National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (2)
- Care Coordination (1)
- Care Management (1)
- Dementia (1)
- Elderly (14)
- Falls (5)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Utilization (1)
- Hospitalization (1)
- Influenza (1)
- (-) Injuries and Wounds (17)
- Long-Term Care (11)
- Medicare (1)
- Medication (6)
- Medication: Safety (2)
- Mortality (1)
- Neurological Disorders (1)
- (-) Nursing Homes (17)
- Obesity (1)
- Opioids (1)
- Outcomes (2)
- Pain (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (2)
- Patient Safety (7)
- Public Reporting (1)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (1)
- Risk (3)
- Surgery (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 17 of 17 Research Studies DisplayedOrtiz D, Meagher AD, Lindroth H
A trauma medical home, evaluating collaborative care for the older injured patient: study protocol for a randomized controlled trial.
It is estimated that 55 million adults will be 65 years and older in the USA by 2020. These older adults are at increased risk for injury and their recovery is multi-faceted. A collaborative care model may improve psychological and functional outcomes of the non-neurologically impaired older trauma patient and reduce health care costs. The investigators discussed the proposed study protocol which would evaluate a collaborative care model to help maximize psychological and functional recovery for non-neurologically injured older patients at four level one trauma centers in the Midwest.
AHRQ-funded; HS026390.
Citation: Ortiz D, Meagher AD, Lindroth H .
A trauma medical home, evaluating collaborative care for the older injured patient: study protocol for a randomized controlled trial.
Trials 2020 Jul 16;21(1):655. doi: 10.1186/s13063-020-04582-x..
Keywords: Elderly, Patient-Centered Healthcare, Injuries and Wounds, Care Coordination, Nursing Homes, Care Management
Sanghavi P, Pan S, Caudry D
Assessment of nursing home reporting of major injury falls for quality measurement on Nursing Home Compare.
The purpose of this study was to assess the accuracy of nursing home self-report of major injury falls on the Minimum Data Set (MDS). They linked inpatient claims for major injury falls with MDS assessments. The investigators concluded that the nursing home-reported data used for the Nursing Home Compare (NHC) falls measure may be highly inaccurate.
AHRQ-funded; HS026957.
Citation: Sanghavi P, Pan S, Caudry D .
Assessment of nursing home reporting of major injury falls for quality measurement on Nursing Home Compare.
Health Serv Res 2020 Apr;55(2):201-10. doi: 10.1111/1475-6773.13247..
Keywords: Falls, Nursing Homes, Quality Measures, Quality Indicators (QIs), Quality of Care, Elderly, Public Reporting, Injuries and Wounds
Berry SD, Zullo AR, Zhang T
Validation of the FRAiL model to predict non-vertebral and hip fractures in nursing home residents.
This study created a tool to assess non-vertebral and hip fracture risk in long-term nursing home (NH) residents called FRAiL (Fracture Risk Assessment in Long term care). The objective of this retrospective cohort study was to assess the performance of the model to predict 2-year risk of fractures in a separate large cohort of NH residents. The study included most long-stay NH residents in the United States (n = 896,840). Fractures were identified using Medicare claims. The mean age of NH residents was 83.8 years and 70.7% were women. Over the 2-year follow-up period 4.6% were hospitalized with non-vertebral fractures, the majority being hip fractures. In the fully adjusted model, 14 out of 15 model characteristics remained significant predictors of non-vertebral fractures. Female sex, wandering, and falls were strongly associated with non-vertebral fractures.
AHRQ-funded; HS022998.
Citation: Berry SD, Zullo AR, Zhang T .
Validation of the FRAiL model to predict non-vertebral and hip fractures in nursing home residents.
Bone 2019 Nov;128:115050. doi: 10.1016/j.bone.2019.115050..
Keywords: Elderly, Nursing Homes, Long-Term Care, Injuries and Wounds
Zhang T, Lary CW, Zullo AR
Post-hip fracture mortality in nursing home residents by obesity status.
