National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (64)
- Adverse Drug Events (ADE) (26)
- Adverse Events (95)
- Alcohol Use (7)
- Ambulatory Care and Surgery (26)
- Antibiotics (36)
- Antimicrobial Stewardship (16)
- Anxiety (7)
- Arthritis (14)
- Asthma (15)
- Autism (5)
- Back Health and Pain (7)
- Behavioral Health (98)
- Blood Clots (7)
- Blood Pressure (10)
- Blood Thinners (3)
- Brain Injury (6)
- Breast Feeding (2)
- Burnout (11)
- Cancer (100)
- Cancer: Breast Cancer (19)
- Cancer: Cervical Cancer (5)
- Cancer: Colorectal Cancer (15)
- Cancer: Lung Cancer (5)
- Cancer: Ovarian Cancer (1)
- Cancer: Prostate Cancer (12)
- Cancer: Skin Cancer (1)
- Cardiovascular Conditions (99)
- Care Coordination (16)
- Caregiving (45)
- Care Management (47)
- Case Study (17)
- Catheter-Associated Urinary Tract Infection (CAUTI) (5)
- Central Line-Associated Bloodstream Infections (CLABSI) (7)
- Children/Adolescents (172)
- Chronic Conditions (80)
- Clinical Decision Support (CDS) (15)
- Clinician-Patient Communication (42)
- Clostridium difficile Infections (7)
- Colonoscopy (4)
- Communication (56)
- Community-Acquired Infections (13)
- Community-Based Practice (13)
- Community Partnerships (1)
- Comparative Effectiveness (28)
- Complementary and Alternative Medicine (3)
- Comprehensive Unit-based Safety Program (CUSP) (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (11)
- COVID-19 (1)
- Critical Care (24)
- Cultural Competence (12)
- Data (13)
- Dementia (21)
- Dental and Oral Health (6)
- Depression (40)
- Diabetes (28)
- Diagnostic Safety and Quality (65)
- Dialysis (3)
- Digestive Disease and Health (11)
- Disabilities (10)
- Disparities (53)
- Domestic Violence (4)
- Ear Infections (1)
- Education (4)
- Education: Academic (2)
- Education: Continuing Medical Education (27)
- Education: Curriculum (1)
- Education: Patient and Caregiver (29)
- Elderly (116)
- Electronic Health Records (EHRs) (101)
- Electronic Prescribing (E-Prescribing) (4)
- Emergency Department (73)
- Emergency Medical Services (EMS) (5)
- Emergency Preparedness (2)
- Evidence-Based Practice (138)
- Eye Disease and Health (3)
- Falls (12)
- Family Health and History (8)
- Genetics (9)
- Guidelines (38)
- Healthcare-Associated Infections (HAIs) (54)
- Healthcare Cost and Utilization Project (HCUP) (45)
- Healthcare Costs (95)
- Healthcare Delivery (84)
- Healthcare Utilization (60)
- Health Information Exchange (HIE) (5)
- Health Information Technology (HIT) (188)
- Health Insurance (52)
- Health Literacy (18)
- Health Promotion (8)
- Health Services Research (HSR) (35)
- Health Status (20)
- Health Systems (12)
- Heart Disease and Health (66)
- Hepatitis (4)
- Home Healthcare (28)
- Hospital Discharge (29)
- Hospitalization (76)
- Hospital Readmissions (36)
- Hospitals (129)
- Human Immunodeficiency Virus (HIV) (50)
- Imaging (32)
- Implementation (24)
- Infectious Diseases (53)
- Influenza (6)
- Injuries and Wounds (28)
- Inpatient Care (36)
- Intensive Care Unit (ICU) (33)
- Kidney Disease and Health (27)
- Labor and Delivery (17)
- Learning Health Systems (5)
- Lifestyle Changes (14)
- Long-Term Care (28)
- Low-Income (22)
- Maternal Care (26)
- Medicaid (41)
- Medical Devices (5)
- Medical Errors (24)
- Medical Expenditure Panel Survey (MEPS) (18)
- Medical Liability (1)
- Medicare (80)
- Medication (214)
