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 195 Research Studies DisplayedMyers SR, Salhi RA, Lerner EB
A pilot study describing access to emergency care in two states using a model emergency care categorization system.
To improve regionalization of care and patient decisions when seeking emergency care, the researchers surveyed emergency departments (EDs) in 2 States. They found that 25 percent provided advanced care, 10.5 percent comprehensive care, and 1.6 percent pediatric critical care. Overall, 75.1 percent of the population could reach advanced or comprehensive ED within 60 minutes by ground transportation.
AHRQ-funded; HS017960; HS018604
Citation: Myers SR, Salhi RA, Lerner EB .
A pilot study describing access to emergency care in two states using a model emergency care categorization system.
Acad Emerg Med. 2013 Sep;20(9):894-903. doi: 10.1111/acem.12208..
Keywords: Emergency Medical Services (EMS), Access to Care, Critical Care, Shared Decision Making
Williams SE, Rothman RL, Offit PA
A randomized trial to increase acceptance of childhood vaccines by vaccine-hesitant parents: a pilot study.
This pilot study evaluated an educational intervention (a video and written information) to improve parental attitudes and vaccine-uptake in vaccine-hesitant parents. It found a modest increase in parental attitudes toward vaccines but no difference in receipt of vaccines between the intervention and control groups at 12 weeks.
AHRQ-funded; HS019675
Citation: Williams SE, Rothman RL, Offit PA .
A randomized trial to increase acceptance of childhood vaccines by vaccine-hesitant parents: a pilot study.
Acad Pediatr. 2013 Sep-Oct;13(5):475-80. doi: 10.1016/j.acap.2013.03.011..
Keywords: Children/Adolescents, Vaccination, Education: Patient and Caregiver, Healthcare Utilization
Robin Yabroff K, Short PF, Machlin S
AHRQ Author: Machlin S
Access to preventive health care for cancer survivors.
The researchers evaluated the association between cancer survivorship and access to primary and preventive health care. They concluded that, although access and preventive care use in cancer survivors is generally equivalent or greater compared to that of other individuals, disparities for uninsured and publicly insured cancer survivors aged 18-64 years suggest that improvements in survivor care are needed.
AHRQ-authored.
Citation: Robin Yabroff K, Short PF, Machlin S .
Access to preventive health care for cancer survivors.
Am J Prev Med 2013 Sep;45(3):304-12. doi: 10.1016/j.amepre.2013.04.021.
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Keywords: Access to Care, Cancer, Medical Expenditure Panel Survey (MEPS), Prevention, Primary Care
Galarraga O, Genberg BL, Martin RA
Conditional economic incentives to improve HIV treatment adherence: literature review and theoretical considerations.
This review summarizes various theories from micro- and behavioral-economics to social and clinical psychology that may help to understand how conditional economic incentives (CEI) work, and how they may be integrated with theories of health behavior that focus more on internal motivation. It concluded that appropriate CEI can help patients adhere to HIV treatment in the short-term, while incentives are in place.
AHRQ-funded; HS019657
Citation: Galarraga O, Genberg BL, Martin RA .
Conditional economic incentives to improve HIV treatment adherence: literature review and theoretical considerations.
AIDS Behav. 2013 Sep;17(7):2283-92. doi: 10.1007/s10461-013-0415-2..
Keywords: Human Immunodeficiency Virus (HIV), Patient Self-Management, Chronic Conditions, Medication, Patient Adherence/Compliance
Hong AL, Sawyer MD, Shore A
Decreasing central-line-associated bloodstream infections in Connecticut intensive care units.
This study demonstrated that the Comprehensive Unit-based Safety Program, a multifaceted approach to prevent central line-associated bloodstream infections (CLABSIs) could be implemented in Connecticut (following successful implementation in Michigan). The program was associated with a reduction in CLABSI rates in Connecticut, even though the State’s baseline CLABSI rate was already low.
AHRQ-funded; 290200600022
Citation: Hong AL, Sawyer MD, Shore A .
Decreasing central-line-associated bloodstream infections in Connecticut intensive care units.
J Healthc Qual. 2013 Sep-Oct;35(5):78-87. doi: 10.1111/j.1945-1474.2012.00210.x..
