National Healthcare Quality and Disparities Report
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Topics
- Asthma (1)
- Cardiovascular Conditions (2)
- Caregiving (1)
- Children/Adolescents (2)
- (-) Chronic Conditions (16)
- Diabetes (2)
- Disparities (1)
- Elderly (1)
- Emergency Department (1)
- Healthcare Cost and Utilization Project (HCUP) (4)
- Health Information Technology (HIT) (1)
- Heart Disease and Health (2)
- Home Healthcare (2)
- Hospital Discharge (1)
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- (-) Hospital Readmissions (16)
- Hospitals (6)
- Kidney Disease and Health (1)
- Long-Term Care (1)
- Medicaid (1)
- Medicare (2)
- Mortality (1)
- Neurological Disorders (1)
- Nursing Homes (1)
- Patient and Family Engagement (1)
- Pneumonia (1)
- Quality Improvement (1)
- Quality of Care (2)
- Racial and Ethnic Minorities (2)
- Respiratory Conditions (6)
- Sleep Problems (1)
- Social Determinants of Health (1)
- Surgery (1)
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 16 of 16 Research Studies DisplayedRojas JC, Chokkara S, Zhu M
Care quality for patients with chronic obstructive pulmonary disease in the readmission penalty era.
The purpose of this study was to assess changes in the quality of care for patients hospitalized for Chronic obstructive pulmonary disease (COPD) after the implementation of the Hospital Readmissions Reduction Program (HRRP) which levied financial penalties on hospitals for excessive COPD readmissions. The researchers reviewed the records from 995 U.S. hospitals in the Premier Healthcare Database, evaluating patients older than 40 years of age hospitalized for COPD. The study included 662,842 pre-HRRP (January 2010-September 2014) and 285,508 post-HRRP (October 2014-December 2018) admissions, and found that recommended care increased at a rate of 0.16% per month pre-HRRP and 0.01% per month post-HRRP. Nonrecommended care decreased at a rate of 0.15% per month pre-HRRP and 0.13% per month post-HRRP. Ideal care increased at a rate of 0.24% per month pre-HRRP and 0.11% per month post-HRRP. The researchers concluded that after HRRP implementation, the pre-HRRP trends toward improving care quality for inpatient COPD care slowed.
AHRQ-funded; HS027804.
Citation: Rojas JC, Chokkara S, Zhu M .
Care quality for patients with chronic obstructive pulmonary disease in the readmission penalty era.
Am J Respir Crit Care Med 2023 Jan; 207(1):29-37. doi: 10.1164/rccm.202203-0496OC..
Keywords: Respiratory Conditions, Quality of Care, Hospital Readmissions, Chronic Conditions
Hirayama A, Goto T, Faridi MK
Association of obstructive sleep apnea with all-cause readmissions after hospitalization for asthma exacerbation in adults aged 18-54 years: a population-based study, 2010-2013.
The authors sought to investigate associations between obstructive sleep apnea (OSA) and readmission risk after hospitalization for asthma exacerbation using data from State Inpatient Databases from seven U.S. states. They found that, overall, OSA was associated with a significantly higher incident rate of all-cause readmission. Additionally, OSA was associated with higher incident rates of readmissions for five major diseases: asthma, COPD, respiratory failure, pneumonia, and congestive heart failure, compared to non-OSA.
AHRQ-funded; HS023305.
Citation: Hirayama A, Goto T, Faridi MK .
Association of obstructive sleep apnea with all-cause readmissions after hospitalization for asthma exacerbation in adults aged 18-54 years: a population-based study, 2010-2013.
J Asthma 2021 Sep;58(9):1176-85. doi: 10.1080/02770903.2020.1781887..
Keywords: Healthcare Cost and Utilization Project (HCUP), Sleep Problems, Hospital Readmissions, Asthma, Respiratory Conditions, Chronic Conditions
Smith JM, Lin H, Thomas-Hawkins C
Timing of home health care initiation and 30-day rehospitalizations among Medicare beneficiaries with diabetes by race and ethnicity.
Older adults with diabetes are at elevated risk of complications following hospitalization. Home health care services mitigate the risk of adverse events and facilitate a safe transition home. In the United States, when home health care services are prescribed, federal guidelines require they begin within two days of hospital discharge. This study examined the association between timing of home health care initiation and 30-day rehospitalization outcomes in a cohort of 786,734 Medicare beneficiaries following a diabetes-related index hospitalization admission during 2015.
AHRQ-funded; HS022406.
Citation: Smith JM, Lin H, Thomas-Hawkins C .
