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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
51 to 75 of 1579 Research Studies DisplayedStarnes LS, Starnes JR, Stopczynski T
Clinical prediction model: multisystem inflammatory syndrome in children versus Kawasaki disease.
This study aimed to develop a prediction model to differentiate between multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD). Using retrospective and prospective cohort data, a logistic regression model was developed, incorporating factors such as age, laboratory values, and clinical indicators. The model showed excellent discrimination (AUC 0.96) and calibration. It offers potential usefulness in aiding the diagnosis of MIS-C but requires further validation.
AHRQ-funded; HS026122.
Citation: Starnes LS, Starnes JR, Stopczynski T .
Clinical prediction model: multisystem inflammatory syndrome in children versus Kawasaki disease.
J Hosp Med 2024 Mar; 19(3):175-84. doi: 10.1002/jhm.13290.
Keywords: Children/Adolescents, Respiratory Conditions, COVID-19, Chronic Conditions
Whittington C, Skains RM, Zhang Y
Delirium due to potentially avoidable hospitalizations among older adults.
This retrospective cross-sectional study examined delirium rates among 39,933 older adults hospitalized for ambulatory care-sensitive conditions (ACSCs) at a large Southeastern academic medical center from 2015 to 2019. Delirium occurred in 15.6% of admissions, with lower rates observed for ACSC admissions compared to non-ACSC admissions. Older age and higher comorbidity were significant predictors of delirium development. While delirium rates were lower for ACSC admissions, optimizing outpatient management of ACSCs remains crucial for reducing hospitalizations and associated complications like delirium.
AHRQ-funded; HS013852.
Citation: Whittington C, Skains RM, Zhang Y .
Delirium due to potentially avoidable hospitalizations among older adults.
J Gerontol A Biol Sci Med Sci 2024 Mar; 79(3). doi: 10.1093/gerona/glad256.
Keywords: Elderly, Hospitalization
Parikh K, Hall M, Tieder JS
Disparities in racial, ethnic, and payer groups for pediatric safety events in US hospitals.
A retrospective cohort study using the 2019 Kids' Inpatient Database found disparities in pediatric safety events. Black and Hispanic children had significantly higher odds in 5 of 7 safety indicators compared to white children, especially in postoperative sepsis and respiratory failure. Medicaid-covered children also showed higher odds in 4 of 7 indicators compared to privately insured children, highlighting the need for targeted interventions to enhance hospital patient safety, particularly among minority and Medicaid-covered populations.
AHRQ-funded; HS028484.
Citation: Parikh K, Hall M, Tieder JS .
Disparities in racial, ethnic, and payer groups for pediatric safety events in US hospitals.
Pediatrics 2024 Mar; 153(3):e2023063714. doi: 10.1542/peds.2023-063714.
Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Racial and Ethnic Minorities, Children/Adolescents, Patient Safety, Hospitals
Iantorno SE, Scaife JH, Bryce JR
Emergency department utilization for pediatric gastrostomy tubes across the United States.
This study investigated the number and nature of emergency department (ED) visits to community hospitals for pediatric gastrostomy tube complication. The authors used the 2019 Nationwide Emergency Department Sample to perform a retrospective cross-sectional analysis of pediatric patients (<18 y) with a primary diagnosis of gastrostomy tube complication. Their primary outcome was a potentially preventable ED visit, defined as an encounter that did not result in any imaging, procedures, or an inpatient admission. They observed 32,036 ED visits at 535 hospitals and 15,165 (47.3%) were potentially preventable. Median age was 2 years, and 17,707 (55%) were male. Compared to White patients, patients with higher odds of potentially preventable visits were Black and Hispanic. Patients with residential zip codes in the first, second, and third median household income quartiles had higher odds of potentially preventable visits compared to the highest.
AHRQ-funded; HS025776.
Citation: Iantorno SE, Scaife JH, Bryce JR .
Emergency department utilization for pediatric gastrostomy tubes across the United States.
J Surg Res 2024 Mar; 295:820-26. doi: 10.1016/j.jss.2023.11.028.
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Healthcare Utilization, Surgery, Adverse Events
Milliren CE, Ozonoff A, Fournier KA
Enhancing pressure injury surveillance using natural language processing.
