the United States.
Arch Dermatol Res 2019 Jul;311(5):377-87. doi: 10.1007/s00403-019-01913-0..
Keywords: Antibiotics, Healthcare Cost and Utilization Project (HCUP), Infectious Diseases, Risk, Skin Conditions
Brauer DG, Lyons SA, Keller MR
Simplified risk prediction indices do not accurately predict 30-day death or readmission after discharge following colorectal surgery.
This study examined the performance of widely used risk prediction indices to predict 30-day death or readmission after discharge following colorectal surgery. The study used a retrospective split-sample cohort of patients discharged after colorectal surgery from inpatient databases of HCUP for the states of New York, California, and Florida from 2006-2014. The commonly used risk prediction model LACE (length of stay, acute admissions, Charlson comorbidity index score, and emergency department visits) was compared with the real outcomes of death or readmission within 30 days after discharge with the cohort. Results showed a poor model fit with LACE and the researchers recommended a better model be developed.
AHRQ-funded; HS019455.
Citation: Brauer DG, Lyons SA, Keller MR .
Simplified risk prediction indices do not accurately predict 30-day death or readmission after discharge following colorectal surgery.
Surgery 2019 May;165(5):882-88. doi: 10.1016/j.surg.2018.12.007..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Surgery, Risk, Adverse Events, Outcomes
Vaidyanathan A, Saha S, Vicedo-Cabrera AM
AHRQ Author: Elixhauser A
Assessment of extreme heat and hospitalizations to inform early warning systems.
The purpose of this study was to conduct multistate analyses to explore associations between heat and all-cause and cause-specific hospitalizations, in order to inform the design and development of heat-health early warning systems. Researchers used a two-stage analysis to estimate heat-health risk relationships between heat index and hospitalizations, then used the results to identify heat index ranges that corresponded with a significant heat-attributable burden and compared these to National Weather Service (NWS) heat alert criteria used during the same time period. The study’s conclusions suggest that locally specific health evidence can inform and calibrate heat alert criteria.
AHRQ-authored.
Citation: Vaidyanathan A, Saha S, Vicedo-Cabrera AM .
Assessment of extreme heat and hospitalizations to inform early warning systems.
Proc Natl Acad Sci U S A 2019 Mar 19;116(12):5420-27. doi: 10.1073/pnas.1806393116..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Public Health, Risk
Lamplot JD, Bansal A, Nguyen JT
Risk of subsequent joint arthroplasty in contralateral or different joint after index shoulder, hip, or knee arthroplasty: association with index joint, demographics, and patient-specific factors.
The purpose of this study using HCUP data was to determine how demographic and other patient-specific factors are associated with the risk of subsequent joint replacement in the contralateral or a different joint following an index joint replacement for osteoarthritis. Results showed a relatively high risk of subsequent replacement of the contralateral joint and a relatively low risk of subsequent replacement of a different joint within 5 to 8 years after an index total hip arthroplasty, total knee arthroplasty, or total shoulder arthroplasty. Obesity was associated with a higher risk of subsequent replacement of the contralateral joint or a different joint.
AHRQ-funded; HS019455.
Citation: Lamplot JD, Bansal A, Nguyen JT .
Risk of subsequent joint arthroplasty in contralateral or different joint after index shoulder, hip, or knee arthroplasty: association with index joint, demographics, and patient-specific factors.
J Bone Joint Surg Am 2018 Oct 17;100(20):1750-56. doi: 10.2106/jbjs.17.00948..
Keywords: Arthritis, Healthcare Cost and Utilization Project (HCUP), Risk, Surgery, Orthopedics, Healthcare Utilization
Dworsky JQ, Childers CP, Maggard-Gibbons M
High-risk colorectal surgery: what are the outcomes for geriatric patients?
