National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (3)
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Cardiovascular Conditions (1)
- Children/Adolescents (2)
- Chronic Conditions (3)
- COVID-19 (1)
- Dialysis (1)
- Disparities (4)
- Education: Patient and Caregiver (1)
- Evidence-Based Practice (2)
- Healthcare Costs (1)
- Health Information Technology (HIT) (3)
- Heart Disease and Health (1)
- Hospitalization (1)
- Hospital Readmissions (1)
- Kidney Disease and Health (6)
- Medical Errors (1)
- Medication (3)
- Medication: Safety (2)
- Mortality (2)
- Outcomes (3)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (2)
- Patient Safety (2)
- Policy (2)
- Prevention (1)
- Provider (1)
- Provider: Pharmacist (2)
- Provider: Physician (1)
- Racial and Ethnic Minorities (3)
- Registries (1)
- Respiratory Conditions (1)
- Risk (2)
- Shared Decision Making (4)
- Sickle Cell Disease (1)
- Surgery (4)
- Telehealth (2)
- (-) Transplantation (19)
- Workforce (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 19 of 19 Research Studies DisplayedThorsness R, Wang V, Patzer RE
Association of social risk factors with home dialysis and kidney transplant rates in dialysis facilities.
This study examines rates of home dialysis and transplant at dialysis facilities that serve patients with high social risk to understand how they fare under the End-Stage Renal Disease Treatment Choices Model.
AHRQ-funded; HS028285.
Citation: Thorsness R, Wang V, Patzer RE .
Association of social risk factors with home dialysis and kidney transplant rates in dialysis facilities.
JAMA 2021 Dec 14;326(22):2323-25. doi: 10.1001/jama.2021.18372..
Keywords: Dialysis, Kidney Disease and Health, Transplantation, Risk
Krissberg JR, Kaufmann MB, Gupta A
Racial disparities in pediatric kidney transplantation under the new Kidney Allocation System in the United States.
This study aimed to assess how implementation of the 2014 Kidney Allocation System (KAS) affected racial and ethnic disparities in pediatric kidney transplantation access and related outcomes. The authors performed a retrospective cohort study of children <18 years of age active on the kidney transplant list from 2008 to 2019 using the Scientific Registry of Transplant Recipients. Results found that all children experienced longer wait times from activation to transplantation post-KAS. Although they found that Black and Hispanic children and other children of color experienced longer times from activation to transplant compared with White children in both eras; this finding was largely attenuated after multivariable analysis. Multivariable analysis also showed that racial and ethnic disparities in time from dialysis initiation to transplantation in the pre-KAS era were lessened in the post-KAS era. No disparities were found in odds of delayed graft function, however Black and Hispanic children experienced longer times with a functioning graft in the post-KAS era.
AHRQ-funded; HS026128.
Citation: Krissberg JR, Kaufmann MB, Gupta A .
Racial disparities in pediatric kidney transplantation under the new Kidney Allocation System in the United States.
Clin J Am Soc Nephrol 2021 Dec; 16(12):1862-71. doi: 10.2215/cjn.06740521..
Keywords: Disparities, Racial and Ethnic Minorities, Kidney Disease and Health, Transplantation
Valbuena VSM, Obayemi JE, Purnell TS
Gender and racial disparities in the transplant surgery workforce.
This review explores trends in the United States (US) transplant surgery workforce with a focus on historical demographics, post-fellowship job market, and quality of life reported by transplant surgeons. Ongoing efforts to improve women and racial/ethnic minority representation in transplant surgery are highlighted in this paper. Future directions to create a transplant workforce that reflects the diversity of the US population are discussed.
AHRQ-funded; HS024600; HS000053.
Citation: Valbuena VSM, Obayemi JE, Purnell TS .
Gender and racial disparities in the transplant surgery workforce.
Curr Opin Organ Transplant 2021 Oct 1;26(5):560-66. doi: 10.1097/mot.0000000000000915..
Keywords: Workforce, Provider: Physician, Transplantation, Racial and Ethnic Minorities
Taber DJ, Fleming JN, Su Z
Significant hospitalization cost savings to the payer with a pharmacist-led mobile health intervention to improve medication safety in kidney transplant recipients.
This paper examined hospitalization cost savings to the payer with a pharmacist-led mobile health intervention to improve medication safety in kidney transplant recipients. This study was an economic analysis of a 12-month, parallel arm, randomized controlled trial in adult kidney recipients 6 to 36 months posttransplant (NCT03247322). All participants received usual posttransplant care, while the intervention arm received supplemental clinical pharmacist-led medication therapy monitoring and management, via a smartphone-enabled mHealth app, integrated with risk-based televisits.
