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
76 to 100 of 142 Research Studies DisplayedBerry JG, Goodman DM, Coller RJ
Association of home respiratory equipment and supply use with health care resource utilization in children.
The purpose of this cohort study was to compare health care use and spending in children using vs not using respiratory medical equipment and supplies (RMES). The investigators found that the use of RMES was associated with high health care spending, especially with hospital and home health care. They suggest that population health initiatives in children may benefit from consideration of RMES in comprehensive risk assessment for health care spending.
AHRQ-funded; HS02513.
Citation: Berry JG, Goodman DM, Coller RJ .
Association of home respiratory equipment and supply use with health care resource utilization in children.
J Pediatr 2019 Apr;207:169-75.e2. doi: 10.1016/j.jpeds.2018.11.046..
Keywords: Children/Adolescents, Healthcare Costs, Healthcare Utilization, Home Healthcare, Respiratory Conditions
Keller SC, Cosgrove SE, Kohut M
Hazards from physical attributes of the home environment among patients on outpatient parenteral antimicrobial therapy.
This study looked at hazards that patients undergoing outpatient parenteral antimicrobial therapy (OPAT) have to avoid while undergoing the treatment at home with a venous catheter. A qualitative study was conducted with patients discharged from 2 academic medical centers in Baltimore, Maryland. Hazards identified included bathing, pets, temperature extremes, household clutter, food and soil exposures and travel. Patients that were interviewed developed strategies to avoid these hazards.
AHRQ-funded; HS025782.
Citation: Keller SC, Cosgrove SE, Kohut M .
Hazards from physical attributes of the home environment among patients on outpatient parenteral antimicrobial therapy.
Am J Infect Control 2019 Apr;47(4):425-30. doi: 10.1016/j.ajic.2018.09.020..
Keywords: Home Healthcare, Infectious Diseases, Patient Safety, Prevention
Leeman H, Cosgrove SE, Williams D
Assessing burden of central line-associated bloodstream infections present on hospital admission.
Investigators described patients presenting to an academic medical center with central line-associated bloodstream infection present on hospital admission over 1 year. Of the 130 admissions, they found that about half presented from home infusion, followed by oncology clinic, hemodialysis, and skilled nursing facility. They concluded that efforts to reduce such infections should address patients across the entire health care system.
AHRQ-funded; HS025782.
Citation: Leeman H, Cosgrove SE, Williams D .
Assessing burden of central line-associated bloodstream infections present on hospital admission.
Am J Infect Control 2020 Feb;48(2):216-18. doi: 10.1016/j.ajic.2019.08.010..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitalization, Home Healthcare, Hospitals, Infectious Diseases
Jones CD, Jones J, Bowles KH
Patient, caregiver, and clinician perspectives on expectations for home healthcare after discharge: a qualitative case study.
The objective of this study was to evaluate and compare expectations for skilled home health care (HHC) from the patient, caregiver, and HHC perspectives after hospital discharge. Results showed that unclear expectations occurred when the patient and/or caregiver expectations were uncertain or misaligned with the services received; in most such cases, the patient and caregiver did not have prior experience with HHC. Recommendations to improve HHC transitions included actively engaging both patients and caregivers in the hospital and HHC settings to provide education about HHC services and assess and address additional care needs.
AHRQ-funded; HS024569.
Citation: Jones CD, Jones J, Bowles KH .
Patient, caregiver, and clinician perspectives on expectations for home healthcare after discharge: a qualitative case study.
J Hosp Med 2019 Feb;14(2):90-95. doi: 10.12788/jhm.3140..
Keywords: Caregiving, Health Services Research (HSR), Home Healthcare, Patient Experience, Provider, Provider: Clinician, Transitions of Care
Arbaje AI, Hughes A, Werner N
Information management goals and process failures during home visits for middle-aged and older adults receiving skilled home healthcare services after hospital discharge: a multisite, qualitative study.
The goal of this study was to identify information management (IM) process failures made during home health visits to middle-aged and older adults after hospital discharge. Communication risks included information overload, information underload, information scatter, information conflict, and erroneous information.
AHRQ-funded; HS022916.
Citation: Arbaje AI, Hughes A, Werner N .
Information management goals and process failures during home visits for middle-aged and older adults receiving skilled home healthcare services after hospital discharge: a multisite, qualitative study.
BMJ Qual Saf 2019 Feb;28(2):111-20. doi: 10.1136/bmjqs-2018-008163..
