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 128 Research Studies DisplayedLipton BJ, Decker SL
AHRQ Author: Decker SL
The effect of health insurance coverage on medical care utilization and health outcomes: evidence from Medicaid adult vision benefits.
The reserarchers examined the effect of vision insurance on eye care utilization and vision health outcomes by taking advantage of quasi-experimental variation in Medicaid coverage of adult vision care. They found that Medicaid beneficiaries with vision coverage are 4.4 percentage points more likely to have seen an eye doctor in the past year,and 5.3 percentage points less likely to report needing but not purchasing eyeglasses or contacts due to cost.
AHRQ-authored.
Citation: Lipton BJ, Decker SL .
The effect of health insurance coverage on medical care utilization and health outcomes: evidence from Medicaid adult vision benefits.
J Health Econ 2015 Dec;44:320-32. doi: 10.1016/j.jhealeco.2015.10.006.
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Keywords: Medicaid, Eye Disease and Health, Healthcare Utilization, Health Services Research (HSR), Outcomes
Melnick ER, Shafer K, Rodulfo N
Understanding overuse of computed tomography for minor head injury in the emergency department: a triangulated qualitative study.
The objective was to identify nonclinical, human factors that promote or inhibit the appropriate use of computed tomography (CT) in patients presenting to the emergency department (ED) with minor head injury. Five core domains emerged from the analysis: establishing trust, anxiety (patient and provider), constraints related to ED practice, the influence of others, and patient expectations.
AHRQ-funded; HS021271.
Citation: Melnick ER, Shafer K, Rodulfo N .
Understanding overuse of computed tomography for minor head injury in the emergency department: a triangulated qualitative study.
Acad Emerg Med 2015 Dec;22(12):1474-83. doi: 10.1111/acem.12824.
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Keywords: Emergency Medical Services (EMS), Imaging, Brain Injury, Shared Decision Making, Health Services Research (HSR)
Islam R, Weir CR, Jones M
Understanding complex clinical reasoning in infectious diseases for improving clinical decision support design.
The purpose of the study was to examine the constituents of decision complexity and explore the cognitive strategies clinicians use to control and adapt to their information environment. The following three themes emerged as the constituents of decision complexity experienced by the Infectious Diseases experts: 1) the overall clinical picture does not match the pattern, 2) a lack of comprehension of the situation and 3) dealing with social and emotional pressures such as fear and anxiety.
AHRQ-funded; HS023349.
Citation: Islam R, Weir CR, Jones M .
Understanding complex clinical reasoning in infectious diseases for improving clinical decision support design.
BMC Med Inform Decis Mak 2015 Nov 30;15:101. doi: 10.1186/s12911-015-0221-z.
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Keywords: Clinical Decision Support (CDS), Health Services Research (HSR), Practice Patterns
McConnochie KM
Pursuit of value in connected healthcare.
The authors highlighted differences in care models to mitigate controversy and to distinguish capacities of these different models. They concluded that the pursuit of value in connected care is fundamentally the same as with in-person care.
AHRQ-funded; HS016871; HS015165; HS018912.
Citation: McConnochie KM .
Pursuit of value in connected healthcare.
Telemed J E Health 2015 Nov;21(11):863-9. doi: 10.1089/tmj.2015.0111.
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Keywords: Healthcare Delivery, Quality of Care, Health Services Research (HSR), Telehealth
Ross RE, Garfield LD, Brown DS
The Affordable Care Act and implications for health care services for American Indian and Alaska Native individuals.
This paper summarizes the Affordable Care Act provisions that directly and/or indirectly affect the service delivery of health care provided by tribes and the Indian Health Service.
AHRQ-funded; HS020269.
Citation: Ross RE, Garfield LD, Brown DS .
The Affordable Care Act and implications for health care services for American Indian and Alaska Native individuals.
J Health Care Poor Underserved 2015 Nov;26(4):1081-8. doi: 10.1353/hpu.2015.0129.
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Keywords: Disparities, Policy, Health Status, Health Services Research (HSR), Racial and Ethnic Minorities
Blendon RJ, Benson JM, Gorski MT
The perspectives of six Latino heritage groups about their health care.
