National Healthcare Quality and Disparities Report
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Topics
- Ambulatory Care and Surgery (2)
- Anxiety (1)
- Arthritis (2)
- Asthma (4)
- Behavioral Health (4)
- Blood Pressure (2)
- Cancer (2)
- Cardiovascular Conditions (2)
- Care Coordination (2)
- Care Management (3)
- Children/Adolescents (11)
- (-) Chronic Conditions (41)
- Clinician-Patient Communication (1)
- Communication (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Critical Care (1)
- Depression (2)
- Diabetes (8)
- Diagnostic Safety and Quality (1)
- Disparities (2)
- Elderly (1)
- Electronic Health Records (EHRs) (2)
- Emergency Department (2)
- Evidence-Based Practice (3)
- Guidelines (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
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- Health Information Technology (HIT) (4)
- Health Insurance (2)
- Health Services Research (HSR) (1)
- Hospitalization (1)
- Hospital Readmissions (2)
- Hospitals (1)
- Implementation (2)
- Medicaid (1)
- Medication (1)
- Nursing (1)
- Opioids (1)
- Outcomes (3)
- Palliative Care (2)
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- Patient-Centered Outcomes Research (2)
- Patient Experience (2)
- Patient Safety (1)
- Payment (1)
- Prevention (1)
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- Primary Care: Models of Care (1)
- Provider (2)
- Provider: Nurse (1)
- Provider Performance (1)
- Quality Improvement (12)
- Quality Indicators (QIs) (5)
- Quality Measures (9)
- (-) Quality of Care (41)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- Registries (1)
- Respiratory Conditions (6)
- Risk (1)
- Screening (1)
- Sickle Cell Disease (1)
- Substance Abuse (1)
- Telehealth (1)
- Transitions of Care (1)
- Transplantation (1)
- Treatments (1)
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 25 of 41 Research Studies DisplayedWaltman A, Konetzka RT, Chia S
Effectiveness of a bundled payments for care improvement program for chronic obstructive pulmonary disease.
This single-site retrospective observational study evaluated the impact of an evidence-based transitions of care program on episode costs and readmission rates, comparing patients hospitalized for COPD exacerbations who received versus those who did not receive the intervention. Between October 2015 and September 2018, 132 received and 161 did not receive the program. Below target mean episode costs were found for six out of eleven quarters for the intervention group, as opposed to only one out of twelve quarters for the control group. Overall, there were non-significant mean savings of $2551 in episode costs relative to target costs for the intervention group, though results varied by index admission diagnosis-related group (DRG). There were additional costs of $4184 per episode for the least-complicated cohort (DRG 192), but savings of $1897 and $1753 for the most complicated index admissions (DRGs 191 and 190, respectively). A significant mean decrease of 0.24 readmissions per episode for intervention was observed in 90-day readmission rates relative to control. Skilled nursing facility readmissions and hospital discharges were factors of higher costs (mean increases of $9098 and $17,095 per episode respectively).
AHRQ-funded; HS027804.
Citation: Waltman A, Konetzka RT, Chia S .
Effectiveness of a bundled payments for care improvement program for chronic obstructive pulmonary disease.
J Gen Intern Med 2023 Sep; 38(12):2662-70. doi: 10.1007/s11606-023-08249-6..
Keywords: Respiratory Conditions, Chronic Conditions, Payment, Quality Improvement, Quality of Care
Mauskar S, Ngo T, Haskell H
In their own words: safety and quality perspectives from families of hospitalized children with medical complexity.
The purpose of this study was to address the gap of research on inpatient safety/quality experience of Children with medical complexity (CMC) and identify otherwise unrecognized, family-prioritized areas for improving safety/quality of children with medical complexity (CMC). Out of 208 families surveyed, 237 (88%) families completed surveys; 83 families offered 138 free-text safety responses about medications, feeds, cares, and other categories. The study found that themes included unmet expectations of hospital care/environment, lack of consistency, provider-patient communication lapses, families' expertise about care, and the value of transparency.
AHRQ-funded; HS025781.
Citation: Mauskar S, Ngo T, Haskell H .
In their own words: safety and quality perspectives from families of hospitalized children with medical complexity.
