National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (1)
- Ambulatory Care and Surgery (2)
- (-) Cancer (34)
- Cancer: Breast Cancer (2)
- Cancer: Colorectal Cancer (5)
- Cancer: Lung Cancer (2)
- Cancer: Ovarian Cancer (1)
- Cancer: Prostate Cancer (2)
- Care Coordination (2)
- Caregiving (1)
- Children/Adolescents (1)
- Chronic Conditions (2)
- Clinician-Patient Communication (1)
- Colonoscopy (1)
- Communication (1)
- Comparative Effectiveness (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Diagnostic Safety and Quality (4)
- Disparities (1)
- Evidence-Based Practice (1)
- Family Health and History (1)
- Genetics (1)
- Healthcare Costs (1)
- Healthcare Delivery (3)
- Healthcare Utilization (1)
- Health Systems (1)
- Hospitals (7)
- Imaging (1)
- Men's Health (1)
- Mortality (1)
- Nursing (2)
- Organizational Change (1)
- Outcomes (3)
- Palliative Care (3)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (4)
- Patient Experience (3)
- Patient Safety (3)
- Policy (1)
- Practice Patterns (1)
- Primary Care (2)
- Primary Care: Models of Care (2)
- Provider (1)
- Provider: Nurse (1)
- Provider Performance (1)
- Quality Improvement (11)
- Quality Indicators (QIs) (4)
- Quality Measures (6)
- (-) Quality of Care (34)
- Quality of Life (2)
- Registries (1)
- Risk (3)
- Screening (3)
- Social Determinants of Health (1)
- Substance Abuse (1)
- Surgery (10)
- Treatments (4)
- Uninsured (1)
- Vulnerable Populations (1)
- Women (2)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 34 Research Studies DisplayedMurphy DR, Zimolzak AJ, Upadhyay DK
Developing electronic clinical quality measures to assess the cancer diagnostic process.
Electronic clinical quality measures (eCQMs) to evaluate quality of cancer diagnosis could facilitate quantification and improvement of diagnostic performance. The purpose of this study was to developed 2 eCQMs to evaluate diagnostic assessment of red-flag clinical findings for colorectal cancer (CRC) and lung cancer. At each site the researchers assessed 100 positive and 20 negative randomly chosen records for each eCQM at each site to validate accuracy and categorized missed opportunities associated with system, provider, or patient factors. The researchers applied the CRC eCQM at both sites, while the lung cancer eCQM was only applied at the VA due to an absence of structured data indicating level of cancer suspicion on most chest imaging results at Geisinger. The study found that for the CRC eCQM, the appropriate follow-up took place in 26, 746 out of 74, 314 patients (36.0%) in the VA after removing clinical exclusions and in 1,009 out of 2,461 patients (41.1%) at Geisinger. The appropriate assessment for lung cancer in the VA took place in 25, 166 out of 40, 924 patients (61.5). Provider factors were cited by reviewers the primary source of missed opportunities at both sites.
AHRQ-funded; HS022087.
Citation: Murphy DR, Zimolzak AJ, Upadhyay DK .
Developing electronic clinical quality measures to assess the cancer diagnostic process.
J Am Med Inform Assoc 2023 Aug 18; 30(9):1526-31. doi: 10.1093/jamia/ocad089..
Keywords: Cancer: Lung Cancer, Cancer, Quality Measures, Diagnostic Safety and Quality, Quality of Care
Jayadevappa R, Malkowicz SB, Vapiwala N
Association between hospital competition and quality of prostate cancer care.
The purpose of this retrospective study was to explore the relationship between hospital competition and outcomes in elderly with localized prostate cancer (PCa). The researchers also evaluated whether race moderated the relationship. The researchers applied the Hirschman-Herfindahl index (HHI) to measure hospital competition. The study outcomes were emergency room (ER) visits, hospitalizations, Medicare expenditure and mortality assessed in acute survivorship phase (two years post-PCa diagnosis), and long-term mortality. The study found that among 253,176 patients, percent change in incident rate of ER visit was 17% higher for one unit increase in HHI. Incident rate of ER was 24% higher for whites and 48% higher for African Americans. For one unit increase in HHI, hazard of short-term all-cause mortality was 7% higher for whites and 11% lower for African Americans. The hazard of long-term all-cause mortality was 10% higher for whites and 13% higher for African Americans.
