National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (1)
- Arthritis (3)
- Behavioral Health (1)
- Cancer: Colorectal Cancer (1)
- Cardiovascular Conditions (1)
- Children/Adolescents (2)
- Depression (1)
- Electronic Health Records (EHRs) (1)
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- (-) Outcomes (17)
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- Provider Performance (4)
- Public Reporting (1)
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- (-) Quality Measures (17)
- Quality of Care (12)
- Sepsis (2)
- Surgery (5)
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 17 of 17 Research Studies DisplayedBingham CA, Harris JG, Qui T
Pediatric Rheumatology Care and Outcomes Improvement Network's quality measure set to improve care of children with juvenile idiopathic arthritis.
The objective of this study was to describe the selection, development, and implementation of quality measures for juvenile idiopathic arthritis (JIA) by the Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN), a multihospital learning health network. Clinicians in PR-COIN and parents of children with JIA collaboratively selected outcome quality measures and a committee of rheumatologists and data analysts developed operational definitions. Initial measures were clinical inactive disease, low pain score, and optimal physical functioning; the revised set included additional measures of disease activity, data quality, and a balancing measure. The authors concluded that PR-COIN's set of JIA quality measures is the first comprehensive set used at the point-of-care for a large cohort of JIA patients in a variety of pediatric rheumatology practice settings.
AHRQ-funded; HS021114.
Citation: Bingham CA, Harris JG, Qui T .
Pediatric Rheumatology Care and Outcomes Improvement Network's quality measure set to improve care of children with juvenile idiopathic arthritis.
Arthritis Care Res 2023 Dec; 75(12):2442-52. doi: 10.1002/acr.25168.
Keywords: Children/Adolescents, Arthritis, Quality Measures, Quality Improvement, Quality of Care, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Barbash IJ, Davis BS, Yabes JG
Treatment patterns and clinical outcomes after the introduction of the Medicare Sepsis Performance Measure (SEP-1).
This study evaluated the effect of Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) on treatment patterns and patient outcomes. Findings showed that, two years after its implementation, SEP-1 was associated with variable changes in process measures, with the greatest effect being an increase in lactate measurement within 3 hours of sepsis onset. There were small increases in antibiotic administration and fluid administration, a small increase in ICU admissions, and no changes in mortality or discharge to home.
Citation: Barbash IJ, Davis BS, Yabes JG .
Treatment patterns and clinical outcomes after the introduction of the Medicare Sepsis Performance Measure (SEP-1).
Ann Intern Med 2021 Jul;174(7):927-35. doi: 10.7326/m20-5043..
Keywords: Sepsis, Medicare, Outcomes, Quality Measures, Quality of Care
Coley RY, Boggs JM, Beck A
Defining success in measurement-based care for depression: a comparison of common metrics.
This study compared response and remission measures with effect size and severity-adjusted effect size (SAES) measures and examined the relationship between baseline symptom severity and treatment success for depression. Electronic records from two large integrated health systems were used to identify new psychotherapy episodes. Findings showed that response was preferable for comparing treatment outcomes, as it did not favor more or less baseline symptom severity, indicated clinically meaningful improvement, and was transparent and easy to calculate.
AHRQ-funded; HS026369.
Citation: Coley RY, Boggs JM, Beck A .
Defining success in measurement-based care for depression: a comparison of common metrics.
Psychiatr Serv 2020 Apr;71(4):312-18. doi: 10.1176/appi.ps.201900295..
Keywords: Depression, Behavioral Health, Patient-Centered Outcomes Research, Outcomes, Quality of Care, Quality Measures
Desai AD, Starmer AJ
Process metrics and outcomes to inform quality improvement in pediatric hospital medicine.
This article provides an overview of the selection, development, and use of process and outcome measures for pediatric hospital medicine quality improvement initiatives. It reviews commonly used categories of process and outcome measures, provides a list of common sources and repositories of previously validated measures, and provides a blueprint for the development of novel measures.
AHRQ-funded; HS024299.
Citation: Desai AD, Starmer AJ .
Process metrics and outcomes to inform quality improvement in pediatric hospital medicine.
Pediatr Clin North Am 2019 Aug;66(4):725-37. doi: 10.1016/j.pcl.2019.03.002..
Keywords: Children/Adolescents, Hospitals, Quality of Care, Quality Improvement, Quality Measures, Outcomes, Patient-Centered Outcomes Research
Spatz ES
Fostering a culture to support surgical outcome measures.
This editorial comments on the relationship of surgical skills (referring to the gentleness, tissue exposure, instrument handling, time and motion, and flow of operation) and patient outcomes
AHRQ-funded; HS023000.
Citation: Spatz ES .
Fostering a culture to support surgical outcome measures.
Circ Cardiovasc Qual Outcomes 2016 Jul;9(4):345-7. doi: 10.1161/circoutcomes.116.003038.
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Keywords: Outcomes, Provider Performance, Quality Measures, Surgery
Rhee C, Filben MR, Massaro AF
Compliance with the national SEP-1 quality measure and association with sepsis outcomes: a multicenter retrospective cohort study.
