National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (417)
- Adverse Drug Events (ADE) (321)
- Adverse Events (737)
- Alcohol Use (61)
- Ambulatory Care and Surgery (204)
- Antibiotics (248)
- Antimicrobial Stewardship (157)
- Anxiety (48)
- Arthritis (130)
- Asthma (122)
- Autism (31)
- Back Health and Pain (58)
- Behavioral Health (699)
- Blood Clots (62)
- Blood Pressure (132)
- Blood Thinners (79)
- Brain Injury (64)
- Breast Feeding (18)
- Burnout (64)
- Cancer (788)
- Cancer: Breast Cancer (197)
- Cancer: Cervical Cancer (21)
- Cancer: Colorectal Cancer (116)
- Cancer: Lung Cancer (83)
- Cancer: Ovarian Cancer (9)
- Cancer: Prostate Cancer (108)
- Cancer: Skin Cancer (15)
- Cardiovascular Conditions (711)
- Care Coordination (104)
- Caregiving (223)
- Care Management (225)
- Case Study (101)
- Catheter-Associated Urinary Tract Infection (CAUTI) (55)
- Centers for Education and Research on Therapeutics (CERTs) (12)
- Central Line-Associated Bloodstream Infections (CLABSI) (61)
- Children's Health Insurance Program (CHIP) (40)
- Children/Adolescents (1542)
- Chronic Conditions (700)
- Clinical Decision Support (CDS) (199)
- Clinician-Patient Communication (281)
- Clostridium difficile Infections (55)
- Colonoscopy (37)
- Communication (383)
- Community-Acquired Infections (59)
- Community-Based Practice (150)
- Community Partnerships (18)
- Comparative Effectiveness (463)
- Complementary and Alternative Medicine (23)
- Comprehensive Unit-based Safety Program (CUSP) (9)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (85)
- COVID-19 (312)
- Critical Care (220)
- Cultural Competence (64)
- Data (174)
- Decision Making (583)
- Dementia (102)
- Dental and Oral Health (66)
- Depression (237)
- Diabetes (369)
- Diagnostic Safety and Quality (545)
- Dialysis (24)
- Digestive Disease and Health (111)
- Disabilities (73)
- Disparities (449)
- Domestic Violence (30)
- Ear Infections (5)
- Education (30)
- Education: Academic (26)
- Education: Continuing Medical Education (159)
- Education: Curriculum (23)
- Education: Patient and Caregiver (231)
- Elderly (944)
- Electronic Health Records (EHRs) (729)
- Electronic Prescribing (E-Prescribing) (26)
- Emergency Department (559)
- Emergency Medical Services (EMS) (163)
- Emergency Preparedness (26)
- Evidence-Based Practice (932)
- Eye Disease and Health (36)
- Falls (85)
- Family Health and History (71)
- Genetics (96)
- Guidelines (364)
- Healthcare-Associated Infections (HAIs) (420)
- Healthcare Cost and Utilization Project (HCUP) (368)
- Healthcare Costs (787)
- Healthcare Delivery (547)
- Healthcare Utilization (384)
- Health Information Exchange (HIE) (51)
- Health Information Technology (HIT) (1425)
- Health Insurance (434)
- Health Literacy (126)
- Health Promotion (78)
- Health Services Research (HSR) (327)
- Health Status (132)
- Health Systems (104)
- Heart Disease and Health (452)
- Hepatitis (41)
- Home Healthcare (141)
- Hospital Discharge (220)
- Hospitalization (534)
- Hospital Readmissions (323)
- Hospitals (757)
- Human Immunodeficiency Virus (HIV) (255)
- Imaging (245)
- Implementation (191)
- Infectious Diseases (260)
- Influenza (41)
- Injuries and Wounds (207)
- Inpatient Care (221)
- Intensive Care Unit (ICU) (267)
- Kidney Disease and Health (199)
- Labor and Delivery (106)
- Learning Health Systems (47)
- Lifestyle Changes (134)
- Long-Term Care (226)
- Low-Income (171)
- Maternal Care (182)
- Medicaid (359)
- Medical Devices (71)
- Medical Errors (205)
- Medical Expenditure Panel Survey (MEPS) (189)
- Medical Liability (26)
- Medicare (573)
- Medication (1681)
- Medication: Safety (231)
- Men's Health (54)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (73)
- Mortality (397)
- Neonatal Intensive Care Unit (NICU) (43)
- Neurological Disorders (197)
- Newborns/Infants (258)
- Nursing (113)
- Nursing Homes (326)
- Nutrition (135)
- Obesity (250)
- Obesity: Weight Management (105)
- Opioids (303)
- Organizational Change (73)
- Orthopedics (106)
- Osteoporosis (30)
- Outcomes (798)
- Pain (208)
- Palliative Care (138)
- Patient-Centered Healthcare (456)
- Patient-Centered Outcomes Research (1033)
- Patient Adherence/Compliance (229)
- Patient and Family Engagement (275)
- Patient Experience (258)
- Patient Safety (1293)
- Patient Self-Management (140)
- Payment (200)
- Pneumonia (82)
- Policy (431)
