National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Care Coordination (1)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
- Comparative Effectiveness (2)
- Critical Care (1)
- Diabetes (1)
- Education: Patient and Caregiver (1)
- Elderly (3)
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- Health Information Technology (HIT) (3)
- (-) Home Healthcare (13)
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- Patient Self-Management (2)
- Provider: Pharmacist (1)
- Provider Performance (1)
- Quality of Care (2)
- Respiratory Conditions (1)
- Risk (1)
- Shared Decision Making (1)
- Stroke (1)
- Transitions of Care (2)
- Treatments (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 13 of 13 Research Studies DisplayedLi J
Home health agencies with high quality of patient care star ratings reduced short-term hospitalization rates and increased days independently at home.
Accurate Medicare Quality of Patient Care home health star ratings are crucial to helping patients find high-quality care, yet critics of these ratings indicate that they are not valid. The purpose of this retrospective study was to assess whether using the highest-rated home health agency available in a ZIP code improves outcomes. The researchers included 1,870,080 Medicare fee-for-service beneficiaries using home health care from July 2015 through July 2016 in the United States. The study found that treatment by the highest-rated agencies available decreased risks of hospitalization, emergency department use, and institutionalization during the initial episode, and increased days independently at home by 2.6% or 3.75 days in the 180 days after the end of the initial episode. Treatment effects were stronger for agencies that were above-average, had 1 or more stars than the next-best agency, and nonrural residents. Effects were positive for both postacute and community-entry patients.
AHRQ-funded; HS026836.
Citation: Li J .
Home health agencies with high quality of patient care star ratings reduced short-term hospitalization rates and increased days independently at home.
Med Care 2024 Jan; 62(1):11-20. doi: 10.1097/mlr.0000000000001930..
Keywords: Home Healthcare, Quality of Care, Hospitalization, Provider Performance
Scharp D, Hobensack M, Davoudi A
Natural language processing applied to clinical documentation in post-acute care settings: a scoping review.
The purpose of this scoping review was to assess the scope of the application of natural language processing to free-text clinical notes in post-acute care and provide a foundation for future natural language processing-based research in the same settings. The researchers searched PubMed, Cumulative Index of Nursing and Allied Health Literature, and Embase in February 2023. Twenty-one eligible studies. Almost all of which were conducted in home health care settings, had quantitative designs that utilized natural language processing applied to clinical documentation in post-acute care settings. Most studies extracted data from electronic health records to explore the risk for negative outcomes, including acute care utilization, medication errors, and suicide mortality. About half of the studies did not report age, sex, race, or ethnicity data or utilize standardized terminologies. Only 8 studies included variables from socio-behavioral domains. Most studies fulfilled all quality appraisal indicators.
AHRQ-funded; HS027742.
Citation: Scharp D, Hobensack M, Davoudi A .
Natural language processing applied to clinical documentation in post-acute care settings: a scoping review.
J Am Med Dir Assoc 2024 Jan; 25(1):69-83. doi: 10.1016/j.jamda.2023.09.006..
Keywords: Health Information Technology (HIT), Home Healthcare
Rahman M, Keohane L, Trivedi AN
High-cost patients had substantial rates of leaving Medicare Advantage and joining traditional Medicare.
The investigators examined the rates at which participants who used three high-cost services switched between Medicare Advantage and traditional Medicare. They found that the switching rate from 2010 to 2011 away from Medicare Advantage and to traditional Medicare exceeded the switching rate in the opposite direction for participants who used long-term nursing home care, short-term nursing home care, and home health care. These results were magnified among people who were enrolled in both Medicare and Medicaid.
AHRQ-funded; HS000011.
Citation: Rahman M, Keohane L, Trivedi AN .
High-cost patients had substantial rates of leaving Medicare Advantage and joining traditional Medicare.
Health Aff 2015 Oct;34(10):1675-81. doi: 10.1377/hlthaff.2015.0272.
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Keywords: Healthcare Costs, Home Healthcare, Long-Term Care, Medicare, Nursing Homes
Rivera-Hernandez M, Yamashita T, Kinney JM
Identifying naturally occurring retirement communities: a spatial analysis.
