National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (1)
- Adverse Events (24)
- Ambulatory Care and Surgery (2)
- Arthritis (1)
- Cancer (5)
- Cancer: Breast Cancer (1)
- Cardiovascular Conditions (5)
- Children/Adolescents (4)
- Chronic Conditions (1)
- Comparative Effectiveness (1)
- Digestive Disease and Health (4)
- Elderly (3)
- Electronic Health Records (EHRs) (1)
- Emergency Department (4)
- Evidence-Based Practice (1)
- Eye Disease and Health (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Cost and Utilization Project (HCUP) (8)
- Healthcare Costs (2)
- Healthcare Delivery (1)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (2)
- Heart Disease and Health (2)
- Hospital Discharge (6)
- Hospitalization (1)
- (-) Hospital Readmissions (60)
- Hospitals (7)
- Infectious Diseases (1)
- Injuries and Wounds (3)
- Kidney Disease and Health (2)
- Medicaid (1)
- Medicare (5)
- Medication (1)
- Mortality (5)
- Neurological Disorders (2)
- Nursing Homes (2)
- Obesity (3)
- Obesity: Weight Management (3)
- Opioids (1)
- Orthopedics (2)
- Outcomes (13)
- Pain (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (8)
- Patient Safety (6)
- Payment (2)
- Pneumonia (1)
- Prevention (1)
- Provider Performance (1)
- Quality Improvement (5)
- Quality Indicators (QIs) (2)
- Quality of Care (5)
- Racial and Ethnic Minorities (2)
- Registries (2)
- Rehabilitation (2)
- Respiratory Conditions (1)
- Risk (17)
- Sexual Health (1)
- Social Determinants of Health (1)
- Substance Abuse (1)
- (-) Surgery (60)
- Teams (1)
- Telehealth (1)
- Tobacco Use (1)
- Transitions of Care (1)
- Transplantation (1)
- Treatments (1)
- Urban Health (1)
- Women (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 60 Research Studies DisplayedHowell TC, Lumpkin S, Chaumont N
Predicting colorectal surgery readmission risk: a surgery-specific predictive model.
The purpose of this retrospective split-sample cohort study was to develop a predictive model for colorectal surgery patients for risk of 30-day readmission. The researchers included patients admitted to the colorectal surgery service who underwent surgery and were discharged from an academic tertiary hospital between 2017 and 2019. A total of 1549 patients met eligibility criteria. The study found the 30-day readmission rate of the cohort was 19.62%. Customized surgery-specific readmission models with comprehensive data sources outperformed the most utilized readmission indices in predicting 30-day readmission in colorectal surgery patients. The performance of the models were improved by utilizing more comprehensive datasets that include administrative and socioeconomic details about a patient and clinical information utilized for decision-making at the time of discharge.
AHRQ-funded; HS026363.
Citation: Howell TC, Lumpkin S, Chaumont N .
Predicting colorectal surgery readmission risk: a surgery-specific predictive model.
IISE Trans Healthc Syst Eng 2023; 13(3):175-81. doi: 10.1080/24725579.2023.2200210..
Keywords: Hospital Readmissions, Surgery, Risk
Brajcich BC, Johnson JK, Holl JL
Evaluation of emergency department treat-and-release encounters after major gastrointestinal surgery.
The purpose of this study was to assess the incidence of, reasons for, and predictors of emergency department treat-and-release encounters after gastrointestinal cancer operations. The researchers identified patients who underwent elective colorectal, esophageal, gastric, hepatobiliary, pancreatic, or small intestinal operations for cancer from the 2015-2017 Healthcare Cost and Utilization Project State Inpatient and State Emergency Department Databases for New York, Maryland, and Florida. The study found that among 51,527 patients at 406 hospitals, 7.9% had an ED treat-and-release encounter, and 10.8% had an ED encounter with readmission. In total, 40.7% of ED encounters were treat-and-release encounters. 12% of ED treat-and-release encounters were for pain, 11.7% for device/ostomy complaints, and 11.4% were for wound complaints (11.4%). ED treat-and-release encounters predictors included non-Hispanic Black race/ethnicity and Medicare or Medicaid coverage.
