National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
701 to 721 of 721 Research Studies DisplayedAnt Ozok A, Wu H, Garrido M
Usability and perceived usefulness of personal health records for preventive health care: a case study focusing on patients' and primary care providers' perspectives.
The purpose of this study was to evaluate the usefulness of a specific patient-centered information technology (Personal Health Record) in improving awareness (for the patients) and compliance with (for both patients and providers) preventive care guidelines. The results were that patients found the tailored health recommendations useful and the PHR easy to understand and use.
AHRQ-funded; HS018762
Citation: Ant Ozok A, Wu H, Garrido M .
Usability and perceived usefulness of personal health records for preventive health care: a case study focusing on patients' and primary care providers' perspectives.
Appl Ergon. 2014 May;45(3):613-28. doi: 10.1016/j.apergo.2013.09.005..
Keywords: Electronic Health Records (EHRs), Quality of Care, Prevention, Primary Care, Web-Based
Everett CM, Thorpe CT, Palta M
The roles of primary care PAs and NPs caring for older adults with diabetes.
The investigators proposed a multidimensional characterization of PA and NP roles on panels of primary care patients with diabetes. They found that PAs and NPs in primary care perform a variety of roles and frequently perform multiple roles within a clinic.
AHRQ-funded; HS017646; HS018368; HS000083.
Citation: Everett CM, Thorpe CT, Palta M .
The roles of primary care PAs and NPs caring for older adults with diabetes.
Jaapa 2014 Apr;27(4):45-9. doi: 10.1097/01.jaa.0000444736.16669.76.
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Keywords: Diabetes, Provider: Health Personnel, Patient-Centered Healthcare, Primary Care, Teams
Babbott S, Manwell LB, Brown R
Electronic medical records and physician stress in primary care: results from the MEMO Study.
In this paper, the investigators assessed relationships between the number of EMR functions, primary care work conditions, and physician satisfaction, stress and burnout. The authors concluded that stress may rise for physicians with a moderate number of EMR functions; they found that time pressure was associated with poor physician outcomes mainly in the high EMR cluster.
AHRQ-funded; HS011955.
Citation: Babbott S, Manwell LB, Brown R .
Electronic medical records and physician stress in primary care: results from the MEMO Study.
J Am Med Inform Assoc 2014 Feb;21(e1):e100-6. doi: 10.1136/amiajnl-2013-001875..
Keywords: Burnout, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Provider: Clinician, Provider: Physician
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
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
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
Bleser WK, Miller-Day M, Naughton D
Strategies for achieving whole-practice engagement and buy-in to the patient-centered medical home.
In this paper the authors describe strategies for obtaining organizational buy-in to and whole-staff engagement of patient-centered medical home (PCMH) transformation and practice improvement. The investigators suggest that their study provides a list of strategies useful for facilitating PCMH transformation in primary care. They assert that these strategies could be investigated empirically in future research, used to guide medical practices undergoing or considering PCMH transformation, and used to inform health care policy makers.
AHRQ-funded; HS019150.
Citation: Bleser WK, Miller-Day M, Naughton D .
Strategies for achieving whole-practice engagement and buy-in to the patient-centered medical home.
Ann Fam Med 2014 Jan-Feb;12(1):37-45. doi: 10.1370/afm.1564..
Keywords: Patient-Centered Healthcare, Organizational Change, Primary Care: Models of Care, Primary Care, Practice Improvement, Provider: Nurse, Provider: Physician, Provider: Clinician, Provider
Basu J, Mobley LR, Thumula V
AHRQ Author: Basu J
The small area predictors of ambulatory care sensitive hospitalizations: a comparison of changes over time.
The investigators examined the predictors of ambulatory care sensitive conditions (ACSCs) admissions in small geographic areas in two cross-sections spanning an 11-year time interval (1995-2005). They found that ACSC admission rates were inversely related to the availability of local primary care physicians, and managed care was associated with declines in ACSC admissions for the elderly. Additionally, minorities, aged elderly, and percent under federal poverty level were found to be associated with higher ACSC rates. They concluded that improvements in socioeconomic conditions and geographic access may have helped improve the quality of primary care received by the elderly over the last decade, particularly among some minority groups.
AHRQ-authored.
Citation: Basu J, Mobley LR, Thumula V .
The small area predictors of ambulatory care sensitive hospitalizations: a comparison of changes over time.
Soc Work Public Health 2014;29(2):176-88. doi: 10.1080/19371918.2013.776316.
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Keywords: Access to Care, Hospitalization, Ambulatory Care and Surgery, Primary Care
Bauer NS, Carroll AE, Downs SM
Understanding the acceptability of a computer decision support system in pediatric primary care.
In this study, the investigators examine the attitudes and opinions of pediatric users' toward the Child Health Improvement through Computer Automation (CHICA) system, a computer decision support system linked to an electronic health record in four community pediatric clinics. The investigators found that pediatric users appreciated the system's automation and enhancements that allowed relevant and meaningful clinical data to be accessible at point of care.
