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 9 of 9 Research Studies DisplayedAmu-Nnadi CN, Ross ES, Garcia NH
Health system integration and cancer center access for rural hospitals.
This study’s goal was to assess health system integration and cancer center access for rural hospitals. The authors compared health systems with and without cancer centers based on rural hospital presence. They found that 90% of cancer centers are in a health system, and 72% of health systems (434/607) have a cancer center. Larger health systems with more trainees more often have cancer centers but are no more likely to include rural hospitals (11% vs 6%). The minority of cancer centers not in health systems (N = 95) more often serve low complexity patient populations in non-metropolitan areas.
AHRQ-funded; HS013852.
Citation: Amu-Nnadi CN, Ross ES, Garcia NH .
Health system integration and cancer center access for rural hospitals.
Am Surg 2024 May; 90(5):1023-29. doi: 10.1177/00031348231216497..
Keywords: Health Systems, Cancer, Rural Health, Rural/Inner-City Residents, Access to Care
Friedman CP, Lomotan EA, Richardson JE
AHRQ Author: Lomotan EA
Socio-technical infrastructure for a learning health system.
This partially AHRQ-authored article discusses the third characteristic that contributes to the uniqueness of learning health systems (LHSs) as an approach to health improvement, specifically infrastructure. It examines the role of infrastructure in the overall architecture of an LHS and describes the three linked elements: 1) Improvement cycles directed at critical health problems; 2) Socio-technical infrastructure providing key services supporting co-occurring improvement cycles; and 3) Governance of the system. It then discusses the scope and meaning of socio-technical infrastructure and provides a diagram and brief description of the 10 interconnected socio-technical services.
AHRQ-authored.
Citation: Friedman CP, Lomotan EA, Richardson JE .
Socio-technical infrastructure for a learning health system.
Learn Health Syst 2024 Jan 16; 8(1):e10405. doi: 10.1002/lrh2.10405..
Keywords: Learning Health Systems, Health Systems
Franklin PD, Drane D
Assessment of learning health system science competency in the equity and justice domain.
This paper assessed learning health system (LHS) competency in the newly added knowledge domain of Equity and Justice. This eighth domain was adopted by AHRQ in mid-2022. The authors developed a proficiency assessment for the new equity and justice domain. The assessment criteria were iteratively defined, reviewed, and edited by content experts and trainees. The new items were developed by trainees and experts at one LHS training center with experience conducting research focused on healthcare inequities among marginalized populations. The same proficiency assessment criteria as for the other domains was applied with four levels of mastery: "no exposure," "foundational awareness," "emerging," and "proficient".
AHRQ-funded; HS026385.
Citation: Franklin PD, Drane D .
Assessment of learning health system science competency in the equity and justice domain.
Learn Health Syst 2024 Jan; 8(1):e10381. doi: 10.1002/lrh2.10381..
Keywords: Learning Health Systems, Health Systems
Yilmaz S, LeClaire M, Begnaud A
Developing LHS scholars' competency around reducing burnout and moral injury.
The study addresses the lack of a wellness competency focusing on burnout and moral injury prevention within Learning Health Systems (LHS). Experts collaborated to develop pathways for implementing such programs, emphasizing distinctions between moral injury and burnout, proposing interventions, and integrating expert input. The study found that a competency aimed at equipping scholars with skills for measuring, intervening, and embedding burnout and moral injury prevention into LHS structures, would potentially improve work lives and patient outcomes within LHS.
AHRQ-funded; HS026379.
Citation: Yilmaz S, LeClaire M, Begnaud A .
Developing LHS scholars' competency around reducing burnout and moral injury.
Learn Health Syst 2024 Jan; 8(1):e10378. doi: 10.1002/lrh2.10378..
Keywords: Learning Health Systems, Health Systems, Burnout, Provider: Health Personnel
Bishai D, Sherry M, Pereira CC
Development and usefulness of a district health systems tool for performance improvement in essential public health functions in Botswana and Mozambique.
This study describes the development of a self-audit tool for public health and the associated methodology for implementing a district health system self-audit tool that can provide quantitative data on how district governments perceive their performance of the essential public health functions. It found that instant feedback from the audit was a feature that 100 percent of pilot respondents found most useful.
