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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.

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1 to 14 of 14 Research Studies Displayed
Rundell SD, Goode AP, Friedly JL
Role of health services research in producing high-value rehabilitation care.
The overall purpose of this article is to present a framework to help clinicians, researchers, educators, and policy makers better understand the role of health services research in developing and evaluating evidence on value in rehabilitation. The authors believe that rehabilitation professionals have a great opportunity to increase their engagement in describing, evaluating, delivering, and disseminating high-value care, but there are several barriers they need to consider to be most successful.
AHRQ-Funded HS022982.
Citation: Rundell SD, Goode AP, Friedly JL . Role of health services research in producing high-value rehabilitation care. Phys Ther 2015 Dec;95(12):1703-11. doi: 10.2522/ptj.20150033..
View abstract on the National Library of Medicine site.
Keywords: Health Services Research (HSR), Rehabilitation, Patient-Centered Outcomes Research, Comparative Effectiveness, Value
Leland NE, Gozalo P, Christian TJ
An examination of the first 30 days after patients are discharged to the community from hip fracture postacute care.
This study examined the percentage of PAC patients who remain in the community at least 30 days after discharge (i.e., successful community discharge) after hip fracture rehabilitation and described differences among PAC facilities based on this outcome. It found that between 1999 and 2007, 57 percent of patients achieved successful community discharge. Black were less likely than similar whites to achieve successful community discharge.
AHRQ-funded; HS000011.
Citation: Leland NE, Gozalo P, Christian TJ . An examination of the first 30 days after patients are discharged to the community from hip fracture postacute care. Med Care 2015 Oct;53(10):879-87. doi: 10.1097/mlr.0000000000000419..
View abstract on the National Library of Medicine site.
Keywords: Rehabilitation, Injuries and Wounds, Outcomes, Innovations and Emerging Issues
Doll JA, Hellkamp A, Ho PM
Participation in cardiac rehabilitation programs among older patients after acute myocardial infarction.
This study identified opportunities to improve the use of cardiac rehabilitation by older adults. It concluded that quality improvement efforts should focus not only on increasing referral rates but also on addressing barriers to attending rehabilitation sessions, such as travel distance, copayments, and lack of coordination between inpatient and outpatient clinicians.
AHRQ-funded; HS021092.
Citation: Doll JA, Hellkamp A, Ho PM . Participation in cardiac rehabilitation programs among older patients after acute myocardial infarction. JAMA Intern Med 2015 Oct;175(10):1700-2. doi: 10.1001/jamainternmed.2015.3819..
View abstract on the National Library of Medicine site.
Keywords: Elderly, Heart Disease and Health, Rehabilitation, Patient Adherence/Compliance, Patient-Centered Outcomes Research
Bates BE, Xie D, Kwong PL
Development and validation of prognostic indices for recovery of physical functioning following stroke: part 1.
The purpose of this study was to develop a prognostic index using Functional Independence Measure grades and stages that would enable clinicians to determine the likelihood of achieving a level of minimum assistance with physical functioning after a stroke. It concluded that by using a simple tool, clinicians can forecast the likelihood of recovery to or above the physical grade IV benchmark by the conclusion of rehabilitation services during the acute stroke hospitalization.
AHRQ-funded; HS018540.
Citation: Bates BE, Xie D, Kwong PL . Development and validation of prognostic indices for recovery of physical functioning following stroke: part 1. PM R 2015 Jul;7(7):685-98. doi: 10.1016/j.pmrj.2015.01.011..
View abstract on the National Library of Medicine site.
Keywords: Stroke, Rehabilitation, Outcomes
Bates BE, Xie D, Kwong PL
Development and validation of prognostic indices for recovery of physical functioning following stroke: part 2.
The purpose of this study was to develop a prognostic index for achievement of modified independence (Functional Independence Measure grade VI) after completion of either comprehensive or consultative rehabilitation after stroke. It found that functional recovery to physical grade VI can be predicted on the basis of patients’ initial status after a stroke occurs and the type of rehabilitation services to be provided by using a simple scoring system.
AHRQ-funded; HS018540.
