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
101 to 125 of 1004 Research Studies DisplayedFletcher EH, Kalofonos I
Adaptation of a Hearing Voices group facilitation training for VA stakeholders.
The purpose of this study was to describe an adaptation of a Hearing Voices (HV) group facilitation training at the Veterans Administration hospital of Greater Los Angeles (VAGLA) and to explore training modifications, trainee perceptions and application and intervention outcomes. Researchers conducted surveys of trainees (n = 18) and collected field notes throughout the 24-hour online training. The study found that the training had high acceptability and appropriateness and high feasibility in implementation.
AHRQ-funded; HS026407.
Citation: Fletcher EH, Kalofonos I .
Adaptation of a Hearing Voices group facilitation training for VA stakeholders.
Community Ment Health J 2022 Nov;58(8):1592-604. doi: 10.1007/s10597-022-00975-1..
Keywords: Behavioral Health, Training
Rodriguez HP, Kyalwazi MJ, Lewis VA
Adoption of patient-reported outcomes by health systems and physician practices in the USA.
This study examined the extent of patient-reported outcome (PRO) measure adoption among health systems and physician practices nationally and examines the organizational capabilities associated with more extensive PRO adoption. A total of 323 US health system and 2,190 physician practices responded to one of two nationally representative surveys. Survey results found that pain (50.6%) and depression (43.8%) PROs were more commonly adopted by all hospitals and medical groups within health systems compared to disability PROs (26.5%). Systems with more advanced health IT functions were more likely to use disability and depression PROs than systems with less advanced health IT. Practice-level advanced health IT was positively associated with use of depression PRO, but not disability or pain PRO use. The three PROs were more likely to be adopted in practices with more chronic care management processes, broader medical and social risk screening, and more processes to support patient responsiveness. Also, compared to independent physician practices, system-owned practices and community health centers were less likely to adopt PROs.
AHRQ-funded; HS024075.
Citation: Rodriguez HP, Kyalwazi MJ, Lewis VA .
Adoption of patient-reported outcomes by health systems and physician practices in the USA.
J Gen Intern Med 2022 Nov;37(15):3885-92. doi: 10.1007/s11606-022-07631-0..
Keywords: Health Systems, Provider: Physician, Patient-Centered Healthcare
Pineles BL, Harris AD, Goodman KE
Adverse maternal and delivery outcomes in children and very young (age ≤13 years) US adolescents compared with older adolescents and adults.
This study compared adverse maternal and delivery outcomes of pregnant 10- to 13-year-olds vs 14- to 17-year-olds and 18- to 19-year-olds. This cross-sectional study looked at all patients aged 10 to 19 years who delivered at hospitals in the Premier Healthcare Database from January 2019 through May 2021. The study included 90,876 deliveries across 655 US hospitals. Controlling for patient race and ethnicity, insurance type, and obesity status: 10- to 13-year-olds had significantly higher risks of preterm delivery and cesarean delivery compared with 14- to 17-year-olds. The risk of preeclampsia was not higher for 10- to 13-year-olds compared to 14- to 17-year-olds. There was a higher risk of preterm delivery for 10- to 13-year-olds compared to 18- to 19-year-olds, but not significantly different for cesarean delivery and preeclampsia.
AHRQ-funded; HS028363.
Citation: Pineles BL, Harris AD, Goodman KE .
Adverse maternal and delivery outcomes in children and very young (age ≤13 years) US adolescents compared with older adolescents and adults.
JAMA 2022 Nov 1;328(17):1766-68. doi: 10.1001/jama.2022.18340..
Keywords: Children/Adolescents, Pregnancy, Labor and Delivery, Women, Outcomes, Adverse Events, Maternal Care
Soper NS, Appukutty AJ, Paje D
Antibiotic overuse after discharge from medical short-stay units.
