National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to healthcare
大象视频
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- Consumer Assessment of Healthcare Providers and Systems (CAHPS庐) Program
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- National Healthcare Quality and Disparities Report Data Tools
- Network of Patient Safety Databases
- 大象视频Quality Indicator Tools for Data Analytics
- Surveys on Patient Safety Culture
- United States Health Information Knowledgebase (USHIK)
- Search Data Sources Available From AHRQ
Search All Research Studies
大象视频Research Studies Date
Topics
- Access to Care (19)
- Adverse Drug Events (ADE) (8)
- Adverse Events (71)
- Ambulatory Care and Surgery (10)
- Antibiotics (15)
- Antimicrobial Stewardship (11)
- Asthma (3)
- Back Health and Pain (1)
- Behavioral Health (11)
- Blood Clots (4)
- Blood Thinners (1)
- Brain Injury (1)
- Burnout (7)
- Cancer (16)
- Cancer: Colorectal Cancer (2)
- Cancer: Prostate Cancer (3)
- Cancer: Skin Cancer (1)
- Cardiovascular Conditions (34)
- Care Coordination (17)
- Caregiving (10)
- Care Management (8)
- Catheter-Associated Urinary Tract Infection (CAUTI) (9)
- Central Line-Associated Bloodstream Infections (CLABSI) (11)
- Children/Adolescents (104)
- Chronic Conditions (13)
- Clinical Decision Support (CDS) (11)
- Clinician-Patient Communication (7)
- Clostridium difficile Infections (10)
- Communication (22)
- Community-Acquired Infections (2)
- Comparative Effectiveness (3)
- Complementary and Alternative Medicine (1)
- Comprehensive Unit-based Safety Program (CUSP) (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (23)
- COVID-19 (29)
- Critical Care (21)
- Cultural Competence (1)
- Data (9)
- Dementia (1)
- Depression (1)
- Diabetes (1)
- Diagnostic Safety and Quality (22)
- Dialysis (1)
- Digestive Disease and Health (1)
- Disparities (14)
- Domestic Violence (1)
- Education: Continuing Medical Education (5)
- Education: Patient and Caregiver (4)
- Elderly (34)
- Electronic Health Records (EHRs) (43)
- Emergency Department (48)
- Emergency Medical Services (EMS) (7)
- Emergency Preparedness (8)
- Evidence-Based Practice (19)
- Falls (16)
- Guidelines (6)
- Healthcare-Associated Infections (HAIs) (70)
- Healthcare Cost and Utilization Project (HCUP) (60)
- Healthcare Costs (87)
- Healthcare Delivery (53)
- Healthcare Utilization (20)
- Health Information Exchange (HIE) (11)
- Health Information Technology (HIT) (84)
- Health Insurance (19)
- Health Literacy (3)
- Health Promotion (1)
- Health Services Research (HSR) (16)
- Health Systems (19)
- Heart Disease and Health (21)
- Home Healthcare (5)
- Hospital Discharge (40)
- Hospitalization (69)
- Hospital Readmissions (89)
- (-) Hospitals (829)
- Human Immunodeficiency Virus (HIV) (1)
- Imaging (4)
- Implementation (19)
- Infectious Diseases (27)
- Influenza (1)
- Injuries and Wounds (16)
- Inpatient Care (67)
- Intensive Care Unit (ICU) (30)
- Kidney Disease and Health (2)
- Labor and Delivery (9)
- Learning Health Systems (1)
- Long-Term Care (9)
- Low-Income (3)
- Maternal Health (17)
- Medicaid (17)
- Medical Devices (3)
- Medical Errors (13)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medical Liability (2)
- Medicare (100)
- Medication (39)
- Medication: Safety (9)
- Men's Health (2)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (6)
- Mortality (52)
- Neonatal Intensive Care Unit (NICU) (3)
- Neurological Disorders (7)
- Newborns/Infants (13)
- Nursing (12)
- Nursing Homes (16)
- Opioids (6)
- Organizational Change (10)
- Orthopedics (8)
- Outcomes (58)
- Pain (3)
- Palliative Care (3)
- Patient-Centered Healthcare (10)