The authors analyzed naturally occurring retirement communities (NORCs) and whether there were spatiotemporal patterns in Ohio between 2000 and 2010. They found that there were different patterns including emerging, disappearing, and enduring NORCs and disproportionate distributions of NORCs across the state between 2000 and 2010. They recommended that locating NORCs could aid governments to create "aging in place" sensitive policies to address issues of independence, social care, health care, volunteerism, and community participation.
AHRQ-funded; HS000011.
Citation: Rivera-Hernandez M, Yamashita T, Kinney JM .
Identifying naturally occurring retirement communities: a spatial analysis.
J Gerontol B Psychol Sci Soc Sci 2015 Jul;70(4):619-27. doi: 10.1093/geronb/gbu077.
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Keywords: Elderly, Home Healthcare
Rhee SM, Valle MF, Wilson LM
Negative pressure wound therapy technologies for chronic wound care in the home setting: a systematic review.
The researchers conducted a systematic review on the efficacy and safety of negative pressure wound therapy (NPWT) for the treatment of chronic wounds in the home setting. Data were limited by variability in the types of comparator groups, methodological limitations, and poor reporting of outcomes. The researchers were unable to draw conclusions about the efficacy or safety of NPWT for the treatment of chronic wounds in the home setting due to the insufficient evidence.
AHRQ-funded; 290201200007I.
Citation: Rhee SM, Valle MF, Wilson LM .
Negative pressure wound therapy technologies for chronic wound care in the home setting: a systematic review.
Wound Repair Regen 2015 Jul-Aug;23(4):506-17. doi: 10.1111/wrr.12295..
Keywords: Injuries and Wounds, Home Healthcare, Comparative Effectiveness, Treatments, Chronic Conditions
McDonald MV, Feldman PH, Barron-Vaya Y
Outcomes of clinical decision support (CDS) and correlates of CDS use for home care patients with high medication regimen complexity: a randomized trial.
The researchers assessed the outcomes of a clinical decision support (CDS) intervention designed for home care patients with high medication regimen complexity (MRC) and examined correlates of CDS use. They found that eighty-two percent of intervention nurses used the CDS but for only 42 percent of their patients. Among intervention patients, CDS use (vs. non-use) was associated with reduced MRC and hospitalization.
AHRQ-funded; HS017837.
Citation: McDonald MV, Feldman PH, Barron-Vaya Y .
Outcomes of clinical decision support (CDS) and correlates of CDS use for home care patients with high medication regimen complexity: a randomized trial.
J Eval Clin Pract 2015 May 26;22(1):10-19. doi: 10.1111/jep.12383.
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Keywords: Clinical Decision Support (CDS), Home Healthcare, Medication, Risk
Baier RR, Cooper E, Wysocki A
Using qualitative methods to create a home health web application user interface for patients with low computer proficiency.
The researchers undertook a multi-phased approach to create a consumer-facing home health web application in Rhode Island. This included reviewing the evidence base to identify design recommendations and then creating a paper prototype and wireframe. They performed qualitative research to iteratively test their proposed user interface with two user groups, home health consumers and hospital case managers and t]hen refined their design to create the final web application.
AHRQ-funded; HS021879
Citation: Baier RR, Cooper E, Wysocki A .
Using qualitative methods to create a home health web application user interface for patients with low computer proficiency.
eGEMS. 2015 May 13;3(2):1166. doi: 10.13063/2327-9214.1166..
Keywords: Home Healthcare, Health Information Technology (HIT), Quality of Care, Education: Patient and Caregiver
Baier RR, Wysocki A, Gravenstein S
A qualitative study of choosing home health care after hospitalization: the unintended consequences of 'patient choice' requirements.
The purpose of this qualitative study is to learn how quality reports are used when choosing home care. Focus groups with 13 home health consumers and interviews with 28 hospital case managers from five hospitals revealed that both groups were unaware of public reports about home care quality.
AHRQ-funded; HS021879
Citation: Baier RR, Wysocki A, Gravenstein S .
A qualitative study of choosing home health care after hospitalization: the unintended consequences of 'patient choice' requirements.
J Gen Intern Med. 2015 May;30(5):634-40. doi: 10.1007/s11606-014-3164-7..
Keywords: Shared Decision Making, Elderly, Home Healthcare, Hospital Discharge, Transitions of Care
Uronis HE, Ekstrom MP, Currow DC
Oxygen for relief of dyspnoea in people with chronic obstructive pulmonary disease who would not qualify for home oxygen: a systematic review and meta-analysis.