- Practice-Based Research Network (PBRN) (16)
- Practice Improvement (34)
- Practice Patterns (305)
- Pregnancy (289)
- Pressure Ulcers (28)
- Prevention (794)
- Primary Care (718)
- Primary Care: Models of Care (86)
- Provider (299)
- Provider: Clinician (67)
- Provider: Health Personnel (91)
- Provider: Nurse (112)
- Provider: Pharmacist (98)
- Provider: Physician (237)
- Provider: Physician Assistant (1)
- Provider Performance (199)
- Public Health (182)
- Public Reporting (40)
- Quality Improvement (551)
- Quality Indicators (QIs) (138)
- Quality Measures (227)
- Quality of Care (990)
- Quality of Life (199)
- Racial and Ethnic Minorities (749)
- Registries (146)
- Rehabilitation (61)
- Research Methodologies (418)
- Respiratory Conditions (367)
- Risk (756)
- Rural/Inner-City Residents (23)
- Rural Health (133)
- Screening (457)
- Sepsis (140)
- Sex Factors (67)
- Sexual Health (126)
- Sickle Cell Disease (49)
- Simulation (48)
- Skin Conditions (121)
- Sleep Problems (70)
- Social Determinants of Health (355)
- Social Media (46)
- Social Stigma (52)
- Stress (71)
- Stroke (162)
- Substance Abuse (299)
- Surgery (1110)
- Surveys on Patient Safety Culture (13)
- System Design (15)
- Teams (137)
- TeamSTEPPS (17)
- Telehealth (256)
- Tobacco Use (83)
- Tobacco Use: Smoking Cessation (22)
- Tools & Toolkits (49)
- Training (143)
- Transitions of Care (192)
- Transplantation (141)
- Trauma (104)
- Treatments (185)
- U.S. Preventive Services Task Force (USPSTF) (217)
- Uninsured (80)
- Urban Health (92)
- Urinary Tract Infection (UTI) (70)
- Vaccination (158)
- Vitamins and Supplements (10)
- Vulnerable Populations (229)
- Web-Based (84)
- Women (545)
- Workflow (66)
- Workforce (89)
- Young Adults (85)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
151 to 175 of 12139 Research Studies DisplayedSchulte A, Biggs MA
Association between facility and clinician characteristics and family planning services provided during U.S. outpatient care visits.
The purpose of this study was to characterize the provision of family planning services in outpatient care settings and evaluate variation by facility and clinician characteristics. The researchers utilized National Ambulatory Medical Care Survey data, to evaluate family planning service provision by facility location, facility type, physician specialty, types of clinicians seen, and if the patient was seen by their primary care provider. The sample used for analysis included 53,489 patient visits between 2011 and 2019 with reproductive-age (15-49 years) individuals. Family planning services were provided at 8% of total sampled visits and were more likely to be provided in urban compared with rural areas and at community health centers compared with private physician practices. Family planning services were also more likely to be provided when the patient saw a physician assistant or nurse compared with only a physician. After controlling for observed covariates, measures of between-clinician heterogeneity demonstrated broad variation in which clinicians offered family planning services.
AHRQ-funded; HS022241.
Citation: Schulte A, Biggs MA .
Association between facility and clinician characteristics and family planning services provided during U.S. outpatient care visits.
Womens Health Issues 2023 Nov-Dec; 33(6):573-81. doi: 10.1016/j.whi.2023.06.008..
Keywords: Ambulatory Care and Surgery, Maternal Care, Women, Sexual Health
Zondlak AN, Oh EJ, Neiman PU
Association of intellectual disability with delayed presentation and worse outcomes in emergency general surgery.
Individuals with intellectual disabilities may be at higher risk of delayed presentation and worse outcomes for emergency general surgery (EGS) conditions. The purpose of this study was to explore the relationship between intellectual disability and both severity of disease and clinical outcomes in patients presenting with typical EGS conditions. The study found that of 1,317,572 adult EGS admissions, 0.38% of patients had an ICD-9/-10 code consistent with current intellectual disability. EGS patients with intellectual disabilities had 31% greater odds of more severe disease at presentation when compared with neurotypical patients. Intellectual disability was also related with a higher likelihood of complications and mortality, longer lengths of stay, lower rate of discharge to home, and higher inpatient costs.
