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 12254 Research Studies DisplayedAbramson EL, Pfoh ER, Barron Y
The effects of electronic prescribing by community-based providers on ambulatory medication safety.
This study was conducted to assess the effect of implementing a commercial electronic health record with e-prescribing on rates and types of prescribing errors. Use of e-prescribing resulted in relatively low error rates (6.0 errors per 100 prescriptions). These rates were sustained over time but without further improvement (6.0 versus 4.5 errors per 100) prescriptions).
AHRQ-funded; HS016970.
Citation: Abramson EL, Pfoh ER, Barron Y .
The effects of electronic prescribing by community-based providers on ambulatory medication safety.
Jt Comm J Qual Patient Saf 2013 Dec;39(12):545-52..
Keywords: Electronic Prescribing (E-Prescribing), Health Information Technology (HIT), Medication: Safety, Medication, Electronic Health Records (EHRs)
Mariscalco MW, Flanigan DC, Mitchell J
The influence of hamstring autograft size on patient-reported outcomes and risk of revision after anterior cruciate ligament reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) Cohort Study.
The purpose of this study was to evaluate the effect of graft size on patient-reported outcomes and revision risk after anterior cruciate ligament (ACL) reconstruction. It found that smaller hamstring autograft size is a predictor of poorer Knee Injury and Osteoarthritis Outcome Score (sport/recreation subscale function) 2 years after primary ACL reconstruction.
AHRQ-funded; HS016075.
Citation: Mariscalco MW, Flanigan DC, Mitchell J .
The influence of hamstring autograft size on patient-reported outcomes and risk of revision after anterior cruciate ligament reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) Cohort Study.
Arthroscopy 2013 Dec;29(12):1948-53. doi: 10.1016/j.arthro.2013.08.025.
Keywords: Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness, Surgery
Boothe DL, Coplowitz S, Greenwood E
Transforming growth factor beta-1 (TGF-beta1) is a serum biomarker of radiation induced fibrosis in patients treated with intracavitary accelerated partial breast irradiation: preliminary results of a prospective study.
This study examined a relationship between serum transforming growth factor b-1 (TGF-b1) values and radiation-induced fibrosis (RIF). The results suggest that serum TGF-b1 levels before surgery, and during radiation therapy, and after radiation therapy could signal whether a patient is at risk for the development of moderate to severe RIF.
AHRQ-funded; HS016075.
Citation: Boothe DL, Coplowitz S, Greenwood E .
Transforming growth factor beta-1 (TGF-beta1) is a serum biomarker of radiation induced fibrosis in patients treated with intracavitary accelerated partial breast irradiation: preliminary results of a prospective study.
Int J Radiat Oncol Biol Phys 2013 Dec 1;87(5):1030-6. doi: 10.1016/j.ijrobp.2013.08.045..
Keywords: Adverse Events, Cancer, Cancer: Breast Cancer, Risk
Hartung DM, Middleton L, McFarland BH
Use of administrative data to identify off-label use of second-generation antipsychotics in a Medicaid population.
The researchers sought to determine the accuracy of administrative claims for identifying off-label use of second-generation antipsychotics (SGAs) in a Medicaid population. They found that Medicaid claims data had high predictive ability for identifying users of SGAs who did not have documentation of schizophrenia or bipolar disorder in the medical record.
AHRQ-funded; HS019456
Citation: Hartung DM, Middleton L, McFarland BH .
Use of administrative data to identify off-label use of second-generation antipsychotics in a Medicaid population.
Psychiatr Serv. 2013 Dec;64(12):1236-42. doi: 10.1176/appi.ps.005482012..
Keywords: Medicaid, Behavioral Health, Medication
Waters TM, Chandler AM, Mion LC
Use of International Classification of Diseases, Ninth Revision, Clinical Modification, codes to identify inpatient fall-related injuries.
The researchers compared falls and fall-related injuries that a fall evaluator or hospital incident report identified with injuries identified according to discharge ICD-9-CM codes for the same set of inpatient episodes of care. They found that the CMS-targeted ICD-9-CM codes used to identify fall-related injuries in claims data do not always detect the most-serious falls.
AHRQ-funded; HS020627.
Citation: Waters TM, Chandler AM, Mion LC .
Use of International Classification of Diseases, Ninth Revision, Clinical Modification, codes to identify inpatient fall-related injuries.
