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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 4 of 4 Research Studies DisplayedSaldanha IJ, Adam GP, Kanaan G
Delivery strategies for postpartum care: a systematic review and meta-analysis.
This systematic review examined the effects of postpartum health care-delivery strategies on health care utilization and maternal outcomes. The authors searched medical databases from inception to November 16, 2022. They found 64 eligible studies (50 randomized controlled trials, 14 nonrandomized comparative studies; N=543,480). The review found that for general postpartum care, care location (clinic, at home, by telephone) did not affect depression or anxiety symptoms (low strength of evidence), and care integration (by multiple types of health care professionals) did not affect depression symptoms or substance use (low strength of evidence). Providing contraceptive care earlier (compared with later) was associated with greater implant use at 6 months (moderate strength of evidence). Low strength of evidence was found for location of breastfeeding affecting hospitalization, other unplanned care utilization, or mental health symptoms. Peer support was associated with higher rates of any or exclusive breastfeeding at 1 month and any breastfeeding at 3-6 months but not other breastfeeding measures (all moderate strength of evidence). Care by a lactation consultant was associated with higher breastfeeding rates at 6 months but not exclusive breastfeeding (all moderate strength of evidence). Moderate strength of evidence was found for the association of use and nonuse of information technology for breastfeeding care with comparable rates of breastfeeding. Moderate strength of evidence was found for the association of testing reminders for screening or preventive care and greater adherence to oral glucose tolerance testing but not random glucose or hemoglobin A1c testing.
AHRQ-funded; 75Q80120D00001; 75Q80121F32007.
Citation: Saldanha IJ, Adam GP, Kanaan G .
Delivery strategies for postpartum care: a systematic review and meta-analysis.
Obstet Gynecol 2023 Sep 1; 142(3):529-42. doi: 10.1097/aog.0000000000005293..
Keywords: Maternal Care, Women, Healthcare Delivery, Evidence-Based Practice, Patient-Centered Outcomes Research
Tugwell P, Welch V, Magwood O
AHRQ Author: Chang C
Protocol for the development of guidance for collaborator and partner engagement in health care evidence syntheses.
The objectives of this protocol were to: Identify, map, and synthesize findings related to engagement in evidence syntheses; Explore how engagement in evidence synthesis promotes health equity; Develop equity-oriented guidance on methods for conducting, evaluating, and reporting engagement. The authors intended to use their findings to develop draft guidance checklists and assess agreement with each item through an international survey. The guidance checklists will be co-produced and after being finalized at a consensus meeting, an international team will develop guidance for collaborators and partner engagement. The authors concluded that incorporating partnership values and expectations may result in better uptake, potentially reducing health inequities.
AHRQ-authored.
Citation: Tugwell P, Welch V, Magwood O .
Protocol for the development of guidance for collaborator and partner engagement in health care evidence syntheses.
Syst Rev 2023 Aug 2; 12(1):134. doi: 10.1186/s13643-023-02279-1..
Keywords: Evidence-Based Practice, Health Services Research (HSR), Healthcare Delivery
Jain A, Brooks JR, Alford CC
AHRQ Author: Jain A, Alford CC, Chang CS, Mueller NM, Umscheid CA, Bierman AS
Awareness of racial and ethnic bias and potential solutions to address bias with use of health care algorithms.
This AHRQ-authored study examined the increased use of health care algorithms in health decision tools, and whether including a patient's race or ethnicity among their inputs can lead clinicians and decision-makers to make choices that vary by race and potentially affect inequities. This qualitative survey included 42 organization representatives (e.g., clinical professional societies, universities, government agencies, payers, and health technology organizations) and individuals. The respondents identified 18 algorithms currently in use with the potential for bias. Seven qualitative themes with 31 subthemes were identified including: (1) algorithms are in widespread use and have significant repercussions, (2) bias can result from algorithms whether or not they explicitly include race, (3) clinicians and patients are often unaware of the use of algorithms and potential for bias, (4) race is a social construct used as a proxy for clinical variables, (5) there is a lack of standardization in how race and social determinants of health are collected and defined, (6) bias can be introduced at all stages of algorithm development, and (7) algorithms should be discussed as part of shared decision-making between the patient and clinician.
AHRQ-authored.
Citation: Jain A, Brooks JR, Alford CC .
Awareness of racial and ethnic bias and potential solutions to address bias with use of health care algorithms.
JAMA Health Forum 2023 Jun 2; 4(6):e231197. doi: 10.1001/jamahealthforum.2023.1197..
Keywords: Racial and Ethnic Minorities, Disparities, Healthcare Delivery, Evidence-Based Practice
Dykes PC, Curtin-Bowen M, Lipsitz S
Cost of inpatient falls and cost-benefit analysis of implementation of an evidence-based fall prevention program.
The financial implications of patient falls within healthcare settings, a primary cause of nonreimbursable negative incidents, have not been thoroughly investigated. The aim of this study was to determine the expenses related to inpatient falls and the potential cost savings achieved through the adoption of a proven fall prevention program. This economic assessment employed a matched case-control approach, utilizing results from an interrupted time series analysis that evaluated the alterations in fall rates after the introduction of an evidence-based fall prevention program to estimate inpatient fall expenses. Subsequently, an economic analysis was conducted to evaluate the cost advantages of implementing the program across two American healthcare systems from June 1, 2013, to August 31, 2019, in New York, New York, and Boston, Massachusetts. All adult patients admitted to the participating units were included in the analysis. Data analysis took place between October 2021 and November 2022. The fall prevention program, based on evidence, was introduced in 33 medical and surgical departments across eight hospitals. The primary outcome was the expense related to inpatient falls. Secondary outcomes included costs and savings linked to the evidence-based fall prevention program. The study found that the case-control study and economic analysis included 10,176 patients who experienced a fall event (with or without injury) and 29,161 matched controls without a fall event (51.9% aged 65-74 years, 67.1% White, and 53.6% male). Prior to the intervention, there were 2,503 falls and 900 injuries; following the intervention, there were 2,078 falls and 758 injuries. Based on a 19% decrease in falls and a 20% decrease in injury-causing falls from the beginning to the end of the post-intervention period, the economic analysis revealed that noninjurious and injurious falls led to cost increases of $35,365 and $36,776, respectively. The introduction of the evidence-based fall prevention program resulted in $14,600 in net avoided expenses for every 1000 patient-days.
AHRQ-funded; HS027557; HS025128
Citation: Dykes PC, Curtin-Bowen M, Lipsitz S .
Cost of inpatient falls and cost-benefit analysis of implementation of an evidence-based fall prevention program.
JAMA Health Forum 2023 Jan 6;4(1):e225125. doi: 10.1001/jamahealthforum.2022.5125.
Keywords: Falls, Healthcare Delivery, Evidence-Based Practice, Prevention