National Healthcare Quality and Disparities Report
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Topics
- Behavioral Health (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children's Health Insurance Program (CHIP) (1)
- Children/Adolescents (2)
- Chronic Conditions (2)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (1)
- Communication (1)
- Comprehensive Unit-based Safety Program (CUSP) (2)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (2)
- Data (1)
- Decision Making (2)
- Depression (1)
- Disparities (2)
- Elderly (1)
- Electronic Health Records (EHRs) (1)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (2)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (10)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Healthcare Delivery (4)
- Health Information Technology (HIT) (3)
- Health Services Research (HSR) (1)
- Health Status (1)
- Hospitals (4)
- Kidney Disease and Health (1)
- Labor and Delivery (1)
- Long-Term Care (2)
- Medicaid (1)
- Medicare (1)
- Medication (2)
- Medication: Safety (1)
- Men's Health (1)
- Nursing Homes (4)
- Organizational Change (4)
- Outcomes (3)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (1)
- Patient Experience (1)
- Patient Safety (10)
- Policy (2)
- Pregnancy (1)
- Primary Care (2)
- Primary Care: Models of Care (2)
- Provider Performance (4)
- Public Reporting (1)
- Quality Improvement (6)
- Quality Indicators (QIs) (2)
- Quality Measures (6)
- (-) Quality of Care (33)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- Rehabilitation (1)
- Research Methodologies (1)
- Social Determinants of Health (1)
- Surgery (3)
- Teams (1)
- Urinary Tract Infection (UTI) (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 33 Research Studies DisplayedMinden SL, Ding L, Cleary PD
Improving the quality of mental health care in multiple sclerosis.
The researchers surveyed multiple sclerosis (MS) patients across the U.S. to determine how many experienced mental health problems and received treatment over the preceding year. Also studied were patient experiences with and ratings of care, type of treatment provider, and the location of care. The researchers found a high unmet need for mental health treatment among persons with MS.
AHRQ-funded; HS016978
Citation: Minden SL, Ding L, Cleary PD .
Improving the quality of mental health care in multiple sclerosis.
J Neurol Sci. 2013 Dec 15;335(1-2):42-7. doi: 10.1016/j.jns.2013.08.021..
Keywords: Behavioral Health, Quality of Care, Chronic Conditions
Lomotan EA, Dougherty D
AHRQ Author: Lomotan EA, Dougherty D
Pediatric health care quality measures: considerations for pharmacotherapy.
The authors used the Pediatric Quality Measures Program that arose from the Children's Health Insurance Program Reauthorization Act in the United States to illustrate the challenges in developing quality measures of pediatric pharmacotherapy. They identified the challenges aw being twofold: (i) weak evidence base for the specific pharmacotherapy in children and (ii) limited data to calculate the measure. They concluded that health information technology is emerging as a tool to improve quality measurement but presents additional challenges.
AHRQ-authored.
Citation: Lomotan EA, Dougherty D .
Pediatric health care quality measures: considerations for pharmacotherapy.
Paediatr Drugs 2013 Dec;15(6):441-7. doi: 10.1007/s40272-013-0042-4.
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Keywords: Children's Health Insurance Program (CHIP), Quality of Care, Medication, Children/Adolescents, Quality Measures
Mukamel DB, Harrington C
Resident satisfaction surveys and clinical quality of care in nursing homes: two sides of the same coin?
The authors of this article believe that quality of nursing homes is a complex, multidimensional construct. Unlike acute care hospitals, where patients are typically treated for one specific condition and stay for a short period of time, the length of stays in nursing homes varies widely. They argue that neither the individual assessment of clinical quality nor evaluation of hotel services are sufficient.
AHRQ-funded; HS021844.
Citation: Mukamel DB, Harrington C .
Resident satisfaction surveys and clinical quality of care in nursing homes: two sides of the same coin?
Aging Health 2013 Dec;9(6):607-9. doi: 10.2217/ahe.13.63..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Long-Term Care, Nursing Homes, Patient Experience, Quality of Care, Quality Improvement, Quality Measures
Sherman KL, Gordon EJ, Mahvi DM
Surgeons' perceptions of public reporting of hospital and individual surgeon quality.
