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
12126 to 12150 of 12201 Research Studies DisplayedDel Fiol G, Curtis C, Cimino JJ
Disseminating context-specific access to online knowledge resources within electronic health record systems.
This paper describes OpenInfobutton (www.openinfobutton.org): a standards-based, open source Web service that was designed to disseminate infobutton capabilities in multiple electronic health record systems and healthcare organizations. Included in this overview are the OpenInfobutton architecture, knowledge resource integration, and experiences at five large healthcare organizations.
AHRQ-funded; HS018352.
Citation: Del Fiol G, Curtis C, Cimino JJ .
Disseminating context-specific access to online knowledge resources within electronic health record systems.
Stud Health Technol Inform 2013;192:672-6..
Keywords: Clinical Decision Support (CDS), Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Web-Based
Goff SL, Pekow PS, White KO
IDEAS for a healthy baby--reducing disparities in use of publicly reported quality data: study protocol for a randomized controlled trial.
This study's goals were to determine the efficacy of a patient navigator intervention to assist low-income pregnant women in the use of publicly available information about quality of care when choosing a pediatrician; to evaluate the relative importance of factors influencing women's choice of pediatric practices; to evaluate the effect of the intervention on patient engagement in management of their own and their child's health care; and to assess variation in efficacy of the intervention for sub-groups based on parity, age, and race/ethnicity. Successful completion of the study aims is expected to yield important new knowledge about the value of guided website navigation as a strategy to increase the impact of publicly reported quality data and to reduce disparities in use of these data.
AHRQ-funded; HS021864.
Citation: Goff SL, Pekow PS, White KO .
IDEAS for a healthy baby--reducing disparities in use of publicly reported quality data: study protocol for a randomized controlled trial.
Trials 2013 Aug 7;14:244. doi: 10.1186/1745-6215-14-244.
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Keywords: Education: Patient and Caregiver, Newborns/Infants, Low-Income, Pregnancy, Public Reporting
Tsui J, Gee GC, Rodriguez HP
Exploring the role of neighborhood socio-demographic factors on HPV vaccine initiation among low-income, ethnic minority girls.
This study of neighborhood factors associated with human papillomavirus (HPV) vaccine uptake, especially among disadvantaged groups, found that initiation rates were highest among girls from the most disadvantaged neighborhoods. However, mother’s awareness of HPV, age, and insurance status were also strong predictors for initiation.
AHRQ-funded; HS020172
Citation: Tsui J, Gee GC, Rodriguez HP .
Exploring the role of neighborhood socio-demographic factors on HPV vaccine initiation among low-income, ethnic minority girls.
J Immigr Minor Health. 2013 Aug;15(4):732-40. doi: 10.1007/s10903-012-9736-x..
Keywords: Vaccination, Children/Adolescents, Women, Health Insurance, Disparities
Gabayan GZ, Asch SM, Hsia RY
Factors associated with short-term bounce-back admissions after emergency department discharge.
The researchers describe the prevalence, characteristics, and predictors of 7-day bounce-back admissions after ED discharge in a cohort of California hospitals. They found that older white men and patients with a disposition of eloped or having left against medical advice especially at risk for a bounce-back admission. They also found that use of Medicaid or Medicare was associated with higher rates of bounce-back admission.
AHRQ-funded; HS018098.
Citation: Gabayan GZ, Asch SM, Hsia RY .
Factors associated with short-term bounce-back admissions after emergency department discharge.
Ann Emerg Med 2013 Aug;62(2):136-44.e1. doi: 10.1016/j.annemergmed.2013.01.017..
Keywords: Emergency Department, Hospital Discharge, Hospital Readmissions
Jonsson Funk M, Visco AG, Weidner AC
Long-term outcomes of vaginal mesh versus native tissue repair for anterior vaginal wall prolapse.
This study estimated the rate of repeat surgery after vaginal mesh versus native tissue repair for anterior vaginal wall prolapse. The researchers found that the overall risk of any future surgery was higher in the women receiving mesh; however, native tissue and vaginal mesh surgery had similar 5-year risks for recurrent prolapse.
AHRQ-funded; HS017950
Citation: Jonsson Funk M, Visco AG, Weidner AC .
Long-term outcomes of vaginal mesh versus native tissue repair for anterior vaginal wall prolapse.
