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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.
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1 to 4 of 4 Research Studies DisplayedHaddad DN, Shipe ME, Absi TS
Preparing for bundled payments: impact of complications post-coronary artery bypass grafting on costs.
This study examined the impact of complications on bundled payments for coronary artery bypass grafting (CABG) for care provided from admission through 90 days post-discharge. The authors linked clinical and internal cost data for patients undergoing CABG from 2014 to 2017 at a single institution. They performed multivariable linear regression to evaluate drivers of high costs, adjusting for preoperative and intraoperative characteristics and postoperative complications. They reviewed records of 1789 patients undergoing CABG with an average of 2.7 vessels. A large proportion of patients were diabetic and obese. Factors associated with increased adjusted costs were preoperative renal failure, diabetes and body mass index, postoperative stroke, prolonged ventilation, rebleeding requiring reoperation, and renal failure with varying magnitude.
AHRQ-funded; HS026122.
Citation: Haddad DN, Shipe ME, Absi TS .
Preparing for bundled payments: impact of complications post-coronary artery bypass grafting on costs.
Ann Thorac Surg 2021 Apr;111(4):1258-63. doi: 10.1016/j.athoracsur.2020.06.105..
Keywords: Cardiovascular Conditions, Surgery, Adverse Events, Healthcare Costs, Payment
Wang Y, Eldridge N, Metersky ML
AHRQ Author: Eldridge N, Rodrick D
Association between Medicare expenditures and adverse events for patients with acute myocardial infarction, heart failure, or pneumonia in the United States.
The purpose of this study was to evaluate whether hospital-specific adverse event rates were associated with hospital-specific risk-standardized 30-day episode-of-care Medicare expenditures for fee-for-service patients discharged with acute myocardial infarction (AMI), heart failure (HF), or pneumonia. Investigators concluded that hospitals with high adverse event rates were more likely to have high 30-day episode-of-care Medicare expenditures for patients discharged with AMI, HF, or pneumonia.
AHRQ-authored; AHRQ-funded; 290201200003C.
Citation: Wang Y, Eldridge N, Metersky ML .
Association between Medicare expenditures and adverse events for patients with acute myocardial infarction, heart failure, or pneumonia in the United States.
JAMA Netw Open 2020 Apr;3(4):e202142. doi: 10.1001/jamanetworkopen.2020.2142..
Keywords: Adverse Events, Patient Safety, Heart Disease and Health, Cardiovascular Conditions, Pneumonia, Medicare, Healthcare Costs
Amin AP, McNeely C, Spertus JA
Incremental cost of acute kidney injury after percutaneous coronary intervention in the United States.
This study examined incremental costs of acute kidney injury (AKI) complications from percutaneous coronary intervention (PCI), which is a common and severe complication. Out of a sample of over 1.4 million PCI patients at 518 US hospitals from 2006 to 2015, AKI occurred in 5.73% of PCI patients. Those with AKI had at least double the hospitalization costs and the incremental cost was $9,448. It was also independently associated with an incremental length of stay of 3.6 days. AKI cost burden was extrapolated at 411.3 million US dollars annually.
AHRQ-funded; HS022481.
Citation: Amin AP, McNeely C, Spertus JA .
Incremental cost of acute kidney injury after percutaneous coronary intervention in the United States.
Am J Cardiol 2020 Jan;125(1):29-33. doi: 10.1016/j.amjcard.2019.09.042..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Adverse Events, Healthcare Costs, Kidney Disease and Health, Patient Safety, Registries
Amin AP, Miller S, Rahn B
Reversing the "risk-treatment paradox" of bleeding in patients undergoing percutaneous coronary intervention: risk-concordant use of bleeding avoidance strategies is associated with reduced bleeding and lower costs.
Bleeding avoidance strategies (BAS) are effective, but are paradoxically used less often with patients at high risk of bleeding. This article describes the implementation of an intervention in a St. Louis, MO, hospital intended to reverse the bleeding risk-treatment paradox. Temporal trends in BAS use and the association of risk-concordant BAS use with bleeding as well as hospital costs of percutaneous coronary intervention were examined. Patient-centered care that aimed directly toward making treatment-related decisions based on predicted risk of bleeding led to a more risk-concordant use of BAS and a reversal of the risk-treatment paradox. The authors conclude that larger multicentered studies will be needed to corroborate these results.
AHRQ-funded; HS022481.
Citation: Amin AP, Miller S, Rahn B .
Reversing the "risk-treatment paradox" of bleeding in patients undergoing percutaneous coronary intervention: risk-concordant use of bleeding avoidance strategies is associated with reduced bleeding and lower costs.
J Am Heart Assoc 2018 Nov 6;7(21):e008551. doi: 10.1161/jaha.118.008551..
Keywords: Adverse Events, Patient Safety, Heart Disease and Health, Risk, Surgery, Cardiovascular Conditions, Healthcare Costs