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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 350 Research Studies DisplayedWu AJ, Du N, Chen TY
Sociodemographic differences of hospitalization and associations of resource utilization for failure to thrive.
The objective of this study was to examine sociodemographic differences between elective and nonelective admissions for failure to thrive. Researchers investigated associations between admission type and hospital resource utilization, including length of stay and feeding tube placement. The study included data on children less than 2 years old with failure to thrive in the Kids' Inpatient Database. The findings showed differences by race and ethnicity, income, and insurance type, among other factors. Nonelective admissions had higher proportions of infants who were Black, Hispanic, and of lower-income, and were associated with longer lengths of stay. The researchers concluded that future research is needed to elucidate drivers of these differences, particularly those related to racial and ethnic disparities and structural racism.
AHRQ-funded; HS000063.
Citation: Wu AJ, Du N, Chen TY .
Sociodemographic differences of hospitalization and associations of resource utilization for failure to thrive.
J Pediatr Gastroenterol Nutr 2023 Mar;76(3):385-89. doi: 10.1097/mpg.0000000000003694.
Keywords: Newborns/Infants, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Healthcare Utilization, Children/Adolescents, Racial and Ethnic Minorities, Low-Income
O'Donnell TFX,, Dansey KD, Marcaccio CL
Racial disparities in treatment of ruptured abdominal aortic aneurysms.
This study evaluated regional center transfer rates, turndown rates, and outcomes for Black vs White patients presenting with ruptured abdominal aortic aneurysms (rAAAs) in two large databases. All rAAA repairs in the Vascular Quality Initiative from 2003 to 2020 was used. The authors used the National Inpatient Sample from 2004 to 2015 to examine turndown rates for repair. They identified 4935 patients with rAAAs in the Vascular Quality Initiative (6.2% Black) and 48,489 in the National Inpatient Sample (6.0% Black). Transfer rates were high; however, Black patients were significantly less likely to undergo transfer before repair compared with White patients (49% Black vs 62% White). No significant differences were found in perioperative mortality or complications. However, Black patients were significantly more likely to be turned down for repair (37% vs 28%). This difference was mostly found to be due to insurance status. Patients with private insurance had undergone surgery at a similar rate. However, among patients with Medicare or Medicaid/self-pay, Black patients were less likely than were White patients to undergo repair (Medicare, 64% vs 72%; Medicaid/self-pay, 43% vs 61%). Medicaid/self-pay patients were less likely to undergo repair than were patients of the same race with either Medicare or private insurance.
AHRQ-funded; HS027285.
Citation: O'Donnell TFX,, Dansey KD, Marcaccio CL .
Racial disparities in treatment of ruptured abdominal aortic aneurysms.
J Vasc Surg 2023 Feb; 77(2):406-14. doi: 10.1016/j.jvs.2022.08.009..
Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Racial and Ethnic Minorities, Cardiovascular Conditions
Encinosa W, Moon K, Figueroa J
Complications, adverse drug events, high costs, and disparities in multisystem inflammatory syndrome in children vs COVID-19.
This cross-sectional study’s goal was to determine outcomes from multisystem inflammatory syndrome in children (MIS-C) after COVID-19. Outcomes examined were 50 complications, adverse medication events, costs, and the Social Vulnerability Index. An analysis was conducted using data from the 2021 HCUP in individuals younger than 21 years from 31 states. There were 4107 individuals hospitalized with MIS-C (median age 9 years, 59.5% male, 38.1% White) and 23,686 hospitalizations for COVID-19 without MIS-C (median age 15 years, 54.5% female, 44.1% White). Hospitalization rate for MIS-C was 1.48 per 100,000 children, ranging from 0.97 hospitalizations per 100 for White and 1.99 hospitalizations per 100 for Black children. Outcomes were worse when organ dysfunction increased from 2 to 8 organs, with deaths increasing from less than 1% to 5.8% for MIS-C, and 1% to 17.2% for COVID-19. Median length of stay increased from 4 to 8 days for MIS-C, and 3 to 16 days for COVID-19. Median costs for MIS-C increased from $16,225 to $53 359 and from $6474 to $98,643 for COVID-19. The percentage of MIS-C cases in Black children doubled from 16.2% to 31.7% as organ dysfunction increased, remaining unchanged with COVID-19.