Int Urogynecol J. 2013 Aug;24(8):1279-85. doi: 10.1007/s00192-013-2043-9..
Keywords: Comparative Effectiveness, Surgery, Women, Outcomes, Risk
Schneeweiss S, Seeger JD, Jackson JW
AHRQ Author: Smith SR
Methods for comparative effectiveness research/patient-centered outcomes research: from efficacy to effectiveness.
This article provides an overview of papers in this supplement resulting from a June 2012 AHRQ-sponsored symposium on research methods for CER and patient-centered outcomes research.
AHRQ-authored.
Citation: Schneeweiss S, Seeger JD, Jackson JW .
Methods for comparative effectiveness research/patient-centered outcomes research: from efficacy to effectiveness.
J Clin Epidemiol 2013 Aug;66(8 Suppl):S1-4. doi: 10.1016/j.jclinepi.2013.05.012.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Research Methodologies
Spector WD, Limcangco R, Williams C
AHRQ Author: Spector WD
Potentially avoidable hospitalizations for elderly long-stay residents in nursing homes.
The authors sought to determine the relationship between clinical risk factors, facility characteristics and State policy variables, and both avoidable and unavoidable hospitalizations. Using data from the Nursing Home Stay file, 2006-2008, they found that three fifths of hospitalizations were potentially avoidable and most were for infections, injuries, and congestive heart failure. Clinical risk factors included renal disease, diabetes, and a high number of medications. Staffing, quality, and reimbursement affected avoidable, but not unavoidable, hospitalizations.
AHRQ-authored.
Citation: Spector WD, Limcangco R, Williams C .
Potentially avoidable hospitalizations for elderly long-stay residents in nursing homes.
Med Care 2013 Aug;51(8):673-81. doi: 10.1097/MLR.0b013e3182984bff.
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Keywords: Elderly, Hospitalization, Long-Term Care, Nursing Homes, Policy
Easter JS, Haukoos JS, Claud J
Traumatic intracranial injury in intoxicated patients with minor head trauma.
This study to estimate the prevalence of intracranial injury following minor head injury found that 8% of 225 intoxicated patients with minor head injury had clinically important injuries requiring either hospital admission or neurosurgical followup. Neither the Canadian CT Head Rule nor NEXUS criteria had adequate sensitivity to be used with these patients.
AHRQ-funded; HS019464; HS017526
Citation: Easter JS, Haukoos JS, Claud J .
Traumatic intracranial injury in intoxicated patients with minor head trauma.
Acad Emerg Med. 2013 Aug;20(8):753-60. doi: 10.1111/acem.12184..
Keywords: Emergency Department, Trauma, Brain Injury, Shared Decision Making
Pohl JM, Nath R, Zheng K
Use of a comprehensive patient safety tool in primary care practices.
This article describes experiences with the use of the Physician Practice Patient Safety Assessment tool in six safety net practices—three of which were primary care nurse-managed health centers and three were physician-led federally qualified health centers. The authors concluded that this tool has enormous relevance for primary care settings, especially those preparing themselves for patient-centered medical home status and meaningful use.
AHRQ-funded; HS017191.
Citation: Pohl JM, Nath R, Zheng K .
Use of a comprehensive patient safety tool in primary care practices.
J Am Assoc Nurse Pract 2013 Aug;25(8):415-8. doi: 10.1111/1745-7599.12021..
Keywords: Patient Safety, Primary Care, Patient-Centered Healthcare, Practice Patterns, Tools & Toolkits
Osborn CY, Mayberry LS, Wallston KA
Understanding patient portal use: implications for medication management.
The authors sought to (1) understand who uses an existing patient portal and reasons for use and nonuse, (2) understand how portal users are using a portal to manage their medications, and (3) explore participants' ideas for improving portal functionality for medication management and adherence support. They found that patients use portals to manage their medications, are enthusiastic about further leveraging portals to support medication management and adherence, and those who use a portal more frequently have better glycemic control.
AHRQ-funded; HS018168; HS013833.
Citation: Osborn CY, Mayberry LS, Wallston KA .
Understanding patient portal use: implications for medication management.
J Med Internet Res 2013 Jul 3;15(7):e133. doi: 10.2196/jmir.2589.