J Am Geriatr Soc 2013 Dec;61(12):2186-91. doi: 10.1111/jgs.12539..
Keywords: Falls, Elderly, Patient Safety, Inpatient Care, Adverse Events
Hatch B, Angier H, Marino M
Using electronic health records to conduct children's health insurance surveillance.
The purpose of this study is to demonstrate secondary usage of electronic health records (EHRs) as an emerging data source for health insurance surveillance by community health centers and other primary care providers to track patients’ insurance coverage status and to identify patients most likely to benefit from outreach and support to obtain and maintain coverage.
AHRQ-funded; HS018569.
Citation: Hatch B, Angier H, Marino M .
Using electronic health records to conduct children's health insurance surveillance.
Pediatrics 2013 Dec;132(6):e1584-91. doi: 10.1542/peds.2013-1470..
Keywords: Electronic Health Records (EHRs), Children/Adolescents, Health Insurance, Children's Health Insurance Program (CHIP), Health Information Technology (HIT)
Hearld LR, Weech-Maldonado R, Asagbra OE
Variations in patient-centered medical home capacity: a linear growth curve analysis.
This study documented physician practices’ PCMH capacity across 12 different domains (e.g., extended access, specialist referral, use of patient registry) over a 3-year period (2008-2010). It concluded that differences in PCMH capacity across the 12 domains and time suggest that more attention should be paid to the longitudinal nature of PCMH implementation and the differential challenges associated with its component parts.
AHRQ-funded; HS019465.
Citation: Hearld LR, Weech-Maldonado R, Asagbra OE .
Variations in patient-centered medical home capacity: a linear growth curve analysis.
Med Care Res Rev 2013 Dec;70(6):597-620. doi: 10.1177/1077558713498117..
Keywords: Patient-Centered Healthcare, Practice Patterns
Srinivas SK, Fager C, Lorch SA
Variations in postdelivery infection and thrombosis by hospital teaching status.
The researchers examined hospital-level variation overall and by teaching status in 2 maternal outcomes, postpartum infections, and thrombosis. They found substantial variation in infection and thrombosis rates among hospitals both overall and by teaching status, suggesting that these 2 outcomes may be useful measures of inpatient obstetric quality.
AHRQ-funded; HS015696.
Citation: Srinivas SK, Fager C, Lorch SA .
Variations in postdelivery infection and thrombosis by hospital teaching status.
Am J Obstet Gynecol 2013 Dec;209(6):567.e1-7. doi: 10.1016/j.ajog.2013.08.002..
Keywords: Pregnancy, Labor and Delivery, Outcomes, Quality of Care
Soeters HM, Napravnik S, Zakharova OM
Opportunities for sexual transmission of antiretroviral drug resistance among HIV-infected patients in care.
The researchers had two aims: to examine patterns of nonadherence, high-risk sexual behavior, detectable HIV viraemia and antiretroviral drug resistance, and to identify factors associated with potential transmission of drug-resistant HIV among patients engaged in HIV care. They found that a small but significant proportion of clinic patients with viraemia and documented resistant HIV continue to engage in sexual behaviors that place others at risk for transmitted drug resistance.
AHRQ-funded; HS018731.
Citation: Soeters HM, Napravnik S, Zakharova OM .
Opportunities for sexual transmission of antiretroviral drug resistance among HIV-infected patients in care.
AIDS 2013 Nov 28;27(18):2873-81. doi: 10.1097/01.aids.0000433240.78739.30..
Keywords: Human Immunodeficiency Virus (HIV), Lifestyle Changes, Patient Adherence/Compliance
Sommers BD, Arntson E, Kenney GM
Lessons from early Medicaid expansions under health reform: interviews with Medicaid officials.
The impending 2014 Medicaid expansion features numerous policy challenges and unanswered questions. The researchers conducted in-depth interviews with high-ranking Medicaid officials in six early expanding states to glean important lessons from their experiences. They concluded that while the context of each state’s expansion is unique, key shared experiences were significant implementation challenges and opportunities for expanding access to needed services.
AHRQ-funded; HS021291.
Citation: Sommers BD, Arntson E, Kenney GM .
Lessons from early Medicaid expansions under health reform: interviews with Medicaid officials.
Medicare Medicaid Res Rev 2013 Nov 22;3(4). doi: 10.5600/mmrr.003.04.a02..
