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
26 to 50 of 195 Research Studies DisplayedSiegler JE, Boehme AK, Fowler BD
Inpatient rehabilitation centers and concern for increasing volume of ischemic stroke patients requiring rehabilitation.
The researchers aimed to quantify the proportion of medically stable ischemic stroke patients with prolonged length of stay (pLOS) caused by a lack of IRF bed availability. They concluded that for the majority of our patients, pLOS was caused by acquired medical complications and delayed disposition, most commonly inpatient rehabilitation.
AHRQ-funded; HS013852.
Citation: Siegler JE, Boehme AK, Fowler BD .
Inpatient rehabilitation centers and concern for increasing volume of ischemic stroke patients requiring rehabilitation.
South Med J 2013 Dec;106(12):693-6. doi: 10.1097/smj.0000000000000036..
Keywords: Stroke, Hospitalization, Hospital Discharge
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
McGuire TG, Glazer J, Newhouse JP
AHRQ Author: Zuvekas SH
Integrating risk adjustment and enrollee premiums in health plan payment.
Paying health plans from two different sources such as risk-adjusted payments from a regulator and premiums charged to individual enrollees raises issues in payment design for both Medicare Advantage plans and the new State-run exchanges created by the Affordable Care Act. The primary purpose of this study is to demonstrate the versatility of least squares methods for risk adjustment in individual insurance markets with enrollee premiums.
AHRQ-authored
Citation: McGuire TG, Glazer J, Newhouse JP .
Integrating risk adjustment and enrollee premiums in health plan payment.
J Health Econ. 2013 Dec;32(6):1263-77. doi: 10.1016/j.jhealeco.2013.05.002..
Keywords: Healthcare Costs, Medical Expenditure Panel Survey (MEPS), Medicare
Nkoy FL, Stone BL, Fassl BA
Longitudinal validation of a tool for asthma self-monitoring.
The purpose of this study was to show longitudinal validation of a new tool, the Asthma Symptom Tracker (AST). The study established longitudinal validation of the AST, a novel tool designed for use by children or their parents to facilitate ongoing monitoring of patients’ asthma symptoms and proactive medical decision-making to prevent acute exacerbations.
AHRQ-funded; HS018166; HS018678.
Citation: Nkoy FL, Stone BL, Fassl BA .
Longitudinal validation of a tool for asthma self-monitoring.
Pediatrics 2013 Dec;132(6):e1554-61. doi: 10.1542/peds.2013-1389..
Keywords: Asthma, Children/Adolescents, Chronic Conditions, Shared Decision Making, Patient Self-Management
John DA, de Castro AB, Duran B
Nativity and occupational class disparities in uninsurance and routine preventive care use among Asian Americans.
The researchers examined how nativity and occupational class among Asian Americans may explain disparities in uninsurance and use of routine preventive healthcare services such as routine physical checkup and dental/eye exams. They found that 35 to 40 percent of workers in blue-collar and service occupations reported no physical checkup or dental/eye exams in the past year.
AHRQ-funded; HS013853
Citation: John DA, de Castro AB, Duran B .
Nativity and occupational class disparities in uninsurance and routine preventive care use among Asian Americans.
J Immigr Minor Health. 2013 Dec;15(6):1011-22. doi: 10.1007/s10903-013-9851-3..
Keywords: Disparities, Uninsured, Racial and Ethnic Minorities, Social Determinants of Health, Prevention
Sarraj A, Albright K, Barreto AD
Optimizing prediction scores for poor outcome after intra-arterial therapy in anterior circulation acute ischemic stroke.
The researchers sought to optimize a score that combines clinical and imaging variables to more accurately predict poor outcome after intra-arterial therapy (IAT) in anterior circulation occlusions. They concluded that the Houston IAT2 score, which combines clinical and imaging variables, performed better than all previous scores in predicting poor outcome after IAT for anterior circulation large artery occlusions.
AHRQ-funded; HS013852.
Citation: Sarraj A, Albright K, Barreto AD .
