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
1 to 25 of 33 Research Studies DisplayedLewis CC, Powell BJ, Brewer SK
Advancing mechanisms of implementation to accelerate sustainable evidence-based practice integration: protocol for generating a research agenda.
This article outlines the protocol for an AHRQ-funded initiative to: 1) establish priorities for an agenda to guide research on implementation mechanisms in health and public health, and 2) disseminate the agenda to research, policy, and practice audiences. The goal is to advance mechanisms of implementation to accelerate sustainable evidence-based practice integration. A network of scientific experts will be created to convene in “Deep Dive” meetings for 3 years. The research agenda will be generated through analysis and synthesis of information from 6 sources: (1) systematic reviews, (2) network members' approaches to studying mechanisms, (3) new proposals presented in implementation proposal feedback sessions, (4) working group sessions conducted in a leading implementation research training institute, (5) breakout sessions at the Society for Implementation Research Collaboration's (SIRC) 2019 conference and (6) SIRC conference abstracts. Mechanism-relevant text segments will be extracted by two members and a third member will generate statements as an input for concept mapping.
AHRQ-funded; HS025632.
Citation: Lewis CC, Powell BJ, Brewer SK .
Advancing mechanisms of implementation to accelerate sustainable evidence-based practice integration: protocol for generating a research agenda.
BMJ Open 2021 Oct 18;11(10):e053474. doi: 10.1136/bmjopen-2021-053474..
Keywords: Implementation, Evidence-Based Practice, Research Methodologies, Health Services Research (HSR)
Murphy DR, Savoy A, Satterly T
Dashboards for visual display of patient safety data: a systematic review.
Methods to visualize patient safety data can support effective monitoring of safety events and discovery of trends. While quality dashboards are common, use and impact of dashboards to visualize patient safety event data remains poorly understood. The objective of this study was to understand development, use and direct or indirect impacts of patient safety dashboards. The investigators conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
AHRQ-funded; HS022087; HS022901; HS027363.
Citation: Murphy DR, Savoy A, Satterly T .
Dashboards for visual display of patient safety data: a systematic review.
BMJ Health Care Inform 2021 Oct;28(1). doi: 10.1136/bmjhci-2021-100437..
Keywords: Patient Safety, Health Services Research (HSR)
Bierman AS, Wang J, O'Malley PG
AHRQ Author: Bierman AS, Wang J, O'Malley PG, Moss DK
Transforming care for people with multiple chronic conditions: Agency for Healthcare Research and Quality's research agenda.
This article describes issues addressing the needs of those with multiple chronic conditions and discusses the AHRQ research agenda.
AHRQ-authored.
Citation: Bierman AS, Wang J, O'Malley PG .
Transforming care for people with multiple chronic conditions: Agency for Healthcare Research and Quality's research agenda.
Health Serv Res 2021 Oct;56(Suppl 1):973-79. doi: 10.1111/1475-6773.13863..
Keywords: Chronic Conditions, Health Services Research (HSR), Healthcare Delivery, Quality of Care, Primary Care, Guidelines, Evidence-Based Practice
Yano EM, Resnick A, Gluck M
AHRQ Author: Kwon H, Mistry KB
Accelerating learning healthcare system development through embedded research: career trajectories, training needs, and strategies for managing and supporting embedded researchers.
Health systems and organizations seeking to achieve learning healthcare system principles are increasingly relying on embedded research teams to optimize delivery of evidence-based, high-quality care that improves patient and staff experience alike. In February 2018, 115 attendees from multiple agencies, institutions and professional societies participated in a conference to accelerate development of learning healthcare systems through embedded research. This paper describes the process.
AHRQ-authored.
Citation: Yano EM, Resnick A, Gluck M .
Accelerating learning healthcare system development through embedded research: career trajectories, training needs, and strategies for managing and supporting embedded researchers.
Healthc 2021 Jun;8(Suppl 1):100479. doi: 10.1016/j.hjdsi.2020.100479..
Keywords: Learning Health Systems, Health Systems, Health Services Research (HSR)
Shortell SM, Gottlieb DJ, Martinez Camblor P
Hospital-based health systems 20 years later: a taxonomy for policy research and analysis.
Building on the original taxonomy of hospital-based health systems from 20 years ago, the investigators developed a new taxonomy to inform emerging public policy and practice developments. The study design included a cluster analysis of the 2016 AHA Annual Survey data to derive measures of differentiation, centralization, and integration to create categories or types of hospital-based health systems.
