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
101 to 125 of 135 Research Studies DisplayedPham R, Cross S, Fernandez B
"Finding the right FIT": rural patient preferences for fecal immunochemical test (FIT) characteristics.
This community-led study was conducted to assess patient preferences for fecal immunochemical tests (FIT) characteristics and to use study findings in concert with clinical effectiveness data to inform regional FIT selection. The authors concluded that FIT characteristics influenced patient's perceptions of test acceptability and feasibility and indicated that health system leaders, payers, and clinicians should select FITs that are both clinically effective and incorporate patient preferred test characteristics.
AHRQ-funded; HS022981.
Citation: Pham R, Cross S, Fernandez B .
"Finding the right FIT": rural patient preferences for fecal immunochemical test (FIT) characteristics.
J Am Board Fam Med 2017 Sep-Oct;30(5):632-44. doi: 10.3122/jabfm.2017.05.170151..
Keywords: Cancer: Colorectal Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Rural Health, Screening
Nagykaldi ZJ, Scheid D, Zhao D
An innovative community-based model for improving preventive care in rural counties.
This quasi-experimental pilot study aimed to implement and evaluate a sustainable, rural community-based patient outreach model for preventive care provided through primary care practices (PCPs) located in a rural county in Oklahoma. Six of the 7 PCPs in the county expressed interest in the project with the result that three of these practices fully implemented the 1-year outreach program starting in mid-2015.
AHRQ-funded; HS023237.
Citation: Nagykaldi ZJ, Scheid D, Zhao D .
An innovative community-based model for improving preventive care in rural counties.
J Am Board Fam Med 2017 Sep-Oct;30(5):583-91. doi: 10.3122/jabfm.2017.05.170035.
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Keywords: Community Partnerships, Patient-Centered Healthcare, Prevention, Primary Care, Rural Health
Holland DE, Brandt C, Targonski PV
Validating performance of a hospital discharge planning decision tool in community hospitals.
The researchers aimed to determine the predictive performance of the Early Screen for Discharge Planning (ESDP) in a rural regional community hospital practice setting. Patients with high ESDP scores reported more problems after discharge, reported lower quality of life, had longer length of stays, and used post-acute care services more than patients with low ESDP scores.
AHRQ-funded; HS022923.
Citation: Holland DE, Brandt C, Targonski PV .
Validating performance of a hospital discharge planning decision tool in community hospitals.
Prof Case Manag 2017 Sep/Oct;22(5):204-13. doi: 10.1097/ncm.0000000000000233.
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Keywords: Shared Decision Making, Hospital Discharge, Outcomes, Rural Health, Tools & Toolkits
Grande SW, Castaldo MG, Carpenter-Song E
A digital advocate? Reactions of rural people who experience homelessness to the idea of recording clinical encounters.
This study examines the reactions of homeless people to the idea of using a smartphone to record their own clinical encounter, either covertly or with permission from their physician. The researchers conducted semi-structured interviews with individuals at a temporary housing shelter in Northern New England. The study found that while many rural, disadvantaged individuals felt marginalized by the wide social distance between themselves and their clinicians, recording technology may serve as an advocate by holding both patients and doctors accountable and by permitting the burden of clinical proof to be shared.
AHRQ-funded; HS021695.
Citation: Grande SW, Castaldo MG, Carpenter-Song E .
A digital advocate? Reactions of rural people who experience homelessness to the idea of recording clinical encounters.
Health Expect 2017 Aug;20(4):618-25. doi: 10.1111/hex.12492..
Keywords: Health Information Exchange (HIE), Clinician-Patient Communication, Rural Health, Vulnerable Populations
Tiase VL, Crouch B, Bennett H
Descriptive analysis of communication patterns between a local poison control center and community emergency departments.
This study leverages a commercial call recording system to gain insight into the intensity and volume of communication between a poison control center and two rural emergency departments.
AHRQ-funded; HS021472.
Citation: Tiase VL, Crouch B, Bennett H .
Descriptive analysis of communication patterns between a local poison control center and community emergency departments.
2017 IEEE International Conference on Healthcare Informatics (ICHI) 2017 Aug:574. doi: 10.1109/ICHI.2017.89.
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Keywords: Communication, Emergency Department, Emergency Medical Services (EMS), Rural Health
Davis MM, Spurlock M, Ramsey K
Milk options observation (MOO): a mixed-methods study of chocolate milk removal on beverage consumption and student/staff behaviors in a rural elementary school.