J Hosp Med 2023 Sep; 18(9):777-86. doi: 10.1002/jhm.13178..
Keywords: Children/Adolescents, Patient Safety, Quality of Care, Chronic Conditions
Rojas JC, Chokkara S, Zhu M
Care quality for patients with chronic obstructive pulmonary disease in the readmission penalty era.
The purpose of this study was to assess changes in the quality of care for patients hospitalized for Chronic obstructive pulmonary disease (COPD) after the implementation of the Hospital Readmissions Reduction Program (HRRP) which levied financial penalties on hospitals for excessive COPD readmissions. The researchers reviewed the records from 995 U.S. hospitals in the Premier Healthcare Database, evaluating patients older than 40 years of age hospitalized for COPD. The study included 662,842 pre-HRRP (January 2010-September 2014) and 285,508 post-HRRP (October 2014-December 2018) admissions, and found that recommended care increased at a rate of 0.16% per month pre-HRRP and 0.01% per month post-HRRP. Nonrecommended care decreased at a rate of 0.15% per month pre-HRRP and 0.13% per month post-HRRP. Ideal care increased at a rate of 0.24% per month pre-HRRP and 0.11% per month post-HRRP. The researchers concluded that after HRRP implementation, the pre-HRRP trends toward improving care quality for inpatient COPD care slowed.
AHRQ-funded; HS027804.
Citation: Rojas JC, Chokkara S, Zhu M .
Care quality for patients with chronic obstructive pulmonary disease in the readmission penalty era.
Am J Respir Crit Care Med 2023 Jan; 207(1):29-37. doi: 10.1164/rccm.202203-0496OC..
Keywords: Respiratory Conditions, Quality of Care, Hospital Readmissions, Chronic Conditions
Cabana MD, Robinson K, Plavin J
Partnering to improve pediatric asthma quality.
The purpose of this article was to explore the need for partnering between emergency departments (Eds) and primary care physicians (PCPs) to improve asthma quality measures, practice level improvements for both PCPs and EDs, and ultimately improve outcomes for children with asthma. Proper and timely management of asthma is thought to prevent ED visits, and the responsibility for addressing improvements in PCP performance should be shared by the PCP practices and health care payors and plans. The ability to measure the drivers of asthma-related visits to the ED may be outside of what a PCP practice can address, and so practices must be able to partner with health plans to successfully measure and develop system-wide interventions for quality and outcomes improvement. Although a child’s asthma may be managed in their PCP office, treatment of asthma issues often takes place in an ED setting or urgent care clinic that may be completely isolated from the patient’s PCP provider and system. Health plans can fill in the missing pieces to provide feedback on performance which can reduce ED visits, improve medication adherence and management, and provide actionable and timely data about hospital visits and discharge to PCP practices for quality improvements. Social determinants and comorbidities play a role in addressing ED visits for asthma. Health plan, public health systems, and provider coordination, integration, and partnerships are required to effectively address those issues and improve outcomes. The authors conclude that a systems approach and thoughtful partnerships across disciplines will be required beyond the PCP practice level to improve the outcomes of children with asthma.
AHRQ-funded; HS025297.
Citation: Cabana MD, Robinson K, Plavin J .
Partnering to improve pediatric asthma quality.
Acad Pediatr 2022 Apr;22(3S):S73-S75. doi: 10.1016/j.acap.2021.06.013..
Keywords: Children/Adolescents, Asthma, Chronic Conditions, Emergency Department, Quality Measures, Quality Improvement, Quality of Care
Ferucci ED, Day GM, Choromanski TL
Outcomes and quality of care in rheumatoid arthritis with or without video telemedicine follow-up visits.
This study’s objective was to evaluate outcomes and quality of care for rheumatoid arthritis (RA) in patients seen by video telemedicine compared to in-person only. Individuals in the Alaska Tribal Health System who were diagnosed with RA were recruited when seeing a rheumatologist either in person or by video telemedicine. Participants completed a Routine Assessment of Patient Index Data 3 (RAPID3) questionnaire and a telephone medicine perception survey at the start of the survey. They also agreed to medical record review. The authors repeated the surveys by telephone and at 6 and 12 months, and medical record abstraction was performed at 12 months for quality measures. By the end of the 12-month period, about half of the 122 RA participants (52%) had ever used telemedicine for RA. Higher RAPID3 score and functional status were associated with the telemedicine group, with no statistically significant change over the 12-month period. The only quality measure that differed between the two groups at 12 months was the proportion of visits in which disease activity was documented, but it was not significantly after multivariate analysis.
