National Healthcare Quality and Disparities Report
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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
326 to 350 of 368 Research Studies DisplayedMueller EL, Sabbatini A, Gebremariam A
Why pediatric patients with cancer visit the emergency department: United States, 2006-2010.
The authors explored reasons prompting emergency department (ED) visits and factors associated with hospital admission among pediatric patients with cancer. They concluded that fever with neutropenia was the most common reason for ED visits among pediatric patients with cancer and was the condition most strongly associated with admission, and that socioeconomic factors appeared to influence ED disposition for this population.
AHRQ-funded; HS022982.
Citation: Mueller EL, Sabbatini A, Gebremariam A .
Why pediatric patients with cancer visit the emergency department: United States, 2006-2010.
Pediatr Blood Cancer 2015 Mar;62(3):490-5. doi: 10.1002/pbc.25288.
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Keywords: Cancer, Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Emergency Department, Hospitalization
Kindermann DR, Mutter RL, Houchens RL
Emergency department transfers and transfer relationships in United States hospitals.
The study objective was to describe transfers out of hospital-based emergency departments (EDs) in a total of 97,021 ED transfer encounters. Among the 50 highest transfer rate disease categories, in U.S. EDs, patients are often transported great distances, more commonly to large teaching hospitals with greater resources.
AHRQ-funded; 290201300002C
Citation: Kindermann DR, Mutter RL, Houchens RL .
Emergency department transfers and transfer relationships in United States hospitals.
Acad Emerg Med. 2015 Feb;22(2):157-65. doi: 10.1111/acem.12586..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Transitions of Care, Hospitals
Smith MW, Stocks C, Santora PB
AHRQ Author: Stocks C
Hospital readmission rates and emergency department visits for mental health and substance abuse conditions.
The purpose of this study is to examine data on the readmission rates and ED visits of individuals diagnosed with mental health and substance abuse (MHSA) conditions to determine which individuals with specific MHSA conditions are more likely to return to the ED or be readmitted. It found that alcohol or drug dependence, dementias, psychotic disorders, autism, impulse control disorders, and personality disorders were most strongly associated with future inpatient admission or ED revisit.
AHRQ-authored; AHRQ-funded; 290200600009C.
Citation: Smith MW, Stocks C, Santora PB .
Hospital readmission rates and emergency department visits for mental health and substance abuse conditions.
Community Ment Health J 2015 Feb;51(2):190-7. doi: 10.1007/s10597-014-9784-x..
Keywords: Emergency Department, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Behavioral Health, Substance Abuse
Moy E, Barrett M, Coffey R
AHRQ Author: Moy E
Missed diagnoses of acute myocardial infarction in the emergency department: variation by patient and facility characteristics.
The purpose of this study is to estimate the frequency of missed heart attacks or their precursors (e.g., unstable angina) in the emergency department (ED) by examining use of EDs in the week prior to hospitalization for heart attack. This study of 111,973 patients found an overall rate of 0.9 percent for missed diagnoses of heart attacks.
AHRQ-authored; AHRQ-funded; 290201300002C
Citation: Moy E, Barrett M, Coffey R .
Missed diagnoses of acute myocardial infarction in the emergency department: variation by patient and facility characteristics.
Diagn. 2015 Feb;2(1):29-40..
Keywords: Diagnostic Safety and Quality, Heart Disease and Health, Emergency Department, Emergency Medical Services (EMS), Healthcare Cost and Utilization Project (HCUP)
Salihu HM, Mogos MF, Salinas-Miranda AA
National trends in maternal use of opioid drugs among pregnancy-related hospitalizations in the United States, 1998 to 2009.
AHRQ-funded; HS019997.
Citation: Salihu HM, Mogos MF, Salinas-Miranda AA .
National trends in maternal use of opioid drugs among pregnancy-related hospitalizations in the United States, 1998 to 2009.
Am J Perinatol 2015 Feb;32(3):289-98. doi: 10.1055/s-0034-1384642..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Medication, Opioids, Pregnancy
Weinberger DM, Klugman KP, Steiner CA
AHRQ Author: Steiner CA
Association between respiratory syncytial virus activity and pneumococcal disease in infants: a time series analysis of US hospitalization data.
