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
2176 to 2193 of 2193 Research Studies DisplayedFrasier LL, Holden S, Holden T
Temporal trends in postmastectomy radiation therapy and breast reconstruction associated with changes in national comprehensive cancer network guidelines.
The researchers sought to determine whether revised guidelines have increased postmastectomy radiation therapy (PMRT) and affected receipt of breast reconstruction. They found that changes in NCCN guidelines have been associated with an increase in PMRT among patients with tumors 5 cm or smaller and 1 to 3 positive nodes without an associated decrease in receipt of reconstruction.
AHRQ-funded; HS022403.
Citation: Frasier LL, Holden S, Holden T .
Temporal trends in postmastectomy radiation therapy and breast reconstruction associated with changes in national comprehensive cancer network guidelines.
JAMA Oncol 2016 Jan;2(1):95-101. doi: 10.1001/jamaoncol.2015.3717.
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Keywords: Cancer: Breast Cancer, Healthcare Delivery, Shared Decision Making, Guidelines, Outcomes
Ferrara A, Hedderson MM, Brown SD
The comparative effectiveness of diabetes prevention strategies to reduce postpartum weight retention in women with gestational diabetes mellitus: the gestational diabetes' effects on moms (GEM) cluster randomized controlled trial.
The researchers compared the effectiveness of diabetes prevention strategies addressing postpartum weight retention for women with gestational diabetes mellitus (GDM) delivered at the health system level: mailed recommendations (usual care) versus usual care plus a Diabetes Prevention Program (DPP)-derived lifestyle intervention. They found that a DPP-derived lifestyle intervention modestly reduced postpartum weight retention and increased vigorous-intensity physical activity.
AHRQ-funded; HS019367.
Citation: Ferrara A, Hedderson MM, Brown SD .
The comparative effectiveness of diabetes prevention strategies to reduce postpartum weight retention in women with gestational diabetes mellitus: the gestational diabetes' effects on moms (GEM) cluster randomized controlled trial.
Diabetes Care 2016 Jan;39(1):65-74. doi: 10.2337/dc15-1254.
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Keywords: Comparative Effectiveness, Diabetes, Lifestyle Changes, Pregnancy, Prevention, Women
Halladay JR, Mottus K, Reiter K
The cost to successfully apply for level 3 medical home recognition.
The National Committee for Quality Assurance patient-centered medical home recognition program provides practices an opportunity to implement medical home activities. Understanding the costs to apply for recognition may enable practices to plan their work. This study found variation in the distribution of costs by activity by practice, but the costs to apply were remarkably similar.
AHRQ-funded; HS022629.
Citation: Halladay JR, Mottus K, Reiter K .
The cost to successfully apply for level 3 medical home recognition.
J Am Board Fam Med 2016 Jan-Feb;29(1):69-77. doi: 10.3122/jabfm.2016.01.150211.
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Keywords: Patient-Centered Healthcare, Healthcare Costs, Care Coordination, Quality of Care
Sathe NA, Nocon RS, Hughes B
The costs of participating in a diabetes quality improvement collaborative: Variation among five clinics.
The costs over the first four years-from June 2009 through May 2013-of an ongoing diabetes Quality improvement collaborative were characterized by activities and over time. Cost/diabetic patient/year ranged across clinic sites from $6 (largest clinic) to $68 (smallest clinic).
AHRQ-funded; HS000084.
Citation: Sathe NA, Nocon RS, Hughes B .
The costs of participating in a diabetes quality improvement collaborative: Variation among five clinics.
Jt Comm J Qual Patient Saf 2016 Jan;42(1):18-25..
Keywords: Diabetes, Quality Improvement, Healthcare Costs, Health Services Research (HSR)
Gatwood J, Balkrishnan R, Erickson SR
The impact of tailored text messages on health beliefs and medication adherence in adults with diabetes: a randomized pilot study.