The researchers conducted a study of flavored milk removal at a rural primary school between May and June 2012. They measured beverage selection/consumption pre- and post-chocolate milk removal and collected observation field notes. Their conclusion was that removing flavored milk from school-provided lunches may lower students' daily added sugar consumption without considerably decreasing calcium and protein intake and may promote healthy weight.
AHRQ-funded; HS022981.
Citation: Davis MM, Spurlock M, Ramsey K .
Milk options observation (MOO): a mixed-methods study of chocolate milk removal on beverage consumption and student/staff behaviors in a rural elementary school.
J Sch Nurs 2017 Aug;33(4):285-98. doi: 10.1177/1059840517703744.
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Keywords: Children/Adolescents, Education, Nutrition, Rural Health
Baernholdt M, Hinton ID, Guofen Y
A national comparison of rural/urban pressure ulcer and fall rates.
Despite recent decline in hospital acquired conditions (HACs), rates for pressure ulcers (PURs) and falls (FRs) remain at levels that require improvement. Contextual factors and care processes may impact HACs. Using the National Database of Nursing Quality Indicators (NDNQI®) this study examined differences in care processes and community, hospital, and nursing unit characteristics that influence PURs and FRs in 4238 rural and urban nursing units.
AHRQ-funded; HS023147.
Citation: Baernholdt M, Hinton ID, Guofen Y .
A national comparison of rural/urban pressure ulcer and fall rates.
Online J Issues Nurs 2017 May;22(2):1-12. doi: 10.3912/OJIN.Vol22No02PPT60..
Keywords: Injuries and Wounds, Nursing, Patient Safety, Pressure Ulcers, Quality of Care, Quality Improvement, Quality Indicators (QIs), Quality Measures, Rural Health, Urban Health
Vyas A, Madhavan SS, Sambamoorthi U
Differences in Medicare expenditures between Appalachian and nationally representative cohorts of elderly women with breast cancer: an application of decomposition technique.
The objective of this study was to determine Medicare expenditures during the initial phase of care among women in West Virginia (WV) who were Medicare beneficiaries with BC and compare them with national estimates. It found that the difference in average Medicare expenditures between the elderly beneficiaries with BC from a rural state (WV) and their national counterparts narrowed but remained significantly lower after multivariate adjustment.
AHRQ-funded; HS018622.
Citation: Vyas A, Madhavan SS, Sambamoorthi U .
Differences in Medicare expenditures between Appalachian and nationally representative cohorts of elderly women with breast cancer: an application of decomposition technique.
J Natl Compr Canc Netw 2017 May;15(5):578-87.
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Keywords: Cancer: Breast Cancer, Elderly, Healthcare Costs, Medicare, Rural Health
Inrig SJ, Higashi RT, Tiro JA
Assessing local capacity to expand rural breast cancer screening and patient navigation: an iterative mixed-method tool.
To expand rural breast cancer screening , the researchers proposed a regional hub-and-spoke model, partnering with local providers to expand access across North Texas. Their capacity assessment tool enabled the hub to establish partnerships with county organizations by tailoring support to local capacity and needs.
AHRQ-funded; HS022418.
Citation: Inrig SJ, Higashi RT, Tiro JA .
Assessing local capacity to expand rural breast cancer screening and patient navigation: an iterative mixed-method tool.
Eval Program Plann 2017 Apr;61:113-24. doi: 10.1016/j.evalprogplan.2016.11.006.
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Keywords: Access to Care, Cancer: Breast Cancer, Patient-Centered Healthcare, Rural Health, Screening
Batsis JA, Pletcher SN, Stahl JE
Telemedicine and primary care obesity management in rural areas - innovative approach for older adults?
The Centers for Medicare and Medicaid recognized the importance of treating obesity and instituted a benefit in primary care settings to encourage intensive behavioral therapy in beneficiaries by primary care clinicians. This benefit covers frequent, brief, clinic visits designed to address older adult obesity. This review outlines some of the challenges with the current benefit and proposed solutions in overcoming rural primary care barriers to implementation, including changes in staffing models.
AHRQ-funded; HS021681.
Citation: Batsis JA, Pletcher SN, Stahl JE .
Telemedicine and primary care obesity management in rural areas - innovative approach for older adults?
