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
51 to 75 of 113 Research Studies DisplayedO'Malley AS, Rich EC
Measuring comprehensiveness of primary care: challenges and opportunities.
This paper discusses challenges to measuring comprehensiveness for a primary care team’s patient panel, presents survey and claims-based measures of comprehensiveness, and provides suggestions for future research. The authors argue that developing valid and reliable measures of comprehensiveness could inform quality improvement efforts and help identify
providers in need of additional support.
providers in need of additional support.
AHRQ-funded.
Citation: O'Malley AS, Rich EC .
Measuring comprehensiveness of primary care: challenges and opportunities.
J Gen Intern Med 2015 Aug;30 Suppl 3:S568-75. doi: 10.1007/s11606-015-3300-z..
Keywords: Primary Care, Quality of Care
Schulz J, DeCamp M, Berkowitz SA
Medicare Shared Savings Program: public reporting and shared savings distributions.
The objectives of this paper are to determine if Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) are meeting public reporting requirements related to shared savings plans, to quantitate the composition of shared savings distribution plans, and to investigate whether early ACO success is associated with specific plan or ACO characteristics. The authors found that just over one-half of MSSP ACOs report detailed shared savings distribution plans online, and these plans vary widely. They concluded that there appears to be no single shared savings distribution plan determinate of ACO success.
AHRQ-funded; HS023684.
Citation: Schulz J, DeCamp M, Berkowitz SA .
Medicare Shared Savings Program: public reporting and shared savings distributions.
Am J Manag Care 2015 Aug;21(8):546-53.
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Keywords: Quality of Care, Payment, Policy, Medicare, Public Reporting
Xu X, Buta E, Anhang Price R
Methodological considerations when studying the association between patient-reported care experiences and mortality.
This study illustrated methodological considerations when assessing the relationship between patient care experiences and mortality. It found that the association between overall care experiences and mortality was significant for deaths not amenable to medical care and all-cause mortality, but not for amenable deaths.
AHRQ-funded; HS016980; HS016978.
Citation: Xu X, Buta E, Anhang Price R .
Methodological considerations when studying the association between patient-reported care experiences and mortality.
Health Serv Res 2015 Aug;50(4):1146-61. doi: 10.1111/1475-6773.12264..
Keywords: Medical Expenditure Panel Survey (MEPS), Patient Experience, Mortality, Quality of Care, Research Methodologies
Dimou FM, Riall TS
Pancreatic resection results in a statewide surgical collaborative.
The authors believe that participation in a regional quality improvement collaborative may provide an alternative model to improving outcomes for patients undergoing pancreatic resection. Furthermore, they argue that a procedure-specific collaborative could help hospitals and physicians improve outcomes for complex procedures such as pancreatic resection.
AHRQ-funded; HS022134.
Citation: Dimou FM, Riall TS .
Pancreatic resection results in a statewide surgical collaborative.
Ann Surg Oncol 2015 Aug;22(8):2462-3. doi: 10.1245/s10434-015-4536-x..
Keywords: Surgery, Patient-Centered Outcomes Research, Quality Improvement, Quality of Care
Healy MA, Krell RW, Abdelsattar ZM
Pancreatic resection results in a statewide surgical collaborative.
This study sought to investigate changes over time in adverse outcomes after pancreatectomy across hospitals with different caseloads in a statewide surgical collaborative. It concluded that participation in regional quality collaboratives by lower-volume hospitals can attenuate the volume–outcome relationship for pancreatic surgery.
AHRQ-funded; HS20937; HS000053.
Citation: Healy MA, Krell RW, Abdelsattar ZM .
Pancreatic resection results in a statewide surgical collaborative.
Ann Surg Oncol 2015 Aug;22(8):2468-74. doi: 10.1245/s10434-015-4529-9..
Keywords: Surgery, Patient Safety, Adverse Events, Hospitals, Quality Improvement, Quality of Care
Berry JG, Zaslavsky AM, Toomey SL
Recognizing differences in hospital quality performance for pediatric inpatient care.
