National Healthcare Quality and Disparities Report
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Topics
- Access to Care (3)
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Asthma (1)
- Behavioral Health (2)
- Blood Pressure (1)
- Cancer (4)
- Cancer: Breast Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cancer: Lung Cancer (1)
- Cardiovascular Conditions (1)
- Care Coordination (4)
- Care Management (3)
- Case Study (1)
- Children/Adolescents (3)
- Chronic Conditions (3)
- Clinician-Patient Communication (10)
- Communication (4)
- Community-Based Practice (3)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (2)
- Cultural Competence (2)
- Data (2)
- Depression (1)
- Diabetes (2)
- Diagnostic Safety and Quality (1)
- Dialysis (1)
- Disparities (2)
- Education: Academic (1)
- Education: Continuing Medical Education (1)
- Education: Patient and Caregiver (2)
- Electronic Health Records (EHRs) (2)
- Emergency Department (4)
- Emergency Medical Services (EMS) (2)
- Evidence-Based Practice (3)
- Genetics (2)
- Guidelines (1)
- Healthcare Costs (2)
- Healthcare Delivery (8)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (2)
- Health Insurance (2)
- Health Services Research (HSR) (1)
- Heart Disease and Health (2)
- Hospital Discharge (1)
- Hospitalization (2)
- Hospital Readmissions (1)
- Human Immunodeficiency Virus (HIV) (1)
- Kidney Disease and Health (1)
- Medical Errors (1)
- Medical Liability (1)
- Medication (3)
- Mortality (1)
- Organizational Change (4)
- Outcomes (1)
- (-) Patient-Centered Healthcare (52)
- Patient-Centered Outcomes Research (5)
- Patient Adherence/Compliance (1)
- Patient and Family Engagement (8)
- Patient Experience (5)
- Patient Safety (2)
- Policy (3)
- Practice Improvement (1)
- Practice Patterns (1)
- Prevention (2)
- Primary Care (17)
- Primary Care: Models of Care (1)
- Provider (2)
- Provider: Pharmacist (1)
- Public Health (1)
- Quality Improvement (3)
- Quality Measures (1)
- Quality of Care (4)
- Racial and Ethnic Minorities (4)
- Research Methodologies (2)
- Risk (2)
- Shared Decision Making (7)
- Sickle Cell Disease (1)
- Skin Conditions (1)
- Social Determinants of Health (1)
- Teams (4)
- Treatments (1)
- Vulnerable Populations (1)
- Web-Based (1)
- Women (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 52 Research Studies DisplayedSmith JJ, Johnston JM, Hiratsuka VY
Medical home implementation and trends in diabetes quality measures for AN/AI primary care patients.
The researchers investigated changes in trend for type 2 diabetes mellitus (DM-II) quality indicators after patient-centered medical home (PCMH) implementation at Southcentral Foundation, a tribal health organization in Alaska. They found that rates of new DM-II diagnoses were stable prior to but increased after implementation. DM-II rates of HbA1c screening increased, though not significantly before and remained stable after implementation.
AHRQ-funded; HS019154.
Citation: Smith JJ, Johnston JM, Hiratsuka VY .
Medical home implementation and trends in diabetes quality measures for AN/AI primary care patients.
Prim Care Diabetes 2015 Apr;9(2):120-6. doi: 10.1016/j.pcd.2014.06.005..
Keywords: Diabetes, Patient-Centered Healthcare, Primary Care, Quality Measures, Racial and Ethnic Minorities
Bierman AS, Tinetti ME
AHRQ Author: Bierman AS
Precision medicine to precision care: managing multimorbidity.
Multimorbidity is the most common condition managed in practice. The authors argue that health-care delivery must be transformed to provide precision care to people with multimorbidity. Accomplishing this transition will require a change in practice, research, and policy from disease-specific to patient-centered models of care delivery.
AHRQ-authored.
Citation: Bierman AS, Tinetti ME .
Precision medicine to precision care: managing multimorbidity.
Lancet 2016 Dec 3;388(10061):2721-23. doi: 10.1016/s0140-6736(16)32232-2.
