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
26 to 50 of 114 Research Studies DisplayedBalaban RB, Zhang F, Vialle-Valentin CE
Impact of a patient navigator program on hospital-based and outpatient utilization over 180 days in a safety-net health system.
The objective of this study was to determine the effect of a care transition program using patient navigators (PNs) on health service utilization among high-risk safety-net patients over a 180-day period. The investigators concluded that a PN program serving high-risk safety-net patients differentially impacted patients based on age, and among younger patients, outcomes varied over time. The investigators suggest that their findings highlight the importance for future research to evaluate care transition programs among different subpopulations and over longer time peri
AHRQ-funded; HS020628.
Citation: Balaban RB, Zhang F, Vialle-Valentin CE .
Impact of a patient navigator program on hospital-based and outpatient utilization over 180 days in a safety-net health system.
J Gen Intern Med 2017 Sep;32(9):981-89. doi: 10.1007/s11606-017-4074-2..
Keywords: Care Management, Healthcare Delivery, Healthcare Utilization, Hospital Readmissions, Patient-Centered Healthcare, Transitions of Care
Bowen ME, Merchant Z, Abdullah K
Patient, provider, and system factors associated with failure to follow-up elevated glucose results in patients without diagnosed diabetes.
Patient, provider, and system factors associated with failure to follow-up elevated glucose values in electronic medical records (EMRs) are not well described. The researchers conducted a chart review in a comprehensive EMR with a patient portal and results management features but found no associations between patient characteristics, diabetes risk factors, or provider characteristics and follow-up failures.
AHRQ-funded; HS022418.
Citation: Bowen ME, Merchant Z, Abdullah K .
Patient, provider, and system factors associated with failure to follow-up elevated glucose results in patients without diagnosed diabetes.
Health Serv Res Manag Epidemiol 2017 Aug 29;4:2333392817721647. doi: 10.1177/2333392817721647.
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Keywords: Diabetes, Electronic Health Records (EHRs), Web-Based, Patient-Centered Healthcare, Diagnostic Safety and Quality
Caldieraro MA, Sylvia LG, Dufour S
Clinical correlates of acute bipolar depressive episode with psychosis.
The aim of this study was to identify the characteristics of depressed bipolar patients with current psychosis compared to those without psychosis. Results showed that psychosis was present in 10.6% of the studied depressed patients. Psychotic patients had less education, lower income, and were more frequently single and unemployed. Psychosis was also associated with a more severe depressive episode, higher suicidality, more comorbid conditions and worse functioning. Most group differences disappeared when controlling for depression severity.
AHRQ-funded; HS019371.
Citation: Caldieraro MA, Sylvia LG, Dufour S .
Clinical correlates of acute bipolar depressive episode with psychosis.
J Affect Disord 2017 Aug 1;217:29-33. doi: 10.1016/j.jad.2017.03.059.
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Keywords: Comparative Effectiveness, Diagnostic Safety and Quality, Behavioral Health, Patient-Centered Healthcare
Olesiuk WJ, Farley JF, Domino ME
Do medical homes offer improved diabetes care for Medicaid enrollees with co-occurring schizophrenia?
The purpose of this study was to determine whether Medicaid recipients with co-occurring diabetes and schizophrenia that are medical-home-enrolled are more likely to receive guideline-concordant diabetes care than those who are not medical-home-enrolled, controlling for confounders. The study concluded that medical-home enrollment is generally associated with greater likelihood of receiving guideline-concordant diabetes care for Medicaid enrollees with diabetes and schizophrenia.
AHRQ-funded; HS023099; HS019659; HS000032.
Citation: Olesiuk WJ, Farley JF, Domino ME .
Do medical homes offer improved diabetes care for Medicaid enrollees with co-occurring schizophrenia?
J Health Care Poor Underserved 2017;28(3):1030-41. doi: 10.1353/hpu.2017.0094..
Keywords: Care Management, Diabetes, Medicaid, Behavioral Health, Patient-Centered Healthcare
Acher AW, Campbell-Flohr SA, Brenny-Fitzpatrick M
Improving patient-centered transitional care after complex abdominal surgery.
Poor-quality transitions of care from hospital to home contribute to high rates of readmission after complex abdominal surgery. The Coordinated Transitional Care (C-TraC) program improved readmission rates in medical patients, but evidence-based surgical transitional care protocols are still lacking. This pilot study evaluated the feasibility and preliminary effectiveness of an adapted surgical C-TraC protocol. The investigators concluded that a phone-based transitional care protocol for surgical patients is feasible, with <1% refusals and 95% engagement.
patients is feasible, with <1% refusals and 95% engagement.
