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
AHRQ Research Studies Date
Topics
- Care Management (1)
- (-) Community-Based Practice (11)
- Diabetes (1)
- Evidence-Based Practice (1)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Healthcare Utilization (1)
- Imaging (1)
- Maternal Care (1)
- Medicaid (2)
- Medication (1)
- Outcomes (1)
- Palliative Care (1)
- Payment (2)
- Pregnancy (2)
- Prevention (1)
- Primary Care (1)
- Provider: Health Personnel (1)
- Provider: Pharmacist (1)
- Quality of Care (2)
- Racial and Ethnic Minorities (2)
- Screening (2)
- Teams (1)
- Training (1)
- Women (3)
- Workforce (1)
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 11 of 11 Research Studies DisplayedHolcomb J, Ferguson G, Roth I
Adoption of an evidence-based intervention for mammography screening adherence in safety net clinics.
This paper describes an evidence-based intervention that was created to reduce mammography appointment no-show rates in underserved women at safety net clinics. An academic-community partnership was used to implement four strategies to improve the adoption and scale-up of the interventions with Federally Qualified Health Centers and charity care clinics. The interventions implemented were: (1) an outreach email blast targeting the community partner member clinics to increase program awareness, (2) an adoption video encouraging enrollment in the program, (3) an outreach webinar educating the community partner member clinics about the program, encouraging enrollment and outlining adoption steps, and (4) an adoption survey adapted from Consolidated Framework for Implementation Research constructs from the Cancer Prevention and Control Research Network for cancer control interventions with Federally Qualified Health Centers.
AHRQ-funded; HS023255.
Citation: Holcomb J, Ferguson G, Roth I .
Adoption of an evidence-based intervention for mammography screening adherence in safety net clinics.
Front Public Health 2021 Nov 4;9:748361. doi: 10.3389/fpubh.2021.748361..
Keywords: Evidence-Based Practice, Imaging, Screening, Women, Community-Based Practice
Raffo JE, Titcombe C, Henning S
Clinical-community linkages: the impact of standard care processes that engage Medicaid-eligible pregnant women in home visiting.
The purpose of this study was to describe how practice sites operationalized clinical-community linkage strategies that best suited their setting and to determine if efforts resulted in improved Maternal Infant Health Program participation and other service use. Findings showed that clinical-community linkages can significantly improve participation of Medicaid-insured women in an evidence-based home visiting program and other prenatal services.
AHRQ-funded; HS020208.
Citation: Raffo JE, Titcombe C, Henning S .
Clinical-community linkages: the impact of standard care processes that engage Medicaid-eligible pregnant women in home visiting.
Womens Health Issues 2021 Nov-Dec;31(6):532-39. doi: 10.1016/j.whi.2021.06.006..
Keywords: Pregnancy, Maternal Care, Women, Medicaid, Community-Based Practice
Carey K, Luo Q, Dor A
Quality and cost in community health centers.
This study’s objective was to explore the relationship between quality and average cost of medical visits provided in US Community Health Centers (CHCs) using composite measures of quality. The authors used the Uniform Data System collected by the Bureau of Primary Care to construct composite measures by combining 9 process and 2 outcome indicators of primary care quality provided in 1331 US CHCs during 2015-2018. They explored different weighting schemes and different combinations of individual quality indicators. They used generalized linear modeling to regress average cost of a medical visit on composite quality measures, controlling for patient and health center factors. The average cost of a medical visit was negatively associated with quality, although the magnitude of the effect varies with different weighting schemes.
AHRQ-funded; HS026816.
Citation: Carey K, Luo Q, Dor A .
Quality and cost in community health centers.
Med Care 2021 Sep;59(9):824-28. doi: 10.1097/mlr.0000000000001571.
AHRQ-funded; HS026816..
AHRQ-funded; HS026816..
Keywords: Community-Based Practice, Quality of Care, Healthcare Costs
Snyder ME, Adeoye-Olatunde OA, Gernant SA
A user-centered evaluation of medication therapy management alerts for community pharmacists: recommendations to improve usability and usefulness.
