National Healthcare Quality and Disparities Report
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Topics
- Access to Care (2)
- Adverse Events (4)
- (-) Ambulatory Care and Surgery (36)
- Antibiotics (5)
- Antimicrobial Stewardship (4)
- Asthma (2)
- Behavioral Health (2)
- Cancer (2)
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Care Management (1)
- Children/Adolescents (6)
- Chronic Conditions (2)
- Clinical Decision Support (CDS) (2)
- Colonoscopy (1)
- COVID-19 (1)
- Depression (1)
- Diabetes (2)
- Education: Patient and Caregiver (2)
- Electronic Health Records (EHRs) (6)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Healthcare-Associated Infections (HAIs) (3)
- Healthcare Costs (3)
- Healthcare Delivery (2)
- Healthcare Utilization (3)
- Health Information Technology (HIT) (10)
- Health Insurance (1)
- Health Services Research (HSR) (1)
- Health Systems (1)
- Heart Disease and Health (1)
- Hospitalization (3)
- Hospitals (2)
- Implementation (1)
- Injuries and Wounds (1)
- Learning Health Systems (1)
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- Medical Expenditure Panel Survey (MEPS) (1)
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- Organizational Change (1)
- Palliative Care (1)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (1)
- Patient Adherence/Compliance (1)
- Patient and Family Engagement (2)
- Patient Safety (8)
- Patient Self-Management (2)
- Payment (2)
- Policy (1)
- Practice Patterns (1)
- Prevention (1)
- Primary Care (3)
- Primary Care: Models of Care (2)
- Provider: Pharmacist (1)
- Provider: Physician (1)
- Provider Performance (1)
- Quality Improvement (1)
- Quality Indicators (QIs) (1)
- Quality of Care (1)
- Respiratory Conditions (1)
- Risk (2)
- Screening (1)
- Shared Decision Making (1)
- Social Determinants of Health (1)
- Surgery (6)
- System Design (1)
- Telehealth (2)
- Vaccination (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 36 Research Studies DisplayedGuzman A, Brown T, Lee JY
Look-back and look-forward durations and the apparent appropriateness of ambulatory antibiotic prescribing.
Researchers assessed how the apparent appropriateness of antibiotic prescribing changes when using different look-back and look-forward periods. Classifying all ambulatory antibiotic prescriptions in the electronic health record of an integrated health care system as chronic, appropriate, potentially appropriate, inappropriate, or not associated with any diagnosis, they concluded that ambulatory programs and studies focused on appropriate or inappropriate antibiotic prescribing can reasonably use a short duration of association between an antibiotic prescription and diagnosis codes. They further indicated that programs and studies focused on potentially appropriate antibiotic prescribing might consider examining longer durations.
AHRQ-funded; HS024930.
Citation: Guzman A, Brown T, Lee JY .
Look-back and look-forward durations and the apparent appropriateness of ambulatory antibiotic prescribing.
Antibiotics 2022 Nov 4;11(11). doi: 10.3390/antibiotics11111554..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Ambulatory Care and Surgery, Practice Patterns
Chatterjee P, Liao JM, Wang E
Characteristics, utilization, and concentration of outpatient care for dual-eligible Medicare beneficiaries.
The purpose of this study was to describe the distribution of outpatient care for dual-eligible Medicare beneficiaries ("duals") and characterize the intensity of outpatient care utilization of duals vs non-dual-eligible beneficiaries ("nonduals"). The researchers assessed the distribution of outpatient care across physician practices and compared the use of different outpatient services between duals and nonduals. The study found that nearly 80% of outpatient visits for duals were provided by 35% of practices. Compared with low-dual and no-dual practices, high-dual practices served more patients, with morhe comorbidities. Duals had 2 less outpatient visits per year compared with nonduals with substantially fewer subspecialty care visits despite having more comorbidities.
AHRQ-funded; HS027595.
Citation: Chatterjee P, Liao JM, Wang E .
Characteristics, utilization, and concentration of outpatient care for dual-eligible Medicare beneficiaries.
Am J Manag Care 2022 Oct;28(10):e370-e77. doi: 10.37765/ajmc.2022.89189..