AHRQ-funded; HS028672; HS027788.
Citation: Zondlak AN, Oh EJ, Neiman PU .
Association of intellectual disability with delayed presentation and worse outcomes in emergency general surgery.
Ann Surg 2023 Nov 1; 278(5):e1118-e22. doi: 10.1097/sla.0000000000005863..
Keywords: Healthcare Cost and Utilization Project (HCUP), Disabilities, Surgery, Outcomes
Marcotte LM, Deeds S, Wheat C
Automated opt-out vs opt-in patient outreach strategies for breast cancer screening: a randomized clinical trial.
The objective of this study was to evaluate the effect on breast cancer screening of an opt-out automatic mammography referral strategy compared with an opt-in automated telephone message strategy. Participants in the pragmatic randomized clinical trial, conducted at a Veterans Affairs (VA) medical center, were female veterans aged 45-75 eligible for breast cancer screening and enrolled in VA primary care. The results indicated that the opt-out population-based breast cancer screening outreach approach compared with an opt-in approach did not result in a significant difference in mammography completion, but did lead to more canceled mammography referrals, which increased staff burden.
AHRQ-funded; HS026369.
Citation: Marcotte LM, Deeds S, Wheat C .
Automated opt-out vs opt-in patient outreach strategies for breast cancer screening: a randomized clinical trial.
JAMA Intern Med 2023 Nov; 183(11):1187-94. doi: 10.1001/jamainternmed.2023.4321..
Keywords: Cancer: Breast Cancer, Cancer, Screening, Prevention, Health Promotion
Bauer TM, Yaser JM, Daramola T
Cardiac rehabilitation reduces two-year mortality after coronary artery bypass grafting.
This study analyzed the outcome of cardiac rehabilitation (CR) use for patients who have undergone coronary revascularization procedures. The study looked at Medicare fee-for-service claims linked to surgical data patients discharged alive following isolated coronary artery bypass grafting (CABG) from January 2015 to October 2019. A total of 3,848/6,412 (60.0%) of patients were enrolled in CR for an average of 23.2 sessions with 770/6,412 (12.0%) completing all recommended 36 sessions. Predictors of post-discharge CR use included increasing age, discharge to home (vs extended care facility), and shorter length of stay. Unadjusted and inverse probability treatment weighting (IPTW) analyses showed significant reduction in 2-year mortality in CR users as compared to CR non-users (unadjusted 9.4%).
AHRQ-funded; HS027830.
Citation: Bauer TM, Yaser JM, Daramola T .
Cardiac rehabilitation reduces two-year mortality after coronary artery bypass grafting.
Ann Thorac Surg 2023 Nov; 116(5):1099-105. doi: 10.1016/j.athoracsur.2023.05.044..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Surgery, Mortality, Outcomes
Ramanathan S, Yan CH, Hubbard C
Changes in antibiotic prescribing by dentists in the United States, 2012-2019.
Dentists are the top specialty prescriber of antibiotics in the United States, prescribing 10% of all outpatient antibiotics. The purpose of this retrospective study was to assess trends in the rates of antibiotic prescribing by dentists. The researchers also evaluated if trends varied by agent, specialty, and patient characteristics. The study found that between 2012 and 2019 dentists wrote more than 216 million antibiotic prescriptions. The annual rate of dental antibiotic prescribing remained steady over time. However, the dental prescribing rate increased in the Northeast, among oral and maxillofacial surgeons, prosthodontists, endodontists, periodontists, and for amoxicillin. The mean days' supply significantly decreased over the study period by 0.023 days per 1,000 dentists per year.
AHRQ-funded; HS025177.
Citation: Ramanathan S, Yan CH, Hubbard C .
Changes in antibiotic prescribing by dentists in the United States, 2012-2019.
Infect Control Hosp Epidemiol 2023 Nov; 44(11):1725-30. doi: 10.1017/ice.2023.151..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Dental and Oral Health
Parikh K, Lopez MA, Hall M
Child Opportunity Index and rehospitalization for ambulatory care sensitive conditions at US children's hospitals.
