National Healthcare Quality and Disparities Report
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Topics
- Ambulatory Care and Surgery (1)
- (-) Cancer (17)
- Cancer: Cervical Cancer (1)
- Cancer: Prostate Cancer (1)
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Care Management (1)
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- Human Immunodeficiency Virus (HIV) (2)
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- Kidney Disease and Health (2)
- Medicare (1)
- Medication (3)
- Men's Health (1)
- Nursing (1)
- Palliative Care (3)
- Patient-Centered Healthcare (1)
- Patient Adherence/Compliance (1)
- Patient Self-Management (2)
- Provider (1)
- Provider: Nurse (1)
- Quality of Care (2)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
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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
1 to 17 of 17 Research Studies DisplayedBecker NV, Scott JW, Moniz MH
Association of chronic disease with patient financial outcomes among commercially insured adults.
This study examined the association between chronic disease and adverse financial outcomes. The authors used claims data for patients enrolled in a preferred provider organization in Michigan. Patients diagnosed with thirteen common chronic conditions (cancer, congestive heart failure, chronic kidney disease, dementia, depression and anxiety, diabetes, hypertension, ischemic heart disease, liver disease, chronic obstructive pulmonary disease and asthma, serious mental illness, stroke, and substance use disorders) were included in the cohort of 2,854,481 adults aged 21 and over. The cohort included 61.4% with no chronic conditions, 17.7% with 1 chronic condition, 14.8% with 2 to 3 chronic conditions, 5.4% with 4 to 6 chronic conditions, and 0.7% with 7 to 13 chronic conditions. Among the cohort, 9.6% had medical debt in collections, 8.3% had nonmedical debt in collections, 16.3% had delinquent debt, 19.3% had a low credit score, and 0.6% had recent bankruptcy. For individuals with 0 vs 7 to 13 chronic conditions, the predicted probabilities of having any medical debt in collections (7.6% vs 32%), any nonmedical debt in collections (7.2% vs 24%), any delinquent debt (14% vs 43%), a low credit score (17% vs 47%) or recent bankruptcy (0.4% vs 1.7%) were all considerably higher for individuals with more chronic conditions and increased with each added chronic condition. Among individuals with medical debt in collections, the estimated amount increased with the number of chronic conditions ($784 for individuals with 0 conditions vs $1252 for individuals with 7-13 conditions).
AHRQ-funded; HS028672.
Citation: Becker NV, Scott JW, Moniz MH .
Association of chronic disease with patient financial outcomes among commercially insured adults.
JAMA Intern Med 2022 Oct;182(10):1044-51. doi: 10.1001/jamainternmed.2022.3687..
Keywords: Chronic Conditions, Healthcare Costs, Cancer, Kidney Disease and Health
Singal AG, Chen Y, Sridhar S
Novel application of predictive modeling: a tailored approach to promoting hcc surveillance in patients with cirrhosis.
Researchers conducted a secondary analysis of a randomized clinical trial evaluating a mailed outreach strategy to promote hepatocellular carcinoma (HCC) surveillance among cirrhosis patients at a safety-net health system. They found that predictive models can help stratify patients' likelihood to respond to surveillance outreach invitations, facilitating tailored strategies to maximize effectiveness and cost-effectiveness of HCC surveillance population health programs.
AHRQ-funded; HS022418.
Citation: Singal AG, Chen Y, Sridhar S .
Novel application of predictive modeling: a tailored approach to promoting hcc surveillance in patients with cirrhosis.
Clin Gastroenterol Hepatol 2022 Aug;20(8):1795-802.e2. doi: 10.1016/j.cgh.2021.02.038..
Keywords: Cancer, Chronic Conditions, Screening
Lee K, Gani F, Canner JK
Racial disparities in utilization of palliative care among patients admitted with advanced solid organ malignancies.
The primary objective of this study was to describe racial differences in the use of inpatient palliative care consultations (IPCC) for patients with advanced cancer who are admitted to a hospital in the United States. Hospital admissions of patients with advanced cancers were identified through the National Inpatient Dataset. Findings showed that death during hospitalization was a significant modifier of the relationship between race and receipt of palliative care consultation. There were significant racial disparities in the utilization of IPCC for patients with advanced cancer.