AHRQ-funded; HS026385.
Citation: Brajcich BC, Johnson JK, Holl JL .
Evaluation of emergency department treat-and-release encounters after major gastrointestinal surgery.
J Surg Oncol 2023 Aug; 128(2):402-08. doi: 10.1002/jso.27292..
Keywords: Emergency Department, Digestive Disease and Health, Surgery, Hospital Readmissions
Difazio RL, Shore BJ, Melvin P
Pneumonia after hip surgery in children with neurological complex chronic conditions.
The purpose of this retrospective cohort study was to estimate rates of postoperative pneumonia in children with neurological complex chronic conditions (CCC) undergoing hip surgery, to determine the effect of pneumonia on postoperative hospital resource use, and to identify predictors. Researchers used data from the Pediatric Health Information System for children 4 years and older with a neurological CCC who had undergone hip surgery from 2016 to 2018 in U.S. children's hospitals. Findings indicate that postoperative pneumonia in children with a neurological CCC was associated with longer length-of-stay, readmissions, and higher costs. Children who had undergone pelvic osteotomies and who had multimorbidity needed additional clinical support to prevent postoperative pneumonia and to decrease resource utilization.
AHRQ-funded; HS024453.
Citation: Difazio RL, Shore BJ, Melvin P .
Pneumonia after hip surgery in children with neurological complex chronic conditions.
Dev Med Child Neurol 2023 Feb; 65(2):232-42. doi: 10.1111/dmcn.15339..
Keywords: Children/Adolescents, Surgery, Neurological Disorders, Pneumonia, Respiratory Conditions, Hospital Readmissions, Adverse Events
Collins CR, Abel MK, Shui A
Preparing for participation in the centers for Medicare and Medicaid Services' bundle care payment initiative-advanced for major bowel surgery.
This study aimed to assess where the largest opportunities for care improvement lay with the bundled payment reimbursement model and how best to identify patients at high risk of suffering costly complications, including hospital readmission. The authors used a cohort of patients from 2014 and 2016 who met inclusion criteria for the Major Bowel Bundled Payment Program and performed a cost analysis to identify opportunities for improved care efficiency. Using the results, they identified readmissions as a target for improvement and then assessed whether the American College of Surgeons' National Surgical Quality Improvement Program surgical risk calculator (ACS NSQIP SRC) could accurately identify patients within the bundled payment population who were at high risk of readmission using a logistic regression model. Patients who were readmitted within 90-days post-surgery were 2.53 times more likely to be high-cost (>$60,000) then non-readmitted patients. However, the ACS NSQIP SRC did not accurately predict patients at high risk of readmission within the first 30 days post-surgery.
AHRQ-funded; HS024532.
Citation: Collins CR, Abel MK, Shui A .
Preparing for participation in the centers for Medicare and Medicaid Services' bundle care payment initiative-advanced for major bowel surgery.
Perioper Med 2022 Dec 9;11(1):54. doi: 10.1186/s13741-022-00286-9..
Keywords: Provider Performance, Payment, Hospital Readmissions, Quality Improvement, Quality of Care, Surgery, Medicare, Medicaid
Bucher BT, Yang M, Richards Steed R, BT, Yang M, Richards Steed R
Geographic proximity of family members and healthcare utilization after complex surgical procedures.
This retrospective cohort study sought to determine the relationship between a patient's proximal familial social support, defined as the geographic proximity of family members, and healthcare utilization after complex cardiovascular and oncologic procedures. The authors defined healthcare utilization outcomes as 30-day all-cause readmission unplanned readmission, nonindex hospital readmission, index hospital length of stay, and home discharge disposition. The number of first-degree relatives (FDRs) living within 30 miles of the patient was measured using 60,895 patients undergoing complex cardiovascular procedures or oncologic procedures. Compared with patients with 0 to 1 FDRs, patients with 6+ FDRs living in close proximity had significantly lower rates of all-cause readmission (12.1% vs 13.5%), unplanned readmission, nonindex readmission; higher rates of home discharge. A larger number of FDRs living within 30 miles of the patient was significantly associated with a lower likelihood of all-cause readmission, 30-day unplanned readmission, nonindex readmission; higher likelihood of home discharge; and shorter index length of stay.