- Patient-Centered Outcomes Research (27)
- Patient Adherence/Compliance (2)
- Patient and Family Engagement (18)
- Patient Experience (33)
- Patient Safety (164)
- Payment (47)
- Pneumonia (8)
- Policy (29)
- Practice Patterns (10)
- Pregnancy (13)
- Pressure Ulcers (3)
- Prevention (45)
- Primary Care (5)
- Primary Care: Models of Care (1)
- Provider (21)
- Provider: Clinician (5)
- Provider: Health Personnel (4)
- Provider: Nurse (19)
- Provider: Pharmacist (2)
- Provider: Physician (17)
- Provider Performance (55)
- Public Health (18)
- Public Reporting (7)
- Quality Improvement (79)
- Quality Indicators (QIs) (32)
- Quality Measures (37)
- Quality of Care (170)
- Racial and Ethnic Minorities (13)
- Registries (4)
- Rehabilitation (2)
- Research Methodologies (4)
- Respiratory Conditions (21)
- Risk (28)
- Rural/Inner-City Residents (5)
- Rural Health (24)
- Sepsis (32)
- Sexual Health (1)
- Shared Decision Making (17)
- Sickle Cell Disease (2)
- Simulation (1)
- Sleep Problems (2)
- Social Determinants of Health (8)
- Stress (1)
- Stroke (9)
- Substance Abuse (8)
- Surgery (116)
- Surveys on Patient Safety Culture (4)
- Teams (21)
- TeamSTEPPS (8)
- Telehealth (9)
- Tools & Toolkits (4)
- Training (6)
- Transitions of Care (45)
- Transplantation (1)
- Trauma (6)
- Treatments (2)
- Uninsured (7)
- Urban Health (3)
- Urinary Tract Infection (UTI) (8)
- Vulnerable Populations (4)
- Web-Based (2)
- Women (18)
- Workflow (3)
- Workforce (17)
大象视频Research Studies
Sign up:
Research Studies is a compilation of published research articles funded by 大象视频or authored by 大象视频researchers.
Results
1 to 25 of 829 Research Studies DisplayedMueller SK, Kelly C, Singleton S
Development of a tool to measure Potentially Inappropriate Inter-Hospital Transfer (IHT): The POINT Study.
This paper reported the development of an adjunct tool to capture potentially inappropriate inter-hospital transfers (IHTs) using results from the first 2 years of the POINT (Identification and Prevention of Potentially Inappropriate Inter-Hospital Transfers) Study. The results of this work will lead to a better understanding of the prevalence, risk factors, and patient safety impact of potentially inappropriate IHTs.
AHRQ-funded; HS028621.
Citation: Mueller SK, Kelly C, Singleton S .
Development of a tool to measure Potentially Inappropriate Inter-Hospital Transfer (IHT): The POINT Study.
J Gen Intern Med 2025 Jun; 40(8):1917-23. doi: 10.1007/s11606-024-09221-8..
Keywords: Hospitals, Patient Safety
Post B, Thai N, Noor EAM
Site-neutral payment reform: little impact on outpatient Medicare spending or hospital-physician integration.
This study examined the effect of site-neutral payment reform on outpatient Medicare spending or hospital-physician integration, which was instituted from the Bipartisan Budget Act of 2015. The authors analyzed 2013-2020 Medicare claims data, compared spending under site-neutral rates with spending under site-based rates and used difference-in-differences analysis to assess the effect on hospital-physician integration. They found that during the period 2017 to 2020, most Medicare payments were unaffected by the Bipartisan Budget Act with only 1.5 percent of outpatient department spending occurring at site-neutral facilities. Counties subject to the Bipartisan Budget Act did not show a statistically significant difference in the percentage of hospital-integrated physicians. The Act did little to reduce Medicare spending or hospital-physician integration.
AHRQ-funded; HS029278.
Citation: Post B, Thai N, Noor EAM .
Site-neutral payment reform: little impact on outpatient Medicare spending or hospital-physician integration.
