National Healthcare Quality and Disparities Report
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Topics
- Cancer (7)
- Cancer: Lung Cancer (2)
- Cancer: Skin Cancer (2)
- Care Coordination (1)
- Caregiving (3)
- Care Management (1)
- Children/Adolescents (2)
- Chronic Conditions (2)
- Comparative Effectiveness (2)
- Disparities (1)
- Education: Patient and Caregiver (2)
- Elderly (1)
- Family Health and History (1)
- Healthcare Costs (2)
- Healthcare Delivery (4)
- Healthcare Utilization (2)
- Health Services Research (HSR) (1)
- Health Status (1)
- Heart Disease and Health (1)
- Hospitalization (2)
- Hospital Readmissions (1)
- Long-Term Care (1)
- Medicare (2)
- Medication (3)
- Mortality (1)
- Nursing Homes (1)
- Opioids (1)
- Pain (4)
- (-) Palliative Care (21)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (4)
- Patient Safety (2)
- Practice Patterns (1)
- Provider: Physician (1)
- Provider Performance (1)
- Public Reporting (1)
- Quality Improvement (3)
- Quality Indicators (QIs) (1)
- Quality Measures (3)
- Quality of Care (8)
- Quality of Life (2)
- Racial and Ethnic Minorities (1)
- Registries (1)
- Respiratory Conditions (1)
- Shared Decision Making (1)
- Surgery (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 21 of 21 Research Studies DisplayedDu XL, Parikh RC, Lairson DR
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
The authors examined racial/ethnic and geographical disparities in cancer care and costs during the last 6 months of life for lung cancer decedents after the FDA's approval of bevacizumab. They found that there were substantial racial/ethnic and geographic disparities in the types of cancer care and costs in the last 6 months of life among lung cancer decedents, regardless of the length of survival times and hospice care status.
AHRQ-funded; HS018956.
Citation: Du XL, Parikh RC, Lairson DR .
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
Lung Cancer 2015 Dec;90(3):442-50. doi: 10.1016/j.lungcan.2015.09.017.
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Keywords: Cancer, Cancer: Lung Cancer, Disparities, Healthcare Costs, Medication, Palliative Care, Patient-Centered Outcomes Research, Practice Patterns, Racial and Ethnic Minorities
Ananth P, Melvin P, Feudtner C
Hospital use in the last year of life for children with life-threatening complex chronic conditions.
The researchers assessed hospital resource use in children by type and number of life-threatening complex chronic conditions (LT-CCCs). They found that hospital use for children with LT-CCCs in the last year of life varies significantly across the type and number of conditions. Children with hematologic/ immunologic or multiple conditions have the greatest hospital use.
AHRQ-funded; HS023092.
Citation: Ananth P, Melvin P, Feudtner C .
Hospital use in the last year of life for children with life-threatening complex chronic conditions.
Pediatrics 2015 Nov;136(5):938-46. doi: 10.1542/peds.2015-0260..
Keywords: Chronic Conditions, Children/Adolescents, Hospitalization, Palliative Care
Kamal AH, Kavalieratos D, Bull J
Usability and acceptability of the QDACT-PC, an electronic point-of-care system for standardized quality monitoring in palliative care.
The researchers performed usability testing of the Quality Data Collection Tool for Palliative Care (QDACT-PC), a novel, point-of-care quality monitoring tool for palliative care. They found that testing the QDACT-PC reveals equivalence with paper for data collection time, but with less burden overall for electronic methods across other domains of usability.
AHRQ-funded; HS022989.
Citation: Kamal AH, Kavalieratos D, Bull J .
Usability and acceptability of the QDACT-PC, an electronic point-of-care system for standardized quality monitoring in palliative care.
J Pain Symptom Manage 2015 Nov;50(5):615-21. doi: 10.1016/j.jpainsymman.2015.05.013.
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Keywords: Healthcare Delivery, Quality of Care, Palliative Care, Patient-Centered Healthcare, Quality Measures
Kamal AH, Harrison KL, Bakitas M
Improving the quality of palliative care through national and regional collaboration efforts.
The purpose of this paper was to review examples of quality-improvement collaborations in palliative care to understand the similarities, differences, and future directions of quality measurement and improvement strategies. These three examples showed areas of robust and growing quality-improvement collaboration in the field of palliative care: the Global Palliative Care Quality Alliance; Palliative Care Quality Network; and Project Educate, Nurture, Advise, Before Life Ends.
AHRQ-funded; HS023681.
Citation: Kamal AH, Harrison KL, Bakitas M .
Improving the quality of palliative care through national and regional collaboration efforts.
Cancer Control 2015 Oct;22(4):396-402. doi: 10.1177/107327481502200405.
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Keywords: Healthcare Delivery, Palliative Care, Quality of Care, Quality Improvement
Wysham NG, Cox CE, Wolf SP
Symptom burden of chronic lung disease compared with lung cancer at time of referral for palliative care consultation.
