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 205 Research Studies DisplayedRay KN, Bohnhoff JC, Schweiberger K
Use of telemedicine for initial outpatient subspecialist consultative visit: a national survey of general pediatricians and pediatric subspecialists.
The authors performed a survey of general pediatricians and pediatric subspecialists about the use of telemedicine for patients newly referred for pediatric subspecialty care. They found that 76% of respondents thought telemedicine should be offered for some and 11% thought telemedicine should be offered for all initial subspecialist visits. Factors perceived to reduce the appropriateness of telemedicine for subspecialty consultation included the need for interpreter services and a prior history of frequent no-shows. They further found that responses from generalists and subspecialists rarely differed significantly.
AHRQ-funded; HS026393.
Citation: Ray KN, Bohnhoff JC, Schweiberger K .
Use of telemedicine for initial outpatient subspecialist consultative visit: a national survey of general pediatricians and pediatric subspecialists.
Healthc 2022 Mar;10(1):100600. doi: 10.1016/j.hjdsi.2021.100600..
Keywords: Children/Adolescents, Telehealth, Health Information Technology (HIT), Provider: Physician, Ambulatory Care and Surgery
Kan K, Shaunfield S, Kanaley M
Health provider perspectives of electronic medication monitoring in outpatient asthma care: a qualitative investigation using the consolidated framework for implementation research.
This study’s objective was to quantitatively explore the experience of health providers using electronic medication monitoring (EMM) in pediatric outpatient asthma care. The authors conducted interviews with 10 health providers using the Consolidated Framework of Implementation Research (CFIR) on their EMM experience with asthma patients from 5 primary care or specialty clinics. The EMM tracked albuterol and inhaled corticosteroid (ICS) use. Health providers called parents whenever ICS adherence waned, or albuterol use increased. The interviews were audio-recorded, transcribed, and deductively analyzed. Most providers felt the intervention improved care delivery, but implementation of the intervention model would require additional employees to handle the increased administrative and clinical workload.
AHRQ-funded; HS026385.
Citation: Kan K, Shaunfield S, Kanaley M .
Health provider perspectives of electronic medication monitoring in outpatient asthma care: a qualitative investigation using the consolidated framework for implementation research.
J Asthma 2022 Feb;59(2):342-51. doi: 10.1080/02770903.2020.1846745..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Ambulatory Care and Surgery
Nielsen TB, Santarossa M, Probst B
Introducing antimicrobial stewardship to the outpatient clinics of a suburban academic health system.
This study’s objective was to determine attitudes of prescribers of antimicrobials to help establish an antimicrobial stewardship program in the outpatient setting. Participants included prescribers at Loyola University Health System, an academic teaching healthcare system with 19 primary care and 3 intermediate- and urgent-care clinics. A voluntary survey was developed using SurveyMonkey and was distributed via email. Data were conducted anonymously. Three metrics were assessed for rates of compliance and included: (1) avoidance of antibiotics in adult acute bronchitis and appropriate antibiotic treatment in (2) patients tested for pharyngitis and (3) children with upper respiratory tract infections. Prescribers were very knowledgeable about what constitutes appropriate prescribing, but fewer than half believed antibiotics were overprescribed in their office. The respondents reported that 74% received intense pressure from patients to prescribe antimicrobials inappropriately. Intermediate- and urgent-care prescribers had higher rates of compliance than primary-care prescribers. However, the latter group responded well to monthly reports and online educational resources.
AHRQ-funded; HS025690.
Citation: Nielsen TB, Santarossa M, Probst B .
Introducing antimicrobial stewardship to the outpatient clinics of a suburban academic health system.
Antimicrob Steward Healthc Epidemiol 2022;2(1):e9. doi: 10.1017/ash.2021.228..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Ambulatory Care and Surgery
Benneyan JC, White T, Nehls N
Systems analysis of a dedicated ambulatory respiratory unit for seeing and ensuring follow-up of patients with COVID-19 symptoms.