AHRQ-funded; HS023754.
Citation: Taber DJ, Fleming JN, Su Z .
Significant hospitalization cost savings to the payer with a pharmacist-led mobile health intervention to improve medication safety in kidney transplant recipients.
Am J Transplant 2021 Oct;21(10):3428-35. doi: 10.1111/ajt.16737..
Keywords: Healthcare Costs, Provider: Pharmacist, Telehealth, Health Information Technology (HIT), Transplantation, Hospitalization, Medication: Safety, Medication
Purnell TS, Simpson DC, Callender CO
Dismantling structural racism as a root cause of racial disparities in COVID-19 and transplantation.
As the United States faces unparalleled challenges due to COVID-19, racial disparities in health and healthcare have once again taken center stage. If effective interventions to address racial disparities in transplantation, including those magnified by COVID-19, are to be designed and implemented at the national level, it is first critical to understand the complex mechanisms by which structural, institutional, interpersonal, and internalized racism influence the presence of racial disparities in healthcare and transplantation. IN this article the authors discuss their viewpoint.
AHRQ-funded; HS024600.
Citation: Purnell TS, Simpson DC, Callender CO .
Dismantling structural racism as a root cause of racial disparities in COVID-19 and transplantation.
Am J Transplant 2021 Jul;21(7):2327-32. doi: 10.1111/ajt.16543..
Keywords: COVID-19, Racial and Ethnic Minorities, Disparities, Transplantation, Surgery, Access to Care
Chu S, Bruin MJ, McKinney WT
Design of a patient-centered decision support tool when selecting an organ transplant center.
Patients in the US in need of a life-saving organ transplant must complete a long process of medical decisions, and a first step is to identify a transplant center to complete an evaluation. This study described a patient-centered process of testing and refinement of a new website (www.transplantcentersearch.org) that was developed to provide data to patients who are seeking a transplant center.
AHRQ-funded; HS026379; HS024527.
Citation: Chu S, Bruin MJ, McKinney WT .
Design of a patient-centered decision support tool when selecting an organ transplant center.
PLoS One 2021 May 17;16(5):e0251102. doi: 10.1371/journal.pone.0251102..
Keywords: Transplantation, Patient-Centered Healthcare, Shared Decision Making, Health Information Technology (HIT)
Gonzales HM, Fleming JN, Gebregziabher M
Pharmacist-led mobile health intervention and transplant medication safety: a randomized controlled clinical trial.
The goal of this study was to examine the efficacy of improving medication safety through a pharmacist-led, mobile health-based intervention. In this single-center study of adult kidney recipients 6-36 months post-transplant, findings showed that participants receiving the intervention experienced a significant reduction in medication errors and a significantly lower incidence risk of Grade 3 or higher adverse events. The intervention arm also demonstrated significantly lower rates of hospitalizations.
AHRQ-funded; HS023754.
Citation: Gonzales HM, Fleming JN, Gebregziabher M .
Pharmacist-led mobile health intervention and transplant medication safety: a randomized controlled clinical trial.
Clin J Am Soc Nephrol 2021 May 8;16(5):776-84. doi: 10.2215/cjn.15911020..
Keywords: Medication: Safety, Medication, Patient Safety, Transplantation, Telehealth, Health Information Technology (HIT), Provider: Pharmacist, Provider, Medical Errors, Adverse Drug Events (ADE), Adverse Events
Schaffhausen CR, Bruin MJ, Chu S
Designing a liver transplant patient and family decision support tool for organ offer decisions.
For liver transplant candidates on the waiting list, deciding to accept a donor organ with known or potential risk factors can be stressful and can lead to declined offers. Current education for patients and family often takes place during transplant evaluations and can be overwhelming and result in low retention and poor understanding of donor quality. In this study, the investigators sought to understand provider experiences when counseling patients about donor risks and donor offers.
AHRQ-funded; HS026379; HS024527.
Citation: Schaffhausen CR, Bruin MJ, Chu S .
Designing a liver transplant patient and family decision support tool for organ offer decisions.
Transplant Direct 2021 May;7(5):e695. doi: 10.1097/txd.0000000000001140..
Keywords: Transplantation, Shared Decision Making, Education: Patient and Caregiver
Schulz GL, Kelly KP, Holtmann M
Navigating decisional conflict as a family when facing the decision of stem cell transplant for a child or adolescent with sickle cell disease.