AHRQ-authored.
Citation: Encinosa W, Moon K, Figueroa J .
Complications, adverse drug events, high costs, and disparities in multisystem inflammatory syndrome in children vs COVID-19.
JAMA Netw Open 2023 Jan;6(1):e2244975. doi: 10.1001/jamanetworkopen.2022.44975..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, COVID-19, Medication, Adverse Drug Events (ADE), Adverse Events, Healthcare Costs, Disparities, Racial and Ethnic Minorities
Steenland MW, Wherry LR
Medicaid expansion led to reductions in postpartum hospitalizations.
The purpose of this study was to assess whether the Medicaid expansions of the Affordable Care Act (ACA) affected rates of postpartum hospitalization. The researchers compared states that did and did not expand Medicaid under the ACA as they related to changes in hospitalizations among birthing people with a Medicaid-financed delivery. The study found a 17% reduction in hospitalizations during the first 60 days postpartum associated with the Medicaid expansions, and evidence of a lesser decrease in hospitalizations between 61 days and 6 months postpartum. The researchers concluded that Medicaid coverage expansion under the ACA resulted in improved postpartum health for low-income birthing people.
AHRQ-funded; HS027464.
Citation: Steenland MW, Wherry LR .
Medicaid expansion led to reductions in postpartum hospitalizations.
Health Aff 2023 Jan; 42(1):18-25. doi: 10.1377/hlthaff.2022.00819..
Keywords: Healthcare Cost and Utilization Project (HCUP), Medicaid, Hospitalization, Maternal Care, Women, Health Insurance, Access to Care
Moriya AS, Chakravarty S
Racial and ethnic disparities in preventable hospitalizations and ED visits five years after ACA Medicaid expansions,.
This AHRQ-authored paper examined whether the 2014 Affordable Care Act (ACA) Medicaid expansions mitigated existing racial or ethnic disparities in preventable hospitalizations and emergency department (ED) visits. The authors used inpatient data from twenty-nine states and ED data from twenty-six states for the period 2011 to 2018. They found that Medicaid expansions decreased disparities in preventable hospitalizations and ED visits between non-Hispanic Black and White nonelderly adults by 10 percent or more. There were no significant effects on disparities between Hispanic and non-Hispanic White nonelderly adults. Their findings highlight sustained improvements in community-level care for non-Hispanic Black populations, but also suggest access barriers experienced by Hispanic adults that need to be addressed beyond Medicaid eligibility expansion.
AHRQ-authored.
Citation: Moriya AS, Chakravarty S .
Racial and ethnic disparities in preventable hospitalizations and ED visits five years after ACA Medicaid expansions,.
Health Aff 2023 Jan; 42(1):26-34. doi: 10.1377/hlthaff.2022.00460..
Keywords: Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Emergency Department, Hospitalization, Disparities, Medicaid, Health Insurance, Access to Care
Cheung PC, Kramer MR, Kempker JA
Intermediate or intensive care unit admission across race and ethnicity.
This study’s aim was to assess the association between race and ethnicity and admission to intermediate (IMCUs) or intensive care units (ICUs) among hospitalized patients. Florida hospital discharge data from the State Inpatient Database was used to assess the relationship between race (White, Black, Other) and Hispanic ethnicity and IMCU or ICU admission. After controlling for demographics and comorbidities, the prevalence of IMCU or ICU admission was higher among non-Hispanic Blacks and non-Hispanic patients of other races compared with non-Hispanic Whites. The prevalence of IMCU or ICU use was lower among Hispanic Whites and Hispanics of other races compared with non-Hispanic Whites after controlling for other demographic characteristics and comorbidities.
AHRQ-funded; HS025240.
Citation: Cheung PC, Kramer MR, Kempker JA .