This paper is a systems analysis of a dedicated ambulatory respiratory unit for patients with COVID-19 symptoms. Workflow redesigns were necessitated by COVID and included new ambulatory workflows to handle surge volumes, protect patients and staff, and ensure timely reliable care. The workflow innovations observed can possibly be used to benefit routine care. Observations found that more than 85% of follow-ups were completed within 24 hours, and no staff or patient infections were associated with unit operations. Identified issues included role confusion, staffing and gatekeeping bottlenecks, and patient reluctance to visit in person or discuss concerns on the phone.
AHRQ-funded; HS027282.
Citation: Benneyan JC, White T, Nehls N .
Systems analysis of a dedicated ambulatory respiratory unit for seeing and ensuring follow-up of patients with COVID-19 symptoms.
J Ambul Care Manage 2021 Oct-Dec;44(4):293-303. doi: 10.1097/jac.0000000000000390..
Keywords: COVID-19, Ambulatory Care and Surgery, Respiratory Conditions, Workflow, Healthcare Delivery
Lafferty M, Manojlovich M, Griggs JJ
Clinicians report barriers and facilitators to high-quality ambulatory oncology care.
This study’s aim was to examine clinician-reported factors within ambulatory oncology practices that affect care delivery processes and outcomes for patients and clinicians. Survey data were collected in 2017 from 298 clinicians across 29 ambulatory practices in Michigan. Clinicians provided written comments on 5 work-system components of the Systems Engineering Initiative for Patient Safety model that affected care delivery and outcome. Unfavorable aspects included staffing shortages and high patient volume, limited physical space, electronic health record usability issues, and order entry. Favorable aspects focused on the skills of colleagues, and collaboration and teamwork of the clinical staff.
AHRQ-funded; HS024914.
Citation: Lafferty M, Manojlovich M, Griggs JJ .
Clinicians report barriers and facilitators to high-quality ambulatory oncology care.
Cancer Nurs 2021 Sep-Oct;44(5):E303-E10. doi: 10.1097/ncc.0000000000000832..
Keywords: Ambulatory Care and Surgery, Healthcare Delivery, Quality of Care
Joseph A, Neyens D, Mihandoust S
Impact of surgical table orientation on flow disruptions and movement patterns during pediatric outpatient surgeries.
This quantitative observational study observed the impacts of surgical table orientation on flow disruptions (FDs), the number of contacts between team members, and the distance traveled. Findings showed that the orientation of the surgical table significantly influenced staff workflow and movement in the operating room, with an angled surgical table orientation being the least disruptive to surgical work. The anesthesia provider, scrub nurse, and circulating nurse experienced more FDs compared to the surgeon.
AHRQ-funded; HS024380.
Citation: Joseph A, Neyens D, Mihandoust S .
Impact of surgical table orientation on flow disruptions and movement patterns during pediatric outpatient surgeries.
Int J Environ Res Public Health 2021 Jul 31;18(15). doi: 10.3390/ijerph18158114..
Keywords: Children/Adolescents, Ambulatory Care and Surgery, Surgery, Workflow
Shi Y, Amill-Rosario A, Rudin RS
Barriers to using clinical decision support in ambulatory care: do clinics in health systems fare better?
In this study, the investigators quantified the use of clinical decision support (CDS) and the specific barriers reported by ambulatory clinics and examined whether CDS utilization and barriers differed based on clinics' affiliation with health systems, providing a benchmark for future empirical research and policies related to this topic.
AHRQ-funded; HS024067.
Citation: Shi Y, Amill-Rosario A, Rudin RS .
Barriers to using clinical decision support in ambulatory care: do clinics in health systems fare better?
J Am Med Inform Assoc 2021 Jul 30;28(8):1667-75. doi: 10.1093/jamia/ocab064..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Ambulatory Care and Surgery, Health Information Technology (HIT), Health Systems
Watterson TL, Stone JA, Brown R
CancelRx: a health IT tool to reduce medication discrepancies in the outpatient setting.