AHRQ-funded; HS024540.
Citation: Ferucci ED, Day GM, Choromanski TL .
Outcomes and quality of care in rheumatoid arthritis with or without video telemedicine follow-up visits.
Arthritis Care Res 2022 Mar;74(3):484-92. doi: 10.1002/acr.24485..
Keywords: Arthritis, Chronic Conditions, Telehealth, Health Information Technology (HIT), Quality of Care, Outcomes
Jaladanki S, Schechter SB, Genies MC
Strategies for sustaining high-quality pediatric asthma care in community hospitals.
This study’s objective was to identify strategies associated with sustained guideline adherence and high-quality pediatric asthma care in community hospitals. Hospitals who were part of the Pathways for Improving Pediatric Asthma Care (PIPA) national quality improvement (QI) intervention were included. Clinicians (n = 19) involved in clinical care of children hospitalized with asthma were interviewed from five higher- and three lower-performing hospitals. Higher-performing hospitals had dedicated local champions who consistently provided reminders of evidence-based practices and delivered ongoing education. These champions also modified/developed electronic health record (EHR) tools. Lower-performing hospital clinicians described unique barriers, including delays in modifying the EHR and lack of automation of EHR tools. For all hospitals, barriers to sustainability included challenges with quality monitoring, decreasing focus of local champions over time, and ongoing difficulties developing around evidence-based practices.
AHRQ-funded; HS027041.
Citation: Jaladanki S, Schechter SB, Genies MC .
Strategies for sustaining high-quality pediatric asthma care in community hospitals.
Health Serv Res 2022 Feb;57(1):125-36. doi: 10.1111/1475-6773.13870..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Chronic Conditions, Hospitals, Quality of Care
Schmajuk G, Li J, Evans M
Quality of care for patients with systemic lupus erythematosus: data from the American College of Rheumatology RISE Registry.
Although multiple national quality measures focus on the management and safety of rheumatoid arthritis, few measures address the care of patients with systemic lupus erythematosus (SLE). In this study, the objective was to apply a group of quality measures relevant to the care of patients with SLE, and use the American College of Rheumatology's Rheumatology Informatics System for Effectiveness (RISE) registry to assess nationwide variations in care.
AHRQ-funded; HS024412.
Citation: Schmajuk G, Li J, Evans M .
Quality of care for patients with systemic lupus erythematosus: data from the American College of Rheumatology RISE Registry.
Arthritis Care Res 2022 Feb;74(2):179-86. doi: 10.1002/acr.24446..
Keywords: Chronic Conditions, Quality Measures, Quality of Care
Izadi Z, Schmajuk G, Gianfrancesco M
Significant gains in rheumatoid arthritis quality measures among RISE Registry practices.
This study examined performance on rheumatoid arthritis (RA) quality measures and assessed the association between practice characteristics and changes in performance over time among participating practices. The authors analyzed data from practices enrolled in the American College of Rheumatology Rheumatology Informatics System for Effectiveness (RISE) registry from 2015 to 2017. Eight quality measures in the areas of RA disease management, cardiovascular risk reduction, and patient safety were analyzed. Data from 59,986 patients from 54 practices were examined. Cohort characteristics were a mean age of 62 years, 77% female, 69% Caucasian, and most patients (46%) were seen in a single-specialty group practice. Measures related to RA functional status and disease activity assessment improved over time, with single-specialty group practices having the fastest rates of improvement across all measures.
AHRQ-funded; HS025638; HS024412.
Citation: Izadi Z, Schmajuk G, Gianfrancesco M .
Significant gains in rheumatoid arthritis quality measures among RISE Registry practices.
Arthritis Care Res 2022 Feb;74(2):219-28. doi: 10.1002/acr.24444..