Keywords: Ambulatory Care and Surgery, Medicare, Medicaid, Care Management, Healthcare Utilization
Kilaru AS, Illenberger N, Meisel ZF
Incidence of timely outpatient follow-up care after emergency department encounters for acute heart failure.
The purpose of this retrospective cohort study was to explore the incidence of outpatient follow-up care after presentation for acute heart failure at the emergency department (ED), and to present patient characteristics associated with receiving timely follow-up care. Using an administrative claims database from a United States commercial insurer, the researchers reviewed 52,732 adult patients with a mean age of 73.9 years discharged from the ED with the principal diagnosis of acute heart failure. The study found that within 30 days of the ED encounter, 23.2% of patients attended an outpatient clinic visit for heart failure, with 15.9% patients hospitalized before they could obtain an outpatient clinic visit. Patients that were younger, women, reporting non-Hispanic Black race, and had fewer previous clinic visits were less likely to obtain outpatient follow-up care. The study concluded that almost 20% of patients require hospitalization within 30 days of an ED for visit for heart failure, and few obtain timely outpatient follow-up after the initial visit.
AHRQ-funded; HS026372.
Citation: Kilaru AS, Illenberger N, Meisel ZF .
Incidence of timely outpatient follow-up care after emergency department encounters for acute heart failure.
Circ Cardiovasc Qual Outcomes 2022 Sep;15(9):e009001. doi: 10.1161/circoutcomes.122.009001..
Keywords: Ambulatory Care and Surgery, Emergency Department, Heart Disease and Health, Cardiovascular Conditions
Keller SC, Cosgrove SE, Miller MA
AHRQ Author: Miller MA
A framework for implementing antibiotic stewardship in ambulatory care: lessons learned from the Agency for Healthcare Research and Quality Safety Program for Improving Antibiotic Use.
This article used lessons learned from AHRQ’s Safety Program for Improving Antibiotic Use in Ambulatory Care to describe a step-by-step framework that assists practices with establishing antibiotic stewardship in outpatient settings. These steps include: obtaining support from practice leadership; establishing antibiotic stewardship teams; garnering support from practice members; building communication skills around antibiotic use; implementing educational content around an infectious syndrome; accessing and monitoring antibiotic prescribing data; and implementing a sustainability plan.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Keller SC, Cosgrove SE, Miller MA .
A framework for implementing antibiotic stewardship in ambulatory care: lessons learned from the Agency for Healthcare Research and Quality Safety Program for Improving Antibiotic Use.
Antimicrob Steward Healthc Epidemiol 2022 Jul 4;2(1):e109. doi: 10.1017/ash.2022.258..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Ambulatory Care and Surgery, Patient Safety
Cuellar A, Pomeroy JML, Burla S
Outpatient care among users and nonusers of direct-to-patient telehealth: observational study.
The purpose of this study was to explore whether telehealth services users depend more on other forms of outpatient care vs. nonusers, and to estimate differences in payment rates between the two groups. The researchers evaluated claims data from 2017, analyzing patients with visits for 3 common diagnoses (N=660,546) and calculating the total number of visits per patient. The study reported that users of telehealth visits had .44 fewer visits to primary care, .11 fewer visits to emergency departments, and .17 fewer visits to retail and urgent care than nonusers. In addition, the average payment rates for telehealth visits were less than all other outpatient care settings. The study concluded that instead of adding to in-person care, telehealth visits may provide a less expensive alternative by substituting for some types of in-person care.
AHRQ-funded; HS025163.
Citation: Cuellar A, Pomeroy JML, Burla S .
Outpatient care among users and nonusers of direct-to-patient telehealth: observational study.
J Med Internet Res 2022 Jun 6;24(6):e37574. doi: 10.2196/37574..
Keywords: Telehealth, Health Information Technology (HIT), Ambulatory Care and Surgery
Levine DM, Chalasani R, Linder JA
Association of the Patient Protection and Affordable Care Act with ambulatory quality, patient experience, utilization, and cost, 2014-2016.