Medication list discrepancies between outpatient clinics and pharmacies can lead to medication errors. Within the last decade, a new health information technology (IT), CancelRx, emerged to send a medication cancellation message from the clinic's electronic health record (EHR) to the outpatient pharmacy's software. The objective of this study was to measure the impact of CancelRx on reducing medication discrepancies between the EHR and pharmacy dispensing software.
AHRQ-funded; HS025793.
Citation: Watterson TL, Stone JA, Brown R .
CancelRx: a health IT tool to reduce medication discrepancies in the outpatient setting.
J Am Med Inform Assoc 2021 Jul 14;28(7):1526-33. doi: 10.1093/jamia/ocab038..
Keywords: Medication: Safety, Medication, Medical Errors, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Electronic Health Records (EHRs), Health Information Technology (HIT), Ambulatory Care and Surgery
Chou LN, Kuo YF, Raji MA
Potentially inappropriate medication prescribing by nurse practitioners and physicians.
This study compared prescribing rates for potentially inappropriate medications (PIMs) by physicians and nurse practitioners (NPs). The authors used 100% Texas Medicare data to define physician and NP visits in 2016. Rates of visits with a PIM prescription from the same provider was measured by initial and refill visits. There were 24.1 per 1000 visits for PIM prescriptions, 9.0 per 1000 visits for an initial PM and 15.1 per 1000 visits for a refill PIM. Visits to an NP was less likely to result in an initial and refill PIM visit than a visit to a physician. There was a strong association of lower odds of a black enrollee receiving a PIM by an NP than white enrollees. There was also less likelihood of receiving a PIM refill from an NP in older patients and in those with more comorbidities.
AHRQ-funded; HS020642; HS020642.
Citation: Chou LN, Kuo YF, Raji MA .
Potentially inappropriate medication prescribing by nurse practitioners and physicians.
J Am Geriatr Soc 2021 Jul;69(7):1916-24. doi: 10.1111/jgs.17120..
Keywords: Medication: Safety, Medication, Provider: Physician, Provider: Nurse, Hospitalization, Practice Patterns, Ambulatory Care and Surgery
Staley BS, Milko LV, Waltz M
Evaluating the clinical utility of early exome sequencing in diverse pediatric outpatient populations in the North Carolina Clinical Genomic Evaluation of Next-generation Exome Sequencing (NCGENES) 2 study: a randomized controlled trial.
Exome sequencing (ES) has probable utility for shortening the diagnostic odyssey of children with suspected genetic disorders. This report described the design and methods of a study evaluating the potential of ES as a routine clinical tool for pediatric patients who have suspected genetic conditions and who are in the early stages of the diagnostic odyssey.
AHRQ-funded; HS000032.
Citation: Staley BS, Milko LV, Waltz M .
Evaluating the clinical utility of early exome sequencing in diverse pediatric outpatient populations in the North Carolina Clinical Genomic Evaluation of Next-generation Exome Sequencing (NCGENES) 2 study: a randomized controlled trial.
Trials 2021 Jun 14;22(1):395. doi: 10.1186/s13063-021-05341-2..
Keywords: Children/Adolescents, Genetics, Ambulatory Care and Surgery
Shekelle PG, Pane JD, Agniel D
Assessment of variation in electronic health record capabilities and reported clinical quality performance in ambulatory care clinics, 2014-2017.
This study’s objective was to assess the association between electronic health records (EHRs) with different degrees of capabilities and publicly reported ambulatory quality measures in at least 3 clinical domains of care. This cross-sectional and longitudinal study was conducted using survey responses from 1141 ambulatory clinics in Minnesota, Washington, and Wisconsin affiliated with a health system and reported performance measures in 2014 to 2017. A composite measure of EHR capability that considered 50 EHR capabilities was created using 7 functional domains: no functional EHR, EHR underuser, EHR, neither underuser nor superuser, and EHR superuser; as well as a standardized composite of ambulatory clinical measures that included a median of 13 individual measures (3 to 25). The proportion of clinics that were EHR superusers increased from 51% in 2014 to 61% in 2017. In all survey years EHR superusers had better clinical quality performance than other clinics. This difference in scores translated into an approximately 9% difference in a clinic’s rank order in clinical quality.