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Keywords: Healthcare Delivery, Chronic Conditions, Guidelines, Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care
Melnick ER, Probst MA, Schoenfeld E
Development and testing of shared decision making interventions for use in emergency care: a research agenda.
This article provides background on decision aids and the conclusions of the 2016 Academic Emergency Medicine consensus conference SDM in practice work group regarding "Shared Decision Making in the Emergency Department: Development of a Policy-Relevant, Patient-Centered Research Agenda."
AHRQ-funded; HS021271; HS024311.
Citation: Melnick ER, Probst MA, Schoenfeld E .
Development and testing of shared decision making interventions for use in emergency care: a research agenda.
Acad Emerg Med 2016 Dec;23(12):1346-53. doi: 10.1111/acem.13045.
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Keywords: Shared Decision Making, Emergency Department, Emergency Medical Services (EMS), Patient-Centered Healthcare, Policy
Gallagher TH, Etchegaray JM, Bergstedt B
Improving communication and resolution following adverse events using a patient-created simulation exercise.
The HealthPact Patient and Family Advisory Council (PFAC) created and led a five-stage simulation exercise to help stakeholders understand what patients experience following an adverse event. Take-homes from these exercises included the fact that the response to adverse events can be complex, siloed, and uncoordinated. Participating in this simulation exercise led stakeholders and patient advocates to express interest in continued collaboration.
AHRQ-funded; HS019531.
Citation: Gallagher TH, Etchegaray JM, Bergstedt B .
Improving communication and resolution following adverse events using a patient-created simulation exercise.
Health Serv Res 2016 Dec;51 Suppl 3:2537-49. doi: 10.1111/1475-6773.12601.
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Keywords: Adverse Events, Clinician-Patient Communication, Medical Errors, Medical Liability, Patient-Centered Healthcare, Patient Safety
Grudzen CR, Anderson JR, Carpenter CR
The 2016 Academic Emergency Medicine Consensus Conference, Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda May 10, 2016, New Orleans, LA.
The authors described the current state of shared decision making in the emergency department context and provided an overview of the conference. They explained that the results of the conference published in the same journal issue provided an essential summary of the future research priorities for shared decision making to increase quality of care and patient-centered outcomes.
AHRQ-funded; HS024172.
Citation: Grudzen CR, Anderson JR, Carpenter CR .
The 2016 Academic Emergency Medicine Consensus Conference, Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda May 10, 2016, New Orleans, LA.
Acad Emerg Med 2016 Dec;23(12):1313-19. doi: 10.1111/acem.13047.
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Keywords: Shared Decision Making, Emergency Department, Emergency Medical Services (EMS), Patient-Centered Healthcare, Policy
Lee T, Thamer M, Zhang Y
Association of peritonitis with hemodialysis catheter dependence after modality switch.
This study characterized vascular access use after switch to hemodialysis and its effect on patient mortality. The researchers found that patients using a permanent vascular access 180 days after switching from peritoneal dialysis to hemodialysis had better adjusted survival during the ensuing year than those using a catheter. They concluded that among patients who switch, prior peritonitis is associated with a higher rate of persistent hemodialysis catheter use, which, in turn, is associated with lower patient survival.
AHRQ-funded; HS022931; HS021229.
Citation: Lee T, Thamer M, Zhang Y .
Association of peritonitis with hemodialysis catheter dependence after modality switch.
Clin J Am Soc Nephrol 2016 Nov 7;11(11):1999-2004. doi: 10.2215/cjn.04970516.
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Keywords: Dialysis, Kidney Disease and Health, Evidence-Based Practice, Mortality, Patient-Centered Healthcare
Lee SJ, Clark MA, Cox JV
Achieving coordinated care for patients with complex cases of cancer: a multiteam system approach.
The authors outlined challenges of care coordination in the context of a multiteam system (MTS), through the care experience of a patient in the Dallas County integrated safety-net system. A cancer diagnosis triggered an additional need for augmented coordination between his different provider teams. The authors recommend that further research and practice investigate the relationships of MTS coordination for shared care management, transfer to and from specialty care, treatment compliance, barriers to care, and health outcomes of chronic comorbid conditions, as well as cancer control and surveillance.