The purpose of this pilot study was to test the effectiveness of tailored text messages focusing on improving medication adherence and health beliefs in adults with diabetes. It found that declines in medication adherence were observed in both groups over time but no significant differences were observed between groups or from baseline to the end of the active study period.
AHRQ-funded; HS021976.
Citation: Gatwood J, Balkrishnan R, Erickson SR .
The impact of tailored text messages on health beliefs and medication adherence in adults with diabetes: a randomized pilot study.
Res Social Adm Pharm 2016 Jan-Feb;12(1):130-40. doi: 10.1016/j.sapharm.2015.04.007.
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Keywords: Diabetes, Medication, Patient Adherence/Compliance, Health Information Technology (HIT), Clinician-Patient Communication
Boudreaux MH, Golberstein E, McAlpine DD
The long-term impacts of Medicaid exposure in early childhood: evidence from the program's origin.
This paper examines the long-term impact of exposure to Medicaid in early childhood on adult health and economic status. Its analyses suggest that exposure to Medicaid in early childhood (age 0-5) is associated with statistically significant and meaningful improvements in adult health (age 25-54), and this effect is only seen in subgroups targeted by the program.
AHRQ-funded; HS021690.
Citation: Boudreaux MH, Golberstein E, McAlpine DD .
The long-term impacts of Medicaid exposure in early childhood: evidence from the program's origin.
J Health Econ 2016 Jan;45:161-75. doi: 10.1016/j.jhealeco.2015.11.001.
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Keywords: Medicaid, Health Status, Children/Adolescents
Hannum SM, Rubinstein RL
The meaningfulness of time; narratives of cancer among chronically ill older adults.
The authors sought to describe how chronically ill older adults experience a new cancer diagnosis and the effects of this on their interpretations of personal health, aging, and the future. Among the fifteen participants, they found that perceived time was fragmented into three distinct segments: the Recalled Past, the Existent Present, and the Imagined Future. They discussed implications for how older adults understood their cancer.
AHRQ-funded; HS020177.
Citation: Hannum SM, Rubinstein RL .
The meaningfulness of time; narratives of cancer among chronically ill older adults.
J Aging Stud 2016 Jan;36:17-25. doi: 10.1016/j.jaging.2015.12.006.
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Keywords: Elderly, Cancer, Chronic Conditions, Health Status
Holman GT, Beasley JW, Karsh BT
The myth of standardized workflow in primary care.
This analysis evaluates workflow variation in terms of the sequence of tasks performed during patient visits. It concluded that the prevalence of specific tasks shifts significantly as primary care visits progress to their conclusion but, notably, PCPs collect patient information throughout the visit.
AHRQ-funded; HS017115; HS017014.
Citation: Holman GT, Beasley JW, Karsh BT .
The myth of standardized workflow in primary care.
J Am Med Inform Assoc 2016 Jan;23(1):29-37. doi: 10.1093/jamia/ocv107.
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Keywords: Primary Care, Workflow
Bakken S, Reame N
The promise and potential perils of big data for advancing symptom management research in populations at risk for health disparities.
The purposes of this chapter are to (a) briefly summarize the current drivers for the use of big data in research; (b) describe the promise of big data and associated data science methods for advancing symptom management research; and (c) explicate the potential perils of big data and data science from the perspective of the ethical principles of autonomy, beneficence, and justice.
AHRQ-funded; HS022961.
Citation: Bakken S, Reame N .
The promise and potential perils of big data for advancing symptom management research in populations at risk for health disparities.
Annu Rev Nurs Res 2016;34:247-60. doi: 10.1891/0739-6686.34.247..
Keywords: Disparities, Data, Patient-Centered Outcomes Research, Registries
Singh JA, Ramachandran R
Time trends in total ankle arthroplasty in the USA: a study of the National Inpatient Sample.
The objective of this study was to assess the time trends in utilization, clinical characteristics, and outcomes of patients undergoing total ankle arthroplasty (TAA) in the USA. It concluded that the utilization rate of TAA increased rapidly in the USA from 1998 to 2010, but post-arthroplasty mortality rate was stable. Underlying diagnosis and medical comorbidity changed over time and both can impact outcomes after TAA.