AHRQ-funded; HS025776.
Citation: Bucher BT, Yang M, Richards Steed R, BT, Yang M, Richards Steed R .
Geographic proximity of family members and healthcare utilization after complex surgical procedures.
Ann Surg 2022 Oct 1;276(4):720-31. doi: 10.1097/sla.0000000000005584..
Keywords: Surgery, Hospital Discharge, Hospital Readmissions, Healthcare Utilization
Yuce TK, Holmstrom A, Soper NJ
Complications and readmissions associated with first assistant training level following elective bariatric surgery.
Little is known regarding the variation in training level and potential clinical impact of the first assistant in bariatric surgery. In this study, the investigators described the postoperative 30-day complications and readmissions following elective bariatric procedures by training level of the first assistant. The investigators concluded that variation in training level of the first assist during bariatric surgery had no influence on DSM or readmissions.
AHRQ-funded; HS000078.
Citation: Yuce TK, Holmstrom A, Soper NJ .
Complications and readmissions associated with first assistant training level following elective bariatric surgery.
J Gastrointest Surg 2021 Aug;25(8):1948-54. doi: 10.1007/s11605-020-04787-0..
Keywords: Obesity: Weight Management, Obesity, Surgery, Hospital Readmissions, Adverse Events
Brauer DG, Wu N, Keller MR
Care fragmentation and mortality in readmission after surgery for hepatopancreatobiliary and gastric cancer: a patient-level and hospital-level analysis of the Healthcare Cost and Utilization Project administrative database.
This study investigates patient-level and hospital-level variables associated with the mortality difference at referral centers and, postoperatively, outside hospitals, in patients undergoing hepatopancreatobiliary (HPB) and gastric oncologic surgeries. Using HCUP data, findings showed that, for readmissions following HPB and gastric oncologic surgery, travel distance and timing were major determinants of care fragmentation. However, these variables were not associated with mortality, nor was annual hospital surgical volume after risk-adjustment.
AHRQ-funded; HS019455.
Citation: Brauer DG, Wu N, Keller MR .
Care fragmentation and mortality in readmission after surgery for hepatopancreatobiliary and gastric cancer: a patient-level and hospital-level analysis of the Healthcare Cost and Utilization Project administrative database.
J Am Coll Surg 2021 Jun;232(6):921-32. doi: 10.1016/j.jamcollsurg.2021.03.017..
Keywords: Healthcare Cost and Utilization Project (HCUP), Cancer, Surgery, Hospital Readmissions, Mortality
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
Aasen DM, Bronsert Rozeboom, PD
Relationships between predischarge and postdischarge infectious complications, length of stay, and unplanned readmissions in the ACS NSQIP database.
This study looked at the relationships between predischarge and postdischarge infectious complications, length of stay, and unplanned hospital readmissions after surgery. Data from the American College of Surgeons National Surgical Quality Improvement database from 2012 to 2017 across nine surgical specialties was used to analyze 30-day postoperative infectious complications including sepsis, surgical site infections, pneumonia, and urinary tract infections. Postoperative infectious complications were identified in 5.2% of cases, of which 59.8% were postdischarge. The specific postdischarge complications identified were 73.4% of surgical site infections, 34.9% of sepsis cases, 26.5% of pneumonia cases, and 53.2% of urinary tract infections. These postoperative infections were associated with an increased risk of readmission. Most infections were diagnosed postdischarge. The trend towards shorter length of stays postoperation also contribute to the increase in infections detected after discharge and the rate of unplanned related postoperative readmissions.
AHRQ-funded; HS026019.
Citation: Aasen DM, Bronsert Rozeboom, PD .
Relationships between predischarge and postdischarge infectious complications, length of stay, and unplanned readmissions in the ACS NSQIP database.
Surgery 2021 Feb;169(2):325-32. doi: 10.1016/j.surg.2020.08.009..