This study’s goal was to assess the feasibility of using nursing handoff notes to identify underreported hospital-acquired pressure injury (HAPI) events. The authors established a natural language processing-assisted manual review process and workflow for data extraction from a corpus of nursing notes across all medical inpatient and intensive care units in a tertiary care pediatric center. Their workflow started with keywords around HAPI and treatments, then regular expressions, distributive semantics, and finally a document classifier. They generated 3 models: a tri-gram classifier, binary logistic regression model using the regular expressions as predictors, and a random forest model using both models together. Their final output was generated using a random forest model validated using derivation and validation sets. Their initial data set involved 70,981 notes during a 1-year period from 5484 unique admissions for 4220 patients. Their interrater human reviewer agreement on identifying HAPI was high. Their random forest model had 95% sensitivity, 71.2% specificity, and 78.7% accuracy. A total of 264 notes from 148 unique admissions were identified describing likely HAPI, with 61 describing new injuries, and 64 describing known yet possibly evolving injuries. HAPI incidence was 11.9 per 1000 discharges, and incidence rate was 1.2 per 1000 bed-days.
AHRQ-funded; HS026246.
Citation: Milliren CE, Ozonoff A, Fournier KA .
Enhancing pressure injury surveillance using natural language processing.
J Patient Saf 2024 Mar 1; 20(2):119-24. doi: 10.1097/pts.0000000000001193.
Keywords: Pressure Ulcers, Healthcare-Associated Infections (HAIs), Health Information Technology (HIT)
Bui LN, Knox M, Miller-Rosales C
Hospital capabilities associated with behavioral health integration within emergency departments.
The objective of this study was to identify hospital capabilities associated with behavioral health processes in emergency departments. Responses to the National Survey of Healthcare Organizations and Systems were linked American Hospital Association Annual Survey data. Most hospitals reported screening for behavioral health conditions and provided direct referrals to community-based clinicians. Approximately half the hospitals used team approaches to behavioral health. Hospitals that reported more barriers to care delivery innovations also reported less screening and usage of a team approach. The authors concluded that research and interventions which focus on removing barriers or adding processes to disseminate best practices offer a path to accelerate behavioral health integration in emergency departments.
AHRQ-funded; HS024075.
Citation: Bui LN, Knox M, Miller-Rosales C .
Hospital capabilities associated with behavioral health integration within emergency departments.
Med Care 2024 Mar; 62(3):170-74. doi: 10.1097/mlr.0000000000001973.
Keywords: Behavioral Health, Emergency Department, Hospitals, Substance Abuse, Teams, Telehealth, Health Information Technology (HIT)
Wust KL, Carayon P, Werner NE
Older adult patients and care partners as knowledge brokers in fragmented health care.
This study explores the knowledge broker roles of older adult patients and their care partners during emergency department (ED) visits. The research concludes that patients and care partners serve as information liaisons between fragmented care systems, providing details on diagnostic testing, medications, health history, and care accommodations. They engage in proactive and reactive knowledge brokering within and across ED work systems, aiding in communication and care coordination to mitigate healthcare fragmentation.
AHRQ-funded; HS026624.
Citation: Wust KL, Carayon P, Werner NE .
Older adult patients and care partners as knowledge brokers in fragmented health care.
Hum Factors 2024 Mar; 66(3):701-13. doi: 10.1177/00187208221092847.
Keywords: Elderly, Emergency Department, Caregiving, Clinician-Patient Communication, Communication
Salwei ME, Hoonakker P, Carayon P
Usability of a human factors-based clinical decision support in the emergency department: lessons learned for design and implementation.
A human-centered design process was followed to assess the usability and adoption of human factors (HF)-based clinical decision support (CDS) in the emergency department (ED). A CDS was developed to aid in pulmonary embolism (PE) diagnosis, showing high usability in testing. However, despite positive perceptions, actual CDS usage remained low due to integration issues with clinician workflow. The findings highlight the need for ongoing refinement of CDS design to align with clinical workflows and enhance usability.
AHRQ-funded; HS026395; HS024558; HS022086. NIH 142099
Citation: Salwei ME, Hoonakker P, Carayon P .
Usability of a human factors-based clinical decision support in the emergency department: lessons learned for design and implementation.
Hum Factors 2024 Mar; 66(3):647-57. doi: 10.1177/00187208221078625.
