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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 25 of 12288 Research Studies DisplayedBeck AF, Henize AW, Klein MD
A data-driven approach to optimizing medical-legal partnership performance and joint advocacy.
This paper discusses ways that medical-legal partnerships (MLPs) have facilitated advocacy at both patient (client) and population levels. MLPs address health-harming legal needs experienced by low-income families. In particular, the article discusses the work of the MLP Cincinnati Child Health-Law Partnership (Child HeLP), a joint initiative that bridges the primary care clinics at Cincinnati Children’s with the Legal Aid Society of Greater Cincinnati (LASGC). The authors found that Child HeLP referral was associated with a 38% reduction in hospitalizations. They discuss their use of quality improvement (QI) methods and statistical process (SPC) charts to optimize their partnership and facilitate identification of patterns amenable to population-level action and policy change. They also discuss how additional clinical-community partnerships have followed the Child HeLP model. There have been 10,190 referrals to legal partners for 7,801 children since Child HeLP’s inception in 2008. The most common reasons for referral are housing instability/adverse housing quality (~40%), public benefit denials or delays (~25%), and unmet educational needs (~20%). Referrals have resulted in an estimated $1,360,000 in recovered benefits and improvements in housing conditions, educational achievement, and other benefits.
AHRQ-funded; HS027996.
Citation: Beck AF, Henize AW, Klein MD .
A data-driven approach to optimizing medical-legal partnership performance and joint advocacy.
J Law Med Ethics 2023 Winter; 51(4):880-88. doi: 10.1017/jme.2023.158..
Keywords: Quality Improvement, Quality of Care, Policy
Solberg LI, Ziegenfuss JY, Rivard RL
Is there room for individual patient-specified preferences in the patient-reported outcome measurement revolution?
The goal of this study was to test the feasibility of collecting qualitative patient-preferred goals and its feasibility as an addition to a standardized process for collecting quantitative composite patient-reported outcome measures (PROMs) from patients undergoing knee joint replacement. The study found that joint replacement patients who responded to quantitative PROMS were willing to report on their other preferred outcomes.
AHRQ-funded; HS025618.
Citation: Solberg LI, Ziegenfuss JY, Rivard RL .
Is there room for individual patient-specified preferences in the patient-reported outcome measurement revolution?
J Patient Cent Res Rev 2023 Fall; 10(4):210-18. doi: 10.17294/2330-0698.2017..
Keywords: Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Xiao Y, Miller K, Werner N
Co-design with patients for improving patient safety: strategies, barriers and pitfalls.
The purpose of this paper was to review discussion from a panel conducted to explore the spectrum of inclusion, engagement, and strategies with patients and family members in patient safety research. Strategies and barriers are included as a springboard for exploration of how to engage patients and family members in co-design of "work systems" and patient-professional collaborative work.
AHRQ-funded; HS028409.
Citation: Xiao Y, Miller K, Werner N .
Co-design with patients for improving patient safety: strategies, barriers and pitfalls.
Proc Hum Factors Ergon Soc Annu Meet 2023 Sep; 67(1):633-38. doi: 10.1177/21695067231192416..
Keywords: Patient Safety, Patient and Family Engagement
Isbell LM, Graber ML, Rovenpor DR
Influence of comorbid depression and diagnostic workup on diagnosis of physical illness: a randomized experiment.
The purpose of this randomized experiment study was to investigate the influence of comorbid depression on diagnostic accuracy. The researchers utilized an interactive vignette that described a patient with a complex presentation of pernicious anemia. Fifty-nine physician participants were randomized to diagnose either a patient with or without (control) comorbid depression and related behaviors. All other clinical information was identical. Physicians recorded a differential diagnosis, ordered tests, and rated patient likeability. The study found that the patient with comorbid depression was less likeable than the control patient. Accuracy of diagnosis was lower in the depression condition compared to the control condition, but this difference was not statistically significant. Accuracy was lower in the depression condition (vs. control) when physicians ordered less tests, but there was no variation for physicians who ordered more tests.
AHRQ-funded; HS025752.
Citation: Isbell LM, Graber ML, Rovenpor DR .