AHRQ-funded; HS024067.
Citation: Shekelle PG, Pane JD, Agniel D .
Assessment of variation in electronic health record capabilities and reported clinical quality performance in ambulatory care clinics, 2014-2017.
JAMA Netw Open 2021 Apr;4(4):e217476. doi: 10.1001/jamanetworkopen.2021.7476..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Ambulatory Care and Surgery, Provider Performance, Quality of Care
Ahmedov M, Pourat N, Liu H
Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey of experiences with ambulatory healthcare for Asians and non-Hispanic Whites in the United States.
This paper discusses the results of the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Clinical and Group (CG-CAHPS) Adult Visit Survey 1.0 which includes data on care experiences to compare specific aspects of care of Asians and Whites. Most surveys were administered by mail with a sample comprised of 64% female, 89% White, 2% Asian, 39% 65 years or older, and 32% were high school graduates or less. Asians reported worse access, lower scores on office staff courtesy and helpfulness and rating their doctors, and were less likely to recommend their doctors to family/friends than did Whites.
AHRQ-funded; HS016980; HS016978.
Citation: Ahmedov M, Pourat N, Liu H .
Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey of experiences with ambulatory healthcare for Asians and non-Hispanic Whites in the United States.
J Patient Rep Outcomes 2021 Mar 24;5(1):29. doi: 10.1186/s41687-021-00303-3..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Racial and Ethnic Minorities, Patient Experience, Quality of Care, Ambulatory Care and Surgery
Post B, Norton EC, Hollenbeck B
Hospital-physician integration and Medicare's site-based outpatient payments.
AHRQ-funded; HS027044.
Citation: Post B, Norton EC, Hollenbeck B .
Hospital-physician integration and Medicare's site-based outpatient payments.
Health Serv Res 2021 Feb;56(1):7-15. doi: 10.1111/1475-6773.13613..
Keywords: Hospitals, Payment, Medicare, Ambulatory Care and Surgery, Healthcare Delivery
Hood-Medland EA, White AEC, Kravitz RL
Agenda setting and visit openings in primary care visits involving patients taking opioids for chronic pain.
This study looked at primary care visit opening styles to assess use of agenda and non-agenda setting visit openings and their effects on participant experience with patients taking opioids for chronic pain. The study analyzed 83 video-recorded US primary care visits at a single academic medical center in California. A total of 49 family medicine and internal resident physicians and 83 patients were filmed. The authors developed a coding scheme that assessed the presence of agenda setting, distinct visit opening styles, and the number of total topics, major topics, surprise patient topics, and returns to prior topics discusses. They identified 2 visit opening styles with agenda setting (agenda eliciting, agenda reframing) and 3 non-agenda opening styles (open-ended question, patient launch, physician launch). Only 11% of visits included agenda setting and was associated with fewer surprise patient topics than visits without agenda setting.
AHRQ-funded; HS022236.
Citation: Hood-Medland EA, White AEC, Kravitz RL .
Agenda setting and visit openings in primary care visits involving patients taking opioids for chronic pain.
BMC Fam Pract 2021 Jan 4;22(1):4. doi: 10.1186/s12875-020-01317-4..
Keywords: Primary Care, Opioids, Medication, Pain, Chronic Conditions, Clinician-Patient Communication, Communication, Ambulatory Care and Surgery
Stephens KA, Ike B, Baldwin LM
Challenges and approaches to population management of long-term opioid therapy patients.