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Emergency Department, Implementation
Darling KE, Warnick J, Guerry WB
Adolescent females' dyadic conversations about body, weight, and appearance.
The purpose of this observational study was to examine body talk between adolescent female dyads aged 13-17. Reciprocally nominated dyads were recruited from a southeastern US high school. Themes that emerged were related to weight, appearance, and personality. The authors concluded that their results provided insight into the social context in which sociocultural norms of weight stigma, body dissatisfaction, and eating-related psychopathology may be reinforced, and that these findings have implications for informing the development of interventions to reduce negative weight- and appearance-related body talk among adolescent girls.
AHRQ-funded; HS027071.
Citation: Darling KE, Warnick J, Guerry WB .
Adolescent females' dyadic conversations about body, weight, and appearance.
J Adolesc Res 2024 Mar; 39(2):487-510. doi: 10.1177/07435584221120111.
Keywords: Children/Adolescents, Obesity, Social Stigma
Hider AM, Gomez-Rexrode AE, Agius J
Association of bundled payments with spending, utilization, and quality for surgical conditions: a scoping review.
This scoping review assessed the body of literature examining episode-based bundled payment models effect on health care spending, utilization, and quality of care for surgical conditions. Bundled payment models let hospitals receive financial incentives to reduce spending on care provided to patients during a predefined clinical episode. The review queried four databases from inception through September 27, 2021. A total of 879 unique articles were found, of which 28 met final inclusion criteria. Of these studies, 23 out of 28 evaluated the impact of voluntary bundled payments in orthopedic surgery and found that bundled payments are associated with reduced spending on total care episodes, attributed primarily to decreases in post-acute care spending. This reduced spending did not worsen clinical outcomes (e.g., readmissions, complications, and mortality). Evidence for non-orthopedic surgery bundled payments remains limited.
AHRQ-funded; HS028606.
Citation: Hider AM, Gomez-Rexrode AE, Agius J .
Association of bundled payments with spending, utilization, and quality for surgical conditions: a scoping review.
Am J Surg 2024 Mar; 229:83-91. doi: 10.1016/j.amjsurg.2023.12.009.
Keywords: Surgery, Payment, Healthcare Costs
Hsieh N
Unpacking intersectional inequities in flu vaccination by sexuality, gender, and race-ethnicity in the United States.
This study examined influenza vaccination inequities at the intersection of sexuality, gender, and race-ethnicity using data from the 2013 to 2018 National Health Interview Survey (N = 166,908). It found that White gay men had the highest vaccination rate (56%), while Black bisexual women had the lowest rate (23%). Sexual minority women (Black or Hispanic) had lower vaccination rates than heterosexual women, but sexual minority men had higher or similar vaccination rates than heterosexual men. While economic enabling, noneconomic enabling, and need-based factors all help to explain a substantial portion of these gaps, they cannot explain all the disadvantages faced by Black lesbian, bisexual, heterosexual women, and Black heterosexual men.
AHRQ-funded; HS029329.
Citation: Hsieh N .
Unpacking intersectional inequities in flu vaccination by sexuality, gender, and race-ethnicity in the United States.
J Health Soc Behav 2024 Mar; 65(1):38-59. doi: 10.1177/00221465231199276.
Keywords: Influenza, Vaccination, Disparities
Ducharme-Crevier L, Furlong-Dillard J, Jung P
Safety of primary nasotracheal intubation in the pediatric intensive care unit (PICU).
This study examined the safety of using primary nasal tracheal intubation (TI) in the pediatric intensive care unit (PICU), which is a minority of all TI procedures. The authors evaluated the association between TI route and safety outcomes in a prospectively collected quality improvement database (National Emergency Airway Registry for Children: NEAR4KIDS) from 2013 to 2020. The primary outcome was severe desaturation and/or severe adverse TI-associated events (TIAEs), using NEAR4KIDS definitions. A total of 22,741 TIs were reported from 60 PICUs, with the majority (96.2%) oral and 3.8% nasal. Infants were represented in higher proportion in the nasal TI than the oral TI (75.9%, vs 46.2%), as well as children with cardiac conditions (46.9% vs. 14.4%). Severe desaturation or severe TIAE occurred in 23.7% of nasal and 22.5% of oral TI. With propensity score (PS) matching, the prevalence of severe desaturation and or severe adverse TIAEs was 23.6% of nasal vs. 19.8% of oral TI (absolute difference 3.8%). First attempt success rate was 72.1% of nasal TI versus 69.2% of oral TI. With PS matching, the overall success rate was not different between two groups (nasal 72.2% vs. oral 71.5%).