Keywords: Comprehensive Unit-based Safety Program (CUSP), Healthcare-Associated Infections (HAIs), Central Line-Associated Bloodstream Infections (CLABSI), Patient Safety, Quality of Care
Suskind AM, Clemens JQ, Dunn RL
Effectiveness of mesh compared with nonmesh sling surgery in Medicare beneficiaries.
This study assessed the effectiveness of mesh compared to nonmesh slings in the surgical treatment of female incontinence. It found that overall rates of complications were similar for patients undergoing either mesh or nonmesh sling procedures. However, patients undergoing the nonmesh procedure were more likely to require a subsequent intervention for bladder outlet obstruction.
AHRQ-funded; HS018726.
Citation: Suskind AM, Clemens JQ, Dunn RL .
Effectiveness of mesh compared with nonmesh sling surgery in Medicare beneficiaries.
Obstet Gynecol. 2013 Sep;122(3):546-52. doi: 10.1097/AOG.0b013e31829e8543..
Keywords: Comparative Effectiveness, Elderly, Patient-Centered Outcomes Research, Surgery, Women, Outcomes, Medicare, Evidence-Based Practice
Quigley DD, Martino SC, Brown JA
Evaluating the content of the communication items in the CAHPS clinician and group survey and supplemental items with what high-performing physicians say they do.
The authors examined the content of the CAHPS® Clinician and Group Survey and found that the survey items captured many of the most commonly mentioned doctor-patient communication behaviors and practices identified by high-performing physicians. However, three key aspects of communication--nonverbal communication, greeting patients, and tracking personal information about patients--were not captured by the current survey.
AHRQ-funded; HS016980.
Citation: Quigley DD, Martino SC, Brown JA .
Evaluating the content of the communication items in the CAHPS clinician and group survey and supplemental items with what high-performing physicians say they do.
Patient. 2013;6(3):169-77. doi: 10.1007/s40271-013-0016-1..
Keywords: Communication, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Clinician-Patient Communication, Provider Performance
Shoemaker SJ, Staub-DeLong L, Wasserman M
Factors affecting adoption and implementation of AHRQ health literacy tools in pharmacies.
The purpose of this study is to understand the facilitators and barriers to the adoption and implementation of AHRQ’s health literacy tools, particularly a tool to assess a pharmacy’s health literacy practices. The study found facilitators including awareness of health literacy, a culture of innovation, and a change champion. It also identified barriers such as lack of leadership support and limited staff time.
AHRQ-funded; 290200600011I
Citation: Shoemaker SJ, Staub-DeLong L, Wasserman M .
Factors affecting adoption and implementation of AHRQ health literacy tools in pharmacies.
Res Social Adm Pharm. 2013 Sep-Oct;9(5):553-63. doi: 10.1016/j.sapharm.2013.05.003..
Keywords: Health Literacy, Education: Patient and Caregiver, Practice Patterns, Tools & Toolkits, Medication
Beaubrun AC, Kanda E, Bond TC
Form CMS-2728 data versus erythropoietin claims data: implications for quality of care studies.
The purpose of this study was to compare predialysis erythropoietin-simulating agents (ESA) care reported on Form CMS-2728 with Medicare claims for ESA treatment submitted for patients 67 years and older at initiation of dialysis with Medicare as the primary payer. It found that the agreement between Form CMS-2728 and claims data is poor and discordant results are observed when comparing the use of these data sources to predict health outcomes.
AHRQ-funded; HS000032.
Citation: Beaubrun AC, Kanda E, Bond TC .
Form CMS-2728 data versus erythropoietin claims data: implications for quality of care studies.
Ren Fail 2013;35(3):320-6. doi: 10.3109/0886022x.2012.747967..
Keywords: Medicare, Data, Elderly, Quality of Care, Kidney Disease and Health
Paez K, Roper RA, Andrews RM
AHRQ Author: Roper RA, Andrews RM
Health information technology and hospital patient safety: a conceptual model to guide research.
The authors developed a conceptual model to guide research in sorting out the complex relationships between health information technology (HIT) and the quality and safety of care. They found the model difficult to operationalize because available HIT adoption data did not characterize features and extent of usage, and patient safety measures did not elucidate the process failures leading to safety-related outcomes. Their findings illustrated the critical need for collecting data that are germane to HIT and the possible mechanisms by which HIT may affect inpatient safety.
