National Healthcare Quality and Disparities Report
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Topics
- Blood Pressure (1)
- Cardiovascular Conditions (2)
- Care Coordination (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
- Comparative Effectiveness (2)
- Critical Care (1)
- Data (2)
- Diabetes (2)
- Education: Patient and Caregiver (1)
- Elderly (4)
- Evidence-Based Practice (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Costs (1)
- Healthcare Delivery (2)
- Health Information Technology (HIT) (5)
- Health Insurance (1)
- Health Services Research (HSR) (3)
- Heart Disease and Health (3)
- (-) Home Healthcare (23)
- Hospital Discharge (5)
- Hospital Readmissions (1)
- Infectious Diseases (1)
- Injuries and Wounds (1)
- Long-Term Care (2)
- Medicaid (1)
- Medicare (1)
- Medication (3)
- Nursing (2)
- Nursing Homes (1)
- Patient Safety (2)
- Patient Self-Management (2)
- Policy (1)
- Prevention (2)
- Provider: Health Personnel (1)
- Provider: Pharmacist (1)
- Quality Improvement (1)
- Quality of Care (1)
- Respiratory Conditions (1)
- Risk (1)
- Sepsis (1)
- Shared Decision Making (3)
- Stroke (1)
- Transitions of Care (5)
- Treatments (1)
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 23 of 23 Research Studies DisplayedYang Y, Bass EJ, Sockolow PS
Knowledge elicitation of homecare admission decision making processes via focus group, member checking and data visualization.
Researchers elicit knowledge related to expert decision-making processes to inform information technology design and related interventions. In this study, the investigators examine knowledge elicitation of homecare admission decision making processes via focus group, member checking and data visualization. The investigators concluded that the data collection and validation methodology showed promise for knowledge elicitation in time-constrained situations.
AHRQ-funded; HS024537.
Citation: Yang Y, Bass EJ, Sockolow PS .
Knowledge elicitation of homecare admission decision making processes via focus group, member checking and data visualization.
AMIA Annu Symp Proc 2018 Dec 5;2018:1127-36..
Keywords: Home Healthcare, Shared Decision Making, Health Information Technology (HIT), Data
Sterling MR, Silva AF, Leung PBK
"It's like they forget that the word 'health' is in 'home health aide'": Understanding the perspectives of home care workers who care for adults with heart failure.
Home care workers (HCWs) were interviewed about their role and perspectives in caring for community-dwelling adults with heart failure (HF) posthospitalization. Researchers conducted a total of 8 focus groups in partnership with the Home Care Industry Education Fund. A total of 46 English- and Spanish-speaking HCWs employed by 21 unique home care agencies participated. Generally they felt overworked and unappreciated but care about their clients and families and still love their job. The majority of HCWs have not received HF training, so do not feel supported when their clients’ symptoms worsened.
AHRQ-funded; HS024569.
Citation: Sterling MR, Silva AF, Leung PBK .
"It's like they forget that the word 'health' is in 'home health aide'": Understanding the perspectives of home care workers who care for adults with heart failure.
J Am Heart Assoc 2018 Dec 4;7(23):e010134. doi: 10.1161/jaha.118.010134..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Home Healthcare, Provider: Health Personnel
Keller SC, Williams D, Rock C
A new frontier: central line-associated bloodstream infection surveillance in home infusion therapy.
As more home infusion agencies consider ways to perform surveillance for central line–associated bloodstream infection (CLABSI), an understanding of the assorted challenges is necessary. The authors discussed these challenges, which include a lack of a widely accepted standard definition of CLABSIs in home infusion therapy, the lack of a reporting platform, the absence of a reporting requirement, and barriers in obtaining the needed information to identify the presence of a potential CLABSI and adjudicate whether it meets a CLABSI definition. The 21st Century Cures Act will expand Medicare coverage for home infusion therapy services by 2021, likely leading to increased pressure for home infusion therapy CLABSI surveillance. Benchmarking of CLABSI data can usher in informed work to reduce CLABSIs and enhance patient safety in home infusion therapy.
AHRQ-funded; HS025782.
Citation: Keller SC, Williams D, Rock C .
A new frontier: central line-associated bloodstream infection surveillance in home infusion therapy.
Am J Infect Control 2018 Dec;46(12):1419-21. doi: 10.1016/j.ajic.2018.05.016..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Home Healthcare, Patient Safety, Sepsis, Infectious Diseases, Prevention
Russell D, Dowding DW, McDonald MV
Factors for compliance with infection control practices in home healthcare: findings from a survey of nurses' knowledge and attitudes toward infection control.