This study investigated antibiotic overuse after discharge from medical short-stay units (SSUs). This cross-sectional study included patients hospitalized in 2 different medical SSUs with a total of 40 beds at a single academic medical center. Eligible adults were discharged with an oral antibiotic from either SSU from May 2018 to September 2019. Of 100 patients discharged from SSUs with antibiotics, 47 had a skin and soft-tissue infection (SSTI), 22 pneumonia, 21 UTI, and 10 had “other” infections. Overall, 78 cases (78%) were defined as overuse, including 39 of 47 of those treated for SSTI, 17 of 21 for UTI, and 14 of 22 for pneumonia. The most common types of overuse were excess duration and guideline discordant selection. Examples of factors influencing overuse included consultant recommendations, miscalculation of duration, and the need for source control procedure.
AHRQ-funded; HS026530.
Citation: Soper NS, Appukutty AJ, Paje D .
Antibiotic overuse after discharge from medical short-stay units.
Nov;43(11):1689-92. doi: 10.1017/ice.2021.346..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Pneumonia, Skin Conditions, Urinary Tract Infection (UTI), Respiratory Conditions, Hospital Discharge
Sullivan BA, Panda A, Wallman-Stokes A
Antibiotic spectrum index: a new tool comparing antibiotic use in three NICUs.
This study looked at a new tool called the antibiotic spectrum index (ASI) which quantifies antibiotic exposure by relative antimicrobial activity, adding information to exposure measured by days of therapy (DOT). This index was tested with very low-birth-weight infants (VLBW, <1500g) in 3 level-4 NICUs for 2 years at 2 sites and for 1 year at a third site. The authors calculated the ASI per antibiotic days and DOT per patient days for all admitted VLBW infants <32 weeks gestational age. The site with the highest DOT per patient days was found to have the lowest ASI per antibiotic days and the site with the highest mortality and infection rates were found to have the highest ASI per antibiotic days. Antibiotic utilization varied by center.
AHRQ-funded; HS026742.
Citation: Sullivan BA, Panda A, Wallman-Stokes A .
Antibiotic spectrum index: a new tool comparing antibiotic use in three NICUs.
Infect Control Hosp Epidemiol 2022 Nov;43(11):1553-57. doi: 10.1017/ice.2021.467..
Keywords: Antibiotics, Medication, Newborns/Infants, Intensive Care Unit (ICU), Critical Care, Antimicrobial Stewardship
Grove LR, Rao N, Domino ME
Are North Carolina clinicians delivering opioid use disorder treatment to Medicaid beneficiaries?
This study’s goal was to inform efforts to increase prescriptions of medications for opioid use disorder (MOUD) among Medicaid beneficiaries. A retrospective study of North Carolina licensed physicians, physician assistants, and nurse practitioners was conducted to estimate Medicaid participation prevalence among clinicians authorized to prescribe buprenorphine and to estimate the association between clinician characteristics and OUD care delivery to Medicaid beneficiaries. Outcomes looked for were indicators of any Medicaid professional claims and Medicaid claims data for buprenorphine and naltrexone. Licensure data from 2018 was merged with 2019 US Drug Enforcement Administration to identify clinicians who used the DEA waiver required to prescribe buprenorphine (n = 1714). Services by waivered clinicians to Medicare beneficiaries ranged from 67% of behavioral health clinicians to 82.9% of specialist physicians. Prevalence of prescribing buprenorphine to Medicaid beneficiaries ranged from 30.3% among specialist physicians to 51.6% among behavioral health clinicians.
AHRQ-funded; HS000032.
Citation: Grove LR, Rao N, Domino ME .
Are North Carolina clinicians delivering opioid use disorder treatment to Medicaid beneficiaries?
Addiction 2022 Nov;117(11):2855-63. doi: 10.1111/add.15854..
Keywords: Opioids, Substance Abuse, Behavioral Health, Vulnerable Populations, Medication, Access to Care, Medicaid
Gibbons RD, Hur K, Lavigne JE
Association between folic acid prescription fills and suicide attempts and intentional self-harm among privately insured US adults.
