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
12101 to 12125 of 12210 Research Studies DisplayedLiss DT, Fishman PA, Rutter CM
Outcomes among chronically ill adults in a medical home prototype.
The researchers compared quality, utilization, and cost outcomes for patients with selected chronic illnesses at a patient-centered medical home (PCMH) prototype site with outcomes for patients with the same chronic illnesses at 19 nonintervention control sites. They concluded that a clinic-level population-based PCMH redesign can decrease downstream utilization and reduce total healthcare costs in a subpopulation of patients with common chronic illnesses.
AHRQ-funded; HS019129.
Citation: Liss DT, Fishman PA, Rutter CM .
Outcomes among chronically ill adults in a medical home prototype.
Am J Manag Care 2013 Oct;19(10):e348-58.
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Keywords: Chronic Conditions, Healthcare Costs, Quality of Care, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Wagner J, Gabler NB, Ratcliffe SJ
Outcomes among patients discharged from busy intensive care units.
This study of 155 U.S. intensive care units (ICUs) found that when their capacities are strained, triage decisions seem to be affected such that patients are discharged from the ICU more quickly, and have slightly greater odds of being readmitted to the ICU. However, short-term patient outcomes are unaffected.
AHRQ-funded; HS018406
Citation: Wagner J, Gabler NB, Ratcliffe SJ .
Outcomes among patients discharged from busy intensive care units.
Ann Intern Med. 2013 Oct 1;159(7):447-55. doi: 10.7326/0003-4819-159-7-201310010-00004..
Keywords: Intensive Care Unit (ICU), Patient Safety, Outcomes, Hospital Discharge, Mortality
Katz DF, Sun J, Khatri V
QTc interval screening in an opioid treatment program.
This pilot study supports the feasibility of implementing a population-based electrocardiographic monitoring program in order to decrease the QTc interval in high-risk patients undergoing methadone maintenance in an opioid treatment program. Clinical characteristics alone were inadequate to identify patients in need of electrocardiographic screening.
AHRQ-funded; HS021138
Citation: Katz DF, Sun J, Khatri V .
QTc interval screening in an opioid treatment program.
Am J Cardiol. 2013 Oct 1;112(7):1013-8. doi: 10.1016/j.amjcard.2013.05.037..
Keywords: Opioids, Medication, Substance Abuse, Screening, Adverse Drug Events (ADE), Adverse Events, Medication: Safety, Risk, Implementation
Moga DC, Carnahan RM, Lund BC
Risks and benefits of bladder antimuscarinics among elderly residents of Veterans Affairs Community Living Centers.
This study evaluated the risks and benefits of drugs to reduce urinary incontinence that were used by elderly VA nursing home residents. It found that the use of these drugs, known as bladder antimuscarinics, resulted in improved continence rates and better social engagement but also led to a higher risk of fractures in new users.
AHRQ-funded; HS016094
Citation: Moga DC, Carnahan RM, Lund BC .
Risks and benefits of bladder antimuscarinics among elderly residents of Veterans Affairs Community Living Centers.
J Am Med Dir Assoc. 2013 Oct;14(10):749-60. doi: 10.1016/j.jamda.2013.03.008..
Keywords: Elderly, Medication, Medication: Safety, Nursing Homes, Long-Term Care, Injuries and Wounds, Patient Safety
Sheppard KD, Brown CJ, Hearld KR
Symptom burden predicts nursing home admissions among older adults.
Using a sample of community-dwelling Medicare beneficiaries in Alabama who were contacted by telephone every 6 months during an eight and a half-year study, researchers found that symptom burden is an independent risk factor for NH admission. The study suggests that symptom assessment and management may reduce NH utilization.
AHRQ-funded; HS013852
Citation: Sheppard KD, Brown CJ, Hearld KR .
Symptom burden predicts nursing home admissions among older adults.
J Pain Symptom Manage. 2013 Oct;46(4):591-7. doi: 10.1016/j.jpainsymman.2012.10...
Keywords: Medicare, Long-Term Care, Elderly, Nursing Homes, Healthcare Costs
Henriksen K, Brady J
AHRQ Author: Henriksen K, Brady J
The pursuit of better diagnostic performance: a human factors perspective.