This study examines the national burden and age-specific outcomes of previously defined high-risk colorectal procedures (HRCP) in geriatric patients using the 2014 National Inpatient Sample. The authors found that outcomes after HRCP are worse for older patients and for nonelective cases. They suggest that this information can inform preoperative counseling and targeted quality improvement projects.
AHRQ-funded; HS000046.
Citation: Dworsky JQ, Childers CP, Maggard-Gibbons M .
High-risk colorectal surgery: what are the outcomes for geriatric patients?
Am Surg 2018 Oct;84(10):1650-54..
Keywords: Elderly, Healthcare Cost and Utilization Project (HCUP), Outcomes, Risk, Surgery
Hirayama A, Goto T, Shimada YJ
Acute exacerbation of chronic obstructive pulmonary disease and subsequent risk of emergency department visits and hospitalizations for atrial fibrillation.
Although emerging evidence has suggested the relationship of chronic obstructive pulmonary disease with atrial fibrillation (AF), little is known about whether acute exacerbation of chronic obstructive pulmonary disease (AECOPD) increases the risk of repeated AF-related healthcare utilization. The investigators found that among patients with existing AF, AECOPD was associated with a higher risk of AF-related ED visit or hospitalization in the first 90-day post-AECOPD period.
AHRQ-funded; HS023305.
Citation: Hirayama A, Goto T, Shimada YJ .
Acute exacerbation of chronic obstructive pulmonary disease and subsequent risk of emergency department visits and hospitalizations for atrial fibrillation.
Circ Arrhythm Electrophysiol 2018 Sep;11(9):e006322. doi: 10.1161/circep.118.006322..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Respiratory Conditions, Heart Disease and Health, Cardiovascular Conditions, Chronic Conditions, Hospitalization, Risk, Healthcare Utilization
Doupnik SK, Lawlor J, Zima BT
Mental health conditions and unplanned hospital readmissions in children.
Mental health conditions (MHCs) are prevalent among hospitalized children and could influence the success of hospital discharge. The objective of this retrospective cross-sectional study was to assess the relationship between MHCs and 30-day readmissions. The investigators concluded that MHCs were associated with a higher likelihood of hospital readmission in children admitted for medical conditions and procedures. They suggest that understanding the influence of MHCs on readmissions could guide strategic planning to reduce unplanned readmissions for children with co-occurring physical and mental health conditions.
AHRQ-funded; HS023292.
Citation: Doupnik SK, Lawlor J, Zima BT .
Mental health conditions and unplanned hospital readmissions in children.
J Hosp Med 2018 Jul;13(7):445-52. doi: 10.12788/jhm.2910..
Keywords: Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Hospital Discharge, Hospital Readmissions, Hospitalization, Risk, Young Adults
Silverberg JI, Kwa L, Kwa MC
Cardiovascular and cerebrovascular comorbidities of juvenile dermatomyositis in US children: an analysis of the National Inpatient Sample.
Juvenile dermatomyositis (JDM) is associated with multiple potential risk factors for cardiovascular disease, however, little is known about cardiovascular risk in JDM. This study sought to examine the association between JDM and cardiovascular risk factors and disease in US children. It concluded that there are significantly higher odds of cardiovascular and cerebrovascular comorbidities among inpatients with JDM, with adolescents, girls and racial/ethnic minorities being at highest risk.
AHRQ-funded; HS023011.
Citation: Silverberg JI, Kwa L, Kwa MC .
Cardiovascular and cerebrovascular comorbidities of juvenile dermatomyositis in US children: an analysis of the National Inpatient Sample.
Rheumatology 2018 Apr;57(4):694-702. doi: 10.1093/rheumatology/kex465..
Keywords: Cardiovascular Conditions, Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Patient-Centered Outcomes Research, Risk
Goto T, Tsugawa Y, Faridi MK
Reduced risk of acute exacerbation of COPD after bariatric surgery: a self-controlled case series study.