AHRQ-funded; HS024075.
Citation: Shortell SM, Gottlieb DJ, Martinez Camblor P .
Hospital-based health systems 20 years later: a taxonomy for policy research and analysis.
Health Serv Res 2021 Jun;56(3):453-63. doi: 10.1111/1475-6773.13621..
Keywords: Hospitals, Health Systems, Health Services Research (HSR), Policy
Sanghavi P, Jena AB, Newhouse JP
Identifying outlier patterns of inconsistent ambulance billing in Medicare.
The objective of this study was to illustrate a method that accounts for sampling variation in identifying suppliers and counties with outlying rates of a particular pattern of inconsistent billing for ambulance services to Medicare. The investigators concluded that health care fraud and abuse were frequently asserted but could be difficult to detect. They suggested that their data-driven approach may be a useful starting point for further investigation.
AHRQ-funded; 6HS022798; HS025720.
Citation: Sanghavi P, Jena AB, Newhouse JP .
Identifying outlier patterns of inconsistent ambulance billing in Medicare.
Health Serv Res 2021 Apr;56(2):188-92. doi: 10.1111/1475-6773.13622..
Keywords: Medicare, Payment, Health Services Research (HSR)
Sood E, Wysocki T, Alderfer MA
Topical review: crowdsourcing as a novel approach to qualitative research.
The purpose of this paper was to describe a novel, five-phase approach to collecting qualitative data from hard-to-reach populations using crowdsourcing methods. The phases of crowdsourcing methodology described were: (I) Preparing; (II) Forming Crowds; (III) Collecting Crowdsourced Data; (IV) Coding and Analyzing Crowdsourced Data; and (V) Generating and Disseminating Findings. The investigators concluded that crowdsourcing is an innovative, efficient, feasible, and timely approach to engaging hard-to-reach populations in qualitative research.
AHRQ-funded; HS026393.
Citation: Sood E, Wysocki T, Alderfer MA .
Topical review: crowdsourcing as a novel approach to qualitative research.
J Pediatr Psychol 2021 Feb 19;46(2):189-96. doi: 10.1093/jpepsy/jsaa096..
Keywords: Health Services Research (HSR), Research Methodologies
Rodriguez PJ, Ward ZJ, Long MW
Applied methods for estimating transition probabilities from electronic health record data.
This study examined the usefulness of electronic health records (EHRs) in estimating transition probabilities for state-transition models. No guidelines exist on appropriate methods. The authors used 3 potential methods to estimate transition probabilities for EHR data, using pediatric eating disorders (EDs) as a case study. They mapped diagnoses to 3 ED health states: anorexia nervous, bulimia nervosa, and other specified feeding or eating disorder using data from PEDsnet, which includes 8 US children’s hospitals. They used 3 approaches: simple first-last proportions, a multistate Markov (MSM) model, and independent survival models. The first-last proportion approach estimated higher probabilities of remaining the same health state, while the other two approaches estimated higher probabilities of transitioning to a different health state. Published literature differed substantially from these estimates. Further research is needed to improve methods for using EHR data to inform transition probabilities.
AHRQ-funded; HS013853.
Citation: Rodriguez PJ, Ward ZJ, Long MW .
Applied methods for estimating transition probabilities from electronic health record data.
Med Decis Making 2021 Feb;41(2):143-52. doi: 10.1177/0272989x20985752..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Research Methodologies
Shu D, Han P, Wang R, Toh S. D, Han P, Wang R
Estimating the marginal hazard ratio by simultaneously using a set of propensity score models: a multiply robust approach.
The inverse probability weighted Cox model is frequently used to estimate the marginal hazard ratio. Its validity requires a crucial condition that the propensity score model be correctly specified. To provide protection against misspecification of the propensity score model, the investigators proposed a weighted estimation method rooted in the empirical likelihood theory. They applied the proposed method to compare the risk of postoperative hospitalization between sleeve gastrectomy and Roux-en-Y gastric bypass using data from a large medical claims and billing database.
AHRQ-funded; HS026214.
Citation: Shu D, Han P, Wang R, Toh S. D, Han P, Wang R .
Estimating the marginal hazard ratio by simultaneously using a set of propensity score models: a multiply robust approach.