AHRQ-funded; HS022418.
Citation: Lee SJ, Clark MA, Cox JV .
Achieving coordinated care for patients with complex cases of cancer: a multiteam system approach.
J Oncol Pract 2016 Nov;12(11):1029-38. doi: 10.1200/jop.2016.013664.
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Keywords: Cancer, Care Coordination, Chronic Conditions, Patient-Centered Healthcare, Teams
Fraze T, Lewis VA, Rodriguez HP
Housing, transportation, and food: how ACOs seek to improve population health by addressing nonmedical needs of patients.
The authors examined how accountable care organizations (ACOs) addressed the nonmedical needs of their patients. They found that ACOs most commonly addressed the need for transportation, housing, and food insecurity, which they identified through the primary care visit or care transformation programs. They concluded that their findings offer insights into how health care organizations such as ACOs integrate themselves with nonmedical organizations.
AHRQ-funded; HS024792.
Citation: Fraze T, Lewis VA, Rodriguez HP .
Housing, transportation, and food: how ACOs seek to improve population health by addressing nonmedical needs of patients.
Health Aff 2016 Nov;35(11):2109-15. doi: 10.1377/hlthaff.2016.0727.
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Keywords: Social Determinants of Health, Patient-Centered Healthcare, Health Insurance, Healthcare Delivery, Primary Care, Public Health
Ferrante JM, Friedman A, Shaw EK
Lessons learned designing and using an online discussion forum for care coordinators in primary care.
In this paper, the authors comprehensively describe their experiences, from start to finish, of designing and using an asynchronous online discussion forum for collecting and analyzing information elicited from care coordinators in Patient-Centered Medical Homes across the United States. They conclude that an asynchronous online discussion forum is a feasible, efficient, and effective method to conduct a qualitative study, particularly when subjects are health professionals.
AHRQ-funded; HS020682.
Citation: Ferrante JM, Friedman A, Shaw EK .
Lessons learned designing and using an online discussion forum for care coordinators in primary care.
Qual Health Res 2016 Nov;26(13):1851-61. doi: 10.1177/1049732315609567..
Keywords: Care Coordination, Health Services Research (HSR), Patient-Centered Healthcare, Primary Care, Research Methodologies
Gerber DE, Reimer T, Williams EL
Resolving rivalries and realigning goals: challenges of clinical and research multiteam systems.
This article describes the care processes for a 64-year-old man with newly diagnosed advanced non-small-cell lung cancer who was enrolled in a first-line clinical trial of a new immunotherapy regimen. Research team and clinical team members have limited knowledge of the roles and work of individuals outside their team. Recommendations to increase trust and collaboration are provided.
AHRQ-funded; HS022418.
Citation: Gerber DE, Reimer T, Williams EL .
Resolving rivalries and realigning goals: challenges of clinical and research multiteam systems.
J Oncol Pract 2016 Nov;12(11):1020-28. doi: 10.1200/jop.2016.013060.
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Keywords: Cancer, Cancer: Lung Cancer, Case Study, Healthcare Delivery, Patient-Centered Healthcare, Teams
Prochaska MT, Press VG, Meltzer DO
Patient perceptions of wearable face-mounted computing technology and the effect on the doctor-patient relationship.
The authors aimed to determine patients' perception of and their privacy concerns with Google Glass. They found that the majority, 64% of respondents, appeared open to and would want their doctor to use face-mounted wearable computers such as Google Glass, even when they were unfamiliar with this technology. Although some patients expressed concerns about privacy, the authors found that patients were much less concerned about wearable technologies affecting the trust they have in their physician.
AHRQ-funded; HS023007.
Citation: Prochaska MT, Press VG, Meltzer DO .
Patient perceptions of wearable face-mounted computing technology and the effect on the doctor-patient relationship.
Appl Clin Inform 2016 Oct 12;7(4):946-53. doi: 10.4338/aci-2016-06-le-0094.
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Keywords: Health Information Technology (HIT), Hospitalization, Patient-Centered Healthcare, Patient Experience, Clinician-Patient Communication
Kantor R, Thyssen JP, Paller AS
Atopic dermatitis, atopic eczema, or eczema? A systematic review, meta-analysis, and recommendation for uniform use of 'atopic dermatitis'.