The authors examined the perspectives of six Latino heritage groups on the health care issues they face. They found that all six heritage groups agree that diabetes is the biggest health problem facing their families.
AHRQ-funded; HS000055.
Citation: Blendon RJ, Benson JM, Gorski MT .
The perspectives of six Latino heritage groups about their health care.
J Immigr Minor Health 2015 Oct;17(5):1347-54. doi: 10.1007/s10903-014-0078-8.
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Keywords: Quality of Care, Health Services Research (HSR), Racial and Ethnic Minorities, Patient Experience, Patient Experience
Kronick R, Berkwits M
AHRQ Author: Kronick R
The future of AHRQ's health services research.
In this article, AHRQ Director Richard Kronick, PhD, sat down with JAMA to talk about the agency’s work and its relationship with other federal health research entities. Dr. Kronick explains how AHRQ’s work is focused on figuring out how to improve health outcomes that patients care about. He also discusses how AHRQ’s mission differs from that of the National Institutes of Health and the Patient-Centered Outcomes Research Institute.
AHRQ-authored.
Citation: Kronick R, Berkwits M .
The future of AHRQ's health services research.
JAMA 2015 Sep 8;314(10):979-81. doi: 10.1001/jama.2015.10260..
Keywords: Health Services Research (HSR), Outcomes
Whicher DM, Kass NE, Audera-Lopez C
Ethical issues in patient safety research: a systematic review of the literature.
The authors provided a review of the literature related to ethics, oversight, and patient safety research; identified issues highlighted in articles as being of ethical relevance; described areas of consensus regarding how to respond to these ethical issues; and highlighted areas where additional ethical analysis and discussion are needed to provide guidance to those in the field.
AHRQ-funded; HS000029.
Citation: Whicher DM, Kass NE, Audera-Lopez C .
Ethical issues in patient safety research: a systematic review of the literature.
J Patient Saf 2015 Sep;11(3):174-84. doi: 10.1097/pts.0000000000000064.
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Keywords: Health Services Research (HSR), Patient Safety, Patient-Centered Outcomes Research
Okumura MJ, Saunders M, Rehm RS
The role of health advocacy in transitions from pediatric to adult care for children with special health care needs: bridging families, provider and community services.
The aim of this study was to develop a theoretical understanding of how family, healthcare providers, and community supports can assist youth and young adults with special healthcare needs (YASHCN) during the transition from pediatric to adult healthcare and services. Transition Advocacy consists of the presence of, or need for, a healthcare advocate who did or can assist the YASHCN with the healthcare transition, particularly to navigate complex health or community services. If advocates were identified, youth were more likely to obtain needed services.
AHRQ-funded; HS017716.
Citation: Okumura MJ, Saunders M, Rehm RS .
The role of health advocacy in transitions from pediatric to adult care for children with special health care needs: bridging families, provider and community services.
J Pediatr Nurs 2015 Sep-Oct;30(5):714-23. doi: 10.1016/j.pedn.2015.05.015.
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Keywords: Children/Adolescents, Community-Based Practice, Disabilities, Health Services Research (HSR), Young Adults
Orman ES, Mayorga ME, Wheeler SB
Declining liver graft quality threatens the future of liver transplantation in the United States.
This study used the United Network for Organ Sharing (UNOS) database to inform a 20-year discrete event simulation estimating liver transplantation (LT) volume from 2010 to 2030. It found that if donor liver utilization practices remain constant, utilization will fall from 78 percent to 44 percent by 2030, resulting in 2,230 fewer LTs.
AHRQ-funded; HS019468.
Citation: Orman ES, Mayorga ME, Wheeler SB .
Declining liver graft quality threatens the future of liver transplantation in the United States.
Liver Transpl 2015 Aug;21(8):1040-50. doi: 10.1002/lt.24160..
Keywords: Healthcare Utilization, Health Services Research (HSR), Transplantation
Geissler KH, Becker C, Stearns SC
Exploring the association of homicides in northern Mexico and healthcare access for US residents.
The reesearchers analyzed whether recent increases in homicides in Mexico are associated with reduced healthcare access for US border residents. They found that, despite a decrease in border crossings, increased violence in Mexico did not appear to negatively affect healthcare access for US border residents.
