National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Blood Clots (1)
- Caregiving (1)
- Children/Adolescents (1)
- Decision Making (2)
- Dental and Oral Health (1)
- Disparities (1)
- Education: Continuing Medical Education (1)
- Education: Patient and Caregiver (2)
- Elderly (1)
- Emergency Department (1)
- Emergency Medical Services (EMS) (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Costs (2)
- Healthcare Delivery (1)
- Health Services Research (HSR) (2)
- Hospitals (3)
- Long-Term Care (2)
- Medicare (2)
- Mortality (1)
- Nursing Homes (2)
- Outcomes (1)
- Palliative Care (1)
- Patient-Centered Outcomes Research (1)
- Patient Experience (2)
- Patient Safety (4)
- Payment (7)
- Policy (4)
- Prevention (1)
- Provider (2)
- Provider: Health Personnel (2)
- (-) Provider Performance (21)
- Public Reporting (4)
- Quality Improvement (10)
- Quality Indicators (QIs) (5)
- Quality Measures (6)
- Quality of Care (14)
- Sex Factors (1)
- Surgery (3)
- Workforce (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 21 of 21 Research Studies DisplayedKronick R, Casalino LP, Bindman AB
AHRQ Author: Kronick R
Apple pickers or federal judges: strong versus weak incentives in physician payment.
The authors provide an introduction for five papers commissioned by AHRQ focusing on incentives for physicians that are featured in this special issue of Health Services Research. These papers concentrate on suggesting a conceptual framework for the use of financial incentives in health care, key implications of the evidence to date on pay for performance and public reporting in health care and several related topics.
AHRQ-authored.
Citation: Kronick R, Casalino LP, Bindman AB .
Apple pickers or federal judges: strong versus weak incentives in physician payment.
Health Serv Res 2015 Dec;50 Suppl 2:2049-56. doi: 10.1111/1475-6773.12424.
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Keywords: Payment, Provider Performance, Policy, Health Services Research (HSR), Quality of Care, Healthcare Costs, Quality Improvement
Berenson RA, Rice T
Beyond measurement and reward: methods of motivating quality improvement and accountability.
The article examines public policies designed to improve quality and accountability that do not rely on financial incentives and public reporting of provider performance. It concludes that public policies related to quality improvement should focus more on methods of enhancing professional intrinsic motivation, while recognizing the potential role of organizations to actively promote and facilitate that motivation.
AHRQ-funded
Citation: Berenson RA, Rice T .
Beyond measurement and reward: methods of motivating quality improvement and accountability.
Health Serv Res 2015 Dec;50 Suppl 2:2155-86. doi: 10.1111/1475-6773.12413.
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Keywords: Quality Improvement, Policy, Provider Performance, Quality of Care, Payment
Layton TJ, Ryan AM
Higher incentive payments in Medicare Advantage's pay-for-performance program did not improve quality but did increase plan offerings.
The researchers evaluated the effects of the size of financial bonuses on quality of care and the number of plan offerings in the Medicare Advantage Quality Bonus Payment Demonstration. They concluded that at great expense to Medicare, double bonuses in the Medicare Advantage Quality Bonus Payment Demonstration were not associated with improved quality but were associated with more plan offerings.
AHRQ-funded; HS018546.
Citation: Layton TJ, Ryan AM .
Higher incentive payments in Medicare Advantage's pay-for-performance program did not improve quality but did increase plan offerings.
Health Serv Res 2015 Dec;50(6):1810-28. doi: 10.1111/1475-6773.12409..
Keywords: Medicare, Payment, Provider Performance, Health Services Research (HSR), Quality Improvement, Quality of Care
Schlesinger M, Grob R, Shaller D
Using patient-reported information to improve clinical practice.
The purposes of this study were to assess what is known about the relationship between patient experience measures and incentives designed to improve care, and to identify how public policy and medical practices can promote patient-valued outcomes in health systems with strong financial incentives. It concluded that unless public policies are attentive to patients' perspectives, stronger financial incentives for clinicians can threaten aspects of care that patients most value.
AHRQ-funded.
Citation: Schlesinger M, Grob R, Shaller D .
Using patient-reported information to improve clinical practice.
Health Serv Res 2015 Dec;50 Suppl 2:2116-54. doi: 10.1111/1475-6773.12420.