AHRQ-funded; HS024511.
Citation: Ducharme-Crevier L, Furlong-Dillard J, Jung P .
Safety of primary nasotracheal intubation in the pediatric intensive care unit (PICU).
Intensive Care Med Paediatr Neonatal 2024; 2(1):7. doi: 10.1007/s44253-024-00035-4..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Patient Safety, Critical Care
Wu J, Yuan CT, Moyal-Smith R
Electronic health record-supported implementation of an evidence-based pathway for perioperative surgical care.
This study examines the role of electronic health records (EHRs) in implementing enhanced recovery pathways (ERPs) for perioperative surgical care. Interviews with informaticians and clinicians from eight US hospitals revealed three thematic clusters: "EHR difficulties," "EHR enablers," and "EHR barriers." Researchers concluded that high performers and improvers successfully integrated ERPs into EHRs with dedicated multidisciplinary teams, while others faced challenges. Early involvement of informatics expertise benefited ERP implementation and sustainability.
AHRQ-funded; 2332015000201.
Citation: Wu J, Yuan CT, Moyal-Smith R .
Electronic health record-supported implementation of an evidence-based pathway for perioperative surgical care.
J Am Med Inform Assoc 2024 Feb 16; 31(3):591-99. doi: 10.1093/jamia/ocad237.
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Surgery, Evidence-Based Practice, Hospitals
Barwise AK, Curtis S, Diedrich DA
Using artificial intelligence to promote equitable care for inpatients with language barriers and complex medical needs: clinical stakeholder perspectives.
The objectives of this planned qualitative study were to use machine learning predictive analytics to identify patients with language barriers and complex medical needs in order to prioritize them for in-person interpreters. The authors conducted semi-structured interviews with clinicians, interpreters, and staff involved in caring for patients or organizing interpreters to understand perceived risks and benefits of artificial intelligence (AI) in this domain. Perceived risks included concerns about transparency, accuracy, redundancy, privacy, stigmatization among patients, alert fatigue, and supply-demand issues; perceived benefits included increased awareness of in-person interpreters, improved standard of care, and prioritization for interpreter utilization. They concluded that the use of AI to identify and prioritize patients for interpreter services has the potential to improve standard of care and address healthcare disparities among patients with language barriers.
AHRQ-funded; HS028475.
Citation: Barwise AK, Curtis S, Diedrich DA .
Using artificial intelligence to promote equitable care for inpatients with language barriers and complex medical needs: clinical stakeholder perspectives.
J Am Med Inform Assoc 2024 Feb 16; 31(3):611-21. doi: 10.1093/jamia/ocad224.
Keywords: Health Information Technology (HIT), Disparities, Communication, Clinician-Patient Communication
Iglesia EGA, Kwan M, Virkud YV
Management of food allergies and food-related anaphylaxis.
This paper discusses the management of IgE-mediated food-protein allergies that may cause anaphylaxis and death in addition to the allergic response to the food-carbohydrate galactose-α-1,3-galactose (alpha-gal) in mammalian meat. In the United States, 9 foods account for more than 90% of IgE-mediated food allergies: crustacean shellfish, dairy, peanut, tree nuts, fin fish, egg, wheat, soy, and sesame. Peanut allergies are the leading food-related cause of fatal and near-fatal anaphylaxis in the US, followed by tree nuts and shellfish. The estimated fatality rate from anaphylaxis is estimated to be 0.04 per million per year. Alpha-gal syndrome has been rising with a seroprevalence of 20% to 31% in the southeastern US. While avoidance of the culprit food is the main management strategy, if there is exposure use of the self-injectable epinephrine pen is the first-line treatment for food-related anaphylaxis. The FDA has just approved an oral immunotherapy product for treatment of peanut allergy, with other immunotherapies currently in development to desensitive one or more foods.
AHRQ-funded; HS026395.
Citation: Iglesia EGA, Kwan M, Virkud YV .
Management of food allergies and food-related anaphylaxis.