This paper describes a large-scale pharmacoepidemiologic study of folic acid prescription fills to determine if there is a decreased risk of suicide attempt. Data were collected from a pharmacoepidemiologic database of US medical claims (MarketScan) for 866,586 patients with private health insurance who filled a folic acid prescription from 2012 to 2017. In the cohort 81.3% were female, and 10.42% were 60 years and older. Overall, there were 261 suicidal events during covered by a folic acid prescription for a rate of 4.73 per 100,000 person-months, compared with 895 suicidal events during months without folic acid for a rate of 10.61 per 100,000 person-months. Adjusting for age and sex, diagnoses related to suicidal behavior, diagnoses related to folic acid deficiency, folate-reducing medications, history of folate-reducing medications, and history of suicidal events, the hazard ratio (HR) for folic acid for suicide events was 0.56, with similar results for the modal dosage of 1 mg of folic acid per day and women of childbearing age. The same association with the negative control cyanocobalamin found no association with suicide attempt.
AHRQ-funded; HS016973.
Citation: Gibbons RD, Hur K, Lavigne JE .
Association between folic acid prescription fills and suicide attempts and intentional self-harm among privately insured US adults.
JAMA Psychiatry 2022 Nov;79(11):118-1123. doi: 10.1001/jamapsychiatry.2022.2990..
Keywords: Medication, Behavioral Health, Adverse Drug Events (ADE), Adverse Events
Yabroff KR, Han X, Zhao J
AHRQ Author: Kirby J
Association of health insurance coverage disruptions with mortality risk among US working-age adults.
This cohort study assessed associations of a prior coverage disruption with mortality risk among large, nationally representative cohorts of working-age adults aged 18 to 64 with public or private health insurance coverage. Most research had previously been conducted among Medicaid enrollees, and little is known about insurance disruption among privately insured adults. The study used data from the 2000 to 2018 National Health Interview Survey (NIHS), specifically from the NHIS Linked Mortality files which contain data from the National Death Index. All data was deidentified and publicly available. The authors found that disruptions were associated with a higher mortality risk in either publicly or privately insured adults.
AHRQ-authored.
Citation: Yabroff KR, Han X, Zhao J .
Association of health insurance coverage disruptions with mortality risk among US working-age adults.
JAMA Health Forum 2022 Nov;3(11):e224258. doi: 10.1001/jamahealthforum.2022.4258..
Keywords: Health Insurance, Mortality, Risk, Access to Care
Angier H, Kaufmann J, Heintzman J
Association of parent preventive care with their child's recommended well-child visits.
The purpose of this retrospective, cohort study was to explore whether there is a relationship between parent preventive care and their children's well-child visits. The researchers utilized electronic health record data to identify children and link them to parents both seen in an OCHIN network of 363 clinics from 17 states, then randomly selected a child between the ages of 3 and 17 with more than 1 ambulatory medical visit between the years 2015 and 2018. The study included a sample of 75,398 linked mother only pairs, 12,438 father only pairs, and 4,156 2-parent pairs. Children in the mother only sample had a 6% greater rate of yearly well-child visits when their mother received preventive care compared to no preventive care, children in the father only sample had a 7% greater rate of yearly well-child visits when their father received preventive care versus no preventive care, and children in the two parent sample had an 11% greater rate of yearly well-child visits when both parents received preventive care compared to neither receiving preventive care. The researchers concluded that well-child visit rates may improve when care is provided for the entire family.
AHRQ-funded; HS025962.
Citation: Angier H, Kaufmann J, Heintzman J .
Association of parent preventive care with their child's recommended well-child visits.
Acad Pediatr 2022 Nov-Dec;22(8):1422-28. doi: 10.1016/j.acap.2022.03.019..
Keywords: Children/Adolescents, Prevention, Family Health and History, Healthcare Utilization
Shah SC, Tarassishin L, Eisele C
Breastfeeding is associated with lower likelihood of Helicobacter pylori colonization in babies, based on a prospective USA maternal-infant cohort.