Health Aff 2025 Jun; 44(6):659-67. doi: 10.1377/hlthaff.2024.00972..
Keywords: Medicare, Healthcare Costs, Ambulatory Care and Surgery, Hospitals
Newcomer EP, O'Neil CA, Vogt L
The effects of a prospective sink environmental hygiene intervention on Pseudomonas aeruginosa and Stenotrophomonas maltophilia burden in hospital sinks.
To reduce the burden of opportunistic premise plumbing pathogens (OPPPs) in hospital sinks, researchers developed an environmental hygiene intervention in 12 intensive care unit (ICU) rooms. The resulting reduction in Gram-negative bacteria, Pseudomonas spp. and Stenotrophomonas spp. suggested that the intervention may be effective.
AHRQ-funded; HS027621.
Citation: Newcomer EP, O'Neil CA, Vogt L .
The effects of a prospective sink environmental hygiene intervention on Pseudomonas aeruginosa and Stenotrophomonas maltophilia burden in hospital sinks.
EBioMedicine 2025 Jun 1; 116:105772. doi: 10.1016/j.ebiom.2025.105772..
Keywords: Hospitals, Healthcare-Associated Infections (HAIs), Prevention
Dalal AK, Plombon S, Konieczny K
Adverse diagnostic events in hospitalised patients: a single-centre, retrospective cohort study.
The purpose of this study was to investigate the prevalence of harmful diagnostic errors during hospital stays. Researchers examined 675 general medicine cases, strategically oversampling high-risk patients including those transferred to intensive care, those who died within 90 days, and those with complex clinical events. Using trained adjudicators and expert panel reviews, they estimated that harmful diagnostic errors occurred in 7.2% of hospitalized patients鈥攁pproximately one in every 14 patients. Of these errors, 6.1% were deemed preventable and 1.1% caused severe harm. Diagnostic delays represented the most common type of error with severely harmful errors occurring predominantly in high-risk cases. The study identified several process failures significantly associated with harmful diagnostic errors, including problems with assessment, diagnostic testing, subspecialty consultation, patient experience, and history-taking. These findings highlight the need for innovative approaches to monitor and prevent adverse diagnostic events in hospital settings.
AHRQ-funded; HS026613.
Citation: Dalal AK, Plombon S, Konieczny K .
Adverse diagnostic events in hospitalised patients: a single-centre, retrospective cohort study.
BMJ Qual Saf 2025 May 19; 34(6):377-88. doi: 10.1136/bmjqs-2024-017183..
Keywords: Diagnostic Safety and Quality, Adverse Events, Patient Safety, Inpatient Care, Hospitals
Afenir D, Sawyer TL, Umoren RA
Assessing the complexity of economic scenarios and decision-making processes for interfacility neonatal transport: cost-related literature, multistakeholder perspectives, and options for improvement.
The purpose of this study was to examine cost factors and decision-making processes in newborn medical transfers between healthcare facilities. Researchers conducted a targeted review of transport literature focusing on neonatal studies, converting findings to 2020 US dollars. The analysis identified eight relevant studies from various countries, showing average ground transport costs of approximately $5,043 and air transport costs around $18,000. Most studies examined costs from either referring or accepting hospital perspectives, but rarely both. The research found that interfacility transfers represented the largest portion of transport expenses. The researchers note that transport decisions involve complex trade-offs affecting multiple stakeholders. Potential improvements include expanding telehealth programs, enhancing provider communication, building specialist capacity at referring hospitals, and developing risk-based planning before delivery to reduce patient risk and transport costs.
AHRQ-funded; HS029607.
Citation: Afenir D, Sawyer TL, Umoren RA .
Assessing the complexity of economic scenarios and decision-making processes for interfacility neonatal transport: cost-related literature, multistakeholder perspectives, and options for improvement.
Air Med J 2025 May-Jun; 44(3):209-16. doi: 10.1016/j.amj.2025.01.005..
Keywords: Newborns/Infants, Hospitals
Diaz A, Mead M, Rohde S
Hospitals acquired by private equity firms: increased postoperative mortality for common inpatient surgeries.
