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 (1)
- Behavioral Health (1)
- Burnout (4)
- Community-Based Practice (1)
- Community Partnerships (1)
- Critical Care (2)
- Diabetes (1)
- Education: Continuing Medical Education (1)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Healthcare Costs (3)
- Healthcare Delivery (3)
- Health Information Technology (HIT) (1)
- Health Services Research (HSR) (2)
- Hospitals (5)
- Long-Term Care (2)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medicare (1)
- Nursing Homes (2)
- Obesity (1)
- Organizational Change (2)
- Palliative Care (1)
- Patient-Centered Healthcare (1)
- Patient Safety (2)
- Policy (2)
- Primary Care (2)
- Provider (13)
- Provider: Clinician (2)
- Provider: Health Personnel (1)
- Provider: Nurse (3)
- Provider: Physician (4)
- Quality Improvement (1)
- Quality Indicators (QIs) (1)
- Quality of Care (3)
- Racial and Ethnic Minorities (1)
- Rural Health (2)
- Teams (2)
- Training (1)
- (-) Workforce (22)
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 22 of 22 Research Studies DisplayedGermack HD, Kandrack R, Martsolf GR
When rural hospitals close, the physician workforce goes.
Researchers examined the relationship between rural hospital closures and the supply of physicians across different specialties in the years leading up to and after a closure. They observed significant annual reductions in the supply of general surgeons in the years leading up to a closure. They also found that rural hospital closures were associated with immediate and persistent decreases in the supply of surgical specialists and long-term decreases in the supply of physicians across multiple specialties. Because this decrease could lead to reduced access to care for rural residents, they recommended that future policy efforts focus on supporting and maintaining health care delivery models that do not depend on hospitals.
AHRQ-funded; HS000032.
Citation: Germack HD, Kandrack R, Martsolf GR .
When rural hospitals close, the physician workforce goes.
Health Aff 2019 Dec;38(12):2086-94. doi: 10.1377/hlthaff.2019.00916..
Keywords: Rural Health, Hospitals, Workforce, Provider: Physician, Provider
Adams DR, Williams NJ, Becker-Haimes EM
Therapist financial strain and turnover: interactions with system-level implementation of evidence-based practices.
In this study, the investigators prospectively examined the relationship between therapist financial strain and turnover in 247 therapists in 28 community mental health agencies. The investigators expected greater therapist financial strain to predict higher turnover and participation in a system-funded evidence-based practice (EBP) training initiative to alleviate this effect. They found that, controlling for covariates, financial strain predicted therapist turnover but not for therapists who participated in an EBP training initiative.
AHRQ-funded; HS000084.
Citation: Adams DR, Williams NJ, Becker-Haimes EM .
Therapist financial strain and turnover: interactions with system-level implementation of evidence-based practices.
Adm Policy Ment Health 2019 Nov;46(6):713-23. doi: 10.1007/s10488-019-00949-8..
Keywords: Healthcare Costs, Evidence-Based Practice, Behavioral Health, Provider, Provider: Clinician, Training, Workforce
Everson J, Richards MR, Buntin MB
Horizontal and vertical integration's role in meaningful use attestation over time.
This study examined rates of attestation and attrition from the meaningful use (MU) program by independent, horizontally integrated, and vertically integrated physicians. The goal was to determine if MU created pressure for independent physicians to join integrated organizations. They compared attestation rates using secondary data from SK&A and Medicare MU Files from 2011-2016 with office-based physicians. The sample size was 291,234 physicians. Forty-nine percent of physicians that remained independent during the period attested to MU at least once during the program, compared with 70% that remained horizontally or vertically integrated. There was also significantly more attrition among independent physicians than those physicians who were integrated.
AHRQ-funded; HS026395.
Citation: Everson J, Richards MR, Buntin MB .
Horizontal and vertical integration's role in meaningful use attestation over time.
Health Serv Res 2019 Oct;54(5):1075-83. doi: 10.1111/1475-6773.13193..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Workforce, Provider: Physician, Provider, Medicare
Brimhall KC
Inclusion and commitment as key pathways between leadership and nonprofit performance.