AHRQ-funded; HS022446.
AHRQ-funded; HS022446.
Citation: Acher AW, Campbell-Flohr SA, Brenny-Fitzpatrick M .
Improving patient-centered transitional care after complex abdominal surgery.
J Am Coll Surg 2017 Aug;225(2):259-65. doi: 10.1016/j.jamcollsurg.2017.04.008..
Keywords: Patient-Centered Healthcare, Quality of Care, Quality Improvement, Surgery, Transitions of Care
McClintock HF, Bogner HR
Incorporating patients' social determinants of health into hypertension and depression care: a pilot randomized controlled trial.
The objective of this study was to carry out a randomized controlled pilot trial to test the effectiveness of an integrated intervention for hypertension and depression incorporating patients' social determinants of health (enhanced intervention) versus an integrated intervention alone (basic intervention). The pilot trial results indicate integrated care management that addresses the social determinants of health for patients with hypertension and depression may be effective.
AHRQ-funded; HS023445.
Citation: McClintock HF, Bogner HR .
Incorporating patients' social determinants of health into hypertension and depression care: a pilot randomized controlled trial.
Community Ment Health J 2017 Aug;53(6):703-10. doi: 10.1007/s10597-017-0131-x.
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Keywords: Depression, Behavioral Health, Blood Pressure, Social Determinants of Health, Patient-Centered Healthcare, Healthcare Delivery
Pellegrini CA, Ledford G, Hoffman SA
Preferences and motivation for weight loss among knee replacement patients: implications for a patient-centered weight loss intervention.
The purpose of this study was to identify knee replacement patient preferences for weight loss programs and qualitatively understand previous motives for weight loss attempts as well as strategies used to facilitate behavior changes. It provides a preliminary examination into the motives for weight loss, strategies utilized during past weight loss attempts, and preferences for future weight loss programs as described by knee replacement patients.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Ledford G, Hoffman SA .
Preferences and motivation for weight loss among knee replacement patients: implications for a patient-centered weight loss intervention.
BMC Musculoskelet Disord 2017 Aug 1;18(1):327. doi: 10.1186/s12891-017-1687-x.
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Keywords: Patient-Centered Healthcare, Surgery, Obesity, Obesity: Weight Management
Hewner S, Casucci S, Sullivan S
Integrating social determinants of health into primary care clinical and informational workflow during care transitions.
Care continuity during transitions between the hospital and home requires reliable communication between providers and settings and an understanding of social determinants that influence recovery. This paper describes the coordinating transitions intervention which uses real time alerts, delivered directly to the primary care practice for complex chronically ill patients discharged from an acute care setting, to facilitate nurse care coordinator led telephone outreach.
AHRQ-funded; HS022575.
Citation: Hewner S, Casucci S, Sullivan S .
Integrating social determinants of health into primary care clinical and informational workflow during care transitions.
eGEMS 2017 Jul 4;5(2):2. doi: 10.13063/2327-9214.1282..
Keywords: Care Coordination, Chronic Conditions, Patient-Centered Healthcare, Social Determinants of Health, Transitions of Care
Hoff T, Scott S
The strategic nature of individual change behavior: how physicians and their staff implement medical home care.
The purpose of this study was to gain insight into patient-centered medical home (PCMH) implementation at the workplace level by understanding better how primary care physicians and staff perceive, experience, and use certain types of PCMH work for adapting to new demands. The investigators indicated that the findings showed that particular forms of PCMH work not only advanced patient care in favorable ways but also enhanced individual and organizational capacity for adapting to this innovative model and its demands.
AHRQ-funded; HS020931.
Citation: Hoff T, Scott S .
The strategic nature of individual change behavior: how physicians and their staff implement medical home care.
Health Care Manage Rev 2017 Jul/Sep;42(3):226-36. doi: 10.1097/hmr.0000000000000109..
Keywords: Patient-Centered Healthcare, Primary Care, Organizational Change, Practice Improvement, Implementation
Grove LR, Olesiuk WJ, Ellis AR
Evaluating the potential for primary care to serve as a mental health home for people with schizophrenia.
This study examined the annual primary care and specialty mental health service utilization of adult North Carolina Medicaid enrollees with schizophrenia and at least one comorbid chronic condition who were in a medical home during 2007-2010. It concluded that medical home enrollment was associated with increased use of primary care and specialty mental health care, as well as increased medication adherence.
AHRQ-funded; HS019659; HS000032.