The researchers evaluated whether variations in respiratory syncytial virus (RSV) epidemic timing and magnitude are associated with variations in pneumococcal disease epidemics and whether changes in pneumococcal disease following the introduction of a pneumococcal conjugate vaccine (PCV7) were associated with changes in the rate of RSV hospitalizations. Their findings indicate that RSV is associated with increases in the incidence of pneumococcal pneumonia.
AHRQ-authored.
Citation: Weinberger DM, Klugman KP, Steiner CA .
Association between respiratory syncytial virus activity and pneumococcal disease in infants: a time series analysis of US hospitalization data.
PLoS Med 2015 Jan 6;12(1):e1001776. doi: 10.1371/journal.pmed.1001776..
Keywords: Healthcare Cost and Utilization Project (HCUP), Newborns/Infants, Respiratory Conditions, Hospitalization
Torio CM, Encinosa WE, Berdahl T
AHRQ Author: Torio CM, Encinosa WE, Berdahl T
Annual report on health care for children and youth in the United States: national estimates of cost, utilization and expenditures for children with mental health conditions.
This study examined national trends in hospital utilization, costs, and expenditures for children with mental health conditions between 2006 and 2011. It found that hospitalizations for all listed mental health conditions increased by nearly 50 percent among children aged 10 to 14 years and by 21 percent for emergency department visits.
AHRQ-authored
Citation: Torio CM, Encinosa WE, Berdahl T .
Annual report on health care for children and youth in the United States: national estimates of cost, utilization and expenditures for children with mental health conditions.
Acad Pediatr. 2015 Jan-Feb;15(1):19-35. doi: 10.1016/j.acap.2014.07.007..
Keywords: Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Medical Expenditure Panel Survey (MEPS), Behavioral Health
Pitzer VE, Viboud C, Alonso WJ
AHRQ Author: Steiner CA
Environmental drivers of the spatiotemporal dynamics of respiratory syncytial virus in the United States.
The authors examined the association between environmental variables and state-specific measures of respiratory syncytial virus (RSV) seasonality. They found that states with low mean vapor pressure and the largest seasonal variation in potential evapotranspiration tended to experience biennial patterns of RSV activity, with alternating years of "early-big" and "late-small" epidemics. Their results successfully connected environmental drivers to the epidemic dynamics of RSV; however, the results do not fully explain why RSV activity begins in Florida, one of the warmest states, when RSV is a winter-seasonal pathogen.
AHRQ-authored.
Citation: Pitzer VE, Viboud C, Alonso WJ .
Environmental drivers of the spatiotemporal dynamics of respiratory syncytial virus in the United States.
PLoS Pathog 2015 Jan;11(1):e1004591. doi: 10.1371/journal.ppat.1004591.
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Keywords: Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Newborns/Infants, Infectious Diseases, Respiratory Conditions
Foote EM, Singleton RJ, Holman RC
AHRQ Author: Steiner CA
Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population.
The authors described the change in lower respiratory tract infection-associated hospitalization rates for American Indian and Alaskan Native (AI/AN) children and for the general US child population aged less than 5 years. They found that the 2009-2011 AI/AN child average annual LRTI-associated hospitalization rate was 1.5 times higher than the US child rate. The Alaska and Southwest regions had the highest rates. The disparity was greatest for infant pneumonia-associated and 2009-2010 H1N1 influenza-associated hospitalizations.
AHRQ-authored.
Citation: Foote EM, Singleton RJ, Holman RC .
Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population.
Int J Circumpolar Health 2015;74:29256. doi: 10.3402/ijch.v74.29256.
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Keywords: Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Racial and Ethnic Minorities, Respiratory Conditions
Hines AL, Andrews RM, Moy E
AHRQ Author: Andrews RM, Moy E
Disparities in rates of inpatient mortality and adverse events: race/ethnicity and language as independent contributors.
The authors investigated inpatient mortality rates and obstetric trauma for self-reported speakers of English, Spanish, and languages of Asia and the Pacific Islands (API) and compared quality of care by language with patterns by race/ethnicity. They found that speaking a non-English principal language and having a non-White race/ethnicity did not place patients at higher risk for inpatient mortality, except for a higher stroke mortality for Japanese-speaking patients. Patients who spoke API languages or had API race/ethnicity had higher risk for obstetric trauma than English-speaking White patients, while Spanish-speaking Hispanic patients had more obstetric trauma than English-speaking Hispanic patients.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Hines AL, Andrews RM, Moy E .