AHRQ-funded; HS024106.
Citation: Jayadevappa R, Malkowicz SB, Vapiwala N .
Association between hospital competition and quality of prostate cancer care.
BMC Health Serv Res 2023 Aug 5; 23(1):828. doi: 10.1186/s12913-023-09851-4..
Keywords: Cancer: Prostate Cancer, Cancer, Men's Health, Hospitals, Quality of Care
Sullivan CE, Day SW, Ivankova N
Establishing nursing-sensitive quality indicators for pediatric oncology: an international mixed methods Delphi study.
The purpose of this study was to create an initial core set of Nursing-sensitive indicators (NSIs) for international pediatric oncology nursing that would be important, actionable, and feasible to measure across different resource settings and countries. The researchers utilized purposive snowball sampling to identify 122 expert pediatric oncology nurses from 43 countries for participation. In round 1, the panelists identified five potential NSIs and constructs. These results were applied to round 2 in which panelists chose their top 10 NSIs and constructs and ranked them according to importance to patient care quality. Those results were then applied to round 3, in which panelists ranked the top 10 NSIs and constructs by order of importance for the particular population, then rated each NSI/Construct for actionability and feasibility of measurement. The study identified the preliminary core set of NSIs and constructs identified by the expert panel, and ranked them in the following order of importance: safe chemotherapy administration and handling, infection prevention/control, pediatric oncology nursing orientation program, early warning score system/recognition of patient deterioration, chemotherapy/biotherapy education/course, pain assessment/management, symptom assessment/management, patient and family education, palliative/end of life care, and continuing nursing education/competency. The study reported that all NSIs and constructs were rated as actionable; all constructs except palliative/end of life care were rated as feasible to measure. The researchers concluded that initial core NSIs and constructs offer improved insight into typical features of international pediatric oncology nursing practice that are important, actionable, and feasible for quality measurement.
AHRQ-funded; HS013852.
Citation: Sullivan CE, Day SW, Ivankova N .
Establishing nursing-sensitive quality indicators for pediatric oncology: an international mixed methods Delphi study.
J Nurs Scholarsh 2023 Jan; 55(1):388-400. doi: 10.1111/jnu.12798..
Keywords: Children/Adolescents, Quality Indicators (QIs), Quality of Care, Nursing, Cancer
Ellsworth BL, Metz AK, Mott MM
Review of cancer-specific quality measures promoting the avoidance of low-value care.
The purpose of this study was to explore cancer quality measures to identify and describe those that encourage the avoidance of caner overtreatment and low-value care. The study also aimed to identify gaps that could direct the future development of cancer-specific quality measures. The researchers collected, reviewed, and identified 313 quality measures encouraging the avoidance of low-value cancer care, from six leading quality measures organizations. Of the 313 quality measures identified, 55 (18%) focused on avoidance of low-value care. Quality measure most likely to focus on low-value care included: 13 end-of-life care measures (50%); 12 breast cancer care measures (18%); 9 lung cancer care measures (31%); 8 colon cancer care measures (20%); 5 prostate cancer care measures (38%); and 4 general cancer care measures (3%). The study concluded that the majority of cancer quality measures are not aimed at avoiding cancer over-treatment and low value care, and existing recommendations have not been incorporated in the field.
AHRQ-funded; HS026030.
Citation: Ellsworth BL, Metz AK, Mott MM .
Review of cancer-specific quality measures promoting the avoidance of low-value care.
Ann Surg Oncol 2022 Jun;39(6):3750-62. doi: 10.1245/s10434-021-11303-4..
Keywords: Cancer, Quality Measures, Quality Indicators (QIs), Quality of Care
Radhakrishnan A, Reyes-Gastelum D, Abrahamse P
Physician specialties involved in thyroid cancer diagnosis and treatment: implications for improving health care disparities.
