National Healthcare Quality and Disparities Report
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Topics
- Ambulatory Care and Surgery (1)
- Asthma (1)
- Cardiovascular Conditions (1)
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- Children/Adolescents (6)
- (-) Chronic Conditions (12)
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- Outcomes (1)
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- Pneumonia (1)
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- Quality of Care (1)
- Respiratory Conditions (2)
- Surgery (2)
- Transitions of Care (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 12 of 12 Research Studies DisplayedJaladanki S, Schechter SB, Genies MC
Strategies for sustaining high-quality pediatric asthma care in community hospitals.
This study’s objective was to identify strategies associated with sustained guideline adherence and high-quality pediatric asthma care in community hospitals. Hospitals who were part of the Pathways for Improving Pediatric Asthma Care (PIPA) national quality improvement (QI) intervention were included. Clinicians (n = 19) involved in clinical care of children hospitalized with asthma were interviewed from five higher- and three lower-performing hospitals. Higher-performing hospitals had dedicated local champions who consistently provided reminders of evidence-based practices and delivered ongoing education. These champions also modified/developed electronic health record (EHR) tools. Lower-performing hospital clinicians described unique barriers, including delays in modifying the EHR and lack of automation of EHR tools. For all hospitals, barriers to sustainability included challenges with quality monitoring, decreasing focus of local champions over time, and ongoing difficulties developing around evidence-based practices.
AHRQ-funded; HS027041.
Citation: Jaladanki S, Schechter SB, Genies MC .
Strategies for sustaining high-quality pediatric asthma care in community hospitals.
Health Serv Res 2022 Feb;57(1):125-36. doi: 10.1111/1475-6773.13870..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Chronic Conditions, Hospitals, Quality of Care
Lipsett SC, Haines L, Monuteaux MC
Variation in oophorectomy rates for children with ovarian torsion across US children's hospitals.
A multicenter study of 1783 children diagnosed with ovarian torsion from 2012 to 2017 undergoing oophorectomy was conducted. Four-hundred and two children (22.5%) underwent oophorectomy. Odds of oophorectomy were higher in children under 11 years of age, children with public insurance, and children with complex chronic conditions.
AHRQ-funded; HS026503.
Citation: Lipsett SC, Haines L, Monuteaux MC .
Variation in oophorectomy rates for children with ovarian torsion across US children's hospitals.
J Pediatr 2021 Apr;231:269-72.e1. doi: 10.1016/j.jpeds.2020.12.019..
Keywords: Children/Adolescents, Chronic Conditions, Surgery, Hospitals
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
Myers LC, Faridi MK, Hasegawa K
The hospital readmissions reduction program and readmissions for chronic obstructive pulmonary disease, 2006-2015.
In October 2012, the initial phase of the Hospital Readmission Reduction Program imposed financial penalties on hospitals with higher-than-expected risk-adjusted 30-day readmission rates for Medicare beneficiaries with congestive heart failure, myocardial infarction, and pneumonia. In this study, the investigators hypothesized that these penalties may also be associated with decreased readmissions for chronic obstructive pulmonary disease (COPD) in the general population before COPD became a target condition (October 2014).
AHRQ-funded; HS023305.
Citation: Myers LC, Faridi MK, Hasegawa K .
The hospital readmissions reduction program and readmissions for chronic obstructive pulmonary disease, 2006-2015.
Ann Am Thorac Soc 2020 Apr;17(4):450-56. doi: 10.1513/AnnalsATS.201909-672OC..
Keywords: Respiratory Conditions, Hospital Readmissions, Hospitals, Chronic Conditions, Medicare
Mueller S, Zheng J, Orav EJ
Inter-hospital transfer and patient outcomes: a retrospective cohort study.
Inter-hospital transfer (IHT, the transfer of patients between hospitals) occurs regularly and exposes patients to risks of discontinuity of care, though outcomes of transferred patients remains largely understudied. The purpose of this retrospective cohort study was to evaluate the association between IHT and healthcare utilisation and clinical outcomes. The investigators concluded that IHT was associated with higher costs, longer LOS and lower odds of discharge home, but was differentially associated with odds of early death and 30 -day mortality depending on patients' disease category.
AHRQ-funded; HS023331.
Citation: Mueller S, Zheng J, Orav EJ .
Inter-hospital transfer and patient outcomes: a retrospective cohort study.
BMJ Qual Saf 2019 Nov;28(11):e1. doi: 10.1136/bmjqs-2018-008087..
Keywords: Transitions of Care, Hospitals, Patient Safety, Elderly, Outcomes, Chronic Conditions, Mortality, Medicare
Popescu I, Sood N, Joshi S
Trends in the use of skilled nursing facility and home health care under the Hospital Readmissions Reduction Program: an interrupted time-series analysis.
Medicare's Hospital Readmission Reduction Program penalizes hospitals with elevated 30-day readmission rates for acute myocardial infarction, heart failure, or pneumonia. The authors investigated if, in order to reduce readmissions, hospitals may have increased referrals to skilled nursing facilities and home health care. They found that hospitals might be shifting to more intensive postacute care to avoid readmissions among seniors with pneumonia. At the same time, penalized hospitals' efforts to prevent readmissions may be keeping higher proportions of their patients in the community.
AHRQ-funded; HS024284; HS025394.
Citation: Popescu I, Sood N, Joshi S .
Trends in the use of skilled nursing facility and home health care under the Hospital Readmissions Reduction Program: an interrupted time-series analysis.
