National Healthcare Quality and Disparities Report
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- Cardiovascular Conditions (4)
- Children/Adolescents (1)
- Elderly (1)
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- (-) Heart Disease and Health (11)
- (-) Hospital Discharge (11)
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- Hospital Readmissions (5)
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- Transitions of Care (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 11 of 11 Research Studies DisplayedKimchi A, Aronow HU, Ni YM
Postdischarge noninvasive telemonitoring and nurse telephone coaching improve outcomes in heart failure patients with high burden of comorbidity.
The purpose of this study was to explore how comorbidity burden modulates the effectiveness of Noninvasive telemonitoring and nurse telephone coaching (NTM-NTC) and identify patients with HF who may benefit from postdischarge NTM-NTC based on their burden of comorbidity. METHODS AND RESULTS: In the Better Effectiveness After Transition - Heart Failure trial, patients hospitalized for acute decompensated HF were randomized to postdischarge NTM-NTC or usual care. In this secondary analysis of 1313 patients with complete data, comorbidity burden was assessed by scoring complication and coexisting diagnoses from index admissions. Clinical outcomes included 30-day and 180-day readmissions, mortality, days alive, and combined days alive and out of the hospital. Patients had a mean of 5.7 comorbidities and were stratified into low (0-2), moderate (3-8), and high comorbidity (≥9) subgroups. Increased comorbidity burden was associated with worse outcomes. NTM-NTC was not associated with readmission rates in any comorbidity subgroup. Among high comorbidity patients, NTM-NTC was associated with significantly lower mortality at 30 days (hazard ratio 0.25, 95% confidence interval 0.07-0.90) and 180 days (hazard ratio 0.51, 95% confidence interval 0.27-0.98), as well as more days alive (160.1 vs 140.3, P = .029) and days alive out of the hospital (152.0 vs 133.2, P = .044) compared with usual care. CONCLUSIONS: Postdischarge NTM-NTC improved survival among patients with HF with a high comorbidity burden. Comorbidity burden may be useful for identifying patients likely to benefit from this management strategy.
AHRQ-funded; HS019311.
Citation: Kimchi A, Aronow HU, Ni YM .
Postdischarge noninvasive telemonitoring and nurse telephone coaching improve outcomes in heart failure patients with high burden of comorbidity.
J Card Fail 2023 May; 29(5):774-83. doi: 10.1016/j.cardfail.2022.11.012..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Telehealth, Health Information Technology (HIT), Hospital Discharge
Weerahandi H, Li L, Bao H
Risk of readmission after discharge from skilled nursing facilities following heart failure hospitalization: a retrospective cohort study.
The goal of this study was to examine outcomes for Medicare patients who were hospitalized with heart failure and who had a subsequent skilled nursing facility (SNF) stay of 30 days or less. Patients were categorized by their length of stay in the SNF and followed for the 30 days after their discharge from the SNF to home. Overall, nearly one-quarter of the SNF discharges to home were readmitted within the 30 day follow-up period. The rate of readmission was highest during the first two days home, but this risk was attenuated by a longer SNF length of stay. The authors conclude that interventions to reduce readmissions may be more effective if they incorporate patient transitions from SNF to home.
AHRQ-funded; HS022882.
Citation: Weerahandi H, Li L, Bao H .
Risk of readmission after discharge from skilled nursing facilities following heart failure hospitalization: a retrospective cohort study.
J Am Med Dir Assoc 2019 Apr;20(4):432-37. doi: 10.1016/j.jamda.2019.01.135..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Hospital Discharge, Hospital Readmissions, Hospitalization, Nursing Homes
Huckfeldt P, Escarce J, Sood N
Thirty-day postdischarge mortality among black and white patients 65 years and older in the Medicare Hospital Readmissions Reduction Program.
The goal of this cohort study was to determine whether short-term mortality rates increased among black and white adults 65 years and older after initiation of the Medicare Hospital Readmissions Reduction Program (HRRP) and whether trends differed by race. Using an interrupted time-series analysis, the researchers found that short-term post-discharge mortality did not appear to increase for black patients under the HRRP, suggesting that certain value-based payment policies can be implemented without harming black populations. However, mortality seemed to increase for white patients with heart failure; this situation warrants investigation.
AHRQ-funded; HS025394.
Citation: Huckfeldt P, Escarce J, Sood N .
Thirty-day postdischarge mortality among black and white patients 65 years and older in the Medicare Hospital Readmissions Reduction Program.
JAMA Netw Open 2019 Mar;2(3):e190634. doi: 10.1001/jamanetworkopen.2019.0634..
Keywords: Medicare, Elderly, Mortality, Heart Disease and Health, Cardiovascular Conditions, Hospital Discharge
Alapati V, Tang F, Charlap E
Discharge heart rate after hospitalization for myocardial infarction and long-term mortality in 2 US registries.
In this study, researchers evaluated the association of discharge and admission heart rates with 3-year mortality. They concluded that a higher discharge heart rate after AMI was more strongly associated with 3-year mortality than a high heart rate at admissions.
AHRQ-funded; HS011282.
Citation: Alapati V, Tang F, Charlap E .
Discharge heart rate after hospitalization for myocardial infarction and long-term mortality in 2 US registries.
J Am Heart Assoc 2019 Feb 5;8(3):e010855. doi: 10.1161/jaha.118.010855..
Keywords: Cardiovascular Conditions, Hospital Discharge, Mortality, Heart Disease and Health, Registries
Amin AP, Pinto D, House JA
Association of same-day discharge after elective percutaneous coronary intervention in the United States with costs and outcomes.