- Medication: Safety (26)
- Men's Health (15)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (10)
- Mortality (56)
- Neonatal Intensive Care Unit (NICU) (2)
- Neurological Disorders (36)
- Newborns/Infants (32)
- Nursing (15)
- Nursing Homes (43)
- Nutrition (16)
- Obesity (27)
- Obesity: Weight Management (16)
- Opioids (36)
- Organizational Change (9)
- Orthopedics (18)
- Osteoporosis (2)
- Outcomes (128)
- Pain (26)
- Palliative Care (15)
- Patient-Centered Healthcare (49)
- Patient-Centered Outcomes Research (142)
- Patient Adherence/Compliance (32)
- Patient and Family Engagement (43)
- Patient Experience (30)
- Patient Safety (176)
- Patient Self-Management (10)
- Payment (25)
- Pneumonia (11)
- Policy (58)
- Practice Improvement (1)
- Practice Patterns (37)
- Pregnancy (47)
- Pressure Ulcers (3)
- Prevention (98)
- Primary Care (81)
- Primary Care: Models of Care (18)
- Provider (92)
- Provider: Clinician (22)
- Provider: Health Personnel (1)
- Provider: Nurse (20)
- Provider: Pharmacist (10)
- Provider: Physician (52)
- Provider Performance (31)
- Public Health (17)
- Public Reporting (2)
- Quality Improvement (90)
- Quality Indicators (QIs) (16)
- Quality Measures (26)
- Quality of Care (142)
- Quality of Life (21)
- Racial and Ethnic Minorities (80)
- Registries (21)
- Rehabilitation (8)
- Research Methodologies (52)
- Respiratory Conditions (47)
- Risk (93)
- Rural Health (14)
- Screening (59)
- Sepsis (25)
- Sex Factors (9)
- Sexual Health (17)
- Shared Decision Making (72)
- Sickle Cell Disease (4)
- Simulation (10)
- Skin Conditions (16)
- Sleep Problems (9)
- Social Determinants of Health (49)
- Social Media (12)
- Social Stigma (16)
- Stress (14)
- Stroke (16)
- Substance Abuse (37)
- Surgery (165)
- Surveys on Patient Safety Culture (5)
- System Design (1)
- Teams (23)
- TeamSTEPPS (4)
- Telehealth (21)
- Tobacco Use (12)
- Tobacco Use: Smoking Cessation (5)
- Tools & Toolkits (7)
- Training (20)
- Transitions of Care (33)
- Transplantation (28)
- Trauma (24)
- Treatments (19)
- U.S. Preventive Services Task Force (USPSTF) (27)
- Uninsured (9)
- Urban Health (15)
- Urinary Tract Infection (UTI) (12)
- Vaccination (19)
- Vulnerable Populations (42)
- Web-Based (2)
- Women (85)
- Workflow (8)
- Workforce (10)
- Young Adults (18)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
26 to 50 of 1425 Research Studies DisplayedCE Kranz, AM DeYoreo, M
AHRQ Author: O'Hanlon
Access, quality, and financial performance of rural hospitals following health system affiliation.
This study examined the effect of a rural hospital affiliating itself with a health system. The comparison study used data from 2008 to 2017. A propensity score-weighted set of twelve measures were used on structure, utilization, financial performance, and quality. The rural hospitals that affiliated themselves with a health system experienced a significant reduction in on-site diagnostic imaging technologies, the availability of obstetric and primary care services, and outpatient nonemergency visits as well as a significant increase in operating margins. While these affiliations may help to keep a rural hospital open, it may also reduce access to services in these rural areas.
AHRQ-funded; HS024067.
Citation: CE Kranz, AM DeYoreo, M .
Access, quality, and financial performance of rural hospitals following health system affiliation.
