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- Ambulatory Care and Surgery (1)
- Asthma (1)
- Autism (1)
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- Home Healthcare (1)
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- Implementation (2)
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- Low-Income (1)
- Nursing (1)
- Nursing Homes (1)
- Organizational Change (1)
- (-) Patient-Centered Healthcare (22)
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- Primary Care: Models of Care (2)
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- Provider: Health Personnel (1)
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- Social Determinants of Health (1)
- Teams (3)
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- Transitions of Care (3)
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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 22 of 22 Research Studies DisplayedAhern J, Singer S, Bhanja A
Considering dentists within the healthcare team: a cross-sectional, multi-state analysis of primary care provider and staff perspectives.
The authors used novel survey data to examine the extent to which primary care providers, other providers, and staff consider dentists part of the healthcare team, and assessed associated practice and individual characteristics. Their findings indicated that dentists are frequently not considered part of the healthcare team in primary care settings. Further, varied responses within practices suggested that provider and staff perceptions may pose challenges to integrating dentists into primary care. Respondents in practices with more integrated diabetes care management processes were more likely to consider dentists as part of the healthcare team, reflecting dental care recommendations made by the American Diabetes Association.
AHRQ-funded; HS024067.
Citation: Ahern J, Singer S, Bhanja A .
Considering dentists within the healthcare team: a cross-sectional, multi-state analysis of primary care provider and staff perspectives.
J Gen Intern Med 2022 Jan;37(1):246-48. doi: 10.1007/s11606-020-06564-w..
Keywords: Primary Care, Provider: Health Personnel, Patient-Centered Healthcare, Care Coordination
Parikh K, Richmond M, Lee M
Outcomes from a pilot patient-centered hospital-to-home transition program for children hospitalized with asthma.
The purpose of this study was to evaluate a multi-component hospital-to-home (H2H) transition program for children hospitalized with an asthma exacerbation. A pilot prospective randomized clinical trial of guideline-based asthma care with and without a patient-centered multi-component H2H program was conducted among children enrolled in K-8(th) grade on Medicaid hospitalized for an asthma exacerbation. The investigators concluded that the pilot data suggested that comprehensive care coordination initiated during the inpatient stay was feasible and acceptable.
AHRQ-funded; HS024554.
Citation: Parikh K, Richmond M, Lee M .
Outcomes from a pilot patient-centered hospital-to-home transition program for children hospitalized with asthma.
J Asthma 2021 Oct;58(10):1384-94. doi: 10.1080/02770903.2020.1795877..
Keywords: Children/Adolescents, Patient-Centered Healthcare, Transitions of Care, Asthma, Hospital Discharge, Care Coordination, Chronic Conditions
Feinberg E, Kuhn J, Eilenberg JS
Improving family navigation for children with autism: a comparison of two pilot randomized controlled trials.
This study looked at impacts of a modification to a pilot program called Family Navigation to help low-income, minority children needing autism-related diagnostic services receive those services. An advisory group recommended modifications to recruitment criteria and study conditions. 40 parent-child dyad participants were randomized between the two pilots to receive usual care (UC) or modified FN. Participant enrollment, satisfaction with clinical care, and timely completion of the diagnostic assessment were compared. Recruitment improved significantly with the modified protocol (4.8% vs. 19.5%) and no participants were excluded from study enrollment compared to the first pilot (43.6%). Families in the second pilot were more likely to complete diagnostic assessment and report greater satisfaction with clinical care.
AHRQ-funded; HS022155; HS022242.
Citation: Feinberg E, Kuhn J, Eilenberg JS .
Improving family navigation for children with autism: a comparison of two pilot randomized controlled trials.
Acad Pediatr 2021 Mar;21(2):265-71. doi: 10.1016/j.acap.2020.04.007..
Keywords: Children/Adolescents, Autism, Patient-Centered Healthcare, Care Coordination, Racial and Ethnic Minorities, Low-Income, Patient and Family Engagement, Chronic Conditions
Quigley DD, Qureshi N, Masarweh LA
Practice leaders report targeting several types of changes in care experienced by patients during patient-centered medical home transformation.