This study analyzed survey responses from nurses at 2 large, certified home healthcare agencies to explore levels of compliance with infection control practices and identify associated demographic, knowledge, and attitudinal correlates. The findings suggested that efforts to improve compliance with infection control practices in home healthcare should focus on strategies to alter perceptions about infection risk and other attitudinal factors.
AHRQ-funded; HS024723.
Citation: Russell D, Dowding DW, McDonald MV .
Factors for compliance with infection control practices in home healthcare: findings from a survey of nurses' knowledge and attitudes toward infection control.
Am J Infect Control 2018 Nov;46(11):1211-17. doi: 10.1016/j.ajic.2018.05.005..
Keywords: Healthcare-Associated Infections (HAIs), Home Healthcare, Prevention, Patient Safety
Sterling MR, Shaw AL, Leung PB
Home care workers in heart failure: a systematic review.
This systematic review aimed to 1) describe utilization patterns of home care workers (HCWs) by adults with heart failure (HF), 2) examine the effect of HCWs on HF outcomes, and 3) review HF interventions that involve HCWs. The investigators concluded that the literature on these HCWs in HF is limited. They suggest that additional research is warranted on the potential role of HCWs in HF self-care and on outcomes among adults with HF.
AHRQ-funded; HS024569; T32 HS000066.
Citation: Sterling MR, Shaw AL, Leung PB .
Home care workers in heart failure: a systematic review.
J Multidiscip Healthc 2018 Sep 25;11:481-92. doi: 10.2147/jmdh.s175512..
Keywords: Health Services Research (HSR), Heart Disease and Health, Home Healthcare
Auger KA, Simmons JM, Tubbs-Cooley HL
Postdischarge Nurse Home Visits and Reuse: the Hospital to Home Outcomes (H2O) Trial.
In this study, the investigators evaluated the effects of a pediatric transition intervention, specifically a single nurse home visit, on postdischarge outcomes in a randomized controlled trial. The investigators concluded that children randomly assigned to the intervention had higher rates of 30-day postdischarge unplanned health care reuse. They also noted that parents in the intervention group recalled more clinical warning signs 2 weeks after discharge.
AHRQ-funded; HS024735.
Citation: Auger KA, Simmons JM, Tubbs-Cooley HL .
Postdischarge Nurse Home Visits and Reuse: the Hospital to Home Outcomes (H2O) Trial.
Pediatrics 2018 Jul;142(1). doi: 10.1542/peds.2017-3919..
Keywords: Children/Adolescents, Home Healthcare, Hospital Discharge, Nursing, Transitions of Care
Dowding DW, Russell D, Onorato N
Technology solutions to support care continuity in home care: a focus group study.
The purpose of this study was to explore perceptions among home care clinicians of the barriers they face and the information they need to improve care continuity for patients with heart failure. The study highlighted areas of improvement for health information technology solutions that could support care delivery for patients with heart failure in a home care setting.
AHRQ-funded; HS023855.
Citation: Dowding DW, Russell D, Onorato N .
Technology solutions to support care continuity in home care: a focus group study.
J Healthc Qual 2018 Jul/Aug;40(4):236-46. doi: 10.1097/jhq.0000000000000104..
Keywords: Healthcare Delivery, Health Information Technology (HIT), Heart Disease and Health, Home Healthcare, Quality Improvement
Myerson RM, Colantonio LD, Safford MM
Does identification of previously undiagnosed conditions change care-seeking behavior?
The purpose of the study was to determine whether identification of previously undiagnosed high cholesterol, hypertension, and/or diabetes during an in-home assessment impacts care seeking among Medicare beneficiaries. The study concluded that in-home assessment of cholesterol, blood pressure, and blood glucose can increase doctor visits for individuals with previously undiagnosed conditions. However, biomarker assessment may have more limited impact among individuals with low access to care.
AHRQ-funded; HS000084.
Citation: Myerson RM, Colantonio LD, Safford MM .
Does identification of previously undiagnosed conditions change care-seeking behavior?
Health Serv Res 2018 Jun;53(3):1517-38. doi: 10.1111/1475-6773.12644..
Keywords: Blood Pressure, Diabetes, Home Healthcare, Cardiovascular Conditions
Jones CD, Burke RE
Inpatient notes - getting past the "black box"-opportunities for hospitalists to improve postacute care transitions.