Little is known about the impact of weight reduction on chronic obstructive pulmonary disease (COPD)-related outcomes in patients who are obese. This study found that the risk of an ED visit or hospitalization for acute exacerbation of COPD substantially decreased after bariatric surgery in patients who are obese. This observation suggests the effectiveness of substantial weight reduction on COPD morbidity.
AHRQ-funded; HS023305.
Citation: Goto T, Tsugawa Y, Faridi MK .
Reduced risk of acute exacerbation of COPD after bariatric surgery: a self-controlled case series study.
Chest 2018 Mar;153(3):611-17. doi: 10.1016/j.chest.2017.07.003.
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Keywords: Respiratory Conditions, Healthcare Cost and Utilization Project (HCUP), Obesity, Risk, Surgery
Berry JG, Gay JC, Joynt Maddox K
Age trends in 30 day hospital readmissions: US national retrospective analysis.
This study assessed trends in and risk factors for readmission to hospital across the age continuum. It concluded that the likelihood of readmission was elevated for children transitioning to adulthood, children and younger adults with mental health disorders, and patients of all ages with multiple chronic conditions.
AHRQ-funded; HS023092.
Citation: Berry JG, Gay JC, Joynt Maddox K .
Age trends in 30 day hospital readmissions: US national retrospective analysis.
BMJ 2018 Feb 27;360:k497. doi: 10.1136/bmj.k497.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Risk
Kwa MC, Silverberg JI
Association between inflammatory skin disease and cardiovascular and cerebrovascular co-morbidities in US adults: analysis of Nationwide Inpatient Sample data.
The objective of this study was to determine whether these inflammatory skin diseases are associated with increased cardiovascular/cerebrovascular risk and/or disease. It concluded that atopic dermatitis or eczema (AD-E), pemphigus, bullous pemphigoid (BP), and hidradenitis were all associated with increased cardiovascular and cerebrovascular risk, especially at younger age.
AHRQ-funded; HS023011.
Citation: Kwa MC, Silverberg JI .
Association between inflammatory skin disease and cardiovascular and cerebrovascular co-morbidities in US adults: analysis of Nationwide Inpatient Sample data.
Am J Clin Dermatol 2017 Dec;18(6):813-23. doi: 10.1007/s40257-017-0293-x.
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Keywords: Cardiovascular Conditions, Healthcare Cost and Utilization Project (HCUP), Risk, Skin Conditions
Zenga J, Suko J, Kallogjeri D
Postoperative hemorrhage and hospital revisit after transoral robotic surgery.
The researchers investigated the incidence and complications related to postoperative hemorrhage (POH) after transoral robotic surgery (TORS). Using HCUP data, they found that the incidence of POH after TORS was low, and few of these patients had a severe complication related to this event. Medical comorbidity and tonsillar subsite may be independent risk factors for POH.
AHRQ-funded; HS019455.
Citation: Zenga J, Suko J, Kallogjeri D .
Postoperative hemorrhage and hospital revisit after transoral robotic surgery.
Laryngoscope 2017 Oct;127(10):2287-92. doi: 10.1002/lary.26626.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Adverse Events, Risk
Moore BJ, White S, Washington R
AHRQ Author: Elixhauser A
Identifying increased risk of readmission and in-hospital mortality using hospital administrative data: the AHRQ Elixhauser Comorbidity Index.
The researchers extended the literature on comorbidity measurement by developing 2 indices, based on the Elixhauser Comorbidity measures, designed to predict 2 frequently reported health outcomes: in-hospital mortality and 30-day readmission in administrative data. The index scores performed as well as using all 29 Elixhauser comorbidity variables separately.
AHRQ-authored; AHRQ-funded.
Citation: Moore BJ, White S, Washington R .
Identifying increased risk of readmission and in-hospital mortality using hospital administrative data: the AHRQ Elixhauser Comorbidity Index.
Med Care 2017 Jul;55(7):698-705. doi: 10.1097/mlr.0000000000000735.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Mortality, Risk
Jacobs BL, He C, Li BY
Variation in readmission expenditures after high-risk surgery.