AHRQ-authored; AHRQ-funded.
Citation: Paez K, Roper RA, Andrews RM .
Health information technology and hospital patient safety: a conceptual model to guide research.
Jt Comm J Qual Patient Saf 2013 Sep;39(9):415-25.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Health Information Technology (HIT), Hospitals, Quality of Care, Patient Safety
Quick B, Harrison TR, King AJ
It's up to you: a multi-message, phased driver facility campaign to increase organ donation registration rates in Illinois.
This project applied successful strategies previously employed in driver facility campaigns to examine whether these strategies would be effective in growing a registry where the majority of individuals have already had the opportunity to register as an organ donor. In facilities with historically high and low registration percentages, these strategies resulted in higher organ donor registration rates, compared with control facilities.
AHRQ-funded; HS019218
Citation: Quick B, Harrison TR, King AJ .
It's up to you: a multi-message, phased driver facility campaign to increase organ donation registration rates in Illinois.
Clin Transplant. 2013 Sep-Oct;27(5):E546-53. doi: 10.1111/ctr.12208..
Keywords: Comparative Effectiveness, Registries, Transplantation, Education: Patient and Caregiver, Evidence-Based Practice
Radecki RP
Letter by Radecki regarding article, "safety of thrombolysis in stroke mimics: results from a multicenter cohort study".
In this letter commenting on an article on the treatment of stroke mimics, the author asserts that the difficult question of the acceptable rate of misdiagnosis remains. He suggests that patients undergoing thrombolytic therapy for acute ischemic stroke have confirmatory testing such as an MRI with diffusion-weighted sequences and that the incidence of neuroimaging negative events be reported.
AHRQ-funded; HS017586
Citation: Radecki RP .
Letter by Radecki regarding article, "safety of thrombolysis in stroke mimics: results from a multicenter cohort study".
Stroke. 2013 Sep;44(9):e105. doi: 10.1161/STROKEAHA.113.002040..
Keywords: Stroke, Shared Decision Making, Patient Safety, Blood Clots
Fitzgibbons Jr RJ, Ramanan B, Arya S
Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias.
This study of 254 men with minimally symptomatic inguinal hernia who were assigned to watchful waiting (WW) found that WW is a reasonable and safe strategy. However, the study which followed these patients for up to 11.5 years found that symptoms usually progressed and an operation was eventually needed, with 79 percent of men older than 65 and 62 percent of younger men receiving surgical repair.
AHRQ-funded; HS09860
Citation: Fitzgibbons Jr RJ, Ramanan B, Arya S .
Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias.
Ann Surg. 2013 Sep;258(3):508-15. doi: 10.1097/SLA.0b013e3182a19725..
Keywords: Surgery, Men's Health, Quality of Care, Patient Safety, Shared Decision Making
Brewer BB, Verran JA
Measuring nursing unit environments with four composite measure.
This article describes a research study that developed four unit-level composite measures reflecting the work environment of nurses. These four measures (originally measured with 14 instruments) enhance the interpretation of environmental factors that have the greatest impact on patient outcomes.
AHRQ-funded; HS011973
Citation: Brewer BB, Verran JA .
Measuring nursing unit environments with four composite measure.
Nurs Econ. 2013 Sep-Oct;31(5):241-9..
Keywords: Patient Safety, Nursing, Workforce
Baur C, Brach C
AHRQ Author: Brach C
Pharmacy research on health literacy can contribute to national goals and health care system improvements.
Three key points about health literacy underscore the articles in this special issue: 1. Effective health communication utilizes both the spoken and written word; 2. A number of health literacy tools can help pharmacists implement health literacy practices; 3. Readability assessments can be a step on a path toward more productive provider–patient communication.
AHRQ-authored.
Citation: Baur C, Brach C .
Pharmacy research on health literacy can contribute to national goals and health care system improvements.
Res Social Adm Pharm 2013 Sep-Oct;9(5):498-502. doi: 10.1016/j.sapharm.2013.06.012.
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Keywords: Healthcare Delivery, Communication, Health Literacy, Provider: Pharmacist
Matthews CA, Whitehead WE, Townsend MK
Risk factors for urinary, fecal, or dual incontinence in the Nurses' Health Study.
