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
12026 to 12050 of 12210 Research Studies DisplayedHwang SW, Chambers C, Chiu S
A comprehensive assessment of health care utilization among homeless adults under a system of universal health insurance.
The researchers comprehensively assessed health care utilization in a population-based sample of homeless adults and matched controls under a universal health insurance system. They found that homeless people had substantially higher rates of ED and hospital use than general population controls; these rates were largely driven by a subset of homeless persons with extremely high-intensity usage of health services.
AHRQ-funded; HS014129.
Citation: Hwang SW, Chambers C, Chiu S .
A comprehensive assessment of health care utilization among homeless adults under a system of universal health insurance.
Am J Public Health 2013 Dec;103 Suppl 2:S294-301. doi: 10.2105/ajph.2013.301369..
Keywords: Healthcare Utilization, Social Determinants of Health, Emergency Department, Emergency Medical Services (EMS)
Jensen JD, Krakow M, John KK
Against conventional wisdom: when the public, the media, and medical practice collide.
In 2009, the U.S. Preventive Services Task Force released new mammography screening guidelines that sparked a torrent of criticism. The goal of this article is to articulate how conflicts of this type arise and to review possible means of redress. The authors concluded that science is routinely simplified as it is prepared for public consumption. In line with the model of information overload, this practice may increase short-term adherence to recommendations at the expense of long-term message consistency and trust in science.
AHRQ-funded; 290200810015C
Citation: Jensen JD, Krakow M, John KK .
Against conventional wisdom: when the public, the media, and medical practice collide.
BMC Med Inform Decis Making 2013;13 Suppl 3:S4. doi: 10.1186/1472-6947-13-s3-s4..
Keywords: Communication, Evidence-Based Practice, Guidelines, Health Services Research (HSR), U.S. Preventive Services Task Force (USPSTF)
Rosenberg JH, Albrecht JS, Fromme EK
Antimicrobial use for symptom management in patients receiving hospice and palliative care: a systematic review.
This systematic review found that limited data are available on the use of antimicrobial therapy for symptom management among patients receiving palliative or hospice care. The lack of comparison between patients who did and did not receive antimicrobial therapy means that there is no accurate estimate of the effectiveness of antimicrobial therapy.
AHRQ-funded; HS021068
Citation: Rosenberg JH, Albrecht JS, Fromme EK .
Antimicrobial use for symptom management in patients receiving hospice and palliative care: a systematic review.
J Palliat Med. 2013 Dec;16(12):1568-74. doi: 10.1089/jpm.2013.0276..
Keywords: Comparative Effectiveness, Antimicrobial Stewardship, Long-Term Care, Palliative Care, Outcomes
Fain K, Alexander GC
Are Food and Drug Administration prescription drug safety plans working? A case study of isotretinoin.
The authors comment on a case study analyzing pharmacy claims in order to examine the impact of the iPledge program (an FDA restricted distribution plan that included electronic registration of patients, physicians, and pharmacists plus monitoring of contraceptive use) on contraceptive use for women of childbearing age taking isotretinoin (Accutane). This drug, used for acute acne, could affect fetal development. The limited effectiveness of the program shows the difficulty of changing patient behavior.
AHRQ-funded; HS0189960
Citation: Fain K, Alexander GC .
Are Food and Drug Administration prescription drug safety plans working? A case study of isotretinoin.
Pharmacoepidemiol Drug Saf. 2013 Dec;22(12):1258-62. doi: 10.1002/pds.3514..
Keywords: Patient Safety, Medication: Safety, Medication, Health Information Technology (HIT), Women
Hellinger FJ
AHRQ Author: Hellinger FJ
Assessing the cost effectiveness of pre-exposure prophylaxis for HIV prevention in the US.
In order to assess the cost-effectiveness of pre-exposure prophylaxis for HIV prevention in the U.S., the author evaluates various studies and finds that they yield widely varying estimates of the cost per quality-adjusted life year (QALY) gained, and that this variations reflects the substantial uncertainty surrounding the determinants of HIV transmission as well as different approaches to translating a reduction in HIV cases into an estimate of the increase in the number of QALYs.
AHRQ-authored.
Citation: Hellinger FJ .
Assessing the cost effectiveness of pre-exposure prophylaxis for HIV prevention in the US.
Pharmacoeconomics. 2013 Dec;31(12):1091-104. doi: 10.1007/s40273-013-0111-0..