Lower Child Opportunity Index (COI) has been related with increased health care use, but the relationship with rehospitalization(s) for ambulatory care sensitive conditions (ACSC) is not known. The purpose of this multicenter retrospective cohort study was to determine the relationship between COI and ACSC rehospitalizations. 184,478 children ages 0 to 17 years with a hospital admission for ambulatory care sensitive conditions in 2017 or 2018 were included. Exposure was COI, and the primary outcome was rehospitalization within 1 year of index admission for ACSC. Of hospitalizations, 28.3% were by children from very low COI and 16.5% were by children from very high COI neighborhoods. In risk-adjusted models, ACSC rehospitalization was higher for children from very low COI than very high COI neighborhoods; any rehospitalization occurred for 18.7% from very low COI and 13.5% from very high COI neighborhoods whereas 2 or more rehospitalization occurred for 4.8% from very low COI and 3.2% from very high COI neighborhoods.
AHRQ-funded; HS024554; HS028484; HS026385.
Citation: Parikh K, Lopez MA, Hall M .
Child Opportunity Index and rehospitalization for ambulatory care sensitive conditions at US children's hospitals.
Hosp Pediatr 2023 Nov; 13(11):1028-37. doi: 10.1542/hpeds.2023-007279..
Keywords: Children/Adolescents, Hospital Readmissions, Hospitals, Ambulatory Care and Surgery
Meiselbach MK, Huskamp HA, Eddelbuettel JCP
Choice of high-deductible health plans among enrollees with a substance use disorder.
Researchers examined factors associated with the decision of individuals with substance use disorders (SUDs) to enroll in high-deductible health plans (HDHPs). They used de-identified administrative commercial claims and enrollment data from OptumLabs to identify individuals at employers that offered at least one HDHP and one non-HDHP plan. Their findings showed that a health reimbursement arrangement was associated with a higher probability of new and re-enrollment in an HDHP. Older enrollees with SUD were less likely to enroll in a new HDHP, while enrollees who were non-White, lower income, and in lower educational attainment census blocks were more likely to newly enroll. The researchers concluded that, given the emerging evidence that HDHPs may discourage SUD treatment, higher HDHP enrollment could exacerbate health disparities.
AHRQ-funded; HS000029.
Citation: Meiselbach MK, Huskamp HA, Eddelbuettel JCP .
Choice of high-deductible health plans among enrollees with a substance use disorder.
J Subst Use Addict Treat 2023 Nov; 154:209152. doi: 10.1016/j.josat.2023.209152.
.
.
Keywords: Health Insurance, Substance Abuse, Behavioral Health
Bierman AS, Mistry KB
AHRQ Author: Bierman AS, Mistry KB
Commentary: Achieving health equity - the role of learning health systems.
The article discussed learning health systems and their role in achieving health equity. Issues considered were prioritization of health equity, development and implementation of models of care, partnerships with patients and communities, research on the effectiveness of interventions across diverse populations, integration strategies, and multisector collaborations to address social needs. The authors concluded that by considering these issues, learning health systems can play a pivotal role in eliminating health inequities.
AHRQ-authored.
Citation: Bierman AS, Mistry KB .
Commentary: Achieving health equity - the role of learning health systems.
Healthc Policy 2023 Nov; 19(2):21-27. doi: 10.12927/hcpol.2023.27236..
Keywords: Learning Health Systems, Health Systems, Disparities
Zhong A, Amat MJ, Anderson TS
Completion of recommended tests and referrals in telehealth vs in-person visits.
The purpose of this retrospective cohort study was to explore the prevalence of diagnostic loop closure for tests and referrals ordered at telehealth visits when compared to in-person visits and characterize related factors. The study included test and referral orders for 4,133 patients A total 27.8% of the orders were placed during a telehealth visit. The study found that of the telehealth orders, 42.6% were completed within the designated time frame vs 58.4% of those ordered during in-person visits and 57.4% of those ordered without a visit. In an adjusted analysis, when compared with patients with in persons visits, patients with telehealth visits were less likely to close the loop for all test types.
AHRQ-funded; HS027282.
Citation: Zhong A, Amat MJ, Anderson TS .
Completion of recommended tests and referrals in telehealth vs in-person visits.
JAMA Netw Open 2023 Nov; 6(11):e2343417. doi: 10.1001/jamanetworkopen.2023.43417..
Keywords: Telehealth, Health Information Technology (HIT), Patient Adherence/Compliance
Stevens ER, Caverly T, Butler JM
Considerations for using predictive models that include race as an input variable: the case study of lung cancer screening.
Indiscriminate use of predictive models incorporating race can reinforce biases present in source data and lead to an exacerbation of health disparities. In some countries, such as the United States, there is therefore a push to remove race from prediction models; however, there are still many prediction models that use race as an input. Biomedical informaticists who are given the responsibility of using these predictive models in healthcare environments are likely to be faced with questions like how to deal with race covariates in these models. The authors report that there is a need for a practical framework to facilitate model user thinking on how to incorporate race in their chosen model to avoid inadvertently amplifying disparities. The purpose of this paper is to utilize a case study of lung cancer screening to propose a simple framework to guide model users in approaching race inputs in the predictive models they are attempting to leverage in electronic health records and clinical workflows.
