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 (5)
- Adverse Drug Events (ADE) (1)
- Adverse Events (3)
- Cancer (2)
- Cardiovascular Conditions (1)
- Children/Adolescents (1)
- Chronic Conditions (2)
- Clinical Decision Support (CDS) (2)
- Clostridium difficile Infections (1)
- Comparative Effectiveness (1)
- COVID-19 (1)
- Dialysis (1)
- Disparities (4)
- Education: Patient and Caregiver (2)
- Emergency Department (1)
- Evidence-Based Practice (2)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (5)
- Health Promotion (1)
- Health Services Research (HSR) (3)
- Heart Disease and Health (1)
- Hospitalization (1)
- Hospital Readmissions (1)
- Hospitals (1)
- Injuries and Wounds (1)
- Kidney Disease and Health (5)
- Medical Errors (1)
- Medication (3)
- Medication: Safety (2)
- Mortality (4)
- Outcomes (4)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (2)
- Patient Safety (1)
- Policy (1)
- Prevention (1)
- Provider (1)
- Provider: Pharmacist (2)
- Provider: Physician (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (3)
- Registries (1)
- Respiratory Conditions (1)
- Risk (4)
- Shared Decision Making (5)
- Sickle Cell Disease (1)
- Social Determinants of Health (1)
- Surgery (4)
- Telehealth (2)
- (-) Transplantation (27)
- Workforce (1)
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
1 to 25 of 27 Research Studies DisplayedThorsness R, Wang V, Patzer RE
Association of social risk factors with home dialysis and kidney transplant rates in dialysis facilities.
This study examines rates of home dialysis and transplant at dialysis facilities that serve patients with high social risk to understand how they fare under the End-Stage Renal Disease Treatment Choices Model.
AHRQ-funded; HS028285.
Citation: Thorsness R, Wang V, Patzer RE .
Association of social risk factors with home dialysis and kidney transplant rates in dialysis facilities.
JAMA 2021 Dec 14;326(22):2323-25. doi: 10.1001/jama.2021.18372..
Keywords: Dialysis, Kidney Disease and Health, Transplantation, Risk
Krissberg JR, Kaufmann MB, Gupta A
Racial disparities in pediatric kidney transplantation under the new Kidney Allocation System in the United States.
This study aimed to assess how implementation of the 2014 Kidney Allocation System (KAS) affected racial and ethnic disparities in pediatric kidney transplantation access and related outcomes. The authors performed a retrospective cohort study of children <18 years of age active on the kidney transplant list from 2008 to 2019 using the Scientific Registry of Transplant Recipients. Results found that all children experienced longer wait times from activation to transplantation post-KAS. Although they found that Black and Hispanic children and other children of color experienced longer times from activation to transplant compared with White children in both eras; this finding was largely attenuated after multivariable analysis. Multivariable analysis also showed that racial and ethnic disparities in time from dialysis initiation to transplantation in the pre-KAS era were lessened in the post-KAS era. No disparities were found in odds of delayed graft function, however Black and Hispanic children experienced longer times with a functioning graft in the post-KAS era.
AHRQ-funded; HS026128.
Citation: Krissberg JR, Kaufmann MB, Gupta A .
Racial disparities in pediatric kidney transplantation under the new Kidney Allocation System in the United States.
Clin J Am Soc Nephrol 2021 Dec; 16(12):1862-71. doi: 10.2215/cjn.06740521..
Keywords: Disparities, Racial and Ethnic Minorities, Kidney Disease and Health, Transplantation
Valbuena VSM, Obayemi JE, Purnell TS
Gender and racial disparities in the transplant surgery workforce.
This review explores trends in the United States (US) transplant surgery workforce with a focus on historical demographics, post-fellowship job market, and quality of life reported by transplant surgeons. Ongoing efforts to improve women and racial/ethnic minority representation in transplant surgery are highlighted in this paper. Future directions to create a transplant workforce that reflects the diversity of the US population are discussed.
AHRQ-funded; HS024600; HS000053.
Citation: Valbuena VSM, Obayemi JE, Purnell TS .
Gender and racial disparities in the transplant surgery workforce.
Curr Opin Organ Transplant 2021 Oct 1;26(5):560-66. doi: 10.1097/mot.0000000000000915..
Keywords: Workforce, Provider: Physician, Transplantation, Racial and Ethnic Minorities
Taber DJ, Fleming JN, Su Z
Significant hospitalization cost savings to the payer with a pharmacist-led mobile health intervention to improve medication safety in kidney transplant recipients.