Keywords: Hospital Readmissions, Adverse Events, Healthcare-Associated Infections (HAIs), Infectious Diseases, Quality Improvement, Quality of Care, Surgery
Braet DJ, Smith JB, Bath J
Risk factors associated with 30-day hospital readmission after carotid endarterectomy.
This study looked at the risk factors associated with 30-day hospital readmission after carotid endarterectomy. Patients in the Cerner Health Facts® database were selected using ICD-9-CM procedure codes. A total of 5257 patients were identified who had undergone elective carotid endarterectomy. Readmission was associated with end-stage renal disease, hemorrhage or hematoma, procedural complications, use of bronchodilators, electrolyte abnormalities, and hypokalemia less than 3.7 mEq/L. Although protamine reduces the risk of bleeding complications, only 40% of patients received that medication.
AHRQ-funded; HS022140.
Citation: Braet DJ, Smith JB, Bath J .
Risk factors associated with 30-day hospital readmission after carotid endarterectomy.
Vascular 2021 Feb;29(1):61-68. doi: 10.1177/1708538120937955..
Keywords: Hospital Readmissions, Surgery, Cardiovascular Conditions, Risk, Adverse Events
Lumpkin ST, Mihas P, Baldwin X
Surgical patient values frame and modify the impact of risk factors for non-routine postdischarge care: a mixed-methods study.
This mixed methods study looked at patient perspectives on risk factors of non-routine postdischarge care (emergency department visit or rehospitalization) for adult colorectal surgery patients. Surgery patients were identified from hospital records from 2017 to 2018. The authors enrolled 258 participants, surveyed 167, and interviewed 18. Depressive symptoms were found to be one of the many risk factors confirmed to increase non-routine health utilization.
AHRQ-funded; HS026363.
Citation: Lumpkin ST, Mihas P, Baldwin X .
Surgical patient values frame and modify the impact of risk factors for non-routine postdischarge care: a mixed-methods study.
Am J Surg 2021 Jan;221(1):195-203. doi: 10.1016/j.amjsurg.2020.05.016..
Keywords: Digestive Disease and Health, Surgery, Risk, Hospital Readmissions, Emergency Department
Yu J, Olsen MA, Margenthaler JA
Indications for readmission following mastectomy for breast cancer: an assessment of patient and operative factors.
In this study, the investigators examined the impact of patient and operative factors on 30-day hospital readmission following mastectomy for breast cancer. Using the 2011 HCUP California State Inpatient Database, they evaluated readmissions in adult women undergoing mastectomy for invasive, in situ, or history of breast cancer. The investigators found that surgical site infection and wound complications were the most common diagnoses requiring readmission and resulted in over half of readmissions in their study population at 30 days.
AHRQ-funded; HS19455.
Citation: Yu J, Olsen MA, Margenthaler JA .
Indications for readmission following mastectomy for breast cancer: an assessment of patient and operative factors.
Breast J 2020 Oct;26(10):1966-72. doi: 10.1111/tbj.14029..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Surgery, Cancer: Breast Cancer, Cancer, Women
Hernandez-Boussard T, Graham LA, Carroll I
Perioperative opioid use and pain-related outcomes in the Veterans Health Administration.
This study characterized perioperative exposure to morphine and its association with postoperative pain and 30-day readmissions. Utilizing nationwide Veterans Healthcare Administration (VHA) data on four high-volume surgical procedures, the researchers found that patients receiving high perioperative oral morphine equivalents were more likely to return to care for pain-related problems.
AHRQ-funded; HS024096.
Citation: Hernandez-Boussard T, Graham LA, Carroll I .
Perioperative opioid use and pain-related outcomes in the Veterans Health Administration.
Am J Surg 2020 Jun;219(6):969-75. doi: 10.1016/j.amjsurg.2019.06.022..
Keywords: Opioids, Medication, Pain, Substance Abuse, Surgery, Hospital Readmissions
Yuce TK, Ellis RJ, Merkow RP
Post-operative complications and readmissions following outpatient elective Nissen fundoplication.