The care provided after hospital discharge in skilled-nursing facilities and home health care is collectively termed postacute care (PAC). In this article, the authors outline 3 key problems with postacute care transitions and offer potential solutions.
AHRQ-funded; HS024569.
Citation: Jones CD, Burke RE .
Inpatient notes - getting past the "black box"-opportunities for hospitalists to improve postacute care transitions.
Ann Intern Med 2018 May 15;168(10):HO2-HO3. doi: 10.7326/m18-0940..
Keywords: Health Services Research (HSR), Home Healthcare, Hospital Discharge, Long-Term Care, Transitions of Care
Ma C, Shang J, Miner S
The prevalence, reasons, and risk factors for hospital readmissions among home health care patients: a systematic review.
This systematic review examined the current evidence about hospital readmissions from home health care (HHC). Among 18 reviewed articles, they found that reported readmission rates and risk factors varied dramatically between studies; reasons for readmissions were understudied; and findings were limited by small sample sizes, single data source, and methodological flaws. They recommended that future studies use multiple national data sources across patients’ care spectrum and advanced statistical models to identify who among HHC patients are most likely to be readmitted to hospital and for what reason.
AHRQ-funded; HS023593.
Citation: Ma C, Shang J, Miner S .
The prevalence, reasons, and risk factors for hospital readmissions among home health care patients: a systematic review.
Home Health Care Manag Pract 2018 May;30(2):83-92.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Home Healthcare, Hospital Readmissions
Sockolow PS, Yang Y, Bass EJ
Data visualization of home care admission nurses' decision-making.
This study investigated nurses’ decision making regarding hospital to home care admissions. They conducted a focus group case study with six admitting home health nurses at a rural agency in Pennsylvania and analyzed the data using thematic analysis.
AHRQ-funded; HS024537.
Citation: Sockolow PS, Yang Y, Bass EJ .
Data visualization of home care admission nurses' decision-making.
AMIA Annu Symp Proc 2018 Apr 16;2017:1597-606..
Keywords: Data, Shared Decision Making, Home Healthcare, Nursing, Transitions of Care
Berridge C
Medicaid becomes the first third-party payer to cover passive remote monitoring for home care: policy analysis.
This study examined passive remote monitoring technologies in state Medicaid programs. Its goals were to identify which states allowed location tracking, sensor systems, and cameras, what policies were in place to track usage, what implementation processes and program monitoring mechanisms were in place, and what related insights Medicaid program stakeholders would like to learn. Interviews were conducted with state, federal, and managed care organization (MCO) Medicaid program stakeholders about the use of these technologies in state waivers that served community-dwelling older adults in 15 states. While two-thirds of the states covered location tracking and activity-monitoring sensors and one-third covered cameras, only 3 states had specific service categories that allowed tracking of when they pay for these technologies. The authors conclude that technologies that have great potential to alter the way older adults receive supportive services are often used without research on their use, social or ethical implications, or outcomes. New service categories are needed to enable oversight, and more interaction between policymakers and researchers in this field would aid in the prioritization of research aims to inform practice.
AHRQ-funded; HS000011.
Citation: Berridge C .
Medicaid becomes the first third-party payer to cover passive remote monitoring for home care: policy analysis.
J Med Internet Res 2018 Feb 21;20(2):e66. doi: 10.2196/jmir.9650..
Keywords: Elderly, Health Information Technology (HIT), Health Insurance, Healthcare Delivery, Home Healthcare, Medicaid, Policy
Rahman M, Keohane L, Trivedi AN
High-cost patients had substantial rates of leaving Medicare Advantage and joining traditional Medicare.
The investigators examined the rates at which participants who used three high-cost services switched between Medicare Advantage and traditional Medicare. They found that the switching rate from 2010 to 2011 away from Medicare Advantage and to traditional Medicare exceeded the switching rate in the opposite direction for participants who used long-term nursing home care, short-term nursing home care, and home health care. These results were magnified among people who were enrolled in both Medicare and Medicaid.
AHRQ-funded; HS000011.
Citation: Rahman M, Keohane L, Trivedi AN .
High-cost patients had substantial rates of leaving Medicare Advantage and joining traditional Medicare.
Health Aff 2015 Oct;34(10):1675-81. doi: 10.1377/hlthaff.2015.0272.