This study was a retrospective analysis of hospital discharges for children aged 0 to 17 years from 3,974 hospitals in 44 states in the 2009 Kids’ Inpatient Database. It found that most children are admitted to hospitals in which all-condition measures of quality have adequate power to show modest differences in performance from average, but most condition-specific measures do not.
AHRQ-funded; HS020513.
Citation: Berry JG, Zaslavsky AM, Toomey SL .
Recognizing differences in hospital quality performance for pediatric inpatient care.
Pediatrics 2015 Aug;136(2):251-62. doi: 10.1542/peds.2014-3131..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Hospitalization, Quality of Care
Chen LM, Sakshaug JW, Miller DC
The association among medical home readiness, quality, and care of vulnerable patients.
The researchers sought to examine the association among patient-centered medical home (PCMH) readiness, quality, and the care of vulnerable patients. They found that performance at PCMH-ready practices was higher for 3 of 9 quality indicators related to chronic disease management and preventive counseling (beta-blocker or diuretic prescribed for hypertension, diet counseling, exercise counseling).
AHRQ-funded; HS018346; HS020671; HS020927.
Citation: Chen LM, Sakshaug JW, Miller DC .
The association among medical home readiness, quality, and care of vulnerable patients.
Am J Manag Care 2015 Aug;21(8):e480-6..
Keywords: Patient-Centered Healthcare, Patient Safety, Quality of Care, Primary Care
Toomey SL, Zaslavsky AM, Elliott MN
The development of a pediatric inpatient experience of care measure: Child HCAHPS.
This article describes the development of Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), which included a national field test with 69 hospitals in 34 States, psychometric analysis, and end-user testing of the final survey. The final Child HCAHPS instrument has 62 items, including 39 patient experience items, 10 screeners, 12 demographic/descriptive items and 1 open-ended item.
AHRQ-funded; HS020513.
Citation: Toomey SL, Zaslavsky AM, Elliott MN .
The development of a pediatric inpatient experience of care measure: Child HCAHPS.
Pediatrics 2015 Aug;136(2):360-9. doi: 10.1542/peds.2015-0966..
Keywords: Children/Adolescents, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Inpatient Care, Patient Experience, Quality of Care
Ryan AM, Burgess JF, Dimick JB
Why we should not be indifferent to specification choices for difference-in-differences.
The purpose of this study was to evaluate the effects of specification choices on the accuracy of estimates in difference-in-differences models. They found that performance of alternative specifications varied dramatically when the probability of treatment was correlated with pre-intervention levels or trends. In these cases, propensity score matching resulted in much more accurate point estimates.
AHRQ-funded; HS018546.
Citation: Ryan AM, Burgess JF, Dimick JB .
Why we should not be indifferent to specification choices for difference-in-differences.
Health Serv Res 2015 Aug;50(4):1211-35. doi: 10.1111/1475-6773.12270..
Keywords: Quality of Care, Health Services Research (HSR)
Magnan EM, Palta M, Pandhi N
The relationship of individual comorbid chronic conditions to diabetes care quality.
The aim of this study was to determine which chronic conditions were related to lack of achievement or achievement of diabetes care quality goals to determine potential targets for future interventions. It found that 62 chronic conditions varied in their relationships to diabetes care goal achievement for specific care goals. For example, congestive heart failure was related to lack of achievement of cholesterol management goals.
AHRQ-funded; HS018368; HS021899.
Citation: Magnan EM, Palta M, Pandhi N .
The relationship of individual comorbid chronic conditions to diabetes care quality.
BMJ Open Diabetes Res Care 2015 Jul 23;3(1):e000080. doi: 10.1136/bmjdrc-2015-000080..
Keywords: Care Management, Chronic Conditions, Diabetes, Quality of Care
Morrato EH, Rabin B, Proctor J
Bringing it home: expanding the local reach of dissemination and implementation training via a university-based workshop.
The Colorado Research in Implementation Science Program (CRISP) developed and delivered an introductory D&I workshop adapted from national programs to extend training reach and foster a local learning community for D&I. This paper describes the context of the local training environment, findings from a pre-workshop needs assessment survey, training design and structure, and post-workshop evaluation. Lessons learned may inform others intending to develop local D&I training workshop.
AHRQ-funded; HS021138.
Citation: Morrato EH, Rabin B, Proctor J .