This study used longitudinal multilevel path analyses to examine whether transformational leadership influenced work group performance through creating a climate for including and increasing employee commitment in a diverse nonprofit health care organization. The results indicated that transformational leaders do help increase perceptions of inclusion, which improves employee performance and commitment to the organization.
AHRQ-funded; HS024650.
Citation: Brimhall KC .
Inclusion and commitment as key pathways between leadership and nonprofit performance.
Nonprofit Manag Leadersh 2019 Fall;30(1):31-49. doi: 10.1002/nml.21368..
Keywords: Workforce, Organizational Change
Kelly LA, McHugh MD, Aiken LH
Nurse Outcomes in Magnet(R) and non-magnet hospitals.
The goal of this study was to determine whether work environments, staffing, and nurse outcomes differ between Magnet and non-Magnet hospitals. Results demonstrated superior nurse work environments in Magnet hospitals compared with non-Magnet hospitals, with better work environments being associated with lower nurse job dissatisfaction and burnout. Three decades of evidence showing superior outcomes for Magnet hospitals place this organizational innovation into a class all of its own as best practice, deserving the attention of hospital leaders, nurses, and the public.
AHRQ-funded; HS017551.
Citation: Kelly LA, McHugh MD, Aiken LH .
Nurse Outcomes in Magnet(R) and non-magnet hospitals.
J Nurs Adm 2019 Oct;49(10S Suppl):S19-s24. doi: 10.1097/nna.0000000000000801..
Keywords: Burnout, Hospitals, Provider, Provider: Nurse, Workforce
White EM, Aiken LH, McHugh MD
Registered nurse burnout, job dissatisfaction, and missed care in nursing homes.
The purpose of this article was to examine the relationship between registered nurse (RN) burnout, job dissatisfaction, and missed care in nursing homes. The investigators concluded that missed nursing care due to inadequate time or resources is common in nursing homes and is associated with RN burnout and job dissatisfaction; they indicated that improved work environments with sufficient staff hold promise for improving care and nurse retention.
AHRQ-funded; HS000011.
Citation: White EM, Aiken LH, McHugh MD .
Registered nurse burnout, job dissatisfaction, and missed care in nursing homes.
J Am Geriatr Soc 2019 Oct;67(10):2065-71. doi: 10.1111/jgs.16051..
Keywords: Provider: Nurse, Provider, Burnout, Nursing Homes, Long-Term Care, Workforce
Ward ST, Dimick JB, Zhang W
Association between hospital staffing models and failure to rescue.
The purpose of this study was to identify hospital staffing models associated with failure to rescue (FTR) rates at low- and high-performing hospitals. The investigators concluded that low FTR hospitals had significantly more staffing resources than high FTR hospitals. They indicated that although hiring additional staff may be beneficial, there remain significant financial limitations for many hospitals to implement robust staffing models.
AHRQ-funded; HS023621; HS024403.
Citation: Ward ST, Dimick JB, Zhang W .
Association between hospital staffing models and failure to rescue.
Ann Surg 2019 Jul;270(1):91-94. doi: 10.1097/sla.0000000000002744..
Keywords: Patient Safety, Hospitals, Workforce, Quality Indicators (QIs), Quality Improvement, Quality of Care, Healthcare Delivery
Kamal AH, Wolf SP, Troy J
Policy changes key to promoting sustainability and growth of the specialty palliative care workforce.
The authors used 2018 clinician survey data to model risk factors associated with palliative care clinicians leaving the field early. Their modeling revealed an impending "workforce valley." They recommended policies that support high-value, team-based palliative care through expansion in all segments of the specialty palliative care workforce, combined with payment reform to encourage the deployment of sustainable teams.
AHRQ-funded; HS023681.
Citation: Kamal AH, Wolf SP, Troy J .
Policy changes key to promoting sustainability and growth of the specialty palliative care workforce.
Health Aff 2019 Jun;38(6):910-18. doi: 10.1377/hlthaff.2019.00018..
Keywords: Palliative Care, Policy, Provider, Teams, Workforce
de Cordova PB, Rogowski J, Riman KA
Effects of public reporting legislation of nurse staffing: a trend analysis.