The authors sought to determine the most commonly-used terms for atopic dermatitis. They found that atopic dermatitis was the most commonly-used term in studies across almost all publication types, languages, and journals and appears to be increasing in popularity. They concluded by suggesting the use of the term atopic dermatitis in publications, healthcare clinician training, and patient education.
AHRQ-funded; HS023011.
Citation: Kantor R, Thyssen JP, Paller AS .
Atopic dermatitis, atopic eczema, or eczema? A systematic review, meta-analysis, and recommendation for uniform use of 'atopic dermatitis'.
Allergy 2016 Oct;71(10):1480-5. doi: 10.1111/all.12982.
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Keywords: Education: Patient and Caregiver, Diagnostic Safety and Quality, Patient-Centered Healthcare, Clinician-Patient Communication, Skin Conditions
Rodriguez HP, Chen X, Martinez AE
Availability of primary care team members can improve teamwork and readiness for change.
Researchers conducted a survey of adult primary care providers and staff in California safety net practices to assess primary care team structure (team size, team member availability, and access to interdisciplinary expertise), teamwork, and readiness for change. Greater team member availability was associated with greater readiness for change, but the relationship was stronger for staff than for primary care providers.
AHRQ-funded; HS020120.
Citation: Rodriguez HP, Chen X, Martinez AE .
Availability of primary care team members can improve teamwork and readiness for change.
Health Care Manage Rev 2016 Oct-Dec;41(4):286-95. doi: 10.1097/hmr.0000000000000082.
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Keywords: Primary Care, Teams, Patient-Centered Healthcare, Organizational Change, Practice Improvement
Gernant SA, Snyder ME, Jaynes H
The effectiveness of pharmacist-provided telephonic medication therapy management on emergency department utilization in home health patients.
This article's objective is to evaluate the effectiveness of a telephonic medication therapy management (MTM) service on reducing emergency department utilization within a Medicare-insured home health population. The authors found that this pharmacist-delivered telephonic medication therapy management program did not decrease emergency department utilization overall but may further reduce the such risk among patients who are at lower risk of utilization.
AHRQ-funded; HS022119.
Citation: Gernant SA, Snyder ME, Jaynes H .
The effectiveness of pharmacist-provided telephonic medication therapy management on emergency department utilization in home health patients.
J Pharm Technol 2016 Oct 1;32(5):179-84. doi: 10.1177/8755122516660376.
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Keywords: Care Management, Emergency Department, Medication, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention, Provider: Pharmacist, Provider
Gao Y, Nocon RS, Gunter KE
AHRQ Author: Ngo-Metzger Q
Characteristics associated with patient-centered medical home capability in health centers: a cross-sectional analysis.
The patient-centered medical home (PCMH) model is being implemented in health centers (HCs) that provide comprehensive primary care to vulnerable populations. The researchers identified characteristics associated with HCs' PCMH capability. EHR adoption likely played a role in HCs' improvement in PCMH capability. Other factors include a greater number of types of financial performance incentives, more types of hospital-HC affiliations, and state-level support and payment for PCMH activities.
AHRQ-authored; AHRQ-funded; HS000084.
Citation: Gao Y, Nocon RS, Gunter KE .
Characteristics associated with patient-centered medical home capability in health centers: a cross-sectional analysis.
J Gen Intern Med 2016 Sep;31(9):1041-51. doi: 10.1007/s11606-016-3729-8.
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Keywords: Patient-Centered Healthcare, Electronic Health Records (EHRs), Primary Care, Community-Based Practice, Vulnerable Populations
Shao H, Brown L, Diana ML
Estimating the costs of supporting safety-net transformation into patient-centered medical homes in post-Katrina New Orleans.
The authors aimed to understand the characteristics of clinics that transformed into patient-centered medical homes and the incremental cost for transformation. The estimated incremental cost for clinics that underwent transformation was $37.61 per visit per 6 months, and overall it cost $24.86 per visit per 6 months in grant funds to support a clinic's transformation.
