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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 10 of 10 Research Studies DisplayedStevens JP, Hatfield LA, Nyweide DJ
Comparison of health outcomes among patients admitted on busy vs less busy days for hospitalists.
Increasingly, hospitalized patients are cared for by hospitalists. When caseloads are higher or patients require more acute care than usual, hospitalists may respond to their cognitive and time constraints by shifting diagnostic or procedural work to specialist colleagues, thereby delaying discharges or missing preventable safety events. This cohort study used Medicare claims data to analyze health outcomes of Medicare patients admitted to the hospital and being treated by hospitalists on busy vs less busy days.
AHRQ-funded; HS024288.
Citation: Stevens JP, Hatfield LA, Nyweide DJ .
Comparison of health outcomes among patients admitted on busy vs less busy days for hospitalists.
JAMA Netw Open 2022 Jan;5(1):e2144261. doi: 10.1001/jamanetworkopen.2021.44261..
Keywords: Outcomes, Emergency Department, Practice Patterns, Hospital Readmissions
Guo F, Lin YL, Raji M
Processes and outcomes of diabetes mellitus care by different types of team primary care models.
This study compared processes and outcomes of care provided to older patients with diabetes by primary care teams composed of only primary care physicians (PCPs) versus team care that included nurse practitioners (NPs) or physician assistants (PAs). The authors studied 3,524 primary care practices identified via social network analysis and 306,741 patients aged 66 and older diagnosed with diabetes mellitus in or before 2015 from Medicare data. Outcomes looked for was more adherence to guideline-recommended care including eye examination, hemoglobin A1c test, and nephropathy monitoring. Preventable hospitalizations and high-risk medication prescribing rates were also measured. Patients in the team care practices received more guideline-recommended diabetes care than patients in PCP only teams. Patients in team care practices had a slightly higher likelihood of being prescribed high-risk medications. The likelihood of preventable hospitalizations was similar among all types of practices.
AHRQ-funded; HS020642.
Citation: Guo F, Lin YL, Raji M .
Processes and outcomes of diabetes mellitus care by different types of team primary care models.
PLoS One 2020 Nov 5;15(11):e0241516. doi: 10.1371/journal.pone.0241516..
Keywords: Elderly, Teams, Primary Care: Models of Care, Healthcare Delivery, Outcomes, Care Coordination, Practice Patterns
Chopra V, Kaatz S, Swaminathan L
Variation in use and outcomes related to midline catheters: results from a multicentre pilot study.
This study examined complication rates from placement of midline vascular catheters. They have become more common in use recently. Complications were analyzed using medical records from hospitalized patients in 12 hospitals from January 2017 to February 2018. Most midline catheters were placed in general ward settings for difficult intravenous access. About half were removed within 5 days of insertion. Major or minor complications occurred in 10.3% of midlines with minor complications accounting for 71% of all adverse events. These minor complications included dislodgement, leaking, and infiltration. Major complications included occlusion, upper-extremity DVT and BSI. Use of midlines and outcomes varied widely across hospitals.
AHRQ-funded; HS025891.
Citation: Chopra V, Kaatz S, Swaminathan L .
Variation in use and outcomes related to midline catheters: results from a multicentre pilot study.
BMJ Qual Saf 2019 Sep;28(9):714-20. doi: 10.1136/bmjqs-2018-008554..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Infectious Diseases, Adverse Events, Practice Patterns, Outcomes, Hospitals
Durstenfeld MS, Katz SD, Park H
Mineralocorticoid receptor antagonist use after hospitalization of patients with heart failure and post-discharge outcomes: a single-center retrospective cohort study.
The purpose of this paper was to describe contemporary mineralocorticoid receptor antagonists (MRA) prescription for heart failure patients before and after the full scope of hospitalizations and the association between MRA discharge prescription and post-hospitalization outcomes. Results showed that, among hospitalized patients with heart failure with a reduced ejection fraction, 75% did not receive MRA before or after hospitalization, and nearly 90% of eligible patients did not have MRA initiated. These results suggest that hospitalization may represent an opportunity to initiate guideline-directed heart failure therapy.
AHRQ-funded; HS023683.
Citation: Durstenfeld MS, Katz SD, Park H .
Mineralocorticoid receptor antagonist use after hospitalization of patients with heart failure and post-discharge outcomes: a single-center retrospective cohort study.
BMC Cardiovasc Disord 2019 Aug 9;19(1):194. doi: 10.1186/s12872-019-1175-3..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Medication, Practice Patterns, Outcomes
Kim HS, Kaplan SH, McCarthy DM
A comparison of analgesic prescribing among ED back and neck pain visits receiving physical therapy versus usual care.
Researchers used a retrospective cohort study to examine whether physical therapy (PT) is associated with lower analgesic prescribing in the emergency department (ED) setting. They found that, in this single center study, ED back and neck pain visits receiving PT were no less likely to receive an opioid prescription and were more likely to receive a benzodiazepine than visits receiving usual care. They conclude that, although prior studies demonstrated that PT may reduce opioid utilization in the subsequent year, these results indicated that analgesic prescribing is not reduced at the initial ED encounter.
AHRQ-funded; HS023011.
Citation: Kim HS, Kaplan SH, McCarthy DM .
A comparison of analgesic prescribing among ED back and neck pain visits receiving physical therapy versus usual care.
Am J Emerg Med 2019 Jul;37(7):1322-26. doi: 10.1016/j.ajem.2018.10.009..
