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
12176 to 12200 of 12214 Research Studies DisplayedMachlin SR, Soni A
AHRQ Author: Machlin SR, Soni A
Health care expenditures for adults with multiple treated chronic conditions: estimates from the Medical Expenditure Panel Survey, 2009.
The authors illustrated the usefulness of MEPS data for examining variations in medical expenditures for people with multiple chronic conditions (MCC). They found that the proportion of adults treated for MCC increased with age, with white non-Hispanic adults most likely and Hispanic and Asian adults least likely to be treated for MCC. Regardless of age or sex, hypertension and hyperlipidemia was the most common dyad among adults treated for MCC, and diabetes in conjunction with these 2 conditions was a common triad. They concluded that MEPS has the capacity to produce national estimates of health care expenditures associated with MCC.
AHRQ-authored.
Citation: Machlin SR, Soni A .
Health care expenditures for adults with multiple treated chronic conditions: estimates from the Medical Expenditure Panel Survey, 2009.
Prev Chronic Dis 2013 Apr 25;10:E63. doi: 10.5888/pcd10.120172.
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Keywords: Cancer: Colorectal Cancer, Chronic Conditions, Healthcare Costs, Medical Expenditure Panel Survey (MEPS)
Steiner CA, Friedman B
AHRQ Author: Steiner CA, Friedman B
Hospital utilization, costs, and mortality for adults with multiple chronic conditions, Nationwide Inpatient Sample, 2009.
The investigators provided a national estimate across all payers of the distribution and cost of selected chronic conditions for hospitalized adults in 2009, stratified by demographic characteristics. They found that there were approximately 28 million adult discharges from US hospitals other than those related to pregnancy and maternity; 39% had 2 to 3 multiple chronic conditions (MCC), and 33% had 4 or more. They concluded that their descriptive analysis of multipayer inpatient data provides a robust national view of the substantial use and costs among adults hospitalized with MCC.
AHRQ-authored.
Citation: Steiner CA, Friedman B .
Hospital utilization, costs, and mortality for adults with multiple chronic conditions, Nationwide Inpatient Sample, 2009.
Prev Chronic Dis 2013 Apr 25;10:E62. doi: 10.5888/pcd10.120292.
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Keywords: Chronic Conditions, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Mortality
Shah MN, Morris D, Jones CM
A qualitative evaluation of a telemedicine-enhanced emergency care program for older adults.
The purpose of this study was to document the experiences of patients, their caregivers, healthcare personnel, and staff members with a program that provides telemedicine-enhanced emergency care to older adults residing in senior living communities (SLCs) and to delineate perceived barriers and facilitators. The authors concluded that telemedicine-enhanced emergency care is an acceptable method of providing emergency care to older adults in SLCs.
AHRQ-funded; HS018047.
Citation: Shah MN, Morris D, Jones CM .
A qualitative evaluation of a telemedicine-enhanced emergency care program for older adults.
J Am Geriatr Soc 2013 Apr;61(4):571-6. doi: 10.1111/jgs.12157..
Keywords: Elderly, Telehealth, Health Information Technology (HIT), Emergency Department, Healthcare Delivery, Long-Term Care
Pylypchuk Y, Sarpong EM
AHRQ Author: Sarpong EM
Comparison of health care utilization: United States versus Canada.
The purpose of this paper was to compare health care utilization between Canadian and U.S. residents. Findings showed that the poor and less educated were more likely to utilize health care in Canada than in the United States, while health care use for residents with high incomes and higher levels of education were not markedly different between the two countries and often higher for U.S residents. Also, foreign-born residents were more likely to use health care in Canada than in the United States.
AHRQ-authored.
Citation: Pylypchuk Y, Sarpong EM .
Comparison of health care utilization: United States versus Canada.
Health Serv Res 2013 Apr;48(2 Pt 1):560-81. doi: 10.1111/j.1475-6773.2012.01466.x.
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Keywords: Health Services Research (HSR), Healthcare Utilization, Medical Expenditure Panel Survey (MEPS), Social Determinants of Health
Merkow RP, Kmiecik TE, Bentrem DJ
Effect of including cancer-specific variables on models examining short-term outcomes.
The objectives of this paper were 1) to examine differences between existing American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) variables and cancer registry variables, and 2) to determine whether the addition of cancer-specific variables improves modeling of short-term outcomes. The researchers found that, although advanced disease stage and neoadjuvant therapy variables were predictors of short-term outcomes, their inclusion did not improve the models.