This study looked at how primary care practices implemented changes during the transition to becoming a patient-centered medical home (PCMH). The authors examined 105 primary care practice leader experiences during PCMH transformation using semi-structured interviews. Practices most commonly targeted changes in care coordination (30%), access to care (25%), and provider communication (24%). Reported areas for PCMH transformation were measured by Clinician & Group CAHPS, PCMH CAHPS, or supplemental CAHPS survey items, including team-based care (35%), providing more on-site services (28%), care management (22%), patient-centered culture (18%), and chronic condition health education (13%). Many PCMH changes are captured by CAHPS survey items, but some are not.
AHRQ-funded; HS025920.
Citation: Quigley DD, Qureshi N, Masarweh LA .
Practice leaders report targeting several types of changes in care experienced by patients during patient-centered medical home transformation.
J Patient Exp 2020 Dec;7(6):1509-18. doi: 10.1177/2374373520934231..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare, Patient Experience, Care Coordination, Quality Improvement, Quality of Care, Implementation
Ortiz D, Meagher AD, Lindroth H
A trauma medical home, evaluating collaborative care for the older injured patient: study protocol for a randomized controlled trial.
It is estimated that 55 million adults will be 65 years and older in the USA by 2020. These older adults are at increased risk for injury and their recovery is multi-faceted. A collaborative care model may improve psychological and functional outcomes of the non-neurologically impaired older trauma patient and reduce health care costs. The investigators discussed the proposed study protocol which would evaluate a collaborative care model to help maximize psychological and functional recovery for non-neurologically injured older patients at four level one trauma centers in the Midwest.
AHRQ-funded; HS026390.
Citation: Ortiz D, Meagher AD, Lindroth H .
A trauma medical home, evaluating collaborative care for the older injured patient: study protocol for a randomized controlled trial.
Trials 2020 Jul 16;21(1):655. doi: 10.1186/s13063-020-04582-x..
Keywords: Elderly, Patient-Centered Healthcare, Injuries and Wounds, Care Coordination, Nursing Homes, Care Management
Amar-Dolan LG, Horn MH, O'Connell B B
"This is how hard it is". family experience of hospital-to-home transition with a tracheostomy.
This study explores the experience of family caregivers of children and young adults with a tracheostomy during the transition from hospital to home care. Researchers sought to identify the specific unmet needs of families to direct future interventions. Using semi-structured interviews, they found a need for family-centered discharge processes including coordination of care and teaching focused on emergency preparedness.
AHRQ-funded; HS000063.
Citation: Amar-Dolan LG, Horn MH, O'Connell B B .
"This is how hard it is". family experience of hospital-to-home transition with a tracheostomy.
Ann Am Thorac Soc 2020 Jul;17(7):860-68. doi: 10.1513/AnnalsATS.201910-780OC..
Keywords: Transitions of Care, Home Healthcare, Caregiving, Patient Experience, Care Coordination, Hospital Discharge, Hospitals, Children/Adolescents, Patient-Centered Healthcare
Nembhard IM, Buta E, Lee YSH
A quasi-experiment assessing the six-months effects of a nurse care coordination program on patient care experiences and clinician teamwork in community health centers.
The authors assessed effects of adding care coordination formally to nurses’ roles on care experiences of high-risk patients and clinician teamwork during the first 6 months of use. They conducted a quasi-experimental study in which changes in staff and patient experiences at six community health center practice locations that introduced the added-role approach for high-risk patients were compared to changes in six locations without the program in the same health system. They found that there were some positive effects of adding care coordination to nurses' role within 6 months of implementation, suggesting value in this improvement strategy. They concluded that addressing compatibility between coordination and other job demands is important when implementing this approach to coordination.
AHRQ-funded; HS016978.
Citation: Nembhard IM, Buta E, Lee YSH .
A quasi-experiment assessing the six-months effects of a nurse care coordination program on patient care experiences and clinician teamwork in community health centers.
BMC Health Serv Res 2020 Feb 24;20(1):137. doi: 10.1186/s12913-020-4986-0..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Care Coordination, Nursing, Patient Experience, Community-Based Practice, Patient-Centered Healthcare, Ambulatory Care and Surgery, Teams
Heeringa J, Mutti A, Furukawa MF
AHRQ Author: Furukawa MF
Horizontal and vertical integration of health care providers: a framework for understanding various provider organizational structures.