Citation: Bates BE, Xie D, Kwong PL . Development and validation of prognostic indices for recovery of physical functioning following stroke: part 2. PM R 2015 Jul;7(7):699-710. doi: 10.1016/j.pmrj.2015.01.012..
View abstract on the National Library of Medicine site.
Keywords: Stroke, Rehabilitation, Outcomes
Reistetter TA, Kuo YF, Karmarkar AM
Geographic and facility variation in inpatient stroke rehabilitation: multilevel analysis of functional status.
This study examined geographic and facility variation in cognitive and motor functional outcomes after postacute inpatient rehabilitation in patients with stroke. Its findings suggest that variation in motor and cognitive function at discharge after postacute rehabilitation in patients with stroke is accounted for more by facility than geographic location.
AHRQ-funded; HS022134.
Citation: Reistetter TA, Kuo YF, Karmarkar AM . Geographic and facility variation in inpatient stroke rehabilitation: multilevel analysis of functional status. Arch Phys Med Rehabil 2015 Jul;96(7):1248-54. doi: 10.1016/j.apmr.2015.02.020..
View abstract on the National Library of Medicine site.
Keywords: Stroke, Rehabilitation, Patient-Centered Outcomes Research
Skolasky RL, Maggard AM, Li D
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part I: Improvement in rehabilitation engagement and functional outcomes.
This study examined whether a brief motivational interviewing-based health behavior change counseling (HBCC) intervention increased patient participation in physical therapy and/or home exercise programs (HEPs), reduced disability, and improved health status after surgery for degenerative lumbar spinal stenosis. It found that HBCC can improve outcomes after spine surgery through improved rehabilitation participation.
AHRQ-funded; HS017990.
Citation: Skolasky RL, Maggard AM, Li D . Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part I: Improvement in rehabilitation engagement and functional outcomes. Arch Phys Med Rehabil 2015 Jul;96(7):1200-7. doi: 10.1016/j.apmr.2015.03.009..
View abstract on the National Library of Medicine site.
Keywords: Patient Adherence/Compliance, Surgery, Comparative Effectiveness, Rehabilitation, Back Health and Pain
Skolasky RL, Maggard AM, Li D
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part II: Patient activation mediates the effects of health behavior change counseling on rehabilitation engagement.
This study sought to determine the effect of health behavior change counseling (HBCC) on patient activation and the influence of patient activation on rehabilitation engagement, and to identify common barriers to engagement among individuals undergoing surgery for degenerative lumbar spinal stenosis. It found that the influence of HBCC on rehabilitation engagement was mediated by patient activation. Despite improvements in patient activation, one-third of patients reported low rehabilitation engagement.
AHRQ-funded; HS017990.
Citation: Skolasky RL, Maggard AM, Li D . Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part II: Patient activation mediates the effects of health behavior change counseling on rehabilitation engagement. Arch Phys Med Rehabil 2015 Jul;96(7):1208-14. doi: 10.1016/j.apmr.2015.02.031..
View abstract on the National Library of Medicine site.
Keywords: Patient Adherence/Compliance, Surgery, Comparative Effectiveness, Rehabilitation, Back Health and Pain
Meagher AD, Beadles CA, Doorey J
Racial and ethnic disparities in discharge to rehabilitation following traumatic brain injury.
The authors investigate racial disparities in discharge destination (inpatient rehabilitation vs skilled nursing facility vs home health vs home) following traumatic brain injury. They found that Hispanic and black patients were significantly less likely to be discharged to a higher level of rehabilitation than similarly matched non-Hispanic white patients. This disparity persisted in the subgroup examination of older adults with uniform Medicare coverage.
AHRQ-funded; HS000032.
Citation: Meagher AD, Beadles CA, Doorey J . Racial and ethnic disparities in discharge to rehabilitation following traumatic brain injury. J Neurosurg 2015 Mar;122(3):595-601. doi: 10.3171/2014.10.jns14187..
View abstract on the National Library of Medicine site.
Keywords: Disparities, Racial / Ethnic Minorities, Brain Injury, Rehabilitation, Hospital Discharge
Stein J, Bettger JP, Sicklick A
Use of a standardized assessment to predict rehabilitation care after acute stroke.
