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
76 to 100 of 1430 Research Studies DisplayedNembhard IM, Morrow CT, Bradley EH
Implementing role-changing versus time-changing innovations in health care: differences in helpfulness of staff improvement teams, management, and network for learning.
This paper examined the hypothesis that the degree to which access to groups that can alter organizational learning depends on innovation type. Team representativeness and network membership were positively associated with implementing role-changing practices; while senior management engagement was positively associated with implementing time-changing practices. The authors concluded that these findings advance implementation science by explaining mixed results across past studies, that the nature of change for workers alters potential facilitators' effects on implementation.
AHRQ-funded; HS018987.
Citation: Nembhard IM, Morrow CT, Bradley EH .
Implementing role-changing versus time-changing innovations in health care: differences in helpfulness of staff improvement teams, management, and network for learning.
Med Care Res Rev 2015 Dec;72(6):707-35. doi: 10.1177/1077558715592315.
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Keywords: Healthcare Delivery, Quality Improvement, Organizational Change, Teams, Quality of Care, Learning Health Systems, Implementation
Nkoy F, Fassl B, Stone B
Improving pediatric asthma care and outcomes across multiple hospitals.
This study aimed to assess the impact of an evidence-based care process model 5 years after implementation at Primary Children's Hospital, a tertiary care facility, and after its dissemination to 7 community hospitals. The intervention resulted in sustained, long-term improvement in asthma care and outcomes at the tertiary care hospital and successful dissemination to community hospitals.
AHRQ-funded; HS018166; HS018678.
Citation: Nkoy F, Fassl B, Stone B .
Improving pediatric asthma care and outcomes across multiple hospitals.
Pediatrics 2015 Dec;136(6):e1602-10. doi: 10.1542/peds.2015-0285..
Keywords: Children/Adolescents, Asthma, Hospitalization, Evidence-Based Practice, Patient-Centered Outcomes Research
Blackmore CC, Castro A
Improving the quality of imaging in the emergency department.
The six-tier efficacy hierarchy of Fryback and Thornbury enables understanding of the value of imaging on multiple levels, ranging from technical efficacy to medical decision-making and higher-level patient and societal outcomes. In this article, the authors elucidate the Fryback and Thornbury framework to define the value of imaging in the ED and to relate emergency imaging to the IOM quality domains.
AHRQ-funded; HS023498.
Citation: Blackmore CC, Castro A .
Improving the quality of imaging in the emergency department.
Acad Emerg Med 2015 Dec;22(12):1385-92. doi: 10.1111/acem.12816.
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Keywords: Shared Decision Making, Emergency Department, Imaging, Quality Improvement
Hellinger FJ
AHRQ Author: Hellinger FJ
In four ACA expansion states, the percentage of uninsured hospitalizations for people with HIV declined, 2012-14.
This study examines the influence of the Affordable Care Act's optional state Medicaid expansion on insurance coverage and health outcomes for hospitalized patients with HIV. It found that the percentage of hospitalizations of uninsured people with HIV in the four expansion states fell from 13.7 percent to 5.5 percent in the study period, while the percentage in the two nonexpanding states increased from 14.5 percent to 15.7 percent.
AHRQ-authored.
Citation: Hellinger FJ .
In four ACA expansion states, the percentage of uninsured hospitalizations for people with HIV declined, 2012-14.
Health Aff 2015 Dec;34(12):2061-8. doi: 10.1377/hlthaff.2015.0718..
Keywords: Policy, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Human Immunodeficiency Virus (HIV), Medicaid, Uninsured
Rehder KJ, Giuliano JS, Jr., Napolitano N
Increased occurrence of tracheal intubation-associated events during nights and weekends in the PICU.
Little is known about how the incidence of tracheal intubation-associated events is affected by the time of day, day of the week, or presence of in-hospital attending-level intensivists. After analyzing 5,096 tracheal intubation courses from the prospective multicenter National Emergency Airway Registry for Children, the researchers found that a higher occurrence of tracheal intubation-associated events was observed during nights and weekends, due primarily to emergent intubations.
AHRQ-funded; HS022464; HS021583.