The purpose of this study was to evaluate the impact of private equity acquisition on surgical outcomes in acute care hospitals. Using a difference-in-differences approach, researchers compared outcomes for Medicare beneficiaries undergoing four common general surgical operations across 67 private equity-acquired hospitals and 634 control hospitals. Results revealed that private equity acquisition was associated with a 2.7-percentage-point increase in thirty-day postoperative mortality compared to control hospitals. This higher mortality was primarily driven by a 3.9-percentage-point increase in failure to rescue, with no observed change in complication rates. Further analysis showed that mortality increases were particularly pronounced for emergency surgeries, while no significant changes occurred for elective procedures.
AHRQ-funded; HS028606.
Citation: Diaz A, Mead M, Rohde S .
Hospitals acquired by private equity firms: increased postoperative mortality for common inpatient surgeries.
Health Aff 2025 May; 44(5):554-62. doi: 10.1377/hlthaff.2024.01102.
Keywords: Hospitals, Surgery, Inpatient Care, Mortality, Healthcare Delivery
Cifra CL, Lin O, Gonzales CL
Interfacility transfer and admission to PICUs in the United States: survey of referral communications in 2023.
The purpose of this study was to examine communication practices during patient transfers to pediatric intensive care units across the U.S. Researchers conducted a mixed-methods study including surveys and interviews with PICU leaders from facilities with 10 or more beds. The surveyed PICUs reported that approximately 29.5% of their annual admissions were direct transfers from other institutions. While verbal handoffs between referring clinicians and PICU physicians occurred in 93% of facilities, only 24% consistently used standardized communication tools. Medical records were frequently unavailable before patient arrival in 72% of cases. Follow-up interviews revealed four key themes: standardized communication can improve efficiency but may also create challenges; dedicated transfer staff enhance communication quality; electronic health record integration would improve information sharing; and implementing structured processes requires staff support to modify existing workflows. These findings highlight opportunities to improve interfacility transfer communication for critically ill children.
AHRQ-funded; HS026965.
Citation: Cifra CL, Lin O, Gonzales CL .
Interfacility transfer and admission to PICUs in the United States: survey of referral communications in 2023.
Pediatr Crit Care Med 2025 May; 26(5):e669-e79. doi: 10.1097/pcc.0000000000003702..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Hospitals, Communication, Transitions of Care
Sandhu S, Liu M, Gottlieb LM
Interoperability of health-related social needs data at US hospitals.
The objective of this study was to measure hospital engagement in interoperable exchange of health-related social needs (HRSN) data. Hospitals that participated in accountable care organizations or patient-centered medical homes and hospitals were more likely to receive external HRSN data. For-profit hospitals and public hospitals were less likely to participate in HRSN data exchange.
AHRQ-funded; HS029762; HS028473.
Citation: Sandhu S, Liu M, Gottlieb LM .
Interoperability of health-related social needs data at US hospitals.
J Am Med Inform Assoc 2025 May; 32(5):914-19. doi: 10.1093/jamia/ocaf049.
Keywords: Hospitals, Health Information Exchange (HIE), Health Information Technology (HIT), Electronic Health Records (EHRs)
Mullens CL, Mead M, Lee JD
Negotiated prices for care at independent and system-affiliated rural hospitals.
This research letter describes a study quantifying changes in travel times for elderly rural patients undergoing surgical care. The authors analyzed beneficiary-level data from the Medicare Provider Analysis and Review file on patients aged 65 to 99 who had undergone one of 16 low-risk or high-risk procedures. Their findings indicated that the percentage of rural patients traveling more than 60 minutes for surgical care significantly increased between 2010 and 2020 for 12 of the procedures.
AHRQ-funded; HS028606.
Citation: Mullens CL, Mead M, Lee JD .
Negotiated prices for care at independent and system-affiliated rural hospitals.
JAMA Netw Open 2025 May; 8(5):e2516188. doi: 10.1001/jamanetworkopen.2025.16188..