AHRQ-funded; HS000029.
Citation: Bishai D, Sherry M, Pereira CC .
Development and usefulness of a district health systems tool for performance improvement in essential public health functions in Botswana and Mozambique.
J Public Health Manag Pract 2016 Nov-Dec;22(6):586-96. doi: 10.1097/phh.0000000000000407.
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Keywords: Health Systems, Public Health, Quality Improvement
Peiris D, Phipps-Taylor MC, Stachowski CA
ACOs holding commercial contracts are larger and more efficient than noncommercial ACOs.
The researchers examined differences between commercial accountable care organizations (ACOs) and noncommercial ACOs. They found that among all ACOs, there was low uptake of quality and efficiency activities; commercial ACOs reported more use of disease monitoring tools, patient satisfaction data, and quality improvement methods; and about two-thirds of the ACOs had established processes for distributing any savings accrued. They concluded that ACO delivery systems remain at a nascent stage.
AHRQ-funded; HS024075.
Citation: Peiris D, Phipps-Taylor MC, Stachowski CA .
ACOs holding commercial contracts are larger and more efficient than noncommercial ACOs.
Health Aff 2016 Oct;35(10):1849-56. doi: 10.1377/hlthaff.2016.0387.
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Keywords: Healthcare Costs, Payment, Health Systems, Medicaid, Medicare
Simianu VV, Fichera A, Bastawrous AL
Number of diverticulitis episodes before resection and factors associated with earlier interventions.
The authors described patterns of episodes of diverticulitis before surgery and factors associated with earlier interventions using inpatient, outpatient, and antibiotic prescription claims. They found that 56.3% of elective resections for uncomplicated diverticulitis occurred after fewer than 3 episodes. Further, they determined that earlier surgery was not explained by younger age, laparoscopy, time between the last 2 episodes preceding surgery, or financial risk-bearing for patients.
AHRQ-funded; HS020025.
Citation: Simianu VV, Fichera A, Bastawrous AL .
Number of diverticulitis episodes before resection and factors associated with earlier interventions.
JAMA Surg 2016 Jul;151(7):604-10. doi: 10.1001/jamasurg.2015.5478.
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Keywords: Shared Decision Making, Digestive Disease and Health, Health Systems, Healthcare Utilization, Surgery
Rangachari P
Role of social knowledge networking technology in facilitating meaningful use of electronic health record medication reconciliation.
In this paper, Rangachari 1) conducted a narrative review of the literature on "technology use," to understand how technologies-in-practice may be transformed from limited use to meaningful use; 2) conducted a narrative review of the literature on "organizational change implementation," to understand how changes in technology use could be successfully implemented and sustained in a healthcare organizational context; and 3) applied lessons learned from the narrative literature reviews to identify strategies for the meaningful use and successful implementation of EHR Medication Reconciliation technology.
AHRQ-funded; HS024335.
Citation: Rangachari P .
Role of social knowledge networking technology in facilitating meaningful use of electronic health record medication reconciliation.
J Hosp Adm 2016 Jun;5(3):98-106. doi: 10.5430/jha.v5n3p98.
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Keywords: Health Systems, Medication, Hospitals, Organizational Change, Electronic Health Records (EHRs)
Fisher ES, Shortell SM, Savitz LA
Implementation science: A potential catalyst for delivery system reform.
Understanding which of the multitude of technological, policy, and organizational changes under way are most effective at improving care is a critical challenge. This article describes 3 ideas that could be helpful: application of a well-grounded conceptual framework; distinguishing 3 distinct types of innovations that health systems are using to improve care; and a focus on building the information systems needed to accelerate timely learning.
AHRQ-funded; HS024075.
Citation: Fisher ES, Shortell SM, Savitz LA .
Implementation science: A potential catalyst for delivery system reform.
JAMA 2016 Jan 26;315(4):339-40. doi: 10.1001/jama.2015.17949..
Keywords: Healthcare Delivery, Implementation, Quality Improvement, Quality of Care, Health Systems