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- Ambulatory Care and Surgery (1)
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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 22 of 22 Research Studies DisplayedQuigley DD, McCleskey SG
Improving care experiences for patients and caregivers at end of life: a systematic review.
End-of-life care is increasing as the US population ages. Approaches to providing high-quality end-of-life care vary across setting, diseases, and populations. Several data collection tools measure patient and/or caregiver care experiences at end of life and can be used for quality improvement. Previous reviews examined palliative care improvements or available measures but none explicitly on improving care experiences. In this study, the researchers reviewed literature on improving patient and/or caregiver end-of-life care experiences.
AHRQ-funded; HS025920.
Citation: Quigley DD, McCleskey SG .
Improving care experiences for patients and caregivers at end of life: a systematic review.
Am J Hosp Palliat Care 2021 Jan;38(1):84-93. doi: 10.1177/1049909120931468..
Keywords: Palliative Care, Caregiving, Patient Experience, Quality Improvement, Quality of Care
Knutzen KE, Schifferdecker KE, Murray GF
Role of norms in variation in cancer centers' end-of-life quality: qualitative case study protocol.
AHRQ-funded; HS022242.
Citation: Knutzen KE, Schifferdecker KE, Murray GF .
Role of norms in variation in cancer centers' end-of-life quality: qualitative case study protocol.
BMC Palliat Care 2020 Aug 27;19(1):136. doi: 10.1186/s12904-020-00641-x..
Keywords: Cancer, Quality of Life, Palliative Care, Quality of Care, Chronic Conditions
Kamal AH, Bowman B, Ritchie CS
Identifying palliative care champions to promote high-quality care to those with serious illness.
This article discusses the shortage of palliative care specialists in the United States now and in the future. In 2010, the shortage quantified as anywhere from 6000 to 18,000 palliative care physicians. Projections to 2030 do not show that the workforce will increase by that time. The authors suggest the use of “Palliative Care Champions” who are physicians with basic palliative care training.
AHRQ-funded; HS023681.
Citation: Kamal AH, Bowman B, Ritchie CS .
Identifying palliative care champions to promote high-quality care to those with serious illness.
J Am Geriatr Soc 2019 May;67(S2):S461-s67. doi: 10.1111/jgs.15799..
Keywords: Palliative Care, Quality of Care, Provider: Clinician, Provider: Physician
Iyer AS, Benzo RP, Bakitas MA
Easing the tension between palliative care and intensive care in chronic obstructive pulmonary disease.
This editorial discusses palliative care and intensive care in chronic obstructive pulmonary disease and comments on an article by Shen, et al., published, in 2018, in the Journal of Palliative Care, entitled “Life-sustaining procedures, palliative care consultation, and do-not resuscitate status in dying patients with COPD in US hospitals: 2010-2014.”
AHRQ-funded; HS023009.
Citation: Iyer AS, Benzo RP, Bakitas MA .
Easing the tension between palliative care and intensive care in chronic obstructive pulmonary disease.
J Palliat Care 2018 Jul;33(3):123-24. doi: 10.1177/0825859718782505..
Keywords: Chronic Conditions, Respiratory Conditions, Critical Care, Elderly, Palliative Care, Quality of Care
Khandelwal N, Curtis JR, Freedman VA
How often is end-of-life care in the United States inconsistent with patients' goals of care?
The purpose of this study was to document the proportion of bereaved respondents who reported care inconsistent with patients' wishes and characterize the predictors of end-of-life care associated with inconsistent care. The study found that one in eight respondents stated care in the last months of life was inconsistent with patients' wishes; such care was associated with worse ratings of care, pain management, and communication with clinicians.
AHRQ-funded; HS022982.
Citation: Khandelwal N, Curtis JR, Freedman VA .
How often is end-of-life care in the United States inconsistent with patients' goals of care?
J Palliat Med 2017 Dec;20(12):1400-04. doi: 10.1089/jpm.2017.0065..
Keywords: Care Management, Healthcare Delivery, Elderly, Palliative Care, Patient-Centered Healthcare, Quality of Care
Kamal AH, Nicolla JM, Power S
Quality improvement pearls for the palliative care and hospice professional.
In this article, the authors provide a prioritized list of 10 tips specifically aimed to palliative care and hospice professionals, using their experience in both failures and successes in performing quality improvement. They aim to demystify quality improvement, highlight areas where rigor and a systematic approach are needed for success, and offer their own lessons learned and mistakes made to promote success for others.
AHRQ-funded; HS023681.
Citation: Kamal AH, Nicolla JM, Power S .
Quality improvement pearls for the palliative care and hospice professional.