The researchers sought to investigate readmission intensity as measured by readmission cost for high-risk surgeries and examine predictors of higher readmission costs. They found that the 30-day readmission rate was 16 percent for major chest and 22 percent for major abdominal surgery. Discharge to a skilled nursing facility was associated with higher readmission costs for both chest and abdominal surgeries.
AHRQ-funded; HS024403; HS023621.
Citation: Jacobs BL, He C, Li BY .
Variation in readmission expenditures after high-risk surgery.
J Surg Res 2017 Jun 1;213:60-68. doi: 10.1016/j.jss.2017.02.017.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Hospital Readmissions, Healthcare Costs, Risk
Graboyes EM, Kallogjeri D, Saeed MJ
30-day hospital readmission following otolaryngology surgery: analysis of a state inpatient database.
Researchers sought to determine patient and hospital-level risk factors associated with 30-day readmission for patients undergoing inpatient otolaryngologic surgery. Approximately one out of 12 patients undergoing otolaryngologic surgery had a 30-day readmission. Readmissions occur across a variety of types of procedures and hospitals. Most of the variability was driven by patient-specific factors, not structural hospital characteristics.
AHRQ-funded; HS019455.
Citation: Graboyes EM, Kallogjeri D, Saeed MJ .
30-day hospital readmission following otolaryngology surgery: analysis of a state inpatient database.
Laryngoscope 2017 Feb;127(2):337-45. doi: 10.1002/lary.25997.
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Keywords: Adverse Events, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Risk, Surgery
Bommarito KM, Gross GA, Willers DM
The effect of clinical chorioamnionitis on cesarean delivery in the United States.
This study examined the association of clinical chorioamnionitis on cesarean delivery in a national sample of hospital discharges. It found that women with clinical chorioamnionitis were more likely to have cesarean delivery than those without clinical chorioamnionitis. The risk of cesarean delivery varied significantly by hospital location, teaching status, and U.S. region.
AHRQ-funded; HS019455.
Citation: Bommarito KM, Gross GA, Willers DM .
The effect of clinical chorioamnionitis on cesarean delivery in the United States.
Health Serv Res 2016 Oct;51(5):1879-95. doi: 10.1111/1475-6773.12447.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Labor and Delivery, Pregnancy, Risk, Women
Hsu D, Brieva J, Silverberg JI
Costs of care for hospitalization for pemphigus in the United States.
The purpose of this study was to determine the incidence of and risk factors for hospitalization with pemphigus and cost of care. It concluded that there is a significant inpatient burden for pemphigus in the United States. Moreover, there appear to be racial/ethnic and health care disparities with respect to pemphigus, such that poor, nonwhite, and/or uninsured or underinsured patients have higher odds of hospitalization.
AHRQ-funded; HS023011.
Citation: Hsu D, Brieva J, Silverberg JI .
Costs of care for hospitalization for pemphigus in the United States.
JAMA Dermatol 2016 Jun;152(6):645-54. doi: 10.1001/jamadermatol.2015.5240..
Keywords: Healthcare Costs, Hospitalization, Disparities, Healthcare Cost and Utilization Project (HCUP), Risk
Hernandez-Boussard TM, McDonald KM, Morrison DE
Risks of adverse events in colorectal patients: population-based study.
The authors sought to assess adverse events in colorectal surgical patients. They found important differential rates of adverse events by diagnostic category, with the highest odds ratio occurring in patients undergoing surgery for ischemic colitis.
AHRQ-funded; HS018558.
Citation: Hernandez-Boussard TM, McDonald KM, Morrison DE .
Risks of adverse events in colorectal patients: population-based study.
J Surg Res 2016 May 15;202(2):328-34. doi: 10.1016/j.jss.2016.01.013.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Surgery, Patient Safety, Risk, Quality Indicators (QIs), Quality of Care, Quality Measures