Keywords: Elderly, Home Healthcare, Hospital Discharge, Patient Safety, Transitions of Care
Jarrin OF, Pouladi FA, Madigan EA
International priorities for home care education, research, practice, and management: qualitative content analysis.
The purpose of this study was to articulate an international vision for the future of home care education, research, practice, and management shared by experienced home care nurses working in leadership roles. Four major themes emerged, in this qualitative study, reflecting international priorities for the future of home care education, research, practice, and management: 1) Build the evidence base for home care; 2) Design better systems of care; 3) Develop leaders at all levels; and 4) Address payment and policy issues.
AHRQ-funded; HS022406.
Citation: Jarrin OF, Pouladi FA, Madigan EA .
International priorities for home care education, research, practice, and management: qualitative content analysis.
Nurse Educ Today 2019 Feb;73:83-87. doi: 10.1016/j.nedt.2018.11.020..
Keywords: Education: Continuing Medical Education, Healthcare Delivery, Home Healthcare, Nursing, Provider
Knierim SD, Moore SL, Raghunath SG
Home visitations for delivering an early childhood obesity intervention in Denver: parent and patient navigator perspectives.
This qualitative study explored parent and patient navigator perspectives of home visitation as part of a childhood obesity program in a low-income, largely Latino population. The investigators concluded that a home visitation program delivering a pediatric obesity prevention curriculum in Denver was convenient and held families accountable, but posed scheduling difficulties and raised safety concerns.
AHRQ-funded; HS021138; HS022143.
Citation: Knierim SD, Moore SL, Raghunath SG .
Home visitations for delivering an early childhood obesity intervention in Denver: parent and patient navigator perspectives.
Matern Child Health J 2018 Nov;22(11):1589-97. doi: 10.1007/s10995-018-2553-7..
Keywords: Children/Adolescents, Home Healthcare, Low-Income, Obesity, Children/Adolescents, Racial and Ethnic Minorities
Yang Y, Bass EJ, Bowles KH
Impact of home care admission nurses' goals on electronic health record documentation strategies at the point of care.
The article reports on a study designed to investigate documentation strategies used by home care nurses with respect to entering electronic data during admission as well as the effect of nursing goals on the process. This was done to characterize admission nurses' practices at the point of care and to establish a basis for design recommendations for electronic health records (EHRs). Five nurses in rural Pennsylvania home care agencies were observed during the admission process. The results of the study lead the authors to recommend that EHR design and training should support the manner in which home care nurses document patient encounters.
AHRQ-funded; HS024537.
Citation: Yang Y, Bass EJ, Bowles KH .
Impact of home care admission nurses' goals on electronic health record documentation strategies at the point of care.
Comput Inform Nurs 2019 Jan;37(1):39-46. doi: 10.1097/cin.0000000000000468..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Home Healthcare, Nursing
Sobotka SA, Gaur DS, Goodman DM
Pediatric patients with home mechanical ventilation: the health services landscape.
Children with invasive home mechanical ventilation (HMV) are a growing population with complex health service needs. Single institution studies provide insight into successful program structures and outcomes. In this study, the investigators aimed to assess health service structures, providers, and programs caring for this population throughout the U.S., and to understand barriers to high-quality care.
AHRQ-funded; HS023007.
Citation: Sobotka SA, Gaur DS, Goodman DM .
Pediatric patients with home mechanical ventilation: the health services landscape.
Pediatr Pulmonol 2019 Jan;54(1):40-46. doi: 10.1002/ppul.24196..
Keywords: Access to Care, Children/Adolescents, Healthcare Delivery, Home Healthcare, Children/Adolescents
Patil SJ, Koopman RJ, Belden J
The role of home BP monitoring: answers to 10 common questions.
This review examines what role home blood-pressure monitoring (HBPM) should take in the management of patients with hypertension. The answers to ten evidence-based questions, with reference to USPSTF recommendations, are used to provide insight. These questions include: Can HPBM be used to confirm a hypertension diagnosis? What are the diagnostic and treatment targets for HBPM? Does HBPM improve control of hypertension? Does HBPM help improve medication adherence? Does HBPM improve BP outcomes?
AHRQ-funded; HS023328.
Citation: Patil SJ, Koopman RJ, Belden J .
The role of home BP monitoring: answers to 10 common questions.
J Fam Pract 2019 Jan/Feb;68(1):29-33..
