National Healthcare Quality and Disparities Report
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- Pain (25)
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- Registries (33)
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- Screening (72)
- Sepsis (13)
- Sex Factors (13)
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- Shared Decision Making (96)
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- Simulation (2)
- Skin Conditions (12)
- Sleep Problems (9)
- Social Determinants of Health (70)
- Social Media (12)
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- Stroke (25)
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- Surgery (162)
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- Teams (30)
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- Transplantation (19)
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- Treatments (37)
- U.S. Preventive Services Task Force (USPSTF) (28)
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- Urinary Tract Infection (UTI) (12)
- Vaccination (32)
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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
2076 to 2100 of 2117 Research Studies DisplayedGoldberger ZD, Alexander GC
Digitalis use in contemporary clinical practice: refitting the foxglove.
The researchers hypothesized that digoxin use for systolic heart failure (HF) has decreased during the past 15 years, despite clinical guidelines supporting its use. They fund that there has been a marked reduction in ambulatory digoxin use in the United States since 1997, with the largest declines in use observed from 1997 through 2001, and especially for patients with HF.
AHRQ-funded; HS018960.
Citation: Goldberger ZD, Alexander GC .
Digitalis use in contemporary clinical practice: refitting the foxglove.
JAMA Intern Med 2014 Jan;174(1):151-4. doi: 10.1001/jamainternmed.2013.10432..
Keywords: Heart Disease and Health, Medication, Ambulatory Care and Surgery, Practice Patterns
Pevnick JM, Li N, Asch SM
Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence.
The researchers evaluated whether formulary decision support (FDS) could reduce patient medication costs, and thereby improve adherence. In the studied population, interruptive FDS shifted prescribing toward preferred tier medications, but these medications were only minimally less expensive for patients. Thus, FDS did not significantly increase adherence.
AHRQ-funded; HS016391.
Citation: Pevnick JM, Li N, Asch SM .
Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence.
BMC Med Inform Decis Mak 2014;14:79. doi: 10.1186/1472-6947-14-79..
Keywords: Electronic Prescribing (E-Prescribing), Medication, Patient Adherence/Compliance, Clinical Decision Support (CDS), Health Information Technology (HIT)
Berenholtz SM, Lubomski LH, Weeks K
Eliminating central line-associated bloodstream infections: a national patient safety imperative.
The researchers conducted a collaborative cohort study to evaluate the impact of the national "On the CUSP: Stop BSI" program on CLABSI rates among participating adult intensive care units (ICUs). It found that one thousand and seventy-one adult ICUs from 44 states, the District of Columbia, and Puerto Rico implemented the national program and achieved a 43% reduction in the overall rate of CLABSI.
AHRQ-funded; 2902006000222.
Citation: Berenholtz SM, Lubomski LH, Weeks K .
Eliminating central line-associated bloodstream infections: a national patient safety imperative.
Infect Control Hosp Epidemiol 2014 Jan;35(1):56-62. doi: 10.1086/674384..
Keywords: Comprehensive Unit-based Safety Program (CUSP), Central Line-Associated Bloodstream Infections (CLABSI), Intensive Care Unit (ICU), Healthcare-Associated Infections (HAIs)
Barbash GI, Friedman B, Glied SA
AHRQ Author: Barbash GI, Friedman B, Glied SA, Steiner CA
Factors associated with adoption of robotic surgical technology in US hospitals and relationship to radical prostatectomy procedure volume.
The authors aimed to identify the factors associated with hospitals' decisions to adopt robotic technology and the consequences of these decisions. They found that hospitals in areas where a higher proportion of other hospitals had already acquired a robot were more likely to acquire one, as were those with more than 300 beds and teaching hospitals. They also found a significant association between years with a robot and the change in the number of radical prostatectomies. They concluded that local area robot competition was associated with the rapid spread of robot technology in the United States.
AHRQ-authored.
Citation: Barbash GI, Friedman B, Glied SA .
Factors associated with adoption of robotic surgical technology in US hospitals and relationship to radical prostatectomy procedure volume.
Ann Surg 2014 Jan;259(1):1-6. doi: 10.1097/SLA.0b013e3182a5c8b8.
