National Healthcare Quality and Disparities Report
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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 8 of 8 Research Studies DisplayedBajaj JS, Peña-Rodriguez M, La Reau A
Longitudinal transkingdom gut microbial approach towards decompensation in outpatients with cirrhosis.
The purpose of this study was to ascertain the crucial role of predicting the onset of initial decompensation development. It emphasizes the significance of transkingdom gut microbial interactions, including archaeal methanogens, as potential markers and predictors, and the need for a longitudinal approach to do so. The study included cirrhosis outpatients who were categorized into three groups: those with compensated cirrhosis in Group 1, those with one incidence of decompensation in Group 2, and those with more than one incidence of decompensation in Group 3. Group 3 was further divided based on stability or further decompensation. The presence of bacteria, viruses, and archaea, along with α/β diversity and temporal taxa fluctuations adjusted for clinical variables were analyzed. The study tracked 157 outpatients and found that between 28% and 47% of those patients developed outcomes. Baseline between those who remained stable/developed outcome: While no differences were seen in α/β diversity, commensals were lower and pathobionts were higher in those who decompensated. After decompensation: those experiencing their first decompensation showed a larger decrease in α/β-diversity, bacterial change and viral change vs those with further decompensation. Archaea: 19% had Methanobacter brevii, which was similar between/within groups. The study concluded that the largest changes in transkingdom gut microbial were observed in those reaching the first decompensation, compared with subsequent decompensating events.
AHRQ-funded; HS025412.
Citation: Bajaj JS, Peña-Rodriguez M, La Reau A .
Longitudinal transkingdom gut microbial approach towards decompensation in outpatients with cirrhosis.
Gut 2023 Apr; 72(4):759-71. doi: 10.1136/gutjnl-2022-328403.
AHRQ-funded; HS025412.
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AHRQ-funded; HS025412.
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Keywords: Chronic Conditions, Ambulatory Care and Surgery, Outcomes
Friese CR, Fauer AJ, Kuisell C
Patient-reported outcomes collected in ambulatory oncology practices: feasibility, patterns, and correlates.
The purpose of this study was to examine the feasibility of soliciting outcomes from adults who received chemotherapy treatment for cancer and to describe the patterns and correlates of patient-reported toxicities. Results determined that querying patients on chemotherapy treatment experiences and toxicities was feasible. Toxicity rates varied across practices, informing quality improvement. Toxicity severity and service use incidence exceed previously published trial data, particularly for pain, fatigue, and gastrointestinal issues. Open-text questions enabled exploration with newer treatment regimens.
AHRQ-funded; HS024914.
Citation: Friese CR, Fauer AJ, Kuisell C .
Patient-reported outcomes collected in ambulatory oncology practices: feasibility, patterns, and correlates.
Health Serv Res 2020 Dec;55(6):966-72. doi: 10.1111/1475-6773.13574..
Keywords: Ambulatory Care and Surgery, Cancer, Treatments, Quality of Care, Patient-Centered Outcomes Research, Outcomes
Carey K, Morgan JR, Lin MY
Patient outcomes following total joint replacement surgery: a comparison of hospitals and ambulatory surgery centers.
This study used a large claims database of non-Medicare patients to examine inpatient and outpatient total knee replacement and total hip replacement surgery performed on a near-elderly population during 2014-2016. Findings support the argument that outpatient total joint replacement is appropriate for select patients treated in both hospital outpatient departments and ambulatory surgery centers, although in the commercially insured population, the latter services may come at a cost. Until further study of outpatient total joint replacement in the Medicare population becomes available, how this will extrapolate to the Medicare population is unknown.
AHRQ-funded; HS022242.
Citation: Carey K, Morgan JR, Lin MY .
Patient outcomes following total joint replacement surgery: a comparison of hospitals and ambulatory surgery centers.
J Arthroplasty 2020 Jan;35(1):7-11. doi: 10.1016/j.arth.2019.08.041..
Keywords: Orthopedics, Surgery, Ambulatory Care and Surgery, Hospitals, Outcomes
Paredes AZ, Malik AT, Cluse M
Discharge disposition to skilled nursing facility after emergent general surgery predicts a poor prognosis.
Emergency general surgery can have a profound impact on the functional status of even previously independent patients. In this study, the investigators examined the role and influence of discharging a patient to a skilled nursing facility. They concluded that after accounting for patient severity and perioperative course, discharge to a skilled nursing facility was an independent risk factor for death, readmission, and postdischarge complications.