AHRQ-funded; HS021857.
Citation: Merkow RP, Kmiecik TE, Bentrem DJ .
Effect of including cancer-specific variables on models examining short-term outcomes.
Cancer 2013 Apr 1;119(7):1412-9. doi: 10.1002/cncr.27891.
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Keywords: Cancer: Colorectal Cancer, Outcomes, Quality Improvement, Registries
Sokas R, Braun B, Chenven L
AHRQ Author: Hogan E
Frontline hospital workers and the worker safety/patient safety nexus.
This article reported on panels and small-group discussions from a day-long workshop held in Washington, D.C., on October 25, 2012, to explore whether and how hospital-based frontline health care workers (HCWs) affect patient safety and how they experience safety in their work settings. Conference sponsors included AHRQ, and workshop sessions focused on the intersection of worker safety and patient safety and on specific steps that health care institutions have used to implement a culture of safety in the workplace.
AHRQ-authored.
Citation: Sokas R, Braun B, Chenven L .
Frontline hospital workers and the worker safety/patient safety nexus.
Jt Comm J Qual Patient Saf 2013 Apr;39(4):185-92.
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Keywords: Provider, Organizational Change, Patient Safety, Hospitals
Hempel S, Newberry S, Wang Z
AHRQ Author: Spector WD
Hospital fall prevention: a systematic review of implementation, components, adherence, and effectiveness.
The authors sought to document systematically the implementation, components, comparators, adherence, and effectiveness of published fall prevention approaches in U.S. acute care hospitals. They found that most interventions included multiple components, and the pooled postintervention incidence rate ratio (IRR) was 0.77. They found no systematic association between implementation intensity, intervention complexity, comparator information, or adherence levels and IRR. They concluded that promising approaches exist, but better reporting of outcomes, implementation, adherence, intervention components, and comparison group information is necessary to establish evidence on how hospitals can successfully prevent falls.
AHRQ-authored; AHRQ-funded; 290201000017I.
Citation: Hempel S, Newberry S, Wang Z .
Hospital fall prevention: a systematic review of implementation, components, adherence, and effectiveness.
J Am Geriatr Soc 2013 Apr;61(4):483-94. doi: 10.1111/jgs.12169.
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Keywords: Adverse Events, Falls, Hospitals, Patient Safety, Prevention
Braithwaite S, Friedman B, Mutter R
AHRQ Author: Friedman B, Mutter R
Microsimulation of financial impact of demand surge on hospitals: the H1N1 influenza pandemic of fall 2009.
Microsimulation was used to assess the financial impact on hospitals of a surge in influenza admissions in advance of the H1N1 pandemic in the fall of 2009 with the goal of estimating net income and losses of a response of filling unused hospital bed capacity proportionately and postponing elective admissions. They concluded that aggregate and distributional results did not suggest that a policy of promising additional financial compensation to hospitals in anticipation of the surge in flu cases was necessary.
AHRQ-authored.
Citation: Braithwaite S, Friedman B, Mutter R .
Microsimulation of financial impact of demand surge on hospitals: the H1N1 influenza pandemic of fall 2009.
Health Serv Res 2013 Apr;48(2 Pt 2):735-52. doi: 10.1111/1475-6773.12041.
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Keywords: Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Influenza
Robertson J, Farris KB, Schultz SK
Older adults' views about "Managing Your Medications" booklet.
The objective of the study was to evaluate the Managing Your Medications (MYM) booklet to improve medication management. Older adults reported it was comprehensible and 17 percent reported behavioral intentions to change their current actions regarding medications. Overall, 12.7 percent of respondents agreed that MYM changed their opinion of the topic. The most popular means to dis¬seminate were doctors’ offices and senior citizens’ centers.
AHRQ-funded; HS016094.
Citation: Robertson J, Farris KB, Schultz SK .
Older adults' views about "Managing Your Medications" booklet.
J Appl Gerontol 2013 Apr;32(3):370-82. doi: 10.1177/0733464811421910..
Keywords: Elderly, Education: Patient and Caregiver, Health Literacy, Medication
Lee SY, Weiner BJ, Harrison MI
AHRQ Author: Harrison MI
Organizational transformation: a systematic review of empirical research in health care and other industries.
The investigators reported findings from a systematic review of empirical research on transformational change in the health care and non-health care literature, with a focus on the antecedents, processes, and outcomes of transformational change. They found that available research documents the multiplicity of factors affecting change and the complexity of their interactions, but less information is available about the processes of transformational change than about its antecedents and consequences. They discussed research and practice implications.
