National Healthcare Quality and Disparities Report
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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 25 of 51 Research Studies DisplayedAnhang Price R, Quigley DD DD, Hargraves JL
A systematic review of strategies to enhance response rates and representativeness of patient experience surveys.
The purpose of this systematic review study was to explore evidence on survey administration strategies to increase response rates and representativeness of patient surveys. The researchers examined 40 peer-reviewed randomized experiments of administration protocols for patient experience surveys. The study found that when compared to mail-only or telephone-only administration of surveys, mail administration with telephone follow-up provides a median response rate benefit of 13%. Researchers also discovered that while surveys administered only by web usually result in lower response rates than those administered by mail or telephone, the limited evidence for a web-mail-telephone process suggests a potential response rate benefit over a mail-telephone process. Monetary incentives are related with substantial improvements in response rates. The study concluded that mixed-mode survey administration results in increased patient survey response rates than a single mode.
AHRQ-funded; HS025920.
Citation: Anhang Price R, Quigley DD DD, Hargraves JL .
A systematic review of strategies to enhance response rates and representativeness of patient experience surveys.
Med Care 2022 Dec;60(12):910-18. doi: 10.1097/mlr.0000000000001784..
Keywords: Patient Experience, Research Methodologies, Health Services Research (HSR)
Saldanha IJ, Adam GP, Bañez LL
AHRQ Author: Bañez LL
Inclusion of nonrandomized studies of interventions in systematic reviews of interventions: updated guidance from the Agency for Health Care Research and Quality Effective Health Care program.
A guidance workgroup comprised systematic review experts utilized an informal consensus generation method to develop guidelines to inform decisions regarding the inclusion of nonrandomized studies of interventions (NRSIs) in systematic reviews (SRs) of the effects of interventions. The study found that varying topics may require varying decisions regarding NRSI inclusion. The researchers identified key considerations to inform the decisions; from refinement of topics through to development of protocols. During the scoping and refinement of topics, considerations were associated with the clinical decisional dilemma, adequacy of randomized controlled trials (RCTs) to address the crucial questions, risk of bias in NRSIs, and the degree to which NRSIs are likely to complement RCTs. When NRSIs are included, during SR team formation, familiarity with topic-specific data sources and advanced analytic methods for NRSIs should be considered. During protocol development, the decision regarding NRSI inclusion or exclusion should be justified, and potential implications explained. When NRSIs are included, the protocol should describe the processes for synthesizing evidence from RCTs and NRSIs and determining the overall strength of evidence. CONCLUSION: We identified specific considerations for decisions regarding NRSI inclusion in SRs and highlight the importance of flexibility and transparency.
AHRQ-authored; AHRQ-funded; 290-2017-00003 -C; 75Q80120D00001- 75Q8120D00003; 75Q80120D00005 - 75Q8120D00009.
Citation: Saldanha IJ, Adam GP, Bañez LL .
Inclusion of nonrandomized studies of interventions in systematic reviews of interventions: updated guidance from the Agency for Health Care Research and Quality Effective Health Care program.
J Clin Epidemiol 2022 Dec; 152:300-06. doi: 10.1016/j.jclinepi.2022.08.015..
Keywords: Evidence-Based Practice, Research Methodologies, Health Services Research (HSR)
Holtrop JS, Davis MM
Primary care research is hard to do during COVID-19: challenges and solutions.
This study examined challenges in conducting primary care research during the COVID-19 pandemic. The authors used their experience on over 15 individual projects during the pandemic. They identified 3 key challenges to conducting primary care research: (1) practice delivery trickle-down effects, (2) limited/changing resources and procedures for research, and (3) a generally tense milieu in US society during the pandemic. They presented strategies, informed by a set of questions, to help researchers decide how to address these challenges observed during our studies. They encouraged normalization and self-compassion; and encouraged researchers and funders to embrace pragmatic and adaptive research designs as the circumstances with COVID-19 evolve over time.
AHRQ-funded; HS027080.
Citation: Holtrop JS, Davis MM .