Influence of comorbid depression and diagnostic workup on diagnosis of physical illness: a randomized experiment.
Diagnosis 2023 Aug; 10(3):257-66. doi: 10.1515/dx-2020-0106..
Keywords: Depression, Behavioral Health
McGuier EA, Kolko DJ, Stadnick NA
Advancing research on teams and team effectiveness in implementation science: an application of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework.
This article described the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, a flexible tool that can facilitate the application of team effectiveness approaches in implementation science. The authors provided an overview of key constructs in team effectiveness research. They also described ways to conceptualize different types of teams and team constructs relevant to implementation within the EPIS framework, and identify future directions for research. Three case examples are used to illustrate the application of EPIS to implementation studies involving teams.
AHRQ-funded; HS026862.
Citation: McGuier EA, Kolko DJ, Stadnick NA .
Advancing research on teams and team effectiveness in implementation science: an application of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework.
Implement Res Pract 2023 Jan-Dec; 4:26334895231190855. doi: 10.1177/26334895231190855..
Keywords: Teams, Implementation, Health Services Research (HSR)
Catchpole K, Cohen T, Alfred M
Human factors integration in robotic surgery.
This study used the example of robotic-assisted surgery (RAS) to explore the methodological and practical challenges of technology integration in surgery, provide examples of evidence-based improvements, and discuss the importance of systems engineering and clinical human factors research and practice. The authors reviewed studies on workload, communication, workflow, workspace, and coordination in robotic surgery, and then discuss the potential for improvement that these studies suggest within the wider healthcare system. They concluded that there is a growing need to understand and develop approaches to safety and quality improvement through human-systems integration at the frontline of care.
AHRQ-funded; HS026491.
Citation: Catchpole K, Cohen T, Alfred M .
Human factors integration in robotic surgery.
Hum Factors 2024 Mar; 66(3):683-700. doi: 10.1177/00187208211068946..
Keywords: Surgery
Amu-Nnadi CN, Ross ES, Garcia NH
Health system integration and cancer center access for rural hospitals.
This study’s goal was to assess health system integration and cancer center access for rural hospitals. The authors compared health systems with and without cancer centers based on rural hospital presence. They found that 90% of cancer centers are in a health system, and 72% of health systems (434/607) have a cancer center. Larger health systems with more trainees more often have cancer centers but are no more likely to include rural hospitals (11% vs 6%). The minority of cancer centers not in health systems (N = 95) more often serve low complexity patient populations in non-metropolitan areas.
AHRQ-funded; HS013852.
Citation: Amu-Nnadi CN, Ross ES, Garcia NH .
Health system integration and cancer center access for rural hospitals.
Am Surg 2024 May; 90(5):1023-29. doi: 10.1177/00031348231216497..
Keywords: Health Systems, Cancer, Rural Health, Rural/Inner-City Residents, Access to Care
Kistler A, Decker S, Steiger D
AHRQ Author: Decker S
A multimode strategy to contact participants and collect responses in a supplement to a longitudinal household survey.
In seeking to understand connections between Americans’ health care expenditures and use and social determinants of health, The Agency for Healthcare Research and Quality (AHRQ) and Westat conducted a new Medical Expenditure Panel Survey (MEPS) supplemental study in 2021 using a multimode (web and paper) instrument. Participants were encouraged to complete the web survey, but were provided the option of responding by paper. Response was encouraged through a multimode contact strategy, including text messages, emails, and/or mailings. The purpose of this paper was to review the protocol for encouraging web response and the response rates when utilizing various contact modes. The overall unweighted response rate for the survey was 74.2%, with 69.3% of responses submitted via the web. Response rates were 85.5% which was the highest among adults for whom both email and mobile phone information were provided.
AHRQ-authored.
Citation: Kistler A, Decker S, Steiger D .
A multimode strategy to contact participants and collect responses in a supplement to a longitudinal household survey.
Survey Methods: Insights From the Field 2024 May 1. doi: 10.13094/SMIF-2024-00001..
Keywords: Medical Expenditure Panel Survey (MEPS)
Kostick-Quenet KM, Lang B, Dorfman N
Patients' and physicians' beliefs and attitudes towards integrating personalized risk estimates into patient education about left ventricular assist device therapy.