The authors sought to characterize providers involved in diagnosing and treating thyroid cancer. Patients with differentiated thyroid cancer from the Georgia and Los Angeles County Surveillance, Epidemiology and End Results registries were surveyed. The authors found that, among thyroid cancer patients, 40.6% reported being informed of their diagnosis by their surgeon, 37.9% by their endocrinologist, and 13.5% by their primary care physician (PCP). The researchers concluded that PCPs were involved in thyroid cancer diagnosis and treatment, and their involvement was greater among older patients and patients of minority race/ethnicity.
AHRQ-funded; HS024512.
Citation: Radhakrishnan A, Reyes-Gastelum D, Abrahamse P .
Physician specialties involved in thyroid cancer diagnosis and treatment: implications for improving health care disparities.
J Clin Endocrinol Metab 2022 Feb 17;107(3):e1096-e105. doi: 10.1210/clinem/dgab781..
Keywords: Cancer, Disparities, Diagnostic Safety and Quality, Practice Patterns, Quality Improvement, Quality of Care
Okado I, Pagano I, Cassel K
Perceptions of care coordination in cancer patient-family caregiver dyads.
The authors examined cancer patients and their family caregivers' perspectives of care coordination (CC) using a dyadic research design. They found that a subgroup of family caregivers reported poorer perception of CC than patients, suggesting that those family caregivers and providers may benefit from intervention. They concluded that further understanding of patient-family caregiver dyads' perspectives of CC can inform development of strategies to integrate family caregivers into the cancer care team, develop effective CC interventions for family caregivers, and contribute to improved quality and value of cancer care.
AHRQ-funded; HS027286.
Citation: Okado I, Pagano I, Cassel K .
Perceptions of care coordination in cancer patient-family caregiver dyads.
Support Care Cancer 2021 May;29(5):2645-52. doi: 10.1007/s00520-020-05764-8..
Keywords: Cancer, Caregiving, Care Coordination, Quality of Care
Reisz PA, Laviana AA, Zhao Z
Assessing the quality of surgical care for clinically localized prostate cancer: results from the CEASAR study.
Prior studies suggest that nationally endorsed quality measures for prostate cancer care are not linked closely with outcomes. Using a prospective, population based cohort the investigators measured clinically relevant variation in structure, process and outcome measures in men undergoing radical prostatectomy. The authors did not identify and meaningful variation in quality of care across racial groups, age groups and surgeon volume strata, in this cohort, suggesting that men were receiving comparable quality of care across these strata.
AHRQ-funded; HS019356.
Citation: Reisz PA, Laviana AA, Zhao Z .
Assessing the quality of surgical care for clinically localized prostate cancer: results from the CEASAR study.
J Urol 2020 Dec;204(6):1236-41. doi: 10.1097/ju.0000000000001198..
Keywords: Surgery, Cancer: Prostate Cancer, Cancer, Quality of Care, Quality of Life, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Friese CR, Fauer AJ, Kuisell C
Patient-reported outcomes collected in ambulatory oncology practices: feasibility, patterns, and correlates.
The purpose of this study was to examine the feasibility of soliciting outcomes from adults who received chemotherapy treatment for cancer and to describe the patterns and correlates of patient-reported toxicities. Results determined that querying patients on chemotherapy treatment experiences and toxicities was feasible. Toxicity rates varied across practices, informing quality improvement. Toxicity severity and service use incidence exceed previously published trial data, particularly for pain, fatigue, and gastrointestinal issues. Open-text questions enabled exploration with newer treatment regimens.
AHRQ-funded; HS024914.
Citation: Friese CR, Fauer AJ, Kuisell C .
Patient-reported outcomes collected in ambulatory oncology practices: feasibility, patterns, and correlates.
Health Serv Res 2020 Dec;55(6):966-72. doi: 10.1111/1475-6773.13574..