Keywords: Opioids, Medication, Practice Patterns, Emergency Department, Patient-Centered Outcomes Research, Pain, Back Health and Pain, Outcomes, Evidence-Based Practice
Schmidt B, Eapen RS, Cowan JE
Practice patterns of primary EBRT with and without ADT in prostate cancer treatment.
This study investigated usage of external-beam radiation therapy (EBRT), with or without neoadjuvant androgen deprivation therapy (ADT), using data from a community-based prospective disease registry (CaPSURE). Data on 1337 men diagnosed between 1990 and 2014 with localized disease who received EBRT as primary treatment was compared. The authors conclude that use of ADT in conjunction with primary EBRT has increased in frequency and duration since 1990, and that men who received ADT have higher risk characteristics than those who receive EBRT alone.
AHRQ-funded; HS019356.
Citation: Schmidt B, Eapen RS, Cowan JE .
Practice patterns of primary EBRT with and without ADT in prostate cancer treatment.
Prostate Cancer Prostatic Dis 2019 Mar;22(1):117-24. doi: 10.1038/s41391-018-0084-3..
Keywords: Cancer: Prostate Cancer, Cancer, Patient-Centered Outcomes Research, Practice Patterns, Evidence-Based Practice, Comparative Effectiveness, Outcomes, Treatments
Spatz ES, Wang Y, Beckman AL
Traditional Chinese medicine for acute myocardial infarction in western medicine hospitals in China.
This study examined the use of traditional Chinese medicine (TCM) in patients admitted for acute myocardial infarction (AMI) in China during the first 24 hours of hospitalization. The data came from the China Patient-centered Evaluative Assessment of Cardiac Events Retrospective Study of Acute Myocardial Infarction. A chart review was done of randomly sampled patients in 2001, 2006 and 2011 in 162 Western medicine hospitals across China. Nearly all (99%) hospitals used some form of TCM, with Salvia miltiorrhiza being the most commonly prescribed. This TCM treatment (and others) was used intravenously and use has increased over the span of the study, despite lack of evidence of benefit or harm.
AHRQ-funded; HS023000.
Citation: Spatz ES, Wang Y, Beckman AL .
Traditional Chinese medicine for acute myocardial infarction in western medicine hospitals in China.
Circ Cardiovasc Qual Outcomes 2018 Mar;11(3):e004190. doi: 10.1161/circoutcomes.117.004190..
Keywords: Adverse Events, Cardiovascular Conditions, Complementary and Alternative Medicine, Heart Disease and Health, Hospitals, Mortality, Outcomes, Patient-Centered Outcomes Research, Patient Safety, Practice Patterns, Risk
Mehta AB, Cooke CR, Wiener RS
Hospital variation in early tracheostomy in the United States: a population-based study.
The researchers determined between-hospital variation in early tracheostomy utilization and the association of early tracheostomy with patient outcomes using hierarchical regression. They concluded that early tracheostomy is potentially overused among mechanically ventilated trauma patients, with nearly half of tracheostomies performed within the first week of mechanical ventilation and large unexplained hospital variation, without clear benefits.
AHRQ-funded; HS020672.
Citation: Mehta AB, Cooke CR, Wiener RS .
Hospital variation in early tracheostomy in the United States: a population-based study.
Crit Care Med 2016 Aug;44(8):1506-14. doi: 10.1097/ccm.0000000000001674.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Practice Patterns, Respiratory Conditions, Respiratory Conditions, Outcomes
Chopra V, Smith S, Swaminathan L
Variations in peripherally inserted central catheter use and outcomes in Michigan hospitals.
The researchers examined the use of peripherally inserted central catheters (PICCs) by conducting a prospective study at 10 hospitals through the Michigan Hospital Medicine Safety Consortium. Their multicenter study found substantial variation in PICC indications, patterns of use, and outcomes at the 10 Michigan hospitals included in the study.
AHRQ-funded; HS022835.
Citation: Chopra V, Smith S, Swaminathan L .
Variations in peripherally inserted central catheter use and outcomes in Michigan hospitals.
JAMA Intern Med 2016 Apr;176(4):548-51. doi: 10.1001/jamainternmed.2015.8402.
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Keywords: Patient Safety, Practice Patterns, Healthcare-Associated Infections (HAIs), Hospitals, Outcomes, Adverse Events
Wang SY, Hall J, Pollack CE
Trends in end-of-life cancer care in the Medicare program.
The researchers sought to examine contemporary trends in end-of-life cancer care and geographic variation of end-of-life care aggressiveness among Medicare beneficiaries. They found that the proportion of beneficiaries receiving at least one potentially aggressive end-of-life intervention increased in repeated hospitalization, repeated ED visits, ICU admissions, and late hospice enrollment but declined in in-hospital death. End-of-life chemotherapy use did not change significantly over time. They concluded that despite growing focus on providing appropriate end-of-life care, there has not been an improvement in aggressive end-of-life cancer care in the Medicare program.
AHRQ-funded; HS023900.
Citation: Wang SY, Hall J, Pollack CE .
Trends in end-of-life cancer care in the Medicare program.
J Geriatr Oncol 2016 Mar;7(2):116-25. doi: 10.1016/j.jgo.2015.11.007.
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Keywords: Cancer, Care Management, Elderly, Medicare, Palliative Care, Outcomes, Patient-Centered Outcomes Research, Practice Patterns