The national impact of the Patient Protection and Affordable Care Act (ACA) continues to be debated. The purpose of this cross-sectional study was to determine the relationship between the ACA and ambulatory quality, patient experience, utilization, and cost by comparing outcomes before (2011-2013) and after (2014-2016) ACA implementation. The study focused on United States adults between 18 and 64 years of age with income less than and greater than or equal to 400% of the federal poverty level (FPL), who had responded to the annual Medical Expenditure Panel Survey. Researchers conducted analysis of data from a sample of 123,171 individuals between January 2021 and March 2022. The study found that after the implementation of ACA, adults with income levels less than 400% of the FPL received increased high value care such as diagnostic and preventive testing when compared with adults with income 400% or higher of the FPL, and there were no differences in the other quality measures. Individuals with income less than 400% of the FPL had greater improvements in access, experience, and communication measures compared with those who had income greater than or equal to 400% of the FPL. Receipt of primary care services increased for individuals with lower income compared to individuals with higher income and for those with lower income compared to those with higher income, total out-of-pocket expenditures decreased. There were no other differences in utilization or cost between those groups. The researchers concluded that in this study, the ACA was not associated with changes in utilization, quality, or cost, but was related to decreased out-of-pocket expenditures and improved patient access, communication, and experience.
AHRQ-funded; 233201500020I; HS026506; HS028127.
Citation: Levine DM, Chalasani R, Linder JA .
Association of the Patient Protection and Affordable Care Act with ambulatory quality, patient experience, utilization, and cost, 2014-2016.
JAMA Netw Open 2022 Jun 1;5(6):e2218167. doi: 10.1001/jamanetworkopen.2022.18167..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Healthcare Utilization, Ambulatory Care and Surgery, Health Insurance, Access to Care
Valley TS, Schutz A, Peltan ID
Organization of outpatient care after COVID-19 hospitalization.
The purpose of this study was to describe post-discharge care delivery for patients with postacute sequelae of COVID-19 (PASC) across a large network of US academic and community hospitals. Beginning in July, 2021, the researchers surveyed 47 hospitals which were participating in the National Heart, Lung, and Blood Institute Clinical Trials Network for the Prevention and Early Treatment of Acute Lung Injury (PETAL Network.) Surveys were completed by physicians, hospital administrators, social workers, research staff or other clinicians over an 8-week period, and data from the 2019 American Hospital Association annual survey database were used to describe the hospitals. The study found that 79% (37) of the responding hospitals provided COVID-specific discharge information to patients hospitalized with COVID-19. Only 26% of hospitals provided discharge information that included potential symptoms or impairments of postacute sequelae of COVID-19. Seventy percent (33) had a PASC clinic (a postdischarge outpatient clinic designed specifically for patients with COVID). Hospitals without PASC clinics were more likely to be located in a ZIP code with a higher Medicare population and a median annual income lower than $40,000, and were also more likely to be smaller, for-profit hospitals. The researchers identified several core areas for possible improvements in PASC care, including: examining the impact of PASC clinics on patient outcomes; assessing the extent to which the pathophysiology and management of PASC differ from sequelae of other infections and syndromes; and exploring whether an inability to systematically identify patients for PASC care may result in an inability for some patients to receive needed care. The researchers concluded that PASC clinics may offer opportunities to coordinate care and serve as an opportunity for making iterative gains in knowledge about PASC clinics and related models and processes and their effectiveness in improving longer-term patient-centered outcomes for survivors of COVID-19.
AHRQ-funded; HS028038.
Citation: Valley TS, Schutz A, Peltan ID .
Organization of outpatient care after COVID-19 hospitalization.
Chest 2022 Jun;161(6):1485-89. doi: 10.1016/j.chest.2022.01.034..
Keywords: COVID-19, Ambulatory Care and Surgery, Hospitalization, Care Coordination, Healthcare Delivery
Ray KN, Bohnhoff JC, Schweiberger K
Use of telemedicine for initial outpatient subspecialist consultative visit: a national survey of general pediatricians and pediatric subspecialists.
The authors performed a survey of general pediatricians and pediatric subspecialists about the use of telemedicine for patients newly referred for pediatric subspecialty care. They found that 76% of respondents thought telemedicine should be offered for some and 11% thought telemedicine should be offered for all initial subspecialist visits. Factors perceived to reduce the appropriateness of telemedicine for subspecialty consultation included the need for interpreter services and a prior history of frequent no-shows. They further found that responses from generalists and subspecialists rarely differed significantly.
AHRQ-funded; HS026393.
Citation: Ray KN, Bohnhoff JC, Schweiberger K .