The authors compared the symptom burden of chronic lung disease with that of lung cancer at the time of initial palliative care consultation. They found that patients with chronic lung disease have symptom burdens similar to those of patients with lung cancer at the time of the first palliative care encounter. They concluded that, given the population burden of chronic lung disease and limitations in the palliative care workforce, attention should be focused on ensuring that pulmonologists are prepared to assess and manage the common palliative care needs of patients with chronic lung disease.
AHRQ-funded; HS023681.
Citation: Wysham NG, Cox CE, Wolf SP .
Symptom burden of chronic lung disease compared with lung cancer at time of referral for palliative care consultation.
Ann Am Thorac Soc 2015 Sep;12(9):1294-301. doi: 10.1513/AnnalsATS.201503-180OC.
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Keywords: Respiratory Conditions, Cancer: Lung Cancer, Pain, Palliative Care, Patient-Centered Outcomes Research
Holden TR, Smith MA, Bartels CM
Hospice enrollment, local hospice utilization patterns, and rehospitalization in Medicare patients.
The study objective was to examine the association between hospice enrollment, local hospice utilization patterns and 30-day rehospitalization in Medicare patients. It found that area-level hospice utilization is inversely proportional to rehospitalization rates. This relationship is not fully explained by direct hospice enrollment, and may reflect a spillover effect of the benefits of hospice extending to nonenrollees.
AHRQ-funded; HS000083.
Citation: Holden TR, Smith MA, Bartels CM .
Hospice enrollment, local hospice utilization patterns, and rehospitalization in Medicare patients.
J Palliat Med 2015 Jul;18(7):601-12. doi: 10.1089/jpm.2014.0395..
Keywords: Long-Term Care, Palliative Care, Hospital Readmissions, Medicare, Healthcare Utilization
DiBiasio EL, Clark MA, Gozalo PL
Timing of survey administration after hospice patient death: stability of bereaved respondents.
The authors examined the stability of bereaved family members' survey responses when administered three, six, and nine months after hospice patient death. They found that bereaved family member responses are stable between three and nine months after the death of the patient.
AHRQ-funded; HS019675.
Citation: DiBiasio EL, Clark MA, Gozalo PL .
Timing of survey administration after hospice patient death: stability of bereaved respondents.
J Pain Symptom Manage 2015 Jul;50(1):17-27. doi: 10.1016/j.jpainsymman.2015.01.006.
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Keywords: Family Health and History, Mortality, Palliative Care
Kamal AH, Nipp RD, Bull J
Symptom burden and performance status among community-dwelling patients with serious illness.
The researchers explored the relationship between prevalence and severity of symptoms and underlying performance status. They found distinct groupings of symptoms with high burden associated with different levels of performance status. This includes high prevalence of fatigue, anorexia, and dyspnea in patients with high performance. Patients with low performance status, however, reported more pain, depression, and constipation.
AHRQ-funded; HS022763.
Citation: Kamal AH, Nipp RD, Bull J .
Symptom burden and performance status among community-dwelling patients with serious illness.
J Palliat Med 2015 Jun;18(6):542-4. doi: 10.1089/jpm.2014.0381..
Keywords: Patient Safety, Quality of Life, Palliative Care, Health Status
Huo J, Du XL, Lairson DR
Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.
The authors examined the patterns of utilization of radiation therapy, chemotherapy, surgery, and hospice at the end-of-life care for patients diagnosed with metastatic melanoma. They found that surgery and hospice care use increased over the 8 years of this study, whereas the use of chemotherapy and radiation therapy remained consistent for patients diagnosed with metastatic melanoma.
AHRQ-funded; HS018956.
Citation: Huo J, Du XL, Lairson DR .
Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.
Am J Clin Oncol 2015 Jun;38(3):235-41. doi: 10.1097/COC.0b013e31829378f9.
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Keywords: Cancer, Cancer: Skin Cancer, Treatments, Elderly, Healthcare Utilization, Palliative Care, Patient-Centered Outcomes Research, Surgery
Smith B, McDuff J, Naierman N
What consumers want to know about quality when choosing a hospice provider.
This study drew on focus group and survey data collected in 5 metropolitan areas to learn more about hospice quality data. The researchers found that participants placed top priority on measures related to pain and symptom management. The National Quality Forum-approved measures resonate well with consumers, who also appear to be ready for access to data on the quality of hospice providers.
AHRQ-funded; HS021870.
Citation: Smith B, McDuff J, Naierman N .
What consumers want to know about quality when choosing a hospice provider.
Am J Hosp Palliat Care 2015 Jun;32(4):393-400. doi: 10.1177/1049909114524475.
