National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Children/Adolescents (3)
- Clinician-Patient Communication (2)
- Communication (1)
- (-) Consumer Assessment of Healthcare Providers and Systems (CAHPS) (22)
- Diabetes (1)
- Disparities (1)
- Education: Patient and Caregiver (1)
- Healthcare Costs (1)
- Health Insurance (1)
- Health Status (1)
- Hospital Discharge (1)
- Hospitalization (1)
- Hospital Readmissions (2)
- Hospitals (8)
- Inpatient Care (1)
- Medicare (3)
- Medication (1)
- Opioids (1)
- Organizational Change (1)
- Pain (1)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (1)
- Patient Experience (13)
- Practice Patterns (1)
- Primary Care (3)
- Provider (1)
- Public Reporting (3)
- Quality Improvement (2)
- Quality Measures (3)
- Quality of Care (17)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (1)
- Shared Decision Making (1)
- Tobacco Use (1)
- Training (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 22 of 22 Research Studies DisplayedNdumele CD, Cohen MS, Cleary PD
Association of state access standards with accessibility to specialists for Medicaid managed care enrollees.
The researchers compared ratings of access to specialists for adult Medicaid and commercial enrollees before and after the implementation of specialty access standards. Overall, there was no significant improvement in timely access to specialty services for Medicaid managed care enrollees in the period following implementation of standard(s) nor was there any impact of access standards on insurance-based disparities in access.
AHRQ-funded; HS016978; HS017589.
Citation: Ndumele CD, Cohen MS, Cleary PD .
Association of state access standards with accessibility to specialists for Medicaid managed care enrollees.
JAMA Intern Med 2017 Oct;177(10):1445-51. doi: 10.1001/jamainternmed.2017.3766.
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Keywords: Access to Care, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Health Insurance, Patient Experience
Hatfield LA, Zaslavsky AM
Implications of variation in the relationships between beneficiary characteristics and Medicare Advantage CAHPS measures.
The researchers studied how differences in quality score adjustments across Medicare Advantage contracts change comparisons for individuals and contracts. They found that, for average consumers, standard adjustment is sufficient to represent variation in contract quality standardized to a common population. For people with characteristics far from average, personalized reporting using their characteristics and contract-specific coefficients can substantially change the expected quality measures across contracts.
AHRQ-funded; HS016978.
Citation: Hatfield LA, Zaslavsky AM .
Implications of variation in the relationships between beneficiary characteristics and Medicare Advantage CAHPS measures.
Health Serv Res 2017 Aug;52(4):1310-29. doi: 10.1111/1475-6773.12544.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Medicare, Health Status, Patient Experience, Quality of Care, Quality Improvement, Quality Measures
Rinne ST, Castaneda J, Lindenauer PK
Chronic obstructive pulmonary disease readmissions and other measures of hospital quality.
This study examined the association between COPD readmissions and other quality measures. There were modest correlations between COPD readmission rates and readmission rates for other medical conditions, including heart failure , acute myocardial infarction, pneumonia, and stroke . In contrast, it also found low correlations between COPD readmission rates and readmission rates for surgical conditions, as well as mortality rates for all measured conditions.
AHRQ-funded; HS016978.
Citation: Rinne ST, Castaneda J, Lindenauer PK .
Chronic obstructive pulmonary disease readmissions and other measures of hospital quality.
Am J Respir Crit Care Med 2017 Jul 1;196(1):47-55. doi: 10.1164/rccm.201609-1944OC.
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Keywords: Respiratory Conditions, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Hospital Readmissions, Hospitals
Khatri N, Gupta V, Varma A
The relationship between HR capabilities and quality of patient care: the mediating role of proactive work behaviors.
The researchers developed a multidimensional construct of human resource (HR) capabilities and tested its relationship with quality of patient care using a national sample of U.S. hospitals. Their analyses using structural equation modeling suggest that the positive relationship of HR capabilities with quality of patient care is mediated by proactive behaviors of health care workers. Implications of the study findings for research and practice are discussed.
AHRQ-funded; HS017549.
Citation: Khatri N, Gupta V, Varma A .
The relationship between HR capabilities and quality of patient care: the mediating role of proactive work behaviors.
Hum Resour Manage 2017 Jul-Aug;56(4):673-91. doi: 10.1002/hrm.21794.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Quality of Care, Patient Experience, Patient Experience
Henke RM, Karaca Z, Jackson P
AHRQ Author: Karaca Z; Wong HS
Discharge planning and hospital readmissions.
This study examines the association between the quality of hospital discharge planning and all-cause 30-day readmissions and same-hospital readmissions. Discharge-planning quality was associated with (a) lower rates of 30-day hospital readmissions and (b) higher rates of same-hospital readmissions for heart failure, pneumonia, and total hip or joint replacement. These results suggest that by improving inpatient discharge planning, hospitals may be able to influence their 30-day readmissions.