Intermediate or intensive care unit admission across race and ethnicity.
South Med J 2022 Dec;115(12):913-18. doi: 10.14423/smj.0000000000001487..
Keywords: Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Intensive Care Unit (ICU)
Interrante JD, Tuttle MS, Admon LK
Severe maternal morbidity and mortality risk at the intersection of rurality, race and ethnicity, and Medicaid.
Using maternal discharge records from childbirth hospitalizations in the HCUP National Inpatient Sample, 2007-15, researchers examined differences in rates of severe maternal morbidity and mortality by rural or urban geography, race and ethnicity, and clinical factors among Medicaid-funded births and privately insured hospital births. The highest rate of severe maternal morbidity and mortality occurred among rural Indigenous Medicaid-funded births; births among Black rural and urban residents and among Hispanic urban residents also experienced elevated rates. The researchers concluded that heightened rates of severe maternal morbidity and mortality among Medicaid-funded births indicate an opportunity for state and federal policy responses to address the maternal health challenges faced by Medicaid beneficiaries, including Black, Indigenous, and rural residents
AHRQ-funded; HS027640.
Citation: Interrante JD, Tuttle MS, Admon LK .
Severe maternal morbidity and mortality risk at the intersection of rurality, race and ethnicity, and Medicaid.
Womens Health Issues 2022 Nov-Dec;32(6):540-49. doi: 10.1016/j.whi.2022.05.003..
Keywords: Healthcare Cost and Utilization Project (HCUP), Maternal Care, Women, Pregnancy, Mortality, Risk, Racial and Ethnic Minorities, Medicaid
Hegland TA, Owens PL, Selden TM
New evidence on geographic disparities in United States hospital capacity.
The purpose of this study was to describe hospital capacity across the United States. The researchers combined American Hospital Association Survey, Hospital Compare, and American Community Survey data with the 2017 near-census of U.S. hospital inpatient discharges from the Healthcare Cost and Utilization Project (HCUP). The study found that 0.11 more beds per 1000 population were supplied to zip codes where Non-Hispanic individuals live than zip codes where non-Hispanic White individuals live. However, the hospitals supplying this capacity have 0.36 fewer staff per bed and perform worse on many care quality measures. Zip codes in the most urban parts of America have the least hospital capacity (2.11 beds per 1000 persons) from across the rural-urban continuum. While more rural areas have higher capacity levels, urban areas have advantages in staff and capital per bed. The researchers did not find systematic differences in care quality between rural and urban areas. The study concluded that lower hospital care quality and resource intensity plays a key role in racial, ethnic, and income disparities in hospital care related outcomes.
AHRQ-authored.
Citation: Hegland TA, Owens PL, Selden TM .
New evidence on geographic disparities in United States hospital capacity.
Health Serv Res 2022 Oct;57(5):1006-19. doi: 10.1111/1475-6773.14010..
Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Hospitals, Quality of Care, Racial and Ethnic Minorities
Pickens G, Smith MW, McDermott KW
Trends in treatment costs of U.S. emergency department visits.
In recent years, emergency department (ED) spending has been increasing more than in other areas of health care. Few studies have focused on changes in ED treatment costs. The purpose of this study was to analyze recent increases in emergency department treatment costs to highlight possibilities for reducing the growth of overall hospital costs. The researchers used data from the Healthcare Cost and Utilization Project (HCUP) and applied Cost-to-Charge Ratios for ED Files to the HCUP Nationwide Emergency Department Sample for 2012 through 2019. The study found that ED treatment costs experienced a 5.4% annual growth rate, increasing from $54 billion to $88 billion, with higher treatment cost per visit responsible for 4.4 of those percentage points. The researchers concluded that the study provides valuable information for decision- and policy-makers by bringing attention to components of the healthcare delivery system with the highest increasing costs as well as trends in overall ED costs.
AHRQ-authored; AHRQ-funded; 290201800001C.
Citation: Pickens G, Smith MW, McDermott KW .
Trends in treatment costs of U.S. emergency department visits.
