National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Ambulatory Care and Surgery (1)
- Blood Clots (1)
- Blood Pressure (1)
- Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cancer: Prostate Cancer (1)
- Care Management (2)
- Chronic Conditions (2)
- Communication (1)
- Community-Based Practice (1)
- Critical Care (1)
- Dental and Oral Health (1)
- Diabetes (1)
- Education: Patient and Caregiver (1)
- Elderly (3)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (3)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (2)
- (-) Healthcare Delivery (33)
- Healthcare Utilization (2)
- Health Information Technology (HIT) (2)
- Health Insurance (1)
- Health Literacy (5)
- Health Services Research (HSR) (9)
- Home Healthcare (1)
- Implementation (1)
- Intensive Care Unit (ICU) (1)
- Long-Term Care (3)
- Medical Expenditure Panel Survey (MEPS) (1)
- Mortality (1)
- Nursing Homes (1)
- Organizational Change (6)
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- Patient-Centered Outcomes Research (2)
- Patient and Family Engagement (3)
- Patient Experience (1)
- Payment (2)
- Policy (3)
- Prevention (1)
- Primary Care (5)
- Primary Care: Models of Care (4)
- Provider: Pharmacist (1)
- Provider Performance (1)
- Quality Improvement (5)
- Quality Indicators (QIs) (2)
- Quality Measures (3)
- Quality of Care (4)
- Research Methodologies (2)
- Shared Decision Making (5)
- Surgery (1)
- Teams (1)
- Telehealth (2)
- Tools & Toolkits (1)
- Women (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 25 of 33 Research Studies DisplayedAdmon AJ, Seymour CW, Gershengorn HB
Hospital-level variation in ICU admission and critical care procedures for patients hospitalized for pulmonary embolism.
The researchers examined the relationship between intensive care unit (ICU) use for patients with pulmonary embolism (PE) and cost, mortality, readmission, and procedure use in 263 hospitals. They found wide variations in ICU admission rates for acute PE without a detectable impact on mortality, cost, or readmission.
AHRQ-funded; HS020672
Citation: Admon AJ, Seymour CW, Gershengorn HB .
Hospital-level variation in ICU admission and critical care procedures for patients hospitalized for pulmonary embolism.
Chest. 2014 Dec;146(6):1452-61. doi: 10.1378/chest.14-0059..
Keywords: Blood Clots, Care Management, Critical Care, Healthcare Delivery, Intensive Care Unit (ICU)
Hollingsworth JM, Birkmeyer JD, Ye Z
Specialty-specific trends in the prevalence and distribution of outpatient surgery: implications for payment and delivery system reforms.
The authors sought to assess the prevalence and distribution of outpatient surgery across specialties. They found that several specialties - urology, gastroenterology, plastic surgery, and ophthalmology - perform most of their cases in outpatient settings. They suggested that incorporating these findings into the design of future payment and delivery system reforms will help to ensure adequate surgeon exposure to the efficiency gains that evolve from them.
AHRQ-funded; HS020927; HS018346.
Citation: Hollingsworth JM, Birkmeyer JD, Ye Z .
Specialty-specific trends in the prevalence and distribution of outpatient surgery: implications for payment and delivery system reforms.
Surg Innov 2014 Dec;21(6):560-5. doi: 10.1177/1553350613520515.
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Keywords: Ambulatory Care and Surgery, Surgery, Healthcare Delivery, Payment
Guise JM, Chang C, Viswanathan M
AHRQ Author: Chang C, Berliner E
Agency for Healthcare Research and Quality Evidence-based Practice Center methods for systematically reviewing complex multicomponent health care interventions.
The purpose of this AHRQ EPC methods white paper was to outline approaches to conducting systematic reviews of complex multicomponent health care interventions. It provided a framework for synthesizing studies of multicomponent interventions and also provided an initial list of critical reporting elements for such studies in order to help systematic reviewers understand the options and tradeoffs available for such reviews.
AHRQ-authored; AHRQ-funded; 290201200010I; 290201200012I; 290201200011I; 290201200015I; 290201200008I; 290201200004C.
Citation: Guise JM, Chang C, Viswanathan M .