The authors evaluated maternal and baby factors associated with likelihood of H. pylori colonization in the babies. They found that H. pylori prevalence was 31.8% in mothers and 19.7% in their babies. Dominant breastfeeding and maternal IBD were associated with significantly lower likelihood of H. pylori colonization among babies; no other clinical factors were associated with H. pylori colonization in the babies. They concluded that dominant breastfeeding may protect against early H. pylori colonization.
AHRQ-funded; HS026395.
Citation: Shah SC, Tarassishin L, Eisele C .
Breastfeeding is associated with lower likelihood of Helicobacter pylori colonization in babies, based on a prospective USA maternal-infant cohort.
Dig Dis Sci 2022 Nov;67(11):5149-57. doi: 10.1007/s10620-021-07371-x..
Keywords: Newborns/Infants, Breast Feeding, Evidence-Based Practice
Semere W, Kaplan L, Valle K
Caregiving needs are unmet for many older homeless adults: findings from the Hope Home study.
Researchers described characteristics of older homeless-experienced adults with caregiving need and determined factors associated with having unmet need. Using data from the longitudinal study, Health Outcomes in People Experiencing Homelessness in Older Middle Age (HOPE HOME), they found that better self-rated health and being a man were associated with higher odds of unmet need. Moderate or high-risk substance use was associated with lower odds of unmet need. They recommended interventions that increase caregiving access for homeless-experienced individuals in order to avoid poor health outcomes and costly long-term-care needs due to untreated disabilities.
AHRQ-funded; HS027844.
Citation: Semere W, Kaplan L, Valle K .
Caregiving needs are unmet for many older homeless adults: findings from the Hope Home study.
J Gen Intern Med 2022 Nov;37(14):3611-19. doi: 10.1007/s11606-022-07438-z..
Keywords: Elderly, Vulnerable Populations, Caregiving, Access to Care
Purnell TS, Bignall ONR, Norris KC
Centering anti-racism and social justice in nephrology education to advance kidney health equity.
This article discusses actions necessary to effectively prepare a new generation of nephrology thought leaders who understand the roles of structural racism and social determinants of health (SDOH) in continuing racial disparities as critical issues in efforts that promote kidney health equity. The authors provide their recommendations for centering antiracism and social justice in nephrology education to advance kidney health equity, including: 1 Acknowledging and adopting evidence-based strategies to address implicit biases and explicit acts of interpersonal racism in healthcare encounters that may perpetuate kidney health disparities; 2) Strive to remove structural racism at the societal and health system levels that systematically introduce inequities in kidney care; 3) incorporate research training inclusive of methodologic and content areas that are vital to health equity; 4) foster role modeling within nephrology education through faculty mentorship and professional networking opportunities. The authors conclude that to effectively advance kidney research and practice, sustainable solutions to eradicate disparities must be developed and a prepared nephrology workforce must be trained, one that centers antiracism and social justice in sustained efforts to advance kidney health equity.
AHRQ-funded; HS024600.
Citation: Purnell TS, Bignall ONR, Norris KC .
Centering anti-racism and social justice in nephrology education to advance kidney health equity.
J Am Soc Nephrol 2022 Nov;33(11):1981-84. doi: 10.1681/asn.2022040432..
Keywords: Racial and Ethnic Minorities, Kidney Disease and Health, Disparities, Education: Continuing Medical Education, Education: Curriculum
Teixeira da Silva D, Petsis D, Santos T
Chlamydia trachomatis/neisseria gonorrhea retesting among adolescents and young adults in a primary care network.
This study describes retesting following Chlamydia trachomatis/Neisseria gonorrhea (CT/NG) diagnosis among adolescent and young adult patients at Title X and non-Title X clinics and measures the association of patient-level factors with CT/NG retesting. Findings showed that guideline-recommended retesting following CT/NG diagnosis was low in this young primary care cohort, especially among male and non-Title X clinic patients.
AHRQ-funded; HS026116.
Citation: Teixeira da Silva D, Petsis D, Santos T .
