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 195 Research Studies DisplayedHaukoos JS, Campbell JD, Conroy AA
Programmatic cost evaluation of nontargeted opt-out rapid HIV screening in the emergency department.
The researchers estimated the total direct costs associated with performing nontargeted opt-out rapid HIV screening in the emergency department per newly-identified HIV-infected patients and compared such costs to those associated with diagnostic rapid HIV testing. They found that compared to diagnostic testing, nontargeted opt-out rapid HIV screening was more costly but identified more HIV infections.
AHRQ-funded; HS017526
Citation: Haukoos JS, Campbell JD, Conroy AA .
Programmatic cost evaluation of nontargeted opt-out rapid HIV screening in the emergency department.
PLoS One. 2013 Dec 31;8(12):e81565. doi: 10.1371/journal.pone.0081565..
Keywords: Comparative Effectiveness, Human Immunodeficiency Virus (HIV), Emergency Medical Services (EMS), Healthcare Costs
Zurovac J, Moreno L, Crosson J
Using multifactorial experiments for comparative effectiveness research in physician practices with electronic health record.
This paper identifies the opportunities for using efficient multifactorial designs and electronic health records (EHR) data to evaluate quality-improvement efforts in physician practices. It concludes that the use of efficient multifactor experimental designs, especially coupled with EHR data, has great promise for helping physician practices, hospitals, and other stakeholders conduct rapid-cycle comparative effectiveness research in order to assess alternative ways of implementing various aspects of care.
AHRQ-funded; HS022789.
Citation: Zurovac J, Moreno L, Crosson J .
Using multifactorial experiments for comparative effectiveness research in physician practices with electronic health record.
eGEMS 2013 Dec 30;1(3):1037. doi: 10.13063/2327-9214.1037..
Keywords: Patient-Centered Outcomes Research, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Comparative Effectiveness
Samji H, Cescon A, Hogg RS
Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada.
The researchers estimated changes in life expectancy among HIV-positive adults on antiretroviral therapy (ART) from 2000–2007 in the U.S. and Canada. They concluded that a 20-year-old HIV-positive adult on ART in the U.S. or Canada is expected to live into their early 70s, a life expectancy approaching that of the general population. Differences by sex, race, HIV transmission risk group, and CD4 count remain.
AHRQ-funded; 290010012.
Citation: Samji H, Cescon A, Hogg RS .
Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada.
PLoS One 2013 Dec 18;8(12):e81355. doi: 10.1371/journal.pone.0081355..
Keywords: Human Immunodeficiency Virus (HIV), Mortality
Minden SL, Ding L, Cleary PD
Improving the quality of mental health care in multiple sclerosis.
The researchers surveyed multiple sclerosis (MS) patients across the U.S. to determine how many experienced mental health problems and received treatment over the preceding year. Also studied were patient experiences with and ratings of care, type of treatment provider, and the location of care. The researchers found a high unmet need for mental health treatment among persons with MS.
AHRQ-funded; HS016978
Citation: Minden SL, Ding L, Cleary PD .
Improving the quality of mental health care in multiple sclerosis.
J Neurol Sci. 2013 Dec 15;335(1-2):42-7. doi: 10.1016/j.jns.2013.08.021..
Keywords: Behavioral Health, Quality of Care, Chronic Conditions
Kuzniewicz MW, Wickremasinghe AC, Newman TB
Invited commentary: does neonatal hyperbilirubinemia cause asthma?
The researchers examined whether an association between neonatal total serum bilirubin levels and childhood asthma is causal. They found that the results do not appear to be due to chance or any obvious biases. It is likely that the observed association is the result of a common cause of both hyperbilirubinemia and asthma confounding. Polymorphisms in the glutathione S-transferase gene are a potential genetic confounder.
AHRQ-funded; HS020618
Citation: Kuzniewicz MW, Wickremasinghe AC, Newman TB .
Invited commentary: does neonatal hyperbilirubinemia cause asthma?
Am J Epidemiol 2013 Dec 15;178(12):1698-701. doi: 10.1093/aje/kwt249..
Keywords: Asthma, Children/Adolescents, Children/Adolescents
Jiang W, Li P, Wang S
WebGLORE: a web service for Grid LOgistic Regression.