Keywords: Arthritis, Chronic Conditions, Quality Measures, Quality Indicators (QIs), Registries, Quality of Care
Reeves SL, Freed GL, Madden B
Trends in quality of care among children with sickle cell anemia.
This study’s goal was to assess trends in the use of antibiotic prophylaxis to prevent serious infections and transcranial Doppler (TCD) screening to identify those at highest risk of overt stroke among children with sickle cell anemia (SCA) using validated quality measures. The authors identified children with SCA who were enrolled in Michigan or New York State (NYS) Medicaid programs from 2011 to 2018. Two outcomes were assessed yearly: (a) filling of ≥300 days of antibiotics, and (b) receipt of greater than or equal to one TCD. A total of 1784 children were eligible for antibiotic prophylaxis (Michigan: 384; NYS: 1400). Annual rates of filling ≥300 days of antibiotics ranged from 16% to 22%, showing similar results by state. There was no change in rates of antibiotic filling over time in Michigan, but there was a decrease in NYS. A total of 3439 children with SCA were eligible for TCD screening (Michigan: 710; NYS: 2729). Annual rates of TCD screening ranged from 39% to 45%, which did not change over time.
AHRQ-funded; HS025292.
Citation: Reeves SL, Freed GL, Madden B .
Trends in quality of care among children with sickle cell anemia.
Pediatr Blood Cancer 2022 Feb; 69(2):e29446. doi: 10.1002/pbc.29446..
Keywords: Children/Adolescents, Sickle Cell Disease, Chronic Conditions, Quality of Care
Jiang DH, Mundell BF, Shah ND
Impact of high deductible health plans on diabetes care quality and outcomes: systematic review.
The authors sought to provide a systematic literature review of the impact of high deductible health plans (HDHPs) on the utilizations of services required for optimal management of diabetes and subsequent health outcomes. They found that, although HDHPs reduce some health care utilization and costs, they appear to do so at the expense of limiting high-value care and medication adherence.
AHRQ-funded; HS025517; HS024075; HS025164; HS025402.
Citation: Jiang DH, Mundell BF, Shah ND .
Impact of high deductible health plans on diabetes care quality and outcomes: systematic review.
Endocr Pract 2021 Nov;27(11):1156-64. doi: 10.1016/j.eprac.2021.07.001..
Keywords: Health Insurance, Diabetes, Chronic Conditions, Outcomes, Quality of Care, Patient-Centered Outcomes Research
Swietek KE, Domino ME, Grove LR
Duration of medical home participation and quality of care for patients with chronic conditions.
The objective of this study was to examine whether the length of participation in a patient-centered medical home (PCMH), an evidence-based practice, led to higher quality care for Medicaid enrollees with multiple co-morbid chronic conditions and major depressive disorder (MDD). The investigators concluded that the PCMH model was associated with higher quality of care for patients with multiple chronic conditions and MDD over time, and these benefits increased the longer a patient was enrolled.
AHRQ-funded; HS000032; HS019659.
Citation: Swietek KE, Domino ME, Grove LR .
Duration of medical home participation and quality of care for patients with chronic conditions.
Health Serv Res 2021 Oct;56(Suppl 1):1069-79. doi: 10.1111/1475-6773.13710..
Keywords: Chronic Conditions, Patient-Centered Healthcare, Quality of Care, Evidence-Based Practice, Depression, Behavioral Health
Bierman AS, Wang J, O'Malley PG
AHRQ Author: Bierman AS, Wang J, O'Malley PG, Moss DK
Transforming care for people with multiple chronic conditions: Agency for Healthcare Research and Quality's research agenda.
This article describes issues addressing the needs of those with multiple chronic conditions and discusses the AHRQ research agenda.
AHRQ-authored.
Citation: Bierman AS, Wang J, O'Malley PG .
Transforming care for people with multiple chronic conditions: Agency for Healthcare Research and Quality's research agenda.
Health Serv Res 2021 Oct;56(Suppl 1):973-79. doi: 10.1111/1475-6773.13863..