Timing of home health care initiation and 30-day rehospitalizations among Medicare beneficiaries with diabetes by race and ethnicity.
Int J Environ Res Public Health 2021 May 25;18(11). doi: 10.3390/ijerph18115623..
Keywords: Elderly, Home Healthcare, Hospital Readmissions, Medicare, Diabetes, Chronic Conditions, Racial and Ethnic Minorities
Puebla Neira DA, Hsu ES, Kuo YF
Readmissions reduction program: mortality and readmissions for chronic obstructive pulmonary disease.
Implementation of the Hospital Readmissions Reduction Program (HRRP) following discharge of patients with chronic obstructive pulmonary disease (COPD) has led to a reduction in 30-day readmissions with unknown effects on postdischarge mortality. The objective of this retrospective cohort study was to examine the association of HRRP with 30-day hospital readmission and 30-day postdischarge mortality rate in patients after discharge from COPD hospitalization.
AHRQ-funded; HS020642.
Citation: Puebla Neira DA, Hsu ES, Kuo YF .
Readmissions reduction program: mortality and readmissions for chronic obstructive pulmonary disease.
Am J Respir Crit Care Med 2021 Feb 15;203(4):437-46. doi: 10.1164/rccm.202002-0310OC..
Keywords: Hospital Readmissions, Respiratory Conditions, Chronic Conditions, Mortality, Hospital Discharge, Hospitalization
Berry JG, Difazio RL, Melvin P
Hospital resource use after hip reconstruction surgery in children with neurological complex chronic conditions.
This study assessed how co-occurring conditions influence recovery after hip reconstruction surgery in children with neurological complex chronic conditions (CCCs). This retrospective analysis of 4058 children age 4 years or older was conducted from 2015 to 2018 in 49 children’s hospitals. The presence of CCCs was assessed using the AHRQ Chronic Condition Indicator system. Outcomes looked for included postoperative hospital length of stay (LOS), 30 -day readmission rates, and median hospital costs. The most common co-occurring conditions were digestive (60.1%) and respiratory (37.9%). Median LOS increased 67% as co-existing conditions increased from one to four or more. Median hospital costs increased 41% and readmission rates increased 250%. Malnutrition was associated with the greatest increase in postoperative hospital use.
AHRQ-funded; HS024453.
Citation: Berry JG, Difazio RL, Melvin P .
Hospital resource use after hip reconstruction surgery in children with neurological complex chronic conditions.
Dev Med Child Neurol 2021 Feb;63(2):204-10. doi: 10.1111/dmcn.14712..
Keywords: Children/Adolescents, Chronic Conditions, Surgery, Hospital Readmissions, Hospitals, Neurological Disorders
Rodríguez HP, Fulton BD, Phillips AZ
The early impact of the Centers for Medicare & Medicaid Services State Innovation Models Initiative on 30-day hospital readmissions among adults with diabetes.
The Centers for Medicare & Medicaid Services (CMS) State Innovation Models (SIM) Initiative funds states to accelerate delivery system and payment reforms. All SIM states focus on improving diabetes care, but SIM's effect on 30-day readmissions among adults with diabetes remains unclear. In this study, the investigators found no evidence that SIM reduced 30-day readmission rates among adults with diabetes during the first 2 years of round 1 implementation, even among CMS beneficiaries.
AHRQ-funded; HS022241.
Citation: Rodríguez HP, Fulton BD, Phillips AZ .
The early impact of the Centers for Medicare & Medicaid Services State Innovation Models Initiative on 30-day hospital readmissions among adults with diabetes.
Med Care 2020 Jun;58(6 Suppl 1):S22-s30. doi: 10.1097/mlr.0000000000001276..
Keywords: Diabetes, Chronic Conditions, Hospital Readmissions, Quality Improvement, Quality of Care
Goto T, Yoshida K, Faridi MK
Contribution of social factors to readmissions within 30 days after hospitalization for COPD exacerbation.
This study examined whether adding social factors improved the predictive ability for 30-day hospital readmissions for COPD. Social factors include educational level and marital status. Out of 905 hospitalizations identified in the Medicare Current Beneficiary Survey from 2006 through 2012, 18.5% were readmitted within 30 days. The optimized model including social factors for prediction improved for early readmissions but not for late readmissions.
AHRQ-funded; HS023305.
Citation: Goto T, Yoshida K, Faridi MK .
Contribution of social factors to readmissions within 30 days after hospitalization for COPD exacerbation.