This article describes and discusses WebGLORE, a free web service enabling privacy-preserving construction of a global logistic regression model from sensitive distributed datasets using HTTP to a trusted server, where the model is synthesized.
AHRQ-funded; HS019564.
Citation: Jiang W, Li P, Wang S .
WebGLORE: a web service for Grid LOgistic Regression.
Bioinformatics. 2013 Dec 15;29(24):3238-40. doi: 10.1093/bioinformatics/btt559..
Keywords: Data, Health Information Technology (HIT), Web-Based
Schiff GD, Puopolo AL, Huben-Kearney A
Primary care closed claims experience of Massachusetts malpractice insurers.
The researchers studied patterns of primary care malpractice types, causes, and outcomes as part of a Massachusetts ambulatory malpractice risk and safety improvement project. During a 5-year period there were 7224 malpractice claims of which 551 (7.7%) were from primary care practices. In Massachusetts, most primary care claims filed were related to alleged misdiagnosis.
AHRQ-funded; HS019508.
Citation: Schiff GD, Puopolo AL, Huben-Kearney A .
Primary care closed claims experience of Massachusetts malpractice insurers.
JAMA Intern Med 2013 Dec 9-23;173(22):2063-8. doi: 10.1001/jamainternmed.2013.11070..
Keywords: Primary Care, Medical Errors, Health Insurance, Patient Safety, Medical Liability
Schwitzer G
Addressing tensions when popular media and evidence-based care collide.
This paper documents recurring problems in media messages about health-care interventions and offers suggestions for new or expanded efforts to improve the public dialogue about health care. It concluded that inaccurate, imbalanced, incomplete news stories may drown out more careful scrutiny of the evidence by many influential news organizations.
AHRQ-funded; 290200810015C
Citation: Schwitzer G .
Addressing tensions when popular media and evidence-based care collide.
BMC Med Inform Decis Making 2013;13 Suppl 3:S3. doi: 10.1186/1472-6947-13-s3-s3..
Keywords: Communication, Education: Patient and Caregiver, Evidence-Based Practice
Starmer AJ, Sectish TC, Simon DW
Rates of medical errors and preventable adverse events among hospitalized children following implementation of a resident handoff bundle.
The researchers sought to determine whether introduction of a multifaceted handoff program was associated with reduced rates of medical errors and preventable adverse events, fewer omissions of key data in written handoffs, improved verbal handoffs, and changes in resident-physician workflow. They found that implementation of a handoff bundle was associated with a significant reduction in medical errors and preventable adverse events among hospitalized children.
AHRQ-funded; HS019456.
Citation: Starmer AJ, Sectish TC, Simon DW .
Rates of medical errors and preventable adverse events among hospitalized children following implementation of a resident handoff bundle.
JAMA 2013 Dec 4;310(21):2262-70. doi: 10.1001/jama.2013.281961..
Keywords: Medical Errors, Adverse Events, Children/Adolescents, Hospitalization, Patient Safety
Gilbert AL, Bauer NS, Carroll AE
Child exposure to parental violence and psychological distress associated with delayed milestones.
The researchers examined the association between parental report of intimate partner violence (IPV) and parental psychological distress (PPD) with child attainment of developmental milestones. They found that parental report of both IPV and PPD during the first 72 months of a child’s life is significantly associated with developmental milestone failure across all 4 developmental domains and within the domains of language, personal-social, and gross motor development.
AHRQ-funded; HS017939; HS018453.
Citation: Gilbert AL, Bauer NS, Carroll AE .
Child exposure to parental violence and psychological distress associated with delayed milestones.
Pediatrics 2013 Dec;132(6):e1577-83. doi: 10.1542/peds.2013-1020..
Keywords: Children/Adolescents, Domestic Violence, Family Health and History, Depression, Anxiety, Behavioral Health
Hwang SW, Chambers C, Chiu S
A comprehensive assessment of health care utilization among homeless adults under a system of universal health insurance.
The researchers comprehensively assessed health care utilization in a population-based sample of homeless adults and matched controls under a universal health insurance system. They found that homeless people had substantially higher rates of ED and hospital use than general population controls; these rates were largely driven by a subset of homeless persons with extremely high-intensity usage of health services.