BMC Geriatr 2017 Jan 5;17(1):6. doi: 10.1186/s12877-016-0396-x.
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Keywords: Telehealth, Primary Care, Obesity, Rural Health, Elderly
Ward MM, Baloh J, Zhu X
Promoting Action on Research Implementation in Health Services framework applied to TeamSTEPPS implementation in small rural hospitals.
An evidence-based program focused on quality enhancement in health care, termed TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety), has been widely promoted by AHRQ. The authors apply the Promoting Action on Research Implementation in Health Services (PARIHS) framework in studying its implementation to identify elements that are most closely related to successful implementation. The current findings provide support for the PARIHS framework.
AHRQ-funded; HS018396.
Citation: Ward MM, Baloh J, Zhu X .
Promoting Action on Research Implementation in Health Services framework applied to TeamSTEPPS implementation in small rural hospitals.
Health Care Manage Rev 2017 Jan/Mar;42(1):2-13. doi: 10.1097/hmr.0000000000000086.
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Keywords: Evidence-Based Practice, Hospitals, Rural Health, TeamSTEPPS, Implementation
Caldwell JT, Ford CL, Wallace SP
Racial and ethnic residential segregation and access to health care in rural areas.
This study examined the relationship between racial/ethnic residential segregation and access to health care in rural areas. In rural areas, segregation contributed to worse access to a usual source of health care but higher reports of health care needs being met among African Americans and Hispanics.
AHRQ-funded; HS000078; HS022811.
Citation: Caldwell JT, Ford CL, Wallace SP .
Racial and ethnic residential segregation and access to health care in rural areas.
Health Place 2017 Jan;43:104-12. doi: 10.1016/j.healthplace.2016.11.015.
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Keywords: Access to Care, Health Services Research (HSR), Racial and Ethnic Minorities, Rural Health, Social Determinants of Health
Mueller LR, Donnelly JP, Jacobson KE
National characteristics of emergency medical services in frontier and remote areas.
This study sought to describe the national characteristics and outcomes of EMS care provided in frontier and remote (FAR) areas in the continental United States (US). It found that FAR responses were more likely to be of American Indian or Alaska Native race. Age, ethnicity, location type, and clinical impressions were similar between FAR and non-FAR responses. On-scene death was more likely in FAR than non-FAR responses.
AHRQ-funded; HS013852.
Citation: Mueller LR, Donnelly JP, Jacobson KE .
National characteristics of emergency medical services in frontier and remote areas.
Prehosp Emerg Care 2016;20(2):191-9. doi: 10.3109/10903127.2015.1086846.
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Keywords: Emergency Medical Services (EMS), Rural Health, Provider: Health Personnel, Health Services Research (HSR), Outcomes
Jarman MP, Castillo RC
Rural risk: geographic disparities in trauma mortality.
The authors sought to quantify differences in injury mortality comparing rural and nonrural residents with traumatic injuries. They concluded that rural residents are significantly more likely than nonrural residents to die after traumatic injury, a disparity that varies by trauma center designation, injury severity, and US Census region.
AHRQ-funded; HS000029.
Citation: Jarman MP, Castillo RC .
Rural risk: geographic disparities in trauma mortality.
Surgery 2016 Dec;160(6):1551-59. doi: 10.1016/j.surg.2016.06.020.
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Keywords: Access to Care, Disparities, Emergency Medical Services (EMS), Healthcare Cost and Utilization Project (HCUP), Rural Health
Caldwell JT, Ford CL, Wallace SP
Intersection of living in a rural versus urban area and race/ethnicity in explaining access to health care in the United States.
The researchers examined whether living in a rural versus urban area differentially exposes populations to social conditions associated with disparities in access to health care. They cocluded that rural status confers additional disadvantage for most of the health care use measures, independently of poverty and health care supply.
AHRQ-funded; HS022811.
Citation: Caldwell JT, Ford CL, Wallace SP .
Intersection of living in a rural versus urban area and race/ethnicity in explaining access to health care in the United States.
Am J Public Health 2016 Aug;106(8):1463-9. doi: 10.2105/ajph.2016.303212.
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Keywords: Rural Health, Urban Health, Racial and Ethnic Minorities, Access to Care, Social Determinants of Health
Zhu X, Baloh J, Ward MM
Deliberation makes a difference: preparation strategies for TeamSTEPPS implementation in small and rural hospitals.