Chlamydia trachomatis/neisseria gonorrhea retesting among adolescents and young adults in a primary care network.
J Adolesc Health 2022 Nov;71(5):545-51. doi: 10.1016/j.jadohealth.2022.06.014..
Keywords: Children/Adolescents, Young Adults, Sexual Health, Infectious Diseases, Primary Care
Sikora A, Martin GS
Critical care pharmacists: improving care by increasing access to medication expertise.
This article discusses the shortage and need for critical care pharmacists in ICUs to improve care and prevent medication errors. There is a gap in critical care pharmacists with both low supply and low demand. Identifying the optimal patient:pharmacist ratio in the ICU is a key question. The authors discuss ways to reduce the gap by increasing the number of critical care pharmacy residency programs and including critical care pharmacists more in multidisciplinary rounds. The authors developed a toolkit for increasing critical care pharmacy services in five actionable steps and provide an annotated bibliography of key references.
AHRQ-funded; HS028485.
Citation: Sikora A, Martin GS .
Critical care pharmacists: improving care by increasing access to medication expertise.
Ann Am Thorac Soc 2022 Nov;19(11):1796-98. doi: 10.1513/AnnalsATS.202206-502VP..
Keywords: Provider: Pharmacist, Medication, Quality Improvement, Quality of Care, Critical Care
White A, Fulda KG, Blythe R
Defining and enhancing collaboration between community pharmacists and primary care providers to improve medication safety.
The purpose of this narrative review was to further define the nature of collaboration between pharmacists and primary care providers in improving medication safety in community settings, and to describe related barriers and strategies. The researchers searched PubMed studies published between January 2000 and December 2020 using search terms including: "collaboration," "community pharmacy," "patient safety," "medication safety," and "primary care physician." The identified articles were placed into 3 categories: 1) defining collaboration, 2) types of collaboration, and 3) barriers and solutions to collaboration. The authors concluded that medication review and other strategies are a common form of collaboration between pharmacists and primary care providers, and that barriers to that collaboration can include erroneous beliefs regarding roles, variation in access to clinical information, and differences in community pharmacy practice.
AHRQ-funded; HS027277.
Citation: White A, Fulda KG, Blythe R .
Defining and enhancing collaboration between community pharmacists and primary care providers to improve medication safety.
Expert Opin Drug Saf 2022 Nov;21(11):1357-64. doi: 10.1080/14740338.2022.2147923..
Keywords: Provider: Pharmacist, Primary Care, Medication, Patient Safety, Community-Based Practice
Arora S, Fowler ME, Harmon C
Differences in pretreatment frailty across gastrointestinal cancers in older adults: results from the Cancer and Aging Resilience Evaluation registry.
The purpose of this study was to explore differences in pretreatment frailty between colorectal (CRC), hepatobiliary, and pancreatic cancers. The researchers included adults aged 60 years and higher enrolled in the Cancer and Aging Resilience Evaluation registry. A 44-item Cancer and Aging Resilience Evaluation frailty index was utilized to define frailty, which included geriatric assessment impairments of functional status, cognitive complaints, health-related quality of life, comorbidities, polypharmacy, anxiety, depression, malnutrition, falls, ability to walk one block, and interference in social activities. A total of 505 patients were included in the study: 41.8% with CRC, 35.2% with pancreatic cancer, and 116 23.0% with hepatobiliary cancer. The study found the following prevalence of frailty: 40.6% pancreatic, 34.3% hepatobiliary, and 23.3% CRC. Frailty was linked with higher rates of malnutrition and instrumental activities of daily living impairments in patients with pancreatic cancer and higher number of comorbidities in patients with hepatobiliary cancer. The study concluded that adults aged 60 and over with pancreatic and hepatobiliary cancers are at high-risk of pretreatment frailty.
AHRQ-funded; HS013852.
Citation: Arora S, Fowler ME, Harmon C .
Differences in pretreatment frailty across gastrointestinal cancers in older adults: results from the Cancer and Aging Resilience Evaluation registry.