JAMA 2024 Feb 13; 331(6):510-21. doi: 10.1001/jama.2023.26857.
Keywords: Care Management
Semere W, Karter AJ, Lyles CR
Care partner engagement in secure messaging between patients with diabetes and their clinicians: cohort study.
This study based on a previous cohort study investigated secure messaging (SM) use among older diabetes patients, exploring the impact of care partners. Analyzing data from a large healthcare system's patient portal, proxy users, mainly older and with lower education, showed higher SM engagement. They initiated SM sooner, had more exchanges, yet didn't bridge existing disparities. Proxy involvement may enhance patient-clinician communication in diabetes care, warranting further research on its impact on clinical outcomes.
AHRQ-funded; HS027844.
Citation: Semere W, Karter AJ, Lyles CR .
Care partner engagement in secure messaging between patients with diabetes and their clinicians: cohort study.
JMIR Diabetes 2024 Feb 9; 9:e49491. doi: 10.2196/49491.
Keywords: Diabetes, Patient and Family Engagement, Clinician-Patient Communication
Kerlikowske K, Zhu W, Su YR
Supplemental magnetic resonance imaging plus mammography compared with magnetic resonance imaging or mammography by extent of breast density.
This study compared using supplemental magnetic resonance imaging (MRI) with or without mammography to inform discussions about supplemental MRI in women with dense breasts. The authors evaluated 52, 237 women aged 40-79 years who underwent 2611 screening MRIs alone and 6518 supplemental MRI plus mammography pairs propensity score-matched to 65, 810 screening mammograms. They estimated rates per 1000 examinations of interval, advanced, and screen-detected early-stage invasive cancers and false-positive recall and biopsy recommendation by breast density (nondense = almost entirely fatty or scattered fibroglandular densities; dense = heterogeneously/extremely dense) adjusting for registry, examination year, age, race and ethnicity, family history of breast cancer, and prior breast biopsy. Screen-detected early-stage cancer rates were statistically higher for MRI plus mammography vs mammography for nondense (9.3 vs 2.9) and dense (7.5 vs 3.5) breasts and for MRI vs MRI plus mammography for dense breasts (19.2 vs 7.5). Interval rates were not statistically different for MRI plus mammography vs mammography for nondense (0.8 vs 0.5) or dense breasts (1.5 vs 1.4), nor were advanced cancer rates. MRI plus mammography had statistically higher false-positive recall and biopsy recommendation rates than mammography alone.
AHRQ-funded; HS018366.
Citation: Kerlikowske K, Zhu W, Su YR .
Supplemental magnetic resonance imaging plus mammography compared with magnetic resonance imaging or mammography by extent of breast density.
J Natl Cancer Inst 2024 Feb 8; 116(2):249-57. doi: 10.1093/jnci/djad201.
Keywords: Imaging, Cancer
Hernandez SE, Solomon D, Moon J
Understanding clinical implementation coordinators' experiences in deploying evidence-based interventions.
Researchers described their fluoroquinolone restriction for the prevention of Clostridioides difficile infection (FIRST) trial, a multisite clinical study which used an electronic health record-based best-practice alert to optimize the use of fluoroquinolone antibiotics in acute care settings. Their goals were to describe the roles and responsibilities of clinical implementation coordinators within antibiotic stewardship teams and to identify facilitators and barriers coordinators experienced within the implementation process. The researchers conducted directed content analysis of semistructured interviews, implementation diaries, and check-in meetings. Their results indicated that clinical implementation coordinators facilitated the implementation process via their roles and responsibilities and acted as strategic partners in the improvement of adoption and sustainability of a fluoroquinolone preauthorization protocol.
AHRQ-funded; HS026226.
Citation: Hernandez SE, Solomon D, Moon J .
Understanding clinical implementation coordinators' experiences in deploying evidence-based interventions.
Am J Health Syst Pharm 2024 Feb 8; 81(4):120-28. doi: 10.1093/ajhp/zxad272.
Keywords: Evidence-Based Practice, Implementation, COVID-19
Anderson KE, Wu RJ, Darden M
Medicare Advantage is associated with lower utilization of total joint arthroplasty.