This study explored stakeholder attitudes toward the utility, acceptability, usefulness, and best practices for integrating personalized risk (PR) estimates into patient education and decision making about Left Ventricular Assist Device (LVAD). This was a 5-year multi-institutional AHRQ project where the authors conducted 40 interviews with stakeholders (physicians, nurse coordinators, patients, and caregivers) and analyzed using Thematic Content Analysis. All stakeholder groups voiced positive views towards PR integration in decision making. Physicians felt PR can improve their decision making by enhancing insight into outcomes, enhance tailored pre-emptive care, increase confidence in decisions, and reduce bias and subjectivity. All stakeholder groups raised concerns about accuracy, representativeness and relevance of algorithms; predictive uncertainty; utility in relation to physician's expertise; potential negative reactions among patients; and overreliance.
AHRQ-funded; HS027784.
Citation: Kostick-Quenet KM, Lang B, Dorfman N .
Patients' and physicians' beliefs and attitudes towards integrating personalized risk estimates into patient education about left ventricular assist device therapy.
Patient Educ Couns 2024 May; 122:108157. doi: 10.1016/j.pec.2024.108157.
Keywords: Education: Patient and Caregiver, Risk, Cardiovascular Conditions
Bouchelle Z, Menko SG, Yazdani M
Parent perspectives on documentation and sharing of health-related social needs data.
This survey aimed to examine parents of pediatric patients’ preferences regarding how health-related social needs (HRSN) screening program data are documented and shared. The authors conducted semi-structured interviews with parents of hospitalized children participating in an HRSN screening program at a quaternary care children's hospital. Interviews were then coded to identify emergent themes. A total of 20 parents were interviewed with all being female, 55% identifying as Black or African American and 20% identifying as Hispanic or Latino. Parents expressed comfort with electronic health record documentation of HRSN data and the use of ICD-10 Revision Z codes as long as this information was used to provide families with meaningful support. Most parents viewed social workers and medical teams as being the most appropriate recipients of the data, with few parents feeling comfortable with HRSN data being shared with payors. Parents wanted transparency around HRSN data sharing, with many expressing concerns that documentation and sharing of HRSN data could lead to unwanted or unsafe disclosures or result in child welfare referrals.
AHRQ-funded; HS028555.
Citation: Bouchelle Z, Menko SG, Yazdani M .
Parent perspectives on documentation and sharing of health-related social needs data.
Hosp Pediatr 2024 Apr; 14(4):308-16. doi: 10.1542/hpeds.2023-007478..
Keywords: Children/Adolescents, Screening, Electronic Health Records (EHRs), Health Information Technology (HIT)
Shaller D, Nembhard I, Matta S
Assessing an innovative method to promote learning from patient narratives: Findings from a field experiment in ambulatory care.
The purpose of this study was to evaluate whether an online interactive report developed to help interpretation of patients' narrative feedback results in change in ambulatory staff learning and behavior at the individual staff and practice level, and patient experience survey scores. The researchers studied 22 ambulatory practice sites in an academic medical center utilizing three primary data sources: 333 staff surveys; 20 in-depth interviews with practice leaders and staff; and 9551 modified CG-CAHPS patient experience surveys augmented by open-ended narrative elicitation questions. The study found that interviews reported that the interface helped narrative interpretation and use for improvement. Staff survey analyses reported improved learning from narratives at intervention sites and higher behavior change at staff and practice levels. Patient experience scores for interactions with office staff and wait time information increased significantly at intervention sites, compared to control sites.
AHRQ-funded; HS016978.
Citation: Shaller D, Nembhard I, Matta S .
Assessing an innovative method to promote learning from patient narratives: Findings from a field experiment in ambulatory care.
Health Serv Res 2024 Apr; 59(2):e14245. doi: 10.1111/1475-6773.14245..
Keywords: Ambulatory Care and Surgery, Patient Experience, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality Improvement, Quality of Care
Westafer LM, Beck SA, Simon C
Barriers and facilitators to harm reduction for opioid use disorder: a qualitative study of people with lived experience.