Improving diagnostic performance is increasingly recognised as a multifaceted challenge. This paper addresses a few of these challenges, including questions that focus on who owns the problem, treating cognitive and system shortcomings as separate issues, why knowledge in the head is not enough, and what we are learning from health information technology and the use of checklists. The authors propose a systems engineering approach making use of rapid-cycle prototyping and simulation, and they call for the formation of substantive partnerships with those in disciplines beyond the clinical domain.
AHRQ-authored.
Citation: Henriksen K, Brady J .
The pursuit of better diagnostic performance: a human factors perspective.
BMJ Qual Saf 2013 Oct;22 Suppl 2:ii1-ii5. doi: 10.1136/bmjqs-2013-001827.
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Keywords: Diagnostic Safety and Quality, Health Information Technology (HIT), Medical Errors, Health Information Technology (HIT), Quality Improvement
Zimring C, Denham ME, Jacob JT
http://journals.sagepub.com/doi/10.1177/193758671300701S09
The role of facility design in preventing healthcare-associated infection: interventions, conclusions, and research needs.
The objective of this report was to summarize the findings and provide recommendations based on the multidisciplinary literature review and industry scan, focusing on the links between the built environment and healthcare-associated infections. It concluded that there are currently few data that demonstrate a reduction in infection rates. There is a need for multidisciplinary collaboration and increased efforts to standardize the evaluation of environmental studies.
AHRQ-funded; 290201000024I.
Citation: Zimring C, Denham ME, Jacob JT .
The role of facility design in preventing healthcare-associated infection: interventions, conclusions, and research needs.
HERD 2013 Oct;7(1 suppl):127-39..
Keywords: Evidence-Based Practice, Quality of Care, Healthcare-Associated Infections (HAIs), Hospitals
Zimring C, Jacob JT, Denham ME
http://journals.sagepub.com/doi/pdf/10.1177/193758671300701S04
The role of facility design in preventing the transmission of healthcare-associated infections: Background and conceptual framework.
This paper describes the conceptual framework and methodology used to conduct a comprehensive literature review of current evidence evaluating the role of the built environment in the transmission of healthcare-associated infections. The methodology involves a chain of transmission interventions model that is a multidisciplinary conceptualization of the interaction between pathogens and the built environment. This model facilitated a systematic literature review of a very large amount of data.
AHRQ-funded; 290201000024I.
Citation: Zimring C, Jacob JT, Denham ME .
The role of facility design in preventing the transmission of healthcare-associated infections: Background and conceptual framework.
HERD 2013 Oct;7(1 suppl):18-30.
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Keywords: Evidence-Based Practice, Quality of Care, Healthcare-Associated Infections (HAIs), Research Methodologies
Jacob JT, Kasali A, Steinberg JP
http://journals.sagepub.com/doi/abs/10.1177/193758671300701S07
The role of the hospital environment in preventing healthcare-associated infections caused by pathogens transmitted through the air.
This review assesses and synthesizes available evidence in the infection control and healthcare design literature on strategies using the built environment to reduce the transmission of pathogens in the air that cause healthcare-associated infections (HAIs). It found that current evidence is limited by the complexity of the interactions between pathogens and potential hosts, and in the methods used to assess impact of these strategies.
AHRQ-funded; 290201000024I.
Citation: Jacob JT, Kasali A, Steinberg JP .
The role of the hospital environment in preventing healthcare-associated infections caused by pathogens transmitted through the air.
HERD 2013 Oct;7(1 suppl):74-98..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care
Steinberg JP, Denham ME, Zimring C
https://www.researchgate.net/publication/276382905/download
The role of the hospital environment in the prevention of healthcare-associated infections by contact transmission.
The authors describe the role of the hospital environment in the spread of pathogens by direct and indirect contact. In addition, the prevention of transmission through interventions involving the built environment is discussed. They conclude that enhanced environmental cleaning including touchless technologies and self-cleaning surfaces can reduce environmental contamination and may prevent infections.
AHRQ-funded; 290201000024I.