Use of telemedicine for initial outpatient subspecialist consultative visit: a national survey of general pediatricians and pediatric subspecialists.
Healthc 2022 Mar;10(1):100600. doi: 10.1016/j.hjdsi.2021.100600..
Keywords: Children/Adolescents, Telehealth, Health Information Technology (HIT), Provider: Physician, Ambulatory Care and Surgery
Kan K, Shaunfield S, Kanaley M
Health provider perspectives of electronic medication monitoring in outpatient asthma care: a qualitative investigation using the consolidated framework for implementation research.
This study’s objective was to quantitatively explore the experience of health providers using electronic medication monitoring (EMM) in pediatric outpatient asthma care. The authors conducted interviews with 10 health providers using the Consolidated Framework of Implementation Research (CFIR) on their EMM experience with asthma patients from 5 primary care or specialty clinics. The EMM tracked albuterol and inhaled corticosteroid (ICS) use. Health providers called parents whenever ICS adherence waned, or albuterol use increased. The interviews were audio-recorded, transcribed, and deductively analyzed. Most providers felt the intervention improved care delivery, but implementation of the intervention model would require additional employees to handle the increased administrative and clinical workload.
AHRQ-funded; HS026385.
Citation: Kan K, Shaunfield S, Kanaley M .
Health provider perspectives of electronic medication monitoring in outpatient asthma care: a qualitative investigation using the consolidated framework for implementation research.
J Asthma 2022 Feb;59(2):342-51. doi: 10.1080/02770903.2020.1846745..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Ambulatory Care and Surgery
Nielsen TB, Santarossa M, Probst B
Introducing antimicrobial stewardship to the outpatient clinics of a suburban academic health system.
This study’s objective was to determine attitudes of prescribers of antimicrobials to help establish an antimicrobial stewardship program in the outpatient setting. Participants included prescribers at Loyola University Health System, an academic teaching healthcare system with 19 primary care and 3 intermediate- and urgent-care clinics. A voluntary survey was developed using SurveyMonkey and was distributed via email. Data were conducted anonymously. Three metrics were assessed for rates of compliance and included: (1) avoidance of antibiotics in adult acute bronchitis and appropriate antibiotic treatment in (2) patients tested for pharyngitis and (3) children with upper respiratory tract infections. Prescribers were very knowledgeable about what constitutes appropriate prescribing, but fewer than half believed antibiotics were overprescribed in their office. The respondents reported that 74% received intense pressure from patients to prescribe antimicrobials inappropriately. Intermediate- and urgent-care prescribers had higher rates of compliance than primary-care prescribers. However, the latter group responded well to monthly reports and online educational resources.
AHRQ-funded; HS025690.
Citation: Nielsen TB, Santarossa M, Probst B .
Introducing antimicrobial stewardship to the outpatient clinics of a suburban academic health system.
Antimicrob Steward Healthc Epidemiol 2022;2(1):e9. doi: 10.1017/ash.2021.228..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Ambulatory Care and Surgery
Ancker JS, Stabile C, Carter J
Informing, reassuring, or alarming? Balancing patient needs in the development of a postsurgical symptom reporting system in cancer.
After ambulatory surgeries, patients who recover at home have multiple questions about wound healing, symptoms and medication side effects, and recovery expectations. In this study, the investigators conducted user testing and rapid application development of a symptom reporting system that supports home-based recovery by inviting patients to self-report symptoms in the days after surgery and receive an immediate feedback report giving context for their reported symptoms.
AHRQ-funded; HS021531.
Citation: Ancker JS, Stabile C, Carter J .
Informing, reassuring, or alarming? Balancing patient needs in the development of a postsurgical symptom reporting system in cancer.
AMIA Annu Symp Proc 2018 Dec 5;2018:166-74..
Keywords: Adverse Events, Ambulatory Care and Surgery, Cancer, Education: Patient and Caregiver, Health Information Technology (HIT), Patient Safety, Surgery
Federman A, Sarzynski E, Brach C
AHRQ Author: Brach C
Challenges optimizing the after visit summary.
The purpose of this study was to describe experiences of health systems implementing a redesigned outpatient after visit summary (AVS) in commercially available electronic health record (EHR) systems to inform future optimization. The authors noted limitations to AVS modifications in EHR systems present challenges to optimizing the tool. They recommended that EHR vendors should incorporate learning from healthcare systems innovation efforts and consider building more flexibility into their product development.