AHRQ-funded; HS014129.
Citation: Hwang SW, Chambers C, Chiu S .
A comprehensive assessment of health care utilization among homeless adults under a system of universal health insurance.
Am J Public Health 2013 Dec;103 Suppl 2:S294-301. doi: 10.2105/ajph.2013.301369..
Keywords: Healthcare Utilization, Social Determinants of Health, Emergency Department, Emergency Medical Services (EMS)
Jensen JD, Krakow M, John KK
Against conventional wisdom: when the public, the media, and medical practice collide.
In 2009, the U.S. Preventive Services Task Force released new mammography screening guidelines that sparked a torrent of criticism. The goal of this article is to articulate how conflicts of this type arise and to review possible means of redress. The authors concluded that science is routinely simplified as it is prepared for public consumption. In line with the model of information overload, this practice may increase short-term adherence to recommendations at the expense of long-term message consistency and trust in science.
AHRQ-funded; 290200810015C
Citation: Jensen JD, Krakow M, John KK .
Against conventional wisdom: when the public, the media, and medical practice collide.
BMC Med Inform Decis Making 2013;13 Suppl 3:S4. doi: 10.1186/1472-6947-13-s3-s4..
Keywords: Communication, Evidence-Based Practice, Guidelines, Health Services Research (HSR), U.S. Preventive Services Task Force (USPSTF)
Rosenberg JH, Albrecht JS, Fromme EK
Antimicrobial use for symptom management in patients receiving hospice and palliative care: a systematic review.
This systematic review found that limited data are available on the use of antimicrobial therapy for symptom management among patients receiving palliative or hospice care. The lack of comparison between patients who did and did not receive antimicrobial therapy means that there is no accurate estimate of the effectiveness of antimicrobial therapy.
AHRQ-funded; HS021068
Citation: Rosenberg JH, Albrecht JS, Fromme EK .
Antimicrobial use for symptom management in patients receiving hospice and palliative care: a systematic review.
J Palliat Med. 2013 Dec;16(12):1568-74. doi: 10.1089/jpm.2013.0276..
Keywords: Comparative Effectiveness, Antimicrobial Stewardship, Long-Term Care, Palliative Care, Outcomes
Fain K, Alexander GC
Are Food and Drug Administration prescription drug safety plans working? A case study of isotretinoin.
The authors comment on a case study analyzing pharmacy claims in order to examine the impact of the iPledge program (an FDA restricted distribution plan that included electronic registration of patients, physicians, and pharmacists plus monitoring of contraceptive use) on contraceptive use for women of childbearing age taking isotretinoin (Accutane). This drug, used for acute acne, could affect fetal development. The limited effectiveness of the program shows the difficulty of changing patient behavior.
AHRQ-funded; HS0189960
Citation: Fain K, Alexander GC .
Are Food and Drug Administration prescription drug safety plans working? A case study of isotretinoin.
Pharmacoepidemiol Drug Saf. 2013 Dec;22(12):1258-62. doi: 10.1002/pds.3514..
Keywords: Patient Safety, Medication: Safety, Medication, Health Information Technology (HIT), Women
Hellinger FJ
AHRQ Author: Hellinger FJ
Assessing the cost effectiveness of pre-exposure prophylaxis for HIV prevention in the US.
In order to assess the cost-effectiveness of pre-exposure prophylaxis for HIV prevention in the U.S., the author evaluates various studies and finds that they yield widely varying estimates of the cost per quality-adjusted life year (QALY) gained, and that this variations reflects the substantial uncertainty surrounding the determinants of HIV transmission as well as different approaches to translating a reduction in HIV cases into an estimate of the increase in the number of QALYs.
AHRQ-authored.
Citation: Hellinger FJ .
Assessing the cost effectiveness of pre-exposure prophylaxis for HIV prevention in the US.
Pharmacoeconomics. 2013 Dec;31(12):1091-104. doi: 10.1007/s40273-013-0111-0..
Keywords: Human Immunodeficiency Virus (HIV), Healthcare Costs, Quality of Life, Healthcare Costs, Prevention
Schumacher JR, Palta M, Loconte NK
Characterizing the psychological distress response before and after a cancer diagnosis.