Citation: Rehder KJ, Giuliano JS, Jr., Napolitano N .
Increased occurrence of tracheal intubation-associated events during nights and weekends in the PICU.
Crit Care Med 2015 Dec;43(12):2668-74. doi: 10.1097/ccm.0000000000001313.
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Keywords: Newborns/Infants, Intensive Care Unit (ICU), Adverse Events, Patient Safety, Critical Care
Smith MJ, Gerber JS, Hersh AL
Inpatient antimicrobial stewardship in pediatrics: a systematic review.
The purpose of this paper was to describe the clinical and economic outcomes associated with pediatric antimicrobial stewardship programs and other supplemental antimicrobial stewardship interventions. The authors concluded that the studies researched demonstrated reductions in antimicrobial utilization, cost, and prescribing errors with no apparent negative impact on patient safety.
AHRQ-funded; HS023320.
Citation: Smith MJ, Gerber JS, Hersh AL .
Inpatient antimicrobial stewardship in pediatrics: a systematic review.
J Pediatric Infect Dis Soc 2015 Dec;4(4):e127-35. doi: 10.1093/jpids/piu141.
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Keywords: Antimicrobial Stewardship, Children/Adolescents, Healthcare Costs, Patient-Centered Outcomes Research, Children/Adolescents
Ellimoottil C, Miller S, Davis M
Insurance expansion and the utilization of inpatient surgery: evidence for a "Woodwork" effect?
The researchers examined rates of elective surgery in previously insured individuals before and after Massachusetts health care reform. They observed no increase in the overall rate of selected discretionary inpatient surgeries in Massachusetts versus control states for the entire population , as well as among the white and low-income subgroups.
AHRQ-funded; HS018346.
Citation: Ellimoottil C, Miller S, Davis M .
Insurance expansion and the utilization of inpatient surgery: evidence for a "Woodwork" effect?
Surg Innov 2015 Dec;22(6):588-92. doi: 10.1177/1553350615573579.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Health Insurance, Policy, Hospitalization
Jacobs PD, Banthin JS, Trachtman S
AHRQ Author: Jacobs PD
Insurer competition in federally run marketplaces is associated with lower premiums.
The researchers studied insurer participation and premiums during the first two years of the Marketplaces. They found that the addition of a single insurer in a county was associated with a 1.2 percent lower premium for the average silver plan and a 3.5 percent lower premium for the benchmark plan in the federally run Marketplaces.
AHRQ-authored.
Citation: Jacobs PD, Banthin JS, Trachtman S .
Insurer competition in federally run marketplaces is associated with lower premiums.
Health Aff 2015 Dec;34(12):2027-35. doi: 10.1377/hlthaff.2015.0548..
Keywords: Healthcare Costs, Health Insurance
Starmer AJ, Destino L, Yoon CS
Intern and resident workflow patterns on pediatric inpatient units: a multicenter time-motion study.
The researchers sought to quantify the proportion of time spent by residents in direct care, indirect care activities, and education across 9 pediatric institutions. They found that across all sites and levels of training, trainees spent more time in interprofessional communication (34.7 percent), and at the computer (20.5 percent), and less time in contact with patients and families (12.0 percent) and in educational activities (4.7 percent).
AHRQ-funded; HS019456.
Citation: Starmer AJ, Destino L, Yoon CS .
Intern and resident workflow patterns on pediatric inpatient units: a multicenter time-motion study.
JAMA Pediatr 2015 Dec;169(12):1175-7. doi: 10.1001/jamapediatrics.2015.2471..
Keywords: Children/Adolescents, Education: Continuing Medical Education, Inpatient Care, Provider, Training, Workflow
Gullett J, Donnelly JP, Sinert R
Interobserver agreement in the evaluation of B-lines using bedside ultrasound.
The researchers evaluated agreement among trained emergency physicians assessing the degree of B-line presence on bedside ultrasound in patients presenting to the emergency department (ED) with acute undifferentiated dyspnea. They concluded that interrater agreement was best in the anterior/superior thoracic zones followed by the lateral/superior zones for both expert/expert and expert/novice pairs.