This paper examined hospitalization cost savings to the payer with a pharmacist-led mobile health intervention to improve medication safety in kidney transplant recipients. This study was an economic analysis of a 12-month, parallel arm, randomized controlled trial in adult kidney recipients 6 to 36 months posttransplant (NCT03247322). All participants received usual posttransplant care, while the intervention arm received supplemental clinical pharmacist-led medication therapy monitoring and management, via a smartphone-enabled mHealth app, integrated with risk-based televisits.
AHRQ-funded; HS023754.
Citation: Taber DJ, Fleming JN, Su Z .
Significant hospitalization cost savings to the payer with a pharmacist-led mobile health intervention to improve medication safety in kidney transplant recipients.
Am J Transplant 2021 Oct;21(10):3428-35. doi: 10.1111/ajt.16737..
Keywords: Healthcare Costs, Provider: Pharmacist, Telehealth, Health Information Technology (HIT), Transplantation, Hospitalization, Medication: Safety, Medication
Purnell TS, Simpson DC, Callender CO
Dismantling structural racism as a root cause of racial disparities in COVID-19 and transplantation.
As the United States faces unparalleled challenges due to COVID-19, racial disparities in health and healthcare have once again taken center stage. If effective interventions to address racial disparities in transplantation, including those magnified by COVID-19, are to be designed and implemented at the national level, it is first critical to understand the complex mechanisms by which structural, institutional, interpersonal, and internalized racism influence the presence of racial disparities in healthcare and transplantation. IN this article the authors discuss their viewpoint.
AHRQ-funded; HS024600.
Citation: Purnell TS, Simpson DC, Callender CO .
Dismantling structural racism as a root cause of racial disparities in COVID-19 and transplantation.
Am J Transplant 2021 Jul;21(7):2327-32. doi: 10.1111/ajt.16543..
Keywords: COVID-19, Racial and Ethnic Minorities, Disparities, Transplantation, Surgery, Access to Care
Chu S, Bruin MJ, McKinney WT
Design of a patient-centered decision support tool when selecting an organ transplant center.
Patients in the US in need of a life-saving organ transplant must complete a long process of medical decisions, and a first step is to identify a transplant center to complete an evaluation. This study described a patient-centered process of testing and refinement of a new website (www.transplantcentersearch.org) that was developed to provide data to patients who are seeking a transplant center.
AHRQ-funded; HS026379; HS024527.
Citation: Chu S, Bruin MJ, McKinney WT .
Design of a patient-centered decision support tool when selecting an organ transplant center.
PLoS One 2021 May 17;16(5):e0251102. doi: 10.1371/journal.pone.0251102..
Keywords: Transplantation, Patient-Centered Healthcare, Shared Decision Making, Health Information Technology (HIT)
Gonzales HM, Fleming JN, Gebregziabher M
Pharmacist-led mobile health intervention and transplant medication safety: a randomized controlled clinical trial.
The goal of this study was to examine the efficacy of improving medication safety through a pharmacist-led, mobile health-based intervention. In this single-center study of adult kidney recipients 6-36 months post-transplant, findings showed that participants receiving the intervention experienced a significant reduction in medication errors and a significantly lower incidence risk of Grade 3 or higher adverse events. The intervention arm also demonstrated significantly lower rates of hospitalizations.
AHRQ-funded; HS023754.
Citation: Gonzales HM, Fleming JN, Gebregziabher M .
Pharmacist-led mobile health intervention and transplant medication safety: a randomized controlled clinical trial.
Clin J Am Soc Nephrol 2021 May 8;16(5):776-84. doi: 10.2215/cjn.15911020..
Keywords: Medication: Safety, Medication, Patient Safety, Transplantation, Telehealth, Health Information Technology (HIT), Provider: Pharmacist, Provider, Medical Errors, Adverse Drug Events (ADE), Adverse Events
Schaffhausen CR, Bruin MJ, Chu S
Designing a liver transplant patient and family decision support tool for organ offer decisions.
For liver transplant candidates on the waiting list, deciding to accept a donor organ with known or potential risk factors can be stressful and can lead to declined offers. Current education for patients and family often takes place during transplant evaluations and can be overwhelming and result in low retention and poor understanding of donor quality. In this study, the investigators sought to understand provider experiences when counseling patients about donor risks and donor offers.
AHRQ-funded; HS026379; HS024527.
Citation: Schaffhausen CR, Bruin MJ, Chu S .
Designing a liver transplant patient and family decision support tool for organ offer decisions.
Transplant Direct 2021 May;7(5):e695. doi: 10.1097/txd.0000000000001140..