J Pain Symptom Manage 2017 Nov;54(5):758-65. doi: 10.1016/j.jpainsymman.2017.07.040..
Keywords: Palliative Care, Quality of Care, Quality Improvement
Kamal AH, Taylor DH, Neely B
One size does not fit all: disease profiles of serious illness patients receiving specialty palliative care.
This study was one of the first to describe symptom burden and functional scores by diagnostic categories and care settings across a community-based interdisciplinary specialty palliative care program. Results demonstrated statistically significant and clinically relevant differences among settings of care, functional status, and symptom profiles between patients with various serious illnesses.
AHRQ-funded; HS023681.
Citation: Kamal AH, Taylor DH, Neely B .
One size does not fit all: disease profiles of serious illness patients receiving specialty palliative care.
J Pain Symptom Manage 2017 Oct;54(4):476-83. doi: 10.1016/j.jpainsymman.2017.07.035..
Keywords: Quality of Care, Palliative Care, Quality Improvement
Kamal AH, Bull J, Wolf SP
Unmet needs of African Americans and whites at the time of palliative care consultation.
Researchers aimed to compare characteristics and palliative care needs of African Americans (AAs) and whites during initial palliative care consultation. Nearly two-thirds in both racial groups reported 3 or more symptoms of any severity; one-third reported 3 or more moderate or severe symptoms. A larger proportion of Africans than whites reported pain of any severity.
AHRQ-funded; HS023681; HS022763.
Citation: Kamal AH, Bull J, Wolf SP .
Unmet needs of African Americans and whites at the time of palliative care consultation.
Am J Hosp Palliat Care 2017 Jun;34(5):461-65. doi: 10.1177/1049909116632508.
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Keywords: Disparities, Quality of Care, Palliative Care, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
LeBlanc TW, Ritchie CS, Friedman F
Adherence to measuring what matters items when caring for patients with hematologic malignancies versus solid tumors.
The authors sought to assess adherence to Measuring What Matters (MWM) measures by palliative care clinicians caring for patients with hematologic malignancies, compared to those with solid tumors. They found that MWM adherence regarding symptom assessment and meeting emotional needs was lower for patients with hematologic malignancies compared to those with solid tumors. They concluded that this finding suggests two key areas for quality improvement initiatives in palliative care for patients with hematologic malignancies.
AHRQ-funded; HS023681; HS022763.
Citation: LeBlanc TW, Ritchie CS, Friedman F .
Adherence to measuring what matters items when caring for patients with hematologic malignancies versus solid tumors.
J Pain Symptom Manage 2016 Dec;52(6):775-82. doi: 10.1016/j.jpainsymman.2016.09.004.
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Keywords: Cancer, Quality of Care, Palliative Care, Patient-Centered Outcomes Research, Quality Measures
Wysham NG, Hochman MJ, Wolf SP
Performance of consultative palliative care model in achieving quality metrics in the ICU.
The purpose of this paper was to assess adherence to proposed quality metrics of ICU-based palliative care by palliative care specialists. The authors found that palliative care consultations in an ICU setting are characterized by variable adherence to candidate ICU palliative care quality metrics. Although symptom management was the foremost reason for palliative care consultation, consultants infrequently documented symptom assessments. The consultants performed better in offering spiritual support and managing documented symptoms.
AHRQ-funded; HS023681.
Citation: Wysham NG, Hochman MJ, Wolf SP .
Performance of consultative palliative care model in achieving quality metrics in the ICU.
J Pain Symptom Manage 2016 Dec;52(6):873-77. doi: 10.1016/j.jpainsymman.2016.05.026.
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Keywords: Critical Care, Intensive Care Unit (ICU), Palliative Care, Quality of Care, Quality Measures
Hochman MJ, Wolf S, Zafar SY
Comparing unmet needs to optimize quality: characterizing inpatient and outpatient palliative care populations.
The researchers compared the unmet needs of palliative care patients by location of care to better characterize these populations. They found that outpatients are more burdened by pain at first palliative care encounter compared to inpatients, yet outpatients experience higher quality of life and better performance status.
AHRQ-funded; HS023681.
Citation: Hochman MJ, Wolf S, Zafar SY .
Comparing unmet needs to optimize quality: characterizing inpatient and outpatient palliative care populations.
J Pain Symptom Manage 2016 Jun;51(6):1033-39.e3. doi: 10.1016/j.jpainsymman.2015.12.338.
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Keywords: Quality of Care, Inpatient Care, Ambulatory Care and Surgery, Palliative Care, Patient-Centered Outcomes Research
Wysham NG, Kamal AH
Integrating palliative care in the intensive care unit. evidence gaps and quality gaps.