Primary care research is hard to do during COVID-19: challenges and solutions.
Ann Fam Med 2022 Nov-Dec; 20(6):568-72. doi: 10.1370/afm.2889..
Keywords: COVID-19, Primary Care, Health Services Research (HSR), Research Methodologies
Coley RY, Duan KI, Hoopes AJ
A call to integrate health equity into learning health system research training.
This paper is a call to integrate health equity into the competency domain for learning health systems (LHS) research training. In 2016, AHRQ recommended seven domains for training and mentoring researchers, but health equity was not included. Scholars in the Consortium for Applied Training to Advance the Learning health system with Scholars/Trainees (CATALyST) K12 program recommend that competency domains be extended to reflect growing demands for evidence on health inequities and interventions to alleviate them. The authors present real-life case studies in an LHS research training program that illustrate facilitators, challenges, and potential solutions at the program, funder, and research community-level to receiving training and mentorship in health equity-focused LHS science. They recommend actions in four areas for LHS research training programs: (a) integrate health equity throughout the current LHS domains; (b) develop training and mentoring in health equity; (c) establish program evaluation standards for consideration of health equity; and (d) bring forth relevant, extant expertise from the areas of health disparities research, community-based participatory research, and community-engaged health services research.
AHRQ-funded; HS026369.
Citation: Coley RY, Duan KI, Hoopes AJ .
A call to integrate health equity into learning health system research training.
Learn Health Syst 2022 Oct;6(4):e10330. doi: 10.1002/lrh2.10330..
Keywords: Learning Health Systems, Health Systems, Health Services Research (HSR), Training, Disparities
Franklin PD, Drane D, Wakschlag L
Development of a learning health system science competency assessment to guide training and proficiency assessment.
This paper describes the development of the learning health systems (LHS) Competency Assessment by the AHRQ-funded ACCELERAT K12 training program. Domain experts and trainees were recruited to define and operationalize items to include in an LHS Competency Assessment to support emerging and existing LHS scientists in prioritizing and monitoring proficiency development. The method used was to conduct sequential interviews with 18 experts who iteratively defined skills and tasks to illustrate stage in proficiency and its progression for each of 42 competencies in the seven LHS expertise domains: systems science; research questions and standards of scientific evidence; research methods; informatics; ethics of research and implementation in health systems; improvement and implementation science; and engagement, leadership, and research management. The LHS Competency Assessment was reviewed, and pilot tested by current trainees and further refinement was completed using their feedback. The LHS Competency Assessment was found to offer consistent, graded criteria across the seven LHS domains.
AHRQ-funded; HS026369.
Citation: Franklin PD, Drane D, Wakschlag L .
Development of a learning health system science competency assessment to guide training and proficiency assessment.
Learn Health Syst 2022 Oct;6(4):e10343. doi: 10.1002/lrh2.10343..
Keywords: Learning Health Systems, Health Systems, Health Services Research (HSR), Training, Education: Curriculum
O'Malley AJ, Landon BE, Zaborski LA
Weak correlations in health services research: weak relationships or common error?
This study examined whether the correlation between a provider's effect on one population of patients and the same provider's effect on another population is underestimated if the effects for each population are estimated separately as opposed to being jointly modeled as random effects, and characterized how the impact of the estimation procedure varies with sample size. The authors used Medicare claims and enrollment data on emergency department (ED) visits, including patient characteristics, the patient’s hospitalization status, and identification of the doctor responsible for the decision to hospitalize the patient. The simulation analysis demonstrated that the joint modeling approach is generally close to unbiased, whereas the stratified approach can be severely biased in small samples. Correlations included 0.98 for female and male patients and only 0.38 using stratified estimation. Correlations for White and non-White patients are 0.99 and 0.28, and for Medicaid dual-eligible and non-dual-eligible patients 0.99 and 0.31, respectively.
AHRQ-funded; HS025408.
Citation: O'Malley AJ, Landon BE, Zaborski LA .
Weak correlations in health services research: weak relationships or common error?
Health Serv Res 2022 Feb;57(1):182-91. doi: 10.1111/1475-6773.13882..