The purpose of this project was to pilot a formal assessment of rehabilitation needs that included standardized measures of function and sociodemographic factors known to influence referral and utilization of rehabilitation after an acute stroke. It concluded that one of the standardized measures of function, the Barthel Index, is easy to use and appears to distinguish patients who can return directly home versus those who require institution-based rehabilitation.
AHRQ-funded; HS019479.
Citation: Stein J, Bettger JP, Sicklick A . Use of a standardized assessment to predict rehabilitation care after acute stroke. Arch Phys Med Rehabil 2015 Feb;96(2):210-7. doi: 10.1016/j.apmr.2014.07.403..
View abstract on the National Library of Medicine site.
Keywords: Stroke, Rehabilitation, Nursing Homes, Decision Making
Luciano A, Meara E
Employment status of people with mental illness: national survey data from 2009 and 2010.
The researchers aimed to describe employment according to mental illness severity in the United States during 2009 and 2010. They found that more severe mental illness was associated with lower employment rates in 2009 and 2010, and they concluded that people with serious mental illness were less likely than people with no, mild, or moderate mental illness to be employed after age 49.
AHRQ-funded; HS022191.
Citation: Luciano A, Meara E . Employment status of people with mental illness: national survey data from 2009 and 2010. Psychiatr Serv 2014 Oct;65(10):1201-9. doi: 10.1176/appi.ps.201300335.
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View abstract on the National Library of Medicine site.
Keywords: Data, Behavioral Health, Rehabilitation
Wang CY, Graham JE, Karmarkar AM
FIM motor scores for classifying community discharge after inpatient rehabilitation for hip fracture.
A major goal of this study was to identify which discharge functional independence measure (FIM)--total, motor, or cognition--best discriminates community versus institutional discharges. It found that the FIM motor scale yields the best overall discrimination of patients discharged to the community versus those discharged to an institution after inpatient rehabilitation for hip fracture.
AHRQ-funded; HS022134.
Citation: Wang CY, Graham JE, Karmarkar AM . FIM motor scores for classifying community discharge after inpatient rehabilitation for hip fracture. PM & R : the journal of injury, function, and rehabilitation 2014 Jun;6(6):493-7. doi: 10.1016/j.pmrj.2013.12.008..
View abstract on the National Library of Medicine site.
Keywords: Hospital Discharge, Rehabilitation, Injuries and Wounds, Elderly
Ottenbacher KJ, Karmarkar A, Graham JE
Thirty-day hospital readmission following discharge from postacute rehabilitation in fee-for-service Medicare patients.
This study sought to determine 30-day readmission rates and factors related to readmission for patients receiving postacute inpatient rehabilitation. It found that among postacute rehabilitation facilities providing services to Medicare fee-for-service beneficiaries, 30-day readmission rates ranged from 5.8 percent to 18.8 percent for selected impairment groups.
AHRQ-funded; HS022134.
Citation: Ottenbacher KJ, Karmarkar A, Graham JE . Thirty-day hospital readmission following discharge from postacute rehabilitation in fee-for-service Medicare patients. JAMA 2014 Feb 12;311(6):604-14. doi: 10.1001/jama.2014.8..
View abstract on the National Library of Medicine site.
Keywords: Hospital Readmissions, Medicare, Rehabilitation, Elderly, Quality Indicators (QIs)
Stineman MG, Xie D, Kurichi JE
Comprehensive versus consultative rehabilitation services postacute stroke: outcomes differ.
The researchers compared outcomes of veteran patients provided with comprehensive rehabilitation with those provided with consultative rehabilitation services after acute stroke using propensity scores. They found that comprehensive rehabilitation services are associated with greater recovery of physical and cognitive independence, improved home discharge likelihood, and improved 1 yr. survival.
AHRQ-funded; HS018540.
Citation: Stineman MG, Xie D, Kurichi JE . Comprehensive versus consultative rehabilitation services postacute stroke: outcomes differ. J Rehabil Res Dev 2014;51(7):1143-54. doi: 10.1682/jrrd.2014.03.0084..
View abstract on the National Library of Medicine site.
Keywords: Comparative Effectiveness, Rehabilitation, Stroke, Patient-Centered Outcomes Research, Veterans

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