This study estimating the prevalence of urinary incontinence, fecal incontinence, and dual incontinence in a group of 64,396 women aged 62-87 years found that 38 percent had urinary incontinence alone, 4 percent had fecal incontinence alone, and 7 percent had dual incontinence. Dual incontinence was primarily associated with advanced age, decompensating medical conditions, depression, and multiparity.
AHRQ-funded; HS018695.
Citation: Matthews CA, Whitehead WE, Townsend MK .
Risk factors for urinary, fecal, or dual incontinence in the Nurses' Health Study.
Obstet Gynecol. 2013 Sep;122(3):539-45. doi: 10.1097/AOG.0b013e31829efbff..
Keywords: Chronic Conditions, Elderly, Women
Dahabreh IJ, Chung M, Kitsios GD
Survey of the methods and reporting practices in published meta-analyses of test performance: 1987 to 2009.
The researchers performed a survey of meta-analyses of test performance to describe the evolution in their methods and reporting. They found that the most common clinical areas were cardiovascular disease and oncology, while the most common test categories were imaging and biomarker tests. They concluded that the methods employed in meta-analyses of test performance have improved with the introduction of quality assessment checklists and the development of more sophisticated statistical methods.
AHRQ-funded; 290200710055I; HS013328.
Citation: Dahabreh IJ, Chung M, Kitsios GD .
Survey of the methods and reporting practices in published meta-analyses of test performance: 1987 to 2009.
Res Synth Methods 2013 Sep;4(3):242-55. doi: 10.1002/jrsm.1083.
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Keywords: Comparative Effectiveness, Diagnostic Safety and Quality, Research Methodologies
Abasaeed R, Kranz AM, Rozier RG
The impact of the Great Recession on untreated dental caries among kindergarten students in North Carolina.
This study to determine the impact of the Great Recession on untreated dental caries in kindergarten-aged children in North Carolina found there were a higher proportion of children with more than one untreated decayed primary tooth as well as fewer children receiving dental treatment after 2006. The study covering 7 school years from 2003 to 2010 and 1,215 schools used increased participation in the National School Lunch Program as an indicator of the Great Recession.
AHRQ-funded; HS000032
Citation: Abasaeed R, Kranz AM, Rozier RG .
The impact of the Great Recession on untreated dental caries among kindergarten students in North Carolina.
J Am Dent Assoc. 2013 Sep;144(9):1038-46..
Keywords: Children/Adolescents, Dental and Oral Health, Healthcare Costs, Access to Care, Low-Income
Le XH, Luque AE, Wang D
Assessing the usage of a guideline-driven interactive case simulation tool for insomnia screening and treatment in an HIV clinical education program.
The researchers report the preliminary results from a study to assess the usage of a guideline-driven insomnia screening and treatment case simulation tool. Using system usage diagrams as an instrument, they quantified visit frequency and length of stay for different types of system resources. Preliminary results have shown that both recommendations and interactive decision diagrams were frequently used, with the former having a longer length of stay but fewer visits.
AHRQ-funded; HS022057.
Citation: Le XH, Luque AE, Wang D .
Assessing the usage of a guideline-driven interactive case simulation tool for insomnia screening and treatment in an HIV clinical education program.
Stud Health Technol Inform 2013;192:323-7..
Keywords: Education: Continuing Medical Education, Guidelines, Human Immunodeficiency Virus (HIV), Screening, Simulation, Sleep Problems
Del Fiol G, Curtis C, Cimino JJ
Disseminating context-specific access to online knowledge resources within electronic health record systems.
This paper describes OpenInfobutton (www.openinfobutton.org): a standards-based, open source Web service that was designed to disseminate infobutton capabilities in multiple electronic health record systems and healthcare organizations. Included in this overview are the OpenInfobutton architecture, knowledge resource integration, and experiences at five large healthcare organizations.
AHRQ-funded; HS018352.
Citation: Del Fiol G, Curtis C, Cimino JJ .
Disseminating context-specific access to online knowledge resources within electronic health record systems.
Stud Health Technol Inform 2013;192:672-6..
Keywords: Clinical Decision Support (CDS), Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Web-Based
Goff SL, Pekow PS, White KO
IDEAS for a healthy baby--reducing disparities in use of publicly reported quality data: study protocol for a randomized controlled trial.