Keywords: Human Immunodeficiency Virus (HIV), Healthcare Costs, Quality of Life, Healthcare Costs, Prevention
Schumacher JR, Palta M, Loconte NK
Characterizing the psychological distress response before and after a cancer diagnosis.
The purpose of this study was to estimate the magnitude and long-term temporal course of the cancer psychological distress response, incorporating negative (depression and anxiety) and positive (psychological well-being). Cancer survivors were more likely to experience clinically significant increases in depression and anxiety, with no significant results being found for well-being.
AHRQ-funded; HS00083
Citation: Schumacher JR, Palta M, Loconte NK .
Characterizing the psychological distress response before and after a cancer diagnosis.
J Behav Med. 2013 Dec;36(6):591-600. doi: 10.1007/s10865-012-9453-x..
Keywords: Cancer, Behavioral Health, Quality of Life
Moy E, Mau MK, Raetzman S
AHRQ Author: Moy E, Andrews R
Ethnic differences in potentially preventable hospitalizations among Asian Americans, Native Hawaiians, and other Pacific Islanders: implications for reducing health care disparities.
This study aimed to produce reliable estimates of health care quality among Native Hawaiian (NH), Other Pacific Islander (PI), and Asian American (AA) small population subgroups. Results showed that, despite efforts to reduce racial/ethnic health care disparities, significant gaps remain in potentially preventable hospitalization rates.
AHRQ-authored.
Citation: Moy E, Mau MK, Raetzman S .
Ethnic differences in potentially preventable hospitalizations among Asian Americans, Native Hawaiians, and other Pacific Islanders: implications for reducing health care disparities.
Ethn Dis 2013 Winter;23(1):6-11.
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Keywords: Disparities, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Quality Indicators (QIs), Racial and Ethnic Minorities
Taha J, Czaja SJ, Sharit J
Factors affecting usage of a personal health record (PHR) to manage health.
This study evaluated the ability of middle-aged and older adults to use a simulated electronic personal health record (PHR) to perform 15 common health management tasks including medication management, interpretation of lab results, and health maintenance activities. Participants in both age groups experienced significant difficulties in using the PHR, with older adults with lower numeracy and technology experience having greater problems.
AHRQ-funded; HS018239
Citation: Taha J, Czaja SJ, Sharit J .
Factors affecting usage of a personal health record (PHR) to manage health.
Psychol Aging. 2013 Dec;28(4):1124-39. doi: 10.1037/a0033911..
Keywords: Electronic Health Records (EHRs), Elderly, Health Information Technology (HIT), Patient Self-Management
Bao Y, Ryan AM, Shao H
Generic initiation and antidepressant therapy adherence under Medicare Part D.
This study assessed the effects of initiating antidepressant treatment with a generic versus a branded prescription (generic initiation) on adherence to antidepressant therapy for the treatment of depression. It found that starting patients with generics had benefits for antidepressant adherence by lowering out-of-pocket costs for all patients and by mitigating the effect of the Part D coverage gap faced by patients not receiving low-income subsidies.
AHRQ-funded; HS018546.
Citation: Bao Y, Ryan AM, Shao H .
Generic initiation and antidepressant therapy adherence under Medicare Part D.
Am J Manag Care 2013 Dec;19(12):989-98..
Keywords: Medication, Depression, Medicare, Patient Adherence/Compliance
Letourneau AR, Calderwood MS, Huang SS
Harnessing claims to improve detection of surgical site infections following hysterectomy and colorectal surgery.
The researchers conducted retrospective cohort studies at 2 academic medical centers, extending analyses of patients undergoing hysterectomy or colorectal surgery. They concluded that claims-enhanced surveillance can help to identify surgical site infections (SSIs) missed by routine surveillance, identifying nearly twice as many SSIs following hysterectomy and 4 times more SSIs following colorectal surgery.
AHRQ-funded; HS021424.
Citation: Letourneau AR, Calderwood MS, Huang SS .
Harnessing claims to improve detection of surgical site infections following hysterectomy and colorectal surgery.
Infect Control Hosp Epidemiol 2013 Dec;34(12):1321-3. doi: 10.1086/673975..
Keywords: Healthcare-Associated Infections (HAIs), Injuries and Wounds, Surgery, Patient Safety, Adverse Events, Women, Digestive Disease and Health
Shapiro JS, Johnson SA, Angiollilo J
Health information exchange improves identification of frequent emergency department users.
