AHRQ Research Studies

Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.

Akosa Antwi Y, Moriya AS, Simon K
Changes in emergency department use among young adults after the Patient Protection and Affordable Care Act's dependent coverage provision.
This study examined the effects of the Affordable Care Act’s expansion of family insurance coverage to include dependents up to the age of 26 on the use of the emergency department by 19 to 25 year young adults. It found a modest but statistically significant decrease in ED use related to weekday visits, nonurgent conditions and conditions treatable in other settings.
Ann Emerg Med 2015 Jun;65(6):664-672.e2. doi: 10.1016/j.annemergmed.2015.01.010
AHRQ Author
View abstract on the National Library of Medicine site.
AHRQ Author: Moriya AS
Santos CA, Brennan DC, Chapman WC
Delayed-onset cytomegalovirus disease coded during hospital readmission in a multicenter, retrospective cohort of liver transplant recipients.
The researchers sought to determine the risk factors and outcomes associated with delayed-onset cytomegalovirus (CMV) disease among liver transplant recipients. Data from a group of 7,229 adult liver transplant recipients showed that delayed onset CMV disease was twice as likely as early onset CMV disease, with transplant failure or rejection being a risk factor.
Liver Transpl 2015 May;21(5):581-90. doi: 10.1002/lt.24089
AHRQ-Funded R24 HS19455
View abstract on the National Library of Medicine site.
Baier RR, Wysocki A, Gravenstein S
A qualitative study of choosing home health care after hospitalization: the unintended consequences of 'patient choice' requirements.
The purpose of this qualitative study is to learn how quality reports are used when choosing home care. Focus groups with 13 home health consumers and interviews with 28 hospital case managers from five hospitals revealed that both groups were unaware of public reports about home care quality.
J Gen Intern Med 2015 May;30(5):634-40. doi: 10.1007/s11606-014-3164-7
AHRQ-Funded R21 HS021879-01
View abstract on the National Library of Medicine site.
Abrahamson K, Miech E, Davila HW
Pay-for-performance policy and data-driven decision making within nursing homes: a qualitative study.
The researchers explored ways in which data were collected, thought about and used by nursing home employees as a result of participation in a pay-for-performance (P4P) program. Their findings indicated that participants in the Minnesota Performance-based Incentive Payment Program’s quality improvement (QI) projects perceived a change in the rate and manner in which they gathered, used, and considered data in their QI decisions.
BMJ Qual Saf 2015 May;24(5):311-7. doi: 10.1136/bmjqs-2014-003362
AHRQ-Funded R18 HS018464
View abstract on the National Library of Medicine site.
Selden TM, Dubay L, Miller GE
Many families may face sharply higher costs if public health insurance for their children is rolled back.
If possible cuts to the Children’s Health Insurance Program (CHIP) and elimination of the Affordable Care Act’s “maintenance of effort” provisions regarding Medicaid and CHIP take place; this study shows that many families would face sharply higher costs of providing insurance coverage for their children.
Health Aff (Millwood) 2015 Apr;34(4):697-706. doi: 10.1377/hlthaff.2015.0003
AHRQ Author
View abstract on the National Library of Medicine site.
AHRQ Author: Selden TM, Miller GE
Sittig DF, Murphy DR, Smith MW
Graphical display of diagnostic test results in electronic health records: a comparison of 8 systems.
In an attempt to understand how well current electronic health records (EHRs) facilitate accurate display and interpretation of clinical laboratory test results, the researchers evaluated the graphical displays of laboratory test results in 8 EHRs using objective criteria for optimal graphs. None of the EHRs met all 11 criteria.
J Am Med Inform Assoc 2015 Mar 18. pii: ocv013. doi: 10.1093/jamia/ocv013 [Epub ahead of print]
AHRQ-Funded R01 HS022087-01
View abstract on the National Library of Medicine site.
Waters TM, Daniels MJ, Bazzoli GJ
Effect of Medicare's nonpayment for hospital-acquired conditions: lessons for future policy.