Citation: Grove LR, Olesiuk WJ, Ellis AR .
Evaluating the potential for primary care to serve as a mental health home for people with schizophrenia.
Gen Hosp Psychiatry 2017 Jul;47:14-19. doi: 10.1016/j.genhosppsych.2017.03.002.
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Keywords: Medication, Behavioral Health, Patient-Centered Healthcare, Patient Adherence/Compliance, Primary Care
Flieger SP
Impact of a patient-centered medical home pilot on utilization, quality, and costs and variation in medical homeness.
This study evaluated the impact of a patient-centered medical home (PCMH) pilot on utilization, costs, and quality and assessed variation in PCMH components. There were no statistically significant findings for utilization, cost, or quality in the expected direction. Medical Home Index (MHI) scores suggest variation in type and level of implemented features.
AHRQ-funded; HS021385.
Citation: Flieger SP .
Impact of a patient-centered medical home pilot on utilization, quality, and costs and variation in medical homeness.
J Ambul Care Manage 2017 Jul/Sep;40(3):228-37. doi: 10.1097/jac.0000000000000162.
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Keywords: Patient-Centered Healthcare, Quality of Care, Primary Care, Healthcare Costs, Healthcare Utilization
Harrison KL, Dzeng E, Ritchie CS
Addressing palliative care clinician burnout in organizations: a workforce necessity, an ethical imperative.
Clinician burnout reduces the capacity for providers and health systems to deliver timely, high quality, patient-centered care and increases the risk that clinicians will leave practice. Efforts to mitigate and prevent burnout currently focus on individual clinicians. However, analysis of the problem of burnout should be expanded to include both individual- and systems-level factors as well as solutions; comprehensive interventions must address both.
AHRQ-funded; HS023681.
Citation: Harrison KL, Dzeng E, Ritchie CS .
Addressing palliative care clinician burnout in organizations: a workforce necessity, an ethical imperative.
J Pain Symptom Manage 2017 Jun;53(6):1091-96. doi: 10.1016/j.jpainsymman.2017.01.007.
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Keywords: Burnout, Palliative Care, Patient-Centered Healthcare, Provider: Clinician, Provider: Physician, Provider
Rocque GB, Pisu M, Jackson BE
Resource use and Medicare costs during lay navigation for geriatric patients with cancer.
This study examined the influence of lay navigation on health care spending and resource use among geriatric patients with cancer within The University of Alabama at Birmingham Health System Cancer Community Network. It found that, compared with a matched comparison group, the mean total costs declined by $781.29 more per quarter per navigated patient, for an estimated $19 million decline per year across the network.
AHRQ-funded; HS023009.
Citation: Rocque GB, Pisu M, Jackson BE .
Resource use and Medicare costs during lay navigation for geriatric patients with cancer.
JAMA Oncol 2017 Jun;3(6):817-25. doi: 10.1001/jamaoncol.2016.6307.
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Keywords: Elderly, Cancer, Healthcare Costs, Medicare, Patient and Family Engagement, Patient-Centered Healthcare, Healthcare Delivery
Lee JL, Frey M, Frey P
Seeing is engaging: vlogs as a tool for patient engagement.
This paper presents The Frey Life, an example of a patient video log (vlog), to show how the platform models and fosters engagement, and provides the patient perspective. The authors discuss potential concerns regarding health vlogs, and suggest implications for physicians, researchers, and medical institutions regarding how to use patient vlogs as a resource.
AHRQ-funded; HS000029.
Citation: Lee JL, Frey M, Frey P .
Seeing is engaging: vlogs as a tool for patient engagement.
Patient 2017 Jun;10(3):267-70. doi: 10.1007/s40271-017-0215-2..
Keywords: Education: Patient and Caregiver, Patient and Family Engagement, Patient-Centered Healthcare, Social Media
Bossick AS, Barone C, Alexander GL
Teen, parent, and clinician expectations about obesity and related conditions during the annual well-child visit.
This study examined family (patient and parent/guardian) and clinician preferences for identification and management of obesity and obesity-related conditions during the well-child visit. Teens and parents expect weight to be discussed at well-child visits, and prefer discussions to come from a trusted clinician who uses serious, consistent language. Providers recognize several challenges and barriers to discussing weight management in the well-child visit.
AHRQ-funded; HS022417.
Citation: Bossick AS, Barone C, Alexander GL .
Teen, parent, and clinician expectations about obesity and related conditions during the annual well-child visit.
J Patient Cent Res Rev 2017 Summer;4(3):114-24. doi: 10.17294/2330-0698.1444.