BMC Pulm Med 2020 Apr 29;20(1):107. doi: 10.1186/s12890-020-1136-8..
Keywords: Respiratory Conditions, Hospital Readmissions, Hospitalization, Social Determinants of Health, Chronic Conditions
Hirayama A, Goto T, Hasegawa K
Association of acute kidney injury with readmissions after hospitalization for acute exacerbation of chronic obstructive pulmonary disease: a population-based study.
This study examined the association between acute kidney injury (AKI) and readmission with hospitalization for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Retrospective, population-based cohort data was used from the HCUP State Inpatient Databases from seven states (Arkansas, California, Florida, Iowa, Nebraska, New York, and Utah) from 2010 through 2013. A total of 356,990 patients were identified as hospitalized for AECOPD. Median age was 71 years and 41.9% were male. Of those 7% had a concurrent diagnosis of AKI. Patients with AKI were found to have a significantly higher risk of 30-day all-cause readmission compared to those without AKI as well as a significantly higher risk of 90-day all-cause readmission, particularly for non-respiratory reasons. These reasons included sepsis, acute renal failure, and congestive heart failure.
AHRQ-funded; HS023305.
Citation: Hirayama A, Goto T, Hasegawa K .
Association of acute kidney injury with readmissions after hospitalization for acute exacerbation of chronic obstructive pulmonary disease: a population-based study.
BMC Nephrol 2020 Apr 3;21(1):116. doi: 10.1186/s12882-020-01780-2..
Keywords: Healthcare Cost and Utilization Project (HCUP), Respiratory Conditions, Chronic Conditions, Hospital Readmissions, Hospitalization, Kidney Disease and Health
Chen J, Sadasivam R, Blok AC
The association between patient-reported clinical factors and 30-day acute care utilization in chronic heart failure.
The purpose of this study was to identify post-discharge patient-reported clinical factors associated with repeat acute care use. Through phone surveys with patients with chronic heart failure, findings indicated that patient-reported poor health status, pain, and poor appetite were positively associated with 30-day acute care utilization. Recommendations included further study before incorporation into risk prediction to drive quality improvement efforts.
AHRQ-funded; HS017786.
Citation: Chen J, Sadasivam R, Blok AC .
The association between patient-reported clinical factors and 30-day acute care utilization in chronic heart failure.
Med Care 2020 Apr;58(4):336-43. doi: 10.1097/mlr.0000000000001258..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Hospital Readmissions, Emergency Department, Chronic Conditions
Myers LC, Faridi MK, Hasegawa K
The hospital readmissions reduction program and readmissions for chronic obstructive pulmonary disease, 2006-2015.
In October 2012, the initial phase of the Hospital Readmission Reduction Program imposed financial penalties on hospitals with higher-than-expected risk-adjusted 30-day readmission rates for Medicare beneficiaries with congestive heart failure, myocardial infarction, and pneumonia. In this study, the investigators hypothesized that these penalties may also be associated with decreased readmissions for chronic obstructive pulmonary disease (COPD) in the general population before COPD became a target condition (October 2014).
AHRQ-funded; HS023305.
Citation: Myers LC, Faridi MK, Hasegawa K .
The hospital readmissions reduction program and readmissions for chronic obstructive pulmonary disease, 2006-2015.
Ann Am Thorac Soc 2020 Apr;17(4):450-56. doi: 10.1513/AnnalsATS.201909-672OC..
Keywords: Respiratory Conditions, Hospital Readmissions, Hospitals, Chronic Conditions, Medicare
Popescu I, Sood N, Joshi S
Trends in the use of skilled nursing facility and home health care under the Hospital Readmissions Reduction Program: an interrupted time-series analysis.
Medicare's Hospital Readmission Reduction Program penalizes hospitals with elevated 30-day readmission rates for acute myocardial infarction, heart failure, or pneumonia. The authors investigated if, in order to reduce readmissions, hospitals may have increased referrals to skilled nursing facilities and home health care. They found that hospitals might be shifting to more intensive postacute care to avoid readmissions among seniors with pneumonia. At the same time, penalized hospitals' efforts to prevent readmissions may be keeping higher proportions of their patients in the community.
AHRQ-funded; HS024284; HS025394.
Citation: Popescu I, Sood N, Joshi S .
Trends in the use of skilled nursing facility and home health care under the Hospital Readmissions Reduction Program: an interrupted time-series analysis.
Med Care 2019 Oct;57(10):757-65. doi: 10.1097/mlr.0000000000001184..