To discover whether Medicare Advantage enrollees have a lower utilization of elective surgical procedures such as inpatient hip and knee total joint arthroplasty (TJA), which have usually been covered by traditional Medicare without restrictions, researchers conducted a cross-sectional study comparing traditional Medicare claims and Medicare Advantage encounter records for enrollees aged 65-85. Their results showed a lower incidence of TJA in Medicare Advantage enrollees. The interval from initial diagnosis to contact with an orthopedic surgeon and to the surgical procedure were shorter among traditional enrollees.
AHRQ-funded; HS000029.
Citation: Anderson KE, Wu RJ, Darden M .
Medicare Advantage is associated with lower utilization of total joint arthroplasty.
J Bone Joint Surg Am 2024 Feb 7; 106(3):198-205. doi: 10.2106/jbjs.23.00507..
Keywords: Medicare, Orthopedics, Surgery
Paglino E, Lundberg DJ, Wrigley-Field E
Excess natural-cause mortality in US counties and its association with reported COVID-19 deaths.
The authors indicate that in the United States, excess deaths reported to non-COVID-19 natural causes may represent unrecognized COVID-19 deaths, deaths caused by interruptions in health care during the pandemic, and/or deaths from the socioeconomic impacts of the pandemic. The researchers created a Bayesian hierarchical model to produce monthly estimates of excess natural-cause mortality for US counties over the first 30 months of the pandemic. The study found that from March 2020 through August 2022, 1,194,610 excess natural-cause deaths occurred nationally. A total of 162,886 of these excess natural-cause deaths were not reported to COVID-19. Overall, 15.8 excess deaths were reported to non-COVID-19 natural causes for every 100 reported COVID-19 deaths. This number was higher in nonmetropolitan counties, the West, and the South. In comparison, reported COVID-19 death counts were greater than estimates of excess natural-cause deaths in metropolitan counties in the New England and Middle Atlantic states. Increases in reported COVID-19 deaths were temporally associated with increases in excess deaths reported to non-COVID-19 natural causes in the same and/or previous month.
AHRQ-funded; HS013853.
Citation: Paglino E, Lundberg DJ, Wrigley-Field E .
Excess natural-cause mortality in US counties and its association with reported COVID-19 deaths.
Proc Natl Acad Sci U S A 2024 Feb 6; 121(6):e2313661121. doi: 10.1073/pnas.2313661121..
Keywords: COVID-19, Mortality
Dayao JKO, Duffy CEL, Cristiano AM
Implementation and evaluation of Exercise is Medicine in primary care clinics within a large academic health system.
The objective of this study was to evaluate the feasibility, implementation, and effectiveness of the Exercise is Medicine (EIM) initiative. Researchers used a combination of the Practical Robust Implementation and Sustainability Model (PRISM) and the Learning Evaluation model to implement EIM; data was collected from the EHR, including Physical Activity Vital Sign (PAVS) scores, and also from qualitative surveys and interviews with the patients, clinicians, and staff of 5 primary care clinics within a large academic health system. The results indicated that EIM is feasible for routine primary care practice within a large academic health system. The researchers concluded that EIM is a model to emulate to help primary care providers address healthy lifestyle behaviors more efficiently.
AHRQ-funded; HS026517.
Citation: Dayao JKO, Duffy CEL, Cristiano AM .
Implementation and evaluation of Exercise is Medicine in primary care clinics within a large academic health system.
Fam Med Community Health 2024 Feb 2; 12(1):e002608. doi: 10.1136/fmch-2023-002608..
Keywords: Primary Care, Lifestyle Changes, Health Promotion, Implementation
Bartsch SM, O'Shea KJ, John DC
The potential epidemiologic, clinical, and economic value of a universal coronavirus vaccine: a modelling study.
This paper’s objective was to develop a modelling study on the potential epidemiologic, clinical, and economic value of a universal coronavirus vaccine to be used in the U.S. The authors used a computational model representing the US population, the spread of SARS-CoV-2, and the various clinical and economic outcomes of COVID-19 such as hospitalizations, deaths, quality-adjusted life years (QALYs) lost, productivity losses, direct medical costs, and total societal costs, to explore the impact of a universal vaccine under different circumstances. They developed and populated this model using data reported by the CDC as well as observational studies conducted during the COVID-19 pandemic. The pan-coronavirus vaccine would be cost-saving as long as its vaccine efficacy is ≥10% and vaccination coverage is ≥10%. They estimated that every 1% increase in efficacy between 10% and 50% could avert an additional 395,000 infections and save $1.0 billion in total societal costs ($45.3 million in productivity losses, $1.1 billion in direct medical costs). Even when a strain-specific coronavirus virus becomes available it would remain cost-saving, as long as it takes at least 2-3 months to develop, test, and bring that more specific vaccine to the market.