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Keywords: Quality Improvement, Quality of Care, Patient Experience, Provider Performance, Policy, Payment, Public Reporting
Le Grand Rogers R, Narvaez Y, Venkatesh AK
Improving emergency physician performance using audit and feedback: a systematic review.
The objective of the review was to assess the effect of audit and feedback on emergency physician performance and identify features critical to success. It concluded that the literature on audit and feedback in the ED reports positive results for interventions across numerous clinical conditions but without the standardized reporting sufficient for meta-analysis.
AHRQ-funded; HS021271.
Citation: Le Grand Rogers R, Narvaez Y, Venkatesh AK .
Improving emergency physician performance using audit and feedback: a systematic review.
Am J Emerg Med 2015 Oct;33(10):1505-14. doi: 10.1016/j.ajem.2015.07.039..
Keywords: Provider Performance, Emergency Medical Services (EMS), Emergency Department
Waljee JF
Discussion: Are quantitative measures of academic productivity correlated with academic rank in plastic surgery? A national study.
The author argues that although bibliometric indices are a readily available assessment of scholarly productivity, important unanswered questions remain regarding their applications and limitations as measures of academic performance.
AHRQ-funded; HS023313.
Citation: Waljee JF .
Discussion: Are quantitative measures of academic productivity correlated with academic rank in plastic surgery? A national study.
Plast Reconstr Surg 2015 Sep;136(3):622-3. doi: 10.1097/prs.0000000000001566..
Keywords: Provider, Provider Performance, Surgery
Waljee JF, Chang KW, Kim HM
Gender disparities in academic practice.
The authors sought to examine differences in faculty position and professional satisfaction among academic physicians by gender. They found that men more often held tenure track positions compared with women and women reported lower levels of professional satisfaction in academic practice compared with men.
AHRQ-funded; HS023313.
Citation: Waljee JF, Chang KW, Kim HM .
Gender disparities in academic practice.
Plast Reconstr Surg 2015 Sep;136(3):380e-87e. doi: 10.1097/prs.0000000000001530..
Keywords: Disparities, Provider, Provider Performance, Sex Factors
Mukamel DB, Ye Z, Glance LG
Does mandating nursing home participation in quality reporting make a difference? Evidence from Massachusetts.
This study investigated one of the mechanisms that may detract from the effectiveness of quality report cards: voluntary versus mandatory participation of nursing homes in public quality reporting. It found that once reporting became mandatory, nonvolunteers improved more than volunteers in all but 2 staffing measures.
AHRQ-funded; HS021844.
Citation: Mukamel DB, Ye Z, Glance LG .
Does mandating nursing home participation in quality reporting make a difference? Evidence from Massachusetts.
Med Care 2015 Aug;53(8):713-9. doi: 10.1097/mlr.0000000000000390..
Keywords: Nursing Homes, Long-Term Care, Public Reporting, Provider Performance, Quality Improvement, Quality of Care, Quality Indicators (QIs), Quality Measures, Elderly
Rajaram R, Chung JW, Kinnier CV
Hospital characteristics associated with penalties in the Centers for Medicare & Medicaid Services Hospital-Acquired Condition Reduction Program.
The purpose of this study was to examine the characteristics of hospitals penalized by the Hospital-Acquired Condition (HAC) Reduction Program. It found that among hospitals participating in the HAC Reduction Program, hospitals that were penalized more frequently had more quality accreditations, and had better performance on other process and outcome measure.
AHRQ-funded; HS000078.
Citation: Rajaram R, Chung JW, Kinnier CV .
Hospital characteristics associated with penalties in the Centers for Medicare & Medicaid Services Hospital-Acquired Condition Reduction Program.
JAMA 2015 Jul 28;314(4):375-83. doi: 10.1001/jama.2015.8609..
Keywords: Hospitals, Healthcare-Associated Infections (HAIs), Patient Safety, Provider Performance
Smith B, McDuff J, Naierman N
What consumers want to know about quality when choosing a hospice provider.
This study drew on focus group and survey data collected in 5 metropolitan areas to learn more about hospice quality data. The researchers found that participants placed top priority on measures related to pain and symptom management. The National Quality Forum-approved measures resonate well with consumers, who also appear to be ready for access to data on the quality of hospice providers.