Disparities in rates of inpatient mortality and adverse events: race/ethnicity and language as independent contributors.
Int J Environ Res Public Health 2014 Dec;11(12):13017-34. doi: 10.3390/ijerph111213017.
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Keywords: Communication, Disparities, Healthcare Cost and Utilization Project (HCUP), Mortality, Racial and Ethnic Minorities
Reiter KL, Jiang HJ, Wang J
AHRQ Author: Jiang HJ
Facing the recession: how did safety-net hospitals fare financially compared with their peers?
The authors examined the effect of the recession on the financial performance of safety-net versus non-safety-net hospitals. They concluded that safety-net hospitals may not be disproportionately vulnerable to macro-economic fluctuations, but their significantly lower margins leave less financial cushion to weather sustained financial pressure.
AHRQ-authored.
Citation: Reiter KL, Jiang HJ, Wang J .
Facing the recession: how did safety-net hospitals fare financially compared with their peers?
Health Serv Res 2014 Dec;49(6):1747-66. doi: 10.1111/1475-6773.12230.
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Keywords: Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitals
Simeone RM, Oster ME, Cassell CH
AHRQ Author: Gray DT
Pediatric inpatient hospital resource use for congenital heart defects.
The authors sought to estimate healthcare costs for infants, children, and adolescents with congenital heart defects (CHDs). Using the 2009 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID), they found that hospitalizations for children with CHDs have disproportionately high hospital costs compared with other pediatric hospitalizations, and the 17% of hospitalizations with critical CHD diagnoses accounted for 27% of CHD hospital costs.
AHRQ-authored.
Citation: Simeone RM, Oster ME, Cassell CH .
Pediatric inpatient hospital resource use for congenital heart defects.
Birth Defects Res A Clin Mol Teratol 2014 Dec;100(12):934-43. doi: 10.1002/bdra.23262.
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Keywords: Cardiovascular Conditions, Children/Adolescents, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitalization
Trudnak Fowler T, Fairbrother G, Owens P
AHRQ Author: Owens P
Trends in complicated newborn hospital stays & costs, 2002-2009: implications for the future.
The researchers used HCUP data to examine trends from 2002 through 2009 in complicated newborn hospital stays, and to explore the relationship between expected sources of payment and reasons for hospitalizations. They concluded that state Medicaid programs are paying for an increasing proportion of births and costly complicated births, and they suggested that policies to prevent common birth complications have the potential to reduce costs for public programs and improve birth outcomes.
AHRQ-authored.
Citation: Trudnak Fowler T, Fairbrother G, Owens P .
Trends in complicated newborn hospital stays & costs, 2002-2009: implications for the future.
Medicare Medicaid Res Rev 2014;4(4). doi: 10.5600/mmrr.004.04.a03.
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Keywords: Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Newborns/Infants
Henke RM, Wier LM, Marder WD
AHRQ Author: Friedman BS, Wong HS
Geographic variation in cesarean delivery in the United States by payer.
This study aimed (1) to determine whether the geographic variation in cesarean delivery rate is consistent for private insurance and Medicaid, and (2) to identify the patient, population, and market factors associated with cesarean rate and determine if these factors vary by payer. It concluded that factors associated with geographic variation in cesarean delivery, a frequent and high-resource inpatient procedure, vary somewhat by payer.
AHRQ-authored; AHRQ-funded; 290200600009C.
Citation: Henke RM, Wier LM, Marder WD .
Geographic variation in cesarean delivery in the United States by payer.
BMC Pregnancy Childbirth 2014 Nov 19;14:387. doi: 10.1186/s12884-014-0387-x.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Health Insurance, Labor and Delivery, Medicaid, Pregnancy
Martsolf GR, Auerbach D, Benevent R
AHRQ Author: Stocks C, Jiang HJ
Examining the value of inpatient nurse staffing: an assessment of quality and patient care costs.
The authors assessed the effect of nurse staffing on quality of care and inpatient care costs. They found that increases in nurse staffing levels were associated with reductions in nursing-sensitive adverse events and length of stay, while changing skill mix by increasing the number of registered nurses, as a proportion of licensed nursing staff, led to reductions in costs.
AHRQ-authored; AHRQ-funded; 290200600009C.
Citation: Martsolf GR, Auerbach D, Benevent R .