AHRQ-authored; AHRQ-funded; HS023844.
Citation: Federman A, Sarzynski E, Brach C .
Challenges optimizing the after visit summary.
Int J Med Inform 2018 Dec;120:14-19. doi: 10.1016/j.ijmedinf.2018.09.009..
Keywords: Ambulatory Care and Surgery, Electronic Health Records (EHRs), Health Information Technology (HIT), System Design
Cherrington AL, Khodneva Y, Richman JS
Impact of peer support on acute care visits and hospitalizations for individuals with diabetes and depressive symptoms: a cluster-randomized controlled trial.
This study examined the impact of peer support on the number of acute care visits and hospitalizations for individuals with diabetes with and without depressive symptoms. This randomized controlled trial was conducted from 2010-2012. One year of peer support was given to intervention participants, and the usual care to control participants. A Patient Health Questionnaire (PHQ-8) was given to participants to assess depression symptoms at the beginning of the trial, at 6 months and then at 12 months. There was a lower rate of acute care visits and hospitalizations in those patients with depressive symptoms in the intervention group, but it made no difference for individuals without depressive symptoms.
AHRQ-funded; HS013852.
Citation: Cherrington AL, Khodneva Y, Richman JS .
Impact of peer support on acute care visits and hospitalizations for individuals with diabetes and depressive symptoms: a cluster-randomized controlled trial.
Diabetes Care 2018 Dec;41(12):2463-70. doi: 10.2337/dc18-0550..
Keywords: Ambulatory Care and Surgery, Chronic Conditions, Depression, Diabetes, Hospitalization, Behavioral Health, Patient Self-Management
Khoong EC, Cherian R, Rivadeneira NA
Accurate measurement In California's safety-net health systems has gaps and barriers.
The purpose of this study was to measure California’s pay-for-performance program in safety-net hospitals. Results showed both suboptimal performance in aspects of ambulatory safety and questionable reliability in data reporting. Health care systems that lack seamlessly integrated electronic health records and patient registries encountered barriers to reporting reliable ambulatory safety data, precluding accurate performance measurement in many areas. The authors recommended that policymakers and safety advocates support the development of information systems and measures that facilitate the accurate ascertainment of the health systems, patients, and clinical tasks at greatest risk for ambulatory safety failures.
AHRQ-funded; HS024412; HS024426.
Citation: Khoong EC, Cherian R, Rivadeneira NA .
Accurate measurement In California's safety-net health systems has gaps and barriers.
Health Aff 2018 Nov;37(11):1760-69. doi: 10.1377/hlthaff.2018.0709..
Keywords: Ambulatory Care and Surgery, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Provider Performance, Quality Indicators (QIs), Payment
Karavite DJ, Miller MW, Ramos MJ
User testing an information foraging tool for ambulatory surgical site infection surveillance.
Surveillance for surgical site infections (SSIs) after ambulatory surgery in children requires a detailed manual chart review to assess criteria defined by the National Health and Safety Network. Electronic health records (EHRs) impose an inefficient search process. Using text mining and business intelligence software, the authors developed an information foraging application, the SSI Workbench, to visually present which postsurgical encounters included SSI-related terms and synonyms, antibiotic, and culture orders. This study compares the Workbench and EHR.
AHRQ-funded; HS020921.
Citation: Karavite DJ, Miller MW, Ramos MJ .
User testing an information foraging tool for ambulatory surgical site infection surveillance.
Appl Clin Inform 2018 Oct;9(4):791-802. doi: 10.1055/s-0038-1675179..
Keywords: Surgery, Ambulatory Care and Surgery, Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare-Associated Infections (HAIs), Patient Safety
Harrison MI, Grantham S
AHRQ Author: Harrison MI
Learning from implementation setbacks: identifying and responding to contextual challenges.
The authors addressed organizational learning about implementation context during setbacks to primary care redesign in an ambulatory system. They found that redesigned teams were not implemented as widely or rapidly as anticipated and did not deliver hoped-for gains in operational metrics; however, team redesign was leading to improvements in chronic care and prevention and eased provider burden. Redesign and system leaders engaged in more thorough organizational learning. Their responses to challenges helped to strengthen the redesign's prospects, improved the delivery system's position in its labor market, and helped the system prepare to meet emerging requirements for value-based care and population health.