Many septic patients receive care that fails the Centers for Medicare and Medicaid Services' SEP-1 measure, but it is unclear whether this reflects meaningful lapses in care, differences in clinical characteristics, or excessive rigidity of the "all-or-nothing" measure. This study’s investigators compared outcomes in cases that passed versus failed SEP-1 during the first 2 years after the measure was implemented.
AHRQ-funded; HS025008.
Citation: Rhee C, Filben MR, Massaro AF .
Compliance with the national SEP-1 quality measure and association with sepsis outcomes: a multicenter retrospective cohort study.
Crit Care Med 2018 Oct;46(10):1585-91. doi: 10.1097/ccm.0000000000003261..
Keywords: Quality Measures, Quality Measures, Outcomes, Sepsis
Niknam BA, Arriaga AF, Rosenbaum PR
Adjustment for atherosclerosis diagnosis distorts the effects of percutaneous coronary intervention and the ranking of hospital performance.
The researchers investigated how adjustment for atherosclerosis affects rankings of hospitals that perform percutaneous coronary intervention (PCI). They found that atherosclerosis is almost always noted in patients with acute myocardial infarction (AMI) who undergo interventional cardiology but less often in medically managed patients, so adjustment for its notation likely removes part of the effect of interventional treatment. Thus, hospitals performing more extensive imaging and more PCIs have higher atherosclerosis diagnosis rates, making their patients appear healthier and artificially reducing the expected mortality rate against which they are benchmarked. The authors concluded that atherosclerosis adjustment is detrimental to hospitals providing more thorough AMI care.
AHRQ-funded; HS023560.
Citation: Niknam BA, Arriaga AF, Rosenbaum PR .
Adjustment for atherosclerosis diagnosis distorts the effects of percutaneous coronary intervention and the ranking of hospital performance.
J Am Heart Assoc 2018 May 25;7(11). doi: 10.1161/jaha.117.008366.
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Keywords: Cardiovascular Conditions, Outcomes, Heart Disease and Health, Provider Performance, Quality Measures
Waljee JF, Dimick JB
Do patient-reported outcomes correlate with clinical outcomes following surgery?
This study examines whether patient-reported outcomes (PROs) correlate with clinical outcomes following surgery. PROs are distinct from clinical outcomes and represent a potential indicator of performance that can be targeted to improve quality of care. Future studies that examine the influence of measurement techniques, case mix, and disease characteristics on PROs will inform efforts to routinely and efficiently integrate these critical outcomes into existing strategies to capture treatment effectiveness and quality of care for surgical conditions.
AHRQ-funded; HS023313.
Citation: Waljee JF, Dimick JB .
Do patient-reported outcomes correlate with clinical outcomes following surgery?
Adv Surg 2017 Sep;51(1):141-50. doi: 10.1016/j.yasu.2017.03.011..
Keywords: Quality of Care, Outcomes, Patient-Centered Outcomes Research, Surgery, Patient Experience, Quality Measures
Kanters A, Mullard AJ, Arambula J
Colorectal cancer: quality of surgical care in Michigan.
Surgery remains the cornerstone therapy for colorectal cancer (CRC). This study assesses CRC quality measures for surgical cases in Michigan with data from 30 hospitals in the Michigan Surgical Quality Collaborative (2014-2015). Adjusted process measures showed gaps in quality of care for CRC, suggesting opportunity for regional quality improvement.
AHRQ-funded; HS000053.
Citation: Kanters A, Mullard AJ, Arambula J .
Colorectal cancer: quality of surgical care in Michigan.
Am J Surg 2017 Mar;213(3):548-52. doi: 10.1016/j.amjsurg.2016.11.038.
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Keywords: Cancer: Colorectal Cancer, Quality of Care, Outcomes, Quality Measures, Surgery
Yazdany J, Robbins M, Schmajuk G
Development of the American College of Rheumatology's rheumatoid arthritis electronic clinical quality measures.
The researchers sought to develop and test electronic clinical quality measures for rheumatoid arthritis. Disease activity assessment, functional status assessment, disease-modifying antirheumatic durg use, and tuberculosis screening measures have achieved national endorsement and are recommended for use in federal quality reporting programs.
AHRQ-funded; HS024412.
Citation: Yazdany J, Robbins M, Schmajuk G .
Development of the American College of Rheumatology's rheumatoid arthritis electronic clinical quality measures.
Arthritis Care Res 2016 Nov;68(11):1579-90. doi: 10.1002/acr.22984.
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Keywords: Electronic Health Records (EHRs), Medication, Quality Measures, Arthritis, Outcomes
Suter LG, Barber CE, Herrin J
American College of Rheumatology white paper on performance outcome measures in rheumatology.
The objective of this study was to highlight the opportunities and challenges of developing and implementing performance outcome measures in rheumatology for accountability purposes. The authors' hypothetical outcome measure was a measure of rheumatoid arthritis disease activity intended for evaluating Accountable Care Organization performance. They provided a summary table of key take-home points for clinicians and policymakers. The authors concluded that the most effective and meaningful measures can only be created through the close collaboration of patients, providers, measure developers, and policymakers.