Health Aff 2019 Dec;38(12):2095-104. doi: 10.1377/hlthaff.2019.00918..
Keywords: Provider Performance, Quality of Care, Hospitals, Rural Health
McCoy RG, Dykhoff HJ, Sangaralingham L
Adoption of new glucose-lowering medications in the U.S.-the case of SGLT2 inhibitors: nationwide cohort study.
This study examined use of new glucose-lowering medications called sodium-glucose cotransporter-2 inhibitors (SGLT2i) that was the most recently approved class of medications for diabetes type 1 and 2 patients. This class of medications have shown additional cardio- and renal-protective benefits as well as lower risk of hypoglycemia. A retrospective analysis of medical and pharmacy claims data from OptumLabs Data Warehouse was conducted for commercially insured and Medicare Advantage adult beneficiaries who filled any glucose-lowering medication from 2013-2016. Among a cohort of over 1 million, only 7.2% initiated a SGLT2i prescription. Patients with other complications, age 75 or older, black, and those with Medicare Advantage were less likely to start a SGLT2i.
AHRQ-funded; HS024075; HS025164; HS025402; HS025517; HS022882.
Citation: McCoy RG, Dykhoff HJ, Sangaralingham L .
Adoption of new glucose-lowering medications in the U.S.-the case of SGLT2 inhibitors: nationwide cohort study.
Diabetes Technol Ther 2019 Dec;21(12):702-12. doi: 10.1089/dia.2019.0213.
.
.
Keywords: Medication, Diabetes, Practice Patterns
Flores EJ, Jue JJ, Giradi G
AHRQ EPC series on Improving translation of evidence: use of a clinical pathway for C. difficile treatment to facilitate the translation of research findings into practice.
In this pilot study, findings from the 2016 AHRQ EPC report on Clostridioides difficile infection were translated into a treatment pathway and disseminated via a cloud-based platform and electronic health record (EHR). Results indicated that pathways can be an approach for disseminating AHRQ EPC report findings within health care systems, with reports including guideline and pathway syntheses. Embedding hyperlinks to pathway content within the EHR may be a viable and low-effort solution for promoting awareness of evidence-based resources.
AHRQ-funded.
Citation: Flores EJ, Jue JJ, Giradi G .
AHRQ EPC series on Improving translation of evidence: use of a clinical pathway for C. difficile treatment to facilitate the translation of research findings into practice.
Jt Comm J Qual Patient Saf 2019 Dec;45(12):822-28. doi: 10.1016/j.jcjq.2019.10.002..
Keywords: Implementation, Evidence-Based Practice, Infectious Diseases, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Electronic Health Records (EHRs), Health Information Technology (HIT)
RIchmond J, Mangrum R, Wang G
An informed public's views on reducing antibiotic overuse.
The purpose of this study was to understand public attitudes about and recommendations to address antibiotic overuse by employing public deliberation (a method for eliciting informed input on value-laden issues). The investigators concluded that when informed about individual and social consequences of antibiotic overuse, patients may be more receptive to antibiotic prescription limits. They suggest that community-physician-government partnerships are needed to create solutions.
AHRQ-funded; 290201000005C.
Citation: RIchmond J, Mangrum R, Wang G .
An informed public's views on reducing antibiotic overuse.
Health Serv Res 2019 Dec;54(6):1283-94. doi: 10.1111/1475-6773.13175..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Health Literacy, Education: Patient and Caregiver
Napolitano N, Laverriere EK, Craig N
Apneic oxygenation as a quality improvement intervention in an academic PICU.
The objective of this prospective pre/post observational study was to evaluate if the use of apneic oxygenation during tracheal intubation in children is feasible and would decrease the occurrence of oxygen desaturation. The investigators concluded that implementation of apneic oxygenation in PICU was feasible, and was associated with significant reduction in moderate and severe oxygen desaturation. They suggest that use of apneic oxygenation should be considered when intubating critically ill children.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Napolitano N, Laverriere EK, Craig N .