Community pharmacists provide comprehensive medication reviews (CMRs) through pharmacy contracts with medication therapy management (MTM) vendors. These CMRs are documented in the vendors' web-based MTM software platforms, which often integrate alerts to assist pharmacists in the detection of medication therapy problems. The objectives of this study were to 1) assess the usability and usefulness of MTM alerts for MTM vendor-contracted community pharmacists and 2) generate recommendations for improving MTM alerts for use by community pharmacists.
AHRQ-funded; HS025005.
Citation: Snyder ME, Adeoye-Olatunde OA, Gernant SA .
A user-centered evaluation of medication therapy management alerts for community pharmacists: recommendations to improve usability and usefulness.
Res Social Adm Pharm 2021 Aug;17(8):1433-43. doi: 10.1016/j.sapharm.2020.10.015..
Keywords: Medication, Provider: Pharmacist, Community-Based Practice
Adams LB, Richmond J, Watson SN
Community health worker training curricula and intervention outcomes in African American and Latinx communities: a systematic review.
This systematic review examined research on the relationship between community health worker (CHW) training curricula and intervention outcomes conducted among African American and Latinx populations. Studies included were quantitative, qualitative, and mixed methods studies employed to conduct outcome and process evaluations of CHW-led interventions. Out of 3,295 articles from the extensive literature search, only 36 met the review’s inclusion criteria. Overall, the strength of evidence linking specific CHW training curricula components to primary health interventions in conditions such as hypertension and diabetes was weak, and no studies directly linked outcomes to specific characteristics of CHW training. Studies that discussed training related to didactic sessions or classified as high intensity reported higher percentages of positive outcomes compared to other CHW training methods.
AHRQ-funded; HS000032; HS026122.
Citation: Adams LB, Richmond J, Watson SN .
Community health worker training curricula and intervention outcomes in African American and Latinx communities: a systematic review.
Health Educ Behav 2021 Aug;48(4):516-31. doi: 10.1177/1090198120959326..
Keywords: Community-Based Practice, Racial and Ethnic Minorities, Training, Outcomes, Provider: Health Personnel
Hatch B, Schmidt T, Davis E
Clinic factors associated with utilization of a pregnancy-intention screening tool in community health centers.
The authors’ goal was to describe the utilization of a pregnancy-intention screening tool integrated in the electronic health record (EHR) of a national network of community health centers (CHCs) and to identify clinic-level factors associated with tool use. They found that medical assistants performed 60.3% of screenings and clinicians performed 11.2%. CHCs with higher tool utilization rates were more likely to be located in rural settings and to serve patient populations with higher proportions of women and lower proportions of patients with non-English language preference. They concluded that many health centers utilized pregnancy-intention screening after an EHR-based tool was made available, though overall screening rates were low.
AHRQ-funded; HS025155.
Citation: Hatch B, Schmidt T, Davis E .
Clinic factors associated with utilization of a pregnancy-intention screening tool in community health centers.
Contraception 2021 May;103(5):336-41. doi: 10.1016/j.contraception.2021.02.003..
Keywords: Community-Based Practice, Pregnancy, Women, Screening
Ukhanova M, Marino M, Angier H
The impact of capitated payment on preventive care utilization in community health clinics.
Only half of the United States population regularly receives recommended preventive care services. Alternative payment models (e.g., a per-member-per-month capitated payment model) may encourage the delivery of preventive services when compared to a fee-for-service visit based model; however, evaluation is lacking in the United States. This study assessed the impact of implementing Oregon's Alternative Payment Methodology (APM) on orders for preventive services within community health centers (CHCs).
AHRQ-funded; HS022651.
Citation: Ukhanova M, Marino M, Angier H .
The impact of capitated payment on preventive care utilization in community health clinics.
Prev Med 2021 Apr;145:106405. doi: 10.1016/j.ypmed.2020.106405..
Keywords: Payment, Community-Based Practice, Prevention, Healthcare Utilization
Sedhom R, Nudotor R, Freund KM
Can community health workers increase palliative care use for African American patients? A pilot study.
