National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (2)
- Cancer (1)
- Children's Health Insurance Program (CHIP) (2)
- Children/Adolescents (4)
- Dental and Oral Health (1)
- Diabetes (1)
- Disparities (3)
- Education: Continuing Medical Education (1)
- Elderly (2)
- Electronic Health Records (EHRs) (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
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- Long-Term Care (1)
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- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (2)
- Nursing (2)
- Nursing Homes (1)
- Outcomes (2)
- Patient-Centered Outcomes Research (2)
- Patient Experience (1)
- Patient Safety (4)
- Pressure Ulcers (1)
- Provider (1)
- Provider Performance (3)
- Quality Improvement (3)
- (-) Quality Indicators (QIs) (16)
- Quality Measures (9)
- Quality of Care (8)
- Racial and Ethnic Minorities (3)
- Rehabilitation (1)
- Surgery (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 16 of 16 Research Studies DisplayedLake ET, Staiger D, Smith JG
The association of missed nursing care with very low birthweight infant outcomes.
This study examined the association of missed nursing care and health outcomes of very low birthweight (VLBW) infants in neonatal intensive care units (NICUs). The authors used 2016 hospital administrative discharge abstracts for VLBW newborns (n = 7,595) and NICU registered nurse survey responses (n = 6,963) from the National Database of Nursing Quality Indicators. Mortality, morbidity, and length of stay (LOS) was examined in 190 sample hospitals from 19 states in all regions. There was a significant association between higher odds of bloodstream infection and longer LOS, but not mortality or severe intraventricular hemorrhage and missed nursing care.
AHRQ-funded; HS024918.
Citation: Lake ET, Staiger D, Smith JG .
The association of missed nursing care with very low birthweight infant outcomes.
Med Care Res Rev 2023 Jun; 80(3):293-302. doi: 10.1177/10775587221150950..
Keywords: Healthcare Cost and Utilization Project (HCUP), Quality Indicators (QIs), Nursing, Newborns/Infants, Outcomes, Healthcare Utilization, Quality of Care
Sanghavi P, Chen Z
Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings.
The purpose of this study was to evaluate the relationship between nursing home characteristics and reporting of 2 of 3 specific clinical outcomes reported by the Nursing Home Care Compare (NHCC) website: major injury falls and pressure ulcers. The researchers of this quality improvement study utilized hospitalization data for all Medicare fee-for-service beneficiaries between January 1, 2011, and December 31, 2017. Hospital admission claims for major injury falls and pressure ulcers were linked with facility-reported evaluations at the nursing home resident level. For each linked hospital claim, it was determined whether the nursing home had reported the event and rates of reporting were computed. To evaluate whether nursing homes reported similarly on both measures, the researchers estimated the relationship between reporting of major injury falls and pressure ulcers within a nursing home, and explored racial and ethnic disparities that could otherwise explain the associations. The study sample included 13,179 nursing homes where 131,000 residents experienced major injury fall or pressure ulcer hospitalizations. Of the 98,669 major injury fall hospitalizations, 60.0% were reported, and of the 39,894 stage 3 or 4 pressure ulcer hospitalizations, 67.7% were reported. Underreporting for both conditions was pervasive, with 69.9% and 71.7% of nursing homes having reporting rates less than 80% for major injury fall and pressure ulcer hospitalizations, respectively. Lower reporting rates had few correlations with facility characteristics other than racial and ethnic composition. Facilities with high vs low fall reporting rates had significantly more White residents (86.9% vs 73.3%), and facilities with high vs low pressure ulcer reporting rates had significantly fewer White residents (69.7% vs 74.9%).
AHRQ-funded; HS026957.
Citation: Sanghavi P, Chen Z .
Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings.
JAMA Netw Open 2023 May; 6(5):e2314822. doi: 10.1001/jamanetworkopen.2023.14822..
Keywords: Quality Measures, Quality of Care, Elderly, Disparities, Racial and Ethnic Minorities, Nursing Homes, Pressure Ulcers, Healthcare-Associated Infections (HAIs), Quality Indicators (QIs), Long-Term Care
Sullivan CE, Day SW, Ivankova N
Establishing nursing-sensitive quality indicators for pediatric oncology: an international mixed methods Delphi study.