Optimizing prediction scores for poor outcome after intra-arterial therapy in anterior circulation acute ischemic stroke.
Stroke 2013 Dec;44(12):3324-30. doi: 10.1161/strokeaha.113.001050..
Keywords: Stroke, Outcomes, Cardiovascular Conditions
Lomotan EA, Dougherty D
AHRQ Author: Lomotan EA, Dougherty D
Pediatric health care quality measures: considerations for pharmacotherapy.
The authors used the Pediatric Quality Measures Program that arose from the Children's Health Insurance Program Reauthorization Act in the United States to illustrate the challenges in developing quality measures of pediatric pharmacotherapy. They identified the challenges aw being twofold: (i) weak evidence base for the specific pharmacotherapy in children and (ii) limited data to calculate the measure. They concluded that health information technology is emerging as a tool to improve quality measurement but presents additional challenges.
AHRQ-authored.
Citation: Lomotan EA, Dougherty D .
Pediatric health care quality measures: considerations for pharmacotherapy.
Paediatr Drugs 2013 Dec;15(6):441-7. doi: 10.1007/s40272-013-0042-4.
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Keywords: Children's Health Insurance Program (CHIP), Quality of Care, Medication, Children/Adolescents, Quality Measures
Chambers C, Katic M, Chiu S
Predictors of medical or surgical and psychiatric hospitalizations among a population-based cohort of homeless adults.
This study identified factors associated with inpatient hospitalizations among a population-based cohort of homeless adults in Toronto, Ontario. Health care need was a strong predictor of medical or surgical and psychiatric hospitalizations. Some hospitalizations among homeless adults were potentially avoidable, whereas others represented an unavoidable use of health services.
AHRQ-funded; HS014129.
Citation: Chambers C, Katic M, Chiu S .
Predictors of medical or surgical and psychiatric hospitalizations among a population-based cohort of homeless adults.
Am J Public Health 2013 Dec;103 Suppl 2:S380-8. doi: 10.2105/ajph.2013.301646..
Keywords: Hospitalization, Social Determinants of Health, Behavioral Health, Health Status
Sarpong EM, Miller GE
AHRQ Author: Sarpong EM, Miller GE
Racial and ethnic differences in childhood asthma treatment in the United States.
The authors examined racial-ethnic differences in asthma controller medication use among insured U.S. children. They found that non-Hispanic black and Hispanic children were less likely to use controllers than non-Hispanic white children. They concluded that the large observed differences in controller use highlight the continuing challenges of ensuring that all U.S. children have access to quality asthma care.
AHRQ-authored.
Citation: Sarpong EM, Miller GE .
Racial and ethnic differences in childhood asthma treatment in the United States.
Health Serv Res 2013 Dec;48(6 Pt 1):2014-36. doi: 10.1111/1475-6773.12077.
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Keywords: Asthma, Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Medication, Racial and Ethnic Minorities
Zhang S, Senteio C, Felizzola J
Racial/ethnic disparities in antiretroviral treatment among HIV-infected pregnant Medicaid enrollees, 2005-2007.
The purpose of this study was to describe racial/ethnic disparities in ARV treatment of low-income Medicaid-eligible HIV-infected women, with a focus on minority populations in southern states. It found that Hispanic or Latino women are a specific subgroup at risk for inadequate ARV therapy in pregnancy. The researchers point out a specific policy issue with regard to the systematic exclusion of many immigrants from Medicaid-covered care during the prenatal period.
AHRQ-funded; HS019470.
Citation: Zhang S, Senteio C, Felizzola J .
Racial/ethnic disparities in antiretroviral treatment among HIV-infected pregnant Medicaid enrollees, 2005-2007.
Am J Public Health 2013 Dec;103(12):e46-53. doi: 10.2105/ajph.2013.301328..
Keywords: Disparities, Human Immunodeficiency Virus (HIV), Pregnancy, Social Determinants of Health
Mennemeyer ST, Owsley C, McGwin Jr G
Reducing older driver motor vehicle collisions via earlier cataract surgery.