Primary care is challenged with safely prescribing opioids for patients with chronic noncancer pain (CNCP), specifically to address risks for overdose, opioid use disorder, and death. In this study, the investigators identified sociotechnical challenges, approaches, and recommendations in primary care to effectively track and monitor patients on long-term opioid therapy, a key component for supporting adoption of opioid prescribing guidelines.
AHRQ-funded; HS023750.
Citation: Stephens KA, Ike B, Baldwin LM .
Challenges and approaches to population management of long-term opioid therapy patients.
J Am Board Fam Med 2021 Jan-Feb;34(1):89-98. doi: 10.3122/jabfm.2021.01.190100..
Keywords: Opioids, Pain, Chronic Conditions, Care Management, Medication, Primary Care, Ambulatory Care and Surgery
Rinke ML, Heo M, Saiman L
Pediatric ambulatory central line-associated bloodstream infections.
Pediatrics 2021 Jan;147(1). doi: 10.1542/peds.2020-0524.
This study looked at ambulatory pediatric central line-associated bloodstream infection (CLABSI) incidence density, risk factors, and outcomes. This retrospective cohort with nested case-control study used data from 5 sites from 2010 through 2015. Chart review was used to confirm central line (CL) use and adjudicated CLABSIs. Out of 4600 potential at-risk children, 247 (15%) experienced 466 ambulatory CLABSIs. Incidence density was highest among patients with tunneled externalized catheters versus peripherally inserted central catheters and totally implanted devices. Clinic visits and low albumin levels were potentially associated with CLABSI. Prophylactic antimicrobial agents for underlying conditions within the preceding 30 days and operating room CL placement were inversely associated with CLABSI. A total of 396 patients were hospitalized because of ambulatory CLABSI with an 8-day median length of stay.
This study looked at ambulatory pediatric central line-associated bloodstream infection (CLABSI) incidence density, risk factors, and outcomes. This retrospective cohort with nested case-control study used data from 5 sites from 2010 through 2015. Chart review was used to confirm central line (CL) use and adjudicated CLABSIs. Out of 4600 potential at-risk children, 247 (15%) experienced 466 ambulatory CLABSIs. Incidence density was highest among patients with tunneled externalized catheters versus peripherally inserted central catheters and totally implanted devices. Clinic visits and low albumin levels were potentially associated with CLABSI. Prophylactic antimicrobial agents for underlying conditions within the preceding 30 days and operating room CL placement were inversely associated with CLABSI. A total of 396 patients were hospitalized because of ambulatory CLABSI with an 8-day median length of stay.
AHRQ-funded; HS024432.
Citation: Rinke ML, Heo M, Saiman L .
Pediatric ambulatory central line-associated bloodstream infections.
Pediatrics 2021 Jan;147(1). doi: 10.1542/peds.2020-0524..
Keywords: Children/Adolescents, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Ambulatory Care and Surgery, Risk, Sepsis
Shenkman E, Thompson L, Bussing R
AHRQ Author: Mistry KB
Provider specialty and receipt of metabolic monitoring for children taking antipsychotics.
Metabolic monitoring is important for children taking antipsychotic medication, given the risk for increased BMI, impaired glucose metabolism, and hyperlipidemia. The purpose of this study was to examine the influence of provider specialty on the receipt of metabolic monitoring. Specifically, differences in the receipt of recommended care when a child receives outpatient care from a primary care provider (PCP), a mental health provider with prescribing privileges, or both was examined.
AHRQ-authored; AHRQ-funded; HS025298.
Citation: Shenkman E, Thompson L, Bussing R .
Provider specialty and receipt of metabolic monitoring for children taking antipsychotics.
Pediatrics 2021 Jan;147(1):e20200658. doi: 10.1542/peds.2020-0658..
Keywords: Children/Adolescents, Medication: Safety, Medication, Ambulatory Care and Surgery
Sharma AE, Yang J, Del Rosario JB
What safety events are reported for ambulatory care? Analysis of incident reports from a Patient Safety Organization.