AHRQ-authored.
Citation: Lee SY, Weiner BJ, Harrison MI .
Organizational transformation: a systematic review of empirical research in health care and other industries.
Med Care Res Rev 2013 Apr;70(2):115-42. doi: 10.1177/1077558712458539.
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Keywords: Healthcare Delivery, Health Services Research (HSR), Organizational Change
Miller GE, Selden TM
AHRQ Author: Miller GE, Selden TM
Tax subsidies for employer-sponsored health insurance: updated microsimulation estimates and sensitivity to alternative incidence assumptions.
Using MEPS data, the authors estimated 2012 tax expenditures for employer-sponsored insurance (ESI) in the United States and explored the sensitivity of estimates to assumptions regarding the incidence of employer premium contributions. They concluded that the aggregate value of the ESI tax subsidy and its distribution across firms can be reliably estimated using simplified incidence assumptions.
AHRQ-authored.
Citation: Miller GE, Selden TM .
Tax subsidies for employer-sponsored health insurance: updated microsimulation estimates and sensitivity to alternative incidence assumptions.
Health Serv Res 2013 Apr;48(2 Pt 2):866-83. doi: 10.1111/1475-6773.12037.
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Keywords: Healthcare Costs, Health Insurance, Medical Expenditure Panel Survey (MEPS)
Pines JM, Mutter RL, Zocchi MS
AHRQ Author: Mutter RL
Variation in emergency department admission rates across the United States.
The authors investigated factors related to variation in hospital-level emergency department (ED) admission rates. Using HCUP data, they found that higher proportions of Medicare and uninsured patients, more inpatient beds, lower ED volumes, for-profit ownership, trauma center status, and higher hospital occupancy rates were associated with higher ED admission rates.
AHRQ-authored.
Citation: Pines JM, Mutter RL, Zocchi MS .
Variation in emergency department admission rates across the United States.
Med Care Res Rev 2013 Apr;70(2):218-31. doi: 10.1177/1077558712470565.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Health Insurance, Healthcare Cost and Utilization Project (HCUP), Hospitalization
Abdus S, Selden TM
AHRQ Author: Abdus S, Selden TM
Adherence with recommended well-child visits has grown, but large gaps persist among various socioeconomic groups.
Using MEPS data, the authors examined trends in well-child visit adherence and whether differences across population subgroups narrowed or widened over time. They found that the ratio of actual to recommended visits rose, with large differences in adherence at the start of the study period across income, race or ethnicity, parent education, region, insurance coverage, and having a usual source of care. None of these differences had narrowed significantly by the end of the study period, and differences widened across parent education, between those with and without insurance coverage, by usual source of care, and between the Northeast and the Midwest and West regions.
AHRQ-authored.
Citation: Abdus S, Selden TM .
Adherence with recommended well-child visits has grown, but large gaps persist among various socioeconomic groups.
Health Aff 2013 Mar;32(3):508-15. doi: 10.1377/hlthaff.2012.0691.
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Keywords: Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Prevention, Social Determinants of Health
Kleinman LC, Dougherty D
AHRQ Author: Dougherty D
Assessing quality improvement in health care: theory for practice.
The authors reviewed the role of theory as a means to enhance the practice of quality improvement (QI) research and to propose a novel conceptual model focused on the operations of health care. They concluded that such a theory can promote opportunities for moving the field forward and organizing the planning and interpretation of comparable studies.
AHRQ-authored.
Citation: Kleinman LC, Dougherty D .
Assessing quality improvement in health care: theory for practice.
Pediatrics 2013 Mar;131 Suppl 1:S110-9. doi: 10.1542/peds.2012-1427n.
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Keywords: Quality Improvement, Healthcare Delivery, Organizational Change, Quality of Care, Health Services Research (HSR)
Clancy CM, Moy E
AHRQ Author: Clancy CM, Moy E
Commentary: measuring what matters most.
The authors discuss a Milbank Quarterly best practices article by Frank and Haw and how it relates to AHRQ's National Healthcare Disparities Report, concluding that helping policymakers glean the information they most need from an overload of data noise will improve the chances that critical disparities can be recognized, targeted, and eliminated.
AHRQ-authored.
Citation: Clancy CM, Moy E .
Commentary: measuring what matters most.
Milbank Q 2013 Mar;91(1):201-4. doi: 10.1111/milq.12008.