The authors conducted a narrative review of 10 years of literature to identify definitional components of key organizational structures in the United States. They found that U.S. policymakers seek to promote provider integration and coordination. They conclude that emerging evidence suggested that organizational structures, composition, and other characteristics influence cost and quality performance. They recommend future research to examine systematically the role of organizational structure in cost and quality outcomes.
AHRQ-authored; AHRQ-funded.
Citation: Heeringa J, Mutti A, Furukawa MF .
Horizontal and vertical integration of health care providers: a framework for understanding various provider organizational structures.
Int J Integr Care 2020 Jan 20;20(1):2. doi: 10.5334/ijic.4635.
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Keywords: Health Systems, Healthcare Delivery, Patient-Centered Healthcare, Care Coordination, Organizational Change, Policy
Derrett S, Gunter KE, Samaranayaka A
Development and testing of the Provider and Staff Perceptions of Integrated Care (PSPIC) Survey.
The authors developed and tested a 21-item questionnaire titled Provider and Staff Perceptions of Integrated Care Survey. The questionnaire was sent to 2,936 providers and staff at 100 federally qualified health centers and other clinics in Midwestern U.S. States, of which 2,604 were deemed eligible. Four mailings were conducted with a 30% response rate from 97 health centers. Four latent factors were suggested: Teams and Care Continuity, Patient Centeredness, Coordination with External Providers, and Coordination with Community Resources.
AHRQ-funded; HS000084.
Citation: Derrett S, Gunter KE, Samaranayaka A .
Development and testing of the Provider and Staff Perceptions of Integrated Care (PSPIC) Survey.
Med Care Res Rev 2019 Dec;76(6):807-29. doi: 10.1177/1077558717745936..
Keywords: Provider, Care Coordination, Patient-Centered Healthcare, Teams
Timbie JW, Kranz AM, Mahmud A
Federally qualified health center strategies for integrating care with hospitals and their association with measures of communication.
Federally qualified health centers have aligned clinical services and systems with local hospitals, but little is known about the specific care integration strategies health centers use or their impact on care. In this study, a research team examined the use of strategies by health centers to integrate care with hospitals and emergency departments (EDs) and their association with performance on measures of health center-hospital communication.
AHRQ-funded; HS024067.
Citation: Timbie JW, Kranz AM, Mahmud A .
Federally qualified health center strategies for integrating care with hospitals and their association with measures of communication.
Jt Comm J Qual Patient Saf 2019 Sep;45(9):620-28. doi: 10.1016/j.jcjq.2019.06.004..
Keywords: Patient-Centered Healthcare, Patient-Centered Outcomes Research, Hospitals, Communication, Emergency Department, Care Coordination, Healthcare Delivery
Bierman AS
AHRQ Author: Bierman AS
Preventing and managing multimorbidity by integrating behavioral health and primary care.
People with multimorbidity are especially challenged in navigating fragmented health systems designed to treat diseases rather than people. The harms associated with this fragmentation, such as adverse events resulting from conflicting treatments and increased costs, have been well documented. As a result, there have been renewed calls for more patient-centered care, with a particular emphasis on the importance of the integration of primary care and behavioral health as fundamental for achieving this goal. This paper discusses preventing and managing multimorbidity by integrating behavioral health and primary care.
AHRQ author - Bierman
Citation: Bierman AS .
Preventing and managing multimorbidity by integrating behavioral health and primary care.
Health Psychol 2019 Sep;38(9):851-54. doi: 10.1037/hea0000787..
Keywords: Care Coordination, Healthcare Delivery, Behavioral Health, Patient-Centered Healthcare, Primary Care
Davis MM, Gunn R, Pham R
Key collaborative factors when Medicaid Accountable Care Organizations work with primary care clinics to improve colorectal cancer screening: relationships, data, and quality improvement infrastructure.
This study focused on ways that Medicaid Accountable Care Organizations (ACOs) are implementing interventions with primary care clinics to improve colorectal cancer screening. The researchers conducted a comparative case study of 14 Medicaid ACOs in Oregon and their contracted primary care clinics. They focused on interventions that reduced structural barriers (12 ACOs), delivered provider assessment and feedback (11 ACOs), and provided patient reminders (7 ACOs). There was an unintended consequence of potential exclusion of smaller clinics and metric focus and fatigue.