Keywords: Chronic Conditions, Health Services Research (HSR), Healthcare Delivery, Quality of Care, Primary Care, Guidelines, Evidence-Based Practice
Piwnica-Worms K, Staiger B, Ross JS
Effects of forced disruption in Medicaid managed care on children with asthma.
The objective of this study was to evaluate the effect of a forced disruption to Medicaid managed care plans and provider networks on health utilization and outcomes for children with persistent asthma. The investigators concluded that while there was a decrease in the number of outpatient visits associated with forced disruption of Medicaid managed care plans for children with persistent asthma, there were no consistent associations with worse asthma quality performance or higher emergent health care utilization.
AHRQ-funded; HS022882; HS025164.
Citation: Piwnica-Worms K, Staiger B, Ross JS .
Effects of forced disruption in Medicaid managed care on children with asthma.
Health Serv Res 2021 Aug;56(4):668-76. doi: 10.1111/1475-6773.13643..
Keywords: Children/Adolescents, Medicaid, Asthma, Respiratory Conditions, Chronic Conditions, Quality of Care
Schechter SB, Pantell MS, Parikh K
Impact of a national quality collaborative on pediatric asthma care quality by insurance status.
The objective of this study was to assess whether disparities in asthma care and outcomes based on insurance type existed before a national quality improvement (QI) collaborative, and to determine the effects of the collaborative on these disparities. The investigators concluded that at baseline, children with public insurance had higher asthma health care utilization than those with private insurance, despite receiving more evidence-based care.
AHRQ-funded; HS026383; HS024554; HS024592.
Citation: Schechter SB, Pantell MS, Parikh K .
Impact of a national quality collaborative on pediatric asthma care quality by insurance status.
Acad Pediatr 2021 Aug;21(6):1018-24. doi: 10.1016/j.acap.2021.02.009..
Keywords: Children/Adolescents, Asthma, Chronic Conditions, Disparities, Quality Improvement, Quality of Care, Health Insurance
Anderson KE, Alexander GC, Niles L
Quality of preventive and chronic illness care for insured adults with opioid use disorder.
Investigators sought to measure quality of non-opioid use disorder (OUD) preventive and chronic illness care and care coordination for individuals with OUD compared with individuals without OUD. They used deidentified data on outpatients throughout the United States from claims for commercially insured and Medicare Advantage enrollees aged 18 years or older with diagnosis codes for OUD. They found that individuals with OUD have moderately lower quality of care across preventive and chronic illness care and care coordination for non-OUD care compared with individuals without OUD. They recommended more attention to measurement and improvement of non-OUD care for these individuals.
AHRQ-funded; HS000029.
Citation: Anderson KE, Alexander GC, Niles L .
Quality of preventive and chronic illness care for insured adults with opioid use disorder.
JAMA Netw Open 2021 Apr;4(4):e214925. doi: 10.1001/jamanetworkopen.2021.4925..
Keywords: Opioids, Medication, Substance Abuse, Quality Indicators (QIs), Quality of Care, Behavioral Health, Chronic Conditions, Prevention
Liu FF, Lew A, Andes E
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
The objective of this study was to share key strategies that led to successful mental health screening (MHS) implementation in one pediatric cystic fibrosis center and to report implementation and screening outcomes. Results showed that leveraging coproduction to address stakeholder needs led to successful implementation of a sustainable MHS process.
AHRQ-funded; HS026393.
Citation: Liu FF, Lew A, Andes E .
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
Pediatr Pulmonol 2020 Dec;55(12):3328-36. doi: 10.1002/ppul.24951..
Keywords: Children/Adolescents, Respiratory Conditions, Chronic Conditions, Depression, Anxiety, Behavioral Health, Screening, Implementation, Quality Improvement, Quality of Care, Diagnostic Safety and Quality
Knutzen KE, Schifferdecker KE, Murray GF
Role of norms in variation in cancer centers' end-of-life quality: qualitative case study protocol.
AHRQ-funded; HS022242.
Citation: Knutzen KE, Schifferdecker KE, Murray GF .
Role of norms in variation in cancer centers' end-of-life quality: qualitative case study protocol.
BMC Palliat Care 2020 Aug 27;19(1):136. doi: 10.1186/s12904-020-00641-x..