The authors examined nurse staffing trends after the New Jersey enactment of P.L.1971, c.136 (C.26:2 H-13) on January 24, 2005, mandating that all health care facilities compile, post, and report staffing information. They found that the number of patients per registered nurse decreased for ten specialties, and conclude that this indicates the importance of public reporting in improving patient safety.
AHRQ-funded; HS024339.
Citation: de Cordova PB, Rogowski J, Riman KA .
Effects of public reporting legislation of nurse staffing: a trend analysis.
Policy Polit Nurs Pract 2019 May;20(2):92-104. doi: 10.1177/1527154419832112..
Keywords: Hospitals, Patient Safety, Workforce, Policy, Provider, Provider: Nurse
Reid R, Rising E, Kaufman A
The influence of a place-based foundation and a public university in growing a rural health workforce.
This article describes a partnership between a private, place-based foundation and the University of New Mexico's Office for Community Health. The university’s resources and the JF Maddox Foundation’s entrepreneurial nature, discretionary grant-making, and local convening capabilities combined to an innovative approach for addressing an acute shortage in the local health care delivery workforce in an isolated, rural setting in New Mexico. Results included a significant increase in recruitment of key health care professionals, a more cohesive medical community, a school-based clinic, and support for other community challenges such as the prevention of teen pregnancy.
AHRQ-funded; HS023904.
Citation: Reid R, Rising E, Kaufman A .
The influence of a place-based foundation and a public university in growing a rural health workforce.
J Community Health 2019 Apr;44(2):292-96. doi: 10.1007/s10900-018-0585-y..
Keywords: Access to Care, Community-Based Practice, Community Partnerships, Rural Health, Workforce
Daniel VT, Ayturk D, Kiefe CI
The current State of the acute care surgery workforce: a boots on the ground perspective.
Acute care surgery (ACS) was proposed to address a general surgery workforce crisis; however, the ACS workforce composition is unknown. A national survey was conducted to determine the differences in the emergency general surgery (EGS) workforce between ACS and non-ACS hospitals. The investigators concluded that ACS and non-ACS hospitals differ in their surgical workforce. It is clear that ACS hospitals have more human capital, which suggests that ACS hospitals may require more dedicated resources compared to non-ACS hospitals.
AHRQ-funded; HS022694.
Citation: Daniel VT, Ayturk D, Kiefe CI .
The current State of the acute care surgery workforce: a boots on the ground perspective.
Am J Surg 2018 Dec;216(6):1076-81. doi: 10.1016/j.amjsurg.2018.08.023..
Keywords: Critical Care, Emergency Department, Hospitals, Workforce
Tabano DC, Anderson ML, Ritzwoller DP
Estimating the impact of diabetes mellitus on worker productivity using self-report, electronic health record and human resource data.
In this study, the investigators assessed the relationship between diabetes mellitus (DM) and measures of worker productivity, direct health care costs, and costs associated with lost productivity (LP) among health care industry workers across two integrated health care systems. They concluded that the impact of DM was reflected in higher rates of LP and higher indirect costs for employers related to LP and higher health care resource use.
AHRQ-funded; HS018913.
Citation: Tabano DC, Anderson ML, Ritzwoller DP .
Estimating the impact of diabetes mellitus on worker productivity using self-report, electronic health record and human resource data.
J Occup Environ Med 2018 Nov;60(11):e569-e74. doi: 10.1097/jom.0000000000001441..
Keywords: Diabetes, Healthcare Costs, Workforce
Brimhall KC, Mor Barak ME
The critical role of workplace inclusion in fostering innovation, job satisfaction, and quality of care in a diverse human service organization.
Using a sample of 213 participants within 21 departmental units in a diverse human service organization, the authors performed multilevel path analysis to examine the critical role of workplace inclusion in fostering innovation, job satisfaction, and quality of care in a diverse human service organization.
AHRQ-funded; HS024650.
Citation: Brimhall KC, Mor Barak ME .
The critical role of workplace inclusion in fostering innovation, job satisfaction, and quality of care in a diverse human service organization.