Am J Emerg Med 2022 Aug;58:89-94. doi: 10.1016/j.ajem.2022.05.035..
Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Emergency Department
Waters TM, Burns N, Kaplan CM
Combined impact of medicare's hospital pay for performance programs on quality and safety outcomes is mixed.
The authors examined the combined impact of Medicare's pay for performance (P4P) programs on clinical areas and populations targeted by the programs, as well as those outside their focus. Using HCUP data, and consistent with previous studies for individual programs, they detected minimal, if any, effect of Medicare's hospital P4P programs on quality and safety. They recommended a redesigning of the P4P programs before continuing to expand them.
AHRQ-funded; HS025148.
Citation: Waters TM, Burns N, Kaplan CM .
Combined impact of medicare's hospital pay for performance programs on quality and safety outcomes is mixed.
BMC Health Serv Res 2022 Jul 28;22(1):958. doi: 10.1186/s12913-022-08348-w..
Keywords: Healthcare Cost and Utilization Project (HCUP), Medicare, Payment, Provider Performance, Hospitals, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care, Patient Safety
Hirai AH, Owens PL, Reid LD
Associations between state-level severe maternal morbidity and other perinatal indicators.
This study used the HCUP State Inpatient Databases (HCUP-SID) to determine the correlation between state-level severe maternal morbidity (SMM) rates and perinatal indicators. HCUP-SID was analyzed from 2017 to 2019 using revised code sets for 20 indicators excluding blood transfusions. Perinatal indicators used included prepregnancy hypertension, prepregnancy diabetes, prepregnancy obesity, low-risk cesarean delivery, preterm birth, infant mortality, and maternal mortality. HCUP-SID data for 10,542,942 maternal deliveries and 11,394,752 live births from the National Vital Statistics System (NVSS) were aggregated for state-level analysis. SMM rates were significantly correlated with 2 of the 7 perinatal indicators: prepregnancy hypertension and low-risk cesarean deliveries. All other perinatal indicators were significantly associated with at least 4 of 7 other indicators, and most correlations were higher in magnitude. Maternity mortality rates were highest in the southeast.
AHRQ-authored.
Citation: Hirai AH, Owens PL, Reid LD .
Associations between state-level severe maternal morbidity and other perinatal indicators.
JAMA Netw Open 2022 Jul;5(7):e2224621. doi: 10.1001/jamanetworkopen.2022.24621..
Keywords: Healthcare Cost and Utilization Project (HCUP), Maternal Care, Pregnancy, Women, Labor and Delivery, Hospitalization
Admon LK, Ford ND, Ko JY
Trends and distribution of in-hospital mortality among pregnant and postpartum individuals by pregnancy period.
The purpose of this study was to examine long-term trends in inpatient death rates among pregnant and postpartum individuals and proportion of deaths by pregnancy period (antenatal, delivery, and postpartum). The researchers examined patterns of inpatient mortality during pregnancy-associated hospitalizations utilizing data from the National Inpatient Sample for 1994 to 2015 and 2017 to 2019. The study found that between 1994 and 2015, among 84,181,338 hospitalizations an estimated 12,654 inpatient deaths occurred among pregnant and postpartum individuals with a mean age of 29.37. Inpatient deaths during delivery hospitalizations decreased from 10.6 deaths per 100 000 delivery hospitalizations to 4.7 deaths per 100 000 delivery hospitalizations between 1994 to 1995 and 2014 to 2015. The rate of inpatient deaths in antenatal and postpartum periods remained unchanged between 1994 to 1995 and 2014 to 2015. The researchers concluded that resources directed toward improving quality of care at obstetric delivery have been associated with decreased rates of severe morbidity and may be associated with decreased mortality, but additional efforts need to be directed toward antenatal and postpartum hospitalizations.
AHRQ-funded; HS027640.
Citation: Admon LK, Ford ND, Ko JY .
Trends and distribution of in-hospital mortality among pregnant and postpartum individuals by pregnancy period.
JAMA Netw Open 2022 Jul;5(7):e2224614. doi: 10.1001/jamanetworkopen.2022.24614..