This research letter discusses a study that examined whether obesity status affected mortality in post-hip fracture patients who were nursing home residents. A national cohort of nursing home (NH) residents was examined from national Medicare fee-for-service claims linked to the Minimum Data Set (MDS) from January 2008 through the end of 2009. A total of 33, 622 long-stay residents were identified who had been hospitalized for a hip fracture. They excluded 6918 patients due to a number of factors. They classified residents based on their BMI: normal BMI, overweight, mild obesity, or moderate/severe obesity. They found that being moderate/severely obese did not increase mortality.
AHRQ-funded; HS022998.
Citation: Zhang T, Lary CW, Zullo AR .
Post-hip fracture mortality in nursing home residents by obesity status.
J Am Geriatr Soc 2019 Sep;67(9):1983-85. doi: 10.1111/jgs.16028..
Keywords: Injuries and Wounds, Surgery, Nursing Homes, Obesity, Mortality, Elderly, Long-Term Care, Patient-Centered Outcomes Research
Libertucci J, Bassis CM, Cassone M
Bacteria detected in both urine and open wounds in nursing home residents: a pilot study.
Researchers sought to determine if bacterial species colonizing open wounds are also found in the urine. Their pilot study of nursing home residents provided evidence that bacterial species identified within the urine can also be identified in open wounds in the same patient at one point in time. They recommended further studies to investigate if these species are of the same lineage and if the urinary microbiota are able to seed colonization of open wounds below the umbilicus.
AHRQ-funded; HS019767.
Citation: Libertucci J, Bassis CM, Cassone M .
Bacteria detected in both urine and open wounds in nursing home residents: a pilot study.
mSphere 2019 Aug 28;4(4). doi: 10.1128/mSphere.00463-19..
Keywords: Elderly, Nursing Homes, Long-Term Care, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Patient Safety
Aspinall SL, Springer SP, Zhao X
Central nervous system medication burden and risk of recurrent serious falls and hip fractures in Veterans Affairs nursing home residents.
This study investigated the association between taking central nervous system (CNS) medications with the risk of serious falls and hip fractures. Study participants were residents at a Veterans Health Administration (VHA) Community Living Center (CLC) between July 1, 2005 and June 30, 2009. This was a nested case-control study. The investigators concluded that there was a higher risk in those residents receiving 3.0 or more daily CNS medications.
AHRQ-funded; HS023779.
Citation: Aspinall SL, Springer SP, Zhao X .
Central nervous system medication burden and risk of recurrent serious falls and hip fractures in Veterans Affairs nursing home residents.
J Am Geriatr Soc 2019 Jan;67(1):74-80. doi: 10.1111/jgs.15603..
Keywords: Elderly, Falls, Injuries and Wounds, Long-Term Care, Medication, Nursing Homes, Patient Safety, Risk
McConeghy KW, Lee Y, Zullo AR
Influenza illness and hip fracture hospitalizations in nursing home residents: are they related?
In this retrospective cohort study, the investigators evaluated the association between influenza and hip fracture hospitalizations in long-stay (LS) nursing home (NH) residents. The study authors found that influenza like illness (ILI) hospitalizations were associated with a 13% average increase in hip fracture hospitalization risk. In a given NH week, an increase in the number ILI hospitalizations from none to two was associated with an approximate one percentage point increase in hip fracture hospitalization risk.
AHRQ-funded; HS022998.
Citation: McConeghy KW, Lee Y, Zullo AR .
Influenza illness and hip fracture hospitalizations in nursing home residents: are they related?
J Gerontol A Biol Sci Med Sci 2018 Nov 10;73(12):1638-42. doi: 10.1093/gerona/glx200..
Keywords: Elderly, Injuries and Wounds, Hospitalization, Influenza, Long-Term Care, Nursing Homes
Berry SD, Zullo AR, Lee Y
Fracture Risk Assessment in Long-term Care (FRAiL): development and validation of a prediction model.
This paper’s objective was to develop and validate a model, Fracture Risk Assessment in Long-term Care (FRAiL) to predict the 2-year risk of hip fracture in nursing home (NH) residents using readily available clinical characteristics. The FRAiL model was developed specifically to identify NH residents at greatest risk for hip fracture, and results identified a different pattern of risk factors compared with community models. This practical model could be used to screen NH residents for fracture risk and to target intervention strategies.
AHRQ-funded; HS022998.
Citation: Berry SD, Zullo AR, Lee Y .
Fracture Risk Assessment in Long-term Care (FRAiL): development and validation of a prediction model.