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Keywords: Diabetes, Health Information Technology (HIT), Medication, Patient Adherence/Compliance, Web-Based
Clancy CM
AHRQ Author: Clancy CM
Children's electronic health records: has the tipping point arrived?
This article describes an electronic health record (EHR) format developed by AHRQ and CMS in consultation with experts from the American Academy of Pediatrics and the American Academy of Family Physicians. Organized around 22 topic areas, this format includes information about needed functionality, best practices, and applicable data standards that can be used as a starting point for EHR developers.
AHRQ-authored.
Citation: Clancy CM .
Children's electronic health records: has the tipping point arrived?
J Comp Eff Res 2013 Jul;2(4):359-61. doi: 10.2217/cer.13.44.
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Keywords: Children/Adolescents, Electronic Health Records (EHRs), Children/Adolescents, Quality Improvement
Clancy CM
AHRQ Author: Clancy CM
Evidence-based toolkit helps organizations reduce patient falls.
This article describes an evidence-based hospital fall-prevention toolkit developed by AHRQ that helps clinicians negotiate the change process at their organization. It was created by a team with expertise both in fall prevention and in organizational change, including staff from the RAND Corporation, ECRI Institute, and Boston University.
AHRQ-authored.
Citation: Clancy CM .
Evidence-based toolkit helps organizations reduce patient falls.
J Nurs Care Qual 2013 Jul-Sep;28(3):195-7. doi: 10.1097/NCQ.0b013e318294a9d1.
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Keywords: Evidence-Based Practice, Falls, Tools & Toolkits, Patient Safety, Prevention
Chambers DA, Haim A, Mullican CA
AHRQ Author: Mullican CA
Health information technology and mental health services research: a path forward.
This article reports on the AHRQ- and NIMH-organized November 2010 workshop, “Health Information Technology and Mental Health: The Way Forward.” The primary workshop goal was to bring together experts in mental health services and interventions research, practitioners, consumers, and technologists to discuss emerging opportunities in uniting all aspects of health IT and mental health research. The workshop resulted in a four-paper series, envisioning a future mental health system in which health IT is fully integrated within mental health service systems, for patient, clinician, and system levels.
AHRQ-authored.
Citation: Chambers DA, Haim A, Mullican CA .
Health information technology and mental health services research: a path forward.
Gen Hosp Psychiatry 2013 Jul-Aug;35(4):329-31. doi: 10.1016/j.genhosppsych.2013.03.006.
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Keywords: Access to Care, Health Information Technology (HIT), Health Services Research (HSR), Health Information Technology (HIT), Behavioral Health
Wagner LM, McDonald SM, Castle NG
Impact of voluntary accreditation on short-stay rehabilitative measures in U.S. nursing homes.
The purpose of this paper was to examine accreditation from nursing homes accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF) and whether this is associated with improved rehabilitation care. Findings indicated that CARF-accredited nursing homes demonstrate better quality with regard to the short-stay quality measures and that approaches beyond traditional regulation and governmental inspections are necessary to improve the quality of care in nursing homes.
AHRQ-funded; HS013983.
Citation: Wagner LM, McDonald SM, Castle NG .
Impact of voluntary accreditation on short-stay rehabilitative measures in U.S. nursing homes.
Rehabil Nurs 2013 Jul-Aug;38(4):167-77. doi: 10.1002/rnj.94.
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Keywords: Quality of Care, Nursing Homes, Quality Measures, Rehabilitation
Werner RM, Konetzka RT, Kim MM
Quality improvement under nursing home compare: the association between changes in process and outcome measures.
The researchers tested the extent to which improvements in outcomes of care are explained by changes in nursing home processes. Of the 5 outcome measures examined, they found that only improvements in the percentage of nursing home residents in moderate or severe pain were associated with changes in nursing home processes of care. They concluded that understanding the mechanism behind improvements in nursing home outcomes may be key to successfully achieving broad quality improvements across nursing homes.
AHRQ-funded; HS021861.
Citation: Werner RM, Konetzka RT, Kim MM .
Quality improvement under nursing home compare: the association between changes in process and outcome measures.
Med Care 2013 Jul;51(7):582-8. doi: 10.1097/MLR.0b013e31828dbae4.
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Keywords: Nursing Homes, Long-Term Care, Quality Improvement, Quality Measures, Quality of Care, Provider Performance, Outcomes
Clancy CM, Collins Sharp BA
AHRQ Author: Clancy CM, Collins Sharp BA
Women's health during health care transformation.
