National Healthcare Quality and Disparities Report
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 2 of 2 Research Studies DisplayedMarkovitz AA, Hollingsworth JM, Ayanian JZ
Performance in the Medicare Shared Savings Program after accounting for nonrandom exit: an instrumental variable analysis.
The purpose of this study was to evaluate the effect of the Medicare Shared Savings Program (MSSP) on spending and quality while accounting for clinicians' nonrandom exit. MSSP ACO participants were compared with control beneficiaries using adjusted longitudinal models that accounted for secular trends, market factors, and beneficiary characteristics. Results showed that, after adjustment for clinicians' nonrandom exit, the MSSP was not associated with improvements in spending or quality. Selection effects, including exit of high-cost clinicians, may drive estimates of savings in the MSSP.
AHRQ-funded; HS025615; HS024728; HS024525.
Citation: Markovitz AA, Hollingsworth JM, Ayanian JZ .
Performance in the Medicare Shared Savings Program after accounting for nonrandom exit: an instrumental variable analysis.
Ann Intern Med 2019 Jul 2;171(1):27-36. doi: 10.7326/m18-2539..
Keywords: Healthcare Costs, Health Services Research (HSR), Medicare, Quality of Care
Althoff KN, Wong C, Hogan B
Mind the gap: observation windows to define periods of event ascertainment as a quality control method for longitudinal electronic health record data.
Under the hypothesis that use of electronic health records in health research may lead to false assumptions of complete event ascertainment, the authors of this article estimated "observation windows" (OWs) as a quality-control approach to reduce the likelihood of false assumption. The impact of OWs on estimating rates of type II diabetes mellitus from HIV clinical cohorts are demonstrated. Data from 16 HIV clinical cohorts to the NA-ACCORD were used to identify and evaluate OWs for an operationalized definition of diabetes occurrence. The authors conclude that OWs have utility as a quality-control approach to complete event ascertainment and help to improve the accuracy of estimates.
AHRQ-funded; 90047713.
Citation: Althoff KN, Wong C, Hogan B .
Mind the gap: observation windows to define periods of event ascertainment as a quality control method for longitudinal electronic health record data.
Ann Epidemiol 2019 May;33:54-63. doi: 10.1016/j.annepidem.2019.01.015..
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Quality of Care