AHRQ-funded; HS024412.
Citation: Suter LG, Barber CE, Herrin J .
American College of Rheumatology white paper on performance outcome measures in rheumatology.
Arthritis Care Res 2016 Oct;68(10):1390-401. doi: 10.1002/acr.22936.
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Keywords: Quality of Care, Quality Measures, Outcomes, Arthritis
Ban KA, Cohen ME, Ko CY
Evaluation of the ProPublica surgeon scorecard "Adjusted Complication Rate" measure specifications.
The authors sought to (1) determine the proportion of cases excluded by ProPublica's specifications, (2) assess the proportion of inpatient complications excluded from ProPublica's measure, and (3) examine the validity of ProPublica's outcome measure by comparing performance on the measure to well-established postoperative outcome measures. They found that ProPublica's outcome measure specifications exclude 82% of cases, miss 84% of postoperative complications, and correlate poorly with well-established postoperative outcomes.
AHRQ-funded; HS021857.
Citation: Ban KA, Cohen ME, Ko CY .
Evaluation of the ProPublica surgeon scorecard "Adjusted Complication Rate" measure specifications.
Ann Surg 2016 Oct;264(4):566-74. doi: 10.1097/sla.0000000000001858.
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Keywords: Adverse Events, Outcomes, Public Reporting, Quality Measures, Surgery
Wahl ER, Yazdany J
Challenges and opportunities in using patient-reported outcomes in quality measurement in rheumatology.
This article reviews the use of patient-reported outcomes (PROs) in assessing health care quality, and highlights challenges and opportunities specific to their use in rheumatology quality measurement. It describes the current use of PROs as quality measures in rheumatology, and frames an agenda for future work supporting development of meaningful quality measures based on PROs.
AHRQ-funded; HS024412.
Citation: Wahl ER, Yazdany J .
Challenges and opportunities in using patient-reported outcomes in quality measurement in rheumatology.
Rheum Dis Clin North Am 2016 May;42(2):363-75. doi: 10.1016/j.rdc.2016.01.008.
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Keywords: Quality of Care, Outcomes, Quality Indicators (QIs), Quality Measures
Cassel CK, Kronick R
AHRQ Author: Kronick R
Learning from the past to measure the future.
The authors argue that paying for value will not work unless it can be measured. The ability to assess health care quality and health outcomes has significantly improved over the past several decades, and there are good examples in specific organizations or clinical areas.
AHRQ-authored.
Citation: Cassel CK, Kronick R .
Learning from the past to measure the future.
JAMA 2015 Sep;314(9):875-6. doi: 10.1001/jama.2015.9186..
Keywords: Quality of Care, Quality Measures, Outcomes
Maggard-Gibbons M
The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program.
This review summarized the history of American College of Surgeons National Surgical Quality Improvement Project and its components, and described the evidence that feeding outcomes back to providers, along with real-time comparisons with other hospital rates, leads to quality improvement, better patient outcomes, cost savings and overall improved patient safety.
AHRQ-funded; 2902007100621.
Citation: Maggard-Gibbons M .
The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program.
BMJ Qual Saf 2014 Jul;23(7):589-99. doi: 10.1136/bmjqs-2013-002223..
Keywords: Quality Improvement, Quality Indicators (QIs), Quality Measures, Quality of Care, Surgery, Patient Safety, Outcomes, Patient-Centered Outcomes Research, Provider Performance
Hanlon JT, Schmader KE
The medication appropriateness index at 20: where it started, where it has been, and where it may be going.
The objective of this narrative review is to describe finding regarding the reliability of the Medication Appropriateness Index (MAI), a comparison of the MAI with other quality measures of potentially inappropriate prescribing, the predictive value of the MAI with important health outcomes, and the responsiveness of the MAI to change within the framework of randomized controlled trials.
AHRQ-funded; HS018721
Citation: Hanlon JT, Schmader KE .
The medication appropriateness index at 20: where it started, where it has been, and where it may be going.
Drugs Aging. 2013 Nov;30(11):893-900. doi: 10.1007/s40266-013-0118-4..
Keywords: Quality of Care, Medication, Outcomes, Quality Measures, Medication: Safety
Werner RM, Konetzka RT, Kim MM
Quality improvement under nursing home compare: the association between changes in process and outcome measures.
The researchers tested the extent to which improvements in outcomes of care are explained by changes in nursing home processes. Of the 5 outcome measures examined, they found that only improvements in the percentage of nursing home residents in moderate or severe pain were associated with changes in nursing home processes of care. They concluded that understanding the mechanism behind improvements in nursing home outcomes may be key to successfully achieving broad quality improvements across nursing homes.
AHRQ-funded; HS021861.
Citation: Werner RM, Konetzka RT, Kim MM .
Quality improvement under nursing home compare: the association between changes in process and outcome measures.
Med Care 2013 Jul;51(7):582-8. doi: 10.1097/MLR.0b013e31828dbae4.
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Keywords: Nursing Homes, Long-Term Care, Quality Improvement, Quality Measures, Quality of Care, Provider Performance, Outcomes