Keywords: Hospitals, Rural Health, Rural/Inner-City Residents, Healthcare Costs
Abid M, Holmes M, Charles A
General surgeon workforce density is not associated with treatment-incidence ratios at the county or hospital service area level in North Carolina.
This study investigated whether increasing the number of general surgeons leads to higher rates of surgical procedures performed. Researchers examined inpatient discharge data from 2016 to 2019 across North Carolina, calculating treatment-incidence ratios (TIRs) for general surgical procedures at both the county and hospital service area levels. After adjusting for demographics and health status, they found no statistically significant relationship between surgeon density and TIRs. The findings suggest that simply adding more surgeons may not increase access to surgical care and that other factors鈥攕uch as geography, referral networks, and healthcare infrastructure鈥攎ay play a more influential role.
AHRQ-funded; HS000032.
Citation: Abid M, Holmes M, Charles A .
General surgeon workforce density is not associated with treatment-incidence ratios at the county or hospital service area level in North Carolina.
Am J Surg 2025 Apr; 242:116231. doi: 10.1016/j.amjsurg.2025.116231..
Keywords: Provider: Physician, Surgery, Hospitals
Pollack LM, Chang A, Thompson MP
Hospital-level variation in cardiac rehabilitation metrics.
This study analyzed 2018-2020 Medicare fee-for-service (FFS) data, Parts A and B, and 2018 American Hospital Association (AHA) data to assessed the delivery of cardiac rehabilitation (CR) care nationwide at the hospital level. By cardiac care tier, 44.4% of hospitals provided comprehensive care, 31.2% provided AMI/PCI care, and 24.4% provided AMI-only care. Across all hospitals, there was substantial variation in CR enrollment. There was also substantial variation in CR performance metrics among hospitals within each tier of cardiac care.
AHRQ-funded; HS027830; HS028397.
Citation: Pollack LM, Chang A, Thompson MP .
Hospital-level variation in cardiac rehabilitation metrics.
Am Heart J 2025 Apr; 282:58-69. doi: 10.1016/j.ahj.2024.12.004..
Keywords: Cardiovascular Conditions, Hospitals, Elderly, Surgery
Post B, Alinezhad F, Young GJ
Impact of hospital-physician integration on Medicare patient mix.
Researchers compared pre- and post-employment patient panels of primary care physicians to assess whether hospital employment inclines the case mix of physicians toward higher-complexity patients with chronic conditions. Conditions measured included arthritis, depression, diabetes, hypertension, and ischemic heart disease. The findings indicated that hospital employment of physicians resulted in neither higher numbers nor higher proportions of complex patients treated by integrated physicians, at least among traditional Medicare patients.
AHRQ-funded; HS029278.
Citation: Post B, Alinezhad F, Young GJ .
Impact of hospital-physician integration on Medicare patient mix.
Am J Manag Care 2025 Apr; 31(4):e95-e101. doi: 10.37765/ajmc.2025.89724.
Keywords: Hospitals, Medicare, Healthcare Delivery, Provider: Physician
Thai NH, Post B, Young G
Hospital-physician integration and cardiac rehabilitation following major cardiovascular events.
This retrospective cohort study evaluated cardiac rehabilitation (CR) by patients who receive care from hospital-integrated physicians compared with independent physicians, and subsequently, to examine CR and recurrent cardiac hospitalizations. The study used claims data from Medicare Part A and Part B for 2016 to 2019. Eligible patients had to be continuously enrolled in fee-for-service Medicare for 12 months or more before and after the index event. The study included 28,596 Medicare patients eligible for CR. Their mean age was 74.0 years, and 16,839 (58.9%) were male. A total of 9037 patients were treated by a hospital-integrated physician, of which 2995 received CR during follow-up. Logistic regression via propensity score weighting showed that having a hospital-integrated physician was associated with an 11% increase in the odds of receiving CR. Additionally, CR participation was associated with a 14% decrease in the odds of recurrent cardiovascular-related hospitalizations.
AHRQ-funded; HS029278.
Citation: Thai NH, Post B, Young G .