Apneic oxygenation as a quality improvement intervention in an academic PICU.
Pediatr Crit Care Med 2019 Dec;20(12):e531-e37. doi: 10.1097/pcc.0000000000002123..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Quality Improvement, Quality of Care, Patient Safety, Adverse Events
Aneja S, Chang E, Omuro A
Applications of artificial intelligence in neuro-oncology.
This article explores the promise that artificial intelligence algorithms has for improving understanding of brain tumors and help drive future innovations in neuro-oncology.
AHRQ-funded; HS023000.
Citation: Aneja S, Chang E, Omuro A .
Applications of artificial intelligence in neuro-oncology.
Curr Opin Neurol 2019 Dec;32(6):850-56. doi: 10.1097/wco.0000000000000761.
.
.
Keywords: Health Information Technology (HIT), Cancer, Diagnostic Safety and Quality, Imaging
Chapman CH, Caram MEV, Radhakrishnan A
Association between PSA values and surveillance quality after prostate cancer surgery.
This study examined the association between PSA values and posttreatment surveillance after prostate cancer surgery. Normally the treatment cutoff rate is 0.2 ng/mL but 4.0 ng/mL may be more appropriate. Data from the US Veterans Health Administration was used to perform a retrospective longitudinal cohort study for men diagnosed with nonmetastatic prostate cancer from 2005 to 2008 who underwent radical prostatectomy. Guideline concordance was high at year 1 (95%) but decreased to 79% in year 7. After adjustment, guideline concordance was lowered for the youngest and oldest, Black, and unmarried men.
AHRQ-funded; HS018726.
Citation: Chapman CH, Caram MEV, Radhakrishnan A .
Association between PSA values and surveillance quality after prostate cancer surgery.
Cancer Med 2019 Dec;8(18):7903-12. doi: 10.1002/cam4.2663..
Keywords: Cancer: Prostate Cancer, Cancer, Surgery, Screening, Guidelines, Prevention, Evidence-Based Practice
Patel DK, Duncan MS, Shah AS
Association of cardiac rehabilitation with decreased hospitalization and mortality risk after cardiac valve surgery.
Investigators sought to characterize cardiac rehabilitation (CR) enrollment after cardiac valve surgery and its association with outcomes, including hospitalizations and mortality. Subjects were all fee-for-service Medicare beneficiaries undergoing open cardiac valve surgery in 2014, identified by inpatient diagnosis codes for open aortic, mitral, tricuspid, and pulmonary valve surgery. They found that fewer than half of Medicare beneficiaries undergoing cardiac valve surgery enrolled in CR programs, and there were marked racial/ethnic disparities among those who do. They recommend further study on barriers to CR enrollment in this population.
AHRQ-funded; HS022990.
Citation: Patel DK, Duncan MS, Shah AS .
Association of cardiac rehabilitation with decreased hospitalization and mortality risk after cardiac valve surgery.
JAMA Cardiol 2019 Dec;4(12):11887-1301. doi: 10.1001/jamacardio.2019.4032..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Rehabilitation, Hospitalization, Surgery, Mortality, Risk, Elderly
Stoops C, Stone S, Evans E
Baby NINJA (Nephrotoxic Injury Negated by Just-in-Time Action): reduction of nephrotoxic medication-associated acute kidney injury in the neonatal intensive care unit.
The purpose of this study was to test if acute kidney injury (AKI) is preventable in patients in the neonatal intensive care unit and if infants at high-risk of nephrotoxic medication-induced AKI can be identified using a systematic surveillance program previously used in the pediatric non-intensive care unit setting. The authors concluded that a systematic surveillance program to identify high-risk infants can prevent nephrotoxic-induced AKI and has the potential to prevent short and long-term consequences of AKI in critically ill infants.
AHRQ-funded; HS023763.
Citation: Stoops C, Stone S, Evans E .