Patients with sickle cell disease (SCD) face unpredictable disease, with stem cell transplant being a curative treatment option with risks. The aim of this study was to describe the level and source of decisional conflict in families of children/adolescents with SCD facing a transplant decision. The investigators concluded that varying levels and sources of decisional conflict existed in pediatric patients with SCD and their families considering transplant.
AHRQ-funded; HS022140.
Citation: Schulz GL, Kelly KP, Holtmann M .
Navigating decisional conflict as a family when facing the decision of stem cell transplant for a child or adolescent with sickle cell disease.
Patient Educ Couns 2021 May;104(5):1086-93. doi: 10.1016/j.pec.2020.10.011..
Keywords: Children/Adolescents, Sickle Cell Disease, Chronic Conditions, Transplantation, Shared Decision Making
Bae S, Johnson M, Massie AB
Mortality and access to kidney transplantation in patients with sickle cell disease-associated kidney failure.
Patients with sickle cell disease-associated kidney failure have high mortality, which might be lowered by kidney transplantation. However, because they show higher post-transplant mortality compared with patients with other kidney failure etiologies, kidney transplantation remains controversial in this population. In this study, the investigators aimed to quantify the decrease in mortality associated with transplantation in this population and determine the chance of receiving transplantation with sickle cell disease as the cause of kidney failure as compared with other etiologies of kidney failure.
AHRQ-funded; HS024600.
Citation: Bae S, Johnson M, Massie AB .
Mortality and access to kidney transplantation in patients with sickle cell disease-associated kidney failure.
Clin J Am Soc Nephrol 2021 Mar 8;16(3):407-14. doi: 10.2215/cjn.02720320..
Keywords: Transplantation, Access to Care, Kidney Disease and Health, Mortality
Pennington KM, Dykhoff HJ, Yao X
The impact of antifungal prophylaxis in lung transplant recipients.
This study evaluated the effect of antifungal prophylaxis on all-cause mortality and invasive fungal infections (IFI) on lung transplant recipients. Administrative claims data was used to identify adult patients who underwent lung transplantation between 2005 and 2018. The authors identified 662 lung transplant recipients. All-cause mortality was found to be significantly lower in those receiving antifungal prophylaxis compared to those who did not. Patients receiving antifungal prophylaxis also had a lower rate of IFI, but it was not statistically significant.
AHRQ-funded; HS025164; HS025402; HS025517; HS024075.
Citation: Pennington KM, Dykhoff HJ, Yao X .
The impact of antifungal prophylaxis in lung transplant recipients.
Ann Am Thorac Soc 2021 Mar;18(3):468-76. doi: 10.1513/AnnalsATS.202003-267OC..
Keywords: Transplantation, Surgery, Medication, Prevention, Respiratory Conditions, Mortality, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
McKinney WT, Schaffhausen CR, Schladt D
Designing a patient-specific search of transplant program performance and outcomes: feedback from heart transplant candidates and recipients.
The Scientific Registry of Transplant Recipients provides transplant program-specific information, but it is unclear what patients and stakeholders need to know. Acceptance criteria for the candidate waitlist and donor organs vary by program and region, but there is no means to search for programs by the clinical profiles of recipients and donors. The authors examined variability in program-specific characteristics that could influence access to transplantation.
AHRQ-funded; HS026379; HS024527.
Citation: McKinney WT, Schaffhausen CR, Schladt D .
Designing a patient-specific search of transplant program performance and outcomes: feedback from heart transplant candidates and recipients.
Clin Transplant 2021 Feb;35(2):e14183. doi: 10.1111/ctr.14183..
Keywords: Transplantation, Surgery, Heart Disease and Health, Cardiovascular Conditions, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice, Shared Decision Making
Wang W, Rees MA, Leichtman AB
Deceased donors as nondirected donors in kidney paired donation.
As proof of concept, the investigators simulated a revised kidney allocation system that included deceased donor (DD) kidneys as chain-initiating kidneys (DD-CIK) in a kidney paired donation pool (KPDP) and estimated potential increases in number of transplants. They considered chains of length 2 in which the DD-CIK gave to a candidate in the KPDP, and that candidate's incompatible donor donated to the DD waitlist.
AHRQ-funded; HS020610.
Citation: Wang W, Rees MA, Leichtman AB .
Deceased donors as nondirected donors in kidney paired donation.
Am J Transplant 2021 Jan;21(1):103-13. doi: 10.1111/ajt.16268..
Keywords: Transplantation, Kidney Disease and Health
Davis AE, Mehrotra S, Ladner DP
Changes in geographic disparity in kidney transplantation since the final rule.