Agency for Healthcare Research and Quality Evidence-based Practice Center methods for systematically reviewing complex multicomponent health care interventions.
J Clin Epidemiol 2014 Nov;67(11):1181-91. doi: 10.1016/j.jclinepi.2014.06.010.
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Keywords: Evidence-Based Practice, Healthcare Delivery, Health Services Research (HSR), Patient-Centered Outcomes Research, Research Methodologies
Rabin BA, Ellis JL, Steiner JF
Health-care utilization by prognosis profile in a managed care setting: using the Surveillance, Epidemiology and End Results Cancer Survival Calculator SEER*CSC.
The authors described health service utilization patterns of subgroups of prostate cancer and colorectal cancer (CRC) patients with different relative probabilities of dying of their cancer or other conditions. They found that although a new diagnosis of cancer increased utilization of cancer-related services for an extended time period, the timing of cancer diagnosis did not appear to affect other types of utilization.
AHRQ-funded; HS019520.
Citation: Rabin BA, Ellis JL, Steiner JF .
Health-care utilization by prognosis profile in a managed care setting: using the Surveillance, Epidemiology and End Results Cancer Survival Calculator SEER*CSC.
J Natl Cancer Inst Monogr 2014 Nov;2014(49):275-81. doi: 10.1093/jncimonographs/lgu023.
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Keywords: Cancer: Prostate Cancer, Cancer: Colorectal Cancer, Cancer, Healthcare Utilization, Mortality, Healthcare Delivery
Lyles CR, Aulakh V, Jameson W
Innovation and transformation in California's safety net health care settings: an inside perspective.
The authors investigated how safety net settings will innovate in order to achieve transformation of care delivery. Through informant interviews, they found that safety net systems have already begun implementing innovative practices supporting their key priority areas, but that more support is needed, specifically to accelerate the change needed to succeed under health reform.
AHRQ-funded; HS017594.
Citation: Lyles CR, Aulakh V, Jameson W .
Innovation and transformation in California's safety net health care settings: an inside perspective.
Am J Med Qual 2014 Nov-Dec;29(6):538-45. doi: 10.1177/1062860613507474.
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Keywords: Healthcare Delivery, Organizational Change
Mutter R, Stocks C
AHRQ Author: Stocks C
Using Healthcare Cost and Utilization Project (HCUP) data for emergency medicine research.
This article mentions Kocher et al., elsewhere in this issue, who use the HCUP Nationwide Inpatient Sample to examine the association between the volume of ED encounters that result in admission and inpatient mortality. It further discusses HCUP strengths, weaknesses, and future.
AHRQ-authored.
Citation: Mutter R, Stocks C .
Using Healthcare Cost and Utilization Project (HCUP) data for emergency medicine research.
Ann Emerg Med 2014 Nov;64(5):458-60. doi: 10.1016/j.annemergmed.2014.09.014.
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Keywords: Emergency Medical Services (EMS), Healthcare Costs, Healthcare Delivery, Health Services Research (HSR), Healthcare Cost and Utilization Project (HCUP)
Laiteerapong N, Kirby J, Gao Y
AHRQ Author: Kirby J, Ngo-Metzger Q
Health care utilization and receipt of preventive care for patients seen at federally funded health centers compared to other sites of primary care.
The investigators compared utilization and preventive care receipt among patients of federal Section 330 health centers (HCs) versus patients of other settings. They found that HC patients had fewer office visits and hospitalizations, were more likely to receive breast cancer screening, had fewer outpatient and emergency room visits, and were more likely to receive dietary advice compared to non-HC patients.
AHRQ-authored.
Citation: Laiteerapong N, Kirby J, Gao Y .
Health care utilization and receipt of preventive care for patients seen at federally funded health centers compared to other sites of primary care.
Health Serv Res 2014 Oct;49(5):1498-518. doi: 10.1111/1475-6773.12178.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Utilization, Prevention, Community-Based Practice, Healthcare Delivery
Parekh AK, Kronick R, Tavenner M
AHRQ Author: Kronick R
Optimizing health for persons with multiple chronic conditions.
The paper discussed four overarching goals resulting from the 2010 HHS report, "Strategic Framework on Multiple Chronic Conditions." These goals are foster health systems change, empower individuals, equip clinicians, and enhance research.