Keywords: Medicaid, Policy
Carroll AE, Buddenbaum JL
High and low-risk specialties experience with the U.S. medical malpractice system.
This study examining the experiences of high-liability risk and low-liability risk medical specialties with the malpractice system found that for the high liability risk specialties, 33 percent of claims result in indemnity payments compared to 28 percent for low-liability risk specialties. The average payment for high-liability risk specialties was $315, compared to $267, 146 for low-liability risk specialties.
AHRQ-funded; HS017572.
Citation: Carroll AE, Buddenbaum JL .
High and low-risk specialties experience with the U.S. medical malpractice system.
BMC Health Serv Res. 2013 Nov 6;13:465. doi: 10.1186/1472-6963-13-465..
Keywords: Medical Liability, Risk, Provider Performance
Cohen SB, Rohde F, Yu W
AHRQ Author: Cohen SB, Rohde F, Yu W
Building wave response rates in a longitudinal survey:Essential for nonsampling error reduction or last in–first out?
This study examined the implications of a reduction in targeted first-round response rates in the Medical Expenditure Panel Survey (MEPS), a national health care survey designed to produce estimates of health care utilization, expenditures, and insurance coverage. Study findings revealed nonuniform results when evaluating the capacity of alternative design strategies to achieve precision targets while simultaneously satisfying data collection budget constraints for a variety of medical care expenditure estimates.
AHRQ-authored.
Citation: Cohen SB, Rohde F, Yu W .
Building wave response rates in a longitudinal survey:Essential for nonsampling error reduction or last in–first out?
Field Methods 2013 Nov;25(4):361-87. doi: 10.1177/1525822x13507863..
Keywords: Medical Expenditure Panel Survey (MEPS), Research Methodologies
Percac-Lima S, Ashburner JM, Bond B
Decreasing disparities in breast cancer screening in refugee women using culturally tailored patient navigation.
The goal of this research was to evaluate whether a patient navigator (PN) program for refugee women decreases disparities in breast cancer screening. Results showed that linguistically and culturally tailored PN decreased disparities over time in breast cancer screening among female refugees from Somalia, the Middle East, and Bosnia.
AHRQ-funded; HS018161.
Citation: Percac-Lima S, Ashburner JM, Bond B .
Decreasing disparities in breast cancer screening in refugee women using culturally tailored patient navigation.
J Gen Intern Med 2013 Nov;28(11):1463-8. doi: 10.1007/s11606-013-2491-4.
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Keywords: Cancer: Breast Cancer, Cultural Competence, Disparities, Racial and Ethnic Minorities, Screening
Shah MN, Gillespie SM, Wood N
High-intensity telemedicine-enhanced acute care for older adults: an innovative healthcare delivery model.
This article describes an innovative healthcare model that uses high-intensity telemedicine services to provide rapid acute care for older adults without requiring them to leave their senior living community (SLC) residences. The project demonstrated that high-intensity telemedicine services for acute illnesses are feasible and acceptable and can provide definitive care without requiring ED or urgent care use.
AHRQ-funded; HS018047.
Citation: Shah MN, Gillespie SM, Wood N .
High-intensity telemedicine-enhanced acute care for older adults: an innovative healthcare delivery model.
J Am Geriatr Soc 2013 Nov;61(11):2000-7. doi: 10.1111/jgs.12523..
Keywords: Elderly, Telehealth, Health Information Technology (HIT), Healthcare Delivery, Long-Term Care
Sentell T, Unick GJ, Ahn HJ
Illness severity and psychiatric hospitalization rates among Asian Americans and Pacific Islanders.
This study of mental illness severity and psychiatric hospitalization among Asian Americans and Pacific Islanders (AA/PIs) in Hawaii found that AA/PI subgroups (Chinese, Japanese, Filipino, and Native Hawaiians) had lower psychiatric hospitalization rates than whites, but rates varied across AA/PI subgroups.
AHRQ-funded; HS019990
Citation: Sentell T, Unick GJ, Ahn HJ .
Illness severity and psychiatric hospitalization rates among Asian Americans and Pacific Islanders.
Psychiatr Serv. 2013 Nov;64(11):1095-102. doi: 10.1176/appi.ps.201200408..