The goal of the project was to measure the incremental increase in the number of frequent ED users who were identified when data
from all EDs participating in an health information exchange were compared with site-specific data. When the researchers analyzed HIE-wide data instead of site-specific data, they identified 20.3 percent more frequent ED users and 16.0 percent more visits by them to the ED.
from all EDs participating in an health information exchange were compared with site-specific data. When the researchers analyzed HIE-wide data instead of site-specific data, they identified 20.3 percent more frequent ED users and 16.0 percent more visits by them to the ED.
AHRQ-funded; HS021261.
Citation: Shapiro JS, Johnson SA, Angiollilo J .
Health information exchange improves identification of frequent emergency department users.
Health Aff 2013 Dec;32(12):2193-8. doi: 10.1377/hlthaff.2013.0167..
Keywords: Data, Emergency Department, Healthcare Utilization, Health Information Exchange (HIE), Health Information Technology (HIT)
Chambers C, Chiu S, Katic M
High utilizers of emergency health services in a population-based cohort of homeless adults.
This study identified predictors of frequent emergency department (ED) use among a population-based sample of homeless adults in Toronto, Ontario. It found that among homeless adults with universal health insurance, a small subgroup accounted for the majority of visits to emergency services. Frequent use was driven by multiple predisposing, enabling, and need factors.
AHRQ-funded; HS014129.
Citation: Chambers C, Chiu S, Katic M .
High utilizers of emergency health services in a population-based cohort of homeless adults.
Am J Public Health 2013 Dec;103 Suppl 2:S302-10. doi: 10.2105/ajph.2013.301397..
Keywords: Emergency Department, Social Determinants of Health, Health Insurance, Healthcare Utilization
Stuart B, Davidoff A, Erten M
AHRQ Author: Davidoff A
How Medicare Part D benefit phases affect adherence with evidence-based medications following acute myocardial infarction.
The authors assessed the impact of Medicare Part D benefit phases on adherence with evidence-based medications after hospitalization for an acute myocardial infarction (AMI). They found that as the Part D doughnut hole is gradually filled in by 2020, Medicare Part D enrollees with critical diseases such as AMI who rely heavily on brand name drugs are likely to exhibit modest increases in adherence, while those reliant on generic drugs are less likely to be affected.
AHRQ-authored.
Citation: Stuart B, Davidoff A, Erten M .
How Medicare Part D benefit phases affect adherence with evidence-based medications following acute myocardial infarction.
Health Serv Res 2013 Dec;48(6 Pt 1):1960-77. doi: 10.1111/1475-6773.12073.
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Keywords: Evidence-Based Practice, Medicare, Medication, Heart Disease and Health, Patient Adherence/Compliance
Bergeron AR, Webb JR, Serper M
Impact of electronic prescribing on medication use in ambulatory care.
This study investigated differences before and after rollout of electronic prescribing (e-prescribing) in (1) patients’ primary adherence to newly prescribed medications, (2) patients' understanding of how to use their medications, and (3) multiple pharmacy use. It found an increase in abandoned prescriptions immediately following the implementation of e-prescribing. However, with time, these issues were resolved and even improved to rates lower than baseline.
AHRQ-funded; HS017220.
Citation: Bergeron AR, Webb JR, Serper M .
Impact of electronic prescribing on medication use in ambulatory care.
Am J Manag Care 2013 Dec;19(12):1012-7..
Keywords: Electronic Prescribing (E-Prescribing), Ambulatory Care and Surgery, Patient Adherence/Compliance, Medication
Taliani CA, Bricker PL, Adelman AM
Implementing effective care management in the patient-centered medical home.
The investigators explored how a disparate group of patient-centered medical homes (PCMHs) embedded care management in their team care environment to identify best practices. They concluded that PCMHs may want to ensure that care managers are available to meet with patients during visits, support patient self-management, fully leverage the electronic medical record for team messaging and patient tracking, and ensure integration into the care team with office huddles and ongoing communication.
AHRQ-funded; HS019150.
Citation: Taliani CA, Bricker PL, Adelman AM .
Implementing effective care management in the patient-centered medical home.
Am J Manag Care 2013 Dec;19(12):957-64.