AHRQ-funded; HS024736.
Citation: Lee K, Gani F, Canner JK .
Racial disparities in utilization of palliative care among patients admitted with advanced solid organ malignancies.
Am J Hosp Palliat Care 2021 Jun;38(6):539-46. doi: 10.1177/1049909120922779..
Keywords: Healthcare Cost and Utilization Project (HCUP), Palliative Care, Cancer, Disparities, Racial and Ethnic Minorities, Healthcare Utilization, Inpatient Care, Chronic Conditions
Knutzen KE, Schifferdecker KE, Murray GF
Role of norms in variation in cancer centers' end-of-life quality: qualitative case study protocol.
AHRQ-funded; HS022242.
Citation: Knutzen KE, Schifferdecker KE, Murray GF .
Role of norms in variation in cancer centers' end-of-life quality: qualitative case study protocol.
BMC Palliat Care 2020 Aug 27;19(1):136. doi: 10.1186/s12904-020-00641-x..
Keywords: Cancer, Quality of Life, Palliative Care, Quality of Care, Chronic Conditions
Lafferty M, Fauer A, Wright N
Causes and consequences of chemotherapy delays in ambulatory oncology practices: a multisite qualitative study.
The purpose of this study was to examine the causes and consequences of chemotherapy treatment delays and possible solutions to improve quality of care. The authors identified four primary themes from the analysis that affect delays. They suggest future investigations to examine nurses' communication practices in the context of timely chemotherapy administration since communication and documentation technologies within healthcare settings continuously evolve.
AHRQ-funded; HS024914.
Citation: Lafferty M, Fauer A, Wright N .
Causes and consequences of chemotherapy delays in ambulatory oncology practices: a multisite qualitative study.
Oncol Nurs Forum 2020 Jul 1;47(4):417-27. doi: 10.1188/20.Onf.417-427..
Keywords: Treatments, Cancer, Ambulatory Care and Surgery, Quality of Care, Clinician-Patient Communication, Communication, Provider: Nurse, Provider, Nursing, Chronic Conditions
Rohner E, Butikofer L, Schmidlin K
Cervical cancer risk in women living with HIV across four continents: a multicohort study.
In this study, the investigators compared invasive cervical cancer (ICC) incidence rates in Europe, South Africa, Latin and North America among women living with HIV who initiated antiretroviral therapy (ART) between 1996 and 2014. The investigators concluded that improving access to early ART initiation and effective cervical cancer screening in women living with HIV should be key parts of global efforts to reduce cancer-related health inequities.
AHRQ-funded; 90047713.
Citation: Rohner E, Butikofer L, Schmidlin K .
Cervical cancer risk in women living with HIV across four continents: a multicohort study.
Int J Cancer 2020 Feb;146(3):601-09. doi: 10.1002/ijc.32260..
Keywords: Cancer: Cervical Cancer, Cancer, Human Immunodeficiency Virus (HIV), Women, Medication, Chronic Conditions
Cole AL, Jazowski SA, Dusetzina SB
Initiation of generic imatinib may improve medication adherence for patients with chronic myeloid leukemia.
Investigators compared adherence to tyrosine kinase inhibitors (TKIs) between patients with chronic myeloid leukemia (CML) who initiated branded or generic imatinib using MarketScan commercial claims data. They found that patients initiating generic imatinib achieved clinically significant improvements in adherence to TKI therapy relative to branded drug users, presumably due to lower out-of-pocket costs. Given the importance of optimal adherence in CML, considering barriers to adherence when selecting initial treatment may improve long-term medication adherence.
AHRQ-funded; HS000032.
Citation: Cole AL, Jazowski SA, Dusetzina SB .
Initiation of generic imatinib may improve medication adherence for patients with chronic myeloid leukemia.
Pharmacoepidemiol Drug Saf 2019 Nov;28(11):1529-33. doi: 10.1002/pds.4893..
Keywords: Patient Adherence/Compliance, Medication, Chronic Conditions, Cancer
Althoff KN, Gebo KA, Moore RD
Contributions of traditional and HIV-related risk factors on non-AIDS-defining cancer, myocardial infarction, and end-stage liver and renal diseases in adults with HIV in the USA and Canada: a collaboration of cohort studies.