Hospital-physician integration and cardiac rehabilitation following major cardiovascular events.
JAMA Netw Open 2025 Mar 3; 8(3):e2462580. doi: 10.1001/jamanetworkopen.2024.62580..
Keywords: Cardiovascular Conditions, Hospitals
Hegland TA, Day RT, Moynihan KM
大象视频Author: Hegland TA
Access to pediatric bed capacity according to social determinants of health: all beds are not created equal.
The objectives of this cross-sectional study were to study pediatric inpatient hospital capacity and resources and to characterize differences according to Social Determinants of Health (SDoH). Data on nonelective inpatient discharges were taken from the Healthcare Cost and Utilization Project. The results showed that, although pediatric bed capacity was evenly distributed according to SDoH, hospitals that served under-represented, disadvantaged, and rural communities had less capability and resource availability.
AHRQ-authored.
Citation: Hegland TA, Day RT, Moynihan KM .
Access to pediatric bed capacity according to social determinants of health: all beds are not created equal.
J Pediatr 2025 Mar; 278:114447. doi: 10.1016/j.jpeds.2024.114447..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Social Determinants of Health, Access to Care, Hospitals
Evans EE, Bradley SE, Vitous CA
Barriers to perioperative palliative care across Veterans Health Administration hospitals: a qualitative evaluation.
This qualitative evaluation explored barriers to perioperative palliative care across 14 Veterans Affairs hospitals through interviews with healthcare providers. Researchers identified six major barrier domains across patient/family, provider, and system levels. Patient and family-related obstacles included difficulties managing expectations and addressing goal-discordant care. Provider-level barriers encompassed knowledge gaps, attitudes toward palliative care, and conflicts with professional identity. At the system level, institutional resources and organizational culture presented significant challenges. These findings highlight important target areas for improving palliative and end-of-life care quality for Veterans undergoing surgery with life-limiting conditions.
AHRQ-funded; HS026772.
Citation: Evans EE, Bradley SE, Vitous CA .
Barriers to perioperative palliative care across Veterans Health Administration hospitals: a qualitative evaluation.
Am J Surg 2025 Mar; 241:116063. doi: 10.1016/j.amjsurg.2024.116063..
Keywords: Palliative Care, Hospitals
Fliegner MA, Hou H, Bauer TM
Interhospital variability in cardiac rehabilitation use after cardiac surgery among Medicare beneficiaries.
The purpose of this study was to investigate variations in cardiac rehabilitation utilization after cardiac surgery and associated outcomes among Medicare beneficiaries. Researchers analyzed data from Medicare patients discharged after cardiac surgery. Although overall participation was 54.1%, hospital-level rates varied dramatically from 0% to 96.8%. Notably, facilities with lower cardiac rehabilitation rates showed higher adjusted one-year mortality and readmission rates compared to hospitals with higher utilization.
AHRQ-funded; HS027830.
Citation: Fliegner MA, Hou H, Bauer TM .
Interhospital variability in cardiac rehabilitation use after cardiac surgery among Medicare beneficiaries.
J Thorac Cardiovasc Surg 2025 Mar; 169(3):916-23.e5. doi: 10.1016/j.jtcvs.2024.04.019..
Keywords: Cardiovascular Conditions, Surgery, Medicare, Hospitals
McDaniel CE, Coon ER, Paciorkowski N
Pediatric randomized clinical trials in community hospitals: strategies to enhance site participation and engagement.
Researchers convened an interdisciplinary group of panelists to identify strategies that promote community hospital participation in pediatric randomized clinical trials. Fourteen strategies were identified within three overarching domains: policy changes in funding and scientific review guidelines, systems for providing centralized resources, and research design tailored to community hospital participation.
AHRQ-funded; HS028683.
Citation: McDaniel CE, Coon ER, Paciorkowski N .
Pediatric randomized clinical trials in community hospitals: strategies to enhance site participation and engagement.
Hosp Pediatr 2025 Mar; 15(3):e83-e87. doi: 10.1542/hpeds.2024-008198..
