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 DisplayedDavis MM, Gunn R, Pham R
Key collaborative factors when Medicaid Accountable Care Organizations work with primary care clinics to improve colorectal cancer screening: relationships, data, and quality improvement infrastructure.
This study focused on ways that Medicaid Accountable Care Organizations (ACOs) are implementing interventions with primary care clinics to improve colorectal cancer screening. The researchers conducted a comparative case study of 14 Medicaid ACOs in Oregon and their contracted primary care clinics. They focused on interventions that reduced structural barriers (12 ACOs), delivered provider assessment and feedback (11 ACOs), and provided patient reminders (7 ACOs). There was an unintended consequence of potential exclusion of smaller clinics and metric focus and fatigue.
AHRQ-funded; HS022981.
Citation: Davis MM, Gunn R, Pham R .
Key collaborative factors when Medicaid Accountable Care Organizations work with primary care clinics to improve colorectal cancer screening: relationships, data, and quality improvement infrastructure.
Prev Chronic Dis 2019 Aug 15;16:E107. doi: 10.5888/pcd16.180395..
Keywords: Primary Care: Models of Care, Primary Care, Screening, Colonoscopy, Cancer: Colorectal Cancer, Cancer, Quality Improvement, Quality of Care, Care Coordination, Patient-Centered Healthcare
Song LD, Newhouse JP, Garcia-De-Albeniz X
Changes in screening colonoscopy following Medicare reimbursement and cost-sharing changes.
This study examined changes in screening colonoscopy rates after Medicare reimbursement and cost-sharing changed when the Affordable Care Act (ACA) was implemented. A 20% random sample of fee-for-service (FFS) Medicare claims from 2002-2012 was used in this study. Screening colonoscopy rates did increase after 2001 when cost-sharing was eliminated but the amount varied depending on the algorithm used to classify the indication.
AHRQ-funded; HS023128.
Citation: Song LD, Newhouse JP, Garcia-De-Albeniz X .
Changes in screening colonoscopy following Medicare reimbursement and cost-sharing changes.
Health Serv Res 2019 Aug;54(4):839-50. doi: 10.1111/1475-6773.13150..
Keywords: Colonoscopy, Healthcare Costs, Healthcare Utilization, Medicare, Payment, Prevention, Screening
Aouad M, Brown TT, Whaley CM
Reference pricing: the case of screening colonoscopies.
In this study, the investigators studied the introduction of reference pricing to the California Public Employees' Retirement System. The investigators found a 10 percentage point increase in the share of patients using an ambulatory surgery center (ASC), leading to a $2300 to $1700 reduction in prices paid for patients who switched to ASCs. They indicated that their results suggested the use of ASCs had a causal effect on prices paid and had no negative effect on patient health outcomes.
AHRQ-funded; HS022098.
Citation: Aouad M, Brown TT, Whaley CM .
Reference pricing: the case of screening colonoscopies.
J Health Econ 2019 May;65:246-59. doi: 10.1016/j.jhealeco.2019.03.002..
Keywords: Colonoscopy, Shared Decision Making, Health Services Research (HSR), Healthcare Costs, Healthcare Delivery, Screening
Mobley LR, Kuo TM, Zhou M
What happened to disparities in CRC screening among FFS Medicare enrollees following Medicare modernization?
This study examined the effects of the change in policy for colorectal screening that was implemented in 2006 for FFS Medicare beneficiaries. This new policy eliminated copayments for colonoscopies or sigmoidoscopies. Disparities in screening by race (Blacks, Asians and Hispanics relative to Whites), and gender (Males relative to Females). The time periods 2001-2005 and 2006-2009 were compared and while there was some improvement in screening rates for minorities and women, the progress was unevenly distributed across the USA.
AHRQ-funded; HS021752.
Citation: Mobley LR, Kuo TM, Zhou M .
What happened to disparities in CRC screening among FFS Medicare enrollees following Medicare modernization?
J Racial Ethn Health Disparities 2019 Apr;6(2):273-91. doi: 10.1007/s40615-018-0522-x..
Keywords: Cancer: Colorectal Cancer, Colonoscopy, Disparities, Medicare, Screening
Halm EA, Beaber EF, McLerran D
Association between primary care visits and colorectal cancer screening outcomes in the era of population health outreach.