The purpose of this study was to identify patient-focused barriers and facilitators to harm reduction strategies in the Emergency department (ED). The researchers conducted semi-structured interviews with a convenience sample of 25 people in Massachusetts diagnosed with an opioid use issue. The study observed themes including accessibility of harm reduction supplies, lack of self-care resulting from withdrawal and feelings of hopelessness, the influence of stigma on the potential for using harm reduction practices, habit and knowledge, and the need for user-centered harm reduction programs.
AHRQ-funded; HS025701.
Citation: Westafer LM, Beck SA, Simon C .
Barriers and facilitators to harm reduction for opioid use disorder: a qualitative study of people with lived experience.
Ann Emerg Med 2024 Apr; 83(4):340-50. doi: 10.1016/j.annemergmed.2023.11.020..
Keywords: Opioids, Substance Abuse, Behavioral Health
Kalwani NM, Osmanlliu E, Parameswaran V
Changes in telemedicine use and ambulatory visit volumes at a multispecialty cardiovascular center during the COVID-19 pandemic.
Researchers conducted a retrospective cohort study to examine trends in telemedicine use and visit volumes across cardiology subspecialties during the early months of the COVID-19 pandemic. Data from patients with ambulatory visits at a multispecialty cardiovascular center in Northern California were analyzed. Results showed that telemedicine visits increased dramatically during the COVID period; usage was above 75% of visits in all cardiology subspecialties in April 2020, stabilizing at rates ranging from over 95% (electrophysiology) to under 25% (heart transplant and vascular medicine). Visit volumes were below pre-COVID levels from March to May 2020, but exceeded pre-COVID levels after June 2020. The researchers concluded that telemedicine can be used to deliver a significant proportion of outpatient cardiovascular care and may increase access to care in cardiology clinics.
AHRQ-funded; HS026128.
Citation: Kalwani NM, Osmanlliu E, Parameswaran V .
Changes in telemedicine use and ambulatory visit volumes at a multispecialty cardiovascular center during the COVID-19 pandemic.
J Telemed Telecare 2024 Apr; 30(3):543-48. doi: 10.1177/1357633x211073428..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Cardiovascular Conditions, Ambulatory Care and Surgery
Smith B, Smith BP, Hollis RH
Development of a comprehensive survey to assess key socioecological determinants of health.
The purpose of this study was to develop and evaluate a comprehensive tool assessing socioecological determinants of health in patients requiring colorectal surgery. The study utilized a modified Delphi process to develop a comprehensive tool that included 31 socioecological determinants of health. Analysis indicated acceptability and feasibility were positive for all domains. Overall, 83% of participants confirmed that others would have no challenges completing the survey, 90.4% of respondents reported the survey was not burdensome, 97.6% of patients reported having enough time to complete the survey, and 80.9% agreed the survey was well integrated into their appointment.
AHRQ-funded; HS023009.
Citation: Smith B, Smith BP, Hollis RH .
Development of a comprehensive survey to assess key socioecological determinants of health.
Surgery 2024 Apr; 175(4):991-99. doi: 10.1016/j.surg.2023.11.011..
Keywords: Social Determinants of Health, Disparities, Surgery
Devine JW, Tadrous M, Hernandez I
Effects of the valsartan recall on heart failure patients: a nationwide analysis.
This study’s objective was to determine if the 2018 generic valsartan recall created a higher likelihood of unfavorable outcomes to heart failure patients receiving valsartan at the recall date than patients using comparable antihypertensives. The authors conducted a cohort study of Optum's de-identified Clinformatics® Datamart (July 2017-January 2019). They compared heart failure patients with commercial or Medicare Advantage insurance who received valsartan to patients who received non-recalled angiotensin receptor blockers (ARBs) and angiotensin converting enzyme-inhibitors (ACE-Is) for 1 year prior and including the recall date. Outcomes examined included a composite for all-cause hospitalization, emergency department (ED), and urgent care (UC) use and a measure of cardiac events which included hospitalizations for acute myocardial infarction and hospitalizations/ED/UC visits for stroke/transient ischemic attack, heart failure or hypertension at 6-months post-recall. Of the 87,130 adherent patients, 15% were valsartan users and 85% were users of non-recalled ARBs/ACE-Is. Valsartan use was not associated with an increased risk of all-cause hospitalization/ED/UC use six-months post-recall (HR 1.00), compared with individuals taking non-recalled ARBs/ACE-Is. Similarly, cardiac events 6-months post-recall did not differ between individuals on valsartan and non-recalled ARBs/ACE-Is.