The purpose of this study was to create an initial core set of Nursing-sensitive indicators (NSIs) for international pediatric oncology nursing that would be important, actionable, and feasible to measure across different resource settings and countries. The researchers utilized purposive snowball sampling to identify 122 expert pediatric oncology nurses from 43 countries for participation. In round 1, the panelists identified five potential NSIs and constructs. These results were applied to round 2 in which panelists chose their top 10 NSIs and constructs and ranked them according to importance to patient care quality. Those results were then applied to round 3, in which panelists ranked the top 10 NSIs and constructs by order of importance for the particular population, then rated each NSI/Construct for actionability and feasibility of measurement. The study identified the preliminary core set of NSIs and constructs identified by the expert panel, and ranked them in the following order of importance: safe chemotherapy administration and handling, infection prevention/control, pediatric oncology nursing orientation program, early warning score system/recognition of patient deterioration, chemotherapy/biotherapy education/course, pain assessment/management, symptom assessment/management, patient and family education, palliative/end of life care, and continuing nursing education/competency. The study reported that all NSIs and constructs were rated as actionable; all constructs except palliative/end of life care were rated as feasible to measure. The researchers concluded that initial core NSIs and constructs offer improved insight into typical features of international pediatric oncology nursing practice that are important, actionable, and feasible for quality measurement.
AHRQ-funded; HS013852.
Citation: Sullivan CE, Day SW, Ivankova N .
Establishing nursing-sensitive quality indicators for pediatric oncology: an international mixed methods Delphi study.
J Nurs Scholarsh 2023 Jan; 55(1):388-400. doi: 10.1111/jnu.12798..
Keywords: Children/Adolescents, Quality Indicators (QIs), Quality of Care, Nursing, Cancer
Sentell TL, Juarez DT, Ahn HJ
Disparities in diabetes-related preventable hospitalizations among working-age Native Hawaiians and Asians in Hawai'i.
Elderly (65+) Native Hawaiian, Filipino, and Japanese men and Filipino women have a higher risk of diabetes-related potentially preventable hospitalizations than whites. The authors sought to determine if similar disparities are seen among the non-elderly (< 65). They found that preventable hospitalizations rates were significantly higher for Native Hawaiians males compared to whites, but significantly lower for Chinese men and women, Japanese men and women, and Filipino men and women. Rates for Native Hawaiian females did not differ significantly from Whites. Disparities in diabetes-related preventable hospitalizations were seen for working-age (18-64) Native Hawaiian men even when their higher population-level diabetes prevalence was considered.
AHRQ-funded; HS019990.
Citation: Sentell TL, Juarez DT, Ahn HJ .
Disparities in diabetes-related preventable hospitalizations among working-age Native Hawaiians and Asians in Hawai'i.
Hawaii J Med Public Health 2014 Dec;73(12 Suppl 3):8-13.
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Keywords: Diabetes, Disparities, Hospitalization, Quality Indicators (QIs), Racial and Ethnic Minorities
Bailey LC, Mistry KB, Tinoco A
AHRQ Author: Mistry KB
Addressing electronic clinical information in the construction of quality measures.
The authors draw on the experience of Centers of Excellence to review both structural and pragmatic considerations in e-measurement. They suggest that addressing these challenges will require investment by vendors, researchers, and clinicians alike in developing better pediatric content for standard terminologies and data models, encouraging wider adoption of technical standards that support reliable quality measurement, better harmonizing data collection with clinical work flow in EHRs, and better understanding the behavior and potential of e-measures.
AHRQ-authored.
Citation: Bailey LC, Mistry KB, Tinoco A .
Addressing electronic clinical information in the construction of quality measures.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S82-9. doi: 10.1016/j.acap.2014.06.006.
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Keywords: Children's Health Insurance Program (CHIP), Electronic Health Records (EHRs), Quality Improvement, Quality Indicators (QIs), Quality Measures
Lorch SA, Passarella M, Zeigler A
Challenges to measuring variation in readmission rates of neonatal intensive care patients.
The authors examined the viability of a hospital readmission quality metric for infants requiring neonatal intensive care. They found that the California cohort showed significant variation in hospital-level readmission rates, supporting the premise that readmission rates of prematurely born infants may reflect care quality. However, state data did not include term and early term infants requiring neonatal intensive care, and there were extensive missing data in the few states with sufficient information on managed care patients to calculate state-level measures. They concluded that constructing a valid readmission measure for NICU care across diverse states and regions requires improved data collection.
AHRQ-funded; HS018661; HS020508.
Citation: Lorch SA, Passarella M, Zeigler A .
Challenges to measuring variation in readmission rates of neonatal intensive care patients.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S47-53. doi: 10.1016/j.acap.2014.06.010.