The researchers used a Monte Carlo simulation model to examine a hypothetical situation where rules in place in the U.S. for authorizing payment for cataract surgery were relaxed in favor of allowing surgery earlier for less bothersome complaints of visual difficulties in doing daily activities. They found that motor vehicle collisions, fatalities, and total societal costs can all be reduced by earlier cataract surgery.
AHRQ-funded; HS017962
Citation: Mennemeyer ST, Owsley C, McGwin Jr G .
Reducing older driver motor vehicle collisions via earlier cataract surgery.
Accid Anal Prev. 2013 Dec;61:203-11. doi: 10.1016/j.aap.2013.01.002..
Keywords: Elderly, Eye Disease and Health, Healthcare Costs
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
Pershing S, Fuchs VR
Restructuring medical education to meet current and future health care needs.
The authors ask whether the duration, sequencing, and requirements of medical education are appropriate to meet current and future challenges to medical care. They conclude that a much more agile system that prepares physicians to practice in a changing environment is needed. This will require change at both the macro regulatory level (e.g., accreditation bodies and specialty boards) as well as the micro level of individual programs taking initiative in innovation.
AHRQ-funded; HS000028.
Citation: Pershing S, Fuchs VR .
Restructuring medical education to meet current and future health care needs.
Acad Med 2013 Dec;88(12):1798-801. doi: 10.1097/acm.0000000000000020..
Keywords: Education: Academic, Education: Continuing Medical Education, Education: Curriculum
Zanocco K, Elaraj D, Sturgeon C
Routine prophylactic central neck dissection for low-risk papillary thyroid cancer: a cost-effectiveness analysis.
The researchers hypothesized that routine prophylactic central neck dissection (pCND) is not cost-effective in low-risk papillary thyroid cancer (PTC).Using a Markov transition-state model, they found that pCND cost $10,315 and produced an effectiveness of 23.785 quality-adjusted life years. They concluded that routine pCND for low-risk PTC is not cost-effective unless the recurrence rate is greater than 10.3 percent.
AHRQ-funded; HS000078.
Citation: Zanocco K, Elaraj D, Sturgeon C .
Routine prophylactic central neck dissection for low-risk papillary thyroid cancer: a cost-effectiveness analysis.
Surgery 2013 Dec;154(6):1148-55; discussion 54-5..
Keywords: Cancer, Surgery, Prevention, Healthcare Costs, Quality of Life
Sherman KL, Gordon EJ, Mahvi DM
Surgeons' perceptions of public reporting of hospital and individual surgeon quality.
This study (1) evaluated surgeons’ perceptions of public reporting of surgical quality; and (2) identified specific barriers to surgeons’ acceptance of public reporting. It found that surgeons are generally in favor of public reporting, but that they continue to have substantive concerns, particularly with respect to reporting individual level outcomes data.
AHRQ-funded; HS021857.
Citation: Sherman KL, Gordon EJ, Mahvi DM .
Surgeons' perceptions of public reporting of hospital and individual surgeon quality.
Med Care 2013 Dec;51(12):1069-75. doi: 10.1097/mlr.0000000000000013..
Keywords: Public Reporting, Quality of Care, Hospitals, Surgery, Provider Performance
Dharmar M, Kuppermann N, Romano PS
Telemedicine consultations and medication errors in rural emergency departments.
This study compared the frequency of physician-related medication errors among seriously ill and injured children receiving telemedicine consultations, similar children receiving telephone consultations, and similar children receiving no consultations in rural emergency departments (EDs). It found that the use of telemedicine to provide pediatric critical care consultations to rural EDs is associated with less frequent physician-related ED medication errors among seriously ill and injured children.
AHRQ-funded; HS013179; HS019712.
Citation: Dharmar M, Kuppermann N, Romano PS .
Telemedicine consultations and medication errors in rural emergency departments.
Pediatrics 2013 Dec;132(6):1090-7. doi: 10.1542/peds.2013-1374..