AHRQ-funded; HS027985.
Citation: Devine JW, Tadrous M, Hernandez I .
Effects of the valsartan recall on heart failure patients: a nationwide analysis.
Pharmacoepidemiol Drug Saf 2024 Apr; 33(4):e5777. doi: 10.1002/pds.5777..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Medication
Michelson KA, Rees CA, Florin TA
Emergency department volume and delayed diagnosis of serious pediatric conditions.
The objective of this retrospective cohort study was to evaluate the association between annual pediatric volume in emergency departments (EDs) with delayed diagnosis. Subjects were children under 18 treated at 954 EDs in eight states with a first-time diagnosis of any of 23 acute, serious conditions, identified using HCUP State ED and Inpatient databases. The findings indicated that EDs with fewer pediatric encounters had more possible delayed diagnoses across all 23 conditions; there were decreased rates of possible delayed diagnosis with increasing ED volume for 21 of 23 conditions. The authors concluded that tools to support timely diagnosis in low-volume EDs are needed.
AHRQ-funded; HS026503.
Citation: Michelson KA, Rees CA, Florin TA .
Emergency department volume and delayed diagnosis of serious pediatric conditions.
JAMA Pediatr 2024 Apr; 178(4):362-68. doi: 10.1001/jamapediatrics.2023.6672..
Keywords: Children/Adolescents, Emergency Department, Diagnostic Safety and Quality
Peebles PJ, Jensen EA, Herrick HM
Endotracheal tube size adjustments within seven days of neonatal intubation.
The purpose of this retrospective multicenter cohort study was to determine weight-based Neonatal endotracheal tube (ETT) sizes for infants undergoing tracheal intubation, and to compare these with recommendations from the Neonatal Resuscitation Program (NRP). The study found that of 7,293 intubations assessed, the initial ETT was downsized in 5.0% of encounters and upsized within 7 days in 1.5%. ETT downsizing was most common when NRP-recommended sizes were attempted in the following weight subgroups: 12.6% with a 3.0 mm and 17.1% with a 3.5 mm. Among infants in these 2 weight subgroups, choice of ETTs 0.5 mm smaller than NRP recommendations was independently related with lower odds of adverse outcomes when compared with NRP-recommended sizes. For infants weighing 1000 to 1199 g: any tracheal intubation related event, 20.8% with 2.5 mm versus 21.9% with 3.0 mm; severe oxygen desaturation, 35.2% with 2.5 mm vs 52.9% with 3.0 mm. Among infants weighing 2000 to 2199 g: severe oxygen desaturation, 41% with 3.0 mm versus 56% with 3.5mm.
AHRQ-funded; HS029029.
Citation: Peebles PJ, Jensen EA, Herrick HM .
Endotracheal tube size adjustments within seven days of neonatal intubation.
Pediatrics 2024 Apr; 153(4):e2023062925. doi: 10.1542/peds.2023-062925..
Keywords: Newborns/Infants, Critical Care
Hechtman RK, Kipnis P, Cano J
Heterogeneity of benefit from earlier time-to-antibiotics for sepsis.
The objectives of this observational cohort study were to identify patient characteristics associated with greater benefit from shorter time-to-antibiotics. Subjects were patients hospitalized with community-onset sepsis and treated with antimicrobials within 12 hours. The findings indicated that metastatic cancer and shock were associated with the greatest benefit. The researchers concluded that shorter time-to-antibiotics for sepsis is particularly important among patients with these conditions.
AHRQ-funded; HS026725.
Citation: Hechtman RK, Kipnis P, Cano J .
Heterogeneity of benefit from earlier time-to-antibiotics for sepsis.
Am J Respir Crit Care Med 2024 Apr 1; 209(7):852-60. doi: 10.1164/rccm.202310-1800OC..