AHRQ-authored; AHRQ-funded.
Citation: Henke RM, Karaca Z, Jackson P .
Discharge planning and hospital readmissions.
Med Care Res Rev 2017 Jun;74(3):345-68. doi: 10.1177/1077558716647652.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospital Discharge, Hospital Readmissions, Hospitals, Hospitalization
Lee JS, Hu HM, Brummett CM
Postoperative opioid prescribing and the pain scores on Hospital Consumer Assessment of Healthcare Providers and Systems Survey.
The researchers sought to evaluate the association between the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) pain measures and postoperative opioid prescribing in surgical patients, which accounts for nearly 40 percent of surgical prescriptions. They found that postoperative opioid prescribing was not correlated with HCAHPS pain measures.
AHRQ-funded; HS023313.
Citation: Lee JS, Hu HM, Brummett CM .
Postoperative opioid prescribing and the pain scores on Hospital Consumer Assessment of Healthcare Providers and Systems Survey.
JAMA 2017 May 16;317(19):2013-15. doi: 10.1001/jama.2017.2827.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Opioids, Pain, Patient Experience
Roberts ET, Mehrotra A, McWilliams JM
High-price and low-price physician practices do not differ significantly on care quality or efficiency.
The researchers examined the relationship between physician practice prices for outpatient services and practices' quality and efficiency of care. Patients of high-price practices reported significantly higher scores on some measures of care coordination and management but did not differ meaningfully in their overall care ratings, receipt of preventive services, acute care use, or total Medicare spending.
AHRQ-funded; HS024072.
Citation: Roberts ET, Mehrotra A, McWilliams JM .
High-price and low-price physician practices do not differ significantly on care quality or efficiency.
Health Aff 2017 May;36(5):855-64. doi: 10.1377/hlthaff.2016.1266.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Healthcare Costs, Practice Patterns
Toomey SL, Elliott MN, Zaslavsky AM
Variation in family experience of pediatric inpatient care as measured by child HCAHPS.
Making national comparisons of family experience of inpatient pediatric care has been limited by the lack of a publicly available survey. A new survey developed by AHRQ and the Centers for Medicare & Medicaid Services makes use of 18 measures. It found that family experience of pediatric inpatient care shows substantial room for improvement and varies considerably across hospitals and measures.
AHRQ-funded; HS020513.
Citation: Toomey SL, Elliott MN, Zaslavsky AM .
Variation in family experience of pediatric inpatient care as measured by child HCAHPS.
Pediatrics 2017 Apr;139(4):e20163372. doi: 10.1542/peds.2016-3372.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Patient Experience, Patient Experience, Quality of Care
Martino SC, Shaller D, Schlesinger M
CAHPS and comments: how closed-ended survey questions and narrative accounts interact in the assessment of patient experience.
The authors investigated whether content from patient narratives explains variation in patients' primary care provider (PCP) ratings beyond information from the closed-ended questions of CAHPS Clinician and Group Survey and whether the relative placement of closed- and open-ended survey questions affects either the content of narratives or the CAHPS composite scores. They found that incorporating a protocol for eliciting narratives into a patient experience survey resulted in minimal distortion of patient feedback, and narratives from sicker patients helped explain variation in provider ratings.
AHRQ-funded; HS016980; HS016978; HS021858.
Citation: Martino SC, Shaller D, Schlesinger M .
CAHPS and comments: how closed-ended survey questions and narrative accounts interact in the assessment of patient experience.
J Patient Exp 2017 Mar;4(1):37-45. doi: 10.1177/2374373516685940.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Primary Care, Quality of Care, Quality Measures
Oladeru OA, Hamadu M, Cleary PD
House staff communication training and patient experience scores.
The purpose of this study was to assess whether communication training for housestaff via role-playing exercises (1) was well-received and (2) improved patient experience scores in housestaff clinics. Forty-four of a possible 45 housestaff (97.8%) participated, with 31 (70.5%) indicating that the role-playing exercise increased their perception of the 5-step strategy the study emphasized.
AHRQ-funded; HS016978.
Citation: Oladeru OA, Hamadu M, Cleary PD .
House staff communication training and patient experience scores.
J Patient Exp 2017 Mar 1;4(1):28-36. doi: 10.1177/2374373517694533..
Keywords: Communication, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Patient Experience, Training
Elliott MN, Cohea CW, Lehrman WG
Accelerating improvement and narrowing gaps: trends in patients' experiences with hospital care reflected in HCAHPS public reporting.