AHRQ-funded; HS028791.
Citation: Stevens ER, Caverly T, Butler JM .
Considerations for using predictive models that include race as an input variable: the case study of lung cancer screening.
J Biomed Inform 2023 Nov; 147:104525. doi: 10.1016/j.jbi.2023.104525..
Keywords: Cancer: Lung Cancer, Cancer, Racial and Ethnic Minorities
Daw JR, Yekta S, Jacobson-Davies FE
Consistency and adequacy of public and commercial health insurance for US children, 2016 to 2021.
This study used the 2016 to 2021 National Survey of Children’s Health to compare overall rates, COVID-19 public health emergency-related changes, and child and family characteristics associated with inconsistent and inadequate coverage for publicly and commercially insured children. The authors were looking at inconsistent insurance, defined by failure to meet 3 criteria: (1) benefits usually/always sufficient to meet child's needs; (2) coverage usually/always allows child to access needed health care practitioners; and (3) no or usually/always reasonable annual out-of-pocket payments for child's health care. Of this nationally representative sample of 203,691 insured children, 34.5% were publicly insured (mean age 8.4 [4.1] years; 47.4% female) and 65.5% were commercially insured (mean age, 8.7 [5.6]; 49.1% female). Most publicly insured children were either non-Hispanic Black (20.9%) or Hispanic (36.4%); living with 2 married parents (38.4%) or a single parent (33.1%); and had a household income less than 200% of the federal poverty level (79%); and most commercially insured children were non-Hispanic White (62.8%), living with 2 married parents (79.0%); and had a household income of 400% of the federal poverty level or higher (49.1%). Compared with commercially insured children, publicly insured children had higher rates of inconsistent coverage (4.2% vs 1.4%; difference, 2.7 percentage points [pp]) and lower rates of inadequate coverage (12.2% vs 33.0%; difference). Compared with the period from 2016 to 2019, inconsistent insurance decreased by 42% for publicly insured children and inadequate insurance decreased by 6% for commercially insured children during the COVID-19 public health emergency (PHE) (2020-2021).
AHRQ-funded; HS029159.
Citation: Daw JR, Yekta S, Jacobson-Davies FE .
Consistency and adequacy of public and commercial health insurance for US children, 2016 to 2021.
JAMA Health Forum 2023 Nov; 4(11):e234179. doi: 10.1001/jamahealthforum.2023.4179..
Keywords: Children/Adolescents, Health Insurance, COVID-19
Cavallaro SC, Michelson KA, D'Ambrosi G
Critical revisits among children after emergency department discharge.
This retrospective study’s objectives were to determine the rate of critical emergency department (ED) revisits among children discharged from the ED and to identify factors associated with critical revisits. Using the HCUP State ED Databases (SEDD) and State Inpatient Databases (SID), researchers examined data from six states, including patients under 21 years old. The findings indicated that critical ED revisits after discharge were uncommon and patient death within three days of ED discharge were rare; patients with complex chronic conditions were more likely to have a critical ED revisit. The researchers concluded that future research should focus on understanding higher risk among patients with asthma or a history of complex chronic conditions.
AHRQ-funded; HS026503.
Citation: Cavallaro SC, Michelson KA, D'Ambrosi G .
Critical revisits among children after emergency department discharge.
Ann Emerg Med 2023 Nov; 82(5):575-82. doi: 10.1016/j.annemergmed.2023.06.006..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Hospital Discharge
DiMeo A, Karlage A, Schoenherr K
Cultural brokering in pregnancy care: a critical review.
This study is a literature review of cultural brokering during pregnancy. The authors identified 33 articles in their literature search. They found that cultural brokering is not clearly defined in the current literature. Only a few articles provided information about language concordance between cultural brokers and patients or clinicians, with no articles describing the impact of cultural brokering on health outcomes. Cultural broker facilitating was described as providing information about language concordance between cultural brokers and patients or clinicians. Barriers included misunderstanding the responsibilities, difficulty maintaining personal boundaries, and limited availability and accessibility of cultural brokers. They propose cultural brokering as interactions that cover four key aims: (1) language support; (2) bridging cultural differences; (3) social support and advocacy; and (4) navigation of the healthcare system.
AHRQ-funded; HS026370.
Citation: DiMeo A, Karlage A, Schoenherr K .
Cultural brokering in pregnancy care: a critical review.
Int J Gynaecol Obstet 2023 Nov; 163(2):357-66. doi: 10.1002/ijgo.15063..