This study (1) evaluated surgeons’ perceptions of public reporting of surgical quality; and (2) identified specific barriers to surgeons’ acceptance of public reporting. It found that surgeons are generally in favor of public reporting, but that they continue to have substantive concerns, particularly with respect to reporting individual level outcomes data.
AHRQ-funded; HS021857.
Citation: Sherman KL, Gordon EJ, Mahvi DM .
Surgeons' perceptions of public reporting of hospital and individual surgeon quality.
Med Care 2013 Dec;51(12):1069-75. doi: 10.1097/mlr.0000000000000013..
Keywords: Public Reporting, Quality of Care, Hospitals, Surgery, Provider Performance
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
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
Clancy CM
AHRQ Author: Clancy CM
Creating a healing environment.
Healthcare-associated infections, or HAIs, are as familiar as they are distressing but they are also largely preventable. The author, a former director of AHRQ, argues that the design of the healthcare facility environment (including layout, placement of equipment, and ease of access to materials) has the ability to improve patient safety, and more specifically, prevent the spread of HAIs.
Citation: Clancy CM .
Creating a healing environment.
HERD 2013 Oct;7(1 suppl):5-7..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care
Lewandowski RE, Acri MC, Hoagwood KE
Evidence for the management of adolescent depression.
This article reports on the development of a care pathway and quality indicators (QIs) for the primary and specialty care management of adolescent depression. It also reviews clinical practice guidelines and identifies barriers to the development of QIs, such as gaps in the empirical evidence. Finally, a research agenda is suggested.
AHRQ-funded; HS020503
Citation: Lewandowski RE, Acri MC, Hoagwood KE .
Evidence for the management of adolescent depression.
Pediatrics. 2013 Oct;132(4):e996-e1009. doi: 10.1542/peds.2013-0600..
Keywords: Children/Adolescents, Depression, Quality Indicators (QIs), Guidelines, Quality of Care
Lenfestey NF, Denham ME, Hall KK
http://journals.sagepub.com/doi/full/10.1177/193758671300701S05
Expert opinions on the role of facility design in the acquisition and prevention of healthcare-associated infections.
The purpose of this study was to assess expert knowledge, perceptions, and experience on the role of the built environment in the acquisition and transmission of healthcare-associated infections (HAIs), facility design decision-making considerations, and strategies for intervention through facility design and technologies. It concluded that no single intervention is entirely effective in mitigating HAI risk; multiple interventions are needed.
AHRQ-funded; 290201000024I.
Citation: Lenfestey NF, Denham ME, Hall KK .
Expert opinions on the role of facility design in the acquisition and prevention of healthcare-associated infections.
HERD 2013 Oct;7(1 suppl):31-45..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care
Fakih MG, George C, Edson BS
Implementing a national program to reduce catheter-associated urinary tract infection: a quality improvement collaboration of state hospital associations, academic medical centers, professional societies, and governmental agencies.
The authors describe a large-scale national effort funded by AHRQ to reduce catheter-associated urinary tract infections (CAUTI). They elucidate the importance of the collaboration between the different national and local associations, societies, and agencies that is required for a successful program. They also illustrate the complexities of implementing both the technical and socioadaptive improvement efforts focused on reducing CAUTI.
AHRQ-funded; 290201000025I; 29032001T
Citation: Fakih MG, George C, Edson BS .
Implementing a national program to reduce catheter-associated urinary tract infection: a quality improvement collaboration of state hospital associations, academic medical centers, professional societies, and governmental agencies.
Infect Control Hosp Epidemiol. 2013 Oct;34(10):1048-54. doi: 10.1086/673149..
Keywords: Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Quality of Care, Patient Safety, Catheter-Associated Urinary Tract Infection (CAUTI)
Liss DT, Fishman PA, Rutter CM
Outcomes among chronically ill adults in a medical home prototype.
The researchers compared quality, utilization, and cost outcomes for patients with selected chronic illnesses at a patient-centered medical home (PCMH) prototype site with outcomes for patients with the same chronic illnesses at 19 nonintervention control sites. They concluded that a clinic-level population-based PCMH redesign can decrease downstream utilization and reduce total healthcare costs in a subpopulation of patients with common chronic illnesses.