Bringing it home: expanding the local reach of dissemination and implementation training via a university-based workshop.
Implement Sci 2015 Jul 4;10:94. doi: 10.1186/s13012-015-0281-6..
Keywords: Communication, Education: Continuing Medical Education, Evidence-Based Practice, Guidelines, Quality of Care, Quality Improvement, Training, Implementation
Nembhard IM, Labao I, Savage S
Breaking the silence: determinants of voice for quality improvement in hospitals.
The researchers examined the drivers of “voice” for health professionals in hospitals. “Voice” is understood as the discretionary communication of ideas, suggestions, concerns, or opinions about work-related issues with the intent to improve organizational or unit functioning. They found that factors related to individuals (e.g., tenure), work (e.g., work configuration), organizational context (e.g., culture), data (e.g., benchmarking), and the external environment (e.g., attention) influenced health professionals’ voice.
AHRQ-funded; HS018987.
Citation: Nembhard IM, Labao I, Savage S .
Breaking the silence: determinants of voice for quality improvement in hospitals.
Health Care Manage Rev 2015 Jul-Sep;40(3):225-36. doi: 10.1097/hmr.0000000000000028..
Keywords: Hospitals, Quality Improvement, Quality of Care, Communication, Organizational Change, Health Services Research (HSR)
Solberg LI, Stuck LH, Crain AL
Organizational factors and change strategies associated with medical home transformation.
The researchers surveyed leaders of the first 132 primary care practices in Minnesota to achieve medical home certification. The Change Process Capability Questionnaire survey and the Physician Practice Connections survey showed that 80% to 100% of these certified clinics had 15 of the 18 organizational factors important for improving care processes and that 60% to 90% had successfully used 16 improvement strategies.
AHRQ-funded; HS019161.
Citation: Solberg LI, Stuck LH, Crain AL .
Organizational factors and change strategies associated with medical home transformation.
Am J Med Qual 2015 Jul-Aug;30(4):337-44. doi: 10.1177/1062860614532307.
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Keywords: Patient-Centered Healthcare, Primary Care, Practice Improvement, Organizational Change, Quality Improvement, Quality of Care, Healthcare Delivery
Durkin MJ, Dicks KV, Baker AW
Postoperative infection in spine surgery: does the month matter?
The authors evaluated for seasonal variation of surgical site infection (SSI) following spine surgery in a network of nonteaching community hospitals. They found that the rate of SSI following fusion or spinal laminectomy/laminoplasty was higher during the summer in this network of community hospitals, most likely due to S. aureus rather than the July effect.
AHRQ-funded; HS023866.
Citation: Durkin MJ, Dicks KV, Baker AW .
Postoperative infection in spine surgery: does the month matter?
J Neurosurg Spine 2015 Jul;23(1):128-34. doi: 10.3171/2014.10.spine14559.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Patient Safety, Hospitals, Outcomes, Quality of Care
Stifter J, Yao Y, Lopez KD
Proposing a new conceptual model and an exemplar measure using health information: Technology to examine the impact of relational nurse continuity on hospital-acquired pressure ulcers.
The authors present a new conceptual model and an innovative use of health information technology to measure relational nurse continuity and to demonstrate the potential for bringing the results of big data science back to the bedside. Understanding the power of big data to address critical clinical issues may foster a new direction for nursing administration theory development.
AHRQ-funded; HS023072.
Citation: Stifter J, Yao Y, Lopez KD .
Proposing a new conceptual model and an exemplar measure using health information: Technology to examine the impact of relational nurse continuity on hospital-acquired pressure ulcers.
ANS Adv Nurs Sci 2015 Jul-Sep;38(3):241-51. doi: 10.1097/ans.0000000000000081.
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Keywords: Nursing, Pressure Ulcers, Quality of Care, Health Information Technology (HIT), Healthcare-Associated Infections (HAIs)
Crane S, Sloane PD, Elder N
Reporting and using near-miss events to improve patient safety in diverse primary care practices: a collaborative approach to learning from our mistakes.
This study assessed the feasibility of a near-miss reporting system in primary care practices and to describe initial reports and practice responses to them. It found that all 7 practices successfully implemented the system, reporting 632 near-miss events in 9 months and initiating 32 quality improvement projects based on the reports.