Keywords: Healthcare Cost and Utilization Project (HCUP), Maternal Care, Mortality, Pregnancy, Women, Hospitals
Hirai AH, Owens PL, Reid LD
Trends in severe maternal morbidity in the US across the transition to ICD-10-CM/PCS from 2012-2019.
This study evaluated national and state trends in severe maternal morbidity (SMM) rates from 2012 to 2019, and potential disruptions associated with the transition to International Classification of Diseases, 10th Revision, Clinical Modification and Procedure Coding System (ICD-10-CM/PCS) in October 2015. This repeated cross-sectional analysis examined delivery hospitalizations in the HCUP’s National Inpatient Sample and State Inpatient Databases. There were almost 6 million delivery hospitalizations in the national sample representing a weighted total of 29.8 million deliveries with a mean maternal age of 28.6 years. SMM rates increased from 69.5 per 10,000 deliveries to 79.7 per 10,000 in 2019 without a significant change across the ICD-10-CM/PCS transition. OF 20 SMM indicators, rates for 10 indicators increased while 3 significantly decreased with 5 of those changes associated with the ICD-10-CM/PCS transition. Acute kidney failure had the largest increase, from 6.4 to 15.3 per 10,000 delivery hospitalizations, with no change associated with ICD transition. Disseminated intravascular coagulation had the largest decrease from 31.3 to 21.2 per 10,000, with a significant drop associated with ICD transition. State SMM rates significantly decreased for 1 state and significantly increased for 21 states from 2012 to 2019 and with varying associations with ICD transition.
AHRQ-authored.
Citation: Hirai AH, Owens PL, Reid LD .
Trends in severe maternal morbidity in the US across the transition to ICD-10-CM/PCS from 2012-2019.
JAMA Netw Open 2022 Jul;5(7):e2222966. doi: 10.1001/jamanetworkopen.2022.22966..
Keywords: Healthcare Cost and Utilization Project (HCUP), Maternal Care, Pregnancy, Women, Labor and Delivery, Hospitalization
Zrelak PA, Utter GH, McDonald KM
Incorporating harms into the weighting of the revised Agency for Healthcare Research and Quality Patient Safety for Selected Indicators Composite (Patient Safety Indicator 90).
The purpose of this study was to reweight AHRQ’s Patient Safety for Selected Indicators Composite (Patient Safety Indicator 90) from weights based solely on the frequency of component Patient Safety Indicators (PSIs) to those that incorporate excess harm reflecting patients' preferences for outcome-related health states. Findings showed that including harms in the weighting scheme changed individual component weights from the original frequency-based weighting. In the reweighted composite, PSIs 11, 13, and 12 contributed the greatest harm. The investigators concluded that reformulation of PSI 90 with harm-based weights is feasible and results in satisfactory reliability and discrimination.
AHRQ-authored; AHRQ-funded; 290201200003I.
Citation: Zrelak PA, Utter GH, McDonald KM .
Incorporating harms into the weighting of the revised Agency for Healthcare Research and Quality Patient Safety for Selected Indicators Composite (Patient Safety Indicator 90).
Health Serv Res 2022 Jun;57(3):654-67. doi: 10.1111/1475-6773.13918..
Keywords: Healthcare Cost and Utilization Project (HCUP), Patient Safety, Quality Indicators (QIs), Quality Measures, Quality of Care, Adverse Events, Medicare
Encinosa W, Figueroa J, Elias Y
Severity of hospitalizations from SARS-CoV-2 vs influenza and respiratory syncytial virus infection in children aged 5 to 11 years in 11 US states.