AHRQ-funded; HS013852.
Citation: Gullett J, Donnelly JP, Sinert R .
Interobserver agreement in the evaluation of B-lines using bedside ultrasound.
J Crit Care 2015 Dec;30(6):1395-9. doi: 10.1016/j.jcrc.2015.08.021.
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Keywords: Emergency Department, Imaging, Respiratory Conditions
Probst MA, Dayan PS, Raja AS
Knowledge translation and barriers to imaging optimization in the emergency department: a research agenda.
This article outlines a research agenda to promote the dissemination and implementation (also known as knowledge translation) of evidence-based interventions for emergency department (ED) imaging, i.e., clinical pathways, clinical decision instruments, and clinical practice guidelines. A multidisciplinary group of stakeholders held online and telephone discussions over a 6-month period culminating at the 2015 Academic Emergency Medicine consensus conference. They were able to identify four overarching research questions.
AHRQ-funded; HS023498.
Citation: Probst MA, Dayan PS, Raja AS .
Knowledge translation and barriers to imaging optimization in the emergency department: a research agenda.
Acad Emerg Med 2015 Dec;22(12):1455-64. doi: 10.1111/acem.12830.
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Keywords: Emergency Department, Evidence-Based Practice, Health Services Research (HSR), Guidelines, Imaging, Implementation
Keim-Malpass J, Adelstein K, Kavalieratos D
Legacy making through illness blogs: online spaces for young adults approaching the end-of-life.
The study analyzed the illness blogs of five young women (aged 25-39 years) at the end-of-life using a narrative approach. Key elements of legacy making and grief processing were explored. The women had varying experiences before their death, but uniform posthumous occurrences with the use of the blog for a space of grief for loved ones.
AHRQ-funded; HS022989.
Citation: Keim-Malpass J, Adelstein K, Kavalieratos D .
Legacy making through illness blogs: online spaces for young adults approaching the end-of-life.
J Adolesc Young Adult Oncol 2015 Dec;4(4):209-12. doi: 10.1089/jayao.2015.0003.
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Keywords: Cancer, Mortality, Web-Based, Young Adults
Fernandez R, Grand JA
Leveraging social science-healthcare collaborations to improve teamwork and patient safety.
This article highlights guiding team science principles from the organizational psychology literature that can be applied to the study of teams in healthcare. The authors' goal is to provide some common language and understanding around teams and teamwork. Additionally, they hope to impart an appreciation for the potential synergy present within clinician-social scientist collaborations.
AHRQ-funded; HS020295; HS022458.
Citation: Fernandez R, Grand JA .
Leveraging social science-healthcare collaborations to improve teamwork and patient safety.
Curr Probl Pediatr Adolesc Health Care 2015 Dec;45(12):370-7. doi: 10.1016/j.cppeds.2015.10.005.
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Keywords: Patient Safety, Teams, Quality Improvement, Quality of Care, Medical Errors, Adverse Events
Neprash HT, Wallace J, Chernew ME
Measuring prices in health care markets using commercial claims data.
The objective of this study was to compare methods of price measurement in health care markets. It concluded that market-level price measures reflecting broad sets of services are likely to rank markets similarly. Price indices relying on individual sentinel services may be more appropriate for examining specialty- or service-specific drivers of prices.
AHRQ-funded; HS000055.
Citation: Neprash HT, Wallace J, Chernew ME .
Measuring prices in health care markets using commercial claims data.
Health Serv Res 2015 Dec;50(6):2037-47. doi: 10.1111/1475-6773.12304..
Keywords: Data, Healthcare Costs, Health Insurance, Health Services Research (HSR)
Rajaram R, Ju MH, Bilimoria KY
National evaluation of hospital readmission after pulmonary resection.
The study’s objectives were to (1) assess readmission rates and timing after pulmonary resection, (2) report the most common reasons for rehospitalization, and (3) identify risk factors for unplanned readmission after pulmonary resection. It found that experiencing a postoperative complication was strongly associated with unplanned readmission.
AHRQ-funded; HS000078.
Citation: Rajaram R, Ju MH, Bilimoria KY .
