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
Topics
- Adverse Events (2)
- Brain Injury (1)
- Dementia (1)
- Disparities (1)
- (-) Elderly (13)
- Emergency Medical Services (EMS) (1)
- (-) Healthcare Cost and Utilization Project (HCUP) (13)
- Healthcare Utilization (1)
- Hospitalization (5)
- Hospital Readmissions (3)
- Hospitals (3)
- Injuries and Wounds (1)
- Medicare (2)
- Mortality (1)
- Orthopedics (1)
- Outcomes (4)
- Policy (1)
- Provider Performance (1)
- Quality Measures (1)
- Quality of Care (1)
- Risk (4)
- Stroke (1)
- Surgery (5)
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 13 of 13 Research Studies DisplayedDworsky JQ, Shellito AD, Childers CP
Association of geriatric events with perioperative outcomes after elective inpatient surgery.
Researchers investigated the prevalence and association of geriatric events (GEs) with clinical outcomes after elective surgery. Using National Inpatient Sample data, they found that, compared to admissions with no GEs, one or more GEs were associated with higher probability of worse outcomes including mortality, postoperative complications, prolonged length of stay, and discharge to a skilled nursing facility. They recommended efforts focusing on mutable factors responsible for GEs in order to optimize surgical care for older adults.
AHRQ-funded; HS000046.
Citation: Dworsky JQ, Shellito AD, Childers CP .
Association of geriatric events with perioperative outcomes after elective inpatient surgery.
J Surg Res 2021 Mar;259:192-99. doi: 10.1016/j.jss.2020.11.011..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Surgery, Adverse Events, Outcomes
Jacobs PD, Basu J
AHRQ Author: Jacobs PD, Basu J
Medicare Advantage and postdischarge quality: evidence from hospital readmissions.
This study compared relative readmission rates for beneficiaries enrolled in Medicare Advantage (MA) and traditional Medicare (TM). HCUP State Inpatient Databases data for 4 states was used from 2009 and 2014. The outcome compared was the probability of a hospital readmission within 30 days of an index admission. There were significantly lower all-cause readmission rates among MA enrollees relative to those in TM in both 2009 and 2014, but MA enrollment was not associated with an increased reduction in readmission rates relative to TM during that time period.
AHRQ-authored
Citation: Jacobs PD, Basu J .
Medicare Advantage and postdischarge quality: evidence from hospital readmissions.
Am J Manag Care 2020 Dec;26(12):524-29. doi: 10.37765/ajmc.2020.88540..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Medicare, Hospital Readmissions, Hospitals, Quality of Care, Provider Performance
Wu SS, Bellantoni m, Weiner JP
Geriatric syndrome risk factors among hospitalized postacute Medicare patients.
The purpose of this study was to assess the association of geriatric syndrome risk factors with postacute utilization among hospitalized Medicare patients (both Medicare Advantage [MA] and fee-for-service [FFS] cohorts) and to examine patterns of postacute care for MA and FFS cohorts with high geriatric syndrome risk. The investigators found that geriatric syndrome risk factors not only play a role in postacute care and inpatient utilization in MA and FFS cohorts but also explain different utilizations between MA and FFS cohorts.
AHRQ-funded; HS000029.
Citation: Wu SS, Bellantoni m, Weiner JP .
Geriatric syndrome risk factors among hospitalized postacute Medicare patients.
Am J Manag Care 2020 Oct;26(10):e319-e26. doi: 10.37765/ajmc.2020.88505..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Medicare, Risk, Healthcare Utilization, Hospitalization
Dworsky JQ, Childers CP, Gornbein J
Hospital experience predicts outcomes after high-risk geriatric surgery.
This study examined if there an association between a hospital’s annual volume of high-risk geriatric surgery and their risk of inpatient mortality, postoperative length of stay, and discharge to nursing facility. Using the 2014 National Inpatient Sample, older adults were identified who had undergone high-risk geriatric surgery. There were an estimated 514,950 hospital encounters at 3,115 hospitals undergoing surgery. A higher proportion of high-risk geriatric surgery patients was associated with decreased mortality and shorter postoperative length of stay. Higher volume hospitals were not associated with mortality but was associated with longer length of stay and decreased discharge to nursing facilities.