Baby NINJA (Nephrotoxic Injury Negated by Just-in-Time Action): reduction of nephrotoxic medication-associated acute kidney injury in the neonatal intensive care unit.
J Pediatr 2019 Dec;215:223-28.e6. doi: 10.1016/j.jpeds.2019.08.046..
Keywords: Newborns/Infants, Medication, Medication: Safety, Patient Safety, Kidney Disease and Health, Intensive Care Unit (ICU), Critical Care, Quality Improvement, Quality of Care, Prevention, Adverse Drug Events (ADE), Adverse Events
Rudd BN, Last BS, Gregor C
Benchmarking treatment effectiveness of community-delivered trauma-focused cognitive behavioral therapy.
The objectives of the current study are to (a) evaluate the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT) delivered from 2013 to 2016 in 15 behavioral health agencies on youth PTSD as well as general mental health symptoms and functioning, and (b) benchmark these clinical outcomes against other published efficacy and effectiveness trials. This study is the first benchmarking study of TF-CBT and provides preliminary findings with regard to the effectiveness, and transportability, of TF-CBT to urban community settings that serve youth in poverty.
AHRQ-funded; HS000084.
Citation: Rudd BN, Last BS, Gregor C .
Benchmarking treatment effectiveness of community-delivered trauma-focused cognitive behavioral therapy.
Am J Community Psychol 2019 Dec;64(3-4):438-50. doi: 10.1002/ajcp.12370..
Keywords: Children/Adolescents, Behavioral Health, Trauma, Stress, Outcomes, Treatments
Sklar M, Seijo C, Goldman RE
Beyond checkboxes: a qualitative assessment of physicians' experiences providing care in a patient-centred medical home.
The patient-centered medical home (PCMH) is an innovative approach to health care reform. Despite a well-established process for recognizing PCMH practices, fidelity to, and/or adaptation of, the PCMH model can limit health care and population health improvements. This study explored the connection between fidelity/adaptation to the PCMH model with implementation successes and challenges through the experiences of family and internal medicine PCMH physicians.
AHRQ-funded; HS024192.
Citation: Sklar M, Seijo C, Goldman RE .
Beyond checkboxes: a qualitative assessment of physicians' experiences providing care in a patient-centred medical home.
J Eval Clin Pract 2019 Dec;25(6):1142-51. doi: 10.1111/jep.13136..
Keywords: Patient-Centered Healthcare, Provider: Physician, Provider, Primary Care
Sheetz KH, Dimick JB, Nathan H
Centralization of high-risk cancer surgery within existing hospital systems.
Centralization is often proposed as a strategy to improve the quality of certain high-risk health care services. In this study, the investigators evaluated the extent to which existing hospital systems centralize high-risk cancer surgery and whether centralization is associated with short-term clinical outcomes. The investigators concluded that greater centralization of complex cancer surgery within existing hospital systems was associated with better outcomes.
AHRQ-funded; HS023597.
Citation: Sheetz KH, Dimick JB, Nathan H .
Centralization of high-risk cancer surgery within existing hospital systems.
J Clin Oncol 2019 Dec 1;37(34):3234-42. doi: 10.1200/jco.18.02035..
Keywords: Surgery, Cancer, Risk, Hospitals, Health Systems, Quality Improvement, Quality Indicators (QIs), Quality of Care, Outcomes
Fleischer E, Neuman MI, Wang ME
Cerebrospinal fluid profiles of infants </=60 days of age with bacterial meningitis.
This study’s aim was to describe the cerebrospinal fluid (CSF) profiles in infants 60 days old or younger with bacterial meningitis and characteristics of infants with bacterial meningitis who do not have CSF abnormalities. Infants with culture-positive bacterial meningitis were evaluated in emergency departments of 11 children’s hospitals between 2011 and 2016. Clinical and laboratory data were abstracted from their medical records. Sensitivity of a CFS Gram-stain and corrected CSF pleocytosis was calculated for bacterial meningitis. Most infants 60 days or younger with bacterial meningitis have CSF pleocytosis or a positive Gram-stain result. Bacterial meningitis was unlikely in infants with no CSF pleocytosis and a negative Gram-stain result.