AHRQ-funded; HS019129.
Citation: Liss DT, Fishman PA, Rutter CM .
Outcomes among chronically ill adults in a medical home prototype.
Am J Manag Care 2013 Oct;19(10):e348-58.
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Keywords: Chronic Conditions, Healthcare Costs, Quality of Care, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Zimring C, Denham ME, Jacob JT
http://journals.sagepub.com/doi/10.1177/193758671300701S09
The role of facility design in preventing healthcare-associated infection: interventions, conclusions, and research needs.
The objective of this report was to summarize the findings and provide recommendations based on the multidisciplinary literature review and industry scan, focusing on the links between the built environment and healthcare-associated infections. It concluded that there are currently few data that demonstrate a reduction in infection rates. There is a need for multidisciplinary collaboration and increased efforts to standardize the evaluation of environmental studies.
AHRQ-funded; 290201000024I.
Citation: Zimring C, Denham ME, Jacob JT .
The role of facility design in preventing healthcare-associated infection: interventions, conclusions, and research needs.
HERD 2013 Oct;7(1 suppl):127-39..
Keywords: Evidence-Based Practice, Quality of Care, Healthcare-Associated Infections (HAIs), Hospitals
Zimring C, Jacob JT, Denham ME
http://journals.sagepub.com/doi/pdf/10.1177/193758671300701S04
The role of facility design in preventing the transmission of healthcare-associated infections: Background and conceptual framework.
This paper describes the conceptual framework and methodology used to conduct a comprehensive literature review of current evidence evaluating the role of the built environment in the transmission of healthcare-associated infections. The methodology involves a chain of transmission interventions model that is a multidisciplinary conceptualization of the interaction between pathogens and the built environment. This model facilitated a systematic literature review of a very large amount of data.
AHRQ-funded; 290201000024I.
Citation: Zimring C, Jacob JT, Denham ME .
The role of facility design in preventing the transmission of healthcare-associated infections: Background and conceptual framework.
HERD 2013 Oct;7(1 suppl):18-30.
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Keywords: Evidence-Based Practice, Quality of Care, Healthcare-Associated Infections (HAIs), Research Methodologies
Jacob JT, Kasali A, Steinberg JP
http://journals.sagepub.com/doi/abs/10.1177/193758671300701S07
The role of the hospital environment in preventing healthcare-associated infections caused by pathogens transmitted through the air.
This review assesses and synthesizes available evidence in the infection control and healthcare design literature on strategies using the built environment to reduce the transmission of pathogens in the air that cause healthcare-associated infections (HAIs). It found that current evidence is limited by the complexity of the interactions between pathogens and potential hosts, and in the methods used to assess impact of these strategies.
AHRQ-funded; 290201000024I.
Citation: Jacob JT, Kasali A, Steinberg JP .
The role of the hospital environment in preventing healthcare-associated infections caused by pathogens transmitted through the air.
HERD 2013 Oct;7(1 suppl):74-98..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care
Denham ME, Kasali A, Steinberg JP
http://journals.sagepub.com/doi/abs/10.1177/193758671300701S08
The role of water in the transmission of healthcare-associated infections: opportunities for intervention through the environment.
The purpose of this review was to assess and synthesize available evidence in the infection control and healthcare design literature on strategies using the built environment to reduce the transmission of pathogens in water that cause healthcare-associated infections (HAIs). It determined that current evidence clearly identifying the environment’s role in the chain of infection is limited.
AHRQ-funded; 290201000024I.
Citation: Denham ME, Kasali A, Steinberg JP .
The role of water in the transmission of healthcare-associated infections: opportunities for intervention through the environment.
HERD 2013 Oct;7(1 suppl):99-126..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care
Hall KK, Kamerow DB
http://journals.sagepub.com/doi/abs/10.1177/193758671300701S03
Understanding the role of facility design in the acquisition and prevention of healthcare-associated infections.
The authors characterize the HAI-Design project and discuss briefly each paper in this issue. These papers highlight how the built environment can impact patient safety through the use of a specific and high-impact example: healthcare-associated infections. The overall goal is to identify design strategies that appear to be effective in interrupting pathogen transmission and reducing HAIs.