Hum Serv Organ Manag Leadersh Gov 2018 Nov/Dec;42(5):474-92..
Keywords: Quality of Care, Workforce, Organizational Change
Mor V, Wallace P
Funding the training of future health services researchers.
This article describes the trends in funding for training health service researches in the United States. The government funds some training through grants by NIH and AHRQ through the National Research Service Award (NRSA) mechanism. However, most of the AHRQ grant programs have reduced their funding levels from 2010 to 2015 by almost half, with only the dissertation grants program (R36) experiencing an increase. Other federal mechanisms to fund training come through postdoctoral or post-MD programs with HRSA or the Veterans Administration. Private funding is also available through the Robert Wood Johnson Foundation. Lastly, AcademyHealth started a Delivery System Science Fellowship (DSSF) program to provide a paid post-doctoral learning experience for early-career researchers. Out of 118 applicants, 25 fellows, six trained as physicians have been accepted. Twenty-one researchers have completed the fellowship, and four are current fellows. There has been a wide background in those fellows. The writers believe more stable funding sources need to be established with a close collaboration between HSR researchers and users.
AHRQ-funded; 233201600155P.
Citation: Mor V, Wallace P .
Funding the training of future health services researchers.
Health Serv Res 2018 Oct;53 Suppl 2:3976-84. doi: 10.1111/1475-6773.12844..
Keywords: Health Services Research (HSR), Workforce
Meyers D, LeRoy L, Bailit M
AHRQ Author: Meyers D, Zhan C
Workforce configurations to provide high-quality, comprehensive primary care: a mixed-method exploration of staffing for four types of primary care practices.
The aim of this study was to explore the team configurations and associated costs required to deliver high-quality, comprehensive primary care. The study estimates provided health care decision-makers with needed guideposts for considering primary care staffing and financing and informed broader discussions on primary care innovations and the necessary resources to provide high-quality, comprehensive primary care in the USA.
AHRQ-authored; AHRQ-funded; 290201000004I; 29032009T.
Citation: Meyers D, LeRoy L, Bailit M .
Workforce configurations to provide high-quality, comprehensive primary care: a mixed-method exploration of staffing for four types of primary care practices.
J Gen Intern Med 2018 Oct;33(10):1774-79. doi: 10.1007/s11606-018-4530-7..
Keywords: Healthcare Delivery, Quality of Care, Primary Care, Workforce, Teams
Costa DK, Moss M
The cost of caring: emotion, burnout, and psychological distress in critical care clinicians.
This paper comments on emotion, burnout, and psychological distress in critical care clinicians. It stresses that the current management approaches for burnout and other forms of psychological distress are insufficient and discusses possibilities for improvement.
AHRQ-funded; HS024552.
Citation: Costa DK, Moss M .
The cost of caring: emotion, burnout, and psychological distress in critical care clinicians.
Ann Am Thorac Soc 2018 Jul;15(7):787-90. doi: 10.1513/AnnalsATS.201804-269PS..
Keywords: Burnout, Critical Care, Provider, Workforce
Huber MT, Ham SA, Qayyum M
Association between job factors, burnout, and preference for a new job: a nationally representative physician survey.
Investigators used an experimental vignette to test associations between physician demographics, salary, and working with exemplary colleagues on the likelihood of preferring a new job among burned out and non-burned out physicians in various specialties. They found that, among burned out physicians, the opportunity for better salary and colleagues made them more likely to prefer a new job compared to non-burned out physicians, with change in salary associated with the greatest difference. They recommended focusing on improving physician-colleague relationships to improve job retention.
AHRQ-funded; HS000078.
Citation: Huber MT, Ham SA, Qayyum M .
Association between job factors, burnout, and preference for a new job: a nationally representative physician survey.
J Gen Intern Med 2018 Jun;33(6):789-91. doi: 10.1007/s11606-018-4412-z..
Keywords: Burnout, Workforce, Provider: Physician, Provider
Berridge C, Tyler DA, Miller SC
Staff empowerment practices and CNA retention: findings from a nationally representative nursing home culture change survey.