AHRQ-funded; HS021870.
Citation: Smith B, McDuff J, Naierman N .
What consumers want to know about quality when choosing a hospice provider.
Am J Hosp Palliat Care 2015 Jun;32(4):393-400. doi: 10.1177/1049909114524475.
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Keywords: Caregiving, Education: Patient and Caregiver, Decision Making, Palliative Care, Provider Performance, Public Reporting, Quality of Care, Quality Indicators (QIs)
Abrahamson K, Miech E, Davila HW
Pay-for-performance policy and data-driven decision making within nursing homes: a qualitative study.
The researchers explored ways in which data were collected, thought about and used by nursing home employees as a result of participation in a pay-for-performance (P4P) program. Their findings indicated that participants in the Minnesota Performance-based Incentive Payment Program’s quality improvement (QI) projects perceived a change in the rate and manner in which they gathered, used, and considered data in their QI decisions.
AHRQ-funded; HS018464
Citation: Abrahamson K, Miech E, Davila HW .
Pay-for-performance policy and data-driven decision making within nursing homes: a qualitative study.
BMJ Qual Saf. 2015 May;24(5):311-7. doi: 10.1136/bmjqs-2014-003362..
Keywords: Nursing Homes, Long-Term Care, Payment, Provider Performance, Decision Making, Policy, Quality Improvement, Quality of Care
Michtalik HJ, Carolan HT, Haut ER
Use of provider-level dashboards and pay-for-performance in venous thromboembolism prophylaxis.
The researchers sequentially examined an individualized physician dashboard and pay-for-performance program to improve venous thromboembolism (VTE) prophylaxis rates among hospitalists. They found that direct feedback using dashboards was associated with significantly improved compliance, with further improvement after incorporating an individual physician pay-for-performance program.
AHRQ-funded; HS017952; HS022331.
Citation: Michtalik HJ, Carolan HT, Haut ER .
Use of provider-level dashboards and pay-for-performance in venous thromboembolism prophylaxis.
J Hosp Med 2015 Mar;10(3):172-8. doi: 10.1002/jhm.2303..
Keywords: Provider Performance, Payment, Blood Clots, Prevention, Quality Improvement, Quality of Care, Hospitals, Patient Safety
Ryan AM, Burgess JF, Pesko MF
The early effects of Medicare's mandatory hospital pay-for-performance program.
This study evaluated the impact of hospital value-based purchasing (HVBP) on clinical quality and patient experience during its initial implementation period. It found that hospitals that were exposed to HVBP did not show greater improvement for either the clinical process or patient experience measures during the program’s initial implementation period.
AHRQ-funded; HS018546
Citation: Ryan AM, Burgess JF, Pesko MF .
The early effects of Medicare's mandatory hospital pay-for-performance program.
Health Serv Res. 2015 Feb;50(1):81-97. doi: 10.1111/1475-6773.12206..
Keywords: Medicare, Provider Performance, Payment, Hospitals, Quality Improvement, Quality of Care, Patient Experience
Dill JS, Morgan JC, Weiner B
Frontline health care workers and perceived career mobility: do high-performance work practices make a difference?
This study examined how high-performance work practices (HPWPs) that focus on career development are related to an individuals' perceived mobility with their current employer, and also examined the relationships between perceived mobility, job satisfaction, and turnover intent. The findings suggest that tuition remission and educational release time positively predict perceived mobility, while measures of perceived organizational support in one's current position and perceived supervisor support for career development are also significant predictors of perceived mobility. Additionally, perceived mobility is a significant predictor of job satisfaction and intent to stay with current employer.
AHRQ-funded; HS000032.
Citation: Dill JS, Morgan JC, Weiner B .
Frontline health care workers and perceived career mobility: do high-performance work practices make a difference?
Health Care Manage Rev 2014 Oct-Dec;39(4):318-28. doi: 10.1097/HMR.0b013e31829fcbfd.
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Keywords: Provider: Health Personnel, Provider Performance, Workforce
Hussey PS, Luft HS, McNamara P
AHRQ Author: McNamara P
Public reporting of provider performance at a crossroads in the United States: summary of current barriers and recommendations on how to move forward.
The authors presented a vision statement and 10 recommendations for public reports to achieve their potential for engaging and informing consumers.