AHRQ-funded; 290201000024I.
Citation: Hall KK, Kamerow DB .
Understanding the role of facility design in the acquisition and prevention of healthcare-associated infections.
HERD 2013 Oct;7(1 suppl):13-17..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care
Hong AL, Sawyer MD, Shore A
Decreasing central-line-associated bloodstream infections in Connecticut intensive care units.
This study demonstrated that the Comprehensive Unit-based Safety Program, a multifaceted approach to prevent central line-associated bloodstream infections (CLABSIs) could be implemented in Connecticut (following successful implementation in Michigan). The program was associated with a reduction in CLABSI rates in Connecticut, even though the State’s baseline CLABSI rate was already low.
AHRQ-funded; 290200600022
Citation: Hong AL, Sawyer MD, Shore A .
Decreasing central-line-associated bloodstream infections in Connecticut intensive care units.
J Healthc Qual. 2013 Sep-Oct;35(5):78-87. doi: 10.1111/j.1945-1474.2012.00210.x..
Keywords: Comprehensive Unit-based Safety Program (CUSP), Healthcare-Associated Infections (HAIs), Central Line-Associated Bloodstream Infections (CLABSI), Patient Safety, Quality of Care
Quigley DD, Martino SC, Brown JA
Evaluating the content of the communication items in the CAHPS clinician and group survey and supplemental items with what high-performing physicians say they do.
The authors examined the content of the CAHPS® Clinician and Group Survey and found that the survey items captured many of the most commonly mentioned doctor-patient communication behaviors and practices identified by high-performing physicians. However, three key aspects of communication--nonverbal communication, greeting patients, and tracking personal information about patients--were not captured by the current survey.
AHRQ-funded; HS016980.
Citation: Quigley DD, Martino SC, Brown JA .
Evaluating the content of the communication items in the CAHPS clinician and group survey and supplemental items with what high-performing physicians say they do.
Patient. 2013;6(3):169-77. doi: 10.1007/s40271-013-0016-1..
Keywords: Communication, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Clinician-Patient Communication, Provider Performance
Beaubrun AC, Kanda E, Bond TC
Form CMS-2728 data versus erythropoietin claims data: implications for quality of care studies.
The purpose of this study was to compare predialysis erythropoietin-simulating agents (ESA) care reported on Form CMS-2728 with Medicare claims for ESA treatment submitted for patients 67 years and older at initiation of dialysis with Medicare as the primary payer. It found that the agreement between Form CMS-2728 and claims data is poor and discordant results are observed when comparing the use of these data sources to predict health outcomes.
AHRQ-funded; HS000032.
Citation: Beaubrun AC, Kanda E, Bond TC .
Form CMS-2728 data versus erythropoietin claims data: implications for quality of care studies.
Ren Fail 2013;35(3):320-6. doi: 10.3109/0886022x.2012.747967..
Keywords: Medicare, Data, Elderly, Quality of Care, Kidney Disease and Health
Paez K, Roper RA, Andrews RM
AHRQ Author: Roper RA, Andrews RM
Health information technology and hospital patient safety: a conceptual model to guide research.
The authors developed a conceptual model to guide research in sorting out the complex relationships between health information technology (HIT) and the quality and safety of care. They found the model difficult to operationalize because available HIT adoption data did not characterize features and extent of usage, and patient safety measures did not elucidate the process failures leading to safety-related outcomes. Their findings illustrated the critical need for collecting data that are germane to HIT and the possible mechanisms by which HIT may affect inpatient safety.
AHRQ-authored; AHRQ-funded.
Citation: Paez K, Roper RA, Andrews RM .
Health information technology and hospital patient safety: a conceptual model to guide research.
Jt Comm J Qual Patient Saf 2013 Sep;39(9):415-25.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Health Information Technology (HIT), Hospitals, Quality of Care, Patient Safety
Fitzgibbons Jr RJ, Ramanan B, Arya S
Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias.