Med Care 2019 Oct;57(10):757-65. doi: 10.1097/mlr.0000000000001184..
Keywords: Home Healthcare, Nursing Homes, Chronic Conditions, Hospital Readmissions, Long-Term Care, Hospitals, Heart Disease and Health, Pneumonia, Cardiovascular Conditions
Silber JH, Rosenbaum PR, Pimentel SD
Comparing resource use in medical admissions of children with complex chronic conditions.
In this study, the investigators explored whether some hospitals display a significantly different pattern of resource utilization than others when caring for similar children with complex chronic conditions (CCCs) admitted for medical diagnoses. The investigators concluded that hospitals treating similar patients with CCCs admitted for similar medical diagnoses, varied greatly in resource utilization. They suggest that Template Matching can aid chief quality officers benchmarking their hospitals to peer institutions and can help determine types of their patients having the most aberrant outcomes, facilitating quality initiatives to target these patients.
AHRQ-funded; HS020508.
Citation: Silber JH, Rosenbaum PR, Pimentel SD .
Comparing resource use in medical admissions of children with complex chronic conditions.
Med Care 2019 Aug;57(8):615-24. doi: 10.1097/mlr.0000000000001149..
Keywords: Children/Adolescents, Chronic Conditions, Hospitals, Healthcare Utilization, Hospitalization
Auger KA, Shah SS, Huang B
Discharge medical complexity, change in medical complexity and pediatric 30-day readmission.
Investigators conducted a five-year retrospective, case-control study of pediatric hospitalizations at a tertiary care children's hospital and estimated odds of 30-day unplanned readmission using adjusted conditional logistic regression. They found that polypharmacy and use of technology at discharge pose a substantial readmission risk for children, but added technology and new complex chronic conditions do not increase risk when accounting for length of stay.
AHRQ-funded; HS204735.
Citation: Auger KA, Shah SS, Huang B .
Discharge medical complexity, change in medical complexity and pediatric 30-day readmission.
J Hosp Med 2019 Aug;14(8):474-81. doi: 10.12788/jhm.3222..
Keywords: Children/Adolescents, Chronic Conditions, Hospital Readmissions, Hospitalization, Hospitals
Casucci S, Lin L, Hewner S
Estimating the causal effects of chronic disease combinations on 30-day hospital readmissions based on observational Medicaid data.
The purpose of this study was to demonstrate how observational causal inference methods can generate insights into the impact of chronic disease combinations on patients' 30-day hospital readmissions. The investigators concluded that multi-hypothesis causal analysis, a new methodological tool, generates meaningful insights from health care claims data, guiding the design of care and intervention programs.
AHRQ-funded; HS022575.
Citation: Casucci S, Lin L, Hewner S .
Estimating the causal effects of chronic disease combinations on 30-day hospital readmissions based on observational Medicaid data.
J Am Med Inform Assoc 2018 Jun;25(6):670-78. doi: 10.1093/jamia/ocx141.
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Keywords: Chronic Conditions, Hospital Readmissions, Medicaid, Hospitals
Simon TD, Cawthon ML, Popalisky J
Development and validation of the Pediatric Medical Complexity Algorithm (PMCA) Version 2.0.
The Pediatric Medical Complexity Algorithm (PMCA) was developed to stratify children by level of medical complexity. The researchers sought to refine PMCA and evaluate its performance based on the duration of eligibility and completeness of Medicaid data. They concluded that PMCA version 2.0 identifies children with C-CD with good sensitivity and very good specificity when applied to Medicaid data.
AHRQ-funded; HS020506.
Citation: Simon TD, Cawthon ML, Popalisky J .
Development and validation of the Pediatric Medical Complexity Algorithm (PMCA) Version 2.0.
Hosp Pediatr 2017 Jul;7(7):373-77. doi: 10.1542/hpeds.2016-0173.
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Keywords: Chronic Conditions, Hospitals, Medicaid, Ambulatory Care and Surgery, Children/Adolescents
Blecker S, Meisel T, Dickson VV
"We're almost guests in their clinical care": inpatient provider attitudes toward chronic disease management.
The purpose of this study was to explore inpatient provider attitudes about chronic disease management and, in particular, barriers and facilitators of chronic disease management in the hospital. It found that a strong relationship with the outpatient provider and involvement of specialists were facilitators of inpatient chronic disease management. Providers perceived benefits to in-hospital chronic disease management for both processes of care and clinical outcomes.
AHRQ-funded; HS023683.
Citation: Blecker S, Meisel T, Dickson VV .
"We're almost guests in their clinical care": inpatient provider attitudes toward chronic disease management.
J Hosp Med 2017 Mar;12(3):162-67. doi: 10.12788/jhm.2699.
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Keywords: Care Management, Chronic Conditions, Hospitals, Provider: Health Personnel
Basu J, Avila R, Ricciardi R
AHRQ Author: Basu J, Ricciardi R
Hospital readmission rates in U.S. states: are readmissions higher where more patients with multiple chronic conditions cluster?
This study examines small area variations in readmission rates to assess whether higher readmission rate in an area is associated with higher clusters of patients with multiple chronic conditions. It found that areas with higher concentration of patients with increased comorbid conditions are more likely to have higher readmission rates.
AHRQ-authored.
Citation: Basu J, Avila R, Ricciardi R .
Hospital readmission rates in U.S. states: are readmissions higher where more patients with multiple chronic conditions cluster?
Health Serv Res 2016 Jun;51(3):1135-51. doi: 10.1111/1475-6773.12401..
Keywords: Chronic Conditions, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Hospitals