AHRQ-funded; HS000046; HS025079.
Citation: Dworsky JQ, Childers CP, Gornbein J .
Hospital experience predicts outcomes after high-risk geriatric surgery.
Surgery 2020 Feb;167(2):468-74. doi: 10.1016/j.surg.2019.07.026..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Surgery, Risk, Hospitals, Outcomes, Mortality
Dworsky JQ, Childers CP, Copeland T
Geriatric events among older adults undergoing nonelective surgery are associated with poor outcomes.
This study analyzed the rate of geriatric events (GEs): delirium, dehydration, falls/fractures, failure to thrive, and pressure ulcers) with older adults undergoing nonelective surgery. The 2013 to 2014 National Inpatient Sample was used to analyze nonelective admissions for 5 common operations: laparoscopic cholecystectomy, colectomy, soft tissue debridgement, small bowel resection, and laparoscopic appendectomy in adults aged 65 years and older and a younger referent group (aged 55-65 years). Logistic regression estimated the association of age and outcomes with GEs. Having any GE was found to be associated with higher probability of all outcomes including mortality, postoperative complications, prolonged length of stay, and skilled nursing facility discharge.
AHRQ-funded; HS00046; HS025079.
Citation: Dworsky JQ, Childers CP, Copeland T .
Geriatric events among older adults undergoing nonelective surgery are associated with poor outcomes.
Am Surg 2019 Oct;85(10):1089-93..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Surgery, Adverse Events, Outcomes
Hirayama A, Goto T, Faridi MK
Age-related differences in the rate and diagnosis of 30-day readmission after hospitalization for acute ischemic stroke.
The purpose of this study was to examine the age-related differences in rate and principal reason of 30-day readmissions in patients hospitalized for acute ischemic stroke. Results showed that, among 620,788 hospitalizations, advanced age was associated with a higher 30-day readmission rate after acute ischemic stroke. Compared with younger adults, older adults were more likely to be readmitted for non-stroke-related conditions.
AHRQ-funded; HS023305.
Citation: Hirayama A, Goto T, Faridi MK .
Age-related differences in the rate and diagnosis of 30-day readmission after hospitalization for acute ischemic stroke.
Int J Stroke 2018 Oct;13(7):717-24. doi: 10.1177/1747493018772790..
Keywords: Elderly, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Hospitalization, Stroke
Dworsky JQ, Childers CP, Maggard-Gibbons M
High-risk colorectal surgery: what are the outcomes for geriatric patients?
This study examines the national burden and age-specific outcomes of previously defined high-risk colorectal procedures (HRCP) in geriatric patients using the 2014 National Inpatient Sample. The authors found that outcomes after HRCP are worse for older patients and for nonelective cases. They suggest that this information can inform preoperative counseling and targeted quality improvement projects.
AHRQ-funded; HS000046.
Citation: Dworsky JQ, Childers CP, Maggard-Gibbons M .
High-risk colorectal surgery: what are the outcomes for geriatric patients?
Am Surg 2018 Oct;84(10):1650-54..
Keywords: Elderly, Healthcare Cost and Utilization Project (HCUP), Outcomes, Risk, Surgery
Agimi Y, Albert SM, Youk AO
AHRQ Author: Steiner CA
Mandatory physician reporting of at-risk drivers: the older driver example.
The hypothesis that mandatory physician reporting laws reduce the rate of crash-related hospitalizations among older adult drivers was tested. Mandatory physician reporting failed to explain any significant variation in crash hospitalization rates, when adjusting for other state-specific laws and characteristics. Vision testing at in-person license renewal was a significant predictor of lower crash hospitalization rate.
AHRQ-authored.
Citation: Agimi Y, Albert SM, Youk AO .
Mandatory physician reporting of at-risk drivers: the older driver example.
Gerontologist 2018 May 8;58(3):578-87. doi: 10.1093/geront/gnw209.
.
.
Keywords: Elderly, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Injuries and Wounds
Agimi Y, Albert SM, Youk AO
AHRQ Author: Steiner CA
Dementia and motor vehicle crash hospitalizations: role of physician reporting laws.