Health care staff document patient safety events using incident reporting systems, which are compiled within Patient Safety Organization databases. In this study, researchers sought to describe the patterns and characteristics of incident reporting behaviors for ambulatory care from in-situ reporting systems from the United States. The investigators concluded that outpatient reporting systems were limited for primary care and home/community settings, but ambulatory care systems reported more harmful events related to diagnosis and patient and caregiver challenges.
AHRQ-funded; HS21322.
Citation: Sharma AE, Yang J, Del Rosario JB .
What safety events are reported for ambulatory care? Analysis of incident reports from a Patient Safety Organization.
Jt Comm J Qual Patient Saf 2021 Jan;47(1):5-14. doi: 10.1016/j.jcjq.2020.08.010..
Keywords: Patient Safety, Ambulatory Care and Surgery
Friese CR, Fauer AJ, Kuisell C
Patient-reported outcomes collected in ambulatory oncology practices: feasibility, patterns, and correlates.
The purpose of this study was to examine the feasibility of soliciting outcomes from adults who received chemotherapy treatment for cancer and to describe the patterns and correlates of patient-reported toxicities. Results determined that querying patients on chemotherapy treatment experiences and toxicities was feasible. Toxicity rates varied across practices, informing quality improvement. Toxicity severity and service use incidence exceed previously published trial data, particularly for pain, fatigue, and gastrointestinal issues. Open-text questions enabled exploration with newer treatment regimens.
AHRQ-funded; HS024914.
Citation: Friese CR, Fauer AJ, Kuisell C .
Patient-reported outcomes collected in ambulatory oncology practices: feasibility, patterns, and correlates.
Health Serv Res 2020 Dec;55(6):966-72. doi: 10.1111/1475-6773.13574..
Keywords: Ambulatory Care and Surgery, Cancer, Treatments, Quality of Care, Patient-Centered Outcomes Research, Outcomes
Agniel D, Haviland A, Shekelle P
Distinguishing high-performing health systems using a composite of publicly reported measures of ambulatory care.
The purpose of this study was to develop and evaluate a measure that ranks health care systems by ambulatory care quality. The authors concluded that their measure, using publicly reported data to produce valid, reliable, and stable ranks of ambulatory care quality for health care systems in Minnesota and California, could also be used in other applications.
AHRQ-funded; HS024067.
Citation: Agniel D, Haviland A, Shekelle P .
Distinguishing high-performing health systems using a composite of publicly reported measures of ambulatory care.
Ann Intern Med 2020 Nov 17;173(10):791-98. doi: 10.7326/m20-0718..
Keywords: Health Systems, Ambulatory Care and Surgery, Quality Indicators (QIs), Quality Measures, Quality of Care, Provider Performance, Healthcare Delivery
Rinke ML, Oyeku SO, Ford WJH
Costs of ambulatory pediatric healthcare-associated infections: Central-line-associated bloodstream infection (CLABSIs), catheter-associated urinary tract infection (CAUTIs), and surgical site infections (SSIs).
Ambulatory healthcare-associated infections (HAIs) occur frequently in children and are associated with morbidity. Less is known about ambulatory HAI costs. This retrospective case control study estimated additional costs associated with pediatric ambulatory central-line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTI), and surgical site infections (SSIs) following ambulatory surgery. The authors concluded that ambulatory HAI in pediatric patients were associated with significant additional costs.
AHRQ-funded; HS024432.
Citation: Rinke ML, Oyeku SO, Ford WJH .
Costs of ambulatory pediatric healthcare-associated infections: Central-line-associated bloodstream infection (CLABSIs), catheter-associated urinary tract infection (CAUTIs), and surgical site infections (SSIs).
Infect Control Hosp Epidemiol 2020 Nov;41(11):1292-97. doi: 10.1017/ice.2020.305..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Ambulatory Care and Surgery, Healthcare Costs, Surgery
Yang J, Landrum MB, Zhou L
Disparities in outpatient visits for mental health and/or substance use disorders during the COVID surge and partial reopening in Massachusetts.