AHRQ-funded; HS026006.
Citation: Fleischer E, Neuman MI, Wang ME .
Cerebrospinal fluid profiles of infants </=60 days of age with bacterial meningitis.
Hosp Pediatr 2019 Dec;9(12):979-82. doi: 10.1542/hpeds.2019-0202..
Keywords: Newborns/Infants, Children/Adolescents, Infectious Diseases
Buxbaum JD, Lindenauer PK, Cooke CR
Changes in coding of pneumonia and impact on the hospital readmission reduction program.
Researchers evaluated whether changes in diagnosis assignment explain reductions in 30-day readmission for patients with pneumonia following the Hospital Readmission Reduction Program (HRRP). They conducted a retrospective cohort study of Medicare discharges in HRRP-eligible hospitals; outcomes were 30-day readmission rates for pneumonia under both "narrow" and "broad" definitions that included certain diagnoses of sepsis and aspiration pneumonia. They concluded that changes in the coding of inpatient pneumonia admissions do not explain readmission reduction following the HRRP.
AHRQ-funded; HS000055.
Citation: Buxbaum JD, Lindenauer PK, Cooke CR .
Changes in coding of pneumonia and impact on the hospital readmission reduction program.
Health Serv Res 2019 Dec;54(6):1326-34. doi: 10.1111/1475-6773.13207..
Keywords: Pneumonia, Hospital Readmissions, Medicare, Hospitalization
Southern WN, Applebaum JR, Salmasian H
Clinician experience of electronic health record configurations displaying 1 vs 4 records at a time.
Most electronic health record (EHR) systems have the capability to display more than 1 patient record at a time; however, there is wide variation in practice. In this study, the investigators looked at clinician satisfaction of EHR configuration with varying numbers of records displayed.
AHRQ-funded; HS026121.
Citation: Southern WN, Applebaum JR, Salmasian H .
Clinician experience of electronic health record configurations displaying 1 vs 4 records at a time.
JAMA Intern Med 2019 Dec;179(12):1723-25. doi: 10.1001/jamainternmed.2019.3688..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Clinician, Provider
Tilden EL, Phillippi JC, Ahlberg M
Describing latent phase duration and associated characteristics among 1281 low-risk women in spontaneous labor.
Recent research suggests that latent phase of labor may terminate at 6 rather than 4 centimeters of cervical dilation. The objectives of this study were to: (a) characterize duration of the latent phase of labor among term, low-risk, United States women in spontaneous labor using the women's self-identified onset; and (b) quantify associations between demographic and maternal/newborn health characteristics and the duration of the latent phase.
AHRQ-funded; HS024733.
Citation: Tilden EL, Phillippi JC, Ahlberg M .
Describing latent phase duration and associated characteristics among 1281 low-risk women in spontaneous labor.
Birth 2019 Dec;46(4):592-601. doi: 10.1111/birt.12428..
Keywords: Labor and Delivery, Pregnancy, Women
Derrett S, Gunter KE, Samaranayaka A
Development and testing of the Provider and Staff Perceptions of Integrated Care (PSPIC) Survey.
The authors developed and tested a 21-item questionnaire titled Provider and Staff Perceptions of Integrated Care Survey. The questionnaire was sent to 2,936 providers and staff at 100 federally qualified health centers and other clinics in Midwestern U.S. States, of which 2,604 were deemed eligible. Four mailings were conducted with a 30% response rate from 97 health centers. Four latent factors were suggested: Teams and Care Continuity, Patient Centeredness, Coordination with External Providers, and Coordination with Community Resources.
AHRQ-funded; HS000084.
Citation: Derrett S, Gunter KE, Samaranayaka A .
Development and testing of the Provider and Staff Perceptions of Integrated Care (PSPIC) Survey.