Keywords: Transplantation, Shared Decision Making, Education: Patient and Caregiver
Schulz GL, Kelly KP, Holtmann M
Navigating decisional conflict as a family when facing the decision of stem cell transplant for a child or adolescent with sickle cell disease.
Patients with sickle cell disease (SCD) face unpredictable disease, with stem cell transplant being a curative treatment option with risks. The aim of this study was to describe the level and source of decisional conflict in families of children/adolescents with SCD facing a transplant decision. The investigators concluded that varying levels and sources of decisional conflict existed in pediatric patients with SCD and their families considering transplant.
AHRQ-funded; HS022140.
Citation: Schulz GL, Kelly KP, Holtmann M .
Navigating decisional conflict as a family when facing the decision of stem cell transplant for a child or adolescent with sickle cell disease.
Patient Educ Couns 2021 May;104(5):1086-93. doi: 10.1016/j.pec.2020.10.011..
Keywords: Children/Adolescents, Sickle Cell Disease, Chronic Conditions, Transplantation, Shared Decision Making
Bae S, Johnson M, Massie AB
Mortality and access to kidney transplantation in patients with sickle cell disease-associated kidney failure.
Patients with sickle cell disease-associated kidney failure have high mortality, which might be lowered by kidney transplantation. However, because they show higher post-transplant mortality compared with patients with other kidney failure etiologies, kidney transplantation remains controversial in this population. In this study, the investigators aimed to quantify the decrease in mortality associated with transplantation in this population and determine the chance of receiving transplantation with sickle cell disease as the cause of kidney failure as compared with other etiologies of kidney failure.
AHRQ-funded; HS024600.
Citation: Bae S, Johnson M, Massie AB .
Mortality and access to kidney transplantation in patients with sickle cell disease-associated kidney failure.
Clin J Am Soc Nephrol 2021 Mar 8;16(3):407-14. doi: 10.2215/cjn.02720320..
Keywords: Transplantation, Access to Care, Kidney Disease and Health, Mortality
Pennington KM, Dykhoff HJ, Yao X
The impact of antifungal prophylaxis in lung transplant recipients.
This study evaluated the effect of antifungal prophylaxis on all-cause mortality and invasive fungal infections (IFI) on lung transplant recipients. Administrative claims data was used to identify adult patients who underwent lung transplantation between 2005 and 2018. The authors identified 662 lung transplant recipients. All-cause mortality was found to be significantly lower in those receiving antifungal prophylaxis compared to those who did not. Patients receiving antifungal prophylaxis also had a lower rate of IFI, but it was not statistically significant.
AHRQ-funded; HS025164; HS025402; HS025517; HS024075.
Citation: Pennington KM, Dykhoff HJ, Yao X .
The impact of antifungal prophylaxis in lung transplant recipients.
Ann Am Thorac Soc 2021 Mar;18(3):468-76. doi: 10.1513/AnnalsATS.202003-267OC..
Keywords: Transplantation, Surgery, Medication, Prevention, Respiratory Conditions, Mortality, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
McKinney WT, Schaffhausen CR, Schladt D
Designing a patient-specific search of transplant program performance and outcomes: feedback from heart transplant candidates and recipients.
The Scientific Registry of Transplant Recipients provides transplant program-specific information, but it is unclear what patients and stakeholders need to know. Acceptance criteria for the candidate waitlist and donor organs vary by program and region, but there is no means to search for programs by the clinical profiles of recipients and donors. The authors examined variability in program-specific characteristics that could influence access to transplantation.
AHRQ-funded; HS026379; HS024527.
Citation: McKinney WT, Schaffhausen CR, Schladt D .
Designing a patient-specific search of transplant program performance and outcomes: feedback from heart transplant candidates and recipients.
Clin Transplant 2021 Feb;35(2):e14183. doi: 10.1111/ctr.14183..
Keywords: Transplantation, Surgery, Heart Disease and Health, Cardiovascular Conditions, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice, Shared Decision Making
Wang W, Rees MA, Leichtman AB
Deceased donors as nondirected donors in kidney paired donation.
As proof of concept, the investigators simulated a revised kidney allocation system that included deceased donor (DD) kidneys as chain-initiating kidneys (DD-CIK) in a kidney paired donation pool (KPDP) and estimated potential increases in number of transplants. They considered chains of length 2 in which the DD-CIK gave to a candidate in the KPDP, and that candidate's incompatible donor donated to the DD waitlist.
AHRQ-funded; HS020610.
Citation: Wang W, Rees MA, Leichtman AB .
Deceased donors as nondirected donors in kidney paired donation.