The researchers studied the implementation of TeamSTEPPS in 14 critical access hospitals, proposing five strategic preparation steps for TeamSTEPPS. They discussed potential steps that hospitals may take to better prepare for TeamSTEPPS implementation.
AHRQ-funded; HS024112; HS018396.
Citation: Zhu X, Baloh J, Ward MM .
Deliberation makes a difference: preparation strategies for TeamSTEPPS implementation in small and rural hospitals.
Med Care Res Rev 2016 Jun;73(3):283-307. doi: 10.1177/1077558715607349.
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Keywords: TeamSTEPPS, Teams, Rural Health, Hospitals, Implementation, Quality Improvement, Quality of Care
Davis MM, Spurlock M, Dulacki K
Disparities in alcohol, drug use, and mental health condition prevalence and access to care in rural, isolated, and reservation areas: Findings from the South Dakota Health Survey.
The authors studied alcohol, drug use, and mental health (ADM) condition prevalence and access to care across diverse geographies in a predominantly rural state. They concluded that geographic disparities in ADM conditions are related to differences in access as opposed to prevalence, particularly for individuals in isolated and reservation areas.
AHRQ-funded; HS022981.
Citation: Davis MM, Spurlock M, Dulacki K .
Disparities in alcohol, drug use, and mental health condition prevalence and access to care in rural, isolated, and reservation areas: Findings from the South Dakota Health Survey.
J Rural Health 2016 Jun;32(3):287-302. doi: 10.1111/jrh.12157.
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Keywords: Disparities, Behavioral Health, Rural Health, Access to Care, Substance Abuse
Peltz A, Wu CL, White ML
Characteristics of rural children admitted to pediatric hospitals.
The researchers assessed characteristics and hospitalizations of rural children admitted to US children's hospitals in 2012. They found that rural children more often resided in low-income ZIP codes and Health Professional Shortage Areas; they further noted that rural children had a higher prevalence of complex chronic conditions and medical technology assistance. Rural children also experienced higher inpatient costs and higher odds of 30-day readmission.
AHRQ-funded; HS023092.
Citation: Peltz A, Wu CL, White ML .
Characteristics of rural children admitted to pediatric hospitals.
Pediatrics 2016 May;137(5). doi: 10.1542/peds.2015-3156.
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Keywords: Children/Adolescents, Hospitalization, Children/Adolescents, Rural Health, Vulnerable Populations
Smith MW, Owens PL, Andrews RM
AHRQ Author: Owens PL, Andrews RM, Steiner CA
Differences in severity at admission for heart failure between rural and urban patients: the value of adding laboratory results to administrative data.
This study’s main objective was to examine the role of laboratory test results in measuring disease severity at the time of admission for inpatients who reside in rural and urban areas. It concluded that heart failure patients from rural areas are hospitalized at lower severity levels than their urban counterparts. Laboratory test data provide insight on clinical severity and practice patterns beyond what is available in administrative discharge data.
AHRQ-authored; AHRQ-funded; 29020060009.
Citation: Smith MW, Owens PL, Andrews RM .
Differences in severity at admission for heart failure between rural and urban patients: the value of adding laboratory results to administrative data.
BMC Health Serv Res 2016 Apr 18;16(1):133. doi: 10.1186/s12913-016-1380-z.
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Keywords: Heart Disease and Health, Hospitalization, Healthcare Cost and Utilization Project (HCUP), Diagnostic Safety and Quality, Rural Health
Weintraub JA, Burgette JM, Chadwick DG
Educating North Carolina's oral health workforce in an evolving environment.
In 2014, North Carolina had 4,681 actively practicing dentists and ranked 47th among US states in dentist-to-population ratio. The need for dentists is increasing as the population grows, and underserved areas persist. This commentary discusses the impact of the state's 2 dental schools and external factors on dental workforce trends.
AHRQ-funded; HS000032.
Citation: Weintraub JA, Burgette JM, Chadwick DG .
Educating North Carolina's oral health workforce in an evolving environment.
N C Med J 2016 Mar-Apr;77(2):107-11. doi: 10.18043/ncm.77.2.107..
Keywords: Dental and Oral Health, Education, Access to Care, Rural Health, Vulnerable Populations
Singh JA, Ramachandaran R
Does rural residence impact total ankle arthroplasty utilization and outcomes?