AHRQ-funded; HS018453; HS017939.
Citation: Bauer NS, Carroll AE, Downs SM .
Understanding the acceptability of a computer decision support system in pediatric primary care.
J Am Med Inform Assoc 2014 Jan-Feb;21(1):146-53. doi: 10.1136/amiajnl-2013-001851..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Shared Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care
Bauer NS, Carroll AE, Downs SM
Understanding the acceptability of a computer decision support system in pediatric primary care.
In this study, the investigators examine the attitudes and opinions of pediatric users' toward the Child Health Improvement through Computer Automation (CHICA) system, a computer decision support system linked to an electronic health record in four community pediatric clinics. The investigators found that pediatric users appreciated the system's automation and enhancements that allowed relevant and meaningful clinical data to be accessible at point of care.
AHRQ-funded; HS018453; HS017939.
Citation: Bauer NS, Carroll AE, Downs SM .
Understanding the acceptability of a computer decision support system in pediatric primary care.
J Am Med Inform Assoc 2014 Jan-Feb;21(1):146-53. doi: 10.1136/amiajnl-2013-001851..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Shared Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care
Schiff GD, Puopolo AL, Huben-Kearney A
Primary care closed claims experience of Massachusetts malpractice insurers.
The researchers studied patterns of primary care malpractice types, causes, and outcomes as part of a Massachusetts ambulatory malpractice risk and safety improvement project. During a 5-year period there were 7224 malpractice claims of which 551 (7.7%) were from primary care practices. In Massachusetts, most primary care claims filed were related to alleged misdiagnosis.
AHRQ-funded; HS019508.
Citation: Schiff GD, Puopolo AL, Huben-Kearney A .
Primary care closed claims experience of Massachusetts malpractice insurers.
JAMA Intern Med 2013 Dec 9-23;173(22):2063-8. doi: 10.1001/jamainternmed.2013.11070..
Keywords: Primary Care, Medical Errors, Health Insurance, Patient Safety, Medical Liability
Everett C, Thorpe C, Palta M
Physician assistants and nurse practitioners perform effective roles on teams caring for Medicare patients with diabetes.
The investigators compared outcomes for two groups of adult Medicare patients with diabetes whose conditions were at various levels of complexity: those whose care teams included PAs or NPs in various roles, and those who received care from physicians only. They found that outcomes were generally equivalent in thirteen comparisons but mixed in seven others, so that no role was best for all outcomes. They concluded that patient characteristics, as well as patients' and organizations' goals, should be considered when determining when and how to deploy PAs and NPs on primary care teams.
AHRQ-funded; HS017646; HS018368; HS000083.
Citation: Everett C, Thorpe C, Palta M .
Physician assistants and nurse practitioners perform effective roles on teams caring for Medicare patients with diabetes.
Health Aff 2013 Nov;32(11):1942-8. doi: 10.1377/hlthaff.2013.0506.
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Keywords: Diabetes, Provider: Health Personnel, Patient-Centered Healthcare, Primary Care, Teams
Begum R, Smith Ryan M, Winther CH
Small practices' experience with EHR, quality measurement, and incentives.
The researchers surveyed clinicians participating in Health eHearts, a cluster-randomized trial of the effect of a financial incentive and quality improvement (QI) assistance program on measures of cardiovascular care compared with the effect of providing quality reports and QI assistance. No differences were detected between groups regarding agreement with selected clinical measures or their relevance to the patient population.
AHRQ-funded; HS019164; HS018275.
Citation: Begum R, Smith Ryan M, Winther CH .
Small practices' experience with EHR, quality measurement, and incentives.
Am J Manag Care 2013 Nov;19(10 Spec No):eSP12-8..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Quality Improvement, Primary Care, Practice Patterns
Everett CM, Thorpe CT, Palta M
Division of primary care services between physicians, physician assistants, and nurse practitioners for older patients with diabetes.
The investigators described the division of patients and services between primary care providers for older diabetes patients on panels with varying levels of PA/NP involvement. They concluded that understanding how patients and services are divided between PA/NPs and physicians will assist in defining provider roles on primary care teams.
AHRQ-funded; HS017646; HS018368; HS000083.
Citation: Everett CM, Thorpe CT, Palta M .
Division of primary care services between physicians, physician assistants, and nurse practitioners for older patients with diabetes.
Med Care Res Rev 2013 Oct;70(5):531-41. doi: 10.1177/1077558713495453.
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Keywords: Diabetes, Provider: Health Personnel, Patient-Centered Healthcare, Primary Care, Teams
Robin Yabroff K, Short PF, Machlin S
AHRQ Author: Machlin S
Access to preventive health care for cancer survivors.
The researchers evaluated the association between cancer survivorship and access to primary and preventive health care. They concluded that, although access and preventive care use in cancer survivors is generally equivalent or greater compared to that of other individuals, disparities for uninsured and publicly insured cancer survivors aged 18-64 years suggest that improvements in survivor care are needed.