Examining the value of inpatient nurse staffing: an assessment of quality and patient care costs.
Med Care 2014 Nov;52(11):982-8. doi: 10.1097/mlr.0000000000000248.
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Keywords: Healthcare Costs, Quality of Care, Healthcare Cost and Utilization Project (HCUP), Inpatient Care, Nursing
Mutter R, Stocks C
AHRQ Author: Stocks C
Using Healthcare Cost and Utilization Project (HCUP) data for emergency medicine research.
This article mentions Kocher et al., elsewhere in this issue, who use the HCUP Nationwide Inpatient Sample to examine the association between the volume of ED encounters that result in admission and inpatient mortality. It further discusses HCUP strengths, weaknesses, and future.
AHRQ-authored.
Citation: Mutter R, Stocks C .
Using Healthcare Cost and Utilization Project (HCUP) data for emergency medicine research.
Ann Emerg Med 2014 Nov;64(5):458-60. doi: 10.1016/j.annemergmed.2014.09.014.
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Keywords: Emergency Medical Services (EMS), Healthcare Costs, Healthcare Delivery, Health Services Research (HSR), Healthcare Cost and Utilization Project (HCUP)
Maeda JL, Mosher Henke R, Marder WD
AHRQ Author: Karaca Z, Friedman BS, Wong HS
Variation in hospital inpatient prices across small geographic areas.
The authors examined whether market competition may influence the difference in the inpatient price per discharge between public and private payers across small geographic areas. They found greater geographic variation in the inpatient price per discharge among private than public payers for most hospital services, while hospitals in more concentrated markets were associated with a higher price per discharge among knee arthroplasty discharges for both payers. They concluded that hospitals charged significantly higher prices to private than public payers.
AHRQ-authored; AHRQ-funded; 290200600009C.
Citation: Maeda JL, Mosher Henke R, Marder WD .
Variation in hospital inpatient prices across small geographic areas.
Am J Manag Care 2014 Nov;20(11):907-16.
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Keywords: Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Orthopedics, Surgery
Basu J
AHRQ Author: Basu J
Has access to care changed in minority communities? A study of preventable hospitalizations over time in selected States.
Basu assessed the changes in access to care in minority communities by examining the association between preventable hospitalization rates and racial/ethnic composition of the community during 1995-2005. Using HCUP data, the results indicated increases in barriers faced by minority adults in accessing primary care over time, with no similar evidence for the elderly subgroup.
AHRQ-authored.
Citation: Basu J .
Has access to care changed in minority communities? A study of preventable hospitalizations over time in selected States.
J Ambul Care Manage 2014 Oct-Dec;37(4):314-30. doi: 10.1097/jac.0000000000000024.
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Keywords: Access to Care, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Primary Care, Racial and Ethnic Minorities
Curtin CM, Hernandez-Boussard T
Readmissions after treatment of distal radius fractures.
The authors assessed the rates and associated diagnoses of readmissions for patients having received an intervention for treatment of distal radius fracture. Using AHRQ data sets, they found that many distal radius fracture patients return to the health care system for pain-related issues, and they recommended implementation of better pain management.
AHRQ-funded; HS018558.
Citation: Curtin CM, Hernandez-Boussard T .
Readmissions after treatment of distal radius fractures.
J Hand Surg Am 2014 Oct;39(10):1926-32. doi: 10.1016/j.jhsa.2014.07.041.
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Keywords: Injuries and Wounds, Quality of Care, Healthcare Cost and Utilization Project (HCUP), Pain, Hospital Readmissions
Jacobs JH, Viboud C, Tchetgen ET
AHRQ Author: Steiner C
The association of meningococcal disease with influenza in the United States, 1989-2009.
The purpose of this paper is to quantify the fraction of meningococcal disease attributable to influenza. The authors found that, over 20 years, 12.8% of meningococcal disease can be attributable to influenza in the preceding weeks with H3N2 accounting for 5.2%, H1N1 4.3%, B 3.0%, and pH1N1 0.2%. They concluded that influenza vaccination could provide protection, particularly in young children where the meningococcal disease vaccine is not recommended or protective against the most common serogroup.
AHRQ-authored.
Citation: Jacobs JH, Viboud C, Tchetgen ET .
The association of meningococcal disease with influenza in the United States, 1989-2009.