JCO Oncol Pract 2022 Nov;18(11):e1796-e806. doi: 10.1200/op.22.00270..
Keywords: Elderly, Cancer, Digestive Disease and Health
Marcaccio CL, Patel PB, de Guerre L
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
The purpose of this study was to identify variations in 5-year outcomes and imaging surveillance after elective endovascular aortic aneurysm repair (EVAR) by sex, race, and ethnicity and to examine possible mechanisms contributing to these variations. The primary outcome was 5-year aneurysm rupture. Secondary outcomes were 5-year reintervention and mortality, and having no aortic imaging follow-up from 6 to 24 months after EVAR. The study found that among 16,040 patients, 73% were White males, 18% were White females, 2.6% were Black males, 1.1% were Black females, 0.9% were Asian males, 0.2% were Asian females, 1.7% were Hispanic males, and 0.4% were Hispanic females. At 5 years, Black females had the highest rupture rates at 6.4% and white males had the lowest at 2.3%. Compared with White males, rupture rates were higher in White females, Black females, and Asian females. Among other groups, Black males had higher reintervention and both Black and Hispanic males had higher rates of no imaging follow-up. In adjusted analyses, White, Black, and Asian females remained at significantly higher risk for 5-year rupture. The researchers concluded that Black females had higher 5-year aneurysm rupture, reintervention, and mortality rates after elective EVAR as compared with White male patients, whereas White females had higher rupture, mortality and loss-to-imaging-follow-up compared to White male patients. Black males had higher reintervention and no imaging follow-up, and Asian females had higher rupture rates.
AHRQ-funded; HS027285.
Citation: Marcaccio CL, Patel PB, de Guerre L .
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
J Vasc Surg 2022 Nov;76(5):1205-15.e4. doi: 10.1016/j.jvs.2022.03.886..
Keywords: Disparities, Racial and Ethnic Minorities, Sex Factors, Outcomes, Imaging, Heart Disease and Health, Cardiovascular Conditions
Marcaccio CL, O'Donnell TFX, Dansey KD
Disparities in reporting and representation by sex, race, and ethnicity in endovascular aortic device trials.
The purpose of this study was to examine the demographics of patients enrolled in critical U.S. endovascular aortic device trials to explore the representation of vulnerable populations, including women and racial and ethnic minorities. The primary outcomes included the percentage of trials reporting participant sex, race, and ethnicity and the percentage of participants across sex, racial, and ethnic groups. The study found that the Food and Drug Administration (FDA) provided 29 approvals from 29 trials of 24 devices with a total of 4046 patients: 52% (15) were EVAR devices, 41% (12) were TEVAR devices, and 3.4% (1) was a FEVAR device, with 1 dissection stent (3.4%). Fifty-two percent of the trials reported the three most common racial groups (White, Black, Asian), and 48% reported Hispanic ethnicity. The TEVAR trials were the most likely to report all three racial groups and Hispanic ethnicity (92% and 75%, respectively), while the EVAR trials had the lowest reporting rates (13% and 20%, respectively). The median female enrollment was 21%, with the EVAR trials having the lowest female enrollment compared with 41% in the TEVAR trials, 21% in the FEVAR trial, and 34% in the dissection stent trial. The study concluded that in critical aortic device trials that led to FDA approval, female patients were underrepresented, especially for EVAR, and racial and ethnic minority groups were under-represented and underreported.
AHRQ-funded; HS027285.
Citation: Marcaccio CL, O'Donnell TFX, Dansey KD .
Disparities in reporting and representation by sex, race, and ethnicity in endovascular aortic device trials.
J Vasc Surg 2022 Nov;76(5):1244-52.e2. doi: 10.1016/j.jvs.2022.05.003..
Keywords: Disparities, Racial and Ethnic Minorities, Heart Disease and Health, Cardiovascular Conditions, Medical Devices, Sex Factors
Soltani Batt, RJ Bavafa, H
Does what happens in the ED stay in the ED? The effects of emergency department physician workload on post-ed care use.
