National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Antimicrobial Stewardship (2)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (1)
- Comparative Effectiveness (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Critical Care (1)
- Diagnostic Safety and Quality (1)
- Disparities (1)
- Elderly (11)
- Emergency Department (1)
- Healthcare Costs (2)
- Healthcare Delivery (3)
- Health Information Technology (HIT) (2)
- Health Insurance (1)
- Health Services Research (HSR) (1)
- Home Healthcare (2)
- Hospitalization (4)
- Injuries and Wounds (1)
- (-) Long-Term Care (18)
- Medicare (2)
- Medication (2)
- Medication: Safety (1)
- Mortality (1)
- Nursing Homes (10)
- Nutrition (1)
- Outcomes (3)
- Palliative Care (1)
- Patient Experience (1)
- Patient Safety (1)
- Policy (1)
- Pressure Ulcers (1)
- Prevention (1)
- Provider Performance (1)
- Quality Improvement (3)
- Quality Measures (2)
- Quality of Care (3)
- Racial and Ethnic Minorities (1)
- Risk (1)
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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
1 to 18 of 18 Research Studies DisplayedMcGarry BE, Temkin-Greener H, Li Y
Role of race and ethnicity in private long-term care insurance ownership.
The authors sought to determine if racial/ethnic disparities exist in the ownership of private long-term care insurance (LTCI) among current Medicare beneficiaries. They found that 12.3% of Blacks and 5.8% of Hispanics, compared with 20.2% of Whites, reported having LTCI coverage and that Hispanics were 48% less likely to have LTCI compared with Whites. Hispanic women were 81% less likely to be insured compared with White women.
AHRQ-funded; HS000044.
Citation: McGarry BE, Temkin-Greener H, Li Y .
Role of race and ethnicity in private long-term care insurance ownership.
Gerontologist 2014 Dec;54(6):1001-12. doi: 10.1093/geront/gnt102.
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Keywords: Disparities, Elderly, Health Insurance, Long-Term Care, Racial and Ethnic Minorities
Larson EL, Cohen B, Murray M
Challenges in conducting research in pediatric long-term care facilities.
The purposes of this article are to describe the challenges associated with conducting research in pediatric long-term care facilities (LTCFs) and to recommend approaches to build a successful collaborative relationship between the clinical and administrative staff in LTCFs and the academic research team.
AHRQ-funded; HS021470.
Citation: Larson EL, Cohen B, Murray M .
Challenges in conducting research in pediatric long-term care facilities.
Clin Pediatr 2014 Oct;53(11):1041-6. doi: 10.1177/0009922814540986..
Keywords: Children/Adolescents, Long-Term Care, Health Services Research (HSR)
Furuno JP, Comer AC, Johnson JK
Using antibiograms to improve antibiotic prescribing in skilled nursing facilities.
The researchers describe the design and implementation of a skilled nursing facility (SNF) specific antibiogram to improve empirical antibiotic prescribing. They estimated the frequency of inappropriate antibiotic prescribing in 3 Maryland SNFs and measured the effectiveness of the antibiograms on antibiotic prescribing in 1 of the SNFs.
AHRQ-funded; 290200600020I
Citation: Furuno JP, Comer AC, Johnson JK .
Using antibiograms to improve antibiotic prescribing in skilled nursing facilities.
Infect Control Hosp Epidemiol. 2014 Oct;35 Suppl 3:S56-61. doi: 10.1086/677818..
Keywords: Long-Term Care, Antimicrobial Stewardship, Nursing Homes, Diagnostic Safety and Quality
Abrahamson K, Mueller C, Davila HW
Nurses as boundary-spanners in reducing avoidable hospitalizations among nursing home residents.
The researchers interviewed 76 nurses working at 38 nursing homes that were implementing quality improvement projects to reduce avoidable hospitalizations. They explored the role of the nurse as boundary-spanner between the organizational goals of the nursing home and external stakeholder systems and how that influences the nursing staff experience.
AHRQ-funded; HS018464
Citation: Abrahamson K, Mueller C, Davila HW .
Nurses as boundary-spanners in reducing avoidable hospitalizations among nursing home residents.
Res Gerontol Nurs. 2014 Sep-Oct;7(5):235-43. doi: 10.3928/19404921-20140519-01..
Keywords: Nursing Homes, Long-Term Care, Elderly, Quality of Care, Quality Improvement
Buys DR, Roth DL, Ritchie CS
Nutritional risk and body mass index predict hospitalization, nursing home admissions, and mortality in community-dwelling older adults: results from the UAB Study of Aging with 8.5 years of follow-up.
This study finds that nutritional risk was prospectively associated with all-cause and nonsurgical hospitalizations and with nursing home admission and mortality in unadjusted models. After adjusting for other risk factors, the association between high nutritional risk and all-cause and nonsurgical hospitalizations remained significant.
AHRQ-funded; HS013852
Citation: Buys DR, Roth DL, Ritchie CS .
Nutritional risk and body mass index predict hospitalization, nursing home admissions, and mortality in community-dwelling older adults: results from the UAB Study of Aging with 8.5 years of follow-up.