PLoS One 2014 Sep 29;9(9):e107486. doi: 10.1371/journal.pone.0107486.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Infectious Diseases, Influenza
Hernandez-Boussard T, Burns CS, Wang NE
The Affordable Care Act reduces emergency department use by young adults: evidence from three States.
The authors tested the impact of the Affordable Care Act (ACA) on how young adults used ED services. They found that the largest relative decreases were found in women and blacks. This relative decrease in ED use implies a total reduction of more than 60,000 visits from young adults across three states in 2011.
AHRQ-funded; HS018558.
Citation: Hernandez-Boussard T, Burns CS, Wang NE .
The Affordable Care Act reduces emergency department use by young adults: evidence from three States.
Health Aff 2014 Sep;33(9):1648-54. doi: 10.1377/hlthaff.2014.0103.
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Keywords: Emergency Department, Health Insurance, Policy, Healthcare Cost and Utilization Project (HCUP), Young Adults
Ellimoottil C, Miller S, Ayanian JZ
Effect of insurance expansion on utilization of inpatient surgery.
The researchers examined the differential effect of the Massachusetts insurance expansion on the use of discretionary vs. nondiscretionary surgical procedures. They found that discretionary surgery increased 9.3 percent while nondiscretionary surgery decreased by 4.5 percent. The greatest increase in discretionary surgery was observed for nonwhite participants.
AHRQ-funded; HS018346.
Citation: Ellimoottil C, Miller S, Ayanian JZ .
Effect of insurance expansion on utilization of inpatient surgery.
JAMA Surg. 2014 Aug;149(8):829-36. doi: 10.1001/jamasurg.2014.857..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Health Insurance, Healthcare Utilization
Schiltz NK, Finkelstein Rosenthal B, Crowley MA
Rehospitalization during the first year of life by insurance status.
The authors assessed the association of insurance status on infant rehospitalization in a population-based setting. They found that Medicaid coverage and being uninsured were strong predictors of rehospitalizations, with Medicaid bearing a disproportionate share of the economic burden. Normal birth weight infants had the lowest risk. They further found that jaundice and acute bronchiolitis were the leading causes of rehospitalization within 30 days and 1 year, respectively.
AHRQ-funded; HS000059.
Citation: Schiltz NK, Finkelstein Rosenthal B, Crowley MA .
Rehospitalization during the first year of life by insurance status.
Clin Pediatr 2014 Aug;53(9):845-53. doi: 10.1177/0009922814536924.
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Keywords: Health Insurance, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Newborns/Infants, Medicaid, Newborns/Infants
Johnson EK, Graham DA, Chow JS
Nationwide emergency department imaging practices for pediatric urolithiasis: room for improvement.
The researchers describe the national use of computed tomography (CT) versus ultrasound imaging for pediatric patients seen at emergency departments (EDs) for suspected urolithiasis (SU) during the period 2006-2010. Use of CT was much higher than use of ultrasound, although it dropped off after 2007. Lowest CT use was seen at EDs that care for more children.
AHRQ-funded; HS019485
Citation: Johnson EK, Graham DA, Chow JS .
Nationwide emergency department imaging practices for pediatric urolithiasis: room for improvement.
J Urol. 2014 Jul;192(1):200-6. doi: 10.1016/j.juro.2014.01.028..
Keywords: Children/Adolescents, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Imaging, Children/Adolescents, Practice Patterns
Newman-Toker DE, Moy E, Valente E
AHRQ Author: Moy E
Missed diagnosis of stroke in the emergency department: a cross-sectional analysis of a large population-based sample.
The authors sought to estimate the frequency of missed stroke and examine associations with patient, emergency department (ED), and hospital characteristics. They estimated 15,000-165,000 misdiagnosed cerebrovascular events annually in US EDs, disproportionately presenting with headache or dizziness. They recommended that physicians evaluating these symptoms be particularly attuned to the possibility of stroke in younger, female, and non-White patients.
AHRQ-authored; AHRQ-funded; HS019252.
Citation: Newman-Toker DE, Moy E, Valente E .
Missed diagnosis of stroke in the emergency department: a cross-sectional analysis of a large population-based sample.
Diagnosis 2014 Jun;1(2):155-66. doi: 10.1515/dx-2013-0038.
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Keywords: Diagnostic Safety and Quality, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Patient Safety, Stroke