The purpose of this study was to estimate the magnitude and long-term temporal course of the cancer psychological distress response, incorporating negative (depression and anxiety) and positive (psychological well-being). Cancer survivors were more likely to experience clinically significant increases in depression and anxiety, with no significant results being found for well-being.
AHRQ-funded; HS00083
Citation: Schumacher JR, Palta M, Loconte NK .
Characterizing the psychological distress response before and after a cancer diagnosis.
J Behav Med. 2013 Dec;36(6):591-600. doi: 10.1007/s10865-012-9453-x..
Keywords: Cancer, Behavioral Health, Quality of Life
Moy E, Mau MK, Raetzman S
AHRQ Author: Moy E, Andrews R
Ethnic differences in potentially preventable hospitalizations among Asian Americans, Native Hawaiians, and other Pacific Islanders: implications for reducing health care disparities.
This study aimed to produce reliable estimates of health care quality among Native Hawaiian (NH), Other Pacific Islander (PI), and Asian American (AA) small population subgroups. Results showed that, despite efforts to reduce racial/ethnic health care disparities, significant gaps remain in potentially preventable hospitalization rates.
AHRQ-authored.
Citation: Moy E, Mau MK, Raetzman S .
Ethnic differences in potentially preventable hospitalizations among Asian Americans, Native Hawaiians, and other Pacific Islanders: implications for reducing health care disparities.
Ethn Dis 2013 Winter;23(1):6-11.
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Keywords: Disparities, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Quality Indicators (QIs), Racial and Ethnic Minorities
Taha J, Czaja SJ, Sharit J
Factors affecting usage of a personal health record (PHR) to manage health.
This study evaluated the ability of middle-aged and older adults to use a simulated electronic personal health record (PHR) to perform 15 common health management tasks including medication management, interpretation of lab results, and health maintenance activities. Participants in both age groups experienced significant difficulties in using the PHR, with older adults with lower numeracy and technology experience having greater problems.
AHRQ-funded; HS018239
Citation: Taha J, Czaja SJ, Sharit J .
Factors affecting usage of a personal health record (PHR) to manage health.
Psychol Aging. 2013 Dec;28(4):1124-39. doi: 10.1037/a0033911..
Keywords: Electronic Health Records (EHRs), Elderly, Health Information Technology (HIT), Patient Self-Management
Bao Y, Ryan AM, Shao H
Generic initiation and antidepressant therapy adherence under Medicare Part D.
This study assessed the effects of initiating antidepressant treatment with a generic versus a branded prescription (generic initiation) on adherence to antidepressant therapy for the treatment of depression. It found that starting patients with generics had benefits for antidepressant adherence by lowering out-of-pocket costs for all patients and by mitigating the effect of the Part D coverage gap faced by patients not receiving low-income subsidies.
AHRQ-funded; HS018546.
Citation: Bao Y, Ryan AM, Shao H .
Generic initiation and antidepressant therapy adherence under Medicare Part D.
Am J Manag Care 2013 Dec;19(12):989-98..
Keywords: Medication, Depression, Medicare, Patient Adherence/Compliance
Letourneau AR, Calderwood MS, Huang SS
Harnessing claims to improve detection of surgical site infections following hysterectomy and colorectal surgery.
The researchers conducted retrospective cohort studies at 2 academic medical centers, extending analyses of patients undergoing hysterectomy or colorectal surgery. They concluded that claims-enhanced surveillance can help to identify surgical site infections (SSIs) missed by routine surveillance, identifying nearly twice as many SSIs following hysterectomy and 4 times more SSIs following colorectal surgery.
AHRQ-funded; HS021424.
Citation: Letourneau AR, Calderwood MS, Huang SS .
Harnessing claims to improve detection of surgical site infections following hysterectomy and colorectal surgery.
Infect Control Hosp Epidemiol 2013 Dec;34(12):1321-3. doi: 10.1086/673975..
Keywords: Healthcare-Associated Infections (HAIs), Injuries and Wounds, Surgery, Patient Safety, Adverse Events, Women, Digestive Disease and Health
Shapiro JS, Johnson SA, Angiollilo J
Health information exchange improves identification of frequent emergency department users.