AHRQ-funded; HS022624.
Citation: Shao H, Brown L, Diana ML .
Estimating the costs of supporting safety-net transformation into patient-centered medical homes in post-Katrina New Orleans.
Medicine 2016 Sep;95(39):e4990. doi: 10.1097/md.0000000000004990.
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Keywords: Patient-Centered Healthcare, Healthcare Costs, Access to Care, Organizational Change
Chandrasekar E, Kim KE, Song S
First year open enrollment findings: health insurance coverage for Asian Americans and the role of navigators.
The role of navigators has been shown to increase enrollment rates of public insurance programs. Cambodian, Chinese, Vietnamese, Korean, and Laotian community-based organizations were able to reach individuals for whom the percentage of uninsured is disproportionately high. A community-level intervention was implemented that was associated with increases in first year marketplace enrollment and greater likelihood of obtaining a primary care physician.
AHRQ-funded; HS022063.
Citation: Chandrasekar E, Kim KE, Song S .
First year open enrollment findings: health insurance coverage for Asian Americans and the role of navigators.
J Racial Ethn Health Disparities 2016 Sep;3(3):537-45. doi: 10.1007/s40615-015-0172-1.
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Keywords: Health Insurance, Policy, Patient-Centered Healthcare, Racial and Ethnic Minorities
Gulbrandsen P, Clayman ML, Beach MC
Shared decision-making as an existential journey: aiming for restored autonomous capacity.
The researchers described the different ways in which illness represents an existential problem, and its implications for shared decision-making. They found that the fundamental uncertainty, state of vulnerability, and lack of power of the ill patient, imbue shared decision-making with a deeper existential significance and call for greater attention to the emotional and relational dimensions of care. They propose that the aim of shared decision-making should be restoration of the patient's autonomous capacity.
AHRQ-funded; HS022932.
Citation: Gulbrandsen P, Clayman ML, Beach MC .
Shared decision-making as an existential journey: aiming for restored autonomous capacity.
Patient Educ Couns 2016 Sep;99(9):1505-10. doi: 10.1016/j.pec.2016.07.014.
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Keywords: Communication, Shared Decision Making, Patient-Centered Healthcare, Patient and Family Engagement, Clinician-Patient Communication
Dorr DA, Anastas T, Ramsey K
Effect of a pragmatic, cluster-randomized controlled trial on patient experience with care: The Transforming Outcomes for Patients Through Medical Home Evaluation and reDesign (TOPMED) Study.
This study's objective is to understand whether focusing on high value elements (HVEs) would improve patient experience with care. The authors found that practices targeting HVEs showed significantly more improvement in patient experience of care. However, contemporaneous trends may have affected results, leading to declines in patient experience.
AHRQ-funded; HS017832.
Citation: Dorr DA, Anastas T, Ramsey K .
Effect of a pragmatic, cluster-randomized controlled trial on patient experience with care: The Transforming Outcomes for Patients Through Medical Home Evaluation and reDesign (TOPMED) Study.
Med Care 2016 Aug;54(8):745-51. doi: 10.1097/mlr.0000000000000552.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient-Centered Healthcare, Patient Experience
Cleary PD
Evolving concepts of patient-centered care and the assessment of patient care experiences: optimism and opposition.
Improving the infrastructure supporting certain aspects of care may have broad effects because system changes can influence multiple outcomes. Thus, rather than detract from general quality improvement efforts, making changes that facilitate patient-centered care may lead to broader improvements. There is good reason to be optimistic that our health care system will increasingly be "patient centered."
AHRQ-funded; HS016978.
Citation: Cleary PD .
Evolving concepts of patient-centered care and the assessment of patient care experiences: optimism and opposition.
J Health Polit Policy Law 2016 Aug;41(4):675-96. doi: 10.1215/03616878-3620881.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient-Centered Healthcare, Patient Experience, Quality of Care, Quality Improvement
Ray KN, Ashcraft LE, Kahn JM
Family perspectives on high-quality pediatric subspecialty referrals.