The researchers assessed associations between primary care provider (PCP) visits and receipt of colorectal cancer (CRC) screening and colonoscopy after a positive fecal immunochemical (FIT) or fecal occult blood test (FOBT). They found that patients with a greater number of PCP visits had higher rates of both incident CRC screening and colonoscopy after positive FIT/FOBT, even in health systems with active population health outreach programs.
AHRQ-funded; HS022418.
Citation: Halm EA, Beaber EF, McLerran D .
Association between primary care visits and colorectal cancer screening outcomes in the era of population health outreach.
J Gen Intern Med 2016 Oct;31(10):1190-7. doi: 10.1007/s11606-016-3760-9..
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Patient-Centered Outcomes Research, Primary Care, Screening
Garcia-Albeniz X, Hsu J, Lipsitch M
Colonoscopy and risk of infective endocarditis in the elderly.
The authors estimated the risk of infective endocarditis (IE) after colonoscopy in individuals aged 70 to 79 without a history of colorectal cancer (CRC), endocarditis, or colectomy from a random 20% sample of Medicare beneficiaries. Their findings suggest that individuals without risk factors for IE and those without gastrointestinal symptoms did not have an elevated IE risk after colonoscopy. However, they found a modestly increased risk among individuals with risk factors for IE who undergo a polypectomy or a biopsy during a colonoscopy following recent symptoms.
AHRQ-funded; HS023128.
Citation: Garcia-Albeniz X, Hsu J, Lipsitch M .
Colonoscopy and risk of infective endocarditis in the elderly.
J Am Coll Cardiol 2016 Aug 2;68(5):570-71. doi: 10.1016/j.jacc.2016.05.041.
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Keywords: Adverse Events, Colonoscopy, Elderly, Healthcare-Associated Infections (HAIs), Risk
Liss DT, Brown T, Lee JY
Diagnostic colonoscopy following a positive fecal occult blood test in community health center patients.
Fecal occult blood testing (FOBT) is a pragmatic screening option for many community health centers (CHCs), but FOBT screening programs will not reduce mortality if patients with positive results do not undergo diagnostic colonoscopy (DC). This study was conducted to investigate DC completion among CHC patients. It found that DC completion was low overall, which raises concerns about whether FOBT can reduce CRC mortality in practice.
AHRQ-funded; HS021141.
Citation: Liss DT, Brown T, Lee JY .
Diagnostic colonoscopy following a positive fecal occult blood test in community health center patients.
Cancer Causes Control 2016 Jul;27(7):881-7. doi: 10.1007/s10552-016-0763-0.
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Community-Based Practice, Screening
Wernli KJ, Brenner AT, Rutter CM
Risks associated with anesthesia services during colonoscopy.
The researchers aimed to quantify the difference in complications from colonoscopy with vs without anesthesia services. They concluded that the overall risk of complications after colonoscopy increases when individuals receive anesthesia services. The widespread adoption of anesthesia services with colonoscopy should be considered within the context of all potential risks.
AHRQ-funded; HS013853; HS019482.
Citation: Wernli KJ, Brenner AT, Rutter CM .
Risks associated with anesthesia services during colonoscopy.
Gastroenterology 2016 Apr;150(4):888-94. doi: 10.1053/j.gastro.2015.12.018.
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Keywords: Adverse Events, Care Management, Colonoscopy, Disparities, Patient Safety, Risk
Killian JT, Holcomb CN, Graham LA
Delays in surgery for patients with coronary stents placed after diagnosis of colorectal cancer.
The researchers sought to determine whether the presence of a coronary stent affected the timing of colorectal cancer resection and the postoperative outcomes. They found that the median time from diagnosis to surgery was 100 days for patients who received a stent after a colonoscopy and 42 days for patients whose stent was present at the time of the colonoscopy.
AHRQ-funded; HS013852.
Citation: Killian JT, Holcomb CN, Graham LA .
Delays in surgery for patients with coronary stents placed after diagnosis of colorectal cancer.
JAMA Surg 2016 Jan;151(1):86-8. doi: 10.1001/jamasurg.2015.3130..
Keywords: Cancer: Colorectal Cancer, Cardiovascular Conditions, Colonoscopy, Heart Disease and Health, Surgery