Keywords: Children/Adolescents, Medical Errors, Medication, Rural Health, Telehealth
Abramson EL, Pfoh ER, Barron Y
The effects of electronic prescribing by community-based providers on ambulatory medication safety.
This study was conducted to assess the effect of implementing a commercial electronic health record with e-prescribing on rates and types of prescribing errors. Use of e-prescribing resulted in relatively low error rates (6.0 errors per 100 prescriptions). These rates were sustained over time but without further improvement (6.0 versus 4.5 errors per 100) prescriptions).
AHRQ-funded; HS016970.
Citation: Abramson EL, Pfoh ER, Barron Y .
The effects of electronic prescribing by community-based providers on ambulatory medication safety.
Jt Comm J Qual Patient Saf 2013 Dec;39(12):545-52..
Keywords: Electronic Prescribing (E-Prescribing), Health Information Technology (HIT), Medication: Safety, Medication, Electronic Health Records (EHRs)
Mariscalco MW, Flanigan DC, Mitchell J
The influence of hamstring autograft size on patient-reported outcomes and risk of revision after anterior cruciate ligament reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) Cohort Study.
The purpose of this study was to evaluate the effect of graft size on patient-reported outcomes and revision risk after anterior cruciate ligament (ACL) reconstruction. It found that smaller hamstring autograft size is a predictor of poorer Knee Injury and Osteoarthritis Outcome Score (sport/recreation subscale function) 2 years after primary ACL reconstruction.
AHRQ-funded; HS016075.
Citation: Mariscalco MW, Flanigan DC, Mitchell J .
The influence of hamstring autograft size on patient-reported outcomes and risk of revision after anterior cruciate ligament reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) Cohort Study.
Arthroscopy 2013 Dec;29(12):1948-53. doi: 10.1016/j.arthro.2013.08.025.
Keywords: Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness, Surgery
Boothe DL, Coplowitz S, Greenwood E
Transforming growth factor beta-1 (TGF-beta1) is a serum biomarker of radiation induced fibrosis in patients treated with intracavitary accelerated partial breast irradiation: preliminary results of a prospective study.
This study examined a relationship between serum transforming growth factor b-1 (TGF-b1) values and radiation-induced fibrosis (RIF). The results suggest that serum TGF-b1 levels before surgery, and during radiation therapy, and after radiation therapy could signal whether a patient is at risk for the development of moderate to severe RIF.
AHRQ-funded; HS016075.
Citation: Boothe DL, Coplowitz S, Greenwood E .
Transforming growth factor beta-1 (TGF-beta1) is a serum biomarker of radiation induced fibrosis in patients treated with intracavitary accelerated partial breast irradiation: preliminary results of a prospective study.
Int J Radiat Oncol Biol Phys 2013 Dec 1;87(5):1030-6. doi: 10.1016/j.ijrobp.2013.08.045..
Keywords: Adverse Events, Cancer, Cancer: Breast Cancer, Risk
Hartung DM, Middleton L, McFarland BH
Use of administrative data to identify off-label use of second-generation antipsychotics in a Medicaid population.
The researchers sought to determine the accuracy of administrative claims for identifying off-label use of second-generation antipsychotics (SGAs) in a Medicaid population. They found that Medicaid claims data had high predictive ability for identifying users of SGAs who did not have documentation of schizophrenia or bipolar disorder in the medical record.
AHRQ-funded; HS019456
Citation: Hartung DM, Middleton L, McFarland BH .
Use of administrative data to identify off-label use of second-generation antipsychotics in a Medicaid population.
Psychiatr Serv. 2013 Dec;64(12):1236-42. doi: 10.1176/appi.ps.005482012..
Keywords: Medicaid, Behavioral Health, Medication
Waters TM, Chandler AM, Mion LC
Use of International Classification of Diseases, Ninth Revision, Clinical Modification, codes to identify inpatient fall-related injuries.