Keywords: Children/Adolescents, Hospitals, Research Methodologies
Lyndon A, Simpson KR, Landstrom GL
Relationship between nurse staffing during labor and cesarean birth rates in U.S. hospitals.
The purpose of this survey of U.S. labor nurses was to examine the relationship between labor/delivery staffing and hospital cesarean and vaginal birth after cesarean (VBAC) rates. Results indicated that better nurse staffing predicted lower cesarean birth rates and higher VBAC rates. The authors concluded that hospitals should be responsible for providing adequate nurse staffing during childbirth.
AHRQ-funded; HS025715.
Citation: Lyndon A, Simpson KR, Landstrom GL .
Relationship between nurse staffing during labor and cesarean birth rates in U.S. hospitals.
Nurs Outlook 2025 Mar-Apr; 73(2):102346. doi: 10.1016/j.outlook.2024.102346..
Keywords: Maternal Health, Hospitals, Inpatient Care, Provider: Nurse, Workforce
Kam KQ, Chen T, Kadri SS
Epidemiology and outcomes of antibiotic de-escalation in patients with suspected sepsis in US hospitals.
Researchers conducted a retrospectively analysis of adults admitted to U.S. hospitals with suspected sepsis to assess the frequency, variation, predictors, and outcomes of antibiotic de-escalation. The findings indicated that antibiotic de-escalation is infrequent, variable across hospitals, linked with clinical and microbiologic factors, and associated with lower risk for acute kidney injury, ICU admission, and in-hospital mortality.
AHRQ-funded; HS029518.
Citation: Kam KQ, Chen T, Kadri SS .
Epidemiology and outcomes of antibiotic de-escalation in patients with suspected sepsis in US hospitals.
Clin Infect Dis 2025 Feb 5; 80(1):108-17. doi: 10.1093/cid/ciae591..
Keywords: Sepsis, Antibiotics, Antimicrobial Stewardship, Hospitals, Medication, Outcomes
Post B, Kitsakos A, Alinezhad F
Hospital-physician integration and Medicare spending: evidence from stable angina.
The objective of this retrospective cohort study was to examine association between hospital-cardiologist integration and Medicare spending for stable angina patients. Data on Medicare beneficiaries was taken from Medicare Standard Analytic Files and the CMS National Downloadable File. Patients of integrated cardiologists were shown to incur comparable spending relative to patients of independent cardiologists, indicating that the impact of hospital-physician integration may depend on clinical context.
AHRQ-funded; HS029278.
Citation: Post B, Kitsakos A, Alinezhad F .
Hospital-physician integration and Medicare spending: evidence from stable angina.
Health Serv Res 2025 Feb; 60(1):e14383. doi: 10.1111/1475-6773.14383..
Keywords: Medicare, Hospitals, Healthcare Costs, Cardiovascular Conditions, Healthcare Delivery
Harris AD, Goodman KE, Pineles L
New kids on the block: estimating use of next-generation gram-negative antibiotics across greater than 700 hospitals in the United States.
The purpose of this retrospective study of hospital discharges using the Premier Healthcare Database was to describe use of new broad-spectrum antibiotics targeting Gram-negative organisms across a large national cohort. The results indicated that ceftazidime-avibactam and ceftolozane-tazobactam were the most frequently prescribed new antibiotics. New antibiotics were most commonly used to treat sepsis among patients with multiple comorbidities.
AHRQ-funded; HS028854.
Citation: Harris AD, Goodman KE, Pineles L .
New kids on the block: estimating use of next-generation gram-negative antibiotics across greater than 700 hospitals in the United States.
Open Forum Infect Dis 2025 Feb; 12(2):ofaf079. doi: 10.1093/ofid/ofaf079..
Keywords: Antibiotics, Medication, Hospitals
Santos T, Lindrooth RC, Lee SD
Oregon community benefit reform influenced not-for-profit hospitals' charity care and medical debt write-off.