Keywords: Health Services Research (HSR), Research Methodologies
Sabbatini AK, Merck LH, Froemming AT
Optimizing patient-centered communication and multidisciplinary care coordination in emergency diagnostic imaging: a research agenda.
This article summarizes findings reached during the patient-centered outcomes session of the 2015 Academic Emergency Medicine consensus conference "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The primary objective was to develop a research agenda focused on 1) defining component parts of the emergency diagnostic imaging care coordination process, 2) identifying gaps in communication that affect emergency diagnostic imaging, and 3) defining optimal methods of communication.
AHRQ-funded; HS022982.
Citation: Sabbatini AK, Merck LH, Froemming AT .
Optimizing patient-centered communication and multidisciplinary care coordination in emergency diagnostic imaging: a research agenda.
Acad Emerg Med 2015 Dec;22(12):1427-34. doi: 10.1111/acem.12826.
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Keywords: Communication, Emergency Department, Health Services Research (HSR), Imaging, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Rundell SD, Goode AP, Friedly JL
Role of health services research in producing high-value rehabilitation care.
The overall purpose of this article is to present a framework to help clinicians, researchers, educators, and policy makers better understand the role of health services research in developing and evaluating evidence on value in rehabilitation. The authors believe that rehabilitation professionals have a great opportunity to increase their engagement in describing, evaluating, delivering, and disseminating high-value care, but there are several barriers they need to consider to be most successful.
AHRQ-Funded HS022982.
Citation: Rundell SD, Goode AP, Friedly JL .
Role of health services research in producing high-value rehabilitation care.
Phys Ther 2015 Dec;95(12):1703-11. doi: 10.2522/ptj.20150033..
Keywords: Health Services Research (HSR), Rehabilitation, Patient-Centered Outcomes Research, Comparative Effectiveness
Calo WA, Cubillos L, Breen J
Experiences of Latinos with limited English proficiency with patient registration systems and their interactions with clinic front office staff: an exploratory study to inform community-based translational research in North Carolina.
This study explored Latino patients with limited English proficiency (LEP) experiences with, and expectations for, interactions with patient registration systems and front office staff. It found that Latino patients in North Carolina experienced health services barriers unique to their LEP background. Participants identified ways in which the lack of cultural and linguistic competence of front office staff negatively affect their experiences seeking health services.
AHRQ-funded; HS000032.
Citation: Calo WA, Cubillos L, Breen J .
Experiences of Latinos with limited English proficiency with patient registration systems and their interactions with clinic front office staff: an exploratory study to inform community-based translational research in North Carolina.
BMC Health Serv Res 2015 Dec 23;15:570. doi: 10.1186/s12913-015-1235-z.
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Keywords: Access to Care, Communication, Health Services Research (HSR), Clinician-Patient Communication, Racial and Ethnic Minorities
Finnerty NM, Rodriguez RM, Carpenter CR
Clinical decision rules for diagnostic imaging in the emergency department: a research agenda.
The objective of this working group and article was to generate a consensus-based research agenda for the development and implementation of clinical decision rules (CDRs) for diagnostic imaging in the emergency department. A research agenda was developed, prioritizing a number of questions, including: what are the optimal methods to justify the derivation and validation of diagnostic imaging CDRs?
AHRQ-funded; HS023498.
Citation: Finnerty NM, Rodriguez RM, Carpenter CR .
Clinical decision rules for diagnostic imaging in the emergency department: a research agenda.
Acad Emerg Med 2015 Dec;22(12):1406-16. doi: 10.1111/acem.12828.
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Keywords: Shared Decision Making, Emergency Department, Health Services Research (HSR), Imaging
Kanzaria HK, McCabe AM, Meisel ZM
Advancing patient-centered outcomes in emergency diagnostic imaging: a research agenda.
This article provides background on patient-centered outcomes research (PCOR) in emergency diagnostic imaging. and the conclusions of the 2015 Academic Emergency Medicine consensus conference PCOR work group regarding "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The goal was to determine a prioritized research agenda to establish which outcomes related to emergency diagnostic imaging are most important to patients, caregivers, and other key stakeholders.
AHRQ-funded; HS023498.
Citation: Kanzaria HK, McCabe AM, Meisel ZM .
Advancing patient-centered outcomes in emergency diagnostic imaging: a research agenda.
Acad Emerg Med 2015 Dec;22(12):1435-46. doi: 10.1111/acem.12832.
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Keywords: Emergency Department, Health Services Research (HSR), Imaging, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Kuehl DR, Berdahl CT, Jackson TD
Advancing the use of administrative data for emergency department diagnostic imaging research.
This article summarizes the discussions of the breakout session on the use of administrative data for emergency imaging research at the May 2015 Academic Emergency Medicine consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The authors describe the areas where administrative data have been applied to research evaluating the use of diagnostic imaging in the ED, the common sources for these data, and the strengths and limitations of administrative data.
AHRQ-funded; HS023498.
Citation: Kuehl DR, Berdahl CT, Jackson TD .
Advancing the use of administrative data for emergency department diagnostic imaging research.
Acad Emerg Med 2015 Dec;22(12):1417-26. doi: 10.1111/acem.12827.
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Keywords: Data, Emergency Department, Health Services Research (HSR), Imaging
Kronick R, Casalino LP, Bindman AB
AHRQ Author: Kronick R
Apple pickers or federal judges: strong versus weak incentives in physician payment.
The authors provide an introduction for five papers commissioned by AHRQ focusing on incentives for physicians that are featured in this special issue of Health Services Research. These papers concentrate on suggesting a conceptual framework for the use of financial incentives in health care, key implications of the evidence to date on pay for performance and public reporting in health care and several related topics.
AHRQ-authored.
Citation: Kronick R, Casalino LP, Bindman AB .
Apple pickers or federal judges: strong versus weak incentives in physician payment.
Health Serv Res 2015 Dec;50 Suppl 2:2049-56. doi: 10.1111/1475-6773.12424.
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Keywords: Payment, Provider Performance, Policy, Health Services Research (HSR), Quality of Care, Healthcare Costs, Quality Improvement
Kuo DZ, Hall M, Agrawal R
Comparison of health care spending and utilization among children with Medicaid insurance.
This study's objectives were to assess health care and spending among children with Medicaid insurance by their resource use. It found that as resource use increases in children with Medicaid, spending rises unevenly across health services: Spending on primary care rises modestly compared with other health services.
AHRQ-funded; HS023092.
Citation: Kuo DZ, Hall M, Agrawal R .
Comparison of health care spending and utilization among children with Medicaid insurance.
Pediatrics 2015 Dec;136(6):1521-9. doi: 10.1542/peds.2015-0871.
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Keywords: Medicaid, Healthcare Utilization, Children/Adolescents, Healthcare Costs, Health Services Research (HSR)
Marin JR, Mills AM
Developing a research agenda to optimize diagnostic imaging in the emergency department: an executive summary of the 2015 Academic Emergency Medicine Consensus Conference.
The 2015 Academic Emergency Medicine consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization" was held on May 12, 2015, with the goal of developing a high-priority research agenda on which to base future research. The authors describe the specific aims of the conference and the methods used to achieve consensus.
AHRQ-funded; HS023498.
Citation: Marin JR, Mills AM .
Developing a research agenda to optimize diagnostic imaging in the emergency department: an executive summary of the 2015 Academic Emergency Medicine Consensus Conference.
Acad Emerg Med 2015 Dec;22(12):1363-71. doi: 10.1111/acem.12818.
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Keywords: Imaging, Emergency Department, Health Services Research (HSR), Research Methodologies
Marin JR, Mills AM
Developing a research agenda to optimize diagnostic imaging in the emergency department: an executive summary of the 2015 Academic Emergency Medicine Consensus Conference.
The 2015 Academic Emergency Medicine consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization" was held on May 12, 2015, with the goal of developing a high-priority research agenda on which to base future research. The authors describe the specific aims of the conference and the methods used to achieve consensus.
AHRQ-funded; HS023498.
Citation: Marin JR, Mills AM .
Developing a research agenda to optimize diagnostic imaging in the emergency department: an executive summary of the 2015 Academic Emergency Medicine Consensus Conference.
Pediatr Emerg Care 2015 Dec;31(12):876-82. doi: 10.1097/pec.0000000000000636.
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Keywords: Imaging, Emergency Department, Health Services Research (HSR), Research Methodologies
Hempel S, Shekelle PG, Liu JL
Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications.
This study developed and psychometrically tested a critical appraisal instrument, the QI Minimum Quality Criteria Set (QI-MQCS) for assessing QI-specific features of quality improvement (QI) publications. The critical appraisal instrument is accompanied by a user manual detailing What to consider, Where to look, and How to rate.
AHRQ-funded; HS018139.
Citation: Hempel S, Shekelle PG, Liu JL .
Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications.
BMJ Qual Saf 2015 Dec;24(12):796-804. doi: 10.1136/bmjqs-2014-003151.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Quality Improvement
Cherney AR, Marin JR, Brown J
AHRQ Author: Henriksen K
Funding research in emergency diagnostic imaging: summary of a panel discussion at the 2015 Academic Emergency Medicine Consensus Conference.
As part of the 2015 Academic Emergency Medicine consensus conference "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization," a panel of representatives from several Federal agencies and organizations including AHRQ was assembled to discuss future opportunities for funding research in this particular area of interest. Representatives from these agencies and organizations discussed their missions and priorities and how they distribute funding.
AHRQ-authored.
Citation: Cherney AR, Marin JR, Brown J .
Funding research in emergency diagnostic imaging: summary of a panel discussion at the 2015 Academic Emergency Medicine Consensus Conference.
Acad Emerg Med 2015 Dec;22(12):1400-5. doi: 10.1111/acem.12825.
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Keywords: Imaging, Emergency Department, Health Services Research (HSR), Healthcare Utilization
Layton TJ, Ryan AM
Higher incentive payments in Medicare Advantage's pay-for-performance program did not improve quality but did increase plan offerings.
The researchers evaluated the effects of the size of financial bonuses on quality of care and the number of plan offerings in the Medicare Advantage Quality Bonus Payment Demonstration. They concluded that at great expense to Medicare, double bonuses in the Medicare Advantage Quality Bonus Payment Demonstration were not associated with improved quality but were associated with more plan offerings.
AHRQ-funded; HS018546.
Citation: Layton TJ, Ryan AM .
Higher incentive payments in Medicare Advantage's pay-for-performance program did not improve quality but did increase plan offerings.
Health Serv Res 2015 Dec;50(6):1810-28. doi: 10.1111/1475-6773.12409..
Keywords: Medicare, Payment, Provider Performance, Health Services Research (HSR), Quality Improvement, Quality of Care
Probst MA, Dayan PS, Raja AS
Knowledge translation and barriers to imaging optimization in the emergency department: a research agenda.
This article outlines a research agenda to promote the dissemination and implementation (also known as knowledge translation) of evidence-based interventions for emergency department (ED) imaging, i.e., clinical pathways, clinical decision instruments, and clinical practice guidelines. A multidisciplinary group of stakeholders held online and telephone discussions over a 6-month period culminating at the 2015 Academic Emergency Medicine consensus conference. They were able to identify four overarching research questions.
AHRQ-funded; HS023498.
Citation: Probst MA, Dayan PS, Raja AS .
Knowledge translation and barriers to imaging optimization in the emergency department: a research agenda.
Acad Emerg Med 2015 Dec;22(12):1455-64. doi: 10.1111/acem.12830.
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Keywords: Emergency Department, Evidence-Based Practice, Health Services Research (HSR), Guidelines, Imaging, Implementation
Neprash HT, Wallace J, Chernew ME
Measuring prices in health care markets using commercial claims data.