The researchers assessed the significance of changes of geographic disparities for four metrics since the 1998 adoption of HHS Final Rule’s emphasizing objective priority criteria: waiting times, transplant rates, pre-transplant mortality, and organ quality. They found that the ranges of the four metrics have worsened by approximately 30% or more after the Final Rule at both the regional and donor service area levels.
AHRQ-funded; HS021078.
Citation: Davis AE, Mehrotra S, Ladner DP .
Changes in geographic disparity in kidney transplantation since the final rule.
Transplantation 2014 Nov 15;98(9):931-6. doi: 10.1097/tp.0000000000000446..
Keywords: Transplantation, Disparities, Policy, Outcomes
Zhang Y, Thamer M, Kshirsagar O
Dialysis chains and placement on the waiting list for a cadaveric kidney transplant.
The purpose of this paper is to investigate the effect of dialysis facility chain status on renal transplantation therapy. The researchers concluded that dialysis chain affiliation expands previously observed ownership-related differences in placement on the waiting list, and for-profit ownership of dialysis chain facilities appears to be a significant impediment to access to renal transplants.
AHRQ-funded; HS020243.
Citation: Zhang Y, Thamer M, Kshirsagar O .
Dialysis chains and placement on the waiting list for a cadaveric kidney transplant.
Transplantation 2014 Sep 15;98(5):543-51. doi: 10.1097/tp.0000000000000106.
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Keywords: Kidney Disease and Health, Transplantation, Access to Care
Feudtner C, Feinstein JA, Zhong W
Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation.
In order to update the pediatric complex chronic conditions (CCC) classification system, the authors incorporated ICD-9 diagnostic codes that had been either omitted or incorrectly specified in the original system, and then translated between ICD-9 and ICD-10 using General Equivalence Mappings (GEMs). They concluded that the updated CCC version 2 system is comprehensive and multidimensional, providing a necessary update to accommodate widespread implementation of ICD-10.
AHRQ-funded; HS018425.
Citation: Feudtner C, Feinstein JA, Zhong W .
Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation.
BMC Pediatr 2014 Aug 8;14:199. doi: 10.1186/1471-2431-14-199.
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Keywords: Children/Adolescents, Chronic Conditions, Transplantation
Davis AE, Mehrotra S, Kilambi V
The effect of the Statewide Sharing variance on geographic disparity in kidney transplantation in the United States.
This study examined the effect of Statewide Sharing on geographic allocation disparity over time between donor service areas (DSAs) within Tennessee and Florida and compared them with geographic disparity between the DSAs within a state for all states with more than one DSA (California, New York, North Carolina, Ohio, Pennsylvania, Texas, and Wisconsin). Findings suggested that changes which are untested run the risk of unintended consequences, and Statewide Sharing should be further studied and considered.
AHRQ-funded; HS021078.
Citation: Davis AE, Mehrotra S, Kilambi V .
The effect of the Statewide Sharing variance on geographic disparity in kidney transplantation in the United States.
Clin J Am Soc Nephrol 2014 Aug 7;9(8):1449-60. doi: 10.2215/cjn.05350513.
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Keywords: Chronic Conditions, Disparities, Kidney Disease and Health, Policy, Transplantation
Santos CA, Brennan DC, Fraser VJ
Delayed-onset cytomegalovirus disease coded during hospital readmission after kidney transplantation.
The researchers sought to expand understanding of the scope, risk factors and outcomes associated with delayed-onset cytomegalovirus (CMV) disease among kidney transplant reci
AHRQ-funded; HS019455
Citation: Santos CA, Brennan DC, Fraser VJ .
Delayed-onset cytomegalovirus disease coded during hospital readmission after kidney transplantation.
Transplantation. 2014 Jul 27;98(2):187-94. doi: 10.1097/TP.0000000000000030..
Keywords: Transplantation, Hospital Readmissions, Risk, Outcomes
Echenique IA, Cohen D, Rudow DL
Impact of repeat testing of living kidney donors within 14 days of the transplant procedure: a multicenter retrospective survey.
The researchers surveyed 15 living donor kidney and/or liver transplant programs in New York State to determine if the requirement for re-testing of the donor within 14 days of the transplant procedure would result in delays and cancelled transplants. They found that no cancellations occurred but 2 centers experienced delays.
AHRQ-funded; HS021060
Citation: Echenique IA, Cohen D, Rudow DL .
Impact of repeat testing of living kidney donors within 14 days of the transplant procedure: a multicenter retrospective survey.
Transpl Infect Dis. 2014 Jun;16(3):403-11. doi: 10.1111/tid.12219..
Keywords: Transplantation, Patient Safety, Surgery