AHRQ-authored; AHRQ-funded; 2902010000341.
Citation: Harrison MI, Grantham S .
Learning from implementation setbacks: identifying and responding to contextual challenges.
Learn Health Syst 2018 Oct;2(4):e10068. doi: 10.1002/lrh2.10068..
Keywords: Organizational Change, Learning Health Systems, Health Systems, Primary Care: Models of Care, Primary Care, Ambulatory Care and Surgery, Implementation
Grundmeier RW, Xiao R, Ross RK
Grundmeier RW, Xiao R, Ross RK, Ramos MJ, Karavite DJ, Michel JJ, Gerber JS, et al. Identifying surgical site infections in electronic health data using predictive models,.
The objective of this study was to prospectively derive and validate a prediction rule for detecting cases warranting investigation for surgical site infections (SSI) after ambulatory surgery. The investigators concluded that electronic health record data can facilitate SSI surveillance with adequate sensitivity and positive predictive value.
AHRQ-funded; HS020921.
Citation: Grundmeier RW, Xiao R, Ross RK .
Grundmeier RW, Xiao R, Ross RK, Ramos MJ, Karavite DJ, Michel JJ, Gerber JS, et al. Identifying surgical site infections in electronic health data using predictive models,.
J Am Med Inform Assoc 2018 Sep;25(9):1160-66. doi: 10.1093/jamia/ocy075..
Keywords: Healthcare-Associated Infections (HAIs), Injuries and Wounds, Surgery, Electronic Health Records (EHRs), Health Information Technology (HIT), Risk, Patient Safety, Adverse Events, Ambulatory Care and Surgery
Saleem JJ, Weiler DT, Satterly T
Field investigation of ambulatory clinic exam room design with respect to computing devices: a pilot study.
The authors of this paper conducted observations and interviews with primary care providers and their patients from three locations within the Phoenix VA Health Care System, in a pilot study comparing the new exam room design standard with the older legacy exam rooms. The study results suggested that the new exam room design did contribute to a greater degree of patient centeredness, though more thorough evaluations are required to support these preliminary results.
AHRQ-funded; HS024488.
Citation: Saleem JJ, Weiler DT, Satterly T .
Field investigation of ambulatory clinic exam room design with respect to computing devices: a pilot study.
Proc Hum Factors Ergon Soc Annu Meet 2018 Sep;62(1):518-22. doi: 10.1177/1541931218621118..
Keywords: Ambulatory Care and Surgery, Patient-Centered Healthcare, Primary Care
Nocon RS, Gunter KE, Gao Y
Development and validation of a short-form safety net medical home scale.
The purpose of this study was to develop a short-form Safety Net Medical Home Scale (SNMHS) for assessing patient-centered medical home (PCMH) capability in safety net clinics. The investigators found that short-form versions of SNMHS showed strong correlations with full scale and may be useful for brief assessment of safety net PCMH capability. They suggested that each short-form SNMHS version may be appropriate for different research, quality improvement, and assessment purposes.
AHRQ-funded; HS000084.
Citation: Nocon RS, Gunter KE, Gao Y .
Development and validation of a short-form safety net medical home scale.
Health Serv Res 2018 Aug;53 Suppl 1:3207-26. doi: 10.1111/1475-6773.12809..
Keywords: Ambulatory Care and Surgery, Patient-Centered Healthcare
Hollingsworth JM, Oerline MK, Ellimoottil C
Effects of the Medicare Modernization Act on spending for outpatient surgery.
The objective of the study was to examine the effects of Medicare's revised ambulatory surgery center (ASC) payment schedule on overall payments for outpatient surgery. The study concluded that despite lessening demand, reduced ASC facility payments did not curb spending for outpatient surgery. In fact, overall payments actually increased following the policy change, driven by higher average episode payments.
AHRQ-funded; HS024525; HS024728.
Citation: Hollingsworth JM, Oerline MK, Ellimoottil C .
Effects of the Medicare Modernization Act on spending for outpatient surgery.
Health Serv Res 2018 Aug;53 Suppl 1:2858-69. doi: 10.1111/1475-6773.12807..