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Keywords: Care Management, Diabetes, Healthcare Delivery, Patient-Centered Healthcare, Quality Improvement, Teams
Siegler JE, Boehme AK, Fowler BD
Inpatient rehabilitation centers and concern for increasing volume of ischemic stroke patients requiring rehabilitation.
The researchers aimed to quantify the proportion of medically stable ischemic stroke patients with prolonged length of stay (pLOS) caused by a lack of IRF bed availability. They concluded that for the majority of our patients, pLOS was caused by acquired medical complications and delayed disposition, most commonly inpatient rehabilitation.
AHRQ-funded; HS013852.
Citation: Siegler JE, Boehme AK, Fowler BD .
Inpatient rehabilitation centers and concern for increasing volume of ischemic stroke patients requiring rehabilitation.
South Med J 2013 Dec;106(12):693-6. doi: 10.1097/smj.0000000000000036..
Keywords: Stroke, Hospitalization, Hospital Discharge
Miller WL, Crabtree BF, Harrison MI
AHRQ Author: Harrison MI
Integrating mixed methods in health services and delivery system research.
The authors introduced this AHRQ-sponsored issue of Health Services Research, describing the papers and briefly indicating where they fit into the emerging mixed methods mosaic. They then provided some suggestions about what may be missing and anticipated a future state of a more integrated approach to health services research and richer dialogue between researchers and those engaged in health care.
AHRQ-authored.
Citation: Miller WL, Crabtree BF, Harrison MI .
Integrating mixed methods in health services and delivery system research.
Health Serv Res 2013 Dec;48(6 Pt 2):2125-33. doi: 10.1111/1475-6773.12123.
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Keywords: Healthcare Delivery, Health Services Research (HSR), Research Methodologies
McGuire TG, Glazer J, Newhouse JP
AHRQ Author: Zuvekas SH
Integrating risk adjustment and enrollee premiums in health plan payment.
Paying health plans from two different sources such as risk-adjusted payments from a regulator and premiums charged to individual enrollees raises issues in payment design for both Medicare Advantage plans and the new State-run exchanges created by the Affordable Care Act. The primary purpose of this study is to demonstrate the versatility of least squares methods for risk adjustment in individual insurance markets with enrollee premiums.
AHRQ-authored
Citation: McGuire TG, Glazer J, Newhouse JP .
Integrating risk adjustment and enrollee premiums in health plan payment.
J Health Econ. 2013 Dec;32(6):1263-77. doi: 10.1016/j.jhealeco.2013.05.002..
Keywords: Healthcare Costs, Medical Expenditure Panel Survey (MEPS), Medicare
Nkoy FL, Stone BL, Fassl BA
Longitudinal validation of a tool for asthma self-monitoring.
The purpose of this study was to show longitudinal validation of a new tool, the Asthma Symptom Tracker (AST). The study established longitudinal validation of the AST, a novel tool designed for use by children or their parents to facilitate ongoing monitoring of patients’ asthma symptoms and proactive medical decision-making to prevent acute exacerbations.
AHRQ-funded; HS018166; HS018678.
Citation: Nkoy FL, Stone BL, Fassl BA .
Longitudinal validation of a tool for asthma self-monitoring.
Pediatrics 2013 Dec;132(6):e1554-61. doi: 10.1542/peds.2013-1389..
Keywords: Asthma, Children/Adolescents, Chronic Conditions, Shared Decision Making, Patient Self-Management
John DA, de Castro AB, Duran B
Nativity and occupational class disparities in uninsurance and routine preventive care use among Asian Americans.
The researchers examined how nativity and occupational class among Asian Americans may explain disparities in uninsurance and use of routine preventive healthcare services such as routine physical checkup and dental/eye exams. They found that 35 to 40 percent of workers in blue-collar and service occupations reported no physical checkup or dental/eye exams in the past year.
AHRQ-funded; HS013853
Citation: John DA, de Castro AB, Duran B .
Nativity and occupational class disparities in uninsurance and routine preventive care use among Asian Americans.
J Immigr Minor Health. 2013 Dec;15(6):1011-22. doi: 10.1007/s10903-013-9851-3..
Keywords: Disparities, Uninsured, Racial and Ethnic Minorities, Social Determinants of Health, Prevention
Sarraj A, Albright K, Barreto AD
Optimizing prediction scores for poor outcome after intra-arterial therapy in anterior circulation acute ischemic stroke.