This study sought to determine the effect of physician reporting laws and state licensing requirements on crash hospitalizations among drivers with dementia. It concluded that physician reporting laws, mandated or legally protected, were not associated with a lower likelihood of dementia among crash hospitalized drivers. Vision testing at in-person renewal and in-person renewal requirements were significantly related with a lower prevalence of dementia in hospitalized older drivers.
AHRQ-authored.
Citation: Agimi Y, Albert SM, Youk AO .
Dementia and motor vehicle crash hospitalizations: role of physician reporting laws.
Neurology 2018 Feb 27;90(9):e808-e13. doi: 10.1212/wnl.0000000000005022.
.
.
Keywords: Dementia, Elderly, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Policy
Thompson MP, Kaplan CM, Cao Y
Reliability of 30-day readmission measures used in the hospital readmission reduction program.
The researchers assessed the reliability of risk-standardized readmission rates (RSRRs) for medical conditions and surgical procedures used in the Hospital Readmission Reduction Program (HRRP). They found that approximately 25 percent of payments for excess readmissions were tied to unreliable RSRRs. Unreliable measures blur the connection between hospital performance and incentives, and threaten the success of the HRRP.
AHRQ-funded; HS023783.
Citation: Thompson MP, Kaplan CM, Cao Y .
Reliability of 30-day readmission measures used in the hospital readmission reduction program.
Health Serv Res 2016 Oct 21;51(6):2095-114. doi: 10.1111/1475-6773.12587.
.
.
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Hospitals, Elderly, Quality Measures
Flottemesch TJ, Raetzman S, Heslin KC
AHRQ Author: Heslin KC
Age-related disparities in trauma center access for severe head injuries following the release of the updated field triage guidelines.
Reflecting perceived undertriage to trauma centers (TCs) for older adults, the American College of Surgeons' Committee on Trauma and the Center for Disease Control revised field triage guidelines in 2011 with additional emphasis on direct transport to a Level I or II trauma center. Researchers examined whether age-based disparities in TC care for severe head injury decreased. Although patterns of increased TC treatment for all groups with severe head trauma indicate improvements, age-based disparities persisted.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Flottemesch TJ, Raetzman S, Heslin KC .
Age-related disparities in trauma center access for severe head injuries following the release of the updated field triage guidelines.
Acad Emerg Med 2016 Apr;24(4):447-57. doi: 10.1111/acem.13150.
.
.
Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Elderly, Brain Injury, Emergency Medical Services (EMS)
Singh JA, Ramachandran R
Age-related differences in the use of total shoulder arthroplasty over time: use and outcomes.
The authors assessed the age-related differences in the use of total shoulder arthroplasty (TSA) and outcomes, and associated time-trends using the United States Nationwide Inpatient Sample (NIS) between 1998 and 2010. They noted a time-related increase in the use of TSA and increasing age-related differences in outcomes indicating a changing epidemiology of the use of TSA and concluded that age-related differences in outcomes suggest that attention should focus on groups with the worst outcomes.
AHRQ-funded; HS021110.
Citation: Singh JA, Ramachandran R .
Age-related differences in the use of total shoulder arthroplasty over time: use and outcomes.
Bone Joint J 2015 Oct;97-b(10):1385-9. doi: 10.1302/0301-620x.97b10.35696.
.
.
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Orthopedics, Surgery
Seitz AE, Adjemian J, Steiner CA
AHRQ Author: Steiner CA
Spatial epidemiology of blastomycosis hospitalizations: detecting clusters and identifying environmental risk factors.
The researchers used a single, multi-state dataset with standard methodology throughout the endemic area to provide new insights into the epidemiology of blastomycosis. They found that the odds of a county being part of a high-risk cluster was associated with increasing percentage of population over age 65, decreasing maximum temperature, increasing mercury, and decreasing copper soil content.
AHRQ-authored.
Citation: Seitz AE, Adjemian J, Steiner CA .
Spatial epidemiology of blastomycosis hospitalizations: detecting clusters and identifying environmental risk factors.
Med Mycol 2015 Jun;53(5):447-54. doi: 10.1093/mmy/myv014..
Keywords: Risk, Hospitalization, Elderly, Healthcare Cost and Utilization Project (HCUP)