Med Care Res Rev 2019 Dec;76(6):807-29. doi: 10.1177/1077558717745936..
Keywords: Provider, Care Coordination, Patient-Centered Healthcare, Teams
Mehta HB, Yong S, Sura SD
Development of comorbidity score for patients undergoing major surgery.
The goal of this study was to develop and validate a claims-based comorbidity score and compare to established comorbidity scores. The researchers used Medicare data to find adults 65 and older who had undergone major surgery to predict 1-year mortality, and 30-day hospital readmission. The comorbidity score was compared to the Charlson, Elixhauser, and CMC-HCC scores. Their newly developed comorbidity score better predicted outcomes than the established comorbidity score systems in the surgical population.
AHRQ-funded; HS022134.
Citation: Mehta HB, Yong S, Sura SD .
Development of comorbidity score for patients undergoing major surgery.
Health Serv Res 2019 Dec;54(6):1223-32. doi: 10.1111/1475-6773.13209..
Keywords: Surgery, Risk, Mortality
Shafer G, Singh H, Suresh G
Diagnostic errors in the neonatal intensive care unit: state of the science and new directions.
In this narrative review, the authors discuss how the concept of diagnostic errors framed as missed opportunities can be applied to the non-linear nature of diagnosis in a critical care environment such as the NICU. They then explore how the etiology of an error in diagnosis can be related to both individual cognitive factors as well as organizational and systemic factors - all of which often contribute to the error.
AHRQ-funded; HS022087.
Citation: Shafer G, Singh H, Suresh G .
Diagnostic errors in the neonatal intensive care unit: state of the science and new directions.
Semin Perinatol 2019 Dec;43(8):151175. doi: 10.1053/j.semperi.2019.08.004..
Keywords: Newborns/Infants, Diagnostic Safety and Quality, Neonatal Intensive Care Unit (NICU), Medical Errors, Adverse Events, Patient Safety
Earnshaw VA, Bogart LM, Menino D
Disclosure, stigma, and social support among young people receiving treatment for substance use disorders and their caregivers: a qualitative analysis.
The purpose of this study was to investigate relational processes experienced by youth with substance use disorders (SUDs) and their caregivers that may act as barriers to, or facilitators of, recovery. Single-session qualitative semi-structured interviews were conducted by clinicians from a SUDs program. There was variability in disclosure experiences. Addressing relational processes within treatment by encouraging patients and caregivers to share the disclosure decision-making process may support the recovery of youth with SUDs.
AHRQ-funded; HS022986.
Citation: Earnshaw VA, Bogart LM, Menino D .
Disclosure, stigma, and social support among young people receiving treatment for substance use disorders and their caregivers: a qualitative analysis.
Int J Ment Health Addict 2019 Dec;17(6):1535-49. doi: 10.1007/s11469-018-9930-8..
Keywords: Children/Adolescents, Caregiving, Substance Abuse, Social Stigma
McMurtry CL, Findling MG, Casey LS
Discrimination in the United States: experiences of Asian Americans.
This study examined the prevalence of racial discrimination among Asian Americans and its impact on health outcomes. A nationally representative, probability-based telephone survey was conducted comparing 500 Asian and 902 white US adults from January to April 2017. Thirteen percent of Asians reported discrimination in healthcare encounters, and at least one in four experienced discrimination in employment, housing, and experienced microaggressions (35%) or racial slurs (32%). This resulted in Asians having higher odds than whites of reporting avoiding health care due to discrimination concerns.
AHRQ-funded; HS000055.
Citation: McMurtry CL, Findling MG, Casey LS .
Discrimination in the United States: experiences of Asian Americans.
Health Serv Res 2019 Dec;54(Suppl2):1419-30. doi: 10.1111/1475-6773.13225..
Keywords: Racial and Ethnic Minorities, Disparities, Social Determinants of Health, Patient Experience
Schoenfeld EM, Probst MA, Quigley
Does shared decision making actually occur in the emergency department? Looking at it from the patients' perspective.