Keywords: Cancer, Quality of Life, Palliative Care, Quality of Care, Chronic Conditions
Swietek KE, Gaynes BN, Jackson GL
Effect of the patient-centered medical home on racial disparities in quality of care.
Research demonstrates that the patient-centered medical home (PCMH) is associated with improved clinical outcomes and quality of care, and the populations that can most benefit from this model require long-term management, e.g., persons with chronic illness and behavioral health conditions. The objective of this study was to estimate the association between enrollment in National Committee for Quality Assurance (NCQA)-recognized PCMHs and racial disparities in quality of care for adults with major depressive disorder (MDD) and comorbid medical conditions.
AHRQ-funded; HS025562.
Citation: Swietek KE, Gaynes BN, Jackson GL .
Effect of the patient-centered medical home on racial disparities in quality of care.
J Gen Intern Med 2020 Aug;35(8):2304-13. doi: 10.1007/s11606-020-05729-x.
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Keywords: Patient-Centered Healthcare, Disparities, Racial and Ethnic Minorities, Quality of Care, Chronic Conditions
Lafferty M, Fauer A, Wright N
Causes and consequences of chemotherapy delays in ambulatory oncology practices: a multisite qualitative study.
The purpose of this study was to examine the causes and consequences of chemotherapy treatment delays and possible solutions to improve quality of care. The authors identified four primary themes from the analysis that affect delays. They suggest future investigations to examine nurses' communication practices in the context of timely chemotherapy administration since communication and documentation technologies within healthcare settings continuously evolve.
AHRQ-funded; HS024914.
Citation: Lafferty M, Fauer A, Wright N .
Causes and consequences of chemotherapy delays in ambulatory oncology practices: a multisite qualitative study.
Oncol Nurs Forum 2020 Jul 1;47(4):417-27. doi: 10.1188/20.Onf.417-427..
Keywords: Treatments, Cancer, Ambulatory Care and Surgery, Quality of Care, Clinician-Patient Communication, Communication, Provider: Nurse, Provider, Nursing, Chronic Conditions
Rodríguez HP, Fulton BD, Phillips AZ
The early impact of the Centers for Medicare & Medicaid Services State Innovation Models Initiative on 30-day hospital readmissions among adults with diabetes.
The Centers for Medicare & Medicaid Services (CMS) State Innovation Models (SIM) Initiative funds states to accelerate delivery system and payment reforms. All SIM states focus on improving diabetes care, but SIM's effect on 30-day readmissions among adults with diabetes remains unclear. In this study, the investigators found no evidence that SIM reduced 30-day readmission rates among adults with diabetes during the first 2 years of round 1 implementation, even among CMS beneficiaries.
AHRQ-funded; HS022241.
Citation: Rodríguez HP, Fulton BD, Phillips AZ .
The early impact of the Centers for Medicare & Medicaid Services State Innovation Models Initiative on 30-day hospital readmissions among adults with diabetes.
Med Care 2020 Jun;58(6 Suppl 1):S22-s30. doi: 10.1097/mlr.0000000000001276..
Keywords: Diabetes, Chronic Conditions, Hospital Readmissions, Quality Improvement, Quality of Care
Schuttner L, Wong ES, Rosland AM
Association of the patient-centered medical home implementation with chronic disease quality in patients with multimorbidity.
The purpose of this retrospective cohort study was to examine the association of Patient-Aligned Care Team (PACT) implementation, the Veterans Health Administration (VA) PCMH model, and care quality for multimorbid patients enrolled in VA primary care from 2012 to 2014. The investigators found that for one-third of metrics (5/15), greater implementation of PACT in 2012 was associated with higher predicted probability of meeting the quality metric in 2013-2014. This association persisted for only two metrics among patients with > 5 chronic diseases.
AHRQ-funded; HS026369.
Citation: Schuttner L, Wong ES, Rosland AM .
Association of the patient-centered medical home implementation with chronic disease quality in patients with multimorbidity.
J Gen Intern Med 2020 Oct;35(10):2932-38. doi: 10.1007/s11606-020-06076-7..