J Gerontol A Biol Sci Med Sci 2018 May 9;73(6):763-69. doi: 10.1093/gerona/glx147.
.
.
Keywords: Elderly, Injuries and Wounds, Long-Term Care, Nursing Homes, Risk
Dore DD, Zullo AR, Mor V
Age, sex, and dose effects of nonbenzodiazepine hypnotics on hip fracture in nursing home residents.
This study examined the rate of hip fracture in nursing home residents prescribed nonbenzodiazepine hypnotics. A sample of nursing home residents was used and linked to Medicare and Minimum Data Set (2007-2008) data. The rate of hip fracture was higher in residents aged 90 and above, and lower in residents 70 or below. There was no different by sex.
AHRQ-funded; HS022998.
Citation: Dore DD, Zullo AR, Mor V .
Age, sex, and dose effects of nonbenzodiazepine hypnotics on hip fracture in nursing home residents.
J Am Med Dir Assoc 2018 Apr;19(4):328-32.e2. doi: 10.1016/j.jamda.2017.09.015..
Keywords: Injuries and Wounds, Medication, Nursing Homes, Long-Term Care, Adverse Drug Events (ADE), Adverse Events, Falls, Risk, Patient Safety
Zullo AR, Zhang T, Banerjee G
Facility and state variation in hip fracture in U.S. nursing home residents.
The purpose of this study was to quantify the variation in hip fracture incidence across U.S. nursing home (NH) facilities and states and examine how hip fracture incidence varies according to facility- and state-level characteristics. The investigators concluded that much of the variation in hip fracture incidence remained unexplained. They suggested that their findings indicated that potentially modifiable state and facility characteristics such as psychoactive drug prescribing and minimum staffing requirements could be addressed to help reduce the rate of hip fracture in U.S. NHs.
AHRQ-funded; HS022998.
Citation: Zullo AR, Zhang T, Banerjee G .
Facility and state variation in hip fracture in U.S. nursing home residents.
J Am Geriatr Soc 2018 Mar;66(3):539-45. doi: 10.1111/jgs.15264..
Keywords: Elderly, Injuries and Wounds, Long-Term Care, Nursing Homes, Patient Safety
Zullo AR, Zhang T, Beudoin FL
Pain treatments after hip fracture among older nursing home residents.
In this retrospective cohort study the investigators examined the association between use of opioids versus other analgesics with death and functioning after hip fracture in older nursing home (NH) residents. The investigators concluded that a rigorous study addressing the limitations of their study is critical to validate their preliminary findings and provide evidence about the effect of using opioid versus nonopioid analgesics to optimize acute pain in NH residents with a hip fracture.
AHRQ-funded; HS022998.
Citation: Zullo AR, Zhang T, Beudoin FL .
Pain treatments after hip fracture among older nursing home residents.
J Am Med Dir Assoc 2018 Feb;19(2):174-76. doi: 10.1016/j.jamda.2017.11.008..
Keywords: Opioids, Pain, Nursing Homes, Long-Term Care, Elderly, Medication, Injuries and Wounds, Patient-Centered Outcomes Research, Healthcare Utilization
Berry SD, Lee Y, Zullo AR
Incidence of hip fracture in U.S. nursing homes.
The researchers described the incidence rate (IR) of hip fracture according to age, sex, and race in a nationwide sample of long-stay nursing home residents. They found that the mean age was 84 years, 74.5% were women, 83.9% were white, and 12.0% were black. The overall IR of hip fracture was 2.3/100 person years, which was similar in men and women across age groups. The IR of hip fracture was highest in Native Americans aged 85 years or older, in whites, and during the first 100 days of institutionalization, while the.IRs of hip fracture were lowest in blacks.
AHRQ-funded; HS022998.
Citation: Berry SD, Lee Y, Zullo AR .
Incidence of hip fracture in U.S. nursing homes.
J Gerontol A Biol Sci Med Sci 2016 Sep;71(9):1230-4. doi: 10.1093/gerona/glw034.
.
.
Keywords: Elderly, Injuries and Wounds, Long-Term Care, Nursing Homes, Racial and Ethnic Minorities
Bali V, Chatterjee S, Johnson ML
Comparative risk of hip fractures in elderly nursing home patients with depression using paroxetine and other selective serotonin reuptake inhibitors.