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Keywords: Children/Adolescents, Clinician-Patient Communication, Obesity, Obesity: Weight Management, Patient-Centered Healthcare
Melnick ER, Hess EP, Guo G
Patient-centered decision support: formative usability evaluation of integrated clinical decision support with a patient decision aid for minor head injury in the emergency department.
The study’s objective was to formatively evaluate an electronic tool that not only helps clinicians at the bedside to determine the need for CT use based on the Canadian CT Head Rule but also promotes evidence-based conversations between patients and clinicians regarding patient-specific risk and patients' specific concerns. It concluded that the Concussion or Brain Bleed app is a useful and usable final product integrating clinical decision support with a patient decision aid.
AHRQ-funded; HS021271.
Citation: Melnick ER, Hess EP, Guo G .
Patient-centered decision support: formative usability evaluation of integrated clinical decision support with a patient decision aid for minor head injury in the emergency department.
J Med Internet Res 2017 May 19;19(5):e174. doi: 10.2196/jmir.7846.
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Keywords: Brain Injury, Shared Decision Making, Emergency Department, Health Information Technology (HIT), Patient-Centered Healthcare
Applequist J, Miller-Day M, Cronholm PF
“In principle we have agreement, but in practice it is a bit more difficult”: obtaining organizational buy-in to patient-centered medical home transformation.
The patient-centered medical home (PCMH) is a model of care that emphasizes the coordination of patient treatment among health care providers. Practice transformation to this model, however, presents a number of challenges. One of these challenges is getting the buy-in of all personnel to commit to making organizational changes in the journey to becoming a nationally recognized medical home. This study, grounded in stakeholder theory, investigated internal messages of buy-in as communicated by practices transitioning to this type of care.
AHRQ-funded; HS019150.
Citation: Applequist J, Miller-Day M, Cronholm PF .
“In principle we have agreement, but in practice it is a bit more difficult”: obtaining organizational buy-in to patient-centered medical home transformation.
Qual Health Res 2017 May;27(6):909-22. doi: 10.1177/1049732316680601..
Keywords: Patient-Centered Healthcare, Organizational Change, Primary Care: Models of Care, Primary Care
Khan A, Baird J, Rogers JE
Parent and provider experience and shared understanding after a family-centered nighttime communication intervention.
This study assessed parent and provider experience and shared understanding after a family-centered, multidisciplinary nighttime communication intervention (nurse-physician brief, family huddle, family update sheet). It concluded that a family-centered, multidisciplinary nighttime communication intervention was associated with improvements in some, but not all, domains of parent/provider experience and shared understanding, particularly provider experience and nurse-family shared understanding.
AHRQ-funded; HS022986; HS000063.
Citation: Khan A, Baird J, Rogers JE .
Parent and provider experience and shared understanding after a family-centered nighttime communication intervention.
Acad Pediatr 2017 May - Jun;17(4):389-402. doi: 10.1016/j.acap.2017.01.012.
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Keywords: Children/Adolescents, Hospitalization, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Clinician-Patient Communication
LeRouge C, Hasselquist MB, Kellogg L
Using heuristic evaluation to enhance the visual display of a provider dashboard for patient-reported outcomes.
A human-centered design (HCD) approach to understanding the data visualization needs for patient-reported outcomes (PRO) in clinical practice can optimize the visual design of an interactive PRO system. Beyond iterative methods, the authors explored the additive value of other HCD methods such as heuristic evaluation. Their evaluation led to several recommendations to improve the display, accessibility, and interpretability of the dashboard’s data.
AHRQ-funded; HS023785.
Citation: LeRouge C, Hasselquist MB, Kellogg L .
Using heuristic evaluation to enhance the visual display of a provider dashboard for patient-reported outcomes.
eGEMS 2017 Apr 20;5(2):Article 6. doi: 10.13063/2327-9214.1283.
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Keywords: Patient-Centered Healthcare, Patient-Centered Outcomes Research, Health Information Technology (HIT), Data, Shared Decision Making
Abujarad F, Alfano S, Bright TJ
AHRQ Author: Bright TJ
Building an informed consent tool starting with the patient: the patient-centered Virtual Multimedia Interactive Informed Consent (VIC).
This paper describes how the authors designed, developed, and evaluated an mHealth tool for advancing the informed consent process. Their tool enables the informed consent process to be performed on tablets (e.g., iPads) utilizing virtual coaching with text-to-speech automated translation as well as an interactive multimedia elements (e.g., graphics, video clips, animations, presentations, etc.). They present the Used-Centered Design approach they adopted to develop the tool and the results of the different methods used during the development of the tool.