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Keywords: Disparities, Quality of Care, Health Status, Policy, Social Determinants of Health
Rubinson L, Mutter R, Viboud C
AHRQ Author: Mutter R
Impact of the fall 2009 influenza A(H1N1)pdm09 pandemic on US hospitals.
The authors investigated the impact of the 2009 influenza A(H1N1)pdm09 pandemic on US hospitals. They found that the fall 2009 pandemic period substantially impacted US hospitals, mostly through increased emergency department visits. Furhter, for a small proportion of hospitals that experienced a high surge in inpatient admissions, increased mortality from selected clinical conditions was associated with both prepandemic outcomes and surge, highlighting the linkage between daily hospital operations and disaster preparedness.
AHRQ-authored.
Citation: Rubinson L, Mutter R, Viboud C .
Impact of the fall 2009 influenza A(H1N1)pdm09 pandemic on US hospitals.
Med Care 2013 Mar;51(3):259-65. doi: 10.1097/MLR.0b013e31827da8ea.
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Keywords: Emergency Department, Emergency Preparedness, Healthcare Cost and Utilization Project (HCUP), Hospitals, Influenza
Baron KG, Lattie E, Ho J
Interest and use of mental health and specialty behavioral medicine counseling in US primary care patients.
This study investigating interest in mental health and specialty behavioral medicine counseling and predictors of utilization over 1 year among primary care patients found high interest but low utilization. Interest in receiving services at the baseline initial survey was the strongest predictor of utilization.
AHRQ-funded; HS00078
Citation: Baron KG, Lattie E, Ho J .
Interest and use of mental health and specialty behavioral medicine counseling in US primary care patients.
Int J Behav Med. 2013 Mar;20(1):69-76. doi: 10.1007/s12529-011-9211-4..
Keywords: Behavioral Health, Healthcare Utilization, Primary Care
Mark TL, Lawrence W, Coffey RM
AHRQ Author: Lawrence W, Steiner C
The value of linking hospital discharge and mortality data for comparative effectiveness research.
The purpose of this paper was to demonstrate the value of linking state community hospital discharge data to vital statistics death files for research by conducting a comparative effectiveness analysis. The analysis revealed that in the matched cohort, in-hospital and 30-day postdischarge mortality rates were significantly lower following endovascular aneurysm repair than open aneurysm repair, but differences in the 1- and 5-year rates were not statistically significant.
AHRQ-authored.
Citation: Mark TL, Lawrence W, Coffey RM .
The value of linking hospital discharge and mortality data for comparative effectiveness research.
J Comp Eff Res 2013 Mar;2(2):175-84. doi: 10.2217/cer.13.4.
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Keywords: Comparative Effectiveness, Data, Healthcare Cost and Utilization Project (HCUP), Mortality, Surgery
Koh HK, Brach C, Harris LM
AHRQ Author: Brach C
A proposed 'health literate care model' would constitute a systems approach to improving patients' engagement in care.
The researchers proposed a Health Literate Care Model that would weave health literacy strategies into the widely adopted Care Model (formerly known as the Chronic Care Model). Their new model calls for approaching all patients with the assumption that they are at risk of not understanding their health conditions or how to deal with them, and then confirming and ensuring patients' understanding. They suggested that health literacy would then become an organizational value infused into all aspects of planning and operations. They also proposed a measurement framework to track the impact of the new Health Literate Care Model on patient outcomes and quality of care.
AHRQ-authored.
Citation: Koh HK, Brach C, Harris LM .
A proposed 'health literate care model' would constitute a systems approach to improving patients' engagement in care.
Health Aff 2013 Feb;32(2):357-67. doi: 10.1377/hlthaff.2012.1205.
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Keywords: Healthcare Delivery, Shared Decision Making, Education: Patient and Caregiver, Health Literacy, Primary Care: Models of Care, Patient and Family Engagement
Lobach DF, Kawamoto K, Anstrom KJ
A randomized trial of population-based clinical decision support to manage health and resource use for Medicaid beneficiaries.
This study tested the impact of 3 clinical decision support modalities (emails to care managers, printed reports to clinic administrators, and letters to patients) on the use and cost of medical services for Medicaid patients. It found that some modalities can significantly reduce emergency department use and medical costs, while other interventions may have had detrimental consequences.
AHRQ-funded; HS015057
Citation: Lobach DF, Kawamoto K, Anstrom KJ .
A randomized trial of population-based clinical decision support to manage health and resource use for Medicaid beneficiaries.