Keywords: U.S. Preventive Services Task Force (USPSTF), Blood Pressure, Home Healthcare, Evidence-Based Practice, Care Management, Guidelines
Dowding D, Merrill JA, Barron Y
Usability evaluation of a dashboard for home care nurses.
Usability tests were conducted on a creation of a dashboard prototype for home care nurses for their patients’ electronic health records (EHRs). The prototype was created by first observing and interviewing several nurses; getting feedback on paper versions of the dashboard; and then a usability evaluation of the electronic prototype. The dashboard was positively evaluated.
AHRQ-funded; HS023855.
Citation: Dowding D, Merrill JA, Barron Y .
Usability evaluation of a dashboard for home care nurses.
Comput Inform Nurs 2019 Jan;37(1):11-19. doi: 10.1097/cin.0000000000000484..
Keywords: Health Information Technology (HIT), Home Healthcare, Nursing, Provider
Yang Y, Bass EJ, Sockolow PS
Knowledge elicitation of homecare admission decision making processes via focus group, member checking and data visualization.
Researchers elicit knowledge related to expert decision-making processes to inform information technology design and related interventions. In this study, the investigators examine knowledge elicitation of homecare admission decision making processes via focus group, member checking and data visualization. The investigators concluded that the data collection and validation methodology showed promise for knowledge elicitation in time-constrained situations.
AHRQ-funded; HS024537.
Citation: Yang Y, Bass EJ, Sockolow PS .
Knowledge elicitation of homecare admission decision making processes via focus group, member checking and data visualization.
AMIA Annu Symp Proc 2018 Dec 5;2018:1127-36..
Keywords: Home Healthcare, Shared Decision Making, Health Information Technology (HIT), Data
Sterling MR, Silva AF, Leung PBK
"It's like they forget that the word 'health' is in 'home health aide'": Understanding the perspectives of home care workers who care for adults with heart failure.
Home care workers (HCWs) were interviewed about their role and perspectives in caring for community-dwelling adults with heart failure (HF) posthospitalization. Researchers conducted a total of 8 focus groups in partnership with the Home Care Industry Education Fund. A total of 46 English- and Spanish-speaking HCWs employed by 21 unique home care agencies participated. Generally they felt overworked and unappreciated but care about their clients and families and still love their job. The majority of HCWs have not received HF training, so do not feel supported when their clients’ symptoms worsened.
AHRQ-funded; HS024569.
Citation: Sterling MR, Silva AF, Leung PBK .
"It's like they forget that the word 'health' is in 'home health aide'": Understanding the perspectives of home care workers who care for adults with heart failure.
J Am Heart Assoc 2018 Dec 4;7(23):e010134. doi: 10.1161/jaha.118.010134..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Home Healthcare, Provider: Health Personnel
Keller SC, Williams D, Rock C
A new frontier: central line-associated bloodstream infection surveillance in home infusion therapy.
As more home infusion agencies consider ways to perform surveillance for central line–associated bloodstream infection (CLABSI), an understanding of the assorted challenges is necessary. The authors discussed these challenges, which include a lack of a widely accepted standard definition of CLABSIs in home infusion therapy, the lack of a reporting platform, the absence of a reporting requirement, and barriers in obtaining the needed information to identify the presence of a potential CLABSI and adjudicate whether it meets a CLABSI definition. The 21st Century Cures Act will expand Medicare coverage for home infusion therapy services by 2021, likely leading to increased pressure for home infusion therapy CLABSI surveillance. Benchmarking of CLABSI data can usher in informed work to reduce CLABSIs and enhance patient safety in home infusion therapy.
AHRQ-funded; HS025782.
Citation: Keller SC, Williams D, Rock C .
A new frontier: central line-associated bloodstream infection surveillance in home infusion therapy.
Am J Infect Control 2018 Dec;46(12):1419-21. doi: 10.1016/j.ajic.2018.05.016..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Home Healthcare, Patient Safety, Sepsis, Infectious Diseases, Prevention
Russell D, Dowding DW, McDonald MV
Factors for compliance with infection control practices in home healthcare: findings from a survey of nurses' knowledge and attitudes toward infection control.
This study analyzed survey responses from nurses at 2 large, certified home healthcare agencies to explore levels of compliance with infection control practices and identify associated demographic, knowledge, and attitudinal correlates. The findings suggested that efforts to improve compliance with infection control practices in home healthcare should focus on strategies to alter perceptions about infection risk and other attitudinal factors.
AHRQ-funded; HS024723.
Citation: Russell D, Dowding DW, McDonald MV .