AHRQ-funded; HS021074.
Citation: Geissler KH, Becker C, Stearns SC .
Exploring the association of homicides in northern Mexico and healthcare access for US residents.
J Immigr Minor Health 2015 Aug;17(4):1214-24. doi: 10.1007/s10903-014-0053-4.
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Keywords: Access to Care, Health Services Research (HSR), Social Determinants of Health
Davis AE, Mehrotra S, Friedewald JJ
Improving geographic equity in kidney transplantation using alternative kidney sharing and optimization modeling.
The authors analyzed current kidney allocation and developed an alternative kidney sharing strategy using a multiperiod linear optimization model, KSHARE, which aims to improve geographic equity in kidney transplantation while also respecting transplant system constraints and priorities. They used Organ Procurement and Transplant Network data to determine that enhancing the practice of sharing kidneys by the KSHARE model may increase geographic equity in kidney transplantation.
AHRQ-funded; HS021078.
Citation: Davis AE, Mehrotra S, Friedewald JJ .
Improving geographic equity in kidney transplantation using alternative kidney sharing and optimization modeling.
Med Decis Making 2015 Aug;35(6):797-807. doi: 10.1177/0272989x14557696.
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Keywords: Access to Care, Disparities, Health Services Research (HSR), Social Determinants of Health, Transplantation
Zingmond DS, Parikh P, Louie R
Improving hospital reporting of patient race and ethnicity--approaches to data auditing.
This study investigated new metrics to improve the reporting of patient race and ethnicity (R/E) by hospitals. It examined agreement between hospital reported R/E versus self-report among mothers delivering babies and a cancer cohort in California. It concluded that comparison between reported R/E and R/E estimates using zip code level data may be a reasonable first approach to evaluate and track hospital R/E reporting.
AHRQ-funded; HS019963.
Citation: Zingmond DS, Parikh P, Louie R .
Improving hospital reporting of patient race and ethnicity--approaches to data auditing.
Health Serv Res 2015 Aug;50 Suppl 1:1372-89. doi: 10.1111/1475-6773.12324..
Keywords: Racial and Ethnic Minorities, Hospitals, Hospital Discharge, Health Services Research (HSR), Registries, Quality Improvement, Quality of Care, Data
Toro-Diaz H, Mayorga ME, Barritt AS
Predicting liver transplant capacity using discrete event simulation.
The researchers constructed a discrete event simulation model informed by current donor characteristics to predict future liver transplant trends through the year 2030. They found that by altering assumptions about the future donor pool, their model can be used to develop policy interventions to prevent a further decline in this lifesaving therapy.
AHRQ-funded; HS019468.
Citation: Toro-Diaz H, Mayorga ME, Barritt AS .
Predicting liver transplant capacity using discrete event simulation.
Med Decis Making 2015 Aug;35(6):784-96. doi: 10.1177/0272989x14559055.
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Keywords: Access to Care, Health Services Research (HSR), Policy, Transplantation
Ryan AM, Burgess JF, Dimick JB
Why we should not be indifferent to specification choices for difference-in-differences.
The purpose of this study was to evaluate the effects of specification choices on the accuracy of estimates in difference-in-differences models. They found that performance of alternative specifications varied dramatically when the probability of treatment was correlated with pre-intervention levels or trends. In these cases, propensity score matching resulted in much more accurate point estimates.
AHRQ-funded; HS018546.
Citation: Ryan AM, Burgess JF, Dimick JB .
Why we should not be indifferent to specification choices for difference-in-differences.
Health Serv Res 2015 Aug;50(4):1211-35. doi: 10.1111/1475-6773.12270..
Keywords: Quality of Care, Health Services Research (HSR)
Ricciardi R
AHRQ Author: Ricciardi R
AHRQ focuses on ambulatory patient safety.
As AHRQ looks to expand its ambulatory safety research efforts, the agency seeks the involvement of a variety of nurses to provide expert opinion and consultation and to conduct research. The author emphasizes that this is an opportunity for both PhD and Doctor of Nursing Practice prepared nurses to lead interprofessional teams to conduct research that can translate into meaningful improvements in ambulatory quality.