Keywords: Ambulatory Care and Surgery, Cancer, Treatments, Quality of Care, Patient-Centered Outcomes Research, Outcomes
Brajcich BC, Bentrem DJ, Yang AD
Short-term risk of performing concurrent procedures with hepatic artery infusion pump placement.
This study’s objective was to characterize the short-term outcomes of concurrent surgery with hepatic artery infusion pump (HAIP) placement using data from the 2005-2017 ACS NSQIP dataset. Findings showed that HAIP placement is not associated with additional morbidity when performed with hepatic and/or colorectal surgery. Decisions regarding HAIP placement should consider the risks of concurrent operations as well as patient- and disease-specific factors.
AHRQ-funded; HS026385.
Citation: Brajcich BC, Bentrem DJ, Yang AD .
Short-term risk of performing concurrent procedures with hepatic artery infusion pump placement.
Ann Surg Oncol 2020 Dec;27(13):5098-106. doi: 10.1245/s10434-020-08938-0..
Keywords: Quality Improvement, Quality of Care, Surgery, Risk, Cancer, Outcomes
Rauscher GH, Tossas-Milligan K, Macarol T
Trends in attaining mammography quality benchmarks with repeated participation in a quality measurement program: going beyond the mammography quality standards act to address breast cancer disparities.
The Mammography Quality Standards Act requires that mammography facilities conduct audits, but there are no specifications on the metrics to be measured. In this study, the authors present trends from the first 5 years of data collection to examine whether continued participation in this quality improvement program was associated with an increase in the number of benchmarks met for breast cancer screening.
AHRQ-funded; HS018366.
Citation: Rauscher GH, Tossas-Milligan K, Macarol T .
Trends in attaining mammography quality benchmarks with repeated participation in a quality measurement program: going beyond the mammography quality standards act to address breast cancer disparities.
J Am Coll Radiol 2020 Nov;17(11):1420-28. doi: 10.1016/j.jacr.2020.07.019..
Keywords: Cancer: Breast Cancer, Cancer, Women, Screening, Quality Measures, Quality Improvement, Quality of Care, Diagnostic Safety and Quality
Jin B, Nembhard IM
Voluntary hospital reporting of performance in cancer care: does volume make a difference?
The authors hypothesized that patient volume is positively associated with both reporting and performance in cancer care. Studying 72 Pennsylvania hospitals accredited by the Commission on Cancer, they found that hospitals that publicly reported their performance had higher patient volumes than hospitals that did not release performance. Among reporting hospitals, no association was found between patient volume and performance on process of care metrics, suggesting that volume is not a predictor of performance for reporting hospitals. They recommended further research to identify other factors that differentiate performance within and across reporting and nonreporting hospitals.
AHRQ-funded; HS017589.
Citation: Jin B, Nembhard IM .
Voluntary hospital reporting of performance in cancer care: does volume make a difference?
J Healthc Qual 2020 Nov/Dec;42(6):e75-e82. doi: 10.1097/jhq.0000000000000225..
Keywords: Cancer, Provider Performance, Hospitals, Quality Indicators (QIs), Quality Measures, Quality of Care
Schlick CJR, Khorfan R, Odell DD
Adequate lymphadenectomy as a quality measure in esophageal cancer: is there an association with treatment approach?
In this study, the authors’ objectives were to (1) explore trends in adequate lymphadenectomy rates over time; (2) evaluate unadjusted lymphadenectomy yield by treatment characteristics; and (3) identify independent factors associated with adequate lymphadenectomy. The investigators found that despite increases over time, only 50% of patients underwent adequate lymphadenectomy during esophageal cancer resection. They also found that adequate lymphadenectomy was not associated with neoadjuvant therapy.
AHRQ-funded; HS026385.
Citation: Schlick CJR, Khorfan R, Odell DD .
Adequate lymphadenectomy as a quality measure in esophageal cancer: is there an association with treatment approach?
Ann Surg Oncol 2020 Oct;27(11):4443-56. doi: 10.1245/s10434-020-08578-4..
Keywords: Cancer, Surgery, Quality Measures, Quality of Care, Quality Improvement
Knutzen KE, Schifferdecker KE, Murray GF
Role of norms in variation in cancer centers' end-of-life quality: qualitative case study protocol.