The objective of this study was to compare total ankle arthroplasty (TAA) utilization and outcomes by patient residence. It demonstrated an absence of any evidence of rural-urban differences in TAA outcomes. The rural-urban differences in TAA utilization noted in 2003 were no longer significant in 2011.
AHRQ-funded; HS021110.
Citation: Singh JA, Ramachandaran R .
Does rural residence impact total ankle arthroplasty utilization and outcomes?
Clin Rheumatol 2016 Feb;35(2):381-6. doi: 10.1007/s10067-015-2908-z.
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Keywords: Centers for Education and Research on Therapeutics (CERTs), Rural Health, Surgery, Patient-Centered Outcomes Research, Healthcare Utilization
Joshi A, Amadi C, Meza J
Comparison of socio-demographic characteristics of a computer based breastfeeding educational intervention among rural Hispanic women.
The purpose of this study was to examine association between socio-demographic characteristics and breastfeeding knowledge, self-efficacy and breastfeeding attrition prediction among rural Hispanic women. It found a significant positive association between self-efficacy and intent to breastfeed. Self-efficacy is an important predictor of intent to breastfeed among rural Hispanic women.
AHRQ-funded; HS021321.
Citation: Joshi A, Amadi C, Meza J .
Comparison of socio-demographic characteristics of a computer based breastfeeding educational intervention among rural Hispanic women.
J Community Health 2015 Oct;40(5):993-1001. doi: 10.1007/s10900-015-0023-3..
Keywords: Breast Feeding, Health Information Technology (HIT), Rural Health, Education: Patient and Caregiver, Racial and Ethnic Minorities
Cochran GL, Horn SD
Potential effect of coding differences on comparisons of rural and urban outcomes.
To investigate the concern that systematic differences in coding exist, the researchers conducted a small pilot study. Their study compared rural and urban disease severity for four common diagnoses in a Midwestern urban academic medical center and eight critical access hospitals (CAHs). They found significantly fewer comorbidities (identified according to ICD-9 codes) in rural subjects, despite their being approximately 15 years older than subjects in the urban comparator group.
AHRQ-funded; HS018059.
Citation: Cochran GL, Horn SD .
Potential effect of coding differences on comparisons of rural and urban outcomes.
J Am Geriatr Soc 2015 Oct;63(10):2210-2. doi: 10.1111/jgs.13692..
Keywords: Rural Health, Urban Health, Comparative Effectiveness, Outcomes
Toth M, Holmes M, Van Houtven C
Rural Medicare beneficiaries have fewer follow-up visits and greater emergency department use postdischarge.
This study tested whether rural Medicare beneficiaries have a lower likelihood of follow-up care and greater likelihood of a readmission and ED visit within 30 days postdischarge, compared with urban beneficiaries. The results provide evidence of lower quality postdischarge care for Medicare beneficiaries in rural settings.
AHRQ-funded; HS000032.
Citation: Toth M, Holmes M, Van Houtven C .
Rural Medicare beneficiaries have fewer follow-up visits and greater emergency department use postdischarge.
Med Care 2015 Sep;53(9):800-8. doi: 10.1097/mlr.0000000000000401..
Keywords: Rural Health, Elderly, Medicare, Hospital Readmissions, Emergency Department, Hospital Discharge
Yang NH, Dharmar M, Yoo BK
Economic evaluation of pediatric telemedicine consultations to rural emergency departments.
The researchers conducted an economic evaluation to estimate the cost, effectiveness, and return on investment (ROI) of telemedicine consultations provided to health care providers of acutely ill and injured children in rural EDs compared with telephone consultations from a health care payer prospective. They found that treating 10 acutely ill and injured children at each rural ED with telemedicine resulted in an annual cost-savings of $46,620 per ED. They concluded that telemedicine consultations to health care providers of acutely ill and injured children presenting to rural EDs are cost-saving or cost-effective compared with telephone consultations.
AHRQ-funded; HS013179.
Citation: Yang NH, Dharmar M, Yoo BK .
Economic evaluation of pediatric telemedicine consultations to rural emergency departments.
Med Decis Making 2015 Aug;35(6):773-83. doi: 10.1177/0272989x15584916.
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Keywords: Healthcare Costs, Emergency Department, Children/Adolescents, Rural Health, Telehealth