The researchers compared falls and fall-related injuries that a fall evaluator or hospital incident report identified with injuries identified according to discharge ICD-9-CM codes for the same set of inpatient episodes of care. They found that the CMS-targeted ICD-9-CM codes used to identify fall-related injuries in claims data do not always detect the most-serious falls.
AHRQ-funded; HS020627.
Citation: Waters TM, Chandler AM, Mion LC .
Use of International Classification of Diseases, Ninth Revision, Clinical Modification, codes to identify inpatient fall-related injuries.
J Am Geriatr Soc 2013 Dec;61(12):2186-91. doi: 10.1111/jgs.12539..
Keywords: Falls, Elderly, Patient Safety, Inpatient Care, Adverse Events
Hatch B, Angier H, Marino M
Using electronic health records to conduct children's health insurance surveillance.
The purpose of this study is to demonstrate secondary usage of electronic health records (EHRs) as an emerging data source for health insurance surveillance by community health centers and other primary care providers to track patients’ insurance coverage status and to identify patients most likely to benefit from outreach and support to obtain and maintain coverage.
AHRQ-funded; HS018569.
Citation: Hatch B, Angier H, Marino M .
Using electronic health records to conduct children's health insurance surveillance.
Pediatrics 2013 Dec;132(6):e1584-91. doi: 10.1542/peds.2013-1470..
Keywords: Electronic Health Records (EHRs), Children/Adolescents, Health Insurance, Children's Health Insurance Program (CHIP), Health Information Technology (HIT)
Hearld LR, Weech-Maldonado R, Asagbra OE
Variations in patient-centered medical home capacity: a linear growth curve analysis.
This study documented physician practices’ PCMH capacity across 12 different domains (e.g., extended access, specialist referral, use of patient registry) over a 3-year period (2008-2010). It concluded that differences in PCMH capacity across the 12 domains and time suggest that more attention should be paid to the longitudinal nature of PCMH implementation and the differential challenges associated with its component parts.
AHRQ-funded; HS019465.
Citation: Hearld LR, Weech-Maldonado R, Asagbra OE .
Variations in patient-centered medical home capacity: a linear growth curve analysis.
Med Care Res Rev 2013 Dec;70(6):597-620. doi: 10.1177/1077558713498117..
Keywords: Patient-Centered Healthcare, Practice Patterns
Srinivas SK, Fager C, Lorch SA
Variations in postdelivery infection and thrombosis by hospital teaching status.
The researchers examined hospital-level variation overall and by teaching status in 2 maternal outcomes, postpartum infections, and thrombosis. They found substantial variation in infection and thrombosis rates among hospitals both overall and by teaching status, suggesting that these 2 outcomes may be useful measures of inpatient obstetric quality.
AHRQ-funded; HS015696.
Citation: Srinivas SK, Fager C, Lorch SA .
Variations in postdelivery infection and thrombosis by hospital teaching status.
Am J Obstet Gynecol 2013 Dec;209(6):567.e1-7. doi: 10.1016/j.ajog.2013.08.002..
Keywords: Pregnancy, Labor and Delivery, Outcomes, Quality of Care
Soeters HM, Napravnik S, Zakharova OM
Opportunities for sexual transmission of antiretroviral drug resistance among HIV-infected patients in care.
The researchers had two aims: to examine patterns of nonadherence, high-risk sexual behavior, detectable HIV viraemia and antiretroviral drug resistance, and to identify factors associated with potential transmission of drug-resistant HIV among patients engaged in HIV care. They found that a small but significant proportion of clinic patients with viraemia and documented resistant HIV continue to engage in sexual behaviors that place others at risk for transmitted drug resistance.
AHRQ-funded; HS018731.
Citation: Soeters HM, Napravnik S, Zakharova OM .
Opportunities for sexual transmission of antiretroviral drug resistance among HIV-infected patients in care.
AIDS 2013 Nov 28;27(18):2873-81. doi: 10.1097/01.aids.0000433240.78739.30..
Keywords: Human Immunodeficiency Virus (HIV), Lifestyle Changes, Patient Adherence/Compliance