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Keywords: Neonatal Intensive Care Unit (NICU), Newborns/Infants, Quality Indicators (QIs), Quality Measures, Hospital Readmissions
Nakamura MM, Toomey SL, Zaslavsky AM
Measuring pediatric hospital readmission rates to drive quality improvement.
The investigators sought to describe the importance of readmissions in children and the challenges of developing readmission quality measures. They found that the policy focus on readmissions has motivated widespread efforts by hospitals and outpatient providers to evaluate and reengineer care processes.
AHRQ-funded; HS020513; HS020508.
Citation: Nakamura MM, Toomey SL, Zaslavsky AM .
Measuring pediatric hospital readmission rates to drive quality improvement.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S39-46. doi: 10.1016/j.acap.2014.06.012.
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Keywords: Children/Adolescents, Quality Improvement, Quality Indicators (QIs), Quality Measures, Hospital Readmissions
Bevans KB, Moon J, Carle AC
Patient reported outcomes as indicators of pediatric health care quality.
The authors described and illustrated in case examples the functions, benefits, and challenges of patient-reported outcomes applications. They concluded that pediatric patient-reported outcomes are increasingly recognized as valuable indicators of health care quality in the clinical environment and as measures of organization- and provider-level performance.
AHRQ-funded; HS020408.
Citation: Bevans KB, Moon J, Carle AC .
Patient reported outcomes as indicators of pediatric health care quality.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S90-6. doi: 10.1016/j.acap.2014.06.002..
Keywords: Children/Adolescents, Quality of Care, Children/Adolescents, Quality Indicators (QIs), Quality Measures, Provider Performance
Gidengil C, Mangione-Smith R, Bailey LC
Using Medicaid and CHIP claims data to support pediatric quality measurement: lessons from 3 centers of excellence in measure development.
The investigators sought to explore the claims data-related issues relevant to quality measure development for Medicaid and the Children's Health Insurance Program (CHIP), illustrating the challenges encountered and solutions developed around 3 distinct performance measure topics: care coordination for children with complex needs, quality of care for high-prevalence conditions, and hospital readmissions. Their three Centers of Excellence in pediatric quality measurement used innovative methods to develop algorithms that use Medicaid claims data to identify children with complex needs; to overcome some shortcomings of existing data for measuring quality of care for common conditions such as otitis media; and to identify readmissions after hospitalizations for lower respiratory infections.
AHRQ-funded; HS020513; HS020506; HS020508.
Citation: Gidengil C, Mangione-Smith R, Bailey LC .
Using Medicaid and CHIP claims data to support pediatric quality measurement: lessons from 3 centers of excellence in measure development.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S76-81. doi: 10.1016/j.acap.2014.06.014.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Medicaid, Quality Indicators (QIs), Quality Measures, Quality of Care
Sentell T, Chang A, Cheng Y
Maternal quality and safety outcomes for Asians and Pacific Islanders in Hawaii: an observational study from five years of statewide data.
The authors investigated maternal quality and safety outcomes across heterogeneous Asian and Pacific Islanders subgroups in the United States. They found significant variation for Asian and Pacific Islander subgroups across maternal quality and safety outcomes.
AHRQ-funded; HS019990; HS021903.
Citation: Sentell T, Chang A, Cheng Y .
Maternal quality and safety outcomes for Asians and Pacific Islanders in Hawaii: an observational study from five years of statewide data.
BMC Pregnancy Childbirth 2014 Aug 30;14:298. doi: 10.1186/1471-2393-14-298.
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Keywords: Disparities, Labor and Delivery, Patient-Centered Outcomes Research, Quality Indicators (QIs), Racial and Ethnic Minorities
Brown SE, Ratcliffe SJ, Halpern SD
An empirical comparison of key statistical attributes among potential ICU quality indicators.
The researchers assessed the performance of candidate indicators of ICU quality based on face validity, relevance to patients, ability to be measured reliably, sufficient variability to identify poor performers, relative insensitivity to severity adjustment, and the ability to capture what providers do rather than patients' characteristics. They concluded that no indicator performed optimally across assessments and recommended that future research seek to define and operationalize quality in a way that is relevant to both patients and providers.
AHRQ-funded; HS018406.
Citation: Brown SE, Ratcliffe SJ, Halpern SD .
An empirical comparison of key statistical attributes among potential ICU quality indicators.
Crit Care Med 2014 Aug;42(8):1821-31. doi: 10.1097/ccm.0000000000000334.