Keywords: Behavioral Health, Hospitalization, Racial and Ethnic Minorities, Disparities
Neugebauer R, Fireman B, Roy JA
Impact of specific glucose-control strategies on microvascular and macrovascular outcomes in 58,000 adults with type 2 diabetes.
This study used comparative effectiveness research methods to compare the effect of four distinct glucose-control strategies on subsequent myocardial infarction and nephropathy in type 2 diabetes. It found that in a large group of adults with type 2 diabetes, more aggressive glucose-control strategies have mixed short-term effects on microvascular complications and do not reduce the myocardial infarction rate over 4 years of follow-up.
AHRQ-funded; 29020050033I.
Citation: Neugebauer R, Fireman B, Roy JA .
Impact of specific glucose-control strategies on microvascular and macrovascular outcomes in 58,000 adults with type 2 diabetes.
Diabetes Care 2013 Nov;36(11):3510-6. doi: 10.2337/dc12-2675..
Keywords: Comparative Effectiveness, Diabetes, Outcomes, Patient-Centered Outcomes Research, Treatments
Zeidan AM, Gore SD, McNally DL
AHRQ Author: Davidoff AJ
Lenalidomide performance in the real world: patterns of use and effectiveness in a Medicare population with myelodysplastic syndromes.
The authors examined the use of lenalidomide in the Medicare population. They found that reductions in transfusion rates were overall consistent with data from clinical trials, and response rates were higher when ≥ 3 lenalidomide cycles were received.
AHRQ-authored.
Citation: Zeidan AM, Gore SD, McNally DL .
Lenalidomide performance in the real world: patterns of use and effectiveness in a Medicare population with myelodysplastic syndromes.
Cancer 2013 Nov 1;119(21):3870-8. doi: 10.1002/cncr.28298.
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Keywords: Comparative Effectiveness, Elderly, Medicare, Medication
Everett C, Thorpe C, Palta M
Physician assistants and nurse practitioners perform effective roles on teams caring for Medicare patients with diabetes.
The investigators compared outcomes for two groups of adult Medicare patients with diabetes whose conditions were at various levels of complexity: those whose care teams included PAs or NPs in various roles, and those who received care from physicians only. They found that outcomes were generally equivalent in thirteen comparisons but mixed in seven others, so that no role was best for all outcomes. They concluded that patient characteristics, as well as patients' and organizations' goals, should be considered when determining when and how to deploy PAs and NPs on primary care teams.
AHRQ-funded; HS017646; HS018368; HS000083.
Citation: Everett C, Thorpe C, Palta M .
Physician assistants and nurse practitioners perform effective roles on teams caring for Medicare patients with diabetes.
Health Aff 2013 Nov;32(11):1942-8. doi: 10.1377/hlthaff.2013.0506.
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Keywords: Diabetes, Provider: Health Personnel, Patient-Centered Healthcare, Primary Care, Teams
Abdus S, Selden TM
AHRQ Author: Abdus S, Selden TM
Preventive services for adults: how have differences across subgroups changed over the past decade?
This study uses MEPS data to track changes over time in the distribution of preventive services use across groups defined by poverty status, race/ethnicity, insurance coverage, Census region, and urbanicity. The analysis found that differences across subgroups tended to persist over time, with some of the largest gaps between adults with and without coverage. Regional differences persisted or widened over the study period.
AHRQ-authored.
Citation: Abdus S, Selden TM .
Preventive services for adults: how have differences across subgroups changed over the past decade?
Med Care 2013 Nov;51(11):999-1007. doi: 10.1097/MLR.0b013e3182a97bc0.
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Keywords: Healthcare Utilization, Health Insurance, Medical Expenditure Panel Survey (MEPS), Prevention, Social Determinants of Health
Begum R, Smith Ryan M, Winther CH
Small practices' experience with EHR, quality measurement, and incentives.
The researchers surveyed clinicians participating in Health eHearts, a cluster-randomized trial of the effect of a financial incentive and quality improvement (QI) assistance program on measures of cardiovascular care compared with the effect of providing quality reports and QI assistance. No differences were detected between groups regarding agreement with selected clinical measures or their relevance to the patient population.
AHRQ-funded; HS019164; HS018275.
Citation: Begum R, Smith Ryan M, Winther CH .
Small practices' experience with EHR, quality measurement, and incentives.