In this study the investigators sought to assess the frequency, content, and quality of shared decision making (SDM) in the emergency department (ED), from patients' perspectives. The investigators found that fewer than half of ED patients surveyed reported they were involved in SDM. The most common decision for which SDM was used was around ED disposition (admission vs. discharge). When SDM was employed, patients generally rated the discussion highly.
AHRQ-funded; HS025701.
Citation: Schoenfeld EM, Probst MA, Quigley .
Does shared decision making actually occur in the emergency department? Looking at it from the patients' perspective.
Acad Emerg Med 2019 Dec;26(12):1369-78. doi: 10.1111/acem.13850..
Keywords: Shared Decision Making, Emergency Department, Clinician-Patient Communication, Patient and Family Engagement
Downs SM, Bauer NS, Saha C
Effect of a computer-based decision support intervention on autism spectrum disorder screening in pediatric primary care clinics: a cluster randomized clinical trial.
This study examined outcomes for implementation of a decision support system called CHICA (Child Health Improvement Through Computer Automation) to improve screening rates for autism in children aged 18 to 24 months. A random sample of 274 children in four urban clinics was used. Two clinics participated in the intervention, and two served as controls. Because participating clinics requested intervention be discontinued for children aged 18 months, only results for those aged 24 months was analyzed. Of the 263 children with reviewed results, 92% were enrolled in Medicaid, 52.5% were African American, and 36.5% were Hispanic. Screening rates increased from 0% at baseline to 100% in 24 months during the study period of November 2010 to November 2012. Screening results were positive for 265 of 980 children screened by CHICA in the time period, with 2 children from the intervention group positively diagnosed in the time frame of the study.
AHRQ-funded; HS018453.
Citation: Downs SM, Bauer NS, Saha C .
Effect of a computer-based decision support intervention on autism spectrum disorder screening in pediatric primary care clinics: a cluster randomized clinical trial.
JAMA Netw Open 2019 Dec 2;2(12):e1917676. doi: 10.1001/jamanetworkopen.2019.17676..
Keywords: Autism, Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT), Primary Care, Children/Adolescents, Screening
Mejia-Chew c, O'Halloran JA, Olsen MA
Effect of infectious disease consultation on mortality and treatment of patients with candida bloodstream infections: a retrospective, cohort study.
Candida bloodstream infection is associated with high mortality. Infectious disease consultation improves outcomes in several infections, including Staphylococcus aureus and cryptococcosis, as well as multidrug-resistant organisms. In this study, the investigators aimed to examine the association between infectious disease consultation and differences in management with mortality in candida bloodstream infections.
AHRQ-funded; HS019455.
Citation: Mejia-Chew c, O'Halloran JA, Olsen MA .
Effect of infectious disease consultation on mortality and treatment of patients with candida bloodstream infections: a retrospective, cohort study.
Lancet Infect Dis 2019 Dec;19(12):1336-44. doi: 10.1016/s1473-3099(19)30405-0..
Keywords: Infectious Diseases, Public Health, Mortality
Salvador J, Bhatt S, Fowler R
Engagement with Project ECHO to increase medication-assisted treatment in rural primary care.
The purpose of this study was to understand the barriers and facilitators that affect engagement with Project ECHO (Extension for Community Healthcare Outcomes) to implement medication-assisted treatment (MAT) in primary care settings. This brief report identified key systematic challenges that may directly limit primary care providers' engagement in telementoring models such as Project ECHO.
AHRQ-funded; HS025345.
Citation: Salvador J, Bhatt S, Fowler R .
Engagement with Project ECHO to increase medication-assisted treatment in rural primary care.
Psychiatr Serv 2019 Dec;70(12):1157-60. doi: 10.1176/appi.ps.201900142..
Keywords: Opioids, Medication, Substance Abuse, Primary Care, Rural Health, Telehealth, Health Information Technology (HIT)