AHRQ-authored.
Citation: Parekh AK, Kronick R, Tavenner M .
Optimizing health for persons with multiple chronic conditions.
JAMA 2014 Sep 24;312(12):1199-200. doi: 10.1001/jama.2014.10181.
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Keywords: Chronic Conditions, Healthcare Delivery
Henrikson NB, Anderson ML, Hubbard RA
Employee knowledge of value-based insurance design benefits.
The authors assessed knowledge of features of a value-based insurance design (VBD). They concluded that incomplete knowledge of benefits is prevalent in an employee population soon after VBD rollout.
AHRQ-funded; HS018913.
Citation: Henrikson NB, Anderson ML, Hubbard RA .
Employee knowledge of value-based insurance design benefits.
Am J Prev Med 2014 Aug;47(2):115-22. doi: 10.1016/j.amepre.2014.03.005.
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Keywords: Evidence-Based Practice, Healthcare Delivery, Health Insurance
Gibson G, Jurasic MM, Wehler CJ
Longitudinal outcomes of using a fluoride performance measure for adults at high risk of experiencing caries.
In this paper, the authors hypothesized that after the implementation of a performance measure regarding appropriate fluoride use, veterans at high risk of experiencing caries would require fewer new dental restorations than in the past. They found that, after use of the performance measure for four years, there were 8.6 percent fewer patients needing two or more restorations, a 10.8 percent decrease in the mean number of restorations, and a modest 3.4 percent fewer patients at high risk of experiencing caries who required new restorations after the initial 12-month period.
AHRQ-funded; HS019527.
Citation: Gibson G, Jurasic MM, Wehler CJ .
Longitudinal outcomes of using a fluoride performance measure for adults at high risk of experiencing caries.
J Am Dent Assoc 2014 May;145(5):443-51. doi: 10.14219/jada.2013.53.
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Keywords: Dental and Oral Health, Healthcare Delivery, Provider Performance, Quality Indicators (QIs), Quality Measures
Liss DT, Fishman PA, Rutter CM
Specialty use among patients with treated hypertension in a patient-centered medical home.
The researchers described changes in outpatient specialty use among patients with treated hypertension during and after patient-centered medical home (PCMH) practice transformation. Their results suggest that more comprehensive primary care in this PCMH redesign enabled primary care teams to deliver more hypertension care, and that many needs of low morbidity patients were within the scope of primary care practice.
AHRQ-funded; HS019129.
Citation: Liss DT, Fishman PA, Rutter CM .
Specialty use among patients with treated hypertension in a patient-centered medical home.
J Gen Intern Med 2014 May;29(5):732-40. doi: 10.1007/s11606-014-2776-2..
Keywords: Blood Pressure, Patient-Centered Healthcare, Primary Care, Healthcare Delivery
Brach C
AHRQ Author: Brach C
A daughter's frustration with the dearth of patient- and family-centered care.
This article is a first-person account of a hospitalization that describes the lack of patient and family inclusion in decision-making, failure to use plain language and other health literacy strategies, and disregard for patient and family preferences. The author concludes that if the health care system is going to shift from paternalistic to patient- and family-centered, providers must be trained in how to communicate and partner with patients and families. The author references resources to help hospitals make systematic changes to hard wire health literate and patient- and family-centered care.
AHRQ-authored.
Citation: Brach C .
A daughter's frustration with the dearth of patient- and family-centered care.
Patient Exp J 2014 Apr 1;1(1):43-47.
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Keywords: Healthcare Delivery, Shared Decision Making, Health Literacy, Patient and Family Engagement, Patient-Centered Healthcare
Leroy L, Bayliss E, Domino M
AHRQ Author: Miller T
The Agency for Healthcare Research and Quality Multiple Chronic Conditions Research Network: overview of research contributions and future priorities.
HHS developed the HHS Strategic Framework on Multiple Chronic Conditions (MCC), and AHRQ contributed by funding the MCC Research Network over 45 diverse grants. This paper described a subset of research contributions made in each topic area and made 3 recommendations for future MCC research: (1) include person-centered and person-driven measures and outcomes, (2) consider the person in the context of their relationships and community, and (3) include mental healthcare as an essential part of overall healthcare.