Am J Manag Care 2013 Nov;19(10 Spec No):eSP12-8..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Quality Improvement, Primary Care, Practice Patterns
Navarro-Millán I, Sattui SE, Curtis JR
Systematic review of tumor necrosis factor inhibitor discontinuation studies in rheumatoid arthritis.
The objective of this article is to conduct a systematic review of the available literature on discontinuation of anti-tumor necrosis factor (anti-TNF) agents in rheumatoid arthritis (RA) patients and the associated features of study designs, including eligibility criteria, outcome definitions, and outcomes of discontinuation. The authors concluded that discontinuation of anti-TNF therapy is achievable for many RA patients who start in clinical remission or low disease activity.
AHRQ-funded; HS018517
Citation: Navarro-Millán I, Sattui SE, Curtis JR .
Systematic review of tumor necrosis factor inhibitor discontinuation studies in rheumatoid arthritis.
Clin Ther. 2013 Nov;35(11):1850-61.e1. doi: 10.1016/j.clinthera.2013.09.015..
Keywords: Comparative Effectiveness, Outcomes, Arthritis, Medication, Chronic Conditions
Hanlon JT, Schmader KE
The medication appropriateness index at 20: where it started, where it has been, and where it may be going.
The objective of this narrative review is to describe finding regarding the reliability of the Medication Appropriateness Index (MAI), a comparison of the MAI with other quality measures of potentially inappropriate prescribing, the predictive value of the MAI with important health outcomes, and the responsiveness of the MAI to change within the framework of randomized controlled trials.
AHRQ-funded; HS018721
Citation: Hanlon JT, Schmader KE .
The medication appropriateness index at 20: where it started, where it has been, and where it may be going.
Drugs Aging. 2013 Nov;30(11):893-900. doi: 10.1007/s40266-013-0118-4..
Keywords: Quality of Care, Medication, Outcomes, Quality Measures, Medication: Safety
Encinosa WE, Bae J
AHRQ Author: Encinosa WE
Will meaningful use electronic medical records reduce hospital costs?
The authors examined what impact the 5 core medication meaningful use (MU) criteria have on hospital-acquired adverse drug events (ADEs) and their costs in 2010, as a baseline for the start of MU implementation in 2011. They developed a quality indicator to track in-hospital ADEs and concluded that the adoption of core medication MU elements will cut ADE rates, with cost savings that recoup 22% of information technology costs.
AHRQ-authored.
Citation: Encinosa WE, Bae J .
Will meaningful use electronic medical records reduce hospital costs?
Am J Manag Care 2013 Nov;19(10 Spec No):eSP19-25.
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Keywords: Adverse Drug Events (ADE), Electronic Health Records (EHRs), Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Medication
Harris AD, Pineles L, Belton B
Universal glove and gown use and acquisition of antibiotic-resistant bacteria in the ICU: a randomized trial.
Antibiotic-resistant bacteria are associated with increased patient morbidity and mortality. It is unknown whether wearing gloves and gowns for all patient contact in the intensive care unit (ICU) decreases acquisition of antibiotic-resistant bacteria. The purpose of this study was to assess whether wearing gloves and gowns for all patient contact in the ICU decreases acquisition of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) compared with usual care.
AHRQ-funded; HS018111; 290200600015.
Citation: Harris AD, Pineles L, Belton B .
Universal glove and gown use and acquisition of antibiotic-resistant bacteria in the ICU: a randomized trial.
JAMA 2013 Oct 16;310(15):1571-80. doi: 10.1001/jama.2013.277815..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Infectious Diseases, Intensive Care Unit (ICU), Hospitals, Prevention, Critical Care
Nicholas LH, Dimick JB
Bariatric surgery in minority patients before and after implementation of a centers of excellence program.
This study compared rates of bariatric surgery for minority Medicare vs. non-Medicare patients before and after the 2006 implementation of a national coverage decision (NCD) restricting Medicare patients to centers of excellence for bariatric surgery. It found that the proportion of nonwhite Medicare patients receiving this procedure dropped from 27.5 percent before the NCD to 25.9 percent afterwards.
AHRQ-funded; HS017765
Citation: Nicholas LH, Dimick JB .
Bariatric surgery in minority patients before and after implementation of a centers of excellence program.
JAMA. 2013 Oct 2;310(13):1399-400. doi: 10.1001/jama.2013.277915..
Keywords: Racial and Ethnic Minorities, Medicare, Healthcare Utilization, Obesity