Keywords: Antibiotics, Sepsis, Medication
Ramadan OI, Rosenbaum PR, Reiter JG
Impact of hospital affiliation with a flagship hospital system on surgical outcomes.
The purpose of this study was to compare general surgery outcomes at flagship systems, flagship hospitals, and flagship hospital affiliates with matched controls. The researchers utilized Medicare claims data from 2018 and 2019 to match patients undergoing inpatient general surgery in flagship system hospitals to controls who underwent the same procedure at hospitals outside the system but within the same region. 32,228 closely matched pairs were formed across 35 regions. The study found that patients at flagship system hospitals had lower 30-day mortality than matched control patients, and patients at flagship hospitals had lower mortality than control patients. Patients at flagship hospital affiliates had similar mortality to matched controls, and flagship hospitals had lower mortality than affiliate hospitals.
AHRQ-funded; HS026116.
Citation: Ramadan OI, Rosenbaum PR, Reiter JG .
Impact of hospital affiliation with a flagship hospital system on surgical outcomes.
Ann Surg 2024 Apr; 279(4):631-39. doi: 10.1097/sla.0000000000006132..
Keywords: Hospitals, Surgery, Outcomes
Nguyen KH, Oronce CIA, Adia AC
Inability to access needed medical care among Asian American, Native Hawaiian, and Pacific Islander Medicaid enrollees.
Researchers examined self-reported inability to access needed medical care and patients’ reasons for not accessing medical care among adult Medicaid enrollees, disaggregated across Asian American, Native Hawaiian, and Pacific Islander ethnic groups. Their findings indicated that Chinese, Other Asian, Native Hawaiian enrollees were significantly less likely to report being unable to access needed medical care compared with non-Hispanic White enrollees. The most common reason given was that health plans would not approve, cover, or pay for care. The researchers concluded that different interventions specific to certain ethnic groups may be needed to mitigate inequities.
AHRQ-funded; HS022241.
Citation: Nguyen KH, Oronce CIA, Adia AC .
Inability to access needed medical care among Asian American, Native Hawaiian, and Pacific Islander Medicaid enrollees.
J Ambul Care Manage 2024 Apr-Jun; 47(2):96-103. doi: 10.1097/jac.0000000000000489..
Keywords: Access to Care, Racial and Ethnic Minorities, Medicaid
Fowler ME, Murdaugh D, Harmon C
Longitudinal changes in patient-reported cognitive complaints among older adults with gastrointestinal malignancies - results from the Cancer and Aging Resilience Evaluation (CARE) Registry.
This longitudinal study evaluated early cognitive complaints (CC) in older adults and predictors among older adults with cancer. The authors examined early CC change on the PROMIS® Short Form4a Cognitive Function among adults ≥ 60 years with GI cancer enrolled in the Cancer and Aging Resilience Evaluation (CARE) undergoing geriatric assessment (GA) at baseline and one 3-6-month follow-up. They included 218 participants. The median follow-up time was 3.7 months, the mean age was 69.2 ± 7.1, and 57.3% were male. They most commonly had colorectal cancer (30.7%) with most stage at III/IV (73.7%). About half (51.8%) had stable cognition baseline to follow-up, 20.6% improved (≥ 5 increase), and 27.5% declined (≥ 5 decrease). Using follow-up t-score, there were no significant baseline predictors. The baseline t-score was the best-fitting predictor of follow-up t-score.
AHRQ-funded; HS013852.
Citation: Fowler ME, Murdaugh D, Harmon C .
Longitudinal changes in patient-reported cognitive complaints among older adults with gastrointestinal malignancies - results from the Cancer and Aging Resilience Evaluation (CARE) Registry.
J Cancer Surviv 2024 Apr; 18(2):521-30. doi: 10.1007/s11764-022-01254-4..
Keywords: Elderly, Cancer
O'Connor KE, Shanholtz CE, Espeleta HC
Mental health symptoms and engagement in a stepped-care mental health service among patients with a violent versus nonviolent injury.
