HCUP 2012 Outstanding Article of the Year
Winners Announced at the AcademyHealth 2013 Annual Research Meeting
On June 24, 2013, the Agency for Healthcare Research and Quality (AHRQ) and AcademyHealth recognized two articles at the AcademyHealth Annual Research Meeting that used HCUP databases to explore and address health care research topics and issues. Both studies were published in peer-reviewed journals in 2012.
"The Effects of Safety Net Hospital Closures and Conversions on Patient Travel Distance to Hospital Services," published in Health Services Research, examines the effects of safety net hospital closure and for-profit conversion on uninsured, Medicaid, and racial/ethnic minorities.
Published in the Journal of Clinical Oncology, "Failure to Rescue As a Source of Variation in Hospital Mortality for Ovarian Cancer," investigates the role of complications, failure to rescue from complications, and mortality based on hospital volume for ovarian cancer.
"These articles epitomize outstanding and important research that contributes to the understanding of health policy issues and health services outcomes," said Dr. Herbert Wong, the AHRQ economist who directed the awards process. "We are honored to see the impact that HCUP has had in the investigation of these critical subjects."
Detailed descriptions of the research follow.
The Effects of Safety Net Hospital Closures and Conversions on Patient Travel Distance to Hospital Services
Safety net hospitals play a critical role in the U.S. health system, as these types of hospitals are either mandated to accept all patients or are private hospitals which serve a number of indigent patients. Certain groups of uninsured and Medicaid patients experience greater disruptions in patters of care, and relative to privately insured individuals, there is also greater travel for mental health and substance abuse care for the uninsured.
"The Effects of Safety Net Hospital Closures and Conversions on Patient Travel Distance to Hospital Services" used various years of the HCUP State Inpatient Databases (SID) for Arizona, California, Florida, and Wisconsin to examine travel distance for patients treated in urban hospitals, and assess how travel was affected for patients after safety net hospital events. This study looks at five diagnosis categories: ambulatory care sensitive conditions, referral sensitive conditions, marker conditions, births, and mental health and substance abuse.
The article concluded that closure or for-profit conversions of safety net hospitals appear to have detrimental effects on particular subgroups of disadvantaged populations. This study suggests that policy makers may need to pay special attention to these patient subgroups, as well as ease transportation barriers when dealing with disruptions resulting from reductions in safety net hospital resources.
Dr. Gloria J. Bazzoli of the Virginia Commonwealth University Department of Health Administration was the lead author of this article. In addition to Dr. Bazzoli, the authors include Dr. Woolton Lee (Centers for Medicare and Medicaid Services), Dr. Hui-Min Hsieh (Kaohsiung Medical University Department of Public Health), and Dr. Lee Rivers Mobley (Georgia State University Institute of Public Health).
Bazzoli GJ, Lee W, Hsieh HM, Mobley LR. The effects of safety net hospital closures and conversions on patient travel distance to hospital services. Health Serv Res. 2012 Feb; 47(1 Pt 1):129-50.
Failure to Rescue As a Source of Variation in Hospital Mortality for Ovarian Cancer
It has been reported that surgical volume has an important effect on outcomes for patients who undergo surgery. However, while the association between high surgical volume and improved outcomes from procedures has been well documented, the associated underlying mechanisms are uncertain.
"Failure to Rescue As a Source of Variation in Hospital Mortality for Ovarian Cancer" used the 1988 through 2009 HCUP Nationwide Inpatient Sample (NIS) to evaluate women who underwent surgery for ovarian cancer, and subsequently rank facilities on the basis of their procedure volume to determine the risk-adjusted mortality, major complication rate, and failure to rescue rate.
The article concluded that mortality is lower for ovarian cancer patients treated at high-volume hospitals. Reduced mortality does not appear to be a result of lower complications rates, but rather a result of the high-volume hospitals ability to rescue patients with complications.
Dr. Jason D. Wright of the Columbia University College of Physicians and Surgeons was the lead author of this article. In addition to Dr. Wright, the authors include Dr. Thomas J. Herzog (Columbia University College of Physicians and Surgeons), Zainab Siddiq (Columbia University College of Physicians and Surgeons), Dr. Rebecca C. Arend (University of Alabama at Birmingham), Dr. Alfred I. Neugut (Columbia University Medical Center), Dr. William M. Burke (Columbia University College of Physicians and Surgeons), Dr. Sharyn N. Lewin (Columbia University College of Physicians and Surgeons), Dr. Cande V. Ananth (Columbia University College of Physicians and Surgeons), and Dr. Dawn L. Hershman (Columbia University Medical Center).
Wright JD, Herzog TJ, Siddiq Z, Arend R, Neugut AI, Burke WM, Lewin SN, Ananth CV, Hershman DL. Failure to rescue as a source of variation in hospital mortality for ovarian cancer. J Clin Oncol. 2012 Nov;30(32):3976-82.
|Internet Citation: HCUP's Outstanding Article of the Year Awards. Healthcare Cost and Utilization Project (HCUP). June 2013. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/awards.jsp.|
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|Last modified 6/24/13|