National Healthcare Quality and Disparities Report
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Search All Research Studies
AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Behavioral Health (1)
- (-) Care Coordination (13)
- Caregiving (3)
- Care Management (2)
- Children/Adolescents (4)
- Chronic Conditions (1)
- Communication (1)
- Community-Based Practice (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (2)
- Disabilities (1)
- Disparities (1)
- Elderly (2)
- Electronic Health Records (EHRs) (1)
- Healthcare Delivery (4)
- Health Information Technology (HIT) (1)
- Health Systems (1)
- Home Healthcare (2)
- Hospital Discharge (3)
- Hospitals (4)
- Implementation (1)
- Injuries and Wounds (1)
- Nursing (1)
- Nursing Homes (3)
- Organizational Change (1)
- Outcomes (1)
- Patient-Centered Healthcare (5)
- Patient Experience (3)
- Policy (1)
- Practice Patterns (1)
- Primary Care (1)
- Primary Care: Models of Care (2)
- Quality Improvement (2)
- Quality of Care (2)
- Racial and Ethnic Minorities (1)
- Surgery (1)
- Teams (2)
- Transitions of Care (3)
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 13 of 13 Research Studies DisplayedDesai AD, Wang G, Wignall J
User-centered design of a longitudinal care plan for children with medical complexity.
This study’s goal was to determine content priorities and design preferences for a longitudinal care plan (LCP) among caregivers and healthcare providers who care for children with complex medical conditions (CMC) in acute care settings. Thirty iterative one-on-one design sessions with 10 caregivers and 20 providers were conducted. There was high within-group variability in content preferences among caregivers compared to provider groups. The authors identified 6 design preferences: a familiar yet customizable layout, a problem-based organization schema, linked content between sections, a table layout for most sections, a balance between unstructured and structured data fields, and use of family-centered terminology.
AHRQ-funded; HS024299.
Citation: Desai AD, Wang G, Wignall J .
User-centered design of a longitudinal care plan for children with medical complexity.
J Am Med Inform Assoc 2020 Dec 9;27(12):1860-70. doi: 10.1093/jamia/ocaa193..
Keywords: Children/Adolescents, Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Care Coordination, Caregiving
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
Guo F, Lin YL, Raji M
Processes and outcomes of diabetes mellitus care by different types of team primary care models.
This study compared processes and outcomes of care provided to older patients with diabetes by primary care teams composed of only primary care physicians (PCPs) versus team care that included nurse practitioners (NPs) or physician assistants (PAs). The authors studied 3,524 primary care practices identified via social network analysis and 306,741 patients aged 66 and older diagnosed with diabetes mellitus in or before 2015 from Medicare data. Outcomes looked for was more adherence to guideline-recommended care including eye examination, hemoglobin A1c test, and nephropathy monitoring. Preventable hospitalizations and high-risk medication prescribing rates were also measured. Patients in the team care practices received more guideline-recommended diabetes care than patients in PCP only teams. Patients in team care practices had a slightly higher likelihood of being prescribed high-risk medications. The likelihood of preventable hospitalizations was similar among all types of practices.
AHRQ-funded; HS020642.
Citation: Guo F, Lin YL, Raji M .
Processes and outcomes of diabetes mellitus care by different types of team primary care models.
PLoS One 2020 Nov 5;15(11):e0241516. doi: 10.1371/journal.pone.0241516..
Keywords: Elderly, Teams, Primary Care: Models of Care, Healthcare Delivery, Outcomes, Care Coordination, Practice Patterns
Lindly OJ, Martin AJ, Lally K
A profile of care coordination, missed school days, and unmet needs among Oregon children with special health care needs with behavioral and mental health conditions.
In order to inform Oregon's Title V needs assessment activities, researchers sought to characterize the state's subpopulation of children with special health care needs (CSHCN) with behavioral and mental health conditions (B/MHC) and to determine associations of care coordination with missed school days and unmet needs for this subpopulation. They found that among Oregon CSHCN with B/MHC, 48.9% missed 4 or more school days, 25% had one or more unmet health services need, and 14.8% had one or more unmet family support services need. They concluded that their approach to identify Oregon CSHCN with B/MHC may be adopted by other states endeavoring to improve health for this vulnerable subpopulation.
AHRQ-funded; HS000063.
Citation: Lindly OJ, Martin AJ, Lally K .
A profile of care coordination, missed school days, and unmet needs among Oregon children with special health care needs with behavioral and mental health conditions.
Community Ment Health J 2020 Nov;56(8):1571-80. doi: 10.1007/s10597-020-00609-4..
Keywords: Children/Adolescents, Disabilities, Behavioral Health, Care Coordination, Healthcare Delivery
Shannon EM, Schnipper JL, Mueller SK
Identifying racial/ethnic disparities in interhospital transfer: an observational study.