The researchers describe the experiences of over 4 million patients discharged from hospitals that participated in the second and fifth years of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) public reporting and assess the changes in HCAHPS scores across different types of hospital and patient groups. They found that HCAHPS scores increased by 2.8 percentage points from 2008 to 2011 in the most positive response category.
AHRQ-funded; HS016978.
Citation: Elliott MN, Cohea CW, Lehrman WG .
Accelerating improvement and narrowing gaps: trends in patients' experiences with hospital care reflected in HCAHPS public reporting.
Health Serv Res 2015 Dec;50(6):1850-67. doi: 10.1111/1475-6773.12305..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Quality of Care, Public Reporting
Aboumatar HJ, Chang BH, Danaf J
Promising practices for achieving patient-centered hospital care: a national study of high-performing US hospitals.
The researchers conducted a national study of hospitals that achieved the highest performance on Hospital Consumer Assessment of Healthcare Providers and Systems HCAHPS to identify promising practices for improving patient-centeredness, common challenges met, and how those were addressed. They found that high-performing hospitals used a set of patient-centered care processes that involved both leaders and clinicians in ensuring that patient needs and preferences are addressed.
AHRQ-funded; HS021921.
Citation: Aboumatar HJ, Chang BH, Danaf J .
Promising practices for achieving patient-centered hospital care: a national study of high-performing US hospitals.
Med Care 2015 Sep;53(9):758-67. doi: 10.1097/mlr.0000000000000396..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Patient Experience, Quality of Care, Patient-Centered Outcomes Research
Toomey SL, Zaslavsky AM, Elliott MN
The development of a pediatric inpatient experience of care measure: Child HCAHPS.
This article describes the development of Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), which included a national field test with 69 hospitals in 34 States, psychometric analysis, and end-user testing of the final survey. The final Child HCAHPS instrument has 62 items, including 39 patient experience items, 10 screeners, 12 demographic/descriptive items and 1 open-ended item.
AHRQ-funded; HS020513.
Citation: Toomey SL, Zaslavsky AM, Elliott MN .
The development of a pediatric inpatient experience of care measure: Child HCAHPS.
Pediatrics 2015 Aug;136(2):360-9. doi: 10.1542/peds.2015-0966..
Keywords: Children/Adolescents, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Inpatient Care, Patient Experience, Quality of Care
Thorpe CT, Johnson H, Dopp AL
Medication oversupply in patients with diabetes.
This article describes the development of Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), which included a national field test with 69 hospitals in 34 States, psychometric analysis, and end-user testing of the final survey. The final Child HCAHPS instrument has 62 items, including 39 patient experience items, 10 screeners, 12 demographic/descriptive items and 1 open-ended item.
AHRQ-funded; HS000083; HS018368; HS017646.
Citation: Thorpe CT, Johnson H, Dopp AL .
Medication oversupply in patients with diabetes.
Res Social Adm Pharm 2015 May-Jun;11(3):382-400. doi: 10.1016/j.sapharm.2014.09.002..
Keywords: Medication, Diabetes, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Hospitals
Zhu J, Weingart SN, Ritter GA
Racial/Ethnic disparities in patient experience with communication in hospitals: real differences or measurement errors?
This study examined assumptions about the degree of commonality across racial/ethnic groups in their perceptions and investigated the validity of racial/ethnic differences in communication quality. Its results provide strongest support for racial/ethnic comparisons on communication with nurses and doctors, and reason to caution against comparisons on communication about medicines due to significant differences in model parameters across groups.
AHRQ-funded; 290010003.
Citation: Zhu J, Weingart SN, Ritter GA .
Racial/Ethnic disparities in patient experience with communication in hospitals: real differences or measurement errors?
Med Care 2015 May;53(5):446-54. doi: 10.1097/mlr.0000000000000350..
Keywords: Disparities, Clinician-Patient Communication, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Racial and Ethnic Minorities, Quality of Care
Nembhard IM, Yuan CT, Shabanova V
The relationship between voice climate and patients' experience of timely care in primary care clinics.
The aims of this study were to assess the relationship between organizational climate and patients’ reports of timely care in primary care clinics and to broadly examine the link between staff’s work environment and patient care experiences. It found that clinical and administrative staff (e.g., nurses and office assistants) reported clinics’ climates to be significantly less supportive of voice than did clinical leaders (e.g., physicians).
AHRQ-funded; HS018987; HS016978.
Citation: Nembhard IM, Yuan CT, Shabanova V .
The relationship between voice climate and patients' experience of timely care in primary care clinics.
Health Care Manage Rev 2015 Apr-Jun;40(2):104-15. doi: 10.1097/hmr.0000000000000017..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Primary Care, Quality of Care, Organizational Change, Provider
Anhang Price R, Elliott MN, Cleary PD
Should health care providers be accountable for patients' care experiences?