This study of 254 men with minimally symptomatic inguinal hernia who were assigned to watchful waiting (WW) found that WW is a reasonable and safe strategy. However, the study which followed these patients for up to 11.5 years found that symptoms usually progressed and an operation was eventually needed, with 79 percent of men older than 65 and 62 percent of younger men receiving surgical repair.
AHRQ-funded; HS09860
Citation: Fitzgibbons Jr RJ, Ramanan B, Arya S .
Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias.
Ann Surg. 2013 Sep;258(3):508-15. doi: 10.1097/SLA.0b013e3182a19725..
Keywords: Surgery, Men's Health, Quality of Care, Patient Safety, Decision Making
Wagner LM, McDonald SM, Castle NG
Impact of voluntary accreditation on short-stay rehabilitative measures in U.S. nursing homes.
The purpose of this paper was to examine accreditation from nursing homes accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF) and whether this is associated with improved rehabilitation care. Findings indicated that CARF-accredited nursing homes demonstrate better quality with regard to the short-stay quality measures and that approaches beyond traditional regulation and governmental inspections are necessary to improve the quality of care in nursing homes.
AHRQ-funded; HS013983.
Citation: Wagner LM, McDonald SM, Castle NG .
Impact of voluntary accreditation on short-stay rehabilitative measures in U.S. nursing homes.
Rehabil Nurs 2013 Jul-Aug;38(4):167-77. doi: 10.1002/rnj.94.
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Keywords: Quality of Care, Nursing Homes, Quality Measures, Rehabilitation
Werner RM, Konetzka RT, Kim MM
Quality improvement under nursing home compare: the association between changes in process and outcome measures.
The researchers tested the extent to which improvements in outcomes of care are explained by changes in nursing home processes. Of the 5 outcome measures examined, they found that only improvements in the percentage of nursing home residents in moderate or severe pain were associated with changes in nursing home processes of care. They concluded that understanding the mechanism behind improvements in nursing home outcomes may be key to successfully achieving broad quality improvements across nursing homes.
AHRQ-funded; HS021861.
Citation: Werner RM, Konetzka RT, Kim MM .
Quality improvement under nursing home compare: the association between changes in process and outcome measures.
Med Care 2013 Jul;51(7):582-8. doi: 10.1097/MLR.0b013e31828dbae4.
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Keywords: Nursing Homes, Long-Term Care, Quality Improvement, Quality Measures, Quality of Care, Provider Performance, Outcomes
Conway PH, Mostashari F, Clancy CM
AHRQ Author: Clancy CM
The future of quality measurement for improvement and accountability.
The authors describe the characteristics of the quality measurement enterprise of the future, outline a potential roadmap for the transition, and identify a set of opportunities for public- and private-sector collaboration.
AHRQ-authored.
Citation: Conway PH, Mostashari F, Clancy CM .
The future of quality measurement for improvement and accountability.
JAMA 2013 Jun 5;309(21):2215-6. doi: 10.1001/jama.2013.4929.
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Keywords: Healthcare Delivery, Policy, Organizational Change, Quality Indicators (QIs), Quality Measures, Quality of Care
Dimick J, Ruhter J, Sarrazin MV
Black patients more likely than whites to undergo surgery at low-quality hospitals in segregated regions.
The authors assessed the extent to which living in racially segregated areas and living in geographic proximity to low-quality hospitals contribute to the disparity of black patients undergoing surgery at lower-quality hospitals more frequently than whites. Using Medicare data, they found that black patients tended to live closer to higher-quality hospitals than white patients but were more likely to receive surgery at low-quality hospitals. To address these disparities, care navigators and public reporting of comparative quality could steer patients and their referring physicians to higher-quality hospitals, while quality improvement efforts could focus on improving outcomes for high-risk surgery at hospitals that disproportionately serve black patients.
AHRQ-funded; HS017765.
Citation: Dimick J, Ruhter J, Sarrazin MV .
Black patients more likely than whites to undergo surgery at low-quality hospitals in segregated regions.
Health Aff 2013 Jun;32(6):1046-53. doi: 10.1377/hlthaff.2011.1365.
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Keywords: Disparities, Quality of Care, Hospitals, Racial and Ethnic Minorities, Surgery