The authors discuss Mularski and colleagues in the same issue, stating that this study provides an important advancement in measuring palliative care quality in the ICU. They commend Mularski and colleagues for advancing the candidate measures of ICU-based palliative care and conclude that this report draws attention to important and persistent deficiencies in comprehensive, patient-centered critical care delivery that needs to be addressed in research and in practice.
AHRQ-funded; HS023681.
Citation: Wysham NG, Kamal AH .
Integrating palliative care in the intensive care unit. evidence gaps and quality gaps.
Ann Am Thorac Soc 2016 May;13(5):595-7. doi: 10.1513/AnnalsATS.201601-061ED.
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Keywords: Evidence-Based Practice, Intensive Care Unit (ICU), Palliative Care, Patient-Centered Outcomes Research, Quality of Care
Kamal AH, Bull J, Ritchie CS
Adherence to measuring what matters measures using point-of-care data collection across diverse clinical settings.
The purpose of this paper was to evaluate the implementation of Measuring What Matters (MWM) measures by exploring documentation of quality measure adherence across six diverse clinical settings inherent to palliative care practice. The authors found that the lowest adherence involved comprehensive assessments during the first visit in hospitalized patients in the intensive care unit and that the highest adherence across all settings involved documentation of management of moderate to severe pain. They recommended additional studies for better understanding of benchmarks and acceptable ranges for adherence tailored to various clinical settings.
AHRQ-funded; HS023681; HS022763.
Citation: Kamal AH, Bull J, Ritchie CS .
Adherence to measuring what matters measures using point-of-care data collection across diverse clinical settings.
J Pain Symptom Manage 2016 Mar;51(3):497-503. doi: 10.1016/j.jpainsymman.2015.12.313.
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Keywords: Quality Measures, Palliative Care, Patient-Centered Outcomes Research, Quality of Care, Patient Safety
Dy SM, Herr K, Bernacki RE
Methodological research priorities in palliative care and hospice quality measurement.
The authors describe three key priorities: 1) defining the population of interest for palliative care quality indicators, 2) developing methods to measure quality from different data sources, and 3) conducting research to advance the development of patient/family-reported indicators. They apply these concepts to the key quality domain of advance care planning and address relevance to implementation of indicators in improving care in order to facilitate improved quality measurement across all populations with serious illness and care for patients and families.
AHRQ-funded; HS023681.
Citation: Dy SM, Herr K, Bernacki RE .
Methodological research priorities in palliative care and hospice quality measurement.
J Pain Symptom Manage 2016 Feb;51(2):155-62. doi: 10.1016/j.jpainsymman.2015.10.019.
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Keywords: Research Methodologies, Palliative Care, Quality Measures, Quality Indicators (QIs), Quality of Care
Kamal AH, Kavalieratos D, Bull J
Usability and acceptability of the QDACT-PC, an electronic point-of-care system for standardized quality monitoring in palliative care.
The researchers performed usability testing of the Quality Data Collection Tool for Palliative Care (QDACT-PC), a novel, point-of-care quality monitoring tool for palliative care. They found that testing the QDACT-PC reveals equivalence with paper for data collection time, but with less burden overall for electronic methods across other domains of usability.
AHRQ-funded; HS022989.
Citation: Kamal AH, Kavalieratos D, Bull J .
Usability and acceptability of the QDACT-PC, an electronic point-of-care system for standardized quality monitoring in palliative care.
J Pain Symptom Manage 2015 Nov;50(5):615-21. doi: 10.1016/j.jpainsymman.2015.05.013.
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Keywords: Healthcare Delivery, Quality of Care, Palliative Care, Patient-Centered Healthcare, Quality Measures
Kamal AH, Harrison KL, Bakitas M
Improving the quality of palliative care through national and regional collaboration efforts.
The purpose of this paper was to review examples of quality-improvement collaborations in palliative care to understand the similarities, differences, and future directions of quality measurement and improvement strategies. These three examples showed areas of robust and growing quality-improvement collaboration in the field of palliative care: the Global Palliative Care Quality Alliance; Palliative Care Quality Network; and Project Educate, Nurture, Advise, Before Life Ends.
AHRQ-funded; HS023681.
Citation: Kamal AH, Harrison KL, Bakitas M .
Improving the quality of palliative care through national and regional collaboration efforts.
Cancer Control 2015 Oct;22(4):396-402. doi: 10.1177/107327481502200405.
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Keywords: Healthcare Delivery, Palliative Care, Quality of Care, Quality Improvement
Smith B, McDuff J, Naierman N
What consumers want to know about quality when choosing a hospice provider.
This study drew on focus group and survey data collected in 5 metropolitan areas to learn more about hospice quality data. The researchers found that participants placed top priority on measures related to pain and symptom management. The National Quality Forum-approved measures resonate well with consumers, who also appear to be ready for access to data on the quality of hospice providers.