AHRQ-authored; AHRQ-funded.
Citation: Hussey PS, Luft HS, McNamara P .
Public reporting of provider performance at a crossroads in the United States: summary of current barriers and recommendations on how to move forward.
Med Care Res Rev 2014 Oct;71(5 Suppl):5s-16s. doi: 10.1177/1077558714535980.
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Keywords: Education: Patient and Caregiver, Quality of Care, Provider: Health Personnel, Provider Performance, Public Reporting
Bevans KB, Moon J, Carle AC
Patient reported outcomes as indicators of pediatric health care quality.
The authors described and illustrated in case examples the functions, benefits, and challenges of patient-reported outcomes applications. They concluded that pediatric patient-reported outcomes are increasingly recognized as valuable indicators of health care quality in the clinical environment and as measures of organization- and provider-level performance.
AHRQ-funded; HS020408.
Citation: Bevans KB, Moon J, Carle AC .
Patient reported outcomes as indicators of pediatric health care quality.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S90-6. doi: 10.1016/j.acap.2014.06.002..
Keywords: Children/Adolescents, Quality of Care, Children/Adolescents, Quality Indicators (QIs), Quality Measures, Provider Performance
Hockenberry JM, Helmchen LA
The nature of surgeon human capital depreciation.
The authors estimated how temporal breaks affect surgeons' performance of coronary artery bypass grafting (CABG). They found that a surgeon's additional day away from the operating room raised patients' inpatient mortality by up to 0.067 percentage points but reduced total hospitalization costs by up to 0.59 percentage points, and among emergent patients treated by high-volume providers, an additional day away raised mortality risk by 0.398 percentage points but reduced cost by up to 1.4 percentage points. They concluded that their results are consistent with the hypothesis that as temporal distance increases, surgeons are less likely to recognize and address life-threatening complications.
AHRQ-funded; HS019743.
Citation: Hockenberry JM, Helmchen LA .
The nature of surgeon human capital depreciation.
J Health Econ 2014 Sep;37:70-80. doi: 10.1016/j.jhealeco.2014.06.001.
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Keywords: Healthcare Costs, Mortality, Provider Performance, Surgery
Maggard-Gibbons M
The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program.
This review summarized the history of American College of Surgeons National Surgical Quality Improvement Project and its components, and described the evidence that feeding outcomes back to providers, along with real-time comparisons with other hospital rates, leads to quality improvement, better patient outcomes, cost savings and overall improved patient safety.
AHRQ-funded; 2902007100621.
Citation: Maggard-Gibbons M .
The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program.
BMJ Qual Saf 2014 Jul;23(7):589-99. doi: 10.1136/bmjqs-2013-002223..
Keywords: Quality Improvement, Quality Indicators (QIs), Quality Measures, Quality of Care, Surgery, Patient Safety, Outcomes, Patient-Centered Outcomes Research, Provider Performance
Arora VM, Berhie S, Horwitz LI
Using standardized videos to validate a measure of handoff quality: the handoff mini-clinical examination exercise.
The researchers report the results of the development of a shorter Handoff Mini-Clinical Examination Exercise (CEX), along with the formal establishment of its construct validity, namely its ability to distinguish between levels of performance in 3 domains of handoff quality. They were able to demonstrate evidence that the Handoff Mini-CEX can draw reliable and valid conclusions regarding handoff performance by physicians in U.S. hospitals.
AHRQ-funded; HS018278
Citation: Arora VM, Berhie S, Horwitz LI .
Using standardized videos to validate a measure of handoff quality: the handoff mini-clinical examination exercise.
J Hospital Med. 2014 Jul;9(7):441-6. doi: 10.1002/jhm.2185.
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Keywords: Provider Performance, Quality Measures, Quality Improvement, Quality of Care, Education: Continuing Medical Education, Patient Safety
Paddock SM
Statistical benchmarks for health care provider performance assessment: a comparison of standard approaches to a hierarchical Bayesian histogram-based method.
The author compares histogram-based statistical benchmarking to other more widely used statistical benchmarking methods to demonstrate whether and how their performance differs, both in terms of setting a performance benchmark and also in terms of which providers are identified as exceeding the performance benchmark. Her study uses publicly available data from 3,240 hospitals on two process-of-care measures.
AHRQ-funded; