National Healthcare Quality and Disparities Report
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Topics
- Access to Care (2)
- Adverse Events (2)
- Alcohol Use (2)
- Antibiotics (1)
- Asthma (1)
- Back Health and Pain (3)
- Behavioral Health (18)
- Blood Pressure (1)
- Burnout (1)
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- Care Coordination (4)
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- Care Management (3)
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- Communication (3)
- Community-Based Practice (10)
- Comparative Effectiveness (5)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Depression (3)
- Diabetes (9)
- Diagnostic Safety and Quality (2)
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- Education: Continuing Medical Education (2)
- Education: Patient and Caregiver (1)
- Elderly (6)
- Electronic Health Records (EHRs) (13)
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- Patient Self-Management (1)
- Policy (1)
- Practice-Based Research Network (PBRN) (2)
- Practice Improvement (3)
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- Pregnancy (1)
- Prevention (11)
- (-) Primary Care (90)
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- Provider: Health Personnel (1)
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- Public Reporting (1)
- Quality Improvement (6)
- Quality Indicators (QIs) (2)
- Quality Measures (2)
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- Quality of Life (1)
- Racial and Ethnic Minorities (3)
- Research Methodologies (1)
- Respiratory Conditions (1)
- Rural Health (1)
- Screening (4)
- Shared Decision Making (2)
- Stress (1)
- Substance Abuse (2)
- Teams (2)
- Telehealth (1)
- Tobacco Use (1)
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- Transitions of Care (1)
- U.S. Preventive Services Task Force (USPSTF) (7)
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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
51 to 75 of 90 Research Studies DisplayedShaikh U, Romano P, Paterniti DA
Organizing for quality improvement in health care: An example from childhood obesity prevention.
The researchers evaluated how the quality improvement (QI) intervention, Healthy Eating Active Living TeleHealth Community of Practice, at 7 rural California clinics addressed the challenges. of preventing and managing obesity and translation of evidence into practice. Key challenges were clinician and staff buy-in, changing ingrained clinical practices, and motivating patient and families. Facilitators included top-down organizational requirements for QI, linkages to local QI resources, and involvement of clinical champions.
AHRQ-funded; HS018567.
Citation: Shaikh U, Romano P, Paterniti DA .
Organizing for quality improvement in health care: An example from childhood obesity prevention.
Qual Manag Health Care 2015 Jul-Sep;24(3):121-8. doi: 10.1097/qmh.0000000000000066.
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Keywords: Quality Improvement, Children/Adolescents, Obesity, Prevention, Primary Care
Crane S, Sloane PD, Elder N
Reporting and using near-miss events to improve patient safety in diverse primary care practices: a collaborative approach to learning from our mistakes.
This study assessed the feasibility of a near-miss reporting system in primary care practices and to describe initial reports and practice responses to them. It found that all 7 practices successfully implemented the system, reporting 632 near-miss events in 9 months and initiating 32 quality improvement projects based on the reports.
AHRQ-funded; HS019558.
Citation: Crane S, Sloane PD, Elder N .
Reporting and using near-miss events to improve patient safety in diverse primary care practices: a collaborative approach to learning from our mistakes.
J Am Board Fam Med 2015 Jul-Aug;28(4):452-60. doi: 10.3122/jabfm.2015.04.140050..
Keywords: Adverse Events, Medical Errors, Patient Safety, Primary Care, Public Reporting, Quality Improvement, Quality of Care
Gittner LS, Husaini BA, Hull PC
Use of Six Sigma for eliminating missed opportunities for prevention services.
Delivery of primary care preventative services can be significantly increased utilizing Six Sigma methods. This study compare missed preventative service opportunities in the study clinic with the community clinic in the same practice. The study clinic had 100% preventative services, compared with only 16.3 percent in the community clinic.
AHRQ-funded; HS011131.
Citation: Gittner LS, Husaini BA, Hull PC .
Use of Six Sigma for eliminating missed opportunities for prevention services.
J Nurs Care Qual 2015 Jul-Sep;30(3):254-60. doi: 10.1097/ncq.0000000000000113..
Keywords: Community-Based Practice, Prevention, Primary Care, Quality Improvement
Fan T, Rossi C
AHRQ Author: Fan T
Primary care behavioral interventions to reduce illicit drug and nonmedical pharmaceutical use in children.
This case study involves a 16-year-old white female nonsmoker who presents for a sports clearance physical. It poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Fan T, Rossi C .
Primary care behavioral interventions to reduce illicit drug and nonmedical pharmaceutical use in children.
Am Fam Physician 2015 Jun 15;91(12):865-6.
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Keywords: Children/Adolescents, Primary Care, Behavioral Health, U.S. Preventive Services Task Force (USPSTF), Substance Abuse
Van Cleave J, Boudreau AA, McAllister J
Care coordination over time in medical homes for children with special health care needs.
This study explored how care coordination changes conceptually and practically in primary care practices when implementing the medical home and to identify reasons for different types of changes. They found that in high-performing medical homes, care coordination activities changed from being mostly reactive to patients’ episodic needs to being more systematically proactive and comprehensive.
AHRQ-funded; HS019157.
Citation: Van Cleave J, Boudreau AA, McAllister J .
Care coordination over time in medical homes for children with special health care needs.
Pediatrics 2015 Jun;135(6):1018-26. doi: 10.1542/peds.2014-1067..
Keywords: Care Coordination, Care Management, Patient-Centered Healthcare, Primary Care
Martsolf GR, Kandrack R, Schneider EC
Categories of practice transformation in a statewide medical home pilot and their association with medical home recognition.
The researchers aimed to characterize patterns of structural change among 81 primary care practices participating in a statewide medical home pilot. They found that multiple types of practice transformation could be distinguished and higher levels of medical home recognition were associated with practices’ capabilities at baseline, rather than transformation over time.
AHRQ-funded; HS022616.
Citation: Martsolf GR, Kandrack R, Schneider EC .
Categories of practice transformation in a statewide medical home pilot and their association with medical home recognition.
J Gen Intern Med 2015 Jun;30(6):817-23. doi: 10.1007/s11606-014-3176-3..
Keywords: Primary Care, Patient-Centered Healthcare, Quality of Care
Wisk LE, Finkelstein JA, Sawicki GS
Predictors of timing of transfer from pediatric- to adult-focused primary care.
The researchers examined the timing of transfer to adult-focused primary care providers (PCPs), the time between last pediatric-focused and first adult-focused PCP visits, and the predictors of transfer timing. They found that most youths are transferring care later than recommended and with gaps of more than a year. They further noted that while youths with chronic conditions have shorter gaps, they may need even shorter transfer intervals to ensure continuous access to care.
AHRQ-funded; HS000063; HS020513.
Citation: Wisk LE, Finkelstein JA, Sawicki GS .
Predictors of timing of transfer from pediatric- to adult-focused primary care.
JAMA Pediatr 2015 Jun;169(6):e150951. doi: 10.1001/jamapediatrics.2015.0951.
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Keywords: Children/Adolescents, Chronic Conditions, Primary Care, Transitions of Care, Young Adults
Field TS, Ogarek J, Garber L
Association of early post-discharge follow-up by a primary care physician and 30-day rehospitalization among older adults.
The researchers aimed to determine whether an office visit with a primary care physician within 7 days after discharge is associated with 30-day rehospitalization. Of 3,661 patients discharged to home during the study year, 1,808 received an office visit within 7 days and of these, 1,000 were with a primary care physician. No protective effect for office visits within 7 days was found.
AHRQ-funded; HS017203.
Citation: Field TS, Ogarek J, Garber L .
Association of early post-discharge follow-up by a primary care physician and 30-day rehospitalization among older adults.
J Gen Intern Med 2015 May;30(5):565-71. doi: 10.1007/s11606-014-3106-4..
Keywords: Hospital Readmissions, Primary Care, Hospital Discharge, Elderly, Healthcare Costs
Annis AM, Holtrop JS, Tao M
Comparison of provider and plan-based targeting strategies for disease management.
The researchers described and contrasted the targeting methods and engagement outcomes for health plan-delivered disease management with those of a provider-delivered care management program. They concluded that both provide advantages and that an optimal model may be to combine the strengths of each approach to maximize benefits in care management.
AHRQ-funded; HS020108.
Citation: Annis AM, Holtrop JS, Tao M .
Comparison of provider and plan-based targeting strategies for disease management.
Am J Manag Care 2015 May;21(5):344-51.
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Keywords: Care Management, Primary Care, Health Insurance, Healthcare Delivery
Morton S, Shih SC, Winther CH
Health IT-enabled care coordination: A national survey of patient-centered medical home clinicians.
This study assessed the feasibility and acceptability of 6 proposed care coordination objectives for stage 3 of the Centers for Medicare and Medicaid Services electronic health record incentive program (Meaningful Use) related to referrals, notification of care from other facilities, patient clinical summaries, and patient dashboards. It found that the activity most frequently supported by health IT was providing clinical summaries to patients.
AHRQ-funded; HS022693.
Citation: Morton S, Shih SC, Winther CH .
Health IT-enabled care coordination: A national survey of patient-centered medical home clinicians.
Ann Fam Med 2015 May-Jun;13(3):250-6. doi: 10.1370/afm.1797..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Primary Care, Patient-Centered Healthcare
Ornstein SM, Nemeth LS, Nietert PJ
Learning from primary care meaningful use exemplars.
This report presents the results of a multimethod study combining an EHR-based clinical quality measurements (CQM) performance assessment, a provider survey, and focus groups among high CQM performers. It concluded that purposeful use of EHR functionality coupled with staff education in a milieu where Quality Improvement is valued and supported is associated with higher performance on CQM.
AHRQ-funded; HS022701; HS018984.
Citation: Ornstein SM, Nemeth LS, Nietert PJ .
Learning from primary care meaningful use exemplars.
J Am Board Fam Med 2015 May-Jun;28(3):360-70. doi: 10.3122/jabfm.2015.03.140219..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Quality Indicators (QIs), Quality of Care
Leis JA, Solomon BS, Wasserman KE
Preventing postpartum depression in a pediatric primary care clinic: a pilot study.
The goal of this study was to integrate an evidence-based preventive intervention for perinatal depression—the Mothers and Babies (MB) Course—into a pediatric primary care clinic serving low-income, minority families, and to explore intervention acceptability and preliminary outcomes. Findings from this pilot study provide preliminary evidence for the acceptability and feasibility of implementing an evidence-based preventive intervention for postpartum depression.
AHRQ-funded; HS017596.
Citation: Leis JA, Solomon BS, Wasserman KE .
Preventing postpartum depression in a pediatric primary care clinic: a pilot study.
Clin Pediatr 2015 May;54(5):487-90. doi: 10.1177/0009922814536775..
Keywords: Pregnancy, Primary Care, Evidence-Based Practice, Low-Income, Racial and Ethnic Minorities
Shi L, Lebrun-Harris LA, Chen LR
AHRQ Author: Ngo-Metzger Q
Preventive counseling services during primary care visits: a comparison of health centers versus other physician offices.
The authors compared preventive counseling services provided by health centers versus other physician offices. They found that health centers provided comparable rates of preventive counseling services compared with other physician offices in the areas of health education, disease management, asthma education, tobacco education, and weight reduction education.
AHRQ-authored.
Citation: Shi L, Lebrun-Harris LA, Chen LR .
Preventive counseling services during primary care visits: a comparison of health centers versus other physician offices.
J Health Care Poor Underserved 2015 May;26(2):519-35. doi: 10.1353/hpu.2015.0028.
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Keywords: Community-Based Practice, Prevention, Primary Care
Singh H, Sittig DF
Setting the record straight on measuring diagnostic errors. Reply to: 'Bad assumptions on primary care diagnostic errors' by Dr Richard Young.
This letter responds to a letter by Dr. Richard Young who criticizes Singh’s article on measuring diagnostic error. Singh defends his systems-based approach to advancing the science of measuring diagnostic error and acknowledges some of the uncertainties and evolution in the diagnostic process that Dr. Young writes about.
AHRQ-funded; HS022087
Citation: Singh H, Sittig DF .
Setting the record straight on measuring diagnostic errors. Reply to: 'Bad assumptions on primary care diagnostic errors' by Dr Richard Young.
BMJ Qual Saf. 2015 May;24(5):345-8. doi: 10.1136/bmjqs-2015-004140..
Keywords: Diagnostic Safety and Quality, Medical Errors, Patient Safety, Primary Care, Quality Measures
Croswell J, Chu K
AHRQ Author: Croswell J
Screening for abdominal aortic aneurysm.
The authors present a case study with three questions focused on an older patient who comes to the physician office for an annual well visit. He was advised by a relative, who is a physician, to be screened for an abdominal aortic aneurysm. The questions focus on different scenarios, types of testing, and statements about appropriate treatment.
AHRQ-authored
Citation: Croswell J, Chu K .
Screening for abdominal aortic aneurysm.
Am Fam Physician 2015 Apr 15;91(8):563-4..
Keywords: Case Study, Prevention, Primary Care, Screening, U.S. Preventive Services Task Force (USPSTF)
Jones CD, Vu MB, O'Donnell CM
A failure to communicate: a qualitative exploration of care coordination between hospitalists and primary care providers around patient hospitalizations.
The purpose of this study was to understand the challenges in coordination of care, as well as potential solutions, from the perspective of hospitalists and PCPs in North Carolina. Hospitalists and PCPs were found to encounter similar care coordination challenges, including (1) lack of time, (2) difficulty reaching other clinicians, and (3) lack of personal relationships with other clinicians.
AHRQ-funded; HS020940.
Citation: Jones CD, Vu MB, O'Donnell CM .
A failure to communicate: a qualitative exploration of care coordination between hospitalists and primary care providers around patient hospitalizations.
J Gen Intern Med 2015 Apr;30(4):417-24. doi: 10.1007/s11606-014-3056-x..
Keywords: Care Coordination, Communication, Hospital Discharge, Hospitalization, Primary Care
Mehrotra A, Gidengil CA, Setodji CM
Antibiotic prescribing for respiratory infections at retail clinics, physician practices, and emergency departments.
The authors compared antibiotic prescribing among retail clinics, primary care practices, and emergency departments (EDs) for acute respiratory infections (ARIs): antibiotics-may-be-appropriate ARIs and antibiotics-never-appropriate ARIs. They found that, compared with primary care practices and EDs, there was no difference at retail clinics in overall ARI antibiotic prescribing, which was more diagnosis-appropriate.
AHRQ-funded; HS018419.
Citation: Mehrotra A, Gidengil CA, Setodji CM .
Antibiotic prescribing for respiratory infections at retail clinics, physician practices, and emergency departments.
Am J Manag Care 2015 Apr;21(4):294-302.
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Keywords: Antibiotics, Emergency Department, Provider: Pharmacist, Primary Care, Respiratory Conditions
Pylypchuk Y, Sarpong E
AHRQ Author: Pylypchuk Y, Sarpong E
Nurse practitioners and their effects on visits to primary care physicians.
The researchers examined the effects of visits to nurse practitioners (NPs) on the demand for primary care physician services. Using a system of simultaneous equations where states’ education requirements for NPs are an identifying exclusion restriction, they found that patients who visit an NP are significantly less likely to visit PCPs, and to receive prescribed medication, medical check-up, and diagnosis from PCPs.
AHRQ-authored
Citation: Pylypchuk Y, Sarpong E .
Nurse practitioners and their effects on visits to primary care physicians.
B E J Econom Anal Policy 2015 Apr;15(2):837–64..
Keywords: Healthcare Delivery, Education: Continuing Medical Education, Primary Care, Provider, Workforce
Nembhard IM, Yuan CT, Shabanova V
The relationship between voice climate and patients' experience of timely care in primary care clinics.
The aims of this study were to assess the relationship between organizational climate and patients’ reports of timely care in primary care clinics and to broadly examine the link between staff’s work environment and patient care experiences. It found that clinical and administrative staff (e.g., nurses and office assistants) reported clinics’ climates to be significantly less supportive of voice than did clinical leaders (e.g., physicians).
AHRQ-funded; HS018987; HS016978.
Citation: Nembhard IM, Yuan CT, Shabanova V .
The relationship between voice climate and patients' experience of timely care in primary care clinics.
Health Care Manage Rev 2015 Apr-Jun;40(2):104-15. doi: 10.1097/hmr.0000000000000017..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Primary Care, Quality of Care, Organizational Change, Provider
Magnan EM, Gittelson R, Bartels CM
Establishing chronic condition concordance and discordance with diabetes: a Delphi study.
This study aimed to provide more information for the future research and clinical use of the concordant/discordant framework by increasing the number of conditions that can be characterized as concordant or discordant with diabetes. By finding that 12 conditions were concordant with diabetes care and 50 were discordant, the study significantly adds to the number of conditions for which there is information on concordance and discordance for diabetes care.
AHRQ-funded; HS018368; HS007646; HS021899.
Citation: Magnan EM, Gittelson R, Bartels CM .
Establishing chronic condition concordance and discordance with diabetes: a Delphi study.
BMC Fam Pract 2015 Mar 28;16:42. doi: 10.1186/s12875-015-0253-6..
Keywords: Chronic Conditions, Diabetes, Primary Care, Practice Patterns
Jarvik JG, Gold LS, Comstock BA
Association of early imaging for back pain with clinical outcomes in older adults.
This study compared function and pain at the 12-month follow-up visit among older adults who received early imaging with those who did not receive early imaging after a new primary care visit for back pain without radiculopathy. It found that early imaging was not associated with better 1-year outcomes. The researchers concluded that the value of early diagnostic imaging in older adults for back pain with radiculopathy is uncertain.
AHRQ-funded; HS019222, HS022972
Citation: Jarvik JG, Gold LS, Comstock BA .
Association of early imaging for back pain with clinical outcomes in older adults.
JAMA. 2015 Mar 17;313(11):1143-53. doi: 10.1001/jama.2015.1871..
Keywords: Back Health and Pain, Elderly, Primary Care, Outcomes, Diagnostic Safety and Quality, Imaging
Bishop TF, Ryan MS, McCullough CM
Do provider attitudes about electronic health records predict future electronic health record use?
The authors studied whether comfort with technology and more positive attitudes about EHRs affect use of EHR functions once they are adopted. They found that comfort with computers and attitudes about EHRs did not predict future use of the EHR functions, suggesting that meaningful use of the EHR may not be affected by providers' prior attitudes about EHRs.
AHRQ-funded; HS018546.
Citation: Bishop TF, Ryan MS, McCullough CM .
Do provider attitudes about electronic health records predict future electronic health record use?
Healthc (Amst) 2015 Mar;3(1):5-11. doi: 10.1016/j.hjdsi.2014.04.002.
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Keywords: Electronic Health Records (EHRs), Provider: Health Personnel, Primary Care
James KA, Ross SE, Vance B
AHRQ Author: Harrison MI
Inefficiency in primary care: common causes and potential solutions.
The researchers undertook a project to better understand the sources of and remedies for inefficiency in primary care. With the data they collected, they created a website (http:// cufamilymedicine.org/efficiency) that busy primary care practices can use to learn about common sources of inefficiency in primary care and real-world suggestions on how to improve.
AHRQ-authored.
Citation: James KA, Ross SE, Vance B .
Inefficiency in primary care: common causes and potential solutions.
Fam Pract Manag 2015 Mar-Apr;22(2):18-22..
Keywords: Primary Care, Organizational Change
Tannenbaum D, Doctor JN, Persell SD
Nudging physician prescription decisions by partitioning the order set: results of a vignette-based study.
The purpose of this study was to examine whether the grouping of menu items systematically affects prescribing practices among primary care providers. It found that provider treatment choice appears to be influenced by the grouping of menu options, suggesting that the layout of EHR order sets is not an arbitrary exercise.
AHRQ-funded; RC4 AG039115 (NIA/AHRQ).
Citation: Tannenbaum D, Doctor JN, Persell SD .
Nudging physician prescription decisions by partitioning the order set: results of a vignette-based study.
J Gen Intern Med 2015 Mar;30(3):298-304. doi: 10.1007/s11606-014-3051-2..
Keywords: Electronic Health Records (EHRs), Primary Care, Clinical Decision Support (CDS), Health Information Technology (HIT), Medication
Panattoni L, Stone A, Chung S
Patients report better satisfaction with part-time primary care physicians, despite less continuity of care and access.
The researchers examined the relationships between a physicians’ clinical full-time equivalent (FTE), continuity of care, access to care, and patient satisfaction with the physician. Their results suggest that PCPs who choose to work fewer clinical hours may have worse continuity and access, but they may provide a better patient experience.
AHRQ-funded; HS019815; HS019167.
Citation: Panattoni L, Stone A, Chung S .
Patients report better satisfaction with part-time primary care physicians, despite less continuity of care and access.
J Gen Intern Med 2015 Mar;30(3):327-33. doi: 10.1007/s11606-014-3104-6..
Keywords: Patient Experience, Primary Care, Access to Care