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Keywords: Healthcare Costs, Home Healthcare, Long-Term Care, Medicare, Nursing Homes
Rivera-Hernandez M, Yamashita T, Kinney JM
Identifying naturally occurring retirement communities: a spatial analysis.
The authors analyzed naturally occurring retirement communities (NORCs) and whether there were spatiotemporal patterns in Ohio between 2000 and 2010. They found that there were different patterns including emerging, disappearing, and enduring NORCs and disproportionate distributions of NORCs across the state between 2000 and 2010. They recommended that locating NORCs could aid governments to create "aging in place" sensitive policies to address issues of independence, social care, health care, volunteerism, and community participation.
AHRQ-funded; HS000011.
Citation: Rivera-Hernandez M, Yamashita T, Kinney JM .
Identifying naturally occurring retirement communities: a spatial analysis.
J Gerontol B Psychol Sci Soc Sci 2015 Jul;70(4):619-27. doi: 10.1093/geronb/gbu077.
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Keywords: Elderly, Home Healthcare
Rhee SM, Valle MF, Wilson LM
Negative pressure wound therapy technologies for chronic wound care in the home setting: a systematic review.
The researchers conducted a systematic review on the efficacy and safety of negative pressure wound therapy (NPWT) for the treatment of chronic wounds in the home setting. Data were limited by variability in the types of comparator groups, methodological limitations, and poor reporting of outcomes. The researchers were unable to draw conclusions about the efficacy or safety of NPWT for the treatment of chronic wounds in the home setting due to the insufficient evidence.
AHRQ-funded; 290201200007I.
Citation: Rhee SM, Valle MF, Wilson LM .
Negative pressure wound therapy technologies for chronic wound care in the home setting: a systematic review.
Wound Repair Regen 2015 Jul-Aug;23(4):506-17. doi: 10.1111/wrr.12295..
Keywords: Injuries and Wounds, Home Healthcare, Comparative Effectiveness, Treatments, Chronic Conditions
McDonald MV, Feldman PH, Barron-Vaya Y
Outcomes of clinical decision support (CDS) and correlates of CDS use for home care patients with high medication regimen complexity: a randomized trial.
The researchers assessed the outcomes of a clinical decision support (CDS) intervention designed for home care patients with high medication regimen complexity (MRC) and examined correlates of CDS use. They found that eighty-two percent of intervention nurses used the CDS but for only 42 percent of their patients. Among intervention patients, CDS use (vs. non-use) was associated with reduced MRC and hospitalization.
AHRQ-funded; HS017837.
Citation: McDonald MV, Feldman PH, Barron-Vaya Y .
Outcomes of clinical decision support (CDS) and correlates of CDS use for home care patients with high medication regimen complexity: a randomized trial.
J Eval Clin Pract 2015 May 26;22(1):10-19. doi: 10.1111/jep.12383.
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Keywords: Clinical Decision Support (CDS), Home Healthcare, Medication, Risk
Baier RR, Cooper E, Wysocki A
Using qualitative methods to create a home health web application user interface for patients with low computer proficiency.
The researchers undertook a multi-phased approach to create a consumer-facing home health web application in Rhode Island. This included reviewing the evidence base to identify design recommendations and then creating a paper prototype and wireframe. They performed qualitative research to iteratively test their proposed user interface with two user groups, home health consumers and hospital case managers and t]hen refined their design to create the final web application.
AHRQ-funded; HS021879
Citation: Baier RR, Cooper E, Wysocki A .
Using qualitative methods to create a home health web application user interface for patients with low computer proficiency.
eGEMS. 2015 May 13;3(2):1166. doi: 10.13063/2327-9214.1166..
Keywords: Home Healthcare, Health Information Technology (HIT), Quality of Care, Education: Patient and Caregiver
Baier RR, Wysocki A, Gravenstein S
A qualitative study of choosing home health care after hospitalization: the unintended consequences of 'patient choice' requirements.
The purpose of this qualitative study is to learn how quality reports are used when choosing home care. Focus groups with 13 home health consumers and interviews with 28 hospital case managers from five hospitals revealed that both groups were unaware of public reports about home care quality.
AHRQ-funded; HS021879
Citation: Baier RR, Wysocki A, Gravenstein S .
A qualitative study of choosing home health care after hospitalization: the unintended consequences of 'patient choice' requirements.
J Gen Intern Med. 2015 May;30(5):634-40. doi: 10.1007/s11606-014-3164-7..