AHRQ-authored.
Citation: Ricciardi R .
AHRQ focuses on ambulatory patient safety.
J Nurs Care Qual 2015 Jul-Sep;30(3):193-6. doi: 10.1097/ncq.0000000000000124..
Keywords: Patient Safety, Nursing, Primary Care, Adverse Events, Health Services Research (HSR)
Nembhard IM, Labao I, Savage S
Breaking the silence: determinants of voice for quality improvement in hospitals.
The researchers examined the drivers of “voice” for health professionals in hospitals. “Voice” is understood as the discretionary communication of ideas, suggestions, concerns, or opinions about work-related issues with the intent to improve organizational or unit functioning. They found that factors related to individuals (e.g., tenure), work (e.g., work configuration), organizational context (e.g., culture), data (e.g., benchmarking), and the external environment (e.g., attention) influenced health professionals’ voice.
AHRQ-funded; HS018987.
Citation: Nembhard IM, Labao I, Savage S .
Breaking the silence: determinants of voice for quality improvement in hospitals.
Health Care Manage Rev 2015 Jul-Sep;40(3):225-36. doi: 10.1097/hmr.0000000000000028..
Keywords: Hospitals, Quality Improvement, Quality of Care, Communication, Organizational Change, Health Services Research (HSR)
Fontaine P, Whitebird R, Solberg LI
Minnesota's early experience with medical home implementation: viewpoints from the front lines.
This study aimed to identify the facilitators and barriers encountered by nine diverse primary care practices selected from the first 80 to achieve patient-centered medical home (PCMH) certification in Minnesota. It found that facilitators to achieve PCMH certification included a requirement for patient involvement, which pushed practices to create patient-centered innovations, and new reimbursement models based on quality indicators for a population.
AHRQ-funded; HS019161.
Citation: Fontaine P, Whitebird R, Solberg LI .
Minnesota's early experience with medical home implementation: viewpoints from the front lines.
J Gen Intern Med 2015 Jul;30(7):899-906. doi: 10.1007/s11606-014-3136-y..
Keywords: Patient-Centered Healthcare, Primary Care, Implementation, Organizational Change, Healthcare Delivery, Practice Improvement, Health Services Research (HSR)
Malecki K, Wisk LE, Walsh M
Oral health equity and unmet dental care needs in a population-based sample: findings from the Survey of the Health of Wisconsin.
The authors explored individual-, psychosocial-, and community-level predictors of oral health status in the Survey of the Health of Wisconsin Oral Health Screening project. Their results suggested that costs were a primary predictor of access to care and poor oral health status, underscoring the role that primary care, in conjunction with dental health care providers, could play in promoting oral health care, particularly in reducing barriers and promoting preventive health behaviors.
AHRQ-funded; HS000063.
Citation: Malecki K, Wisk LE, Walsh M .
Oral health equity and unmet dental care needs in a population-based sample: findings from the Survey of the Health of Wisconsin.
Am J Public Health 2015 Jul;105 Suppl 3:S466-74. doi: 10.2105/ajph.2014.302338.
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Keywords: Access to Care, Dental and Oral Health, Disparities, Healthcare Costs, Health Services Research (HSR)
Pallas SW, Khuat TH, Le QD
The changing donor landscape of health sector aid to Vietnam: a qualitative case study.
The study objective was to identify how donors and government agencies in Vietnam responded to donor proliferation in health sector aid between 1995 and 2012. The study concludes that central government and donor agencies in Vietnam responded to donor proliferation in health sector aid by endorsing aid effectiveness policies but implementing these policies inconsistently in practice.
AHRQ-funded; HS017589.
Citation: Pallas SW, Khuat TH, Le QD .
The changing donor landscape of health sector aid to Vietnam: a qualitative case study.
Soc Sci Med 2015 May;132:165-72. doi: 10.1016/j.socscimed.2015.03.027..
Keywords: Policy, Health Services Research (HSR), Healthcare Costs
Holzer J, Kass N
Understanding the supports of and challenges to community engagement in the CTSAs.