This article describes health care transformation as it affects women as a result of the Affordable Care Act of 2010. Topics discussed include USPSTF-recommended preventve services, patient-centered medical homes, access, health disparities, and the Veterans Health Administration healthcare system.
AHRQ-authored.
Citation: Clancy CM, Collins Sharp BA .
Women's health during health care transformation.
J Gen Intern Med 2013 Jul;28 Suppl 2:S500-3. doi: 10.1007/s11606-013-2473-6.
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Keywords: Healthcare Delivery, Policy, Policy, Women
Huang SS, Septimus E, Kleinman K
Targeted versus universal decolonization to prevent ICU infection.
In this pragmatic, cluster-randomized trial the authors compared targeted versus universal decolonization of patients in intensive care units (ICUs) as strategies for preventing health care-associated infections, particularly those caused by methicillin-resistant Staphylococcus aureus (MRSA). They found that in routine ICU practice, universal decolonization was more effective than targeted decolonization or screening and isolation in reducing rates of MRSA clinical isolates and bloodstream infection from any pathogen.
AHRQ-funded; 290201000008I.
Citation: Huang SS, Septimus E, Kleinman K .
Targeted versus universal decolonization to prevent ICU infection.
N Engl J Med 2013 Jun 13;368(24):2255-65. doi: 10.1056/NEJMoa1207290..
Keywords: Comparative Effectiveness, Infectious Diseases, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Intensive Care Unit (ICU), Patient-Centered Healthcare, Patient Safety, Prevention
Conway PH, Mostashari F, Clancy CM
AHRQ Author: Clancy CM
The future of quality measurement for improvement and accountability.
The authors describe the characteristics of the quality measurement enterprise of the future, outline a potential roadmap for the transition, and identify a set of opportunities for public- and private-sector collaboration.
AHRQ-authored.
Citation: Conway PH, Mostashari F, Clancy CM .
The future of quality measurement for improvement and accountability.
JAMA 2013 Jun 5;309(21):2215-6. doi: 10.1001/jama.2013.4929.
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Keywords: Healthcare Delivery, Policy, Organizational Change, Quality Indicators (QIs), Quality Measures, Quality of Care
DeVoe JE, Stenger R
Aligning provider incentives to improve primary healthcare delivery in the United States.
This critical review uses a theoretical framework from game-theory models to discuss some of the dominant primary care provider payment models and how they create 'prisoner's dilemmas' that have stalled past reform efforts, then illustrates an escape from the dilemma. It concludes that a blend of guaranteed payment and selective incentives designed to encourage primary care providers to deliver high quality care, efficient and equitable care and to eliminate incentives towards over-servicing could reach outcomes leading to shared benefits for everyone involved.
AHRQ-funded; HS014645; HS016181.
Citation: DeVoe JE, Stenger R .
Aligning provider incentives to improve primary healthcare delivery in the United States.
OA Fam Med 2013 Jun 1;1(1):7.
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Keywords: Healthcare Delivery, Payment, Primary Care, Quality Improvement
Dimick J, Ruhter J, Sarrazin MV
Black patients more likely than whites to undergo surgery at low-quality hospitals in segregated regions.
The authors assessed the extent to which living in racially segregated areas and living in geographic proximity to low-quality hospitals contribute to the disparity of black patients undergoing surgery at lower-quality hospitals more frequently than whites. Using Medicare data, they found that black patients tended to live closer to higher-quality hospitals than white patients but were more likely to receive surgery at low-quality hospitals. To address these disparities, care navigators and public reporting of comparative quality could steer patients and their referring physicians to higher-quality hospitals, while quality improvement efforts could focus on improving outcomes for high-risk surgery at hospitals that disproportionately serve black patients.
AHRQ-funded; HS017765.
Citation: Dimick J, Ruhter J, Sarrazin MV .
Black patients more likely than whites to undergo surgery at low-quality hospitals in segregated regions.
Health Aff 2013 Jun;32(6):1046-53. doi: 10.1377/hlthaff.2011.1365.
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Keywords: Disparities, Quality of Care, Hospitals, Racial and Ethnic Minorities, Surgery
Clancy CM, Margolis PA, Miller M
AHRQ Author: Clancy CM
Collaborative networks for both improvement and research.