By the time emergency use authorization had been granted for the Pfizer-BioNTech vaccine in October 2021 in children aged 5 to 11 years, there had been 1.8 million diagnoses of SARS-CoV-2 infection, 8,000 hospitalizations, and 143 deaths in that age group. Very little has been reported on the severity of those hospitalizations relative to the influenza virus and respiratory syncytial virus (RSV) which are the most common childhood viruses. The purpose of this study was to compare hospitalizations of children aged 5 to 11 for SARS-CoV-2 infection and multisystem inflammatory system in children (MIS-C, a sequela of COVID-19 disease) with the hospitalizations of children aged 5 to 11 years who were infected with influenza and RSV. The researchers utilized inpatient data from the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project from the first 11 states with complete first-quarter data as of October 2021, representing 24% of the US population of children aged 5 to 11 years. The researchers examined 46 complications in 7 body systems, total care costs and charges, and data on race and ethnicity. The resulting cross-sectional study included patient data from a total of 2,269 children. The study found that COVID-19 hospitalizations occurred at the rate of 10.8 per 100,000 children, while Influenza and RSV were rare during the first quarter of 2021 with 23 total hospital discharges combined. However, in 2017, which researchers also measured for data on influenza and RSV, influenza and RSV had 17.0 and 6.2 hospitalizations per 100,000 children, respectively. Inpatient death for all viruses was rare. MIS-C had the highest rates of cardiovascular, hematologic, and gastrointestinal complications. Children with RSV ha the highest rate of respiratory complications. Children with COVID-19 (without MISC-C) had the highest rate of neurologic complications, whereas children with influenza had the highest rate of muscoskeletal complications. Children with MIS-C had the longest median length of stay at a median cost of $23,585 per stay compared to children with influenza with a median length of stay of 2 days and a cost of $5,200.
AHRQ-authored.
Citation: Encinosa W, Figueroa J, Elias Y .
Severity of hospitalizations from SARS-CoV-2 vs influenza and respiratory syncytial virus infection in children aged 5 to 11 years in 11 US states.
JAMA Pediatr 2022 May;176(5):520-22. doi: 10.1001/jamapediatrics.2021.6566..
Keywords: Healthcare Cost and Utilization Project (HCUP), COVID-19, Children/Adolescents, Hospitalization, Influenza, Respiratory Conditions
Murphy PB, Oslock WM, Ingraham AM
Quality of care for gallstone pancreatitis-the impact of the acute care surgery model and hospital-level operative resources.
This study aimed to determine the influence of structure and process related to operating room access on achieving index cholecystectomy for gallstone pancreatitis. In 2015, 2811 US hospitals on acute care surgery practices were surveyed, including infrastructure for operative access, with 1690 hospitals (60%) responding. The authors identified patients ≥ 18 years who were admitted with gallstone pancreatitis. Over the study period, 5656 patients were admitted with gallstone pancreatitis, and 70% had an index cholecystectomy. High-performing hospitals had an index cholecystectomy rate of 84.1%, compared to 58.5% at low-performing hospitals. High-performing hospitals were associated with teaching, and access to dedicated daytime operative resources.
AHRQ-funded; HS022694.
Citation: Murphy PB, Oslock WM, Ingraham AM .
Quality of care for gallstone pancreatitis-the impact of the acute care surgery model and hospital-level operative resources.
J Gastrointest Surg 2022 Apr;26(4):849-60. doi: 10.1007/s11605-021-05145-4..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Quality of Care
Michelson KA, Cushing AM, Bucholz EM
Association of county-level availability of pediatricians with emergency department visits.
This study examined whether children in counties with more pediatricians had fewer emergency department (ED) visits. The authors conducted a cross-sectional study of all ED visits among children younger than 18 years from 6 states. Each additional pediatrician per 1000 children was associated with a 13.7% decrease in ED visits in the state-adjusted model. In the full model however, there was no association. Other factors such as presence of an urgent care facility, high socioeconomic status, urban status and higher proportions of White race and nonpublic insurance were also associated with decreased ED visit rates.
AHRQ-funded; HS026503.
Citation: Michelson KA, Cushing AM, Bucholz EM .
Association of county-level availability of pediatricians with emergency department visits.
Pediatr Emerg Care 2022 Feb;38(2):e953-e57. doi: 10.1097/pec.0000000000002502..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Healthcare Utilization, Workforce, Provider: Physician, Rural Health
Greenberg JK, Brown DS, Olsen MA
Association of Medicaid expansion under the Affordable Care Act with access to elective spine surgical care.