The researchers sought to optimize a score that combines clinical and imaging variables to more accurately predict poor outcome after intra-arterial therapy (IAT) in anterior circulation occlusions. They concluded that the Houston IAT2 score, which combines clinical and imaging variables, performed better than all previous scores in predicting poor outcome after IAT for anterior circulation large artery occlusions.
AHRQ-funded; HS013852.
Citation: Sarraj A, Albright K, Barreto AD .
Optimizing prediction scores for poor outcome after intra-arterial therapy in anterior circulation acute ischemic stroke.
Stroke 2013 Dec;44(12):3324-30. doi: 10.1161/strokeaha.113.001050..
Keywords: Stroke, Outcomes, Cardiovascular Conditions
Lomotan EA, Dougherty D
AHRQ Author: Lomotan EA, Dougherty D
Pediatric health care quality measures: considerations for pharmacotherapy.
The authors used the Pediatric Quality Measures Program that arose from the Children's Health Insurance Program Reauthorization Act in the United States to illustrate the challenges in developing quality measures of pediatric pharmacotherapy. They identified the challenges aw being twofold: (i) weak evidence base for the specific pharmacotherapy in children and (ii) limited data to calculate the measure. They concluded that health information technology is emerging as a tool to improve quality measurement but presents additional challenges.
AHRQ-authored.
Citation: Lomotan EA, Dougherty D .
Pediatric health care quality measures: considerations for pharmacotherapy.
Paediatr Drugs 2013 Dec;15(6):441-7. doi: 10.1007/s40272-013-0042-4.
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Keywords: Children's Health Insurance Program (CHIP), Quality of Care, Medication, Children/Adolescents, Quality Measures
Chambers C, Katic M, Chiu S
Predictors of medical or surgical and psychiatric hospitalizations among a population-based cohort of homeless adults.
This study identified factors associated with inpatient hospitalizations among a population-based cohort of homeless adults in Toronto, Ontario. Health care need was a strong predictor of medical or surgical and psychiatric hospitalizations. Some hospitalizations among homeless adults were potentially avoidable, whereas others represented an unavoidable use of health services.
AHRQ-funded; HS014129.
Citation: Chambers C, Katic M, Chiu S .
Predictors of medical or surgical and psychiatric hospitalizations among a population-based cohort of homeless adults.
Am J Public Health 2013 Dec;103 Suppl 2:S380-8. doi: 10.2105/ajph.2013.301646..
Keywords: Hospitalization, Social Determinants of Health, Behavioral Health, Health Status
Sarpong EM, Miller GE
AHRQ Author: Sarpong EM, Miller GE
Racial and ethnic differences in childhood asthma treatment in the United States.
The authors examined racial-ethnic differences in asthma controller medication use among insured U.S. children. They found that non-Hispanic black and Hispanic children were less likely to use controllers than non-Hispanic white children. They concluded that the large observed differences in controller use highlight the continuing challenges of ensuring that all U.S. children have access to quality asthma care.
AHRQ-authored.
Citation: Sarpong EM, Miller GE .
Racial and ethnic differences in childhood asthma treatment in the United States.
Health Serv Res 2013 Dec;48(6 Pt 1):2014-36. doi: 10.1111/1475-6773.12077.
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Keywords: Asthma, Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Medication, Racial and Ethnic Minorities
Zhang S, Senteio C, Felizzola J
Racial/ethnic disparities in antiretroviral treatment among HIV-infected pregnant Medicaid enrollees, 2005-2007.
The purpose of this study was to describe racial/ethnic disparities in ARV treatment of low-income Medicaid-eligible HIV-infected women, with a focus on minority populations in southern states. It found that Hispanic or Latino women are a specific subgroup at risk for inadequate ARV therapy in pregnancy. The researchers point out a specific policy issue with regard to the systematic exclusion of many immigrants from Medicaid-covered care during the prenatal period.
AHRQ-funded; HS019470.
Citation: Zhang S, Senteio C, Felizzola J .
Racial/ethnic disparities in antiretroviral treatment among HIV-infected pregnant Medicaid enrollees, 2005-2007.
Am J Public Health 2013 Dec;103(12):e46-53. doi: 10.2105/ajph.2013.301328..
Keywords: Disparities, Human Immunodeficiency Virus (HIV), Pregnancy, Social Determinants of Health