African American patients with cancer underutilize advance care planning (ACP) and palliative care (PC). This feasibility study investigated whether community health workers (CHWs) could improve ACP and PC utilization for African American patients with advanced cancer. The investigators concluded that utilization of CHWs to address PC domains and social determinants of health was feasible. Although study enrollment was identified as a potential barrier, most recruited patients were retained on study.
AHRQ-funded; HS024736.
Citation: Sedhom R, Nudotor R, Freund KM .
Can community health workers increase palliative care use for African American patients? A pilot study.
JCO Oncol Pract 2021 Feb;17(2):e158-e67. doi: 10.1200/op.20.00574..
Keywords: Palliative Care, Community-Based Practice, Racial and Ethnic Minorities
Luo Q, Dor A, Pittman P
Optimal staffing in community health centers to improve quality of care.
The authors explored optimal workforce configurations in the production of care quality in community health centers (CHCs), accounting for interactions among occupational categories, as well as contributions to the volume of services. By linking the Uniform Data System with Internal Revenue Service nonprofit tax return data, they found that primary care physicians and advanced practice clinicians achieved similar quality outcomes. They recommended that CHCs optimize their workforce configuration to improve quality with further hiring of advanced practice clinicians as a cost-effective investment for CHCs.
AHRQ-funded; HS026816.
Citation: Luo Q, Dor A, Pittman P .
Optimal staffing in community health centers to improve quality of care.
Health Serv Res 2021 Feb;56(1):112-22. doi: 10.1111/1475-6773.13566..
Keywords: Community-Based Practice, Workforce, Quality of Care
Cottrell EK, Dambrun K, O'Malley J
Documenting new ways of delivering care under Oregon's Alternative Payment and Advanced Care Model.
This study’s objective was to describe trends in rates of traditional face-to-face office visits and “Care Services That Engage Patients” (Care STEPs) documentation among community health centers (CHCs) involved in the first 3 phases Oregon’s Alternative Payment and Advanced Care Model (APCM) pilot program. In this program, participating community health centers (CHCs) received per-member-per-month payments for empaneled Medicaid patients in lieu of standard fee-for-service Medicaid payments. Among participating CHCs, the mean rate of face-to-face visits with billable providers declined. Care STEPS documentation increased, but the difference was not statistically significant. The Care STEPs category New Visit Types were documented most frequently. There were significant increases in document of Patient Care Coordination and Integration, and a smaller but still significant increase in Reducing Barriers to Health. There was a significant decrease in documentation done by physicians and advanced practice providers with an increase by ancillary staff.
AHRQ-funded; R01 HS022651.
Citation: Cottrell EK, Dambrun K, O'Malley J .
Documenting new ways of delivering care under Oregon's Alternative Payment and Advanced Care Model.
J Am Board Fam Med 2021 Jan-Feb;34(1):78-88. doi: 10.3122/jabfm.2021.01.200027..
Keywords: Healthcare Delivery, Payment, Community-Based Practice, Medicaid
Miller-Rosales C, Rodriguez HP
Interdisciplinary primary care team expertise and diabetes care management.
Researchers examined whether care team role expertise is associated with patients' experiences of chronic care for type 2 diabetes and whether the relationship is stronger for small community health center (CHC) sites. Results of surveys conducted with adults with diabetes that assessed nonphysician team roles involved in managing their chronic care were integrated with clinical and administrative data from 14 CHCs. They found that patients with access to care team expertise in self-management support, including diabetes educators, nutritionists, community health workers, and other general staff report better experiences of chronic care. They concluded that these team roles may reduce barriers to patient self-management and improve patients' overall experiences of chronic care, particularly in small CHC sites.
Citation: Miller-Rosales C, Rodriguez HP .
Interdisciplinary primary care team expertise and diabetes care management.
J Am Board Fam Med 2021 Jan-Feb;34(1):151-61. doi: 10.3122/jabfm.2021.01.200187..
Keywords: Primary Care, Diabetes, Teams, Care Management, Community-Based Practice