Traditionally, laparoscopic Nissen fundoplication (LNF) has been considered an inpatient procedure. Advances in surgical and anesthetic techniques have led to a shift towards outpatient LNF procedures. However, differences in surgical outcomes between outpatient and inpatient LNF are poorly understood. The objectives of this study were (1) to describe the frequency of outpatient LNF in a national cohort and (2) to identify any differences in complications or readmission rates between outpatient and inpatient LNF.
AHRQ-funded; HS024516.
Citation: Yuce TK, Ellis RJ, Merkow RP .
Post-operative complications and readmissions following outpatient elective Nissen fundoplication.
Surg Endosc 2020 May;34(5):2143-48. doi: 10.1007/s00464-019-07020-5..
Keywords: Surgery, Hospital Readmissions, Adverse Events, Ambulatory Care and Surgery, Digestive Disease and Health, Patient Safety
Yuce TK, Khorfan R, Soper NJ
Post-operative complications and readmissions associated with smoking following bariatric surgery.
The link between smoking and poor postoperative outcomes is well established. Despite this, current smokers are still offered bariatric surgery. In this study, the investigators describe the risk of postoperative 30-day complications and readmission following laparoscopic sleeve gastrectomy and laparoscopic Roux-En-Y gastric bypass in smokers. The investigators concluded that smokers undergoing bariatric surgery experienced significantly worse 30-day outcomes when compared with non-smokers.
AHRQ-funded; HS000078.
Citation: Yuce TK, Khorfan R, Soper NJ .
Post-operative complications and readmissions associated with smoking following bariatric surgery.
J Gastrointest Surg 2020 Mar;24(3):525-30. doi: 10.1007/s11605-019-04488-3..
Keywords: Surgery, Tobacco Use, Adverse Events, Hospital Readmissions, Obesity: Weight Management, Obesity, Risk, Outcomes
Longo M, Pennington Z, Gelfand Y
Readmission after spinal epidural abscess management in urban populations: a bi-institutional study.
This study examined 90-day readmission rates and causes after spinal epidural abscess (SEA) occurrence in urban populations. Neurosurgery records from two large urban institutions were reviewed to identify patients who were treated with SEA. Out of 103 patients with identified SEA, 97 were included. The mean age was 57.1 years and 57.7% were male. The 90-readmission rate for all causes was 37.1% with infection being the most common cause. Patients with prior immunocompromised status or hepatic disease had higher odds of 90-day readmission after SEA treatment.
AHRQ-funded; HS026396.
Citation: Longo M, Pennington Z, Gelfand Y .
Readmission after spinal epidural abscess management in urban populations: a bi-institutional study.
J Neurosurg Spine 2020 Mar;32(3):465–72. doi: 10.3171/2019.8.Spine19790..
Keywords: Hospital Readmissions, Urban Health, Surgery, Risk
Hu QL, Livhits MJ, Ko CY MJ, Ko CY
Same-day discharge is not associated with increased readmissions or complications after thyroid operations.
The purpose of this study was to determine whether same-day discharge following thyroid surgery resulted in increased rehospitalization. Data from the American College of Surgeons National Surgical Quality Improvement Program Targeted Thyroidectomy database was used to identify patients who underwent thyroid resections. Results showed that, in a national cohort of patients undergoing thyroid surgery, same-day discharge was not associated with greater rates of readmission or complications when compared with discharge 1 or 2 days after thyroid surgery.
AHRQ-funded; 233201500020I.
Citation: Hu QL, Livhits MJ, Ko CY MJ, Ko CY .
Same-day discharge is not associated with increased readmissions or complications after thyroid operations.
Surgery 2020 Jan;167(1):117-23. doi: 10.1016/j.surg.2019.06.054..
Keywords: Surgery, Ambulatory Care and Surgery, Hospital Readmissions, Hospital Discharge, Adverse Events, Patient-Centered Outcomes Research, Quality Improvement, Quality of Care
Smith AB, Mueller D, Garren B
Using qualitative research to reduce readmissions and optimize perioperative cystectomy care.