Keywords: Home Healthcare, Nursing Homes, Chronic Conditions, Hospital Readmissions, Long-Term Care, Hospitals, Heart Disease and Health, Pneumonia, Cardiovascular Conditions
Auger KA, Shah SS, Huang B
Discharge medical complexity, change in medical complexity and pediatric 30-day readmission.
Investigators conducted a five-year retrospective, case-control study of pediatric hospitalizations at a tertiary care children's hospital and estimated odds of 30-day unplanned readmission using adjusted conditional logistic regression. They found that polypharmacy and use of technology at discharge pose a substantial readmission risk for children, but added technology and new complex chronic conditions do not increase risk when accounting for length of stay.
AHRQ-funded; HS204735.
Citation: Auger KA, Shah SS, Huang B .
Discharge medical complexity, change in medical complexity and pediatric 30-day readmission.
J Hosp Med 2019 Aug;14(8):474-81. doi: 10.12788/jhm.3222..
Keywords: Children/Adolescents, Chronic Conditions, Hospital Readmissions, Hospitalization, Hospitals
Basu J, Hanchate A, Koroukian S
AHRQ Author: Basu, J
Multiple chronic conditions and disparities in 30-Day hospital readmissions among nonelderly adults.
This study examined the patterns of 30-day hospital readmissions by race/ethnicity and multiple chronic conditions (MCC) burden among nonelderly adult patients. The authors found considerable heterogeneity in levels of readmission risk among racial/ethnic subgroups stratified by chronic conditions. Among patients with a lowest MCC burden, African Americans had the highest risk of readmission, but with a higher MCC burden, the risk of readmission increased most for Hispanics.
AHRQ-authored.
Citation: Basu J, Hanchate A, Koroukian S .
Multiple chronic conditions and disparities in 30-Day hospital readmissions among nonelderly adults.
J Ambul Care Manage 2018 Oct/Dec;41(4):262-73. doi: 10.1097/jac.0000000000000246..
Keywords: Chronic Conditions, Disparities, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Racial and Ethnic Minorities
Casucci S, Lin L, Hewner S
Estimating the causal effects of chronic disease combinations on 30-day hospital readmissions based on observational Medicaid data.
The purpose of this study was to demonstrate how observational causal inference methods can generate insights into the impact of chronic disease combinations on patients' 30-day hospital readmissions. The investigators concluded that multi-hypothesis causal analysis, a new methodological tool, generates meaningful insights from health care claims data, guiding the design of care and intervention programs.
AHRQ-funded; HS022575.
Citation: Casucci S, Lin L, Hewner S .
Estimating the causal effects of chronic disease combinations on 30-day hospital readmissions based on observational Medicaid data.
J Am Med Inform Assoc 2018 Jun;25(6):670-78. doi: 10.1093/jamia/ocx141.
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Keywords: Chronic Conditions, Hospital Readmissions, Medicaid, Hospitals
Ganapathy D, Acharya C, Lachar J
The patient buddy app can potentially prevent hepatic encephalopathy-related readmissions.
The researchers aimed to define the feasibility of using the Patient Buddy App and its impact on 30-day readmissions by engaging and educating cirrhotic inpatients and caregivers in a pilot study. In their proof-of-concept trial, the use of Patient Buddy is feasible in recently discharged patients with cirrhosis and their caregivers. Eight hepatic encephalopathy-related readmissions were potentially avoided after the use of the App.
AHRQ-funded; HS024004.
Citation: Ganapathy D, Acharya C, Lachar J .
The patient buddy app can potentially prevent hepatic encephalopathy-related readmissions.
Liver Int 2017 Dec;37(12):1843-51. doi: 10.1111/liv.13494.
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Keywords: Caregiving, Chronic Conditions, Health Information Technology (HIT), Patient and Family Engagement, Hospital Readmissions
Basu J, Avila R, Ricciardi R
AHRQ Author: Basu J, Ricciardi R
Hospital readmission rates in U.S. states: are readmissions higher where more patients with multiple chronic conditions cluster?
This study examines small area variations in readmission rates to assess whether higher readmission rate in an area is associated with higher clusters of patients with multiple chronic conditions. It found that areas with higher concentration of patients with increased comorbid conditions are more likely to have higher readmission rates.
AHRQ-authored.
Citation: Basu J, Avila R, Ricciardi R .
Hospital readmission rates in U.S. states: are readmissions higher where more patients with multiple chronic conditions cluster?
Health Serv Res 2016 Jun;51(3):1135-51. doi: 10.1111/1475-6773.12401..
Keywords: Chronic Conditions, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Hospitals