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Keywords: Caregiving, Education: Patient and Caregiver, Shared Decision Making, Palliative Care, Provider Performance, Public Reporting, Quality of Care, Quality Indicators (QIs)
Kamal AH
Signposts along the journey toward high-quality palliative care: the value of measuring what matters.
The author of this letter discusses the rationale behind and the usefulness of the group of palliative care measures that were chosen through the deliberations of a Technical Advisory Panel, a Clinical User Panel, and public comment. He states that the 10 measures chosen represent important signposts along the journey toward high quality palliative care and that this is the first iteration of this effort, with updates planned.
AHRQ-funded; HS022763.
Citation: Kamal AH .
Signposts along the journey toward high-quality palliative care: the value of measuring what matters.
J Pain Symptom Manage 2015 May;49(5):e1-2. doi: 10.1016/j.jpainsymman.2015.03.002..
Keywords: Palliative Care, Quality of Care, Patient Safety, Quality Measures
Ragsdale L, Zhong W, Morrison W
Pediatric exposure to opioid and sedation medications during terminal hospitalizations in the United States, 2007-2011.
The researchers conducted a retrospective study in which they examined the prescribing patterns of opioid and sedation medications among 37,459 children who died in 430 hospitals in the US 2007-2011. Their study reveals an overall high prevalence of exposure to opioid and sedation medications among pediatric terminal hospitalizations, yet with slightly less than one-half of patients receiving both opioids and sedatives daily near the end of life.
AHRQ-funded; HS018425.
Citation: Ragsdale L, Zhong W, Morrison W .
Pediatric exposure to opioid and sedation medications during terminal hospitalizations in the United States, 2007-2011.
J Pediatr 2015 Mar;166(3):587-93.e1. doi: 10.1016/j.jpeds.2014.10.017..
Keywords: Children/Adolescents, Hospitalization, Medication, Opioids, Pain, Palliative Care
Kamal AH, Nipp RD, Bull JH
Quality of palliative care for patients with advanced cancer in a community consortium.
The authors formed the Carolinas Consortium for Palliative Care and collected a quality data registry to monitor their practice and to inform quality improvement efforts. They demonstrated that measures evaluating process assessment, as opposed to interventions, are better documented. They concluded that analyzing data on quality is feasible and valuable in community-based palliative care and that, overall, processes to collect data on quality using nontechnology methods may underestimate true adherence to quality measures.
AHRQ-funded; HS022763.
Citation: Kamal AH, Nipp RD, Bull JH .
Quality of palliative care for patients with advanced cancer in a community consortium.
J Pain Symptom Manage 2015 Feb;49(2):289-92. doi: 10.1016/j.jpainsymman.2014.05.024.
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Keywords: Cancer, Healthcare Delivery, Quality of Care, Palliative Care, Registries
Kamal AH, Hanson LC, Casarett DJ
The quality imperative for palliative care.
This article discusses moving beyond demonstrating what palliative care is to focusing on the quality of how it is accomplished. This effort includes developing standardized methods to collect data without adding additional burden, comparing and sharing experiences to promote discipline-wide quality assessment and improvement initiatives, and demonstrating intentions for quality improvement on the clinical frontline.
AHRQ-funded; HS022763.
Citation: Kamal AH, Hanson LC, Casarett DJ .
The quality imperative for palliative care.
J Pain Symptom Manage 2015 Feb;49(2):243-53. doi: 10.1016/j.jpainsymman.2014.06.008.
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Keywords: Palliative Care, Quality Improvement, Quality of Care, Healthcare Delivery
Cagle JG, Zimmerman S, Cohen LW
EMPOWER: an intervention to address barriers to pain management in hospice.
The researchers tested the preliminary efficacy of the Effective Management of Pain: Overcoming Worries to Enable Relief (EMPOWER) intervention. At two weeks, caregivers in the intervention group reported better knowledge about pain management, fewer concerns about pain and pain medications, lower patient pain over the past week, and trended toward improvement in most other areas under study. EMPOWER had a greater effect for black subjects vs. whites on reducing concern about stigma. At three months, the intervention group trended better on most study outcomes. The researchers concluded that EMPOWER is a promising model to reduce barriers to pain management in hospice.
AHRQ-funded; HS019068.
Citation: Cagle JG, Zimmerman S, Cohen LW .
EMPOWER: an intervention to address barriers to pain management in hospice.
J Pain Symptom Manage 2015 Jan;49(1):1-12. doi: 10.1016/j.jpainsymman.2014.05.007.
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Keywords: Care Management, Caregiving, Comparative Effectiveness, Education: Patient and Caregiver, Medication, Pain, Palliative Care
Hwang D, Teno JM, Clark M
Family perceptions of quality of hospice care in the nursing home.