The researchers conducted a systematic review and meta-analysis to determine whether oxygen therapy provides symptomatic relief in COPD patients with breathlessness who do not qualify currently for long-term oxygen. They concluded that continuous oxygen during exertion, but not short-burst therapy, reduced dyspnoea in mildly- and non-hypoxemic people with COPD who would not otherwise qualify for home oxygen therapy.
AHRQ-funded; HS000079.
Citation: Uronis HE, Ekstrom MP, Currow DC .
Oxygen for relief of dyspnoea in people with chronic obstructive pulmonary disease who would not qualify for home oxygen: a systematic review and meta-analysis.
Thorax 2015 May;70(5):492-4. doi: 10.1136/thoraxjnl-2014-205720..
Keywords: Comparative Effectiveness, Home Healthcare, Respiratory Conditions
Wellman BR, Frail CK, Zillich AJ
Pharmacists' experiences with a telephonic medication therapy management program for home health care patients.
This qualitative study involved interviewing four pharmacists on their experiences with a telephone medication therapy management (MTM) program. Several themes emerged from the analysis, including: communication and relationships, coordinating care and patient self-management, logistics, professional fulfillment, service delivery and content, and training opportunities. The researchers concluded that their study provides possible strategies to overcome barriers and facilitate service provision for future telephonic MTM services.
AHRQ-funded; HS022119.
Citation: Wellman BR, Frail CK, Zillich AJ .
Pharmacists' experiences with a telephonic medication therapy management program for home health care patients.
Consult Pharm 2015 Mar;30(3):163-74. doi: 10.4140/TCP.n.2015.163..
Keywords: Home Healthcare, Medication, Provider: Pharmacist, Patient Self-Management
Prvu Bettger J, McCoy L, Smith EE
Contemporary trends and predictors of postacute service use and routine discharge home after stroke.
The authors examined trends in discharge to inpatient rehabilitation facilities, skilled nursing facilities, home with home health, and home without services for patients with ischemic or hemorrhagic stroke at hospitals participating in Get With The Guidelines-Stroke. They found that four in 10 stroke patients are discharged home without postacute care services. They recommended further research to explain the shift in service use by type and its effect on outcomes.
AHRQ-funded; HS019479.
Citation: Prvu Bettger J, McCoy L, Smith EE .
Contemporary trends and predictors of postacute service use and routine discharge home after stroke.
J Am Heart Assoc 2015 Feb 23;4(2). doi: 10.1161/jaha.114.001038.
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Keywords: Critical Care, Hospital Discharge, Home Healthcare, Stroke
Nasarwanji N, Werner NE, Carl K
Identifying challenges associated with the care transition workflow from hospital to skilled home health care: perspectives of home health care agency providers.
The authors studied the workflow for transitioning older adults from the hospital to skilled home health care (SHHC). They found three overarching challenges to optimal care transitions: information access, coordination, and communication/teamwork. They recommended that future investigations test whether redesigning the transition from hospital to SHHC improves workflow and care quality.
AHRQ-funded; HS022916.
Citation: Nasarwanji N, Werner NE, Carl K .
Identifying challenges associated with the care transition workflow from hospital to skilled home health care: perspectives of home health care agency providers.
Home Health Care Serv Q 2015;34(3-4):185-203. doi: 10.1080/01621424.2015.1092908.
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Keywords: Care Coordination, Elderly, Home Healthcare, Hospital Discharge, Transitions of Care
Casper GR, Flatley Brennan P, Perreault JO
vizHOME--a context-based home assessment: preliminary implications for informatics.
The focus of this paper is on the first phase of the vizHOME study, specifically on the exploration and documentation of the individual’s performance of self-management tasks including such things as medication management and use of a monitoring device. The researchers learned from the participants that while the tools may perform satisfactorily in usability assessment, they may not meet the needs of many users.
AHRQ-funded; HS022548.
Citation: Casper GR, Flatley Brennan P, Perreault JO .
vizHOME--a context-based home assessment: preliminary implications for informatics.
Stud Health Technol Inform 2015;216:842-6..
Keywords: Diabetes, Patient Self-Management, Home Healthcare, Health Information Technology (HIT), Medication