This article examines whether staff empowerment practices common to nursing home culture change are associated with certified nursing assistant (CNA) retention. It concluded that after adjustment for covariates, a greater staff empowerment practice score was positively associated with greater retention. Compared with the low empowerment category, nursing homes with scores in the medium category had a 44 percent greater likelihood of having higher CNA retention.
AHRQ-funded; HS000011.
Citation: Berridge C, Tyler DA, Miller SC .
Staff empowerment practices and CNA retention: findings from a nationally representative nursing home culture change survey.
J Appl Gerontol 2018 Apr;37(4):419-34. doi: 10.1177/0733464816665204.
.
.
Keywords: Long-Term Care, Nursing Homes, Provider, Provider: Health Personnel, Workforce
Snyder CR, Frogner BK, Skillman SM
Facilitating racial and ethnic diversity in the health workforce.
This study explored changes in the racial and ethnic diversity of the health workforce in the United States over the last decade, and evidence on the effectiveness of programs designed to promote racial and ethnic diversity in the U.S. health workforce. Findings suggested that although the health workforce overall is becoming more diverse, people of color are most often represented among the entry-level, lower-skilled health occupations.
AHRQ-funded; HS022982.
Citation: Snyder CR, Frogner BK, Skillman SM .
Facilitating racial and ethnic diversity in the health workforce.
J Allied Health 2018 Spring;47(1):58-65..
Keywords: Provider, Racial and Ethnic Minorities, Workforce
Leyenaar JK, Frintner MP
Graduating pediatric residents entering the hospital medicine workforce, 2006-2015.
This study analyzed the population of graduating pediatric residents entering the new subspecialty – pediatric hospital medicine (PHM). Data was analyzed from the American Academic of Pediatrics Annual Survey of Graduating Residents, 2006-2015. A total of 5969 graduates completed the survey, and 10.3% reported that they were entering PHM and 33.9% were reporting subspecialty fellowships. A multivariable analysis was done of the demographics, and a higher rate of residents entering PHM were female, to have children, to report that family factors limited their job selection, and to have higher levels of student debt than residents entering fellowships.
AHRQ-funded; HS024133.
Citation: Leyenaar JK, Frintner MP .
Graduating pediatric residents entering the hospital medicine workforce, 2006-2015.
Acad Pediatr 2018 Mar;18(2):200-07. doi: 10.1016/j.acap.2017.05.001..
Keywords: Education: Continuing Medical Education, Provider, Provider: Clinician, Provider: Physician, Workforce
Kim LY, Rose DE, Soban LM
Primary care tasks associated with provider burnout: findings from a Veterans Health Administration survey.
The purpose of this study was to investigate (1) the extent to which primary care providers (PCPs) share responsibility for 14 discrete primary care tasks with other team members, and (2) which, if any, of the primary care tasks performed by the PCPs (without reliance on team members) are associated with PCP burnout.
AHRQ-funded; HS000046.
Citation: Kim LY, Rose DE, Soban LM .
Primary care tasks associated with provider burnout: findings from a Veterans Health Administration survey.
J Gen Intern Med 2018 Jan;33(1):50-56. doi: 10.1007/s11606-017-4188-6..
Keywords: Healthcare Delivery, Health Services Research (HSR), Patient-Centered Healthcare, Primary Care, Provider, Workforce
Biener A, Cawley J, Meyerhoefer C
AHRQ Author: Biener A
The impact of obesity on medical care costs and labor market outcomes in the US.
The economic consequences of obesity are not well understood. Researchers analyzed data for 2001-2015 and estimated the percentage of healthcare costs that were associated with adult obesity. They found that a substantial and rising percentage of healthcare costs are associated with obesity. This is true for the US, for individual states, for each category of expenditure, and for each type of payer.
AHRQ-authored.
Citation: Biener A, Cawley J, Meyerhoefer C .
The impact of obesity on medical care costs and labor market outcomes in the US.
Clin Chem 2018 Jan;64(1):108-17. doi: 10.1373/clinchem.2017.272450.
.
.
Keywords: Healthcare Costs, Medical Expenditure Panel Survey (MEPS), Obesity, Workforce