Am J Transplant 2021 Jan;21(1):103-13. doi: 10.1111/ajt.16268..
Keywords: Transplantation, Kidney Disease and Health
Rodrigue JR, Fleishman A, Fitzpatrick S
Organ donation video messaging in motor vehicle offices: results of a randomized trial.
Since nearly all registered organ donors in the United States signed up via a driver's license transaction, motor vehicle (MV) offices represent an important venue for organ donation education. The researchers evaluated the impact of organ donation video messaging in MV offices. There was a relatively low uptake of the video intervention by customers that most likely contributed to the negative trial finding.
HS022061; HS024204
Citation: Rodrigue JR, Fleishman A, Fitzpatrick S .
Organ donation video messaging in motor vehicle offices: results of a randomized trial.
Prog Transplant 2015 Dec;25(4):332-8. doi: 10.7182/pit2015166..
Keywords: Transplantation, Health Promotion, Education: Patient and Caregiver
Donnelly JP, Wang HE, Locke JE
Hospital-onset Clostridium difficile infection among solid organ transplant recipients.
The researchers examined hospital-onset Clostridium difficile infection (CDI) from 2012 to 2014 among transplant recipients in the University HealthSystem Consortium, which includes academic medical center-affiliated hospitals in the United States. They found that factors associated with CDI among transplant recipients included transplant type, risk of mortality, comorbidities, and inpatient complications.
AHRQ-funded; HS013852.
Citation: Donnelly JP, Wang HE, Locke JE .
Hospital-onset Clostridium difficile infection among solid organ transplant recipients.
Am J Transplant 2015 Nov;15(11):2970-7. doi: 10.1111/ajt.13491.
.
.
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Transplantation, Adverse Events, Mortality
Fumo DE, Kapoor V, Reece LJ
Historical matching strategies in kidney paired donation: the 7-year evolution of a web-based virtual matching system.
Failure to convert computer-identified possible kidney paired donation (KPD) exchanges into transplants has prohibited KPD from reaching its full potential. This study analyzes the progress of exchanges in moving from "offers" to completed transplants. The "offer" and 1-way success rates were 21.9 and 15.5 percent, respectively. Three reasons for failure were found that could be prospectively prevented by changes in protocol or software.
AHRQ-funded; HS020610.
Citation: Fumo DE, Kapoor V, Reece LJ .
Historical matching strategies in kidney paired donation: the 7-year evolution of a web-based virtual matching system.
Am J Transplant 2015 Oct;15(10):2646-54. doi: 10.1111/ajt.13337.
.
.
Keywords: Health Information Technology (HIT), Transplantation, Shared Decision Making, Clinical Decision Support (CDS)
Bray M, Wang W, Song PX
Planning for uncertainty and fallbacks can increase the number of transplants in a kidney-paired donation program.
The researchers outlined and examined, through example and by simulation, four schemes for selecting potential matches in a realistic model of a kidney-paired donation system. Their proposed schemes take account of probabilities that chosen transplants may not be completed as well as allowing for contingency plans when the optimal solution fails.
AHRQ-funded; HS020610.
Citation: Bray M, Wang W, Song PX .
Planning for uncertainty and fallbacks can increase the number of transplants in a kidney-paired donation program.
Am J Transplant 2015 Oct;15(10):2636-45. doi: 10.1111/ajt.13413.
.
.
Keywords: Transplantation, Clinical Decision Support (CDS), Health Information Technology (HIT)
Traino HM, Nonterah CW, Cyrus JW
Disparities in the completion of steps to kidney transplantation: protocol for a systematic review.
This review will catalogue disparities in the steps to transplantation as well as the barriers and facilitators to completion of each step identified in the extant literature. The results of the review will be used to generate recommendations for future research to improve equity in access to kidney transplantation.
AHRQ-funded; HS018113.
Citation: Traino HM, Nonterah CW, Cyrus JW .
Disparities in the completion of steps to kidney transplantation: protocol for a systematic review.
BMJ Open 2015 Sep 08;5(9):e008677. doi: 10.1136/bmjopen-2015-008677.
.
.
Keywords: Disparities, Transplantation, Kidney Disease and Health, Access to Care, Guidelines
Parikh ND, Waljee AK, Singal AG
Downstaging hepatocellular carcinoma: a systematic review and pooled analysis.
The researchers aimed to characterize rates of successful downstaging to within Milan criteria and post-liver transplantation recurrence and survival among patients who underwent downstaging. They concluded that the success rate of downstaging hepatocellular carcinoma to within Milan criteria exceeds 40 percent; however, posttransplant HCC recurrence rates are high at 16 percent.