Interhospital transfer (IHT) is often performed to provide patients with specialized care. Racial/ethnic disparities in IHT have been suggested but are not well-characterized. The purpose of this study was to evaluate the association between race/ethnicity and IHT. The investigators found that Black and Hispanic patients had lower odds of IHT, largely explained by a higher likelihood of being hospitalized at urban teaching hospitals. Racial/ethnic disparities in transfer were demonstrated at community hospitals, in certain geographic regions and among patients with specific diseases.
AHRQ-funded; HS023331.
Citation: Shannon EM, Schnipper JL, Mueller SK .
Identifying racial/ethnic disparities in interhospital transfer: an observational study.
J Gen Intern Med 2020 Oct;35(10):2939-46. doi: 10.1007/s11606-020-06046-z..
Keywords: Racial and Ethnic Minorities, Disparities, Transitions of Care, Hospitals, Care Coordination
Berry JG, Glaspy T, Eagan B
Pediatric complex care and surgery comanagement: preparation for spinal fusion.
This study assessed the impact of preoperative comanagement with complex care pediatricians (CCP) on children with neuromuscular scoliosis undergoing spinal fusion surgery. A chart review of 79 children aged 5-21 years undergoing spinal fusion Jan. 2014-June 2016 was conducted at a children’s hospital. Cerebral palsy (64%) was the most common neuromuscular condition with the mean age of surgery of 14 years. Thirty-nine children had a preoperative CCP evaluation a median 63 days before the preanesthesia visit. More organ systems were affected by coexisting conditions in children with CCP evaluation than those without an evaluation. The rate of last-minute care coordination activities required for surgical clearance as well as last-minute development of new preoperative plans were lower for children with CCP evaluation than those without.
AHRQ-funded; HS024453.
Citation: Berry JG, Glaspy T, Eagan B .
Pediatric complex care and surgery comanagement: preparation for spinal fusion.
J Child Health Care 2020 Sep;24(3):402-10. doi: 10.1177/1367493519864741..
Keywords: Children/Adolescents, Surgery, Care Management, Care Coordination
Callister C, Jones J, Schroeder S
Caregiver experiences of care coordination for recently discharged patients: a qualitative metasynthesis.
Caregivers of patients often provide key support for patients after hospitalization. This qualitative metasynthesis described caregiver perspectives about care coordination for patients discharged from the hospital. A literature search of Ovid Medline and CINAHL completed on May 23, 2018, identified 1,546 studies. Twelve articles were included in the final metasynthesis. Caregiver perspectives about care coordination were compiled into overall themes.
AHRQ-funded; HS024569.
Citation: Callister C, Jones J, Schroeder S .
Caregiver experiences of care coordination for recently discharged patients: a qualitative metasynthesis.
West J Nurs Res 2020 Aug;42(8):649-59. doi: 10.1177/0193945919880183..
Keywords: Caregiving, Care Coordination, Hospital Discharge, Home Healthcare
White EM, Kosar CM, Rahman M
Trends in hospitals and skilled nursing facilities sharing medical providers, 2008-16.
Hospitals and skilled nursing facilities (SNFs) face increasing pressure to improve care coordination and reduce unnecessary readmissions. One strategy to accomplish this is to share physicians and advanced practice clinicians, so that the same providers see patients in both settings. Using 2008-16 Medicare claims, the investigators found that as SNFs moved increasingly toward using SNF specialists, there was a steady decline in the number of facilities sharing medical providers and in the proportion of SNF primary care delivered by provider practices with both hospital and SNF clinicians (hospital-SNF practices).
AHRQ-funded; T32 HS000011.
Citation: White EM, Kosar CM, Rahman M .
Trends in hospitals and skilled nursing facilities sharing medical providers, 2008-16.
Health Aff 2020 Aug;39(8):1312-20. doi: 10.1377/hlthaff.2019.01502..
Keywords: Hospitals, Nursing Homes, Care Coordination, Healthcare Delivery
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
Campbell Britton M, Petersen-Pickett J, Hodshon B
Mapping the care transition from hospital to skilled nursing facility.
Researchers used process mapping to illustrate the sequence of events involved with hospital discharge and admission to a skilled nursing facility (SNF). These transitions are often associated with breakdowns in communication that may place patients at risk for adverse events. A quality improvement (QI) team worked with frontline staff at an academic medical center and two local SNFs in the northeastern United States. The final process map included care management, medicine, nursing, admissions and physical therapy service staff. The process map showed numerous activities that need to be coordinated between care teams, and highlighted specific opportunities for improving communication between different teams.
AHRQ-funded; HS023554.
Citation: Campbell Britton M, Petersen-Pickett J, Hodshon B .
Mapping the care transition from hospital to skilled nursing facility.
J Eval Clin Pract 2020 Jun;26(3):786-90. doi: 10.1111/jep.13238..
Keywords: Transitions of Care, Care Coordination, Quality Improvement, Communication, Hospital Discharge, Hospitals, Nursing Homes, Quality of Care
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