AHRQ-authored; AHRQ-funded; HS022444.
Citation: Leroy L, Bayliss E, Domino M .
The Agency for Healthcare Research and Quality Multiple Chronic Conditions Research Network: overview of research contributions and future priorities.
Med Care 2014 Mar;52 Suppl 3:S15-22. doi: 10.1097/mlr.0000000000000095.
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Keywords: Chronic Conditions, Healthcare Delivery, Health Services Research (HSR), Patient-Centered Outcomes Research, Quality Measures
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
Brach C, Dreyer BP, Schillinger D
AHRQ Author: Brach C
Physicians' roles in creating health literate organizations: a call to action.
Physicians are being called on to deliver patient-centered care, reduce medical errors, and generally increase health care quality and health outcomes, all while containing costs. Fully engaging patients in prevention, decision-making and self-management activities is critical to achieving these aims. The authors of this paper concluded that being health literate must be a new way of delivering care rather than an add-on. For national health literacy goals to be met, health care organizations must ingrain health literacy into their routines.
AHRQ-authored.
Citation: Brach C, Dreyer BP, Schillinger D .
Physicians' roles in creating health literate organizations: a call to action.
J Gen Intern Med 2014 Feb;29(2):273-5. doi: 10.1007/s11606-013-2619-6.
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Keywords: Healthcare Delivery, Shared Decision Making, Health Literacy, Patient and Family Engagement, Patient-Centered Healthcare
Wexler RK
Invited letter: the evolving model of health care in the United States: system change is not enough.
In this letter, the author argues that the spread of new health care delivery models such as the Patient-Centered Medical Home and Accountable Care Organizations are necessary to improve population health but do not fully address the need for a fundamental change in how patients think about and access care. He calls for raising patient awareness of how the health care delivery system works and draws attention to practitioners’ concerns about patient satisfaction as a definitive marker of quality.
AHRQ-funded; HS020693
Citation: Wexler RK .
Invited letter: the evolving model of health care in the United States: system change is not enough.
Adv Health Care Manag. 2014;16:173-6..
Keywords: Access to Care, Healthcare Delivery, Patient-Centered Healthcare, Patient Experience, Primary Care, Primary Care: Models of Care
Taliani CA, Bricker PL, Adelman AM
Implementing effective care management in the patient-centered medical home.
The investigators explored how a disparate group of patient-centered medical homes (PCMHs) embedded care management in their team care environment to identify best practices. They concluded that PCMHs may want to ensure that care managers are available to meet with patients during visits, support patient self-management, fully leverage the electronic medical record for team messaging and patient tracking, and ensure integration into the care team with office huddles and ongoing communication.
AHRQ-funded; HS019150.
Citation: Taliani CA, Bricker PL, Adelman AM .
Implementing effective care management in the patient-centered medical home.
Am J Manag Care 2013 Dec;19(12):957-64.
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Keywords: Care Management, Diabetes, Healthcare Delivery, Patient-Centered Healthcare, Quality Improvement, Teams
Miller WL, Crabtree BF, Harrison MI
AHRQ Author: Harrison MI
Integrating mixed methods in health services and delivery system research.
The authors introduced this AHRQ-sponsored issue of Health Services Research, describing the papers and briefly indicating where they fit into the emerging mixed methods mosaic. They then provided some suggestions about what may be missing and anticipated a future state of a more integrated approach to health services research and richer dialogue between researchers and those engaged in health care.
AHRQ-authored.
Citation: Miller WL, Crabtree BF, Harrison MI .
Integrating mixed methods in health services and delivery system research.
Health Serv Res 2013 Dec;48(6 Pt 2):2125-33. doi: 10.1111/1475-6773.12123.
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Keywords: Healthcare Delivery, Health Services Research (HSR), Research Methodologies
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
Chen J, Liu L, Zhang D
A flexible model for the mean and variance functions, with application to medical cost data.
The authors considered an extension to generalized linear models by assuming nonlinear associations of covariates in the mean function and allowing the variance to be an unknown but smooth function of the mean. They discussed their application of the model to the annual medical costs of heart failure patients in the clinical data repository at the University of Virginia Hospital System.