Keywords: Shared Decision Making, Elderly, Home Healthcare, Hospital Discharge, Transitions of Care
Uronis HE, Ekstrom MP, Currow DC
Oxygen for relief of dyspnoea in people with chronic obstructive pulmonary disease who would not qualify for home oxygen: a systematic review and meta-analysis.
The researchers conducted a systematic review and meta-analysis to determine whether oxygen therapy provides symptomatic relief in COPD patients with breathlessness who do not qualify currently for long-term oxygen. They concluded that continuous oxygen during exertion, but not short-burst therapy, reduced dyspnoea in mildly- and non-hypoxemic people with COPD who would not otherwise qualify for home oxygen therapy.
AHRQ-funded; HS000079.
Citation: Uronis HE, Ekstrom MP, Currow DC .
Oxygen for relief of dyspnoea in people with chronic obstructive pulmonary disease who would not qualify for home oxygen: a systematic review and meta-analysis.
Thorax 2015 May;70(5):492-4. doi: 10.1136/thoraxjnl-2014-205720..
Keywords: Comparative Effectiveness, Home Healthcare, Respiratory Conditions
Wellman BR, Frail CK, Zillich AJ
Pharmacists' experiences with a telephonic medication therapy management program for home health care patients.
This qualitative study involved interviewing four pharmacists on their experiences with a telephone medication therapy management (MTM) program. Several themes emerged from the analysis, including: communication and relationships, coordinating care and patient self-management, logistics, professional fulfillment, service delivery and content, and training opportunities. The researchers concluded that their study provides possible strategies to overcome barriers and facilitate service provision for future telephonic MTM services.
AHRQ-funded; HS022119.
Citation: Wellman BR, Frail CK, Zillich AJ .
Pharmacists' experiences with a telephonic medication therapy management program for home health care patients.
Consult Pharm 2015 Mar;30(3):163-74. doi: 10.4140/TCP.n.2015.163..
Keywords: Home Healthcare, Medication, Provider: Pharmacist, Patient Self-Management
Prvu Bettger J, McCoy L, Smith EE
Contemporary trends and predictors of postacute service use and routine discharge home after stroke.
The authors examined trends in discharge to inpatient rehabilitation facilities, skilled nursing facilities, home with home health, and home without services for patients with ischemic or hemorrhagic stroke at hospitals participating in Get With The Guidelines-Stroke. They found that four in 10 stroke patients are discharged home without postacute care services. They recommended further research to explain the shift in service use by type and its effect on outcomes.
AHRQ-funded; HS019479.
Citation: Prvu Bettger J, McCoy L, Smith EE .
Contemporary trends and predictors of postacute service use and routine discharge home after stroke.
J Am Heart Assoc 2015 Feb 23;4(2). doi: 10.1161/jaha.114.001038.
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Keywords: Critical Care, Hospital Discharge, Home Healthcare, Stroke
Nasarwanji N, Werner NE, Carl K
Identifying challenges associated with the care transition workflow from hospital to skilled home health care: perspectives of home health care agency providers.
The authors studied the workflow for transitioning older adults from the hospital to skilled home health care (SHHC). They found three overarching challenges to optimal care transitions: information access, coordination, and communication/teamwork. They recommended that future investigations test whether redesigning the transition from hospital to SHHC improves workflow and care quality.
AHRQ-funded; HS022916.
Citation: Nasarwanji N, Werner NE, Carl K .
Identifying challenges associated with the care transition workflow from hospital to skilled home health care: perspectives of home health care agency providers.
Home Health Care Serv Q 2015;34(3-4):185-203. doi: 10.1080/01621424.2015.1092908.
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Keywords: Care Coordination, Elderly, Home Healthcare, Hospital Discharge, Transitions of Care
Casper GR, Flatley Brennan P, Perreault JO
vizHOME--a context-based home assessment: preliminary implications for informatics.
The focus of this paper is on the first phase of the vizHOME study, specifically on the exploration and documentation of the individual’s performance of self-management tasks including such things as medication management and use of a monitoring device. The researchers learned from the participants that while the tools may perform satisfactorily in usability assessment, they may not meet the needs of many users.
AHRQ-funded; HS022548.
Citation: Casper GR, Flatley Brennan P, Perreault JO .
vizHOME--a context-based home assessment: preliminary implications for informatics.
Stud Health Technol Inform 2015;216:842-6..
Keywords: Diabetes, Patient Self-Management, Home Healthcare, Health Information Technology (HIT), Medication