Keywords: Patient-Centered Healthcare, Implementation, Chronic Conditions, Primary Care: Models of Care, Primary Care, Quality Improvement, Quality of Care
Parchman ML, Anderson ML, Dorr DA
A randomized trial of external practice support to improve cardiovascular risk factors in primary care.
Researchers conducted a randomized controlled trial to compare the effectiveness of adding various forms of enhanced external support to practice facilitation on primary care practices' clinical quality measure (CQM) performance. They concluded that, although they found no significant differences in CQM performance across study arms, the ability of a practice to reach a target level of performance may be enhanced by adding both educational outreach visits and shared learning to practice facilitation.
AHRQ-funded; HS023908.
Citation: Parchman ML, Anderson ML, Dorr DA .
A randomized trial of external practice support to improve cardiovascular risk factors in primary care.
Ann Fam Med 2019 Aug 12;17(Suppl 1):S40-s49. doi: 10.1370/afm.2407..
Keywords: Cardiovascular Conditions, Primary Care, Quality Improvement, Provider Performance, Quality Measures, Quality of Care, Risk, Evidence-Based Practice, Patient-Centered Healthcare, Chronic Conditions
Wu SS, Chan KS, Bae J
Electronic clinical reminder and quality of primary diabetes care.
The goal of this retrospective cohort study was to examine the association of EMR's clinical reminder use with a comprehensive set of diabetes quality metrics in office-based physicians and within solo- versus multi-physician practices. Data on visits made by adults with diabetes were identified from the National Ambulatory Medical Care Survey and a multiple logistic regression was used to test for associations between clinical reminder use and recommended services by the American Diabetes Association. The researchers found no statistically significant relationship that suggests clinical reminder use improves diabetes process guidelines for solo practices, and they conclude that other resource efforts are needed to reduce gaps in primary diabetes care.
AHRQ-funded; HS000029.
Citation: Wu SS, Chan KS, Bae J .
Electronic clinical reminder and quality of primary diabetes care.
Prim Care Diabetes 2019 Apr;13(2):150-57. doi: 10.1016/j.pcd.2018.08.007..
Keywords: Care Management, Chronic Conditions, Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Quality of Care
Swietek KE, Domino ME, Beadles C
Do medical homes improve quality of care for persons with multiple chronic conditions?
The purpose of this study was to examine the association between medical home enrollment and receipt of recommended care for Medicaid beneficiaries with multiple chronic conditions (MCC). The investigators found that patient-centered medical home enrollment was associated with an increased likelihood of receiving eight recommended mental and physical health services, including A1C testing for persons with diabetes, lipid profiles for persons with diabetes and/or hyperlipidemia, and psychotherapy for persons with major depression and persons with schizophrenia.
AHRQ-funded; HS019659.
Citation: Swietek KE, Domino ME, Beadles C .
Do medical homes improve quality of care for persons with multiple chronic conditions?
Health Serv Res 2018 Dec;53(6):4667-81. doi: 10.1111/1475-6773.13024..
Keywords: Chronic Conditions, Quality of Care, Patient-Centered Healthcare, Quality Improvement
Wang A, Pollack T, Kadziel LA
Impact of practice facilitation in primary care on chronic disease care processes and outcomes: a systematic review.
The goal of this systematic review was to evaluate the impact of practice facilitation on chronic disease outcomes in the primary care setting. Researchers extracted and assessed the quality of the data on chronic disease process and clinical outcome measures from U.S. studies that implemented practice facilitation and reported quantifiable care processes and chronic disease outcomes. The results of this evaluation suggest that practice facilitation may improve chronic disease care measures; practices across all studies were aware of practice facilitation. The authors conclude that the results support the potential expansion of practice facilitation in primary care, but that future work will need to investigate potential opportunities to improve chronic disease outcomes in other health care settings.
AHRQ-funded; HS000084.
Citation: Wang A, Pollack T, Kadziel LA .
Impact of practice facilitation in primary care on chronic disease care processes and outcomes: a systematic review.
J Gen Intern Med 2018 Nov;33(11):1968-77. doi: 10.1007/s11606-018-4581-9.
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Keywords: Care Management, Chronic Conditions, Primary Care, Quality of Care, Quality Improvement