This study's goals were to determine the efficacy of a patient navigator intervention to assist low-income pregnant women in the use of publicly available information about quality of care when choosing a pediatrician; to evaluate the relative importance of factors influencing women's choice of pediatric practices; to evaluate the effect of the intervention on patient engagement in management of their own and their child's health care; and to assess variation in efficacy of the intervention for sub-groups based on parity, age, and race/ethnicity. Successful completion of the study aims is expected to yield important new knowledge about the value of guided website navigation as a strategy to increase the impact of publicly reported quality data and to reduce disparities in use of these data.
AHRQ-funded; HS021864.
Citation: Goff SL, Pekow PS, White KO .
IDEAS for a healthy baby--reducing disparities in use of publicly reported quality data: study protocol for a randomized controlled trial.
Trials 2013 Aug 7;14:244. doi: 10.1186/1745-6215-14-244.
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Keywords: Education: Patient and Caregiver, Newborns/Infants, Low-Income, Pregnancy, Public Reporting
Tsui J, Gee GC, Rodriguez HP
Exploring the role of neighborhood socio-demographic factors on HPV vaccine initiation among low-income, ethnic minority girls.
This study of neighborhood factors associated with human papillomavirus (HPV) vaccine uptake, especially among disadvantaged groups, found that initiation rates were highest among girls from the most disadvantaged neighborhoods. However, mother’s awareness of HPV, age, and insurance status were also strong predictors for initiation.
AHRQ-funded; HS020172
Citation: Tsui J, Gee GC, Rodriguez HP .
Exploring the role of neighborhood socio-demographic factors on HPV vaccine initiation among low-income, ethnic minority girls.
J Immigr Minor Health. 2013 Aug;15(4):732-40. doi: 10.1007/s10903-012-9736-x..
Keywords: Vaccination, Children/Adolescents, Women, Health Insurance, Disparities
Gabayan GZ, Asch SM, Hsia RY
Factors associated with short-term bounce-back admissions after emergency department discharge.
The researchers describe the prevalence, characteristics, and predictors of 7-day bounce-back admissions after ED discharge in a cohort of California hospitals. They found that older white men and patients with a disposition of eloped or having left against medical advice especially at risk for a bounce-back admission. They also found that use of Medicaid or Medicare was associated with higher rates of bounce-back admission.
AHRQ-funded; HS018098.
Citation: Gabayan GZ, Asch SM, Hsia RY .
Factors associated with short-term bounce-back admissions after emergency department discharge.
Ann Emerg Med 2013 Aug;62(2):136-44.e1. doi: 10.1016/j.annemergmed.2013.01.017..
Keywords: Emergency Department, Hospital Discharge, Hospital Readmissions
Jonsson Funk M, Visco AG, Weidner AC
Long-term outcomes of vaginal mesh versus native tissue repair for anterior vaginal wall prolapse.
This study estimated the rate of repeat surgery after vaginal mesh versus native tissue repair for anterior vaginal wall prolapse. The researchers found that the overall risk of any future surgery was higher in the women receiving mesh; however, native tissue and vaginal mesh surgery had similar 5-year risks for recurrent prolapse.
AHRQ-funded; HS017950
Citation: Jonsson Funk M, Visco AG, Weidner AC .
Long-term outcomes of vaginal mesh versus native tissue repair for anterior vaginal wall prolapse.
Int Urogynecol J. 2013 Aug;24(8):1279-85. doi: 10.1007/s00192-013-2043-9..
Keywords: Comparative Effectiveness, Surgery, Women, Outcomes, Risk
Schneeweiss S, Seeger JD, Jackson JW
AHRQ Author: Smith SR
Methods for comparative effectiveness research/patient-centered outcomes research: from efficacy to effectiveness.
This article provides an overview of papers in this supplement resulting from a June 2012 AHRQ-sponsored symposium on research methods for CER and patient-centered outcomes research.
AHRQ-authored.
Citation: Schneeweiss S, Seeger JD, Jackson JW .
Methods for comparative effectiveness research/patient-centered outcomes research: from efficacy to effectiveness.
J Clin Epidemiol 2013 Aug;66(8 Suppl):S1-4. doi: 10.1016/j.jclinepi.2013.05.012.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Research Methodologies