This study measured the association between Medicare’s nonpayment policy and 4 outcomes addressed by the Hospital-Acquired Conditions Initiative and found improvements in both the rates of central-line associated bloodstream infections and catheter-related urinary tract infections but no improvements for either hospital acquired pressure ulcers or injurious patient falls.
JAMA Intern Med 2015 Mar;175(3):347-54. doi: 10.1001/jamainternmed.2014.5486
AHRQ-Funded R01 HS020627-01
View abstract on the National Library of Medicine site.
Siddiqui M, Roberts ET, Pollack CE
The effect of emergency department copayments for Medicaid beneficiaries following the Deficit Reduction Act of 2005.
This study evaluated the effect of the 2005 Deficit Reduction Act allowing States to enforce emergency department (ED) copayments for nonurgent visits and on ED utilization among Medicaid beneficiaries. It found that granting States permission to collect copayments for nonurgent visits did not significantly change ED or outpatient medical provider use among Medicaid beneficiaries.
JAMA Intern Med 2015 Mar;175(3):393-8. doi: 10.1001/jamainternmed.2014.7582
AHRQ-Funded 1 T32 HS019488-02
View abstract on the National Library of Medicine site.
Li T, Vedula SS, Hadar N
Innovations in data collection, management, and archiving for systematic reviews.
The authors provide a step-by-step tutorial for collecting, managing, and archiving data for systematic reviews and suggest steps for developing rigorous data collection forms in the Systematic Review Data Repository to facilitate implementation of the methodological standards and expectations of the Institute of Medicine and other organizations.
Ann Intern Med 2015 Feb 17;162(4):287-94. doi: 10.7326/M14-1603
AHRQ-Funded 290-2007-10055-I, 290-2012-00012-I
View abstract on the National Library of Medicine site.
Chou R, Turner JA, Devine EB
The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
This systematic review evaluated evidence on the effectiveness and harms of long-term (more than 3 months) opiod therapy for chronic pain in adults. It concluded that evidence is insufficient to determine the effectiveness of this therapy for improving chronic pain and function.
Ann Intern Med 2015 Feb 17;162(4):276-86. doi: 10.7326/M14-2559
AHRQ-Funded 290-2012-00014I
View abstract on the National Library of Medicine site.
Spittel ML, Riley WT, Kaplan RM
Educational attainment and life expectancy: a perspective from the NIH Office of Behavioral and Social Sciences Research.
This article is the introduction to a special issue of papers on the subject of educational attainment and life expectancy. The significance of this collection of research papers is that the findings offer new insights into the complex processes underlying the widely known, but poorly understood, association between higher educational attainment and better health status together with greater life expectancy.
Soc Sci Med 2015 Feb;127:203-5. doi: 10.1016/j.socscimed.2014.11.017
AHRQ Author
View abstract on the National Library of Medicine site.
AHRQ Author: Kaplan RM
Anhang Price R, Elliott MN, Cleary PD
Should health care providers be accountable for patients' care experiences?
Using evidence from the Consumer Assessment of Healthcare Providers and Systems surveys, the authors address seven common critiques of patient experience measures. These include: lack of consumer expertise, the subjectivity of patient satisfaction, and the trade-off between providing good patient experiences and providing high-quality clinical care.
J Gen Intern Med 2015 Feb;30(2):253-6. doi: 10.1007/s11606-014-3111-7
AHRQ-Funded 2 U18 HS016980, 2 U18 HS 016978
View abstract on the National Library of Medicine site.
Wang G, Gold M, Siegel J
Deliberation: obtaining informed input from a diverse public.
The Deliberative Methods Demonstration was a randomized controlled experiment comparing four deliberation methods and a reading materials control group. After surveying 907 participants before and after deliberation, the researchers found that changes in knowledge about using medical evidence in decisionmaking were not associated with race, ethnicity, or education.
J Health Care Poor Underserved 2015 Feb;26(1):223-42. doi: 10.1353/hpu.2015.0021
AHRQ Author
View abstract on the National Library of Medicine site.
AHRQ Author: Siegel J
Singh H, Sittig DF
Advancing the science of measurement of diagnostic errors in healthcare: the Safer Dx framework.