AHRQ-funded; HS022981.
Citation: Davis MM, Gunn R, Pham R .
Key collaborative factors when Medicaid Accountable Care Organizations work with primary care clinics to improve colorectal cancer screening: relationships, data, and quality improvement infrastructure.
Prev Chronic Dis 2019 Aug 15;16:E107. doi: 10.5888/pcd16.180395..
Keywords: Primary Care: Models of Care, Primary Care, Screening, Colonoscopy, Cancer: Colorectal Cancer, Cancer, Quality Improvement, Quality of Care, Care Coordination, Patient-Centered Healthcare
Senft N, Everson J
eHealth engagement as a response to negative healthcare experiences: cross-sectional survey analysis.
The goal of this study was to determine how the negative healthcare experiences of low patient centeredness and care coordination problems motivate the use of different eHealth activities, and whether more highly educated individuals are more likely than those less highly educated to use eHealth following negative experiences. Researchers used factor analysis to group 25 different eHealth activities into categories, based on the correlation between respondents' reports of their usage. Their findings indicate that individuals use a greater number of eHealth activities, especially activities independent of healthcare providers, when they experience problems with their healthcare; people with lower levels of education who have had negative healthcare experiences seem more inclined to use eHealth. The researchers recommend that, in order to maximize the potential for eHealth to meet the needs of all patients, especially those who are underserved, additional work is needed to ensure that eHealth resources are accessible to all members of the population.
AHRQ-funded; HS026122.
Citation: Senft N, Everson J .
eHealth engagement as a response to negative healthcare experiences: cross-sectional survey analysis.
J Med Internet Res 2018 Dec 5;20(12):e11034. doi: 10.2196/11034..
Keywords: Care Coordination, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Healthcare, Patient Experience, Telehealth
Kranz AM, Dalton S, Damberg C
Using health IT to coordinate care and improve quality in safety-net clinics.
Health centers provide care to vulnerable and high-need populations. Recent investments have promoted use of health information technology (HIT) capabilities for improving care coordination and quality of care in health centers. This study examined factors associated with use of these HIT capabilities and the association between these capabilities and quality of care in a census of health centers in the United States.
AHRQ-funded; HS024067.
Citation: Kranz AM, Dalton S, Damberg C .
Using health IT to coordinate care and improve quality in safety-net clinics.
Jt Comm J Qual Patient Saf 2018 Dec;44(12):731-40. doi: 10.1016/j.jcjq.2018.03.006..
Keywords: Health Information Technology (HIT), Care Coordination, Patient-Centered Healthcare, Quality Improvement, Quality of Care, Vulnerable Populations, Care Management
Tomoaia-Cotisel A, Farrell TW, Solberg LI
AHRQ Author: Harrison MI, Genevro JL
Implementation of care management: an analysis of recent AHRQ research.
This article describes care management (CM) implementation and associated lessons from 12 Agency for Healthcare Research and Quality-sponsored projects. Two rounds of data collection resulted in project-specific narratives that were analyzed using an iterative approach analogous to framework analysis. Informants also participated as coauthors. Variation emerged across practices and over time regarding CM services provided, personnel delivering these services, target populations, and setting(s).
AHRQ-authored; AHRQ-funded; HS021933; 2902007.
Citation: Tomoaia-Cotisel A, Farrell TW, Solberg LI .
Implementation of care management: an analysis of recent AHRQ research.
Med Care Res Rev 2018 Feb;75(1):46-65. doi: 10.1177/1077558716673459.
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Keywords: Care Coordination, Patient-Centered Healthcare, Primary Care, Implementation
Hewner S, Casucci S, Sullivan S
Integrating social determinants of health into primary care clinical and informational workflow during care transitions.
Care continuity during transitions between the hospital and home requires reliable communication between providers and settings and an understanding of social determinants that influence recovery. This paper describes the coordinating transitions intervention which uses real time alerts, delivered directly to the primary care practice for complex chronically ill patients discharged from an acute care setting, to facilitate nurse care coordinator led telephone outreach.
AHRQ-funded; HS022575.
Citation: Hewner S, Casucci S, Sullivan S .
Integrating social determinants of health into primary care clinical and informational workflow during care transitions.
eGEMS 2017 Jul 4;5(2):2. doi: 10.13063/2327-9214.1282..