This study examined differences in engagement between survivors of nonviolent versus violent injury in the Trauma Resilience and Recovery Program (TRRP), a technology-enhanced model designed to provide evidence-based mental health screening and treatment. Data was analyzed from adult patients enrolled in TRRP and admitted to a Level-I trauma service. Results showed that engagement in services at bedside was similar for survivors of violent and nonviolent traumatic injury; patients with a violent injury had higher levels of posttraumatic stress disorder and depressive symptoms 30 days after injury, but were less likely to engage in mental health screening. The authors concluded that patients with violent traumatic injury have higher levels of mental health needs but face greater barriers to accessing services. Effective strategies are needed to ensure continuity of care and access to mental health care.
AHRQ-funded; HS028006.
Citation: O'Connor KE, Shanholtz CE, Espeleta HC .
Mental health symptoms and engagement in a stepped-care mental health service among patients with a violent versus nonviolent injury.
J Trauma Acute Care Surg 2024 Apr; 96(4):650-57. doi: 10.1097/ta.0000000000004078..
Keywords: Behavioral Health, Patient and Family Engagement, Trauma
Howard RA, Thelen Ae, Chen X
Mortality and severe complications among newly graduated surgeons in the United States.
The objective of study was to evaluate severe complications and mortality over years of independent practice among general surgeons to discover if patient outcomes differed between early and later career surgeons. Medicare claims data was evaluated for 30-day outcomes for 26 operations. The results indicated that rates of mortality and severe complications were higher among newly graduated surgeons compared to later career surgeons.
AHRQ-funded; HS027653.
Citation: Howard RA, Thelen Ae, Chen X .
Mortality and severe complications among newly graduated surgeons in the United States.
Ann Surg 2024 Apr; 279(4):555-60. doi: 10.1097/sla.0000000000006128..
Keywords: Mortality, Provider: Physician, Surgery, Adverse Events
Scott HF, Lindberg DM, Brackman S
Pediatric sepsis in general emergency departments: association between pediatric sepsis case volume, care quality, and outcome.
The purpose of this study was to evaluate whether a general emergency department's (ED) annual pediatric sepsis volume increases the odds of delivering care aligned with Surviving Sepsis pediatric guidelines. The researchers included 1,527 ED encounters between January 1, 2015, and September 30, 2021. The study found that care was aligned with the guidelines in 41.1% of encounters, and annual pediatric sepsis volume was minimally related with the probability of guideline-concordant care. Care concordance increased from 23.1% in 2015 to 52.8% in 2021.
AHRQ-funded; HS025696.
Citation: Scott HF, Lindberg DM, Brackman S .
Pediatric sepsis in general emergency departments: association between pediatric sepsis case volume, care quality, and outcome.
Ann Emerg Med 2024 Apr; 83(4):318-26. doi: 10.1016/j.annemergmed.2023.10.011..
Keywords: Children/Adolescents, Sepsis, Emergency Department, Quality of Care, Guidelines, Evidence-Based Practice
Dualeh SHA, Powell CA, Kunnath N
Rate of emergency lower extremity amputations in the United States among Medicare beneficiaries.
This study’s objective was to determine the rate of emergency versus elective lower extremity amputations in the US. The study evaluated Medicare beneficiaries who underwent lower extremity amputation between 2015 and 2020. The authors determined the rate for each zip code and placed into rank order from lowest to highest rate. They merged each beneficiary's place of residence and location of care with the American Hospital Association Annual Survey using Google Maps Application Programming Interface to determine the travel distance for patients to undergo their procedure. Of 233,084 patients, 66.3% were men, 69.8% were White. The average age at amputation was 74 years. There was wide variation in rates of emergency lower extremity amputation, with the quintile of zip codes demonstrating an emergency amputation rate of 3.7%, whereas the highest quintile demonstrating 90%. The median travel distance in the lowest emergency surgery rate quintile was 34.6 miles compared with 10.5 miles in the highest quintile of emergency surgery, suggesting variable access to essential vascular care.
AHRQ-funded; HS028606.
Citation: Dualeh SHA, Powell CA, Kunnath N .
Rate of emergency lower extremity amputations in the United States among Medicare beneficiaries.
Ann Surg 2024 Apr; 279(4):714-19. doi: 10.1097/sla.0000000000006105..
Keywords: Medicare, Surgery