Stat Med 2021 Feb;40(5):1224-42. doi: 10.1002/sim.8837..
Keywords: Research Methodologies, Health Services Research (HSR)
Kuo YF, Lin YL, D Jupiter, et al.
How to identify team-based primary care in the United States using Medicare data.
The authors assessed whether analyses using different sets of Medicare data can produce results similar to those from analyses using 100% data from an entire state in identifying primary care teams through social network analysis. They found that, depending on specific study purposes, researchers could use either 100% data from Medicare beneficiaries in randomly selected primary care services areas or data from a 20% national sample of Medicare beneficiaries to study team-based primary care in the United States.
AHRQ-funded; HS020642.
Citation: Kuo YF, Lin YL, D Jupiter, et al..
How to identify team-based primary care in the United States using Medicare data.
Med Care 2021 Feb;59(2):118-22. doi: 10.1097/mlr.0000000000001478.
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Keywords: Teams, Primary Care: Models of Care, Primary Care, Medicare, Health Services Research (HSR), Healthcare Delivery
Thompson HM
Stakeholder experiences with gender identity data capture in electronic health records: implementation effectiveness and a visibility paradox.
Advocates have endorsed transgender visibility via gender identity (GI) data capture with the advent of the Affordable Care Act and electronic health record (EHR) requirements. Visibility in data in order to enumerate a population contrasts with ways in which other LGBT and public health scholars have deployed these concepts. This article aims to assess the effectiveness of GI data capture in EHRs and implications for trans health care quality improvements and research.
AHRQ-funded; HS026385.
Citation: Thompson HM .
Stakeholder experiences with gender identity data capture in electronic health records: implementation effectiveness and a visibility paradox.
Health Educ Behav 2021 Feb;48(1):93-101. doi: 10.1177/1090198120963102.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Vulnerable Populations, Sex Factors
McIntosh S, Cirillo D, Wood N
Patient evaluation of an acute care pediatric telemedicine service in urban neighborhoods.
The authors characterized health problems prompting neighborhood telemedicine use and to assessed parent perceptions of its value. They found that family preferences and the high value placed on neighborhood telemedicine suggest such service is important, and that service provided by neighborhood telemedicine holds potential to meet a large demand for care of acute childhood illness.
AHRQ-funded; HS018912.
Citation: McIntosh S, Cirillo D, Wood N .
Patient evaluation of an acute care pediatric telemedicine service in urban neighborhoods.
Telemed J E Health 2014 Dec;20(12):1121-6. doi: 10.1089/tmj.2014.0032.
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Keywords: Children/Adolescents, Health Services Research (HSR), Patient Experience, Telehealth, Urban Health
Bradford WD, Lastrapes WD
A prescription for unemployment? Recessions and the demand for mental health drugs.
The authors estimated the relationship between mental health drug prescriptions and the level of labor market activity in the USA. They found that the number of mental health drug prescriptions rises by about 10% when employment falls by 1% and when unemployment rises by 100 basis points, but only for patients in the Northeast region.
AHRQ-funded; HS011326.
Citation: Bradford WD, Lastrapes WD .
A prescription for unemployment? Recessions and the demand for mental health drugs.
Health Econ 2014 Nov;23(11):1301-25. doi: 10.1002/hec.2983.
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Keywords: Medication, Healthcare Utilization, Health Services Research (HSR), Behavioral Health
Guise JM, Chang C, Viswanathan M
AHRQ Author: Chang C, Berliner E
Agency for Healthcare Research and Quality Evidence-based Practice Center methods for systematically reviewing complex multicomponent health care interventions.
The purpose of this AHRQ EPC methods white paper was to outline approaches to conducting systematic reviews of complex multicomponent health care interventions. It provided a framework for synthesizing studies of multicomponent interventions and also provided an initial list of critical reporting elements for such studies in order to help systematic reviewers understand the options and tradeoffs available for such reviews.
AHRQ-authored; AHRQ-funded; 290201200010I; 290201200012I; 290201200011I; 290201200015I; 290201200008I; 290201200004C.
Citation: Guise JM, Chang C, Viswanathan M .
Agency for Healthcare Research and Quality Evidence-based Practice Center methods for systematically reviewing complex multicomponent health care interventions.
J Clin Epidemiol 2014 Nov;67(11):1181-91. doi: 10.1016/j.jclinepi.2014.06.010.