AHRQ-authored; AHRQ-funded; HS023987.
Citation: Abujarad F, Alfano S, Bright TJ .
Building an informed consent tool starting with the patient: the patient-centered Virtual Multimedia Interactive Informed Consent (VIC).
AMIA Annu Symp Proc 2017 Apr 16;2017:374-83..
Keywords: Health Information Technology (HIT), Health Literacy, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient Experience, Telehealth
Berry ABL, Lim C, Hartzler AL
Eliciting values of patients with multiple chronic conditions: evaluation of a patient-centered framework.
The authors of this study developed a patient-centered values framework based on a field study with patients and caregivers. In this paper they report on a survey that evaluated how the framework generalized beyond field study participants, and how well the framework supported values elicitation.
AHRQ-funded; HS022364.
Citation: Berry ABL, Lim C, Hartzler AL .
Eliciting values of patients with multiple chronic conditions: evaluation of a patient-centered framework.
AMIA Annu Symp Proc 2017 Apr 16;2017:430-39..
Keywords: Chronic Conditions, Patient-Centered Healthcare
Inrig SJ, Higashi RT, Tiro JA
Assessing local capacity to expand rural breast cancer screening and patient navigation: an iterative mixed-method tool.
To expand rural breast cancer screening , the researchers proposed a regional hub-and-spoke model, partnering with local providers to expand access across North Texas. Their capacity assessment tool enabled the hub to establish partnerships with county organizations by tailoring support to local capacity and needs.
AHRQ-funded; HS022418.
Citation: Inrig SJ, Higashi RT, Tiro JA .
Assessing local capacity to expand rural breast cancer screening and patient navigation: an iterative mixed-method tool.
Eval Program Plann 2017 Apr;61:113-24. doi: 10.1016/j.evalprogplan.2016.11.006.
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Keywords: Access to Care, Cancer: Breast Cancer, Patient-Centered Healthcare, Rural Health, Screening
Frasso R, Golinkoff A, Klusaritz H
How nurse-led practices perceive implementation of the patient-centered medical home.
The purpose of this study was to investigate the implementation of a Patient-Centered Medical Home (PCMH) model in nurse-led primary care practices and to identify facilitators and barriers to the implementation of this model. The investigators indicate that their data suggest two categories of processes that facilitate the integration of PCMH in the nurse-led practice setting: patient-oriented facilitators and organizational facilitators.
AHRQ-funded; HS019150.
Citation: Frasso R, Golinkoff A, Klusaritz H .
How nurse-led practices perceive implementation of the patient-centered medical home.
Appl Nurs Res 2017 Apr;34:34-39. doi: 10.1016/j.apnr.2017.02.005.
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Keywords: Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care, Provider, Provider: Nurse, Quality of Care
Rocque GB, Dionne-Odom JN, Sylvia Huang CH
Implementation and impact of patient lay navigator-led advance care planning conversations.
Advance care planning (ACP) improves alignment between patient preferences for life-sustaining treatment and care received at end of life (EOL). This study evaluated implementation of lay navigator-led ACP and concluded that a navigator-led ACP program was feasible and may be associated with lower rates of resource utilization near EOL.
AHRQ-funded; HS023009.
Citation: Rocque GB, Dionne-Odom JN, Sylvia Huang CH .
Implementation and impact of patient lay navigator-led advance care planning conversations.
J Pain Symptom Manage 2017 Apr;53(4):682-92. doi: 10.1016/j.jpainsymman.2016.11.012.
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Keywords: Communication, Elderly, Palliative Care, Patient-Centered Healthcare, Provider: Health Personnel
Gunter KE, Nocon RS, Gao Y
Medical home characteristics and quality of diabetes care in safety net clinics.
The researchers examined associations between patient-centered medical home (PCMH) characteristics and quality of diabetes care in 15 safety net clinics in five states. They found that PCMH characteristics had mixed, inconsistent associations with the quality of diabetes care. The PCMH model may require refinement in design and implementation to improve diabetes care among vulnerable populations.
AHRQ-funded; HS000084.
Citation: Gunter KE, Nocon RS, Gao Y .
Medical home characteristics and quality of diabetes care in safety net clinics.
J Community Health 2017 Apr;42(2):303-11. doi: 10.1007/s10900-016-0256-9.
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Keywords: Diabetes, Patient-Centered Healthcare, Quality of Care, Chronic Conditions