Keywords: Maternal Care, Women, Clinician-Patient Communication, Cultural Competence
Baghdadi JD, O'Hara LM, Johnson JK
Diagnostic stewardship to support optimal use of multiplex molecular respiratory panels: a survey from the Society for Healthcare Epidemiology of America Research Network.
This study’s objective was to explore current and future approaches to diagnostic stewardship of multiplex polymerase chain reaction (PCR) respiratory panels. The authors conducted a survey of the Society for Healthcare Epidemiology of America Research Network, with 41 sites completing the survey (response rate, 50%). Results of the survey were that multiplex PCR respiratory panels were perceived as supporting accurate diagnoses at 35 sites (85%), supporting more efficient patient care at 33 sites (80%), and improving patient outcomes at 23 sites (56%). Additionally, 24 sites (58%) had implemented diagnostic stewardship, with a median of 3 interventions (interquartile range, 1-4) per site. The interventions most frequently reported as effective were structured order sets to guide test ordering (4 sites), restrictions on test ordering based on clinician or patient characteristics (3 sites), and structured communication of results (2 sites), with 3 sites reporting that education was “helpful” but with limitations.
AHRQ-funded; HS028854.
Citation: Baghdadi JD, O'Hara LM, Johnson JK .
Diagnostic stewardship to support optimal use of multiplex molecular respiratory panels: a survey from the Society for Healthcare Epidemiology of America Research Network.
Infect Control Hosp Epidemiol 2023 Nov; 44(11):1823-28. doi: 10.1017/ice.2023.72..
Keywords: Diagnostic Safety and Quality, Respiratory Conditions
Winer JC, Richardson T, Berg KJ
Effect modifiers of the association of high-flow nasal cannula and bronchiolitis length of stay.
In hospitalized children with bronchiolitis, the use of High-flow nasal cannula (HFNC) therapy is related with a longer length of stay (LOS) when used outside of the ICU. The purpose of this study was to explore the relationship between HFNC and LOS to determine if demographic and clinical factors modify the effect of HFNC usage on LOS. Of 8,060 included patients, 27.0% received HFNC during admission. The study found that age group, weight, complex chronic condition, initial tachypnea, initial desaturation, and ICU services were significantly related with LOS. The effect of HFNC on LOS varied among hospitals (P < .001), with the estimated increase in LOS ranging from 32% to 139%. 1- to 6-month-old infants, patients without initial desaturation, and patients without ICU services had the highest relationship between HFNC and LOS, respectively.
AHRQ-funded; HS026006.
Citation: Winer JC, Richardson T, Berg KJ .
Effect modifiers of the association of high-flow nasal cannula and bronchiolitis length of stay.
Hosp Pediatr 2023 Nov; 13(11):1018-27. doi: 10.1542/hpeds.2023-007295..
Keywords: Children/Adolescents, Respiratory Conditions, Hospitalization
O'Leary KJ, Johnson JK, Williams MV
Effect of complementary interventions to redesign care on teamwork and quality for hospitalized medical patients: a pragmatic controlled trial.
The objective of this pragmatic controlled trial was to evaluate the effect of interventions to redesign hospital care delivery on teamwork and patient outcomes. Survey participants were healthcare professionals and hospitalized medical patients in medical units at four U.S. hospitals. The results showed that the median teamwork climate score was higher after the intervention among nurses, but that interventions to redesign care for hospitalized patients were not associated with improved patient outcomes.
AHRQ-funded; HS02564.
Citation: O'Leary KJ, Johnson JK, Williams MV .
Effect of complementary interventions to redesign care on teamwork and quality for hospitalized medical patients: a pragmatic controlled trial.
Ann Intern Med 2023 Nov; 176(11):1456-64. doi: 10.7326/m23-0953..
Keywords: Teams, Inpatient Care, Hospitals, Quality of Care, Outcomes
Molloy MJ, Auger KA, Hall M
Epidemiology and severity of illness of MIS-C and Kawasaki Disease during the COVID-19 pandemic.
Researchers sought to understand the illness severity of multisystem inflammatory syndrome in children (MIS-C) compared with Kawasaki disease (KD) and to evaluate changes in MIS-C illness severity over time during the coronavirus pandemic. Data on the hospitalization of children with MIS-C and KD were taken from the Pediatric Health Information System administrative database. The results showed a higher proportion of hospitalizations with shock for MIS-C compared with KD, but a significant decrease in the odds of shock in MIS-C patients was observed over time; MIS-C was a source of lower morbidity than KD as the pandemic progressed. The researchers concluded that their findings provide evidence that MIS-C is a distinct condition from KD.