This study examined the need for qualitative research on meaningful patient-reported outcomes (PROs) to prevent complications and readmissions after cystectomy. The investigators looked at the potential use of mobile communication devices (mHealth) to capture patients’ experiences and to improve outcomes. Interviews were conducted with 15 readmitted patients and 10 of their partners over 45 semi-structured in-depth interviews. The most common perspectives were that patients and their caregivers were overloaded with cystectomy education; they need to know what are normal post-operative symptoms; and that using mHealth would help with patient and caregiver education.
AHRQ-funded; HS024134.
Citation: Smith AB, Mueller D, Garren B .
Using qualitative research to reduce readmissions and optimize perioperative cystectomy care.
Cancer 2019 Oct 15;125(20):3545-53. doi: 10.1002/cncr.32362..
Keywords: Hospital Readmissions, Surgery, Health Information Technology (HIT), Quality Improvement, Quality of Care, Hospitals, Patient-Centered Healthcare
Schwarzkopf R, Behery OA, Yu H
Patterns and costs of 90-day readmission for surgical and medical complications following total hip and knee arthroplasty.
Unplanned readmissions following elective total hip (THA) and knee (TKA) arthroplasty as a result of surgical complications likely have different quality improvement targets and cost implications than those for nonsurgical readmissions. In this study, the investigators compared payments, timing, and location of unplanned readmissions with Center for Medicare and Medicaid Services (CMS)-defined surgical complications to readmissions without such complications.
AHRQ-funded; HS022882.
Citation: Schwarzkopf R, Behery OA, Yu H .
Patterns and costs of 90-day readmission for surgical and medical complications following total hip and knee arthroplasty.
J Arthroplasty 2019 Oct;34(10):2304-07. doi: 10.1016/j.arth.2019.05.046..
Keywords: Orthopedics, Surgery, Hospital Readmissions, Adverse Events, Quality Improvement, Quality of Care, Medicare, Hospitals
Sheetz KH, Woodside KJ, Shahinian VB
Trends in bariatric surgery procedures among patients with ESKD in the United States.
This study examined trends in bariatric surgery among patients with end-stage kidney disease (ESKD) in the United States. There was an almost ninefold increase in surgery between 2006 and 2016 for ESKD patients and also for sleeve gastrectomy surgery. ESKD patients showed similar complication rates compared with non-ESKD patients, but there were more readmissions.
AHRQ-funded; HS023597; HS000053.
Citation: Sheetz KH, Woodside KJ, Shahinian VB .
Trends in bariatric surgery procedures among patients with ESKD in the United States.
Clin J Am Soc Nephrol 2019 Aug 7;14(8):1193-99. doi: 10.2215/cjn.01480219..
Keywords: Obesity, Surgery, Kidney Disease and Health, Obesity: Weight Management, Hospital Readmissions, Adverse Events, Outcomes
Chhabra KR, Ibrahim AM, Thumma JR
Impact of Medicare readmissions penalties on targeted surgical conditions.
The authors used Medicare claims to evaluate the effects of the 2013 expansion of the Hospital Readmissions Reduction Program on risk-adjusted readmission rates, episode payments, lengths-of-stay, and observation status use for hip and knee replacement surgery. They found that medical readmission penalties led to readmission reductions for surgical patients, that targeted surgical penalties did not have an additional effect, and that readmission reductions are approaching a point below which further reductions may be unlikely.
AHRQ-funded; HS000053.
Citation: Chhabra KR, Ibrahim AM, Thumma JR .
Impact of Medicare readmissions penalties on targeted surgical conditions.
Health Aff 2019 Jul;38(7):1207-15. doi: 10.1377/hlthaff.2019.00096..
Keywords: Surgery, Hospital Readmissions, Orthopedics, Payment
Borza T, Oerline MK, Skolarus TA
Association between hospital participation in Medicare Shared Savings Program Accountable Care Organizations and readmission following major surgery.
Accountable Care Organizations (ACOs) and readmission rates following major surgery. A retrospective cohort study was conducted using a 20% national Medicare sample to identify beneficiaries undergoing 1 of 7 common surgical procedures: abdominal aortic aneurysm repair, colectomy, cystectomy, prostatectomy, lung resection, total knee arthroplasty, and total hip arthroplasty between 2010 and 2014. Thirty-day risk-adjusted readmission rates was the primary outcome studied. Out of 2974 hospitals in the study, 389 were ACO affiliated. While rates fell for both cohorts, ACO hospitals had a higher decrease in hospitalizations over the same time period.