AHRQ-funded; HS021110.
Citation: Singh JA, Ramachandran R .
Time trends in total ankle arthroplasty in the USA: a study of the National Inpatient Sample.
Clin Rheumatol 2016 Jan;35(1):239-45. doi: 10.1007/s10067-014-2703-2.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Centers for Education and Research on Therapeutics (CERTs), Surgery, Patient-Centered Outcomes Research, Healthcare Utilization
Patel SR, Gorritz M, Olfson M
Training community-based primary care physicians in the screening and management of mental health disorders among Latino primary care patients.
The researchers evaluated a quality improvement intervention to improve the screening and management (e.g., referral to psychiatric care) of common mental disorders in small independent Latino primary care practices. They concluded that improving the quality of mental health care in low-resourced primary care settings may require academic detailing and consultation/liaison psychiatric intervention supplemented with staff outreach to achieve meaningful improvement in the processes of care.
AHRQ-funded; HS021112.
Citation: Patel SR, Gorritz M, Olfson M .
Training community-based primary care physicians in the screening and management of mental health disorders among Latino primary care patients.
Gen Hosp Psychiatry 2016 Jan-Feb;38:71-8. doi: 10.1016/j.genhosppsych.2015.09.006.
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Keywords: Community-Based Practice, Primary Care, Behavioral Health, Racial and Ethnic Minorities, Quality Improvement
Dimou F, Sineshaw H, Parmar AD
Trends in receipt and timing of multimodality therapy in early-stage pancreatic cancer.
The researchers described treatment patterns and time trends with regard to age and treatment center in the receipt of multimodality therapy for early-stage pancreatic cancer. They concluded that despite increased use of multimodality therapy, it remains underutilized in all patients and especially in older patients. Receipt of multimodality therapy and neoadjuvant therapy is highly dependent on treatment at NCI-designated cancer centers.
AHRQ-funded; HS022134.
Citation: Dimou F, Sineshaw H, Parmar AD .
Trends in receipt and timing of multimodality therapy in early-stage pancreatic cancer.
J Gastrointest Surg 2016 Jan;20(1):93-103; discussion 03. doi: 10.1007/s11605-015-2952-7.
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Keywords: Cancer, Disparities, Practice Patterns, Elderly, Patient-Centered Outcomes Research
Barry CL, Kennedy-Hendricks A, Gollust SE
Understanding Americans' views on opioid pain reliever abuse.
Using a public opinion survey, the authors examined Americans' personal experience with opioid pain reliever use and abuse, and views about the seriousness of the problem, factors causing it, responsibility for addressing it and support for policies to resolve it. Fifty-eight percent of respondents ranked the problem as serious, on a par with other major health concerns. Individual-orientated factors, including a lack of understanding about how easy it is to become addicted and improper storage and disposal ranked highest as causes, and those abusing opioid pain relievers and their physicians were viewed as most responsible for solving the problem. Of the policies recommended to curb the epidemic, 14 out of 16 were supported by a majority of Americans.
AHRQ-funded; HS000029.
Citation: Barry CL, Kennedy-Hendricks A, Gollust SE .
Understanding Americans' views on opioid pain reliever abuse.
Addiction 2016 Jan;111(1):85-93. doi: 10.1111/add.13077.
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Keywords: Medication, Opioids, Pain, Substance Abuse
Chavez LJ, Liu CF, Tefft N
Unhealthy alcohol use in older adults: association with readmissions and emergency department use in the 30 days after hospital discharge.
This study examined the association between AUDIT-C alcohol screening results and 30-day readmissions or ED visits. Alcohol screening results indicating high-risk drinking that were available in medical records were modestly associated with risk for 30-day readmissions and were not associated with risk for ED visits.
AHRQ-funded; HS022800.
Citation: Chavez LJ, Liu CF, Tefft N .