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Keywords: Evidence-Based Practice, Healthcare Delivery, Health Services Research (HSR), Patient-Centered Outcomes Research, Research Methodologies
Mutter R, Stocks C
AHRQ Author: Stocks C
Using Healthcare Cost and Utilization Project (HCUP) data for emergency medicine research.
This article mentions Kocher et al., elsewhere in this issue, who use the HCUP Nationwide Inpatient Sample to examine the association between the volume of ED encounters that result in admission and inpatient mortality. It further discusses HCUP strengths, weaknesses, and future.
AHRQ-authored.
Citation: Mutter R, Stocks C .
Using Healthcare Cost and Utilization Project (HCUP) data for emergency medicine research.
Ann Emerg Med 2014 Nov;64(5):458-60. doi: 10.1016/j.annemergmed.2014.09.014.
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Keywords: Emergency Medical Services (EMS), Healthcare Costs, Healthcare Delivery, Health Services Research (HSR), Healthcare Cost and Utilization Project (HCUP)
Larson EL, Cohen B, Murray M
Challenges in conducting research in pediatric long-term care facilities.
The purposes of this article are to describe the challenges associated with conducting research in pediatric long-term care facilities (LTCFs) and to recommend approaches to build a successful collaborative relationship between the clinical and administrative staff in LTCFs and the academic research team.
AHRQ-funded; HS021470.
Citation: Larson EL, Cohen B, Murray M .
Challenges in conducting research in pediatric long-term care facilities.
Clin Pediatr 2014 Oct;53(11):1041-6. doi: 10.1177/0009922814540986..
Keywords: Children/Adolescents, Long-Term Care, Health Services Research (HSR)
Gold R, Bailey SR, O'Malley JP
Estimating demand for care after a Medicaid expansion: lessons from Oregon.
In order to estimate how the Affordable Care Act's Medicaid expansions will affect demand for services, the authors measured ambulatory care utilization among adult patients who gained insurance during Oregon's 2008 Medicaid expansion. They found that, in comparisons of the pre- and postcoverage periods, the mean annual encounters among persons who gained insurance increased 22% to 35%, but declined in the comparison groups.
AHRQ-funded; HS021522.
Citation: Gold R, Bailey SR, O'Malley JP .
Estimating demand for care after a Medicaid expansion: lessons from Oregon.
J Ambul Care Manage 2014 Oct-Dec;37(4):282-92. doi: 10.1097/jac.0000000000000023.
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Keywords: Access to Care, Healthcare Utilization, Policy, Health Services Research (HSR), Medicaid
Damberg CL, McNamara P
AHRQ Author: McNamara P
Postscript: research agenda to guide the next generation of public reports for consumers.
The authors identified five areas for additional public reporting tools research that, if addressed, could foster better design and delivery of quality and cost information to consumers.
AHRQ-authored.
Citation: Damberg CL, McNamara P .
Postscript: research agenda to guide the next generation of public reports for consumers.
Med Care Res Rev 2014 Oct;71(5 Suppl):97s-107s. doi: 10.1177/1077558714535982.
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Keywords: Education: Patient and Caregiver, Shared Decision Making, Quality of Care, Health Services Research (HSR), Public Reporting
Horner-Johnson W, Fujiura GT, Goode TD
Promoting a new research agenda: health disparities research at the intersection of disability, race, and ethnicity.
This article introduces a special issue of Medical Care that seeks to bridge the gap between research on racial and ethnic disparities and research on disability-related health disparities. The papers examine evidence of racial and ethnic disparities within various populations of people with disabilities, and explore unique issues at the intersection of disability, race, and ethnicity.
AHRQ-funded; HS021920
Citation: Horner-Johnson W, Fujiura GT, Goode TD .
Promoting a new research agenda: health disparities research at the intersection of disability, race, and ethnicity.
Med Care. 2014 Oct;52(10 Suppl 3):S1-2. doi: 10.1097/MLR.0000000000000220..
Keywords: Disparities, Racial and Ethnic Minorities, Health Services Research (HSR)
Mistry KB, Chesley F, Llanos K
AHRQ Author: Mistry KB, Chesley F, Dougherty D.
Advancing children's health care and outcomes through the pediatric quality measures program.
This article focuses on the Pediatric Quality Measures Program and provides an overview of the program's goals and related activities, lessons learned, and future opportunities.
AHRQ-authored.
Citation: Mistry KB, Chesley F, Llanos K .