Adults with HIV have an increased burden of non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, and end-stage renal disease. The objective of this study was to estimate the population attributable fractions (PAFs) of preventable or modifiable HIV-related and traditional risk factors for non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, and end-stage renal disease outcomes.
AHRQ-funded; 90047713.
Citation: Althoff KN, Gebo KA, Moore RD .
Contributions of traditional and HIV-related risk factors on non-AIDS-defining cancer, myocardial infarction, and end-stage liver and renal diseases in adults with HIV in the USA and Canada: a collaboration of cohort studies.
Lancet HIV 2019 Feb;6(2):e93-e104. doi: 10.1016/s2352-3018(18)30295-9.
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Keywords: Cancer, Cardiovascular Conditions, Chronic Conditions, Kidney Disease and Health, Human Immunodeficiency Virus (HIV), Heart Disease and Health, Risk
Shen C, Zhao B, Liu L
Financial burden for patients with chronic myeloid leukemia enrolled in Medicare Part D taking targeted oral anticancer medications.
In this study, the investigators examined financial burden for patients with chronic myeloid leukemia enrolled in Medicare Part D taking targeted oral anticancer medications. The authors concluded that patients experience quick entry and exit from the coverage gap (also called the donut hole) as a result of the high price of targeted oral anticancer medications. They suggested that closing the donut hole would provide financial relief during the initial month(s) of treatment but will not completely eliminate the financial burden.
AHRQ-funded; HS020263.
Citation: Shen C, Zhao B, Liu L .
Financial burden for patients with chronic myeloid leukemia enrolled in Medicare Part D taking targeted oral anticancer medications.
J Oncol Pract 2017 Feb;13(2):e152-e62. doi: 10.1200/JOP.2016.014639..
Keywords: Cancer, Chronic Conditions, Elderly, Healthcare Costs, Medicare, Medication
Kenzik KM, Kent EE, Martin MY
Chronic condition clusters and functional impairment in older cancer survivors: a population-based study.
The purpose of this study was to identify chronic condition clusters at pre- and post-cancer diagnosis, evaluate predictors of developing clusters post-cancer, and examine the impact on functional impairment among older cancer survivors. It found that distinct condition clusters of two or more chronic conditions are prevalent among older cancer survivors. Cluster prevalence increases from pre- to post-cancer diagnosis.
AHRQ-funded; HS023009; HS013852.
Citation: Kenzik KM, Kent EE, Martin MY .
Chronic condition clusters and functional impairment in older cancer survivors: a population-based study.
J Cancer Surviv 2016 Dec;10(6):1096-103. doi: 10.1007/s11764-016-0553-4.
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Keywords: Chronic Conditions, Cancer, Elderly, Research Methodologies, Health Status
Lee SJ, Clark MA, Cox JV
Achieving coordinated care for patients with complex cases of cancer: a multiteam system approach.
The authors outlined challenges of care coordination in the context of a multiteam system (MTS), through the care experience of a patient in the Dallas County integrated safety-net system. A cancer diagnosis triggered an additional need for augmented coordination between his different provider teams. The authors recommend that further research and practice investigate the relationships of MTS coordination for shared care management, transfer to and from specialty care, treatment compliance, barriers to care, and health outcomes of chronic comorbid conditions, as well as cancer control and surveillance.
AHRQ-funded; HS022418.
Citation: Lee SJ, Clark MA, Cox JV .
Achieving coordinated care for patients with complex cases of cancer: a multiteam system approach.
J Oncol Pract 2016 Nov;12(11):1029-38. doi: 10.1200/jop.2016.013664.
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Keywords: Cancer, Care Coordination, Chronic Conditions, Patient-Centered Healthcare, Teams
Darlow S, Wen KY
Development testing of mobile health interventions for cancer patient self-management: a review.
The purpose of the current study was to conduct a review of published articles that describe the development process of mobile health interventions for patients’ cancer care self-management. The following trends emerged: importance of stakeholder engagement during the development process, addressing the unique needs and experiences of cancer patients and care providers, ensuring user satisfaction with the system, and identifying perceived benefits and limitations of the system.
AHRQ-funded; HS019001.
Citation: Darlow S, Wen KY .