AHRQ-funded; HS022418.
Citation: Parikh ND, Waljee AK, Singal AG .
Downstaging hepatocellular carcinoma: a systematic review and pooled analysis.
Liver Transpl 2015 Sep;21(9):1142-52. doi: 10.1002/lt.24169..
Keywords: Cancer, Risk, Transplantation
Orman ES, Mayorga ME, Wheeler SB
Declining liver graft quality threatens the future of liver transplantation in the United States.
This study used the United Network for Organ Sharing (UNOS) database to inform a 20-year discrete event simulation estimating liver transplantation (LT) volume from 2010 to 2030. It found that if donor liver utilization practices remain constant, utilization will fall from 78 percent to 44 percent by 2030, resulting in 2,230 fewer LTs.
AHRQ-funded; HS019468.
Citation: Orman ES, Mayorga ME, Wheeler SB .
Declining liver graft quality threatens the future of liver transplantation in the United States.
Liver Transpl 2015 Aug;21(8):1040-50. doi: 10.1002/lt.24160..
Keywords: Healthcare Utilization, Health Services Research (HSR), Transplantation
McElroy LM, Schmidt KA, Richards CT
Early postoperative emergency department care of abdominal transplant recipients.
The goal of this study was to describe early postoperative ED care of transplant recipients. It found that transplant recipients have a high frequency of ED visits in the first post transplantation year and high rates of subsequent hospital admission.
AHRQ-funded; HS000078.
Citation: McElroy LM, Schmidt KA, Richards CT .
Early postoperative emergency department care of abdominal transplant recipients.
Transplantation 2015 Aug;99(8):1652-7. doi: 10.1097/tp.0000000000000781..
Keywords: Emergency Department, Transplantation, Hospital Readmissions, Hospitals
Davis AE, Mehrotra S, Friedewald JJ
Improving geographic equity in kidney transplantation using alternative kidney sharing and optimization modeling.
The authors analyzed current kidney allocation and developed an alternative kidney sharing strategy using a multiperiod linear optimization model, KSHARE, which aims to improve geographic equity in kidney transplantation while also respecting transplant system constraints and priorities. They used Organ Procurement and Transplant Network data to determine that enhancing the practice of sharing kidneys by the KSHARE model may increase geographic equity in kidney transplantation.
AHRQ-funded; HS021078.
Citation: Davis AE, Mehrotra S, Friedewald JJ .
Improving geographic equity in kidney transplantation using alternative kidney sharing and optimization modeling.
Med Decis Making 2015 Aug;35(6):797-807. doi: 10.1177/0272989x14557696.
.
.
Keywords: Access to Care, Disparities, Health Services Research (HSR), Social Determinants of Health, Transplantation
Toro-Diaz H, Mayorga ME, Barritt AS
Predicting liver transplant capacity using discrete event simulation.
The researchers constructed a discrete event simulation model informed by current donor characteristics to predict future liver transplant trends through the year 2030. They found that by altering assumptions about the future donor pool, their model can be used to develop policy interventions to prevent a further decline in this lifesaving therapy.
AHRQ-funded; HS019468.
Citation: Toro-Diaz H, Mayorga ME, Barritt AS .
Predicting liver transplant capacity using discrete event simulation.
Med Decis Making 2015 Aug;35(6):784-96. doi: 10.1177/0272989x14559055.
.
.
Keywords: Access to Care, Health Services Research (HSR), Policy, Transplantation
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.
AHRQ-funded; HS019455
Citation: Santos CA, Brennan DC, Chapman WC .
Delayed-onset cytomegalovirus disease coded during hospital readmission in a multicenter, retrospective cohort of liver transplant recipients.
Liver Transpl. 2015 May;21(5):581-90. doi: 10.1002/lt.24089..
Keywords: Outcomes, Transplantation, Quality of Care, Chronic Conditions
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 of delayed-onset CMV disease among a representative cohort of liver transplant recipients from multiple centers. They found that delayed-onset CMV disease coded during hospital readmission occurred more commonly than early-onset CMV disease and that prior transplant failure or rejection was a risk factor for delayed-onset CMV disease.
AHRQ-funded; HS019455.
Citation: Santos CA, Brennan DC, Chapman WC .
Delayed-onset cytomegalovirus disease coded during hospital readmission in a multicenter, retrospective cohort of liver transplant recipients.
Liver Transpl 2015 May;21(5):581-90. doi: 10.1002/lt.24089..
Keywords: Healthcare Cost and Utilization Project (HCUP), Risk, Transplantation, Outcomes