National evaluation of hospital readmission after pulmonary resection.
J Thorac Cardiovasc Surg 2015 Dec;150(6):1508-14.e2. doi: 10.1016/j.jtcvs.2015.05.047..
Keywords: Hospital Readmissions, Risk, Surgery, Quality Indicators (QIs), Adverse Events
Lepore M, Leland NE
Nursing homes that increased the proportion of Medicare days saw gains in quality outcomes for long-stay residents.
The authors examined nationwide facility-level nursing home data for the period 2007-2010. They found that increasing the proportion of Medicare-covered patient days in a nursing home was significantly associated with improvements in the quality of daily pain, pressure ulcers, and performing activities of daily living.
AHRQ-funded; HS022907.
Citation: Lepore M, Leland NE .
Nursing homes that increased the proportion of Medicare days saw gains in quality outcomes for long-stay residents.
Health Aff 2015 Dec;34(12):2121-8. doi: 10.1377/hlthaff.2015.0303.
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Keywords: Long-Term Care, Medicare, Nursing Homes, Patient-Centered Outcomes Research, Quality Improvement
Liang C, Gong Y
On building an ontological knowledge base for managing patient safety events.
The authors developed a semantic web ontology based on the WHO International Classification for Patient Safety (ICPS) and AHRQ Common Formats for patient safety event reporting. The ontology holds potential in enhancing knowledge management and information retrieval, as well as providing flexible data entry and case analysis. They detailed their efforts in data acquisition, transformation, implementation and initial evaluation of the ontology.
AHRQ-funded; HS022895.
Citation: Liang C, Gong Y .
On building an ontological knowledge base for managing patient safety events.
Stud Health Technol Inform 2015;216:202-6.
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Keywords: Adverse Events, Medical Errors, Patient Safety, Electronic Health Records (EHRs), Health Information Technology (HIT)
Hersh WR, Totten AM, Eden KB
Outcomes from health information exchange: systematic review and future research needs.
The authors systematically reviewed the available research on health information exchange (HIE) outcomes and analyzed future research needs. After analyzing 34 studies on outcomes of HIE, they found that although the evidence supports benefits of HIE in reducing the use of specific resources and improving the quality of care, the full impact of HIE on clinical outcomes and potential harms are inadequately studied.
AHRQ-funded; 290201200014I.
Citation: Hersh WR, Totten AM, Eden KB .
Outcomes from health information exchange: systematic review and future research needs.
JMIR Med Inform 2015 Dec 15;3(4):e39. doi: 10.2196/medinform.5215.
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Keywords: Quality of Care, Health Information Exchange (HIE), Health Information Technology (HIT), Outcomes
Darger B, Gonzales N, Banuelos RC
Outcomes of patients requiring blood pressure control before thrombolysis with tPA for acute ischemic stroke.
The purpose of this study was to assess safety and efficacy of thrombolysis in the setting of aggressive blood pressure (BP) control as it compares to standard BP control or no BP control prior to thrombolysis. The researchers observed no association between BP control and adverse outcomes in ischemic stroke patients undergoing thrombolysis.
AHRQ-funded; HS017586.
Citation: Darger B, Gonzales N, Banuelos RC .
Outcomes of patients requiring blood pressure control before thrombolysis with tPA for acute ischemic stroke.
West J Emerg Med 2015 Dec;16(7):1002-6. doi: 10.5811/westjem.2015.8.27859.
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Keywords: Blood Pressure, Stroke, Medication, Outcomes
Torio C
AHRQ Author: Torio C
Paediatric pain-related conditions impact healthcare expenditures.
The author comments on a cross-sectional study (Groenewald et al., Pain 2015; 156:951–7) that highlights the impact of pediatric pain-related conditions on national healthcare expenditures. She argues that to reduce the national toll of pain on the US economy, future studies should determine the most effective strategies to reduce on a population-level disruption and the personal, financial and social costs of pain.
AHRQ-authored.
Citation: Torio C .
Paediatric pain-related conditions impact healthcare expenditures.
Evid Based Med 2015 Dec;20(6):229. doi: 10.1136/ebmed-2015-110207..