AHRQ-funded; HS022694.
Citation: Paredes AZ, Malik AT, Cluse M .
Discharge disposition to skilled nursing facility after emergent general surgery predicts a poor prognosis.
Surgery 2019 Oct;166(4):489-95. doi: 10.1016/j.surg.2019.04.034..
Keywords: Nursing Homes, Hospital Discharge, Elderly, Ambulatory Care and Surgery, Emergency Department, Outcomes, Hospital Readmissions, Outcomes, Risk
Carney RM, Freedland KE, Steinmeyer BC
Collaborative care for depression symptoms in an outpatient cardiology setting: a randomized clinical trial.
The purpose of this study was to determine whether collaborative care (CC) for patients who screen positive for depression during an outpatient cardiology visit results in greater improvement in depression symptoms and better medical outcomes than seen in patients who screen positive for depression but receive only usual care (UC). Tthis trial did not show that CC produces better depression outcomes than UC.
AHRQ-funded; HS018335.
Citation: Carney RM, Freedland KE, Steinmeyer BC .
Collaborative care for depression symptoms in an outpatient cardiology setting: a randomized clinical trial.
Int J Cardiol 2016 Sep 15;219:164-71. doi: 10.1016/j.ijcard.2016.06.045.
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Keywords: Care Management, Cardiovascular Conditions, Depression, Healthcare Delivery, Behavioral Health, Outcomes, Ambulatory Care and Surgery, Teams
Bickman L, Douglas SR, De Andrade AR
Implementing a measurement feedback system: a tale of two sites.
A randomized experiment was conducted in two outpatient clinics evaluating contextualized feedback systems. Only one of the two participating clinics had an enhanced outcome because of feedback. Clinicians' questionnaire completion rate and feedback viewing were 50 % higher at this clinic. The discussion focused on the differences in implementation at each site and how these differences may have contributed to the different outcomes of the experiment.
AHRQ-funded; HS018036.
Citation: Bickman L, Douglas SR, De Andrade AR .
Implementing a measurement feedback system: a tale of two sites.
Adm Policy Ment Health 2016 May;43(3):410-25. doi: 10.1007/s10488-015-0647-8.
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Keywords: Behavioral Health, Outcomes, Ambulatory Care and Surgery, Patient-Centered Healthcare
Robinson JC, Brown TT, Whaley C
Consumer choice between hospital-based and freestanding facilities for arthroscopy: Impact on prices, spending, and surgical complications.
The purpose of this study was to evaluate the impact of reference-based benefits on consumer choices, facility prices, employer spending, and surgical outcomes for orthopaedic procedures performed at ambulatory surgery centers. It found that the shift to reference-based benefits was associated with an increase in the utilization of freestanding ambulatory surgery centers by 14.3 percentage points for knee arthroscopy and by 9.9 percentage points for shoulder arthroscopy and a corresponding decrease in the use of hospital-based facilities.
AHRQ-funded; HS022098.
Citation: Robinson JC, Brown TT, Whaley C .
Consumer choice between hospital-based and freestanding facilities for arthroscopy: Impact on prices, spending, and surgical complications.
J Bone Joint Surg Am 2015 Sep 16;97(18):1473-81. doi: 10.2106/jbjs.o.00240..
Keywords: Surgery, Ambulatory Care and Surgery, Outcomes
Erickson KF, Mell MW, Winkelmayer WC
Provider visit frequency and vascular access interventions in hemodialysis.
This study sought to determine whether more frequent face-to-face provider (physician and advanced practitioner) visits lead to more procedures and therapeutic interventions aimed at preserving arteriovenous fistulas and grafts and improved vascular access outcomes. It found that more frequent face-to-ace provider visits were associated with more procedures and therapeutic interventions aimed at preserving vascular accesses, but not with prolonged vascular access survival.
AHRQ-funded; HS019178.
Citation: Erickson KF, Mell MW, Winkelmayer WC .
Provider visit frequency and vascular access interventions in hemodialysis.
Clin J Am Soc Nephrol 2015 Feb 6;10(2):269-77. doi: 10.2215/cjn.05540614..
Keywords: Care Management, Dialysis, Kidney Disease and Health, Outcomes, Ambulatory Care and Surgery