AHRQ-funded; HS021870.
Citation: Smith B, McDuff J, Naierman N .
What consumers want to know about quality when choosing a hospice provider.
Am J Hosp Palliat Care 2015 Jun;32(4):393-400. doi: 10.1177/1049909114524475.
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Keywords: Caregiving, Education: Patient and Caregiver, Shared Decision Making, Palliative Care, Provider Performance, Public Reporting, Quality of Care, Quality Indicators (QIs)
Kamal AH
Signposts along the journey toward high-quality palliative care: the value of measuring what matters.
The author of this letter discusses the rationale behind and the usefulness of the group of palliative care measures that were chosen through the deliberations of a Technical Advisory Panel, a Clinical User Panel, and public comment. He states that the 10 measures chosen represent important signposts along the journey toward high quality palliative care and that this is the first iteration of this effort, with updates planned.
AHRQ-funded; HS022763.
Citation: Kamal AH .
Signposts along the journey toward high-quality palliative care: the value of measuring what matters.
J Pain Symptom Manage 2015 May;49(5):e1-2. doi: 10.1016/j.jpainsymman.2015.03.002..
Keywords: Palliative Care, Quality of Care, Patient Safety, Quality Measures
Kamal AH, Nipp RD, Bull JH
Quality of palliative care for patients with advanced cancer in a community consortium.
The authors formed the Carolinas Consortium for Palliative Care and collected a quality data registry to monitor their practice and to inform quality improvement efforts. They demonstrated that measures evaluating process assessment, as opposed to interventions, are better documented. They concluded that analyzing data on quality is feasible and valuable in community-based palliative care and that, overall, processes to collect data on quality using nontechnology methods may underestimate true adherence to quality measures.
AHRQ-funded; HS022763.
Citation: Kamal AH, Nipp RD, Bull JH .
Quality of palliative care for patients with advanced cancer in a community consortium.
J Pain Symptom Manage 2015 Feb;49(2):289-92. doi: 10.1016/j.jpainsymman.2014.05.024.
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Keywords: Cancer, Healthcare Delivery, Quality of Care, Palliative Care, Registries
Kamal AH, Hanson LC, Casarett DJ
The quality imperative for palliative care.
This article discusses moving beyond demonstrating what palliative care is to focusing on the quality of how it is accomplished. This effort includes developing standardized methods to collect data without adding additional burden, comparing and sharing experiences to promote discipline-wide quality assessment and improvement initiatives, and demonstrating intentions for quality improvement on the clinical frontline.
AHRQ-funded; HS022763.
Citation: Kamal AH, Hanson LC, Casarett DJ .
The quality imperative for palliative care.
J Pain Symptom Manage 2015 Feb;49(2):243-53. doi: 10.1016/j.jpainsymman.2014.06.008.
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Keywords: Palliative Care, Quality Improvement, Quality of Care, Healthcare Delivery
Hwang D, Teno JM, Clark M
Family perceptions of quality of hospice care in the nursing home.
The investigators examined bereaved family members' perceptions of nursing home-hospice collaborations in terms of what family members believe went well or could have been improved. The focus group participants identified three major aspects of collaboration as important to care delivery: knowing who (nursing home or hospice) is responsible for which aspects of patient care, concern about information coordination between the nursing home and hospice, and the need for hospice to advocate for high-quality care rather than their having to directly do so on behalf of their family members. These concerns have been incorporated into the revised Family Evaluation of Hospice Care, a post-death survey used to evaluate quality of hospice care.
AHRQ-funded; HS019675.
Citation: Hwang D, Teno JM, Clark M .
Family perceptions of quality of hospice care in the nursing home.
J Pain Symptom Manage 2014 Dec;48(6):1100-7. doi: 10.1016/j.jpainsymman.2014.04.003.
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Keywords: Care Coordination, Nursing Homes, Palliative Care, Quality of Care
Kamal AH
Getting to proven: evaluating quality across all of palliative care.
In this letter, Kamal calls for the development of quality measures for palliative care, paying attention to procedures, multidisciplinary team members who perform multidomain assessments, the new settings of care where quality measurement should be tailored, and the care models that transition across generalist and specialist palliative care.
AHRQ-funded; HS022763.
Citation: Kamal AH .
Getting to proven: evaluating quality across all of palliative care.
J Pain Symptom Manage 2014 Jan;47(1):e1-2. doi: 10.1016/j.jpainsymman.2013.09.007.
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Keywords: Quality of Care, Health Services Research (HSR), Palliative Care, Quality Measures, Quality Measures