The purpose of this study was to examine (1) the incidence and trends in same day discharge (SDD); (2) hospital variation in SDD; (3) the association between SDD and readmissions for bleeding, acute kidney injury (AKI), acute myocardial infarction (AMI), or mortality at 30, 90, and 365 days after PCI; and (4) hospital costs of SDD and its drivers.
AHRQ-funded; HS022418.
Citation: Amin AP, Pinto D, House JA .
Association of same-day discharge after elective percutaneous coronary intervention in the United States with costs and outcomes.
JAMA Cardiol 2018 Nov;3(11):1041-49. doi: 10.1001/jamacardio.2018.3029..
Keywords: Healthcare Costs, Hospital Discharge, Patient-Centered Outcomes Research, Heart Disease and Health
Kavalieratos D, Rollman BL, Arnold RM
Homeward Bound, not hospital rebound: how transitional palliative care can reduce readmission.
Comment on a study concerning heart failure palliative care interventions.
AHRQ-funded; HS022989.
Citation: Kavalieratos D, Rollman BL, Arnold RM .
Homeward Bound, not hospital rebound: how transitional palliative care can reduce readmission.
Heart 2016 Jul 15;102(14):1079-80. doi: 10.1136/heartjnl-2016-309385.
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Keywords: Heart Disease and Health, Hospital Discharge, Hospital Readmissions, Palliative Care
Faridi KF, Peterson ED, McCoy LA
Timing of first postdischarge follow-up and medication adherence after acute myocardial infarction.
The investigators sought to determine whether earlier outpatient follow-up after acute myocardial infarction (AMI) is associated with higher rates of medication adherence. They found that delayed outpatient follow-up beyond the first 6 weeks after AMI is associated with worse short-term and long-term patient medication adherence. They concluded that medication adherence is modifiable via improved care transitions.
AHRQ-funded; HS021092.
Citation: Faridi KF, Peterson ED, McCoy LA .
Timing of first postdischarge follow-up and medication adherence after acute myocardial infarction.
JAMA Cardiol 2016 May 1;1(2):147-55. doi: 10.1001/jamacardio.2016.0001.
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Keywords: Hospital Discharge, Medication, Heart Disease and Health, Patient Adherence/Compliance, Patient-Centered Healthcare
Ong MK, Romano PS, Edgington S
Effectiveness of remote patient monitoring after discharge of hospitalized patients with heart failure: the better effectiveness after transition-heart failure (BEAT-HF) randomized clinical trial.
The researchers evaluated the effectiveness of a care transition intervention using remote patient monitoring in reducing 180-day all-cause readmissions among a broad population of older adults hospitalized with HF. Theyn found that intervention and usual care groups did not differ significantly in readmissions for any cause 180 days after discharge.
AHRQ-funded; HS019311.
Citation: Ong MK, Romano PS, Edgington S .
Effectiveness of remote patient monitoring after discharge of hospitalized patients with heart failure: the better effectiveness after transition-heart failure (BEAT-HF) randomized clinical trial.
JAMA Intern Med 2016 Mar;176(3):310-8. doi: 10.1001/jamainternmed.2015.7712.
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Keywords: Heart Disease and Health, Hospital Readmissions, Telehealth, Quality of Life, Hospital Discharge
Dharmarajan K, Chaudhry SI
New approaches to reduce readmissions in patients with heart failure.
The authors discuss a study by Ong and colleagues that presents the results of Better Effectiveness After Transition–Heart Failure (BEATHF), a randomized clinical trial of a combined telemonitoring and care transitions intervention to prevent readmission in patients with heart failure. The BEAT-HF intervention did not lower readmissions after hospitalization for heart failure.
AHRQ-funded; HS023554.
Citation: Dharmarajan K, Chaudhry SI .
New approaches to reduce readmissions in patients with heart failure.
JAMA Intern Med 2016 Mar;176(3):318-20. doi: 10.1001/jamainternmed.2015.7993.
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Keywords: Heart Disease and Health, Hospital Discharge, Hospital Readmissions, Quality of Life, Transitions of Care
Conlon TW, Falkensammer CB, Hammond RS
Association of left ventricular systolic function and vasopressor support with survival following pediatric out-of-hospital cardiac arrest.
This study characterizes the association of hospital discharge survival with left ventricular systolic function evaluated by transthoracic echocardiography and vasoactive infusion support following return of spontaneous circulation after pediatric out-of-hospital cardiac arrest. It found that in patients receiving transthoracic echocardiography within the first 24 hours, decreased left ventricular systolic function and vasopressor use were common.
AHRQ-funded; HS022464.
Citation: Conlon TW, Falkensammer CB, Hammond RS .
Association of left ventricular systolic function and vasopressor support with survival following pediatric out-of-hospital cardiac arrest.
Pediatr Crit Care Med 2015 Feb;16(2):146-54. doi: 10.1097/pcc.0000000000000305..
Keywords: Children/Adolescents, Hospital Discharge, Mortality, Heart Disease and Health
Carey K, Lin MY
Hospital length of stay and readmission: an early investigation.
This study is a retrospective examination of the association between length of stay in an index hospitalization and readmission within 7 days and within 30 days of discharge. It found negative associations between length of stay and readmission probability, particularly for heart attack patients; however, the magnitude of the effect was modest for heart attack.
AHRQ-funded; HS020995.
Citation: Carey K, Lin MY .
Hospital length of stay and readmission: an early investigation.
Med Care Res Rev 2014 Feb;71(1):99-111. doi: 10.1177/1077558713504998..
Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Hospital Readmissions, Hospitalization, Hospital Discharge