Using evidence from the Consumer Assessment of Healthcare Providers and Systems surveys, the authors address seven common critiques of patient experience measures. These include: lack of consumer expertise, the subjectivity of patient satisfaction, and the trade-off between providing good patient experiences and providing high-quality clinical care.
AHRQ-funded; HS016980; HS016978
Citation: Anhang Price R, Elliott MN, Cleary PD .
Should health care providers be accountable for patients' care experiences?
J Gen Intern Med. 2015 Feb;30(2):253-6. doi: 10.1007/s11606-014-3111-7..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Patient Experience, Patient-Centered Healthcare
Shadel WG, Elliott MN, Haas AC
Clinician advice to quit smoking among seniors.
This study describes patterns of clinician cessation advice to US seniors, including variation by Medicare beneficiary characteristics. It found that only 51% of smokers say they receive cessation advice “always” or “usually” at doctor visits, with advice more often given to the young, those in low-smoking regions, Asians, and women.
AHRQ-funded; HS016978.
Citation: Shadel WG, Elliott MN, Haas AC .
Clinician advice to quit smoking among seniors.
Prev Med 2015 Jan;70:83-9. doi: 10.1016/j.ypmed.2014.11.020..
Keywords: Tobacco Use, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Education: Patient and Caregiver, Medicare, Clinician-Patient Communication
Schlesinger M, Kanouse DE, Martino SC
Complexity, public reporting, and choice of doctors: a look inside the blackest box of consumer behavior.
The authors identified four pathways through which complexity may impair consumer choice. They examined these pathways using data from an experiment in which consumers hypothetically selected a primary care physician. They found that some of the loss of decision quality accompanying more complex choice sets can be explained by consumers' skills and decision-making style, but even after accounting for these factors, complexity undermines the quality of decision making in ways that cannot be fully explained. They concluded by discussing implications for report designers, sponsors, and policy makers aspiring to promote consumer empowerment and health care quality.
AHRQ-funded; HS016978; HS016980.
Citation: Schlesinger M, Kanouse DE, Martino SC .
Complexity, public reporting, and choice of doctors: a look inside the blackest box of consumer behavior.
Med Care Res Rev 2014 Oct;71(5 Suppl):38s-64s. doi: 10.1177/1077558713496321.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Shared Decision Making, Quality of Care, Primary Care, Public Reporting
Shaller D, Kanouse DE, Schlesinger M
Context-based strategies for engaging consumers with public reports about health care providers.
The authors identified three key factors influencing consumer engagement and showed how they manifest in different ways and combinations for four particular choice contexts that appear to offer realistic opportunities for engagement. They also analyzed how these engagement factors play out differently in each choice context and suggest specific strategies that sponsors of public reports can use in each context.
AHRQ-funded; HS016978; HS016980.
Citation: Shaller D, Kanouse DE, Schlesinger M .
Context-based strategies for engaging consumers with public reports about health care providers.
Med Care Res Rev 2014 Oct;71(5 Suppl):17s-37s. doi: 10.1177/1077558713493118.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Patient and Family Engagement, Public Reporting
Anhang Price R, Elliott MN, Zaslavsky AM
Examining the role of patient experience surveys in measuring health care quality.
The authors reviewed the literature on the association between patient experiences and other measures of health care quality. They concluded that patient experience measures that are collected using psychometrically sound instruments, employing recommended sample sizes and adjustment procedures, and implemented according to standard protocols are intrinsically meaningful and are appropriate complements for clinical process and outcome measures in public reporting and pay-for-performance programs.
AHRQ-funded; HS016980; HS016978.
Citation: Anhang Price R, Elliott MN, Zaslavsky AM .
Examining the role of patient experience surveys in measuring health care quality.
Med Care Res Rev 2014 Oct;71(5):522-54. doi: 10.1177/1077558714541480.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Quality of Care, Quality Improvement, Quality Measures
Hays RD, Berman LJ, Kanter MH
Evaluating the psychometric properties of the CAHPS Patient-Centered Medical Home survey.
This study surveyed Medicare beneficiaries to evaluate the reliability and validity of a new five-item care coordination measure. The composite score had a strong unique association with the CAHPS global rating of health care, after controlling for the CAHPS core composite scores.
AHRQ-funded; HS016980
Citation: Hays RD, Berman LJ, Kanter MH .
Evaluating the psychometric properties of the CAHPS Patient-Centered Medical Home survey.
Clin Ther. 2014 May;36(5):689-696.e1. doi: 10.1016/j.clinthera.2014.04.004..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Medicare, Patient Experience, Patient-Centered Healthcare