AHRQ-authored.
Citation: Robin Yabroff K, Short PF, Machlin S .
Access to preventive health care for cancer survivors.
Am J Prev Med 2013 Sep;45(3):304-12. doi: 10.1016/j.amepre.2013.04.021.
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Keywords: Access to Care, Cancer, Medical Expenditure Panel Survey (MEPS), Prevention, Primary Care
Pohl JM, Nath R, Zheng K
Use of a comprehensive patient safety tool in primary care practices.
This article describes experiences with the use of the Physician Practice Patient Safety Assessment tool in six safety net practices—three of which were primary care nurse-managed health centers and three were physician-led federally qualified health centers. The authors concluded that this tool has enormous relevance for primary care settings, especially those preparing themselves for patient-centered medical home status and meaningful use.
AHRQ-funded; HS017191.
Citation: Pohl JM, Nath R, Zheng K .
Use of a comprehensive patient safety tool in primary care practices.
J Am Assoc Nurse Pract 2013 Aug;25(8):415-8. doi: 10.1111/1745-7599.12021..
Keywords: Patient Safety, Primary Care, Patient-Centered Healthcare, Practice Patterns, Tools & Toolkits
DeVoe JE, Stenger R
Aligning provider incentives to improve primary healthcare delivery in the United States.
This critical review uses a theoretical framework from game-theory models to discuss some of the dominant primary care provider payment models and how they create 'prisoner's dilemmas' that have stalled past reform efforts, then illustrates an escape from the dilemma. It concludes that a blend of guaranteed payment and selective incentives designed to encourage primary care providers to deliver high quality care, efficient and equitable care and to eliminate incentives towards over-servicing could reach outcomes leading to shared benefits for everyone involved.
AHRQ-funded; HS014645; HS016181.
Citation: DeVoe JE, Stenger R .
Aligning provider incentives to improve primary healthcare delivery in the United States.
OA Fam Med 2013 Jun 1;1(1):7.
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Keywords: Healthcare Delivery, Payment, Primary Care, Quality Improvement
McNellis RJ, Genevro JL, Meyers DS
AHRQ Author: McNellis RJ, Genevro JL, Meyers DS
Lessons learned from the study of primary care transformation.
This article discusses the patient-centered medical home (PCMH) model. The authors conclude that the transformation of primary care is essential to achieving the triple aim of better outcomes, better value, and better experience of care, and that the PCMH may be the most viable solution in the current health care environment.
AHRQ-authored.
Citation: McNellis RJ, Genevro JL, Meyers DS .
Lessons learned from the study of primary care transformation.
Ann Fam Med 2013 May-Jun;11 Suppl 1:S1-5. doi: 10.1370/afm.1548.
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Keywords: Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Healthcare Delivery, Organizational Change, Quality Improvement, Quality of Care
Baron KG, Lattie E, Ho J
Interest and use of mental health and specialty behavioral medicine counseling in US primary care patients.
This study investigating interest in mental health and specialty behavioral medicine counseling and predictors of utilization over 1 year among primary care patients found high interest but low utilization. Interest in receiving services at the baseline initial survey was the strongest predictor of utilization.
AHRQ-funded; HS00078
Citation: Baron KG, Lattie E, Ho J .
Interest and use of mental health and specialty behavioral medicine counseling in US primary care patients.
Int J Behav Med. 2013 Mar;20(1):69-76. doi: 10.1007/s12529-011-9211-4..
Keywords: Behavioral Health, Healthcare Utilization, Primary Care
Taylor EF, Machta RM, Meyers DS
AHRQ Author: Meyers DS, Genevro J
Enhancing the primary care team to provide redesigned care: the roles of practice facilitators and care managers.
This article discusses how practice facilitators and care managers can play important but distinct roles in redesigning and improving care delivery in order to deliver coordinated, accessible, comprehensive, and patient-centered care.
AHRQ-authored.
Citation: Taylor EF, Machta RM, Meyers DS .
Enhancing the primary care team to provide redesigned care: the roles of practice facilitators and care managers.
Ann Fam Med 2013 Jan-Feb;11(1):80-3. doi: 10.1370/afm.1462.
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Keywords: Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Healthcare Delivery, Organizational Change, Quality Improvement, Quality of Care
Houser SH, Ray MN, Maisiak R
Telephone follow-up in primary care: can interactive voice response calls work?
The purpose of the study was to assess patient perceptions about follow-up calls after ambulatory care visits, to evaluate differences in perceptions about human calls and interactive voice response system (IVRS) calls, and to explore the association between follow-up calls and patient satisfaction with care. It found that there were no differences in attitudes between patients receiving calls from clinic staff or from an IVRS.
AHRQ-funded; HS017060.
Citation: Houser SH, Ray MN, Maisiak R .
Telephone follow-up in primary care: can interactive voice response calls work?
Stud Health Technol Inform 2013;192:112-6..
Keywords: Primary Care, Patient Experience, Health Information Technology (HIT)