Unhealthy alcohol use in older adults: association with readmissions and emergency department use in the 30 days after hospital discharge.
Drug Alcohol Depend 2016 Jan;158:94-101. doi: 10.1016/j.drugalcdep.2015.11.008.
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Keywords: Alcohol Use, Elderly, Emergency Department, Hospital Readmissions, Lifestyle Changes
Rhodes RL, Nazir F, Lopez S
Use and predictors of end-of-life care among HIV patients in a safety net health system.
The authors examined completion of advance directives, use of palliative care, and enrollment in hospice among HIV patients who receive care at an urban safety net hospital. They found that the rates of advance directive completion, palliative care use, and hospice use were low. They recommended that advances should be made in identifying those patients earlier in their disease trajectories.
AHRQ-funded; HS022418.
Citation: Rhodes RL, Nazir F, Lopez S .
Use and predictors of end-of-life care among HIV patients in a safety net health system.
J Pain Symptom Manage 2016 Jan;51(1):120-5. doi: 10.1016/j.jpainsymman.2015.08.010.
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Keywords: Human Immunodeficiency Virus (HIV), Palliative Care, Urban Health
Murphy DJ, Lyu PF, Gregg SR
Using incentives to improve resource utilization: a quasi-experimental evaluation of an ICU quality improvement program.
In this paper, the investigators described the effect of a multifaceted quality improvement program designed to decrease the avoidable arterial blood gases, chest radiographs, and red blood cell transfusions on utilization of these resources and patient outcomes. The researchers found that implementation of their multifaceted quality improvement program, including financial incentives, was associated with significant improvements in resource utilization. They suggest that their findings provide evidence supporting the safety, effectiveness, and sustainability of incentive-based quality improvement interventions.
AHRQ-funded; HS000055.
Citation: Murphy DJ, Lyu PF, Gregg SR .
Using incentives to improve resource utilization: a quasi-experimental evaluation of an ICU quality improvement program.
Crit Care Med 2016 Jan;44(1):162-70. doi: 10.1097/ccm.0000000000001395..
Keywords: Healthcare Utilization, Quality Improvement
Stein BN, Pellish RS, Thompson KD
Using therapeutic drug monitoring to identify variable infliximab metabolism in an individual patient with ulcerative colitis.
In this case report, the authors demonstrate how therapeutic drug monitoring can be used to personalize a dosing regimen to ensure appropriate induction, and to safely deescalate therapy after remission is achieved. By identifying a change in drug clearance in an individual patient over time, they were able to attain significant cost savings despite the high price of serially measured drug and antibody concentrations.
AHRQ-funded; HS021747.
Citation: Stein BN, Pellish RS, Thompson KD .
Using therapeutic drug monitoring to identify variable infliximab metabolism in an individual patient with ulcerative colitis.
J Clin Gastroenterol 2016 Jan;50(1):66-8. doi: 10.1097/mcg.0000000000000370.
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Keywords: Care Management, Digestive Disease and Health, Quality of Care, Medication
Vogel JA, Newgard CD, Holmes JF
Validation of the Denver emergency department trauma organ failure score to predict post-injury multiple organ failure.
The objective of the study was to externally validate the Denver Emergency Department (ED) Trauma Organ Failure (TOF) Score, a 6-item instrument that includes age, intubation, hematocrit, systolic blood pressure, blood urea nitrogen, and white blood cell count, which was designed to predict the development of multiple organ failure (MOF) within 7 days of hospitalization. It was determined that the Denver ED TOF Score predicted development of MOF within 7 days of hospitalization.
AHRQ-funded; HS017526; HS023901.
Citation: Vogel JA, Newgard CD, Holmes JF .
Validation of the Denver emergency department trauma organ failure score to predict post-injury multiple organ failure.
J Am Coll Surg 2016 Jan;222(1):73-82. doi: 10.1016/j.jamcollsurg.2015.10.010.
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Keywords: Emergency Department, Trauma, Shared Decision Making, Risk, Injuries and Wounds