AHRQ-funded; HS020263.
Citation: Chen J, Liu L, Zhang D .
A flexible model for the mean and variance functions, with application to medical cost data.
Stat Med 2013 Oct 30;32(24):4306-18. doi: 10.1002/sim.5838.
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Keywords: Healthcare Delivery, Healthcare Costs, Health Services Research (HSR)
Randhawa G
AHRQ Author: Randhawa G
Moving to a user-driven research paradigm.
The combination of changes in research practice and in health care delivery, growing complexity in decision-making, increasing use of electronic health records, and growing resource constraints necessitate a shift to a user-driven research paradigm to generate new knowledge. This article's conceptual framework was created to clarify the perspective of the decision makers as well as the range of factors and the variability in thresholds used to make decisions. It may help researchers in creating actionable information to meet the needs of decision makers, which is needed for the transition to a user-driven research paradigm.
AHRQ-authored.
Citation: Randhawa G .
Moving to a user-driven research paradigm.
EGEMS 2013 Oct;1(2):1017. doi: 10.13063/2327-9214.1017.
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Keywords: Shared Decision Making, Electronic Health Records (EHRs), Evidence-Based Practice, Healthcare Delivery, Implementation
Baur C, Brach C
AHRQ Author: Brach C
Pharmacy research on health literacy can contribute to national goals and health care system improvements.
Three key points about health literacy underscore the articles in this special issue: 1. Effective health communication utilizes both the spoken and written word; 2. A number of health literacy tools can help pharmacists implement health literacy practices; 3. Readability assessments can be a step on a path toward more productive provider–patient communication.
AHRQ-authored.
Citation: Baur C, Brach C .
Pharmacy research on health literacy can contribute to national goals and health care system improvements.
Res Social Adm Pharm 2013 Sep-Oct;9(5):498-502. doi: 10.1016/j.sapharm.2013.06.012.
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Keywords: Healthcare Delivery, Communication, Health Literacy, Provider: Pharmacist
Clancy CM, Collins Sharp BA
AHRQ Author: Clancy CM, Collins Sharp BA
Women's health during health care transformation.
This article describes health care transformation as it affects women as a result of the Affordable Care Act of 2010. Topics discussed include USPSTF-recommended preventve services, patient-centered medical homes, access, health disparities, and the Veterans Health Administration healthcare system.
AHRQ-authored.
Citation: Clancy CM, Collins Sharp BA .
Women's health during health care transformation.
J Gen Intern Med 2013 Jul;28 Suppl 2:S500-3. doi: 10.1007/s11606-013-2473-6.
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Keywords: Healthcare Delivery, Policy, Policy, Women
Conway PH, Mostashari F, Clancy CM
AHRQ Author: Clancy CM
The future of quality measurement for improvement and accountability.
The authors describe the characteristics of the quality measurement enterprise of the future, outline a potential roadmap for the transition, and identify a set of opportunities for public- and private-sector collaboration.
AHRQ-authored.
Citation: Conway PH, Mostashari F, Clancy CM .
The future of quality measurement for improvement and accountability.
JAMA 2013 Jun 5;309(21):2215-6. doi: 10.1001/jama.2013.4929.
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Keywords: Healthcare Delivery, Policy, Organizational Change, Quality Indicators (QIs), Quality Measures, Quality of Care
DeVoe JE, Stenger R
Aligning provider incentives to improve primary healthcare delivery in the United States.
This critical review uses a theoretical framework from game-theory models to discuss some of the dominant primary care provider payment models and how they create 'prisoner's dilemmas' that have stalled past reform efforts, then illustrates an escape from the dilemma. It concludes that a blend of guaranteed payment and selective incentives designed to encourage primary care providers to deliver high quality care, efficient and equitable care and to eliminate incentives towards over-servicing could reach outcomes leading to shared benefits for everyone involved.
AHRQ-funded; HS014645; HS016181.
Citation: DeVoe JE, Stenger R .
Aligning provider incentives to improve primary healthcare delivery in the United States.
OA Fam Med 2013 Jun 1;1(1):7.
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Keywords: Healthcare Delivery, Payment, Primary Care, Quality Improvement