The researchers sought to develop a framework for high-quality, patient-centered referrals from the perspectives of patients and their families. They identified family-centered outcomes, processes, and structures of high-quality pediatric subspecialty referrals which can be used to inform future interventions to improve patient-centered outcomes for children in need of specialty care.
AHRQ-funded; HS022989.
Citation: Ray KN, Ashcraft LE, Kahn JM .
Family perspectives on high-quality pediatric subspecialty referrals.
Acad Pediatr 2016 Aug;16(6):594-600. doi: 10.1016/j.acap.2016.05.147.
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Keywords: Children/Adolescents, Quality of Care, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Children/Adolescents
Jonassaint CR, Jones VL, Leong S
A systematic review of the association between depression and health care utilization in children and adults with sickle cell disease.
The authors sought to determine whether depression or depressive symptoms are associated with health care utilization among children and adults with sickle cell disease (SCD). They found that, overall, depressive symptoms are common in SCD and may increase risk for poor outcomes including health care utilization. They further found a modest association between depression and health care utilization in SCD.
AHRQ-funded; HS022989.
Citation: Jonassaint CR, Jones VL, Leong S .
A systematic review of the association between depression and health care utilization in children and adults with sickle cell disease.
Br J Haematol 2016 Jul;174(1):136-47. doi: 10.1111/bjh.14023.
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Keywords: Children/Adolescents, Depression, Healthcare Utilization, Patient-Centered Healthcare, Sickle Cell Disease
Richesson RL, Sun J, Pathak J
Clinical phenotyping in selected national networks: demonstrating the need for high-throughput, portable, and computational methods.
The authors sought to use electronic health records data to advance understanding of disease risk and drug response, and to support the practice of precision medicine on a national scale. They found that machine learning approaches that generate phenotype definitions from patient features and clinical profiles will result in truly computational phenotypes, as it comes from data rather than experts. They suggested that research networks and phenotype developers cooperate to develop methods, collaboration platforms, and data standards that will enable computational phenotyping and modernize biomedical research.
AHRQ-funded; HS023921; HS023077.
Citation: Richesson RL, Sun J, Pathak J .
Clinical phenotyping in selected national networks: demonstrating the need for high-throughput, portable, and computational methods.
Artif Intell Med 2016 Jul;71:57-61. doi: 10.1016/j.artmed.2016.05.005.
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Keywords: Data, Electronic Health Records (EHRs), Genetics, Patient-Centered Healthcare
Hung D, Chung S, Martinez M
Effect of organizational culture on patient access, care continuity, and experience of primary care.
The authors examined relationships between organizational culture and patient-centered outcomes in primary care. They found that, compared with a "Group-oriented" culture, a "Rational" culture type was associated with longer appointment wait times, and both "Hierarchical" and "Developmental" culture types were associated with less care continuity, but better patient experiences with care.
AHRQ-funded; HS019815; HS019167.
Citation: Hung D, Chung S, Martinez M .
Effect of organizational culture on patient access, care continuity, and experience of primary care.
J Ambul Care Manage 2016 Jul-Sep;39(3):242-52. doi: 10.1097/jac.0000000000000116.
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Keywords: Access to Care, Organizational Change, Patient-Centered Healthcare, Patient Experience, Primary Care
McCoy RG, Lipska KJ, Yao X
Intensive treatment and severe hypoglycemia among adults with type 2 diabetes.
The objectives of this study were to estimate the prevalence of intensive treatment and the association between intensive treatment, clinical complexity, and incidence of severe hypoglycemia among adults with type 2 diabetes who are not using insulin. The researchers found that over 20% of patients with type 2 diabetes received intensive treatment that might have been unnecessary and that among patients with high clinical complexity, intensive treatment nearly doubled the risk of severe hypoglycemia.
AHRQ-funded; HS018339.
Citation: McCoy RG, Lipska KJ, Yao X .
Intensive treatment and severe hypoglycemia among adults with type 2 diabetes.
JAMA Intern Med 2016 Jul;176(7):969-78. doi: 10.1001/jamainternmed.2016.2275.
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Keywords: Adverse Drug Events (ADE), Diabetes, Medication, Patient-Centered Healthcare, Risk