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Keywords: Hospitals, Cancer: Prostate Cancer, Surgery
Pan IW, Smith BD, Shih YC
Factors contributing to underuse of radiation among younger women with breast cancer.
This study explores factors associated with noncompliance of RT among insured young patients. It found that competing demands from child care, especially the presence of a young child in the home, can constitute a barrier to complete guideline-concordant breast cancer therapy.
AHRQ-funded; HS018535.
Citation: Pan IW, Smith BD, Shih YC .
Factors contributing to underuse of radiation among younger women with breast cancer.
J Natl Cancer Inst 2014 Jan;106(1):djt340. doi: 10.1093/jnci/djt340..
Keywords: Cancer: Breast Cancer, Health Insurance, Patient Adherence/Compliance, Surgery, Treatments
Moy E, Freeman W
AHRQ Author: Moy E, Freeman W
Federal investments to eliminate racial/ethnic health-care disparities.
The authors presented a model that describes the relationships among social disadvantage, health-care disparities, and health disparities. They proposed that increasing the diversity of the public health and health-care workforces is an efficient strategy for reducing disparities because it impacts both access to care and patient-provider communication.
AHRQ-authored.
Citation: Moy E, Freeman W .
Federal investments to eliminate racial/ethnic health-care disparities.
Public Health Rep 2014 Jan-Feb;129 Suppl 2:62-70. doi: 10.1177/00333549141291s212.
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Keywords: Access to Care, Disparities, Racial and Ethnic Minorities, Social Determinants of Health, Vulnerable Populations
James KA, Fernald DH, Huff J
AHRQ Author: Ricciardi R
GAPS in implementing health assessments in primary care: a literature review.
The authors conducted a systematic review of literature about health assessments in ambulatory and primary care. They found that training and standardization of practice workflows improves implementation of health assessments, but gaps remain on identification and selection of health assessments, integration with electronic health records, and optimal intervals of health assessments administration.
AHRQ-authored; AHRQ-funded; 29020071008.
Citation: James KA, Fernald DH, Huff J .
GAPS in implementing health assessments in primary care: a literature review.
J Ambul Care Manage 2014 Jan-Mar;37(1):2-10. doi: 10.1097/jac.0000000000000000.
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Keywords: Electronic Health Records (EHRs), Health Status, Ambulatory Care and Surgery, Primary Care, Practice Patterns
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
Kachalia A, Little A, Isavoran M
Greatest impact of safe harbor rule may be to improve patient safety, not reduce liability claims paid by physicians.
The Oregon Health Authority analyzed the potential for safe harbors to improve patient safety and the performance of the medical liability system, as well as legal challenges and stakeholder concerns that might arise with legislation enacting safe harbors. They found that such legislation would have changed the liability outcome in favor of the physician defendant in only 1 percent of 266 claims from the period 2002–09 that were reviewed.
AHRQ-funded; HS019535.
Citation: Kachalia A, Little A, Isavoran M .
Greatest impact of safe harbor rule may be to improve patient safety, not reduce liability claims paid by physicians.
Health Aff 2014 Jan;33(1):59-66. doi: 10.1377/hlthaff.2013.0834..
Keywords: Patient Safety, Medical Liability, Medical Errors, Quality of Care, Policy
Nagykaldi ZJ, Yeaman B, Jones M
HIE-i-health information exchange with intelligence.
This article reports on the development and pilot testing of an innovative approach to implement health information exchange with intelligence (HIE-i) in primary care settings. Records of 346 patients were studied in 6 primary care practices. The results suggest that coupling a geographically inclusive set of clinical data with HIE-based clinical decision support for prevention can considerably improve prospective care delivery.
AHRQ-funded; 290200710009I.
Citation: Nagykaldi ZJ, Yeaman B, Jones M .
HIE-i-health information exchange with intelligence.
J Ambul Care Manage 2014 Jan-Mar;37(1):20-31. doi: 10.1097/jac.0000000000000002..
Keywords: Clinical Decision Support (CDS), Health Information Exchange (HIE), Health Information Technology (HIT), Prevention, Primary Care
Sage WM, Gallagher TH, Armstrong S
How policy makers can smooth the way for communication-and- resolution programs.