Advancing children's health care and outcomes through the pediatric quality measures program.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S19-26. doi: 10.1016/j.acap.2014.06.025.
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Keywords: Children's Health Insurance Program (CHIP), Quality of Care, Health Services Research (HSR), Children/Adolescents, Quality Measures
Dougherty D, Mistry KB, Llanos K
AHRQ Author: Dougherty D, Mistry KB, Chesley F
An AHRQ and CMS perspective on the pediatric quality measures program.
This article describes the Pediatric Quality Measures Program (PQMP). The PQMP has worked to close gaps in children’s health care quality by increasing the portfolio of new measures and methods as envisioned by the CHIPRA legislation. It is the adoption and use of these measures that can lead to improvements in the quality of care and elimination of disparities in health care for children over time.
AHRQ-authored.
Citation: Dougherty D, Mistry KB, Llanos K .
An AHRQ and CMS perspective on the pediatric quality measures program.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S17-8. doi: 10.1016/j.acap.2014.06.017.
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Keywords: Children's Health Insurance Program (CHIP), Quality of Care, Health Services Research (HSR), Children/Adolescents, Quality Measures
Forrest CB, Silber JH
Concept and measurement of pediatric value.
The authors investigate providing information on pediatric value, which will require new investments in data collection systems that include outcomes that matter to children and families and costs measured at the level of the child. They discuss analysis of these data to account for the perspective of the user of the information. They recommend that, in the case of families, direct standardization be used to contrast care in one health care system with another according to the unique characteristics of each family and child.
AHRQ-funded; HS020408.
Citation: Forrest CB, Silber JH .
Concept and measurement of pediatric value.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S33-8. doi: 10.1016/j.acap.2014.03.013.
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Keywords: Children/Adolescents, Health Services Research (HSR), Quality Measures, Quality Measures, Children/Adolescents
Jaana M, Vartak S, Ward MM
Evidence-based health care management: what is the research evidence available for health care managers?
The authors conducted a scoping review of systematic reviews and meta-analyses to determine the availability and accessibility of evidence for health care managers. They found that 96.5% of their search results were not on target, and they suggested a better classification within PubMed to increase the accessibility of meaningful resources and to facilitate evidence retrieval. They recommended that health care journals take initiatives encouraging the publication of reviews in relevant management areas.
AHRQ-funded; HS018396.
Citation: Jaana M, Vartak S, Ward MM .
Evidence-based health care management: what is the research evidence available for health care managers?
Eval Health Prof 2014 Sep;37(3):314-34. doi: 10.1177/0163278713511325.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Research Methodologies
Dougherty D, Mistry KB, Lindly O
AHRQ Author: Dougherty D, Mistry KB, Desoto M, Chesley F
Systematic evidence-based quality measurement life-cycle approach to measure retirement in CHIPRA.
The authors assessed selected child core set (CCS) measures for potential retirement. The Subcommittee of the National Advisory Council on Healthcare Research and Quality recommended 3 measures for retirement: access to primary care; testing for strep before recommending antibiotics for pharyngitis; and annual HbA1c testing of children with diabetes. CMS recommended that state Medicaid and CHIP programs retire 2 of the recommended measures from the CCS, but retained the access to primary care measure.
AHRQ-authored.
Citation: Dougherty D, Mistry KB, Lindly O .
Systematic evidence-based quality measurement life-cycle approach to measure retirement in CHIPRA.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S97-s103. doi: 10.1016/j.acap.2014.06.015.
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Keywords: Children's Health Insurance Program (CHIP), Quality of Care, Health Services Research (HSR), Children/Adolescents, Quality Measures
Holzer JK, Ellis L, Merritt MW
Why we need community engagement in medical research.
The aim of this article was to illustrate how community engagement can help to remedy shortfalls of community trust, participant enrollment, and uptake of research findings. After briefly describing these shortfalls, the authors considered 3 case examples that demonstrate the potential of community engagement to address each. They also discussed the ethical importance and implications of demonstrating respect for the community.
AHRQ-funded; HS017589.
Citation: Holzer JK, Ellis L, Merritt MW .
Why we need community engagement in medical research.
J Investig Med 2014 Aug;62(6):851-5. doi: 10.1097/jim.0000000000000097..
Keywords: Health Services Research (HSR), Patient-Centered Outcomes Research, Research Methodologies, Implementation