AHRQ-funded; HS022242.
Citation: Knutzen KE, Schifferdecker KE, Murray GF .
Role of norms in variation in cancer centers' end-of-life quality: qualitative case study protocol.
BMC Palliat Care 2020 Aug 27;19(1):136. doi: 10.1186/s12904-020-00641-x..
Keywords: Cancer, Quality of Life, Palliative Care, Quality of Care, Chronic Conditions
Lafferty M, Fauer A, Wright N
Causes and consequences of chemotherapy delays in ambulatory oncology practices: a multisite qualitative study.
The purpose of this study was to examine the causes and consequences of chemotherapy treatment delays and possible solutions to improve quality of care. The authors identified four primary themes from the analysis that affect delays. They suggest future investigations to examine nurses' communication practices in the context of timely chemotherapy administration since communication and documentation technologies within healthcare settings continuously evolve.
AHRQ-funded; HS024914.
Citation: Lafferty M, Fauer A, Wright N .
Causes and consequences of chemotherapy delays in ambulatory oncology practices: a multisite qualitative study.
Oncol Nurs Forum 2020 Jul 1;47(4):417-27. doi: 10.1188/20.Onf.417-427..
Keywords: Treatments, Cancer, Ambulatory Care and Surgery, Quality of Care, Clinician-Patient Communication, Communication, Provider: Nurse, Provider, Nursing, Chronic Conditions
Kanters AE, Vu JV, Schuman AD AE, Vu JV, Schuman AD
Completeness of operative reports for rectal cancer surgery.
This study examined the completeness of operative reports for rectal cancer surgery and whether they contain the key elements recommended by the National Accreditation Program for Rectal Cancer. Ten hospitals in Michigan submitted rectal cancer operative reports from June-December 2018. These reports were analyzed for completeness and to identify key elements in the synoptic operative template. Out of 110 reports, 31 contained all 24 elements and they all used a synoptic template. Overall, 62 reported used a synoptic template and 48 did not.
AHRQ-funded; HS000053.
Citation: Kanters AE, Vu JV, Schuman AD AE, Vu JV, Schuman AD .
Completeness of operative reports for rectal cancer surgery.
Am J Surg 2020 Jul;220(1):165-69. doi: 10.1016/j.amjsurg.2019.09.036..
Keywords: Cancer: Colorectal Cancer, Cancer, Surgery, Quality Improvement, Quality of Care
De la Garza Ramos R, Gelfand Y, Benton JA
Rates, risk factors, and complications of red blood cell transfusion in metastatic spinal tumor surgery: an analysis of a prospective multicenter surgical database.
The goal of this study was to identify rates, risks, and complications of red blood cell (RBC) transfusion in metastatic spinal tumor surgery. The multicenter prospective American College of Surgeons National Quality Improvement Program database was used to identify adult patients with disseminated cancer who underwent metastatic spinal tumor surgery from 2012-2016. A patient was included if at least 1 intraoperative/postoperative RBC transfusion was received within the first 72 hours of surgery start time. Out of 1601 patients included, 623 (38.9%) received a RBC transfusion. There was an overall higher complication rate in patients who received a transfusion compared to those who didn’t. These complications included sepsis (3.5% vs. 1.9%), deep vein thrombosis (6.1% vs. 3.3%), and prolonged ventilation (3.9% vs. 1.3%). Future research into complication prevention was recommended.
https://www.pubmed.ncbi.nlm.nih.gov/32298819
Citation: De la Garza Ramos R, Gelfand Y, Benton JA .
Rates, risk factors, and complications of red blood cell transfusion in metastatic spinal tumor surgery: an analysis of a prospective multicenter surgical database.
World Neurosurg 2020 Jul;139:e308-e15. doi: 10.1016/j.wneu.2020.03.202..
Keywords: Quality Improvement, Quality of Care, Surgery, Risk, Cancer
Ellis RJ, Schlick CJR, Feinglass J
Failure to administer recommended chemotherapy: acceptable variation or cancer care quality blind spot?