The investigators examined bereaved family members' perceptions of nursing home-hospice collaborations in terms of what family members believe went well or could have been improved. The focus group participants identified three major aspects of collaboration as important to care delivery: knowing who (nursing home or hospice) is responsible for which aspects of patient care, concern about information coordination between the nursing home and hospice, and the need for hospice to advocate for high-quality care rather than their having to directly do so on behalf of their family members. These concerns have been incorporated into the revised Family Evaluation of Hospice Care, a post-death survey used to evaluate quality of hospice care.
AHRQ-funded; HS019675.
Citation: Hwang D, Teno JM, Clark M .
Family perceptions of quality of hospice care in the nursing home.
J Pain Symptom Manage 2014 Dec;48(6):1100-7. doi: 10.1016/j.jpainsymman.2014.04.003.
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Keywords: Care Coordination, Nursing Homes, Palliative Care, Quality of Care
Rocke DJ, Beumer HW, Taylor DH, Jr.
Physician and patient and caregiver health attitudes and their effect on Medicare resource allocation for patients with advanced cancer.
The investigators sought to determine how baseline attitudes toward quality vs quantity of life affect end-of-life resource allocation. They found that, compared with patients and caregivers, otolaryngology-head and neck surgery (OHNS) physician allocations differed significantly in all 15 benefit categories except home care. They concluded that understanding the effect of baseline attitudes is important for effective end-of-life discussions.
AHRQ-funded; HS018360.
Citation: Rocke DJ, Beumer HW, Taylor DH, Jr. .
Physician and patient and caregiver health attitudes and their effect on Medicare resource allocation for patients with advanced cancer.
JAMA Otolaryngol Head Neck Surg 2014 Jun;140(6):497-503. doi: 10.1001/jamaoto.2014.494.
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Keywords: Cancer, Caregiving, Medicare, Palliative Care, Provider: Physician, Quality of Life
Huo J, Lairson DR, Du XL
Survival and cost-effectiveness of hospice care for metastatic melanoma patients.
The authors analyzed the association of hospice use with survival and health care costs among patients diagnosed with metastatic melanoma. They found that the median survival time was 6.1 months for patients with no hospice care, 6.5 months for patients enrolled in hospice for 1 to 3 days, and 10.2 months for patients enrolled for 4 or more days. Patients with 4 or more days of hospice care incurred lower end-of-life costs than the comparison groups.
AHRQ-funded; HS018956.
Citation: Huo J, Lairson DR, Du XL .
Survival and cost-effectiveness of hospice care for metastatic melanoma patients.
Am J Manag Care 2014 May;20(5):366-73.
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Keywords: Cancer, Cancer: Skin Cancer, Healthcare Costs, Palliative Care, Patient-Centered Outcomes Research
Kavalieratos D, Kamal AH, Abernethy AP
Comparing unmet needs between community-based palliative care patients with heart failure and patients with cancer.
This study characterized the unresolved symptom and treatment needs which patients with heart failure and those with cancer present to palliative care. It found that patients with HF presented with fewer unresolved symptoms; however, they were more likely to report dyspnea and more commonly experienced dyspnea-related treatment gaps.
AHRQ-funded; HS000032; HS017587
Citation: Kavalieratos D, Kamal AH, Abernethy AP .
Comparing unmet needs between community-based palliative care patients with heart failure and patients with cancer.
J Palliat Med. 2014 Apr;17(4):475-81. doi: 10.1089/jpm.2013.0526..
Keywords: Palliative Care, Cancer, Heart Disease and Health, Chronic Conditions
Martinez KA, Aslakson RA, Wilson RF
A systematic review of health care interventions for pain in patients with advanced cancer.
The authors sought to synthesize the evidence on the effectiveness of pain-focused interventions in patients with advanced cancer. In nineteen studies, they found moderate strength of evidence that pain management in advanced cancer can be improved using health care interventions, particularly nurse-led patient-centered interventions.
AHRQ-funded; 290200710061.
Citation: Martinez KA, Aslakson RA, Wilson RF .
A systematic review of health care interventions for pain in patients with advanced cancer.
Am J Hosp Palliat Care 2014 Feb;31(1):79-86. doi: 10.1177/1049909113476129.
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Keywords: Cancer, Comparative Effectiveness, Pain, Palliative Care, Quality Improvement
Kamal AH
Getting to proven: evaluating quality across all of palliative care.
In this letter, Kamal calls for the development of quality measures for palliative care, paying attention to procedures, multidisciplinary team members who perform multidomain assessments, the new settings of care where quality measurement should be tailored, and the care models that transition across generalist and specialist palliative care.
AHRQ-funded; HS022763.
Citation: Kamal AH .
Getting to proven: evaluating quality across all of palliative care.
J Pain Symptom Manage 2014 Jan;47(1):e1-2. doi: 10.1016/j.jpainsymman.2013.09.007.
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Keywords: Quality of Care, Health Services Research (HSR), Palliative Care, Quality Measures, Quality Measures