Factors for compliance with infection control practices in home healthcare: findings from a survey of nurses' knowledge and attitudes toward infection control.
Am J Infect Control 2018 Nov;46(11):1211-17. doi: 10.1016/j.ajic.2018.05.005..
Keywords: Healthcare-Associated Infections (HAIs), Home Healthcare, Prevention, Patient Safety
Sterling MR, Shaw AL, Leung PB
Home care workers in heart failure: a systematic review.
This systematic review aimed to 1) describe utilization patterns of home care workers (HCWs) by adults with heart failure (HF), 2) examine the effect of HCWs on HF outcomes, and 3) review HF interventions that involve HCWs. The investigators concluded that the literature on these HCWs in HF is limited. They suggest that additional research is warranted on the potential role of HCWs in HF self-care and on outcomes among adults with HF.
AHRQ-funded; HS024569; T32 HS000066.
Citation: Sterling MR, Shaw AL, Leung PB .
Home care workers in heart failure: a systematic review.
J Multidiscip Healthc 2018 Sep 25;11:481-92. doi: 10.2147/jmdh.s175512..
Keywords: Health Services Research (HSR), Heart Disease and Health, Home Healthcare
Auger KA, Simmons JM, Tubbs-Cooley HL
Postdischarge Nurse Home Visits and Reuse: the Hospital to Home Outcomes (H2O) Trial.
In this study, the investigators evaluated the effects of a pediatric transition intervention, specifically a single nurse home visit, on postdischarge outcomes in a randomized controlled trial. The investigators concluded that children randomly assigned to the intervention had higher rates of 30-day postdischarge unplanned health care reuse. They also noted that parents in the intervention group recalled more clinical warning signs 2 weeks after discharge.
AHRQ-funded; HS024735.
Citation: Auger KA, Simmons JM, Tubbs-Cooley HL .
Postdischarge Nurse Home Visits and Reuse: the Hospital to Home Outcomes (H2O) Trial.
Pediatrics 2018 Jul;142(1). doi: 10.1542/peds.2017-3919..
Keywords: Children/Adolescents, Home Healthcare, Hospital Discharge, Nursing, Transitions of Care
Dowding DW, Russell D, Onorato N
Technology solutions to support care continuity in home care: a focus group study.
The purpose of this study was to explore perceptions among home care clinicians of the barriers they face and the information they need to improve care continuity for patients with heart failure. The study highlighted areas of improvement for health information technology solutions that could support care delivery for patients with heart failure in a home care setting.
AHRQ-funded; HS023855.
Citation: Dowding DW, Russell D, Onorato N .
Technology solutions to support care continuity in home care: a focus group study.
J Healthc Qual 2018 Jul/Aug;40(4):236-46. doi: 10.1097/jhq.0000000000000104..
Keywords: Healthcare Delivery, Health Information Technology (HIT), Heart Disease and Health, Home Healthcare, Quality Improvement
Myerson RM, Colantonio LD, Safford MM
Does identification of previously undiagnosed conditions change care-seeking behavior?
The purpose of the study was to determine whether identification of previously undiagnosed high cholesterol, hypertension, and/or diabetes during an in-home assessment impacts care seeking among Medicare beneficiaries. The study concluded that in-home assessment of cholesterol, blood pressure, and blood glucose can increase doctor visits for individuals with previously undiagnosed conditions. However, biomarker assessment may have more limited impact among individuals with low access to care.
AHRQ-funded; HS000084.
Citation: Myerson RM, Colantonio LD, Safford MM .
Does identification of previously undiagnosed conditions change care-seeking behavior?
Health Serv Res 2018 Jun;53(3):1517-38. doi: 10.1111/1475-6773.12644..
Keywords: Blood Pressure, Diabetes, Home Healthcare, Cardiovascular Conditions
Jones CD, Burke RE
Inpatient notes - getting past the "black box"-opportunities for hospitalists to improve postacute care transitions.
The care provided after hospital discharge in skilled-nursing facilities and home health care is collectively termed postacute care (PAC). In this article, the authors outline 3 key problems with postacute care transitions and offer potential solutions.
AHRQ-funded; HS024569.
Citation: Jones CD, Burke RE .
Inpatient notes - getting past the "black box"-opportunities for hospitalists to improve postacute care transitions.
Ann Intern Med 2018 May 15;168(10):HO2-HO3. doi: 10.7326/m18-0940..