AHRQ-funded; HS019558.
Citation: Crane S, Sloane PD, Elder N .
Reporting and using near-miss events to improve patient safety in diverse primary care practices: a collaborative approach to learning from our mistakes.
J Am Board Fam Med 2015 Jul-Aug;28(4):452-60. doi: 10.3122/jabfm.2015.04.140050..
Keywords: Adverse Events, Medical Errors, Patient Safety, Primary Care, Public Reporting, Quality Improvement, Quality of Care
Linares-Perdomo O, East TD, Brower R
Standardizing predicted body weight equations for mechanical ventilation tidal volume settings.
Predicted body weight (PBW) equations use height, age, and sex as input variables. The researchers compared National Institutes of Health (NIH) ARDS Network (ARDSNet), actuarial table (ACTUARIAL), and Stewart (STEWART) PBW equations used in clinical trials, across physiologic ranges for age and height. They concluded that significant differences between PBW equations for both men and women could be important sources of interstudy variation. Studies should adopt a standard PBW equation.
AHRQ-funded; HS006594.
Citation: Linares-Perdomo O, East TD, Brower R .
Standardizing predicted body weight equations for mechanical ventilation tidal volume settings.
Chest 2015 Jul;148(1):73-8. doi: 10.1378/chest.14-2843..
Keywords: Research Methodologies, Respiratory Conditions, Quality of Care
Carter EJ, Cohen B, Murray MT
Using workflow diagrams to address hand hygiene in pediatric long-term care facilities.
The aim of the study was to engage staff in the development of workflow diagrams, which highlighted hand hygiene (HH) practices during commonly performed patient-care activities. Facility teams developed six workflow diagrams that underwent 22 validation observations. Four main themes emerged: 1) diagram specificity, 2) wording and layout, 3) timing of HH indications, and 4) environmental hygiene.
AHRQ-funded; HS021470.
Citation: Carter EJ, Cohen B, Murray MT .
Using workflow diagrams to address hand hygiene in pediatric long-term care facilities.
J Pediatr Nurs 2015 Jul-Aug;30(4):e17-21. doi: 10.1016/j.pedn.2014.12.002..
Keywords: Patient Safety, Quality of Care, Children/Adolescents, Long-Term Care
Martsolf GR, Kandrack R, Schneider EC
Categories of practice transformation in a statewide medical home pilot and their association with medical home recognition.
The researchers aimed to characterize patterns of structural change among 81 primary care practices participating in a statewide medical home pilot. They found that multiple types of practice transformation could be distinguished and higher levels of medical home recognition were associated with practices’ capabilities at baseline, rather than transformation over time.
AHRQ-funded; HS022616.
Citation: Martsolf GR, Kandrack R, Schneider EC .
Categories of practice transformation in a statewide medical home pilot and their association with medical home recognition.
J Gen Intern Med 2015 Jun;30(6):817-23. doi: 10.1007/s11606-014-3176-3..
Keywords: Primary Care, Patient-Centered Healthcare, Quality of Care
Sjoding MW, Prescott HC, Wunsch H
Hospitals with the highest intensive care utilization provide lower quality pneumonia care to the elderly.
The researchers investigate the relationship between a hospital’s ICU admission rate for elderly patients with pneumonia and the quality of care it provided to patients with pneumonia. They found that quality of care was lower among hospitals with the highest rates of ICU admission for elderly patients with pneumonia; such hospitals were less likely to deliver pneumonia processes of care and had worse outcomes for patients with pneumonia.
AHRQ-funded; HS020672.
Citation: Sjoding MW, Prescott HC, Wunsch H .
Hospitals with the highest intensive care utilization provide lower quality pneumonia care to the elderly.
Crit Care Med 2015 Jun;43(6):1178-86. doi: 10.1097/ccm.0000000000000925..
Keywords: Intensive Care Unit (ICU), Elderly, Inpatient Care, Quality of Care, Outcomes
Ford E, Phillips M, Bojechko C
TU-G-BRD-08: in-vivo EPID dosimetry: quantifying the detectability of four classes of errors.