The purpose of this study was to examine changes in outpatient visits for mental health and/or substance use disorders (MH/SUD) in an integrated healthcare organization during the initial Massachusetts COVID-19 surge and partial state reopening. The investigators concluded that MH/SUD visit volume increased during the COVID surge and was supported by rapidly-scaled telemedicine.
AHRQ-funded; HS025375.
Citation: Yang J, Landrum MB, Zhou L .
Disparities in outpatient visits for mental health and/or substance use disorders during the COVID surge and partial reopening in Massachusetts.
Gen Hosp Psychiatry 2020 Nov-Dec;67:100-06. doi: 10.1016/j.genhosppsych.2020.09.004..
Keywords: Behavioral Health, Substance Abuse, COVID-19, Disparities, Access to Care, Ambulatory Care and Surgery, Telehealth, Health Information Technology (HIT)
Santosa KB, Keane AM, Keller M
Inpatient versus outpatient management of negative pressure wound therapy in pediatric patients.
Negative pressure wound therapy (NPWT) is commonly used to manage complex wounds in the pediatric population. With recently developed portable NPWT devices, providers have the opportunity to transition NPWT to the outpatient setting. However, there are no studies describing outpatient NPWT in pediatric patients. Therefore, the purpose of this study was to leverage a population-level analysis to advance current knowledge about outpatient NPWT use in pediatric patients.
AHRQ-funded; HS019455.
Citation: Santosa KB, Keane AM, Keller M .
Inpatient versus outpatient management of negative pressure wound therapy in pediatric patients.
J Surg Res 2020 Oct;254:197-205. doi: 10.1016/j.jss.2020.04.025..
Keywords: Children/Adolescents, Injuries and Wounds, Treatments, Care Management, Ambulatory Care and Surgery, Hospitalization
Fischer SH, Rudin RS, Shi Y
Trends in the use of computerized physician order entry by health-system affiliated ambulatory clinics in the United States, 2014-2016.
This study examined trends in the use of computerized physical order entry (CPOE) by health-system affiliated ambulatory clinics from 2014-2016 in the United States. A total of 19,109 ambulatory clinics that participated in all 3 years of the Healthcare Information and Management Systems Society Analytics survey was analyzed. They calculated descriptive statistics to examine overall trends in use, location of order entry, and system-level use of CPOE. The use of CPOE increased from than 9 percentage points from 2015 to 2016, from 58% to 67%. Larger clinics and those affiliated with multi-health hospital systems were more likely to use CPOE.
AHRQ-funded; HS024067.
Citation: Fischer SH, Rudin RS, Shi Y .
Trends in the use of computerized physician order entry by health-system affiliated ambulatory clinics in the United States, 2014-2016.
BMC Health Serv Res 2020 Sep 7;20(1):836. doi: 10.1186/s12913-020-05679-4..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Ambulatory Care and Surgery, Health Systems
McClellan C, Maclean JC, Saloner B
AHRQ Author: McClellan C
Integrated care models and behavioral health care utilization: quasi-experimental evidence from Medicaid health homes.
This study provided the first population-level evidence on the effects of Medicaid health homes (HH) on behavioral health care service use. As of 2016, 16 states had adopted an HH for enrollees with serious mental illness and/or substance use disorder. Using data from the National Survey on Drug Use and Health, the authors found that HH adoption increased service use among enrollees and enrollee self-reported health improved post-HH.
AHRQ-authored.
Citation: McClellan C, Maclean JC, Saloner B .
Integrated care models and behavioral health care utilization: quasi-experimental evidence from Medicaid health homes.
Health Econ 2020 Sep;29(9):1086-97. doi: 10.1002/hec.4027..
Keywords: Behavioral Health, Medicaid, Substance Abuse, Primary Care: Models of Care, Primary Care, Ambulatory Care and Surgery, Patient-Centered Outcomes Research