This study examined the effect of a new Oregon policy to increase not-for-profit hospitals鈥 community investment. Phase 1 started in 2020, which expanded patient financial assistance requirements and medical debt protections. Phase 2 in 2021 imposed a hospital-specific minimum community benefit spending floor. The researchers found that Oregon's patient financial assistance and medical debt protections were associated with higher charity care spending ($423,000 per hospital) and higher levels of bad debt ($846,000 per hospital) by Oregon hospitals relative to control hospitals. However, it is too soon to understand the effects of minimum community benefit spending floors.
AHRQ-funded; HS029701.
Citation: Santos T, Lindrooth RC, Lee SD .
Oregon community benefit reform influenced not-for-profit hospitals' charity care and medical debt write-off.
Health Aff 2025 Feb; 44(2):196-205. doi: 10.1377/hlthaff.2024.00760..
Keywords: Hospitals, Healthcare Costs
Ruppel H, Luo B, Rasooly IR
A systems engineering approach to alarm management on pediatric medical-surgical units.
The objectives of this project were to re鈥恊ngineer the monitoring system for hospitalized children in acute care wards and to create a standard of care for the alarm system to meet the needs of multiple-patient populations while minimizing alarm burden and optimizing patient safety. The project team worked over a 5鈥恲ear period with 500+ bed urban children's hospital. While the initiative showed a 21% reduction in alarm notifications across 14 medical鈥搒urgical units, the project had mixed results which the authors discuss.
AHRQ-funded; HS026620. Patient Safety Learning Lab funding.
Citation: Ruppel H, Luo B, Rasooly IR .
A systems engineering approach to alarm management on pediatric medical-surgical units.
J Hosp Med 2025 Jan; 20(1):98-103. doi: 10.1002/jhm.13507.
Keywords: Children/Adolescents, Surgery, Patient Safety, Quality Improvement, Quality of Care, Hospitals
Geanacopoulos AT, Peltz A, Melton K
Pediatric triage accuracy in pediatric and general emergency departments.
This cross-sectional study examined pediatric triage accuracy in emergency departments using data from the National Hospital Ambulatory Medical Care Survey (2017-2021). Among 149 million pediatric visits with Emergency Severity Index scores of 3-5, mistriage occurred frequently: 53.7% of ESI 3, 57.7% of ESI 4, and 22.9% of ESI 5 visits. Children in general emergency departments were 29% more likely to be mistriaged than those in pediatric-specific facilities. Age was a significant factor, with children under one year having 2.4 times higher odds of mistriage compared to adolescents aged 13-17. These findings highlight substantial gaps in resource prediction during initial triage assessment, particularly for younger children and in general emergency settings.
AHRQ-funded; HS000063.
Citation: Geanacopoulos AT, Peltz A, Melton K .
Pediatric triage accuracy in pediatric and general emergency departments.
Hosp Pediatr 2025 Jan; 15(1):37-45. doi: 10.1542/hpeds.2024-008063..
Keywords: Children/Adolescents, Emergency Department, Diagnostic Safety and Quality, Hospitals
Burden M, Keniston A, Pell J
Unlocking inpatient workload insights with electronic health record event logs.
This article explores how electronic health record (EHR) event logs can provide valuable insights into inpatient clinician workload and work design. Conventional workload measures like work relative value units inadequately capture the full scope of clinical effort in hospital settings. The authors identify potential EHR event log measures relevant to inpatient settings, including time metrics, workload indicators, responsiveness measures, teamwork assessments, and care efficiency markers. They discuss opportunities for applying these metrics in practice management, education, and quality improvement initiatives to optimize work design and potentially reduce clinician burnout. Despite promising applications, challenges remain in standardizing data aggregation practices, validating measures, and ensuring appropriate data interpretation. The authors emphasize that organizations must develop best practices around data privacy, foster psychological safety when sharing insights, and encourage interdisciplinary collaboration when making decisions based on these metrics.
AHRQ-funded; HS029020.
Citation: Burden M, Keniston A, Pell J .
Unlocking inpatient workload insights with electronic health record event logs.
J Hosp Med 2025 Jan; 20(1):79-84. doi: 10.1002/jhm.13386.
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals
