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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
1 to 10 of 10 Research Studies DisplayedGovindarajan P, Shiboski S, Grimes B
Effect of acute stroke care regionalization on intravenous alteplase use in two urban counties.
Investigators sought to determine whether increasing access to primary stroke centers (regionalization) led to an increase in intravenous alteplase use in acute ischemic stroke patients. Studying two urban counties in the western region of US that regionalized acute stroke care, they found that in Santa Clara County, intravenous alteplase was administered to 1.7% of patients in the pre-regionalization period and 2.1% in the post-regionalization period, while in San Mateo County, the numbers were 1.3% and 3.2%, respectively. In the post-regionalization phase, San Mateo County had greater change in paramedic stroke detection, higher number of transports to primary stroke centers, and more frequent use of intravenous alteplase at stroke centers. They concluded that greater post-regionalization improvements in San Mateo County contributed to significantly improved county-level thrombolysis use than Santa Clara County.
AHRQ-funded; HS026207; HS017965.
Citation: Govindarajan P, Shiboski S, Grimes B .
Effect of acute stroke care regionalization on intravenous alteplase use in two urban counties.
Prehosp Emerg Care 2020 Jul-Aug;24(4):505-14. doi: 10.1080/10903127.2019.1679303..
Keywords: Stroke, Cardiovascular Conditions, Urban Health, Access to Care, Emergency Medical Services (EMS), Critical Care
Hsuan C, Hsia RY, Horwitz JR
Ambulance diversions following public hospital emergency department closures.
The purpose of this study was to examine whether hospitals are more likely to temporarily close their emergency departments to ambulances, through ambulance diversions, if neighboring diverting hospitals are public vs private. Results showed that sample hospitals respond differently to diversions by neighboring public (vs private) hospitals. The authors conclude that these findings suggest that these hospitals might be strategically declaring ambulance diversions to avoid treating low-paying patients served by public hospitals.
AHRQ-funded; HS024247.
Citation: Hsuan C, Hsia RY, Horwitz JR .
Ambulance diversions following public hospital emergency department closures.
Health Serv Res 2019 Aug;54(4):870-79. doi: 10.1111/1475-6773.13147..
Keywords: Access to Care, Emergency Department, Emergency Medical Services (EMS), Health Services Research (HSR), Hospitals
Ray KN, Olson LM, Edgerton EA
Access to high pediatric-readiness emergency care in the United States.
The researchers determined the geographic accessibility of emergency departments (EDs) with high pediatric readiness by assessing the percentage of US children living within a 30-minute drive time of an ED with high pediatric readiness, as defined by collaboratively developed published guidelines. They concluded that a significant proportion of US children do not have timely access to EDs with high pediatric readiness.
AHRQ-funded; HS022989.
Citation: Ray KN, Olson LM, Edgerton EA .
Access to high pediatric-readiness emergency care in the United States.
J Pediatr 2018 Mar;194:225-32.e1. doi: 10.1016/j.jpeds.2017.10.074.
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Keywords: Access to Care, Children/Adolescents, Emergency Department, Emergency Medical Services (EMS), Children/Adolescents
Khubchandani JA, Shen C, Ayturk D
Disparities in access to emergency general surgery care in the United States.
This study examined national emergency general surgery capacity and county-level determinants of access to emergency general surgery care with special attention to disparities. The study concluded that gaps in access to emergency general surgery services exist across the United States, disproportionately affecting underserved, rural communities and policy initiatives need to increase emergency general surgery capacity nationwide.
AHRQ-funded; HS022694.
Citation: Khubchandani JA, Shen C, Ayturk D .
Disparities in access to emergency general surgery care in the United States.
Surgery 2018 Feb;163(2):243-50. doi: 10.1016/j.surg.2017.07.026..
Keywords: Access to Care, Disparities, Emergency Medical Services (EMS), Surgery, Vulnerable Populations
Jarman MP, Castillo RC
Rural risk: geographic disparities in trauma mortality.
The authors sought to quantify differences in injury mortality comparing rural and nonrural residents with traumatic injuries. They concluded that rural residents are significantly more likely than nonrural residents to die after traumatic injury, a disparity that varies by trauma center designation, injury severity, and US Census region.
AHRQ-funded; HS000029.
Citation: Jarman MP, Castillo RC .
Rural risk: geographic disparities in trauma mortality.