The authors discuss collaborative improvement networks, which can serve as large-scale, health system laboratories to engage clinicians, researchers, patients, and parents in testing approaches to translate research into practice. Creation of total population registries in collaborative network sites provides large, representative study samples with high-quality data which can be used to generate evidence and to inform clinical decision-making. Collaborative networks for improvement and research offer the opportunity not only to make improvements but also to study improvements to determine which interventions and combination of strategies work best in which settings.
AHRQ-authored; AHRQ-funded; HS021114.
Citation: Clancy CM, Margolis PA, Miller M .
Collaborative networks for both improvement and research.
Pediatrics 2013 Jun;131 Suppl 4:S210-4. doi: 10.1542/peds.2012-3786H.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Patient-Centered Outcomes Research, Children/Adolescents, Implementation
Lebrun-Harris LA, Baggett TP, Jenkins DM
AHRQ Author: Ngo-Metzger Q
Health status and health care experiences among homeless patients in federally supported health centers: findings from the 2009 patient survey.
This study examined health status and health care experiences of homeless patients in health centers and compared them to nonhomeless counterparts. It found that homeless patients had worse health status (chronic conditions, mental health problems, and substance abuse) compared with housed respondents. They were also twice as likely to have unmet medical needs in the past year.
AHRQ-authored
Citation: Lebrun-Harris LA, Baggett TP, Jenkins DM .
Health status and health care experiences among homeless patients in federally supported health centers: findings from the 2009 patient survey.
Health Serv Res. 2013 Jun;48(3):992-1017. doi: 10.1111/1475-6773.12009..
Keywords: Health Status, Community-Based Practice, Access to Care, Disparities
Shrestha S, Foxman B, Weinberger DM
AHRQ Author: Steiner C
Identifying the interaction between influenza and pneumococcal pneumonia using incidence data.
The authors integrated weekly incidence reports and a mechanistic transmission model within a likelihood-based inference framework to characterize the nature, timing, and magnitude of the interaction between influenza and pneumococcal pneumonia. They found support for a strong but short-lived interaction, with influenza infection increasing susceptibility to pneumococcal pneumonia ~100-fold. They inferred modest population-level impacts arising from strong processes at the level of an individual.
AHRQ-authored.
Citation: Shrestha S, Foxman B, Weinberger DM .
Identifying the interaction between influenza and pneumococcal pneumonia using incidence data.
Sci Transl Med 2013 Jun 26;5(191):191ra84. doi: 10.1126/scitranslmed.3005982.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Influenza, Pneumonia
Henke RM, Maeda JL, Marder WD
AHRQ Author: Friedman BS, Wong HS
Medicare and commercial inpatient resource use: impact of hospital competition.
The authors examined the influence of hospital competition on small-area inpatient resource use by payer. Using HCUP data, they found that policies or incentives that promote or encourage competition in less competitive markets may reduce variation in resource use for both Medicare and private payers.
AHRQ-authored; AHRQ-funded; 290200600009C.
Citation: Henke RM, Maeda JL, Marder WD .
Medicare and commercial inpatient resource use: impact of hospital competition.
Am J Manag Care 2013 Jun;19(6):e238-48.
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Keywords: Healthcare Utilization, Healthcare Cost and Utilization Project (HCUP), Hospitals, Medicare
Davidoff AJ, Weiss SR, Baer MR
AHRQ Author: Davidoff AJ
Patterns of erythropoiesis-stimulating agent use among Medicare beneficiaries with myelodysplastic syndromes and consistency with clinical guidelines.
The researchers used SEER registries data to assess population-based patterns of erythropoiesis-stimulating agents (ESA) use relative to treatment guidelines. They found widespread use of ESA in Medicare beneficiaries with myelodysplastic syndromes.
AHRQ-authored.
Citation: Davidoff AJ, Weiss SR, Baer MR .
Patterns of erythropoiesis-stimulating agent use among Medicare beneficiaries with myelodysplastic syndromes and consistency with clinical guidelines.
Leuk Res 2013 Jun;37(6):675-80. doi: 10.1016/j.leukres.2013.02.021.
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Keywords: Guidelines, Healthcare Utilization, Medicare, Practice Patterns, Registries