Keywords: Health Services Research (HSR), Home Healthcare, Hospital Discharge, Long-Term Care, Transitions of Care
Ma C, Shang J, Miner S
The prevalence, reasons, and risk factors for hospital readmissions among home health care patients: a systematic review.
This systematic review examined the current evidence about hospital readmissions from home health care (HHC). Among 18 reviewed articles, they found that reported readmission rates and risk factors varied dramatically between studies; reasons for readmissions were understudied; and findings were limited by small sample sizes, single data source, and methodological flaws. They recommended that future studies use multiple national data sources across patients’ care spectrum and advanced statistical models to identify who among HHC patients are most likely to be readmitted to hospital and for what reason.
AHRQ-funded; HS023593.
Citation: Ma C, Shang J, Miner S .
The prevalence, reasons, and risk factors for hospital readmissions among home health care patients: a systematic review.
Home Health Care Manag Pract 2018 May;30(2):83-92.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Home Healthcare, Hospital Readmissions
Sockolow PS, Yang Y, Bass EJ
Data visualization of home care admission nurses' decision-making.
This study investigated nurses’ decision making regarding hospital to home care admissions. They conducted a focus group case study with six admitting home health nurses at a rural agency in Pennsylvania and analyzed the data using thematic analysis.
AHRQ-funded; HS024537.
Citation: Sockolow PS, Yang Y, Bass EJ .
Data visualization of home care admission nurses' decision-making.
AMIA Annu Symp Proc 2018 Apr 16;2017:1597-606..
Keywords: Data, Shared Decision Making, Home Healthcare, Nursing, Transitions of Care
Berridge C
Medicaid becomes the first third-party payer to cover passive remote monitoring for home care: policy analysis.
This study examined passive remote monitoring technologies in state Medicaid programs. Its goals were to identify which states allowed location tracking, sensor systems, and cameras, what policies were in place to track usage, what implementation processes and program monitoring mechanisms were in place, and what related insights Medicaid program stakeholders would like to learn. Interviews were conducted with state, federal, and managed care organization (MCO) Medicaid program stakeholders about the use of these technologies in state waivers that served community-dwelling older adults in 15 states. While two-thirds of the states covered location tracking and activity-monitoring sensors and one-third covered cameras, only 3 states had specific service categories that allowed tracking of when they pay for these technologies. The authors conclude that technologies that have great potential to alter the way older adults receive supportive services are often used without research on their use, social or ethical implications, or outcomes. New service categories are needed to enable oversight, and more interaction between policymakers and researchers in this field would aid in the prioritization of research aims to inform practice.
AHRQ-funded; HS000011.
Citation: Berridge C .
Medicaid becomes the first third-party payer to cover passive remote monitoring for home care: policy analysis.
J Med Internet Res 2018 Feb 21;20(2):e66. doi: 10.2196/jmir.9650..
Keywords: Elderly, Health Information Technology (HIT), Health Insurance, Healthcare Delivery, Home Healthcare, Medicaid, Policy
Wang Y, Spatz ES, Tariq M
Home health agency performance in the United States: 2011-15.
This review’s evaluation of home health agency quality performance included 11,462 Medicare-certified home health agencies that served 92.4 percent of all ZIP codes nationwide, accounting for 315.2 million people. It found that home health agency performance on several quality indicators varied, and many agencies were persistently in the lowest quartile of performance.
AHRQ-funded; HS023000.
Citation: Wang Y, Spatz ES, Tariq M .
Home health agency performance in the United States: 2011-15.
J Am Geriatr Soc 2017 Dec;65(12):2572-79. doi: 10.1111/jgs.14987.
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Keywords: Quality of Care, Home Healthcare, Quality Indicators (QIs), Quality Measures
Werner NE, Malkana S, Gurses AP
Toward a process-level view of distributed healthcare tasks: medication management as a case study.
Researchers aimed to highlight the importance of using a process-level view in analyzing distributed healthcare tasks through a case study analysis of medication management (MM). Their findings identified key cross-system characteristics not observable at the task-level: (1) identification of emergent properties (e.g., role ambiguity, loosely-coupled teams performing MM) and associated barriers; and (2) examination of barrier propagation across system boundaries.
AHRQ-funded; HS022916.
Citation: Werner NE, Malkana S, Gurses AP .
Toward a process-level view of distributed healthcare tasks: medication management as a case study.
Appl Ergon 2017 Nov;65:255-68. doi: 10.1016/j.apergo.2017.06.020.
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Keywords: Care Management, Elderly, Home Healthcare, Medication, Transitions of Care