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Keywords: Quality of Care, Intensive Care Unit (ICU), Patient Safety, Quality Indicators (QIs), Hospital Readmissions
Maggard-Gibbons M
The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program.
This review summarized the history of American College of Surgeons National Surgical Quality Improvement Project and its components, and described the evidence that feeding outcomes back to providers, along with real-time comparisons with other hospital rates, leads to quality improvement, better patient outcomes, cost savings and overall improved patient safety.
AHRQ-funded; 2902007100621.
Citation: Maggard-Gibbons M .
The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program.
BMJ Qual Saf 2014 Jul;23(7):589-99. doi: 10.1136/bmjqs-2013-002223..
Keywords: Quality Improvement, Quality Indicators (QIs), Quality Measures, Quality of Care, Surgery, Patient Safety, Outcomes, Patient-Centered Outcomes Research, Provider Performance
Shelton J, Kummerow K, Phillips S
Patient safety in the era of the 80-hour workweek.
The purpose of this paper was to evaluate the effect of duty-hour regulations (DHR) on patient safety. The researchers found no differences in the patient safety indicator (PSI) rates over time for hemorrhage or hematoma, physiologic or metabolic derangement, accidental puncture or laceration, or wound dehiscence. Teaching hospitals had higher rates than non-teaching hospitals both preintervention and postintervention for all the PSIs except wound dehiscence.
AHRQ-funded; HS013833.
Citation: Shelton J, Kummerow K, Phillips S .
Patient safety in the era of the 80-hour workweek.
J Surg Educ 2014 Jul-Aug;71(4):551-9. doi: 10.1016/j.jsurg.2013.12.011.
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Keywords: Adverse Events, Education: Continuing Medical Education, Patient Safety, Quality Indicators (QIs), Provider
Gibson G, Jurasic MM, Wehler CJ
Longitudinal outcomes of using a fluoride performance measure for adults at high risk of experiencing caries.
In this paper, the authors hypothesized that after the implementation of a performance measure regarding appropriate fluoride use, veterans at high risk of experiencing caries would require fewer new dental restorations than in the past. They found that, after use of the performance measure for four years, there were 8.6 percent fewer patients needing two or more restorations, a 10.8 percent decrease in the mean number of restorations, and a modest 3.4 percent fewer patients at high risk of experiencing caries who required new restorations after the initial 12-month period.
AHRQ-funded; HS019527.
Citation: Gibson G, Jurasic MM, Wehler CJ .
Longitudinal outcomes of using a fluoride performance measure for adults at high risk of experiencing caries.
J Am Dent Assoc 2014 May;145(5):443-51. doi: 10.14219/jada.2013.53.
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Keywords: Dental and Oral Health, Healthcare Delivery, Provider Performance, Quality Indicators (QIs), Quality Measures
Weissman JS, López L, Schneider EC
The association of hospital quality ratings with adverse events.
The researchers used a survey of 2,582 patients hospitalized at 16 acute care Massachusetts hospitals to understand how patient-reported quality is related to adverse events (AEs). Although patients with AEs rated hospital quality lower than others, patients with AEs who experienced ‘service recovery’ rated their quality of care at levels similar to those not experiencing AEs.
AHRQ-funded
Citation: Weissman JS, López L, Schneider EC .
The association of hospital quality ratings with adverse events.
Int J Qual Health Care. 2014 Apr;26(2):129-35. doi: 10.1093/intqhc/mzt092..
Keywords: Adverse Events, Quality of Care, Hospitals, Patient Experience, Patient Safety, Quality Indicators (QIs), Quality Measures
Ottenbacher KJ, Karmarkar A, Graham JE
Thirty-day hospital readmission following discharge from postacute rehabilitation in fee-for-service Medicare patients.
This study sought to determine 30-day readmission rates and factors related to readmission for patients receiving postacute inpatient rehabilitation. It found that among postacute rehabilitation facilities providing services to Medicare fee-for-service beneficiaries, 30-day readmission rates ranged from 5.8 percent to 18.8 percent for selected impairment groups.
AHRQ-funded; HS022134.
Citation: Ottenbacher KJ, Karmarkar A, Graham JE .
Thirty-day hospital readmission following discharge from postacute rehabilitation in fee-for-service Medicare patients.
JAMA 2014 Feb 12;311(6):604-14. doi: 10.1001/jama.2014.8..
Keywords: Hospital Readmissions, Medicare, Rehabilitation, Elderly, Quality Indicators (QIs)