The purpose of this study was to evaluate the effects of Emergency Department (ED) crowding on the performance of systems outside of the ED: specifically, on the use of post-ED care. The researchers also examined the mediating effects of care intensity in the ED on post-ED use of care. The study utilized microdata from a large U.S. hospital dataset gathered from over four years of exhaustive billing data in an integrated health system. The study found that when ED provider workload increased from the 5th percentile to the median, the number of medical services for patients who were discharged home from the ED increased by 5% and was stable after. The researchers also discovered that when a physician is busier, they order a greater number of tests for patients who are less severe. The study concluded that "extra" testing by providers results in "extra" post-ED care use for those patients, and that earlier studies estimating the cost of ED crowding underestimate the actual effect, because they do not take into account the "extra" post-ED care use.
AHRQ-funded; HS024558.
Citation: Soltani Batt, RJ Bavafa, H .
Does what happens in the ED stay in the ED? The effects of emergency department physician workload on post-ed care use.
Manuf Serv Oper Manag 2022 Nov-Dec;24(6):3079-98. doi: 10.1287/msom.2022.1110..
Keywords: Emergency Department, Healthcare Utilization
Chui MA, Berbakov ME, Gilson AM
Effectiveness and sustainment of a tailored over-the-counter medication safety intervention in community pharmacies: a randomized controlled trial.
This paper is a protocol of a pilot study to address a gap in medication safety and decrease misuse of over-the-counter (OTC) medications by older adults aged 65 years or older by creating a pharmacy “Senior Section”. The study will occur in three phases: adaptation, effectiveness using a randomized controlled trial, and sustainment. The study will take place within a regional Midwest integrated health system in conjunction with administration leadership and pharmacy sites. The authors hope this project will provide a road map for pharmacy organizations to tailor and adopt the Senior Section.
AHRQ-funded; HS027737.
Citation: Chui MA, Berbakov ME, Gilson AM .
Effectiveness and sustainment of a tailored over-the-counter medication safety intervention in community pharmacies: a randomized controlled trial.
Res Social Adm Pharm 2022 Nov;18(11):3953-63. doi: 10.1016/j.sapharm.2022.06.008..
Keywords: Medication, Medication: Safety, Patient Safety, Provider: Pharmacist
James TG, Miller MD, McKee MM
Emergency department condition acuity, length of stay, and revisits among deaf and hard-of-hearing patients: a retrospective chart review.
This study assessed emergency department (ED) condition acuity, length of stay (LOS), and acute ED revisits among deaf and hard-of-hearing (DHH) patients. Findings identified that DHH American Sign Language users have longer ED LOS than non-DHH English-speakers.
AHRQ-funded; HS027537.
Citation: James TG, Miller MD, McKee MM .
Emergency department condition acuity, length of stay, and revisits among deaf and hard-of-hearing patients: a retrospective chart review.
Acad Emerg Med 2022 Nov;29(11):1290-300. doi: 10.1111/acem.14573..
Keywords: Emergency Department, Disabilities, Vulnerable Populations
Krauss DM, Molefe A, Hung L
AHRQ Author: Henderson S, Miller M
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
In this study, researchers summarized themes for maintaining infection prevention activities learned from the implementation of a quality improvement (QI) program during the COVID-19 pandemic. They concluded that future shocks such as the pandemic must be anticipated, and the healthcare system must be resilient to the resulting disruptions to healthcare-associated infection prevention activities. Their study encountered four themes for successful maintenance of infection prevention activities during the current pandemic: the value of a pre-existing infection prevention infrastructure; a flexibility in approach; broad buy-in for maintaining QI programs; and the facilitation of idea-sharing.
AHRQ-authored; AHRQ-funded; 233201500016I.
Citation: Krauss DM, Molefe A, Hung L .
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
BMJ Open Qual 2022 Nov;11(4):e001926. doi: 10.1136/bmjoq-2022-001926..