AHRQ-funded; R01HS028165.
Citation: Bartsch SM, O'Shea KJ, John DC .
The potential epidemiologic, clinical, and economic value of a universal coronavirus vaccine: a modelling study.
EClinicalMedicine 2024 Feb; 68:102369. doi: 10.1016/j.eclinm.2023.102369..
Keywords: COVID-19, Vaccination, Public Health
Gladen KM, Tellez D, Napolitano N
Adverse tracheal intubation events in critically ill underweight and obese children: retrospective study of the National Emergency Airway for Children Registry (2013-2020).
This retrospective cohort study’s aim was to determine the association between being underweight or obese with adverse airway outcomes, including adverse tracheal intubation (TI)-associated events (TIAEs) and/or severe peri-intubation hypoxemia (pulse oximetry oxygen saturation < 80%) in critically ill children. The National Emergency Airway for Children registry dataset of 2013-2020 was used to identify 24,342 critically ill children who underwent TI between 2013 and 2020. Underweight was most common in infants (34%); and obesity was most common in children older than 8 years old (15.1%). The underweight patients more often had oxygenation and ventilation failure (34.0%, 36.2%, respectively) as the indication for TI and a history of difficult airway (16.7%). Apneic oxygenation was used more often in overweight and obese patients (19.1%, 19.6%) than in underweight or normal weight patients (14.1%, 17.1%). TIAEs and/or hypoxemia occurred more often in underweight (27.1%) and obese (24.3%) patients. TI in underweight children was associated with greater odds of adverse airway outcome compared with normal weight children after adjusting for potential confounders (underweight: adjusted odds ratio [aOR], 1.09). Both underweight and obesity were associated with hypoxemia after adjusting for covariates and site clustering (underweight: aOR, 1.11; and obesity: aOR, 1.22).
AHRQ-funded; HS024511.
Citation: Gladen KM, Tellez D, Napolitano N .
Adverse tracheal intubation events in critically ill underweight and obese children: retrospective study of the National Emergency Airway for Children Registry (2013-2020).
Pediatr Crit Care Med 2024 Feb; 25(2):147-58. doi: 10.1097/pcc.0000000000003387..
Keywords: Children/Adolescents, Critical Care
Sleath B, Beznos B, Carpenter DM
African American patient-provider communication about glaucoma vision quality-of-life.
A study was conducted to examine African American patient-provider communication about glaucoma-related quality-of-life. Patients completed a vision quality-of-life assessment to examine patient-provider characteristics, patient demographics, and socio-demographics. The study determined that patients with worse literacy, more severe glaucoma, or depression are likely to have a lower vision quality-of-life.
AHRQ-funded; HS025370.
Citation: Sleath B, Beznos B, Carpenter DM .
African American patient-provider communication about glaucoma vision quality-of-life.
Eye 2024 Feb; 38(2):343-48. doi: 10.1038/s41433-023-02693-8..
Keywords: Eye Disease and Health, Racial and Ethnic Minorities, Clinician-Patient Communication, Communication, Quality of Life
Hogg-Graham R, Benitez JA, Lacy ME
Association between community social vulnerability and preventable hospitalizations.
The purpose of this study was to explore the relationship between variations in social vulnerability and preventable hospitalization rates. The researchers analyzed county-level preventable hospitalization rates for 33 states linked with data from the 2020 Social Vulnerability Index (SVI). The study found that preventable hospitalizations were 40% greater in the most vulnerable counties compared with the least vulnerable. Adjusted regression results confirm the strong relationship between social vulnerability and preventable hospitalizations.
AHRQ-funded; HS025494.
Citation: Hogg-Graham R, Benitez JA, Lacy ME .
Association between community social vulnerability and preventable hospitalizations.
Med Care Res Rev 2024 Feb; 81(1):31-38. doi: 10.1177/10775587231197248..
Keywords: Hospitalization, Social Determinants of Health