AHRQ-funded; HS026763; HS028102.
Citation: Molloy MJ, Auger KA, Hall M .
Epidemiology and severity of illness of MIS-C and Kawasaki Disease during the COVID-19 pandemic.
Pediatrics 2023 Nov 1; 152(5). doi: 10.1542/peds.2023-062101..
Keywords: Children/Adolescents, COVID-19
Mahenthiran AK, Logan CD, Janczewski LM
Evaluation of nationwide trends in nodal sampling guideline adherence for gastric cancer: 2005-2017.
This study’s purpose was to evaluate trends in program-level disparities in adherence to gastric cancer nodal sampling guidelines. The cohort included 55,421 patients who underwent resection of gastric cancer from 2005 to 2017 identified in the National Cancer Database. Of that total 27,201 (49.1%) of patients met adherence criteria for lymph node sampling. Academic hospitals treated 44.4% of the total cohort. Overall, lymph node sampling criteria were met in 59.2% of patients treated at high-volume academic programs and 37.0% of patients treated at low-volume nonacademic programs. Adherence rates improved overall from 2005 to 2017 for both low-volume nonacademic programs (27.8% in 2005 to 50.1% in 2017) and high-volume academic programs (46.0% in 2005 to 69.8% in 2017).
AHRQ-funded; HS026385.
Citation: Mahenthiran AK, Logan CD, Janczewski LM .
Evaluation of nationwide trends in nodal sampling guideline adherence for gastric cancer: 2005-2017.
J Surg Res 2023 Nov; 291:514-26. doi: 10.1016/j.jss.2023.07.011..
Keywords: Cancer, Guidelines, Evidence-Based Practice
Salinas KE, Bazan M, Rivera L
Experiences and communication preferences in pregnancy care among patients with a Spanish language preference: a qualitative study.
The purpose of this study was to explore Spanish-speaking patients' experiences and preferences regarding communication during pregnancy care with specific attention to language barriers. The researchers conducted focus groups with patients with a Spanish language preference who gave birth between July 2022 and February 2023 at an academic medical center. A total of seven focus groups with 27 total participants were held. The study identified three key themes regarding preferences in patient experiences and communication when seeking pregnancy care: 1. language discordance and concordance between patients and clinicians exist on a spectrum and are not binary; 2. language-discordant care presents communication challenges, even when interpreters are present; and 3. language discordance can be effectively addressed with positive interpersonal engagements between clinicians and patients.
AHRQ-funded; HS026370.
Citation: Salinas KE, Bazan M, Rivera L .
Experiences and communication preferences in pregnancy care among patients with a Spanish language preference: a qualitative study.
Obstet Gynecol 2023 Nov 1; 142(5):1227-36. doi: 10.1097/aog.0000000000005369..
Keywords: Maternal Care, Women, Communication, Cultural Competence, Racial and Ethnic Minorities
Scott JW, Knowlton LM, Murphy P
Financial toxicity after trauma and acute care surgery: from understanding to action.
The negative impact of major injuries and surgical emergencies on patients’ long-term financial wellbeing is a factor that is often overlooked by clinicians and researchers. The concept of financial toxicity includes the objective financial repercussions of illness and medical care and also subjective financial concerns of patients. The purpose of this review was to 1) provide a conceptual overview of financial toxicity after trauma or emergency surgery, 2) outline what is known about the long-term economic outcomes among trauma and emergency surgery patients, 3) examine the relationship between financial toxicity and long-term physical and mental health outcomes, 4) describe policies and programs that may mitigate financial toxicity, and 5) identify the current knowledge gaps and urgent next steps for clinicians and researchers engaged in this area of work.
AHRQ-funded; HS028672.
Citation: Scott JW, Knowlton LM, Murphy P .
Financial toxicity after trauma and acute care surgery: from understanding to action.
J Trauma Acute Care Surg 2023 Nov 1; 95(5):800-05. doi: 10.1097/ta.0000000000003979..
Keywords: Healthcare Costs, Trauma, Surgery
Kang-Yi CD, Kuriyan A, Kinkler G
Generating actionable evidence for school-based mental health service delivery: public-academic partnership based evaluations.
This paper reported the key findings of evaluations of Philadelphia's school mental health programs reimbursable through Medicaid billing since 2008. The evaluations included acute mental health service use of children who received school-based care and Medicaid expenditure, children's behaviors to measure school mental health providers' performance, and effects of school mental health programs on children's behavioral health functioning, school outcomes, and other service usage. The paper discussed how programs have been refined based on evaluation results, and shared lessons learned for successful public-academic partnership-based evaluations.