The authors argue that State and federal policy makers should try to allay potential defendants’ fears of litigation (e.g., by protecting apologies from use in court), facilitate patient participation (e.g., by ensuring access to legal representation), and address the reputational and economic concerns of health care providers (e.g., by clarifying practices governing National Practitioner Data Bank reporting and payers’ financial recourse following medical error).
AHRQ-funded; HS019505; HS019531; HS019561; HS019565; HSO19608; HS19537.
Citation: Sage WM, Gallagher TH, Armstrong S .
How policy makers can smooth the way for communication-and- resolution programs.
Health Aff 2014 Jan;33(1):11-9. doi: 10.1377/hlthaff.2013.0930..
Keywords: Communication, Policy, Medical Liability, Policy
Sockolow PS, Bowles KH, Adelsberger MC
Impact of homecare electronic health record on timeliness of clinical documentation, reimbursement, and patient outcomes.
The study objective was to assess the impact of attaining efficiency and health goals of a point-of-care EHR in home care. To realize this objective, the researchers compared clinical documentation workflow, financial time-to-billing and patient physiological and behavioral outcomes to evaluate its impact. The findings indicate that EHR use significantly improved the timeliness of clinical documentation and billing for reimbursement but had limited impact on improving patient outcomes.
AHRQ-funded; HS021008.
Citation: Sockolow PS, Bowles KH, Adelsberger MC .
Impact of homecare electronic health record on timeliness of clinical documentation, reimbursement, and patient outcomes.
Appl Clin Inform 2014;5(2):445-62. doi: 10.4338/aci-2013-12-ra-0106..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Home Healthcare
Mello MM, Senecal SK, Kuznetsov Y
Implementing hospital-based communication-and-resolution programs: lessons learned in New York City.
The researchers report on the experiences of five hospitals with implementing the communications-and-resolution program (CRP) in general surgery over a twenty-two-month period. They found that all of the hospitals improved disclosure and surveillance of adverse events but were not able to fully implement the program’s compensation component. These experiences suggest that strong support from top leadership at the hospital and insurer levels, and adequate staff resources, are critical for the success of CRPs.
AHRQ-funded; HS019505.
Citation: Mello MM, Senecal SK, Kuznetsov Y .
Implementing hospital-based communication-and-resolution programs: lessons learned in New York City.
Health Aff 2014 Jan;33(1):30-8. doi: 10.1377/hlthaff.2013.0849..
Keywords: Adverse Events, Communication, Medical Liability, Patient Safety
Cochran G, Field C, Caetano R
Injury-related consequences of alcohol misuse among injured patients who received screening and brief intervention for alcohol: a latent class analysis.
This study identifies latent classes of intervention recipients based on injury-related consequences and risks of alcohol misuse and then determines which profiles experienced the greatest improvements in drinking. It found that the patients who reported the greatest improvements in drinking following discharge were those characterized by multiple alcohol-related risks and those characterized by a history of alcohol-related accidents and injuries.
AHRQ-funded; HS021394.
Citation: Cochran G, Field C, Caetano R .
Injury-related consequences of alcohol misuse among injured patients who received screening and brief intervention for alcohol: a latent class analysis.
Subst Abus 2014;35(2):153-62. doi: 10.1080/08897077.2013.820679..
Keywords: Alcohol Use, Substance Abuse, Risk
Wexler RK
Invited letter: the evolving model of health care in the United States: system change is not enough.
In this letter, the author argues that the spread of new health care delivery models such as the Patient-Centered Medical Home and Accountable Care Organizations are necessary to improve population health but do not fully address the need for a fundamental change in how patients think about and access care. He calls for raising patient awareness of how the health care delivery system works and draws attention to practitioners’ concerns about patient satisfaction as a definitive marker of quality.
AHRQ-funded; HS020693
Citation: Wexler RK .
Invited letter: the evolving model of health care in the United States: system change is not enough.
Adv Health Care Manag. 2014;16:173-6..