Development testing of mobile health interventions for cancer patient self-management: a review.
Health Informatics J 2016 Sep;22(3):633-50. doi: 10.1177/1460458215577994..
Keywords: Patient Self-Management, Cancer, Chronic Conditions, Telehealth, Health Information Technology (HIT)
Kenzik KM, Kvale EA, Rocque GB
Treatment summaries and follow-up care instructions for cancer survivors: improving survivor self-efficacy and health care utilization.
The researchers examined the association of receiving summaries and care plans with cancer survivor self-efficacy for chronic illness management. They found that explanation of the follow-up care plan, beyond the written component, enhances survivor self-efficacy for managing cancer as a chronic condition-an important mediator for improving health care utilization outcomes.
AHRQ-funded; HS023009; HS013852.
Citation: Kenzik KM, Kvale EA, Rocque GB .
Treatment summaries and follow-up care instructions for cancer survivors: improving survivor self-efficacy and health care utilization.
Oncologist 2016 Jul;21(7):817-24. doi: 10.1634/theoncologist.2015-0517.
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Keywords: Cancer, Chronic Conditions, Education: Patient and Caregiver, Elderly, Patient Self-Management
Raval AD, Madhavan S, Mattes MD
Types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer.
The authors sought to examine the association between types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer. They found that a significant proportion of elderly men with chronic conditions have received aggressive initial cancer treatment, and they suggested a conservative approach for the initial prostate cancer treatment among elderly men with significant chronic conditions and localised prostate cancer.
AHRQ-funded; HS018622.
Citation: Raval AD, Madhavan S, Mattes MD .
Types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer.
Int J Clin Pract 2016 Jul;70(7):606-18. doi: 10.1111/ijcp.12838.
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Keywords: Cancer, Cancer: Prostate Cancer, Care Management, Chronic Conditions, Elderly, Men's Health
Hannum SM, Rubinstein RL
The meaningfulness of time; narratives of cancer among chronically ill older adults.
The authors sought to describe how chronically ill older adults experience a new cancer diagnosis and the effects of this on their interpretations of personal health, aging, and the future. Among the fifteen participants, they found that perceived time was fragmented into three distinct segments: the Recalled Past, the Existent Present, and the Imagined Future. They discussed implications for how older adults understood their cancer.
AHRQ-funded; HS020177.
Citation: Hannum SM, Rubinstein RL .
The meaningfulness of time; narratives of cancer among chronically ill older adults.
J Aging Stud 2016 Jan;36:17-25. doi: 10.1016/j.jaging.2015.12.006.
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Keywords: Elderly, Cancer, Chronic Conditions, Health Status
Gross CP, Fried TR, Tinetti ME
Decision-making and cancer screening: a qualitative study of older adults with multiple chronic conditions.
The researchers sought to understand how older persons with multiple chronic conditions (MCC) approach decisions about cancer screenings. They found that some older persons with MCC employ heuristics which circumvent the traditional quantitative comparison of risks and benefits, providing an important challenge to informed decision making.
AHRQ-funded; HS018598.
Citation: Gross CP, Fried TR, Tinetti ME .
Decision-making and cancer screening: a qualitative study of older adults with multiple chronic conditions.
J Geriatr Oncol 2015 Mar;6(2):93-100. doi: 10.1016/j.jgo.2014.12.001..
Keywords: Cancer, Chronic Conditions, Shared Decision Making, Elderly, Screening
Kavalieratos D, Kamal AH, Abernethy AP
Comparing unmet needs between community-based palliative care patients with heart failure and patients with cancer.
This study characterized the unresolved symptom and treatment needs which patients with heart failure and those with cancer present to palliative care. It found that patients with HF presented with fewer unresolved symptoms; however, they were more likely to report dyspnea and more commonly experienced dyspnea-related treatment gaps.
AHRQ-funded; HS000032; HS017587
Citation: Kavalieratos D, Kamal AH, Abernethy AP .
Comparing unmet needs between community-based palliative care patients with heart failure and patients with cancer.
J Palliat Med. 2014 Apr;17(4):475-81. doi: 10.1089/jpm.2013.0526..
Keywords: Palliative Care, Cancer, Heart Disease and Health, Chronic Conditions