Keywords: Payment, Policy, Ambulatory Care and Surgery, Surgery
Pandolfe F, Wright A, Slack WV
Rethinking the outpatient medication list: increasing patient activation and education while architecting for centralization and improved medication reconciliation.
The purpose of this study was to identify barriers impacting the time consuming and error fraught process of medication reconciliation and to design and implement an electronic medication management system where patient and trusted healthcare proxies can participate in establishing and maintaining an inclusive and up-to-date list of medications.
AHRQ-funded; HS021495.
Citation: Pandolfe F, Wright A, Slack WV .
Rethinking the outpatient medication list: increasing patient activation and education while architecting for centralization and improved medication reconciliation.
J Am Med Inform Assoc 2018 Aug;25(8):1047-53. doi: 10.1093/jamia/ocy047..
Keywords: Education: Patient and Caregiver, Health Information Technology (HIT), Medication, Ambulatory Care and Surgery, Patient and Family Engagement
Ricciardi R, Shofer M
AHRQ Author: Ricciardi R, Shofer M.
Moving patient safety into ambulatory settings and beyond.
This paper discusses patient safety across various clinical settings, the importance of patient and family engagement, and innovations in patient safety such as the Patient Safety Learning Laboratories.
AHRQ-authored.
Citation: Ricciardi R, Shofer M .
Moving patient safety into ambulatory settings and beyond.
J Nurs Care Qual 2018 Jul/Sep;33(3):195-99. doi: 10.1097/ncq.0000000000000329.
Keywords: Ambulatory Care and Surgery, Patient and Family Engagement, Patient Safety
Havele SA, Pfoh ER, Yan C
Physicians' views of self-monitoring of blood glucose in patients with type 2 diabetes not on insulin.
This qualitative study examines to what extent and why physicians still prescribe self-monitoring of blood glucose in patients with non-insulin-treated type 2 diabetes when the evidence shows it increases cost without improving hemoglobin A1c, general well-being, or health-related quality of life.
AHRQ-funded; HS024128.
Citation: Havele SA, Pfoh ER, Yan C .
Physicians' views of self-monitoring of blood glucose in patients with type 2 diabetes not on insulin.
Ann Fam Med 2018 Jul;16(4):349-52. doi: 10.1370/afm.2244..
Keywords: Diabetes, Evidence-Based Practice, Ambulatory Care and Surgery, Patient-Centered Outcomes Research, Patient Self-Management
Beebe L, Smith KD, Oppizzi LM
Telephone Intervention-Problem Solving (TIPS) for schizophrenia spectrum disorders: responses of stable outpatients over nine months.
In this study, the investigators conducted a descriptive analysis of data gathered during calls to 87 stable outpatients with schizophrenia spectrum disorders, receiving weekly telephone intervention-problem solving (TIPS) for nine months. The investigators suggest that their findings regarding racial differences in antipsychotic delivery method warrant further investigation.
AHRQ-funded; HS022166.
Citation: Beebe L, Smith KD, Oppizzi LM .
Telephone Intervention-Problem Solving (TIPS) for schizophrenia spectrum disorders: responses of stable outpatients over nine months.
Issues Ment Health Nurs 2018 Jul;39(7):561-67. doi: 10.1080/01612840.2018.1431824..
Keywords: Ambulatory Care and Surgery, Medication, Behavioral Health, Patient Adherence/Compliance
Shah PD, Marciniak MW, Golden SD
Pharmacies versus doctors' offices for adolescent vaccination.
This study sought to understand the relative advantage of pharmacies compared to doctors' offices for delivering HPV vaccination to adolescents. The authors concluded that to be more appealing to parents as HPV vaccine providers, pharmacy providers within community and hospital settings should build on their relative advantage with respect to accessibility and enhance their appeal of their healthcare environment.
AHRQ-funded; HS000032.
Citation: Shah PD, Marciniak MW, Golden SD .
Pharmacies versus doctors' offices for adolescent vaccination.
Vaccine 2018 Jun 7;36(24):3453-59. doi: 10.1016/j.vaccine.2018.04.088..
Keywords: Children/Adolescents, Health Services Research (HSR), Ambulatory Care and Surgery, Provider: Pharmacist, Vaccination