The researchers sought to understand the supports and challenges experienced by multiple Clinical and Translational Science Awards programs as they pursued community engagement. The interviews identified three support themes, including: funding, existing relationships with communities, and leadership and a partnership approach at the institution. Six challenge themes arose: need for capacity development, lack of positive relationships with communities, lack of leadership, funding constraints, time and staff constraints, and unsustainable models.
AHRQ-funded; HS017589.
Citation: Holzer J, Kass N .
Understanding the supports of and challenges to community engagement in the CTSAs.
Clin Transl Sci 2015 Apr;8(2):116-22. doi: 10.1111/cts.12205..
Keywords: Community Partnerships, Community-Based Practice, Health Services Research (HSR), Research Methodologies
Mullen MT, Branas CC, Kasner SE
Optimization modeling to maximize population access to comprehensive stroke centers.
This report demonstrates how mathematical optimization modeling can inform the strategic development of the US network of stroke centers by simulating the conversion of primary stroke centers into comprehensive stroke centers (CSCs). Optimal system simulation can be used to develop efficient care systems that maximize accessibility. Under optimal conditions, a large proportion of the US population will be unable to access a CSC within 60 minutes.
AHRQ-funded; HS013852; HS017960; HS010914.
Citation: Mullen MT, Branas CC, Kasner SE .
Optimization modeling to maximize population access to comprehensive stroke centers.
Neurology 2015 Mar 24;84(12):1196-205. doi: 10.1212/wnl.0000000000001390..
Keywords: Stroke, Access to Care, Health Services Research (HSR)
Hollingsworth JM, Funk RJ, Owen-Smith J
Assessing the reach of health reform to outpatient surgery with social network analysis.
The researchers used the tools of social network analysis to assess the proportion of outpatient surgery currently delivered in ambulatory surgery centers (ASCs) that are largely unconnected to nearby hospitals. Their study of all Florida ASCs and hospitals found that 83% of the $4.3 billion in charges for ASC-based care originate from facilities that have substantial integration with their local health care systems.
AHRQ-funded; HS020927; HS018726.
Citation: Hollingsworth JM, Funk RJ, Owen-Smith J .
Assessing the reach of health reform to outpatient surgery with social network analysis.
Ann Surg 2015 Mar;261(3):468-72. doi: 10.1097/sla.0000000000000880..
Keywords: Ambulatory Care and Surgery, Policy, Health Services Research (HSR)
Marshall DA, Burgos-Liz L, IJzerman MJ
Selecting a dynamic simulation modeling method for health care delivery research-part 2: report of the ISPOR Dynamic Simulation Modeling Emerging Good Practices Task Force.
This report builds on previous work, systematically comparing each of the three most commonly used dynamic simulation modeling methods—system dynamics, discrete- event simulation, and agent-based modeling. It reviews criteria for selecting the most suitable method depending on: 1) the purpose— type of problem and research questions being investigated, 2) the object—scope of the model, and 3) the method to model the object to achieve the purpose.
AHRQ-funded; HS023710.
Citation: Marshall DA, Burgos-Liz L, IJzerman MJ .
Selecting a dynamic simulation modeling method for health care delivery research-part 2: report of the ISPOR Dynamic Simulation Modeling Emerging Good Practices Task Force.
Value Health 2015 Mar;18(2):147-60. doi: 10.1016/j.jval.2015.01.006..
Keywords: Healthcare Delivery, Health Services Research (HSR)
Chen Y, Hong C, Riley RD
An alternative pseudolikelihood method for multivariate random-effects meta-analysis.
This paper describes the standard likelihood inferences for multivariate meta-analysis (MMA) and the proposed pseudolikelihood method. The authors next extend the proposed method to the missing data situation where only a proportion of studies have all outcomes reported. They then conduct simulation studies to compare the proposed method with the current methods and investigate the prevalence of singular covariance matrix problems, bias, coverage probability (CP), and relative efficiency (RE). Finally, they apply the proposed method to three meta-analyses.
AHRQ-funded; HS022900.
Citation: Chen Y, Hong C, Riley RD .
An alternative pseudolikelihood method for multivariate random-effects meta-analysis.
Stat Med 2015 Feb 10;34(3):361-80. doi: 10.1002/sim.6350..
Keywords: Research Methodologies, Health Services Research (HSR)