The researchers evaluated comparative safety of paroxetine and other selective serotonin reuptake inhibitors (SSRIs) for the risk of hip fractures. They found no differential risk of hip fractures between paroxetine and other SSRIs.
AHRQ-funded; HS021264.
Citation: Bali V, Chatterjee S, Johnson ML .
Comparative risk of hip fractures in elderly nursing home patients with depression using paroxetine and other selective serotonin reuptake inhibitors.
J Comp Eff Res 2016 Aug;5(5):461-73. doi: 10.2217/cer-2016-0009.
.
.
Keywords: Medication, Elderly, Injuries and Wounds, Nursing Homes, Patient Safety
Jung HY, Trivedi AN, Grabowski DC
Does more therapy in skilled nursing facilities lead to better outcomes in patients with hip fracture?
The study objectives were: (1) to examine temporal trends in therapy hour volumes and (2) to evaluate whether more therapy hours are associated with improved patient outcomes. It concluded that increases in the quantity of therapy during the study period cannot be explained by changes in case mix at skilled nursing facility (SNF) admission.
AHRQ-funded; HS020756.
Citation: Jung HY, Trivedi AN, Grabowski DC .
Does more therapy in skilled nursing facilities lead to better outcomes in patients with hip fracture?
Phys Ther 2016 Jan;96(1):81-9. doi: 10.2522/ptj.20150090.
.
.
Keywords: Outcomes, Injuries and Wounds, Medicare, Nursing Homes
Leland NE, Gozalo P, Bynum J
What happens to patients when they fracture their hip during a skilled nursing facility stay?
This study characterized outcomes of patients experiencing a fall and subsequent hip fracture while in a nursing home receiving skilled nursing facility (SNF) services. In the first 90 days following hospitalization for surgical repair of the hip fracture, 24.1 percent of patients died, 7.3 percent were discharged to the community but remained fewer than 30 days, and 14.0 percent achieved successful community discharge.
AHRQ-funded; HS000011.
Citation: Leland NE, Gozalo P, Bynum J .
What happens to patients when they fracture their hip during a skilled nursing facility stay?
J Am Med Dir Assoc 2015 Sep;16(9):767-74. doi: 10.1016/j.jamda.2015.03.026..
Keywords: Nursing Homes, Falls, Injuries and Wounds, Outcomes
Aspinall SL, Zhao X, Semia TP
Epidemiology of drug-disease interactions in older veteran nursing home residents.
The objective of this study was to assess the prevalence of and factors associated with potentially inappropriate drug– disease combinations according to the AGS 2012 Beers criteria that are clinically important in elderly adults residing in Veterans Affairs Community Living Centers. It found that drug-disease interactions were common in older residents with dementia or cognitive impairment or a history of falls or hip fracture.
AHRQ-funded; HS018721.
Citation: Aspinall SL, Zhao X, Semia TP .
Epidemiology of drug-disease interactions in older veteran nursing home residents.
J Am Geriatr Soc 2015 Jan;63(1):77-84. doi: 10.1111/jgs.13197..
Keywords: Adverse Drug Events (ADE), Adverse Events, Dementia, Elderly, Falls, Injuries and Wounds, Medication, Medication: Safety, Neurological Disorders, Nursing Homes, Patient Safety
Moga DC, Carnahan RM, Lund BC
Risks and benefits of bladder antimuscarinics among elderly residents of Veterans Affairs Community Living Centers.
This study evaluated the risks and benefits of drugs to reduce urinary incontinence that were used by elderly VA nursing home residents. It found that the use of these drugs, known as bladder antimuscarinics, resulted in improved continence rates and better social engagement but also led to a higher risk of fractures in new users.
AHRQ-funded; HS016094
Citation: Moga DC, Carnahan RM, Lund BC .
Risks and benefits of bladder antimuscarinics among elderly residents of Veterans Affairs Community Living Centers.
J Am Med Dir Assoc. 2013 Oct;14(10):749-60. doi: 10.1016/j.jamda.2013.03.008..
Keywords: Elderly, Medication, Medication: Safety, Nursing Homes, Long-Term Care, Injuries and Wounds, Patient Safety