Keywords: Access to Care, Healthcare Delivery, Patient-Centered Healthcare, Patient Experience, Primary Care, Primary Care: Models of Care
Minsinger KD, Kassis HM, Block CA
Meta-analysis of the effect of automated contrast injection devices versus manual injection and contrast volume on risk of contrast-induced nephropathy.
The researchers conducted a meta-analysis examining the currently published evidence on the reduction of contrast volume and the possible reduction of contrast-induced nephropathy (CIN) with the use of automated contrast injectors (ACIs) versus manual injection. They found that the incidence of contrast-induced nephropathy was significantly reduced by 15% for those using ACIs compared with manual injection.
AHRQ-funded; HS018443.
Citation: Minsinger KD, Kassis HM, Block CA .
Meta-analysis of the effect of automated contrast injection devices versus manual injection and contrast volume on risk of contrast-induced nephropathy.
Am J Cardiol 2014 Jan;113(1):49-53. doi: 10.1016/j.amjcard.2013.08.040..
Keywords: Heart Disease and Health, Kidney Disease and Health, Risk
Quanbeck A, Chih MY, Isham A
Mobile delivery of treatment for alcohol use disorders: A review of the literature.
This article explores questions about mobile applications intended for patients dealing with alcohol-use disorders (AUD) s including: What mHealth applications to treat AUDs exist that have been evaluated in the peer-reviewed literature and how can they be categorized? What are common features of these applications? How effective are currently commercially available mHealth applications for AUDs? What are the characteristics, benefits, and limitations of mHealth applications for AUDs?
AHRQ-funded; HS01991702.
Citation: Quanbeck A, Chih MY, Isham A .
Mobile delivery of treatment for alcohol use disorders: A review of the literature.
Alcohol Res 2014;36(1):111-22..
Keywords: Alcohol Use, Health Information Technology (HIT), Substance Abuse, Telehealth
Schwartz AL, Sommers BD
Moving for Medicaid? Recent eligibility expansions did not induce migration from other states.
This study used 26 measures of low value services to examine service use and associated spending detected by these measures in Medicaid. In the six categories of care measured, services detected by a limited number of measures of low-value care constituted modest proportions of overall spending (2.7 percent) but affected 42 percent of beneficiaries.
AHRQ-funded; HS00055; HS021291
Citation: Schwartz AL, Sommers BD .
Moving for Medicaid? Recent eligibility expansions did not induce migration from other states.
Health Aff. 2014 Jan;33(1):88-94. doi: 10.1377/hlthaff.2013.0910..
Keywords: Medicaid, Healthcare Costs, Low-Income, Healthcare Utilization
Sommers BD, Kenney GM, Epstein AM
New evidence on the Affordable Care Act: coverage impacts of early Medicaid expansions.
Since 2010 California, Connecticut, Minnesota, and Washington, D.C., have taken advantage of the Affordable Care Act’s option to expand coverage earlier to a portion of low-income childless adults. The researchers present new data on these expansions focusing on several questions including the extent to which childless adults’ new enrollment in Medicaid result from extending coverage to uninsured people as opposed to replacing private coverage.
AHRQ-funded; HS021291.
Citation: Sommers BD, Kenney GM, Epstein AM .
New evidence on the Affordable Care Act: coverage impacts of early Medicaid expansions.
Health Aff 2014 Jan;33(1):78-87. doi: 10.1377/hlthaff.2013.1087..
Keywords: Low-Income, Uninsured, Medicaid, Health Insurance
Schoenthaler A, Montague E, Baier Manwell L
Patient-physician racial/ethnic concordance and blood pressure control: the role of trust and medication adherence.
The researchers examined the associations between racial/ethnic concordance and blood pressure (BP) control to determine whether patient trust and medication adherence mediate these associations. They found that higher levels of trust were associated with better medication adherence and a tendency toward better BP control, irrespective of patient–physician racial/ethnic concordance.
AHRQ-funded; HS011955.
Citation: Schoenthaler A, Montague E, Baier Manwell L .
Patient-physician racial/ethnic concordance and blood pressure control: the role of trust and medication adherence.
Ethn Health 2014;19(5):565-78. doi: 10.1080/13557858.2013.857764..