This study's goal was to evaluate the impact of Medicaid expansion under the Affordable Care Act on the volume and payer mix of elective spine surgery in the United States. The authors evaluated elective spinal surgeries performed in the U.S. from 2011 to 2016 and included 10 states with expanded Medicaid access and 4 states that did not. They identified 218,648 surgical procedures performed in 10 Medicaid expansion states and 118,693 procedures performed in 4 nonexpansion states. Medicaid expansion was associated with a 17% increase in mean hospital spine surgical volume and a 23% increase in Medicaid volume. Privately insured surgical volumes did not change significantly. This increase indicated improved access to care.
AHRQ-funded; HS027075.
Citation: Greenberg JK, Brown DS, Olsen MA .
Association of Medicaid expansion under the Affordable Care Act with access to elective spine surgical care.
J Neurosurg Spine 2022 Feb;36(2):336–44. doi: 10.3171/2021.3.Spine2122..
Keywords: Healthcare Cost and Utilization Project (HCUP), Medicaid, Access to Care, Surgery
Reid LD, Weiss AJ, Fingar KR
Contributors to disparities in postpartum readmission rates between safety-net and non-safety-net hospitals: a decomposition analysis.
The authors assessed how patient, hospital, and community characteristics explain the safety-net hospital (SNH)/non-SNH disparity in postpartum readmission rates. Using HCUP data, they found that higher postpartum readmission rates at SNHs versus non-SNHs were largely due to differences in the patient mix rather than hospital factors. They recommended hospital initiatives to reduce the risk of postpartum readmissions among SNH patients. They concluded that improving factors that contribute to the disparity, including underlying health conditions and health inequities associated with race, will require enduring investments in public health.
AHRQ-authored; AHRQ-funded; 290201800001C.
Citation: Reid LD, Weiss AJ, Fingar KR .
Contributors to disparities in postpartum readmission rates between safety-net and non-safety-net hospitals: a decomposition analysis.
J Hosp Med 2022 Feb;17(2):77-87. doi: 10.1002/jhm.2769..
Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Hospital Readmissions, Maternal Care, Women, Disparities
Chang L, Rees CA, Michelson KA
Association of socioeconomic characteristics with where children receive emergency care.
This study’s objective was to characterize national associations of neighborhood income and insurance type for children with the characteristics of emergency departments (EDs) from which they receive care. The authors conducted a cross-sectional study of ED visits by children from 2014 to 2017 using the Nationwide Emergency Department Sample. Emergency department characteristics were characterized by pediatric volume category. There was a total of 107.6 million ED visits from 2014 to 2017. Children outside of the wealthiest neighborhood income quartile had lower proportions of visits to high-volume pediatric EDs and greater proportions of visits to low-volume pediatric EDs than children in the wealthiest quartile. Publicly insured children were modestly more likely to visit higher-volume pediatric EDs than privately insurance and uninsured children. This association appears to be principally driven by urban-rural differences in access to pediatric emergency care.
AHRQ-funded; HS026503.
Citation: Chang L, Rees CA, Michelson KA .
Association of socioeconomic characteristics with where children receive emergency care.
Pediatr Emerg Care 2022 Jan;38(1):e264-e67. doi: 10.1097/pec.0000000000002244..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Health Insurance, Uninsured, Low-Income
Ingraham A, Schumacher J, Fernandes-Taylor S
General surgeon involvement in the care of patients designated with an American Association for the Surgery of Trauma-endorsed ICD-10-CM emergency general surgery diagnosis code in Wisconsin.
The authors sought to: (1) translate previously-developed ICD-9-CM diagnosis codes representing emergency general surgery (EGS) conditions to ICD-10-CM codes and (2) determine the national burden of and assess surgeon involvement across EGS conditions. They found that, of the seven most common EGS diagnoses, surgeon involvement was highest for appendicitis and biliary tract disease. For the other five most common conditions, surgeons were involved in roughly 20% of patient care episodes.