This study examined hospital variation in cancer patients who did not receive recommended chemotherapy. Patients with breast, colon, and lung cancers who did not receive chemotherapy from 2000 to 2015 were identified from the National Cancer Database. A total of 183,148 patients at 1281 hospitals were included. For breast cancer, 3.5% of patients failed to receive recommended chemotherapy, and 6.6% with colon, and 10.7% with lung cancer. Sociodemographic factors showed that patients were less likely to receive chemotherapy if they were uninsured or on Medicaid, as were non-Hispanic black patients with both breast and colon cancer. There was also significant hospital variation with failure to administer as high as 21.8% for breast, 40.2% for colon, and 40.0% for lung cancer.
AHRQ-funded; HS000078; HS026385.
Citation: Ellis RJ, Schlick CJR, Feinglass J .
Failure to administer recommended chemotherapy: acceptable variation or cancer care quality blind spot?
BMJ Qual Saf 2020 Feb;29(2):103-12. doi: 10.1136/bmjqs-2019-009742..
Keywords: Treatments, Cancer, Healthcare Delivery, Access to Care, Healthcare Utilization, Social Determinants of Health, Vulnerable Populations, Uninsured, Hospitals, Quality of Care
Kanters AE, Cleary RK, Obi SH
Uptake of total mesorectal excision and total mesorectal excision grading for rectal cancer: a statewide study.
Investigators sought to assess trends in total mesorectal excision performance and grading in Michigan hospitals. They found that the rates of total mesorectal excision performance and grade assignment were widely variable throughout the state of Michigan. Overall, grade assignment remained very low, suggesting an opportunity for quality improvement projects to increase total mesorectal excision performance and grading, involving both the surgeons and pathologists for effective implementation.
AHRQ-funded; HS000053.
Citation: Kanters AE, Cleary RK, Obi SH .
Uptake of total mesorectal excision and total mesorectal excision grading for rectal cancer: a statewide study.
Dis Colon Rectum 2020 Jan;63(1):53-59. doi: 10.1097/dcr.0000000000001526..
Keywords: Cancer: Colorectal Cancer, Cancer, Surgery, Quality Improvement, Quality of Care
Sheetz KH, Dimick JB, Nathan H
Centralization of high-risk cancer surgery within existing hospital systems.
Centralization is often proposed as a strategy to improve the quality of certain high-risk health care services. In this study, the investigators evaluated the extent to which existing hospital systems centralize high-risk cancer surgery and whether centralization is associated with short-term clinical outcomes. The investigators concluded that greater centralization of complex cancer surgery within existing hospital systems was associated with better outcomes.
AHRQ-funded; HS023597.
Citation: Sheetz KH, Dimick JB, Nathan H .
Centralization of high-risk cancer surgery within existing hospital systems.
J Clin Oncol 2019 Dec 1;37(34):3234-42. doi: 10.1200/jco.18.02035..
Keywords: Surgery, Cancer, Risk, Hospitals, Health Systems, Quality Improvement, Quality Indicators (QIs), Quality of Care, Outcomes
Evensen CT, Yost KJ, Keller S
Development and testing of the CAHPS Cancer Care Survey.
In order to develop the CAHPS Cancer Care Survey instrument, the authors conducted cognitive tests of the instrument as well as field tests at six cancer centers and four community oncology practices; the survey was then finalized and obtained the CAHPS trademark. The authors recommend mail-only, mail-telephone mixed-mode, and Web-mail mixed-mode data collection methods.
AHRQ-funded; 290200600019I.
Citation: Evensen CT, Yost KJ, Keller S .
Development and testing of the CAHPS Cancer Care Survey.
J Oncol Pract 2019 Nov;15(11):e969-e78. doi: 10.1200/jop.19.00039..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Cancer, Patient Experience, Quality of Care
Ellis RJ, Zhang LM, Ko CY
Variation in hospital utilization of minimally invasive distal pancreatectomy for localized pancreatic neoplasms.