Keywords: COVID-19, Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Quality Improvement, Quality of Care, Critical Care, Intensive Care Unit (ICU), Prevention, Urinary Tract Infection (UTI), Infectious Diseases
Thompson MP, Yaser JM, Forrest A
Evaluating the feasibility of a statewide collaboration to improve cardiac rehabilitation participation: the Michigan Cardiac Rehab Network.
The purpose of this study as to assess the feasibility of the Michigan Cardiac Rehab Network to improve Cardiac Rehabilitation (CR) participation. The researchers utilized Multipayer claims data from the Michigan Value Collaborative to identify 95 hospitals and 84 CR facilities and convene a multidisciplinary group of advisors. Three CR facilities were selected for virtual site visits to identify areas of success and barriers to improvement. The study found that 51% of hospitals provided interventional cardiology services and 35% provided cardiac surgical services. The multidisciplinary group of advisors was convened and represented a broad range of roles within 13 institutions. CR enrollment statewide among eligible admissions was 33.4%, with broad differences in CR performance measures among participating hospitals and eligible admissions. Virtual site visits highlighted successes in increasing CR participation but an array of barriers to participation associated with referrals, capacity and staffing constraints, and geographic and financial barriers.
AHRQ-funded; HS027830.
Citation: Thompson MP, Yaser JM, Forrest A .
Evaluating the feasibility of a statewide collaboration to improve cardiac rehabilitation participation: the Michigan Cardiac Rehab Network.
J Cardiopulm Rehabil Prev 2022 Nov 1;42(6):e75-e81. doi: 10.1097/hcr.0000000000000706..
Keywords: Cardiovascular Conditions, Rehabilitation, Quality Improvement, Quality of Care
Hickey EJ, Feinberg E, Kuhn J
Family impact during the time between autism screening and definitive diagnosis.
The purpose of this study was to explore parental perceptions of the impact their child’s behavior had on their family between the time risk of Autism Spectrum Disorder (ASD) was identified and before formal medical diagnosis, and then compare family impact among those whose child met diagnostic criteria for ASD and those who did not. The study found that the parents of children who received a non-ASD diagnosis reported a higher baseline level of family impact. Perception of difficult child behavior was a stronger predictor of family impact than later diagnostic group, and child functioning did not predict family impact. The researchers concluded that in this specific population, perceived difficult child behavior is a stronger predictor of family impact than later diagnostic category.
AHRQ-funded; HS022242.
Citation: Hickey EJ, Feinberg E, Kuhn J .
Family impact during the time between autism screening and definitive diagnosis.
J Autism Dev Disord 2022 Nov;52(11):4908-20. doi: 10.1007/s10803-021-05354-5..
Keywords: Autism, Screening, Diagnostic Safety and Quality
Scott JW, Scott KW, Moniz M
Financial outcomes after traumatic injury among working-age US adults with commercial insurance.
This cross-sectional study linked insurance claims and consumer credit report data to evaluate the experience of financial distress in commercially insured adults after traumatic injury. Data from Blue Cross Blue Shield of Michigan’s preferred provider organization insurance claims from 2019 through 2021 were included. The authors identified working-age adults aged 21 to 64 whose January 2021 credit reports occurred more than 6 months after hospital admission for traumatic injury. This cohort of 3164 adults was compared demographically to 2223 patients in the comparison cohort. Relative to the comparison cohort, the post injury cohort had a 23% higher likelihood of having medical debt in collections, a 70% higher amount of medical debt in collections, and a 110% higher bankruptcy rate. For many commercially insured patients, the burden of out-of-pocket costs after hospitalization exceeded their ability to pay and could be associated with bankruptcy risk.
AHRQ-funded; HS028672; HS025465; HS028817.
Citation: Scott JW, Scott KW, Moniz M .
Financial outcomes after traumatic injury among working-age US adults with commercial insurance.
JAMA Health Forum 2022 Nov;3(11):e224105. doi: 10.1001/jamahealthforum.2022.4105..
Keywords: Trauma, Healthcare Costs, Health Insurance