The Safer Dx framework can help stakeholders measure a monitor diagnostic errors, which are considered hard to tackle and remain elusive to improvement efforts because they are difficult to define and measure.
BMJ Qual Saf 2015 Feb;24(2):103-10. doi: 10.1136/bmjqs-2014-003675
AHRQ-Funded R01 HS022087
View abstract on the National Library of Medicine site.
Sanghavi P, Jena AB, Newhouse JP
Outcomes after out-of-hospital cardiac arrest treated by basic vs advanced life support.
Patients with out-of-hospital cardiac arrest who received basic life support had a higher survival rate and had better neurological functioning at hospital discharge and at 90 days after discharge than those patients who received advanced life support.
JAMA Intern Med 2015 Feb;175(2):196-204. doi: 10.1001/jamainternmed.2014.5420
AHRQ-Funded Health Services Research Dissertation Award (R36)
View abstract on the National Library of Medicine site.
Pershing S, Pal Chee C, Asch SM
Treating age-related macular degeneration: comparing the use of two drugs among medicare and veterans affairs populations.
The researchers compared the diffusion of 2 injectable drugs for macular degeneration in fee-for-service Medicare versus the Veterans Affairs systems during 2005-2011. Although physicians under Medicare had a direct financial incentive to prescribe the more expensive drug, by 2009, more than 60 percent of injections were for the less expensive drug. Under the VA, both drugs were used about equally, particularly from 2009 to 2011.
Health Aff (Millwood) 2015 Feb;34(2):229-38. doi: 10.1377/hlthaff.2014.1032
AHRQ-Funded 5 R01 HS018434
View abstract on the National Library of Medicine site.
Paddock SM, Adams JL, Hoces de la Guardia F
Better-than-average and worse-than-average hospitals may not significantly differ from average hospitals: an analysis of Medicare Hospital Compare ratings.
The researchers examine the degree to which a consumer might be misled by comparing hospitals based on performance tiers by using 30-day mortality and readmission outcome measures from Medicare Hospital Compare. They found that in the majority of cases, performances for hospitals reported as either top or bottom tier on the Medicare website did not significantly differ from that of mid-tier hospitals.
BMJ Qual Saf 2015 Feb;24(2):128-34. doi: 10.1136/bmjqs-2014-003405
AHRQ-Funded 1 R21 HS021860
View abstract on the National Library of Medicine site.
Hilligoss B, Vogus TJ
Navigating care transitions: a process model of how doctors overcome organizational barriers and create awareness.
Using interviews and observations of doctors, the researchers examined transitions from an emergency department to inpatient units through a 2-year study of an academic medical center. They describe and document 3 challenges to between-unit transitions of care and identify the adaptive workarounds that doctors employ to resolve these challenges, thus addressing a significant gap in the literature on high-reliability healthcare organizations.
Med Care Res Rev 2015 Feb;72(1):25-48. doi: 10.1177/1077558714563170
AHRQ-Funded R36 HS018758
View abstract on the National Library of Medicine site.
Hill SC
Medicaid expansion in opt-out states would produce consumer savings and less financial burden than exchange coverage.
This study compares estimated out-of-pocket spending for care and premiums for families of adults with incomes above the poverty level who would have been eligible for Medicaid in Medicaid opt-out States under two simulation scenarios: obtaining coverage through an Affordable Care Act silver plan and enrolling in expanded Medicaid.
Health Aff (Millwood) 2015 Feb;34(2):340-9. doi: 10.1377/hlthaff.2014.1058
AHRQ Author
View abstract on the National Library of Medicine site.
AHRQ Author: Hill SC
Callaghan BC, Kerber KA, Burke JF
Headaches and neuroimaging—reply.
The authors of this letter, replying to two letters commenting on their earlier article on headaches and neuroimaging, find that they all share the view that neuroimaging is overused in headache presentations. They also discuss the potential downsides of interventions to reduce use, the impact of medical malpractice on overuse of tests, and the lack of consensus in defining low-value tests.
JAMA Intern Med 2015 Feb;175(2):313-4. doi: 10.1001/jamainternmed.2014.7014
AHRQ-Funded R18 HS017690
View abstract on the National Library of Medicine site.