AHRQ-funded; HS026862.
Citation: Kang-Yi CD, Kuriyan A, Kinkler G .
Generating actionable evidence for school-based mental health service delivery: public-academic partnership based evaluations.
Community Ment Health J 2023 Nov; 59(8):1588-600. doi: 10.1007/s10597-023-01147-5..
Keywords: Children/Adolescents, Behavioral Health, Healthcare Delivery, Community-Based Practice
Luo BT, Barton HJ, Wooldridge AR
Human factors engineering for the pediatric hospitalist.
The authors summarized how human factors engineering (HFE) can provide a framework and tools to help understand and improve complex care processes and resulting outcomes. They offered examples of HFE's application to pediatric hospital medicine, highlighted an HFE-based framework, provided tools for leveraging this model, and listed resources for those interested in learning more about HFE.
AHRQ-funded; HS027214.
Citation: Luo BT, Barton HJ, Wooldridge AR .
Human factors engineering for the pediatric hospitalist.
Hosp Pediatr 2023 Nov; 13(11):e365-e70. doi: 10.1542/hpeds.2023-007258..
Keywords: Children/Adolescents, Hospitals, Provider: Clinician
Kerlikowske K, Bissell MCS, Sprague BL
Impact of BMI on prevalence of dense breasts by race and ethnicity.
Researchers evaluated differences in body mass index (BMI) in relation to differences in dense breasts prevalence by race/ethnicity. Their results indicated that dense breasts were most prevalent among Asian women followed by non-Hispanic White, Hispanic, and Black women. Clinically important differences in breast density prevalence are present across racial/ethnic groups after accounting for age, menopausal status, and BMI. IMPACT: If breast density is the sole criterion used to notify women of dense breasts and discuss supplemental screening it may result in implementing inequitable screening strategies across racial/ethnic groups.
AHRQ-funded; HS018366.
Citation: Kerlikowske K, Bissell MCS, Sprague BL .
Impact of BMI on prevalence of dense breasts by race and ethnicity.
Cancer Epidemiol Biomarkers Prev 2023 Nov; 32(11):1524-30. doi: 10.1158/1055-9965.Epi-23-0049..
Keywords: Obesity, Women, Racial and Ethnic Minorities, Cancer: Breast Cancer, Cancer, Imaging
Kelm JD, Aubry ST, Cain-Nielsen AH
Impact of state opioid laws on prescribing in trauma patients.
In this cross-sectional study, researchers compared oral morphine equivalents prescribed at discharge before and after the implementation of Michigan's Public Act 251, which established a state-wide policy that limited opioid prescriptions for acute pain to a 7-day supply. Subjects were adult patients who received oral opioids at discharge from a Level 1 trauma center. The findings indicated that prescription amounts for opioids in trauma patients decreased by approximately one-half following the implementation of Public Act 251; there was no compensatory increase in subsequent refill prescriptions. The researchers concluded that further work is needed to evaluate the effect of such policies on pain management and functional recovery after injury.
AHRQ-funded; HS028672; HS027788.
Citation: Kelm JD, Aubry ST, Cain-Nielsen AH .
Impact of state opioid laws on prescribing in trauma patients.
Surgery 2023 Nov; 174(5):1255-62. doi: 10.1016/j.surg.2023.08.006..
Keywords: Opioids, Policy, Medication
Kukhareva PV, Li H, Caverly TJ
Implementation of lung cancer screening in primary care and pulmonary clinics: pragmatic clinical trial of electronic health record-integrated everyday shared decision-making tool and clinician-facing prompts.
The authors conducted pre- and post-intervention analysis in primary care and pulmonary clinics to explore whether clinician-facing electronic health record (EHR) prompts and an EHR-integrated shared decision-making (SDM) tool designed to support incorporation of SDM into primary care could improve low-dose computer tomography scan imaging ordering and completion. Subjects were patients who met US Preventive Services Task Force criteria for lung cancer screening (LCS). The results indicated that EHR prompts and the EHR-integrated SDM tool were promising approaches to improving LCS in the primary care setting. The authors noted that further research is warranted.
AHRQ-funded; HS026198; HS028791.
Citation: Kukhareva PV, Li H, Caverly TJ .
Implementation of lung cancer screening in primary care and pulmonary clinics: pragmatic clinical trial of electronic health record-integrated everyday shared decision-making tool and clinician-facing prompts.
Chest 2023 Nov; 164(5):1325-38. doi: 10.1016/j.chest.2023.04.040..
Keywords: Cancer: Lung Cancer, Cancer, Screening, Primary Care, Electronic Health Records (EHRs), Health Information Technology (HIT), Decision Making