J Gerontol A Biol Sci Med Sci. 2014 Sep;69(9):1146-53. doi: 10.1093/gerona/glu024..
Keywords: Nutrition, Hospitalization, Elderly, Long-Term Care, Mortality
Aparasu RR, Chatterjee S, Chen H
Risk of hospitalization and use of first- versus second-generation antipsychotics among nursing home residents.
This study examined the risk of all-cause hospitalization among dual-eligible elderly nursing home residents who were using antipsychotic medications and found that, on average, there was a 58 percent increase in hospitalization risk after 20 days of using a first-generation drug.
AHRQ-funded; HS016920
Citation: Aparasu RR, Chatterjee S, Chen H .
Risk of hospitalization and use of first- versus second-generation antipsychotics among nursing home residents.
Psychiatr Serv. 2014 Jun;65(6):781-8. doi: 10.1176/appi.ps.201300093..
Keywords: Long-Term Care, Medication, Hospitalization, Elderly, Risk
Olsho LE, Spector WD, Williams CS
AHRQ Author: Spector WD
Evaluation of AHRQ's on-time pressure ulcer prevention program: a facilitator-assisted clinical decision support intervention for nursing homes.
The researchers evaluated the effectiveness of the On-Time Quality Improvement for Long Term Care (On-Time) program in reducing the rate of in-house-acquired pressure ulcers among nursing home residents. They found that On-Time implementation is associated with sizable reductions in pressure ulcer incidence.
AHRQ-authored; AHRQ-funded; 290200600011I.
Citation: Olsho LE, Spector WD, Williams CS .
Evaluation of AHRQ's on-time pressure ulcer prevention program: a facilitator-assisted clinical decision support intervention for nursing homes.
Med Care 2014 Mar;52(3):258-66. doi: 10.1097/mlr.0000000000000080.
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Keywords: Clinical Decision Support (CDS), Long-Term Care, Nursing Homes, Pressure Ulcers, Prevention
Thomas KS
The relationship between Older Americans Act in-home services and low-care residents in nursing homes.
This study examining the relationship between the proportion of older adults in a State who receive in-home services funded by the Older Americans Act and the proportion of residents in nursing homes finds that for every additional 1 percent of the 65+ population that receives personal care services, there is a 0.8% decrease in the proportion of low-care residents in nursing homes.
AHRQ-funded; HS00011
Citation: Thomas KS .
The relationship between Older Americans Act in-home services and low-care residents in nursing homes.
J Aging Health. 2014 Mar;26(2):250-60. doi: 10.1177/0898264313513611..
Keywords: Elderly, Long-Term Care, Home Healthcare, Nursing Homes, Healthcare Delivery
Spector WD
AHRQ Author: Spector WD
Response to letter to the editor regarding the paper "potentially avoidable hospitalization for elderly long-stay residents in nursing homes".
The author argues against the strategy than is implied by Dr. Powers’ letter to the editor. Rather than adding one aspect of care organization at a time to administrative data, he states that we should identify a small set of easily collected measures that generally modify the effects of care organization innovations. With these in place, we can then add measures like consistent assignment to better understand how it improves clinical outcomes.
AHRQ-authored
Citation: Spector WD .
Response to letter to the editor regarding the paper "potentially avoidable hospitalization for elderly long-stay residents in nursing homes".
Med Care 2014 Jan;52(1):93-4. doi: 10.1097/mlr.0000000000000072..
Keywords: Hospitalization, Elderly, Outcomes, Long-Term Care, Nursing Homes
Rosenberg JH, Albrecht JS, Fromme EK
Antimicrobial use for symptom management in patients receiving hospice and palliative care: a systematic review.
This systematic review found that limited data are available on the use of antimicrobial therapy for symptom management among patients receiving palliative or hospice care. The lack of comparison between patients who did and did not receive antimicrobial therapy means that there is no accurate estimate of the effectiveness of antimicrobial therapy.
AHRQ-funded; HS021068
Citation: Rosenberg JH, Albrecht JS, Fromme EK .
Antimicrobial use for symptom management in patients receiving hospice and palliative care: a systematic review.
J Palliat Med. 2013 Dec;16(12):1568-74. doi: 10.1089/jpm.2013.0276..
Keywords: Comparative Effectiveness, Antimicrobial Stewardship, Long-Term Care, Palliative Care, Outcomes
Mukamel DB, Harrington C
Resident satisfaction surveys and clinical quality of care in nursing homes: two sides of the same coin?
The authors of this article believe that quality of nursing homes is a complex, multidimensional construct. Unlike acute care hospitals, where patients are typically treated for one specific condition and stay for a short period of time, the length of stays in nursing homes varies widely. They argue that neither the individual assessment of clinical quality nor evaluation of hotel services are sufficient.
AHRQ-funded; HS021844.
Citation: Mukamel DB, Harrington C .
Resident satisfaction surveys and clinical quality of care in nursing homes: two sides of the same coin?
Aging Health 2013 Dec;9(6):607-9. doi: 10.2217/ahe.13.63..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Long-Term Care, Nursing Homes, Patient Experience, Quality of Care, Quality Improvement, Quality Measures
Shah MN, Gillespie SM, Wood N
High-intensity telemedicine-enhanced acute care for older adults: an innovative healthcare delivery model.