AHRQ-funded; HS025224.
Citation: Ingraham A, Schumacher J, Fernandes-Taylor S .
General surgeon involvement in the care of patients designated with an American Association for the Surgery of Trauma-endorsed ICD-10-CM emergency general surgery diagnosis code in Wisconsin.
J Trauma Acute Care Surg 2022 Jan;92(1):117-25. doi: 10.1097/ta.0000000000003387..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Critical Care
Williams D, Stout MJ, Rosenbloom JI
Preeclampsia predicts risk of hospitalization for heart failure with preserved ejection fraction.
Preeclampsia is associated with increased risk of future heart failure (HF), but the relationship between preeclampsia and HF subtypes are not well-established. The objective of this analysis was to identify the risk of HF with preserved ejection fraction (HFpEF) following a delivery complicated by preeclampsia/eclampsia. The investigators concluded that preeclampsia/eclampsia was an independent risk factor for future hospitalizations for HFpEF.
AHRQ-funded; HS019455.
Citation: Williams D, Stout MJ, Rosenbloom JI .
Preeclampsia predicts risk of hospitalization for heart failure with preserved ejection fraction.
J Am Coll Cardiol 2021 Dec 7;78(23):2281-90. doi: 10.1016/j.jacc.2021.09.1360..
Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Cardiovascular Conditions, Hospitalization, Risk, Labor and Delivery, Pregnancy, Women
Chovatiya R, Silverberg JI
Association of herpes zoster and chronic inflammatory skin disease in US inpatients.
The purpose of this study was to determine whether chronic inflammatory skin disease (CISD) is associated with herpes zoster (HZ). Data from the Nationwide Inpatient Sample 2002-2012 were analyzed. Findings showed that many CISDs are associated with increased hospitalization for HZ, even below the ages recommended for HZ vaccination. Recommendations included additional studies to establish CISD-specific vaccination guidelines.
AHRQ-funded; HS023011.
Citation: Chovatiya R, Silverberg JI .
Association of herpes zoster and chronic inflammatory skin disease in US inpatients.
J Am Acad Dermatol 2021 Dec;85(6):1437-45. doi: 10.1016/j.jaad.2019.12.073..
Keywords: Healthcare Cost and Utilization Project (HCUP), Skin Conditions, Chronic Conditions
Heslin KC, Barrett ML, Hensche M
Effects of hurricanes on emergency department utilization: an analysis across 7 US storms.
This study examines changes in emergency department (ED) utilization for residents of 344 counties after the occurrence of 7 US hurricanes between 2005 and 2016. Using HCUP data, findings showed that the overall population rate of weekly ED visits changed little post-hurricane, but rates by disease categories and age demonstrated varying results. ED utilization rates for respiratory disorders exhibited the largest post-hurricane increase, especially 2-3 weeks following the hurricane. The change in population rates by disease categories and age tended to be higher for people residing in counties closer to the hurricane path.
Citation: Heslin KC, Barrett ML, Hensche M .
Effects of hurricanes on emergency department utilization: an analysis across 7 US storms.
Disaster Med Public Health Prep 2021 Dec;15(6):762-69. doi: 10.1017/dmp.2020.281..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Healthcare Utilization, Emergency Preparedness
Ingraham NE, King S, Proper J
Morbidity and mortality trends of pancreatitis: an observational study.
The authors assessed temporal trends of incidence, complications, management, and outcomes for acute pancreatitis in hospitalized patients at the national level. Using HCUP data, they found that the incidence of pancreatitis, from 2008 to 2015, has increased whereas inpatient mortality has decreased.
AHRQ-funded; HS026732.
Citation: Ingraham NE, King S, Proper J .
Morbidity and mortality trends of pancreatitis: an observational study.
Surg Infect 2021 Dec;22(10):1021-30. doi: 10.1089/sur.2020.473..
Keywords: Healthcare Cost and Utilization Project (HCUP), Digestive Disease and Health, Mortality