Surgery 2016 Dec;160(6):1551-59. doi: 10.1016/j.surg.2016.06.020.
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Keywords: Access to Care, Disparities, Emergency Medical Services (EMS), Healthcare Cost and Utilization Project (HCUP), Rural Health
Shaw JJ, Psoinos CM, Santry HP
It's all about location, location, location: A new perspective on trauma transport.
The objective of this study was to determine the effect of aeromedical transport on trauma mortality when accounting for geographic factors. It concluded that helicopter transport does not impart a survival benefit for trauma patients when geographic considerations are taken into account.
AHRQ-funded; HS022694.
Citation: Shaw JJ, Psoinos CM, Santry HP .
It's all about location, location, location: A new perspective on trauma transport.
Ann Surg 2016 Feb;263(2):413-8. doi: 10.1097/sla.0000000000001265..
Keywords: Trauma, Emergency Medical Services (EMS), Registries, Mortality, Access to Care
Lee DC, Carr BG, Smith TE
The impact of hospital closures and hospital and population characteristics on increasing emergency department volume: a geographic analysis.
The objective of this study was to test the association of hospital and population characteristics and the effect of hospital closures with increases in emergency department volume. Emergency volume increased nearly twice as fast at tertiary referral centers (4.8 percent) and nonurban hospitals (3.7 percent versus urban at 2.1 percent) after adjusting for other characteristics. The effect of hospital closures also strongly predicted variation in growth.
AHRQ-funded; HS018362; HS010914.
Citation: Lee DC, Carr BG, Smith TE .
The impact of hospital closures and hospital and population characteristics on increasing emergency department volume: a geographic analysis.
Popul Health Manag 2015 Dec;18(6):459-66. doi: 10.1089/pop.2014.0123.
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Keywords: Emergency Medical Services (EMS), Emergency Department, Hospitals, Access to Care
Geissler KH, Holmes GM
Emergency department use in the US-Mexico border region and violence in Mexico: is there a relationship?
This study assessed the association between homicide rates in northern Mexico and potentially avoidable use of emergency departments (ED) in the US-Mexico border region. It concluded that a substantial majority of ED encounters in the US-Mexico border region were potentially avoidable. However, there was not a strong relationship between homicide rates in northern Mexico and the distribution of ED discharges in Arizona and California.
AHRQ-funded; HS021074.
Citation: Geissler KH, Holmes GM .
Emergency department use in the US-Mexico border region and violence in Mexico: is there a relationship?
J Rural Health 2015 Summer;31(3):316-25. doi: 10.1111/jrh.12109.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Medical Services (EMS), Healthcare Utilization, Access to Care, Vulnerable Populations
Binswanger IA, Whitley E, Haffey PR
A patient navigation intervention for drug-involved former prison inmates.
The researchers designed a randomized controlled trial of patient navigation to reduce barriers to health care and hospitalizations for former prison inmates. They found recruitment of former inmates highly feasible, but found that follow-up was limited by rearrests. They concluded that their results suggest a significantly lower rate of hospitalizations among navigation participants, although the rate of emergency department/urgent care visits was not improved.
AHRQ-funded; HS019464.
Citation: Binswanger IA, Whitley E, Haffey PR .
A patient navigation intervention for drug-involved former prison inmates.
Subst Abus 2015;36(1):34-41. doi: 10.1080/08897077.2014.932320.
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Keywords: Access to Care, Emergency Medical Services (EMS), Healthcare Utilization, Hospitalization, Substance Abuse
Myers SR, Salhi RA, Lerner EB
A pilot study describing access to emergency care in two states using a model emergency care categorization system.
To improve regionalization of care and patient decisions when seeking emergency care, the researchers surveyed emergency departments (EDs) in 2 States. They found that 25 percent provided advanced care, 10.5 percent comprehensive care, and 1.6 percent pediatric critical care. Overall, 75.1 percent of the population could reach advanced or comprehensive ED within 60 minutes by ground transportation.
AHRQ-funded; HS017960; HS018604
Citation: Myers SR, Salhi RA, Lerner EB .
A pilot study describing access to emergency care in two states using a model emergency care categorization system.
Acad Emerg Med. 2013 Sep;20(9):894-903. doi: 10.1111/acem.12208..
Keywords: Emergency Medical Services (EMS), Access to Care, Critical Care, Shared Decision Making