The objectives of this study were to identify factors associated with use of minimally invasive distal pancreatectomy (MIDP) for localized neoplasms and to assess hospital variation in MIDP utilization. Results showed that utilization of MIDP for localized pancreatic neoplasms is highly variable; while some patient-level factors are associated with MIDP use, hospital adoption of MIDP appears to be the primary driver of utilization. Monitoring hospital-level use of MIDP may be a useful quality measure to monitor uptake of emerging techniques in pancreatic surgery.
AHRQ-funded; HS026385; HS000078.
Citation: Ellis RJ, Zhang LM, Ko CY .
Variation in hospital utilization of minimally invasive distal pancreatectomy for localized pancreatic neoplasms.
J Gastrointest Surg 2020 Dec;24(12):2780-88. doi: 10.1007/s11605-019-04414-7..
Keywords: Cancer, Surgery, Hospitals, Quality of Care
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.
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
Antunez AG, Kanters AE, Regenbogen SE
Evaluation of access to hospitals most ready to achieve national accreditation for rectal cancer treatment.
This cohort study looked at hospitals’ readiness to be part of the American College of Surgeons National Accreditation Program for Rectal Cancer (NAPRC), and what types of hospitals are most likely to receive NAPRC accreditation. A total of 1315 American College of Surgeons Commission on Cancer-accredited hospitals from the National Cancer Database were sorted into 4 cohorts from 2011 to 2015. They were organized by high versus low volume, adherence to process standards, and patient and hospital characteristics and oncologic outcomes were compared. Among those hospitals, 38 (2.9%) met proposed thresholds for all 5 NAPRC process standards, and 220 (16.7%) met the threshold on 4 standards. Low-adherence hospitals were more likely to serve patients who were older, as well more public insurance recipients, or were black or Hispanic.
ARHQ-funded; HS000053.
Citation: Antunez AG, Kanters AE, Regenbogen SE .
Evaluation of access to hospitals most ready to achieve national accreditation for rectal cancer treatment.
JAMA Surg 2019 Jun;154(6):516-23. doi: 10.1001/jamasurg.2018.5521..
Keywords: Cancer: Colorectal Cancer, Cancer, Hospitals, Quality Improvement, Quality of Care
Skinner D, Franz B, Howard J
The politics of primary care expansion: lessons from cancer survivorship and substance abuse.
The purpose of this study was to understand the perspectives of primary care innovators treating patient populations not traditionally considered to be within the purview of primary care. The authors indicated that their study findings suggested that the politics surrounding entrenched professional identities contributed to barriers faced by conference participants in their efforts to provide innovative care for these nontraditional populations. Specifically, obstacles surfaced in relation to sharing patients across disciplinary boundaries, which resulted in issues of possessiveness, a questioning of provider qualifications, and a lack of interprofessional trust.
AHRQ-funded; HS021287.
Citation: Skinner D, Franz B, Howard J .
The politics of primary care expansion: lessons from cancer survivorship and substance abuse.
J Healthc Manag 2018 Sep-Oct;63(5):323-36. doi: 10.1097/jhm-d-16-00030..
Keywords: Primary Care, Primary Care: Models of Care, Patient-Centered Healthcare, Cancer, Substance Abuse, Policy, Healthcare Delivery, Organizational Change, Quality of Care
Roydhouse JK, Gutman R, Keating NL
Differences between proxy and patient assessments of cancer care experiences and quality ratings.
This study assessed the impact of proxy survey responses on cancer care experience reports and quality ratings. Adjusted proxy scores were modestly higher for medical care experiences but lower for nursing care and care coordination experiences. There were no significant differences between adjusted patient and proxy ratings of quality.
AHRQ-funded; HS000011.
Citation: Roydhouse JK, Gutman R, Keating NL .
Differences between proxy and patient assessments of cancer care experiences and quality ratings.
Health Serv Res 2018 Apr;53(2):919-43. doi: 10.1111/1475-6773.12672.
.
.
Keywords: Cancer, Cancer: Colorectal Cancer, Cancer: Lung Cancer, Quality of Care, Patient Experience