Keywords: Blood Pressure, Racial and Ethnic Minorities, Medication, Patient Adherence/Compliance
Ritholz MD, Wolpert H, Beste M
Patient-provider relationships across the transition from pediatric to adult diabetes care: a qualitative study.
The purpose of this study was to explore perceptions that emerging adults with type 1 diabetes (T1D) have of their patient-provider relationships across the transition from pediatric to adult care. Several themes emerged from the analysis including the importance of improving provider approaches to transition. Patients recommended that pediatric providers actively promote emerging adults’ autonomy while maintaining parental support.
AHRQ-funded; HS000063.
Citation: Ritholz MD, Wolpert H, Beste M .
Patient-provider relationships across the transition from pediatric to adult diabetes care: a qualitative study.
Diabetes Educ 2014 Jan-Feb;40(1):40-7. doi: 10.1177/0145721713513177..
Keywords: Chronic Conditions, Diabetes, Patient Experience, Clinician-Patient Communication, Transitions of Care
Wernli KJ, DeMartini WB, Ichikawa L
Patterns of breast magnetic resonance imaging use in community practice.
The researchers described patterns of breast MRI use in US community practice during the period 2005 through 2009. They found that the overall rate of breast MRI from 2005 through 2009 nearly tripled from 4.2 to 11.5 examinations per 1000 women, with the most rapid increase from 2005 to 2007.
AHRQ-funded; HS019482.
Citation: Wernli KJ, DeMartini WB, Ichikawa L .
Patterns of breast magnetic resonance imaging use in community practice.
JAMA Intern Med 2014 Jan;174(1):125-32. doi: 10.1001/jamainternmed.2013.11963..
Keywords: Cancer: Breast Cancer, Data, Healthcare Utilization, Imaging, Registries
Fuji KT, Abbott AA, Galt KA
Personal health record design: qualitative exploration of issues inhibiting optimal use.
Few studies have examined the barriers to personal health record (PHR) use resulting from design issues identified by actual users. The researchers conducted interviews with 59 patients who had received training in using Microsoft Health Vault for PHRs to manage their diabetes-related health information. Three barriers to use (difficulty of use, lack of value, life got in the way) could be traced back to PHR design considerations.
AHRQ-funded; HS018625.
Citation: Fuji KT, Abbott AA, Galt KA .
Personal health record design: qualitative exploration of issues inhibiting optimal use.
Diabetes Care 2014;37(1):e13-4. doi: 10.2337/dc13-1630..
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Self-Management
Southern WN, Drainoni ML, Smith BD
Physician nonadherence with a hepatitis C screening program.
The researchers sought to measure adherence to an hepatitis C virus (HCV) screening protocol during a multifaceted continuous intervention. They found that overall adherence to the guideline was low, suggesting that attitudinal and external barriers remained. They concluded that when implementing complex clinical practice guidelines, planners must address attitudinal and external barriers to maximize adherence.
AHRQ-funded; 2902006000012.
Citation: Southern WN, Drainoni ML, Smith BD .
Physician nonadherence with a hepatitis C screening program.
Qual Manag Health Care 2014 Jan-Mar;23(1):1-9. doi: 10.1097/qmh.0000000000000007..
Keywords: Hepatitis, Screening, Patient Adherence/Compliance
Mooney TK, Gibbons MB, Gallop R
Psychotherapy credibility ratings: patient predictors of credibility and the relation of credibility to therapy outcome.
The researchers examined the relation between credibility ratings for adult psychotherapies and various patient factors as well as the relation between credibility ratings and subsequent symptom change. Their findings indicate that patient beliefs after a brief exposure to treatment may influence symptom improvement. Age and education may influence the patient’s beliefs about the credibility of a treatment.
AHRQ-funded; HS022124.
Citation: Mooney TK, Gibbons MB, Gallop R .
Psychotherapy credibility ratings: patient predictors of credibility and the relation of credibility to therapy outcome.
Psychother Res 2014;24(5):565-77. doi: 10.1080/10503307.2013.847988..
Keywords: Anxiety, Depression, Behavioral Health, Outcomes, Patient-Centered Outcomes Research