Keywords: Care Coordination, Chronic Conditions, Patient-Centered Healthcare, Social Determinants of Health, Transitions of Care
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
Ferrante JM, Friedman A, Shaw EK
Lessons learned designing and using an online discussion forum for care coordinators in primary care.
In this paper, the authors comprehensively describe their experiences, from start to finish, of designing and using an asynchronous online discussion forum for collecting and analyzing information elicited from care coordinators in Patient-Centered Medical Homes across the United States. They conclude that an asynchronous online discussion forum is a feasible, efficient, and effective method to conduct a qualitative study, particularly when subjects are health professionals.
AHRQ-funded; HS020682.
Citation: Ferrante JM, Friedman A, Shaw EK .
Lessons learned designing and using an online discussion forum for care coordinators in primary care.
Qual Health Res 2016 Nov;26(13):1851-61. doi: 10.1177/1049732315609567..
Keywords: Care Coordination, Health Services Research (HSR), Patient-Centered Healthcare, Primary Care, Research Methodologies
Friedman A, Howard J, Shaw EK
Facilitators and barriers to care coordination in patient-centered medical homes (PCMHs) from coordinators' perspectives.
This is the first study describing experiences of care coordinators across the US from their own perspectives. It concluded that while all the barriers and facilitators were important to performing coordinators' roles, relationship building was key to effective care coordination, whether with clinicians, patients, or outside organizations.
AHRQ-funded; HS020682.
Citation: Friedman A, Howard J, Shaw EK .
Facilitators and barriers to care coordination in patient-centered medical homes (PCMHs) from coordinators' perspectives.
J Am Board Fam Med 2016 Jan-Feb;29(1):90-101. doi: 10.3122/jabfm.2016.01.150175.
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Keywords: Care Coordination, Patient-Centered Healthcare, Healthcare Delivery
Halladay JR, Mottus K, Reiter K
The cost to successfully apply for level 3 medical home recognition.
The National Committee for Quality Assurance patient-centered medical home recognition program provides practices an opportunity to implement medical home activities. Understanding the costs to apply for recognition may enable practices to plan their work. This study found variation in the distribution of costs by activity by practice, but the costs to apply were remarkably similar.
AHRQ-funded; HS022629.
Citation: Halladay JR, Mottus K, Reiter K .
The cost to successfully apply for level 3 medical home recognition.
J Am Board Fam Med 2016 Jan-Feb;29(1):69-77. doi: 10.3122/jabfm.2016.01.150211.
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Keywords: Patient-Centered Healthcare, Healthcare Costs, Care Coordination, Quality of Care
Van Cleave J, Boudreau AA, McAllister J
Care coordination over time in medical homes for children with special health care needs.
This study explored how care coordination changes conceptually and practically in primary care practices when implementing the medical home and to identify reasons for different types of changes. They found that in high-performing medical homes, care coordination activities changed from being mostly reactive to patients’ episodic needs to being more systematically proactive and comprehensive.
AHRQ-funded; HS019157.
Citation: Van Cleave J, Boudreau AA, McAllister J .
Care coordination over time in medical homes for children with special health care needs.
Pediatrics 2015 Jun;135(6):1018-26. doi: 10.1542/peds.2014-1067..
Keywords: Care Coordination, Care Management, Patient-Centered Healthcare, Primary Care
Brennan PF, Valdez R, Alexander G
Patient-centered care, collaboration, communication, and coordination: a report from AMIA's 2013 Policy Meeting.
AMIA’s 2013 Health Policy Invitational was focused on examining existing challenges surrounding full engagement of the patient and crafting a research agenda and policy framework encouraging the use of informatics solutions to achieve this goal. This paper summarizes the meeting as well as the research agenda and policy recommendations prioritized among the invited experts and stakeholders.
AHRQ-funded; HS021825.
Citation: Brennan PF, Valdez R, Alexander G .
Patient-centered care, collaboration, communication, and coordination: a report from AMIA's 2013 Policy Meeting.
J Am Med Inform Assoc 2015 Apr;22(e1):e2-6. doi: 10.1136/amiajnl-2014-003176..
Keywords: Care Coordination, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Healthcare, Policy