The objective of this study was to compare methods of price measurement in health care markets. It concluded that market-level price measures reflecting broad sets of services are likely to rank markets similarly. Price indices relying on individual sentinel services may be more appropriate for examining specialty- or service-specific drivers of prices.
AHRQ-funded; HS000055.
Citation: Neprash HT, Wallace J, Chernew ME .
Measuring prices in health care markets using commercial claims data.
Health Serv Res 2015 Dec;50(6):2037-47. doi: 10.1111/1475-6773.12304..
Keywords: Data, Healthcare Costs, Health Insurance, Health Services Research (HSR)
Luft HS
Policy-oriented research on improved physician incentives for higher value health care.
Policy makers (both public and private) are seeking ways to improve the value delivered within our health care system. To inform such policy changes, this paper identifies areas in which little is known about the effects of specific incentives (FFS, salary, etc.) on the two components of value: resource use and quality. Specific suggestions are offered focusing on fundamental "building block" studies.
AHRQ-funded.
Citation: Luft HS .
Policy-oriented research on improved physician incentives for higher value health care.
Health Serv Res 2015 Dec;50 Suppl 2:2187-215. doi: 10.1111/1475-6773.12423.
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Keywords: Policy, Health Insurance, Payment, Health Services Research (HSR)
Lewiss RE, Chan W, Sheng AY
Research priorities in the utilization and interpretation of diagnostic imaging: Education, assessment, and competency.
A group of radiologists, physicists, and emergency physicians convened at the 2015 Academic Emergency Medicine consensus conference to discuss and prioritize a research agenda related to education, assessment, and competency in ordering and interpreting diagnostic imaging. In this article, the authors review the supporting reliability and validity evidence and make specific recommendations for future research on the education, competency, and assessment of learning diagnostic imaging.
AHRQ-funded; HS023498.
Citation: Lewiss RE, Chan W, Sheng AY .
Research priorities in the utilization and interpretation of diagnostic imaging: Education, assessment, and competency.
Acad Emerg Med 2015 Dec;22(12):1447-54. doi: 10.1111/acem.12833.
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Keywords: Imaging, Education: Continuing Medical Education, Emergency Department, Emergency Medical Services (EMS), Healthcare Utilization, Health Services Research (HSR)
Lipton BJ, Decker SL
AHRQ Author: Decker SL
The effect of health insurance coverage on medical care utilization and health outcomes: evidence from Medicaid adult vision benefits.
The reserarchers examined the effect of vision insurance on eye care utilization and vision health outcomes by taking advantage of quasi-experimental variation in Medicaid coverage of adult vision care. They found that Medicaid beneficiaries with vision coverage are 4.4 percentage points more likely to have seen an eye doctor in the past year,and 5.3 percentage points less likely to report needing but not purchasing eyeglasses or contacts due to cost.
AHRQ-authored.
Citation: Lipton BJ, Decker SL .
The effect of health insurance coverage on medical care utilization and health outcomes: evidence from Medicaid adult vision benefits.
J Health Econ 2015 Dec;44:320-32. doi: 10.1016/j.jhealeco.2015.10.006.
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Keywords: Medicaid, Eye Disease and Health, Healthcare Utilization, Health Services Research (HSR), Outcomes
Melnick ER, Shafer K, Rodulfo N
Understanding overuse of computed tomography for minor head injury in the emergency department: a triangulated qualitative study.
The objective was to identify nonclinical, human factors that promote or inhibit the appropriate use of computed tomography (CT) in patients presenting to the emergency department (ED) with minor head injury. Five core domains emerged from the analysis: establishing trust, anxiety (patient and provider), constraints related to ED practice, the influence of others, and patient expectations.
AHRQ-funded; HS021271.
Citation: Melnick ER, Shafer K, Rodulfo N .
Understanding overuse of computed tomography for minor head injury in the emergency department: a triangulated qualitative study.
Acad Emerg Med 2015 Dec;22(12):1474-83. doi: 10.1111/acem.12824.
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Keywords: Emergency Medical Services (EMS), Imaging, Brain Injury, Shared Decision Making, Health Services Research (HSR)