J Med Syst. 2013 Feb;37(1):9922. doi: 10.1007/s10916-012-9922-3..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Medicaid, Emergency Medical Services (EMS), Quality of Care
O'Leary KJ, Devisetty VK, Patel AR
Comparison of traditional trigger tool to data warehouse based screening for identifying hospital adverse events.
This study compared a traditional trigger tool with an enterprise data warehouse (EDW) based screening method to detect hospital adverse events (AEs). The authors found relatively poor agreement between traditional trigger tool and EDW based screening with only approximately a third of all AEs detected by both methods. They recommended a combination of complementary methods as the optimal approach to detecting AEs among hospitalized patients.
AHRQ-funded; HS019630.
Citation: O'Leary KJ, Devisetty VK, Patel AR .
Comparison of traditional trigger tool to data warehouse based screening for identifying hospital adverse events.
BMJ Qual Saf 2013 Feb;22(2):130-8. doi: 10.1136/bmjqs-2012-001102.
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Keywords: Adverse Events, Hospitals, Medical Errors, Patient Safety, Quality Indicators (QIs)
Sharkey S, Hudak S, Horn SD
AHRQ Author: Spector W
Exploratory study of nursing home factors associated with successful implementation of clinical decision support tools for pressure ulcer prevention.
The researchers determined those factors that are associated with nursing homes' success in implementing the On-Time quality improvement (QI) for pressure ulcer prevention program and integrating health information technology (HIT) tools into practice at the unit level. They found that after at least 9 months of implementation effort, 36% of the nursing homes achieved level III of the On-Time QI-HIT program. They concluded that the learning from On-Time QI offers several lessons associated with facility factors that contribute to high level of implementation of a QI-HIT program in a nursing home.
AHRQ-authored; AHRQ-funded; 29020050020.
Citation: Sharkey S, Hudak S, Horn SD .
Exploratory study of nursing home factors associated with successful implementation of clinical decision support tools for pressure ulcer prevention.
Adv Skin Wound Care 2013 Feb;26(2):83-92; quiz p.93-4. doi: 10.1097/01.ASW.0000426718.59326.bb.
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Keywords: Health Information Technology (HIT), Nursing Homes, Pressure Ulcers, Prevention, Quality Improvement
Fleurence R, Selby JV, Odom-Walker K
AHRQ Author: Slutsky JR
How the Patient-Centered Outcomes Research Institute is engaging patients and others in shaping its research agenda.
This article describes PCORI's approach to generating topics for research and how it is being used in selection of research that PCORI will fund. It further describes challenges facing this approach, including a lack of common language and training on the part of patients and resistance on the part of researchers to questions that are not researcher generated.
AHRQ-authored.
Citation: Fleurence R, Selby JV, Odom-Walker K .
How the Patient-Centered Outcomes Research Institute is engaging patients and others in shaping its research agenda.
Health Aff 2013 Feb;32(2):393-400. doi: 10.1377/hlthaff.2012.1176.
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Keywords: Health Services Research (HSR), Patient and Family Engagement, Patient-Centered Outcomes Research, Research Methodologies
Koh HK, Baur C, Brach C
AHRQ Author: Brach C
Toward a systems approach to health literacy research.
The authors discuss a call for research exploring how health care organizations can effectively address health literacy and patient-centered care. Topics include AHRQ's Health Literacy Universal Precautions Toolkit, Accountable Care Organizations, and Patient Centered Medical Homes.
AHRQ-authored.
Citation: Koh HK, Baur C, Brach C .
Toward a systems approach to health literacy research.
J Health Commun 2013;18(1):1-5. doi: 10.1080/10810730.2013.759029.
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Keywords: Healthcare Delivery, Health Literacy, Health Services Research (HSR), Patient-Centered Healthcare, Tools & Toolkits
Boland MR, Miotto R, Weng C
A method for probing disease relatedness using common clinical eligibility criteria.
The researchers explored the feasibility of using disease-specific common eligibility features (CEFs) for representing diseases and understanding their relatedness. They constructed disease-specific CEF networks to assess the degree of overlap among three types of diseases. Using these automatically derived networks, they were able to highlight connections among schizophrenia, epilepsy and depression. This finding and similar observations confirm the value of using clinical trial eligibility criteria for identifying disease relatedness.
AHRQ-funded; HS019853.
Citation: Boland MR, Miotto R, Weng C .
A method for probing disease relatedness using common clinical eligibility criteria.
Stud Health Technol Inform 2013;192:481-5..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Registries