AHRQ-funded; HS024728; HS024525.
Citation: Borza T, Oerline MK, Skolarus TA .
Association between hospital participation in Medicare Shared Savings Program Accountable Care Organizations and readmission following major surgery.
Ann Surg 2019 May;269(5):873-78. doi: 10.1097/sla.0000000000002737..
Keywords: Hospitals, Surgery, Hospital Readmissions, Medicare, Healthcare Costs, Healthcare Delivery
Bath J, Smith JB, Kruse RL
Cohort study of risk factors for 30-day readmission after abdominal aortic aneurysm repair.
This retrospective cohort study examined 30-day readmission rates for patients who had abdominal aortic aneurysm (AAA) repair comparing two different procedures,. The cohort was selected from inpatients (2009-2016) who had undergone elective AAA repair using the multicenter Cerner Health Facts(R) database and were identified ICD-9 procedure codes. The two procedures compared were 3,101 endovascular aneurysm repairs (EVAR) and 1,622 open procedures. Patients who had EVAR were less likely to be readmitted. Risk factors for readmission included surgical site infection, age, receipt of bronchodilators or steroids, serum potassium > 5.2 mEq/L, and higher Charlson co-morbidity scores. The most common infections causing readmission were pneumonia and urinary tract infection after EVAR.
AHRQ-funded; HS022140.
Citation: Bath J, Smith JB, Kruse RL .
Cohort study of risk factors for 30-day readmission after abdominal aortic aneurysm repair.
Vasa 2019 May;48(3):251-61. doi: 10.1024/0301-1526/a000767..
Keywords: Risk, Hospital Readmissions, Surgery, Outcomes, Comparative Effectiveness, Patient-Centered Outcomes Research
Brauer DG, Lyons SA, Keller MR
Simplified risk prediction indices do not accurately predict 30-day death or readmission after discharge following colorectal surgery.
This study examined the performance of widely used risk prediction indices to predict 30-day death or readmission after discharge following colorectal surgery. The study used a retrospective split-sample cohort of patients discharged after colorectal surgery from inpatient databases of HCUP for the states of New York, California, and Florida from 2006-2014. The commonly used risk prediction model LACE (length of stay, acute admissions, Charlson comorbidity index score, and emergency department visits) was compared with the real outcomes of death or readmission within 30 days after discharge with the cohort. Results showed a poor model fit with LACE and the researchers recommended a better model be developed.
AHRQ-funded; HS019455.
Citation: Brauer DG, Lyons SA, Keller MR .
Simplified risk prediction indices do not accurately predict 30-day death or readmission after discharge following colorectal surgery.
Surgery 2019 May;165(5):882-88. doi: 10.1016/j.surg.2018.12.007..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Surgery, Risk, Adverse Events, Outcomes
Lam L, Ahn HJ, Okajima K
Gender differences in the rate of 30-day readmissions after percutaneous coronary intervention for acute coronary syndrome.
This study investigated whether women have higher 30-day hospital readmission rates than men who have undergone percutaneous coronary intervention (PCI) after acute coronary syndrome (ACS). In general, women have been reported having higher readmission rates than men after ACS. Statewide hospitalization data for 2010 to 2015 in Hawaii was analyzed to compare gender differences. Overall, the women in the study were older, more identified as Native Hawaiian and have more cardiovascular risk factors compared with the men. Readmission rates were found to be higher than for men after undergoing PCI, but as shown above there were more risk factors for these women.
AHRQ-funded; HS019990.
Citation: Lam L, Ahn HJ, Okajima K .
Gender differences in the rate of 30-day readmissions after percutaneous coronary intervention for acute coronary syndrome.
Womens Health Issues 2019 Jan-Feb;29(1):17-22. doi: 10.1016/j.whi.2018.09.002..
Keywords: Cardiovascular Conditions, Hospital Readmissions, Heart Disease and Health, Sexual Health, Surgery