Citation: Steinberg JP, Denham ME, Zimring C .
The role of the hospital environment in the prevention of healthcare-associated infections by contact transmission.
HERD 2013 Oct;7(1 suppl):46-73..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Prevention, Patient Safety
Denham ME, Kasali A, Steinberg JP
http://journals.sagepub.com/doi/abs/10.1177/193758671300701S08
The role of water in the transmission of healthcare-associated infections: opportunities for intervention through the environment.
The purpose of this review was to assess and synthesize available evidence in the infection control and healthcare design literature on strategies using the built environment to reduce the transmission of pathogens in water that cause healthcare-associated infections (HAIs). It determined that current evidence clearly identifying the environment’s role in the chain of infection is limited.
AHRQ-funded; 290201000024I.
Citation: Denham ME, Kasali A, Steinberg JP .
The role of water in the transmission of healthcare-associated infections: opportunities for intervention through the environment.
HERD 2013 Oct;7(1 suppl):99-126..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care
Hall KK, Kamerow DB
http://journals.sagepub.com/doi/abs/10.1177/193758671300701S03
Understanding the role of facility design in the acquisition and prevention of healthcare-associated infections.
The authors characterize the HAI-Design project and discuss briefly each paper in this issue. These papers highlight how the built environment can impact patient safety through the use of a specific and high-impact example: healthcare-associated infections. The overall goal is to identify design strategies that appear to be effective in interrupting pathogen transmission and reducing HAIs.
AHRQ-funded; 290201000024I.
Citation: Hall KK, Kamerow DB .
Understanding the role of facility design in the acquisition and prevention of healthcare-associated infections.
HERD 2013 Oct;7(1 suppl):13-17..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care
Nurgalieva ZZ, Franzini L, Morgan RO
Utilization of lymph node dissection, race/ethnicity, and breast cancer outcomes.
This study reports on the impact of nodal surgery utilization on survival among white, African American, Hispanic, and Asian women in a large population of women with breast cancer. It found that the disparities in survival among African American and Hispanic women with breast cancer are not explained by nodal surgery utilization among women with micrometastasis and macrometastasis in sentinel lymph nodes.
AHRQ-funded; HS018956.
Citation: Nurgalieva ZZ, Franzini L, Morgan RO .
Utilization of lymph node dissection, race/ethnicity, and breast cancer outcomes.
Am J Manag Care 2013 Oct;19(10):805-10..
Keywords: Cancer: Breast Cancer, Comparative Effectiveness, Disparities, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
O'Donnell BE, Schneider KM, Brooks JM
Standardizing Medicare payment information to support examining geographic variation in costs.
This paper describes a method for standardizing claim payments, and demonstrates the difference in actual versus standardized payments by geographic region. It found that without standardization of payments, certain areas of the country are mischaracterized as either high or low healthcare resource-consuming areas.
AHRQ-funded; HS019574; HS019440.
Citation: O'Donnell BE, Schneider KM, Brooks JM .
Standardizing Medicare payment information to support examining geographic variation in costs.
Medicare Medicaid Res Rev 2013 Sep 10;3(3). doi: 10.5600/mmrr.003.03.a06..
Keywords: Medicare, Healthcare Costs, Hospitalization, Hospitals
Glanz JM, Wagner NM, Narwaney KJ
A mixed methods study of parental vaccine decision making and parent-provider trust.
Given the growing public health problem of parental vaccine hesitancy, researchers investigated parental vaccine decisionmaking through the use of focus groups and a mailed survey. They found that parents had overall trust in their pediatricians but not in the information they provided about vaccines. Parents refusing or delaying vaccines were twice as likely to begin thinking about vaccines before their child was born.
AHRQ-funded; HS019760
Citation: Glanz JM, Wagner NM, Narwaney KJ .
A mixed methods study of parental vaccine decision making and parent-provider trust.
Acad Pediatr. 2013 Sep-Oct;13(5):481-8. doi: 10.1016/j.acap.2013.05.030..
Keywords: Children/Adolescents, Vaccination, Education: Patient and Caregiver, Healthcare Utilization, Shared Decision Making
Myers 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