The researchers analyzed 17 patients; EPID images of the exit dose were acquired and used to reconstruct the planar dose at isocenter. Their data demonstrate the ability of EPID-based in-vivo dosimetry in detecting variations in patient habitus and errors related to machine parameters such as systematic multi-leaf collimator misalignments and machine output changes.
AHRQ-funded; HS022244.
Citation: Ford E, Phillips M, Bojechko C .
TU-G-BRD-08: in-vivo EPID dosimetry: quantifying the detectability of four classes of errors.
Med Phys 2015 Jun;42(6 Part 35):3629. doi: 10.1118/1.4925743..
Keywords: Patient Safety, Imaging, Quality of Care
Smith B, McDuff J, Naierman N
What consumers want to know about quality when choosing a hospice provider.
This study drew on focus group and survey data collected in 5 metropolitan areas to learn more about hospice quality data. The researchers found that participants placed top priority on measures related to pain and symptom management. The National Quality Forum-approved measures resonate well with consumers, who also appear to be ready for access to data on the quality of hospice providers.
AHRQ-funded; HS021870.
Citation: Smith B, McDuff J, Naierman N .
What consumers want to know about quality when choosing a hospice provider.
Am J Hosp Palliat Care 2015 Jun;32(4):393-400. doi: 10.1177/1049909114524475.
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Keywords: Caregiving, Education: Patient and Caregiver, Shared Decision Making, Palliative Care, Provider Performance, Public Reporting, Quality of Care, Quality Indicators (QIs)
Baier RR, Cooper E, Wysocki A
Using qualitative methods to create a home health web application user interface for patients with low computer proficiency.
The researchers undertook a multi-phased approach to create a consumer-facing home health web application in Rhode Island. This included reviewing the evidence base to identify design recommendations and then creating a paper prototype and wireframe. They performed qualitative research to iteratively test their proposed user interface with two user groups, home health consumers and hospital case managers and t]hen refined their design to create the final web application.
AHRQ-funded; HS021879
Citation: Baier RR, Cooper E, Wysocki A .
Using qualitative methods to create a home health web application user interface for patients with low computer proficiency.
eGEMS. 2015 May 13;3(2):1166. doi: 10.13063/2327-9214.1166..
Keywords: Home Healthcare, Health Information Technology (HIT), Quality of Care, Education: Patient and Caregiver
Santos CA, Brennan DC, Chapman WC
Delayed-onset cytomegalovirus disease coded during hospital readmission in a multicenter, retrospective cohort of liver transplant recipients.
The researchers sought to determine the risk factors and outcomes associated with delayed-onset cytomegalovirus (CMV) disease among liver transplant recipients. Data from a group of 7,229 adult liver transplant recipients showed that delayed onset CMV disease was twice as likely as early onset CMV disease, with transplant failure or rejection being a risk factor.
AHRQ-funded; HS019455
Citation: Santos CA, Brennan DC, Chapman WC .
Delayed-onset cytomegalovirus disease coded during hospital readmission in a multicenter, retrospective cohort of liver transplant recipients.
Liver Transpl. 2015 May;21(5):581-90. doi: 10.1002/lt.24089..
Keywords: Outcomes, Transplantation, Quality of Care, Chronic Conditions
Singh JA, Ramachandran R
Does hospital volume predict outcomes and complications after total shoulder arthroplasty in the US?
The researchers assessed the association of hospital procedure volume for total shoulder arthroplasty (TSA) with patient outcomes and complications. They found that, compared to low volume hospitals (<5, 5–9, or 10–14 procedures annually), patients receiving TSA at higher volume hospitals (15–24 or ‡25 procedures annually) had significantly lower likelihood of being discharged to an inpatient medical facility.
AHRQ-funded; HS021110.
Citation: Singh JA, Ramachandran R .
Does hospital volume predict outcomes and complications after total shoulder arthroplasty in the US?
Arthritis Care Res 2015 May;67(6):885-90. doi: 10.1002/acr.22507..
Keywords: Patient-Centered Outcomes Research, Adverse Events, Patient Safety, Quality of Care, Healthcare Cost and Utilization Project (HCUP)