This article describes an innovative healthcare model that uses high-intensity telemedicine services to provide rapid acute care for older adults without requiring them to leave their senior living community (SLC) residences. The project demonstrated that high-intensity telemedicine services for acute illnesses are feasible and acceptable and can provide definitive care without requiring ED or urgent care use.
AHRQ-funded; HS018047.
Citation: Shah MN, Gillespie SM, Wood N .
High-intensity telemedicine-enhanced acute care for older adults: an innovative healthcare delivery model.
J Am Geriatr Soc 2013 Nov;61(11):2000-7. doi: 10.1111/jgs.12523..
Keywords: Elderly, Telehealth, Health Information Technology (HIT), Healthcare Delivery, Long-Term Care
Huckfeldt PJ, Sood NB, Romley JA
Medicare payment reform and provider entry and exit in the post-acute care market.
The researchers examined the impact of Medicare payment reform on the entry and exit of post-acute providers (home health agencies and skilled nursing facilities). They found that payment reforms reducing average and marginal payments reduced entries and increased exits from the market, with entries more likely to be affected.
AHRQ-funded; HS018541
Citation: Huckfeldt PJ, Sood NB, Romley JA .
Medicare payment reform and provider entry and exit in the post-acute care market.
Health Serv Res. 2013 Oct;48(5):1557-80. doi: 10.1111/1475-6773.12059..
Keywords: Medicare, Critical Care, Healthcare Costs, Home Healthcare, Long-Term Care
Moga DC, Carnahan RM, Lund BC
Risks and benefits of bladder antimuscarinics among elderly residents of Veterans Affairs Community Living Centers.
This study evaluated the risks and benefits of drugs to reduce urinary incontinence that were used by elderly VA nursing home residents. It found that the use of these drugs, known as bladder antimuscarinics, resulted in improved continence rates and better social engagement but also led to a higher risk of fractures in new users.
AHRQ-funded; HS016094
Citation: Moga DC, Carnahan RM, Lund BC .
Risks and benefits of bladder antimuscarinics among elderly residents of Veterans Affairs Community Living Centers.
J Am Med Dir Assoc. 2013 Oct;14(10):749-60. doi: 10.1016/j.jamda.2013.03.008..
Keywords: Elderly, Medication, Medication: Safety, Nursing Homes, Long-Term Care, Injuries and Wounds, Patient Safety
Sheppard KD, Brown CJ, Hearld KR
Symptom burden predicts nursing home admissions among older adults.
Using a sample of community-dwelling Medicare beneficiaries in Alabama who were contacted by telephone every 6 months during an eight and a half-year study, researchers found that symptom burden is an independent risk factor for NH admission. The study suggests that symptom assessment and management may reduce NH utilization.
AHRQ-funded; HS013852
Citation: Sheppard KD, Brown CJ, Hearld KR .
Symptom burden predicts nursing home admissions among older adults.
J Pain Symptom Manage. 2013 Oct;46(4):591-7. doi: 10.1016/j.jpainsymman.2012.10...
Keywords: Medicare, Long-Term Care, Elderly, Nursing Homes, Healthcare Costs
Spector WD, Limcangco R, Williams C
AHRQ Author: Spector WD
Potentially avoidable hospitalizations for elderly long-stay residents in nursing homes.
The authors sought to determine the relationship between clinical risk factors, facility characteristics and State policy variables, and both avoidable and unavoidable hospitalizations. Using data from the Nursing Home Stay file, 2006-2008, they found that three fifths of hospitalizations were potentially avoidable and most were for infections, injuries, and congestive heart failure. Clinical risk factors included renal disease, diabetes, and a high number of medications. Staffing, quality, and reimbursement affected avoidable, but not unavoidable, hospitalizations.
AHRQ-authored.
Citation: Spector WD, Limcangco R, Williams C .
Potentially avoidable hospitalizations for elderly long-stay residents in nursing homes.
Med Care 2013 Aug;51(8):673-81. doi: 10.1097/MLR.0b013e3182984bff.
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Keywords: Elderly, Hospitalization, Long-Term Care, Nursing Homes, Policy
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
Shah MN, Morris D, Jones CM
A qualitative evaluation of a telemedicine-enhanced emergency care program for older adults.
The purpose of this study was to document the experiences of patients, their caregivers, healthcare personnel, and staff members with a program that provides telemedicine-enhanced emergency care to older adults residing in senior living communities (SLCs) and to delineate perceived barriers and facilitators. The authors concluded that telemedicine-enhanced emergency care is an acceptable method of providing emergency care to older adults in SLCs.
AHRQ-funded; HS018047.
Citation: Shah MN, Morris D, Jones CM .
A qualitative evaluation of a telemedicine-enhanced emergency care program for older adults.
J Am Geriatr Soc 2013 Apr;61(4):571-6. doi: 10.1111/jgs.12157..
Keywords: Elderly, Telehealth, Health Information Technology (HIT), Emergency Department, Healthcare Delivery, Long-Term Care