Keywords: Pain, Children/Adolescents, Healthcare Costs, Children/Adolescents
Sun DL, Harris N, Walther G
Peer assessment enhances student learning: the results of a matched randomized crossover experiment in a college statistics class.
It has been conjectured that students learn from the practice of peer assessment. Using an online educational platform, the researchers conducted an in-class matched-set, randomized crossover experiment with high power to detect small effects. They established that peer assessment causes a small but significant gain in student achievement.
AHRQ-funded; HS022192.
Citation: Sun DL, Harris N, Walther G .
Peer assessment enhances student learning: the results of a matched randomized crossover experiment in a college statistics class.
PLoS One 2015;10(12):e0143177. doi: 10.1371/journal.pone.0143177.
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Keywords: Education, Web-Based, Research Methodologies
Furukawa MF, King J, Patel V
AHRQ Author: Furukawa MF
Physician attitudes on ease of use of EHR functionalities related to Meaningful Use.
The researchers assessed physician attitudes on ease of use of electronic health record (EHR) functionalities related to "Meaningful Use" (MU) and whether perceived ease of use was associated with EHR characteristics. Their study of a nationally representative survey of office-based physicians found that physicians' adoption and perceived ease of use of EHR functionalities related to MU was generally high.
AHRQ-authored.
Citation: Furukawa MF, King J, Patel V .
Physician attitudes on ease of use of EHR functionalities related to Meaningful Use.
Am J Manag Care 2015 Dec;21(12):e684-92.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Practice Patterns
Berdahl C, Schuur JD, Fisher NL
Policy measures and reimbursement for emergency medical imaging in the era of payment reform: proceedings from a panel discussion of the 2015 Academic Emergency Medicine Consensus Conference.
In May 2015, Academic Emergency Medicine convened a consensus conference titled "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." As part of the conference, a panel of health care policy leaders and emergency physicians discussed the effect of the Affordable Casre Act and other quality programs on ED diagnostic imaging. This article discusses the content of the panel's presentations.
AHRQ-funded; HS023498.
Citation: Berdahl C, Schuur JD, Fisher NL .
Policy measures and reimbursement for emergency medical imaging in the era of payment reform: proceedings from a panel discussion of the 2015 Academic Emergency Medicine Consensus Conference.
Acad Emerg Med 2015 Dec;22(12):1393-9. doi: 10.1111/acem.12829.
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Keywords: Emergency Department, Healthcare Costs, Payment, Policy, Imaging, Policy, Quality Improvement
Luft HS
Policy-oriented research on improved physician incentives for higher value health care.
Policy makers (both public and private) are seeking ways to improve the value delivered within our health care system. To inform such policy changes, this paper identifies areas in which little is known about the effects of specific incentives (FFS, salary, etc.) on the two components of value: resource use and quality. Specific suggestions are offered focusing on fundamental "building block" studies.
AHRQ-funded.
Citation: Luft HS .
Policy-oriented research on improved physician incentives for higher value health care.
Health Serv Res 2015 Dec;50 Suppl 2:2187-215. doi: 10.1111/1475-6773.12423.
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Keywords: Policy, Health Insurance, Payment, Health Services Research (HSR)
Dolor RJ, Campbell-Voytal K, Daly J
Practice-based Research Network Research Good Practices (PRGPs): summary of recommendations.
The authors summarized recommendations for improving research processes within practice-based research networks (PBRNs) to ensure research integrity. The result, the PBRN Research Good Practices (PRGPs) document, is organized into four chapters: (1) Building PBRN Infrastructure; (2) Study Development and Implementation; (3) Data Management, and (4) Dissemination Policies.
AHRQ-funded; HS021641; HS021644; HS016713; HS019601.
Citation: Dolor RJ, Campbell-Voytal K, Daly J .
Practice-based Research Network Research Good Practices (PRGPs): summary of recommendations.
Clin Transl Sci 2015 Dec;8(6):638-46. doi: 10.1111/cts.12317.
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Keywords: Guidelines, Practice-Based Research Network (PBRN), Research Methodologies, Implementation