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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 4 of 4 Research Studies DisplayedHoffman GJ, Alexander Nb, Ha J
Medicare's hospital readmission reduction program reduced fall-related health care use: an unexpected benefit?
This study’s objective was to assess whether the Medicare Hospital Readmissions Reduction Program (HRRP) was associated with a reduction in severe fall-related injuries (FRIs). The authors looked at secondary data from Medicare to assess changes in 30- and 90-day FRI readmissions before and after HRRP's announcement (April 2010) and implementation (October 2012) for conditions targeted by the HRRP (acute myocardial infarction [AMI], congestive heart failure [CHF], and pneumonia) versus "non-targeted" (gastrointestinal) conditions. They tested for modification by hospitals with "high-risk" before HRRP and accounted for potential upcoding. They also explored changes in 30-day FRI readmissions involving emergency department (ED) or outpatient care, care processes (length of stay, discharge destination, and primary care visit), and patient selection (age and comorbidities). They identified 1.5 million (522,596 pre-HRRP, 514,844 announcement, and 474,029 implementation period) index discharges. After its announcement, HRRP was associated with 12%-20% reductions in 30- and 90-day FRI readmissions for patients with CHF (-0.42 percentage points [ppt]) and AMI (-0.35). Two years after implementation, HRRP was associated with reductions in 90-day FRI readmission for AMI (-1.27 ppt) and CHF (-0.98 ppt) patients. After HRRP's announcement, decreases were observed in home health (AMI: -2.43 ppt; CHF: -8.83 ppt; pneumonia: -1.97 ppt) and skilled nursing facility referrals (AMI: -5.95 ppt; CHF: -3.19 ppt; pneumonia: -10.27 ppt).
AHRQ-funded; HS025838.
Citation: Hoffman GJ, Alexander Nb, Ha J .
Medicare's hospital readmission reduction program reduced fall-related health care use: an unexpected benefit?
Health Serv Res 2024 Feb; 59(1):e14246. doi: 10.1111/1475-6773.14246..
Keywords: Hospital Readmissions, Medicare, Falls
Hoffman GJ, Tinetti ME, Ha J
Prehospital and posthospital fall injuries in older US adults.
Investigators estimated the risk of older adult fall injury within and across discrete periods during a 12-month care episode anchored by an acute hospitalization using national data from 2006 to 2014. Participants in this cohort study included Medicare fee-for-service beneficiaries aged 65 and older from the Health and Retirement Study. The investigators found that an episode-based assessment of fall injury illustrated substantial variability in period-specific risks over an extended period including an anchor hospitalization. Risk transitions between periods included sizable increases just before hospitalization that do not fully subside after hospital discharge. Financial incentives to coordinate hospital and posthospital care for patients at risk for fall injury are needed.
AHRQ-funded; HS025838.
Citation: Hoffman GJ, Tinetti ME, Ha J .
Prehospital and posthospital fall injuries in older US adults.
JAMA Netw Open 2020 Aug 3;3(8):e2013243. doi: 10.1001/jamanetworkopen.2020.13243..
Keywords: Elderly, Falls, Injuries and Wounds, Risk, Hospitalization, Medicare
Randolph AC, Lin YL, Volpi E
Tricyclic antidepressant and/or gamma-aminobutyric acid-analog use is associated with fall risk in diabetic peripheral neuropathy.
This study invested whether tricyclic antidepressant and/or gamma-aminobutyric acid-analog (TCA/GABA) use is associated fall risk in older diabetic peripheral neuropathy (DPN) patients. A nationally representative 5% Medicare sample between the years 2008 and 2010 were used, and 5,550 patients with TCA/GABA prescriptions were compared to 22,200 patients without a TCA/GABA prescription. Patients were followed until there was an incidence of a fall or first incidence of a fracture during the follow-up period of up to 5 years. After covariate adjustment, there was a statistically significant increase in falls and fractures for patients using TCAs or GABA-analogs.
AHRQ-funded; HS020642.
Citation: Randolph AC, Lin YL, Volpi E .
Tricyclic antidepressant and/or gamma-aminobutyric acid-analog use is associated with fall risk in diabetic peripheral neuropathy.
J Am Geriatr Soc 2019 Jun;67(6):1174-81. doi: 10.1111/jgs.15779..
Keywords: Medication, Diabetes, Elderly, Falls, Injuries and Wounds, Medicare, Risk
Hoffman GJ, Hays RD, Shapiro MF
The costs of fall-related injuries among older adults: annual per-faller, service component, and patient out-of-pocket costs.
The researchers estimated expenditures for fall-related injuries (FRIs) among older Medicare beneficiaries. Estimated FRI expenditures were $9,389. Inpatient, physician/outpatient, skilled nursing facility, and home health comprised 31, 18, 39, and 12 percent of the total. OOP costs were $1,363. Expenditures for FRIs initially treated in inpatient/ED/outpatient settings were $21,424/$6,142/$8,622.
AHRQ-funded; HS000046.
Citation: Hoffman GJ, Hays RD, Shapiro MF .
The costs of fall-related injuries among older adults: annual per-faller, service component, and patient out-of-pocket costs.
Health Serv Res 2017 Oct;52(5):1794-816. doi: 10.1111/1475-6773.12554.
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Keywords: Elderly, Falls, Healthcare Costs, Medicare, Patient Safety