The goal of the project was to measure the incremental increase in the number of frequent ED users who were identified when data
from all EDs participating in an health information exchange were compared with site-specific data. When the researchers analyzed HIE-wide data instead of site-specific data, they identified 20.3 percent more frequent ED users and 16.0 percent more visits by them to the ED.
from all EDs participating in an health information exchange were compared with site-specific data. When the researchers analyzed HIE-wide data instead of site-specific data, they identified 20.3 percent more frequent ED users and 16.0 percent more visits by them to the ED.
AHRQ-funded; HS021261.
Citation: Shapiro JS, Johnson SA, Angiollilo J .
Health information exchange improves identification of frequent emergency department users.
Health Aff 2013 Dec;32(12):2193-8. doi: 10.1377/hlthaff.2013.0167..
Keywords: Data, Emergency Department, Healthcare Utilization, Health Information Exchange (HIE), Health Information Technology (HIT)
Chambers C, Chiu S, Katic M
High utilizers of emergency health services in a population-based cohort of homeless adults.
This study identified predictors of frequent emergency department (ED) use among a population-based sample of homeless adults in Toronto, Ontario. It found that among homeless adults with universal health insurance, a small subgroup accounted for the majority of visits to emergency services. Frequent use was driven by multiple predisposing, enabling, and need factors.
AHRQ-funded; HS014129.
Citation: Chambers C, Chiu S, Katic M .
High utilizers of emergency health services in a population-based cohort of homeless adults.
Am J Public Health 2013 Dec;103 Suppl 2:S302-10. doi: 10.2105/ajph.2013.301397..
Keywords: Emergency Department, Social Determinants of Health, Health Insurance, Healthcare Utilization
Stuart B, Davidoff A, Erten M
AHRQ Author: Davidoff A
How Medicare Part D benefit phases affect adherence with evidence-based medications following acute myocardial infarction.
The authors assessed the impact of Medicare Part D benefit phases on adherence with evidence-based medications after hospitalization for an acute myocardial infarction (AMI). They found that as the Part D doughnut hole is gradually filled in by 2020, Medicare Part D enrollees with critical diseases such as AMI who rely heavily on brand name drugs are likely to exhibit modest increases in adherence, while those reliant on generic drugs are less likely to be affected.
AHRQ-authored.
Citation: Stuart B, Davidoff A, Erten M .
How Medicare Part D benefit phases affect adherence with evidence-based medications following acute myocardial infarction.
Health Serv Res 2013 Dec;48(6 Pt 1):1960-77. doi: 10.1111/1475-6773.12073.
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Keywords: Evidence-Based Practice, Medicare, Medication, Heart Disease and Health, Patient Adherence/Compliance
Bergeron AR, Webb JR, Serper M
Impact of electronic prescribing on medication use in ambulatory care.
This study investigated differences before and after rollout of electronic prescribing (e-prescribing) in (1) patients’ primary adherence to newly prescribed medications, (2) patients' understanding of how to use their medications, and (3) multiple pharmacy use. It found an increase in abandoned prescriptions immediately following the implementation of e-prescribing. However, with time, these issues were resolved and even improved to rates lower than baseline.
AHRQ-funded; HS017220.
Citation: Bergeron AR, Webb JR, Serper M .
Impact of electronic prescribing on medication use in ambulatory care.
Am J Manag Care 2013 Dec;19(12):1012-7..
Keywords: Electronic Prescribing (E-Prescribing), Ambulatory Care and Surgery, Patient Adherence/Compliance, Medication
Taliani CA, Bricker PL, Adelman AM
Implementing effective care management in the patient-centered medical home.
The investigators explored how a disparate group of patient-centered medical homes (PCMHs) embedded care management in their team care environment to identify best practices. They concluded that PCMHs may want to ensure that care managers are available to meet with patients during visits, support patient self-management, fully leverage the electronic medical record for team messaging and patient tracking, and ensure integration into the care team with office huddles and ongoing communication.
AHRQ-funded; HS019150.
Citation: Taliani CA, Bricker PL, Adelman AM .
Implementing effective care management in the patient-centered medical home.
Am J Manag Care 2013 Dec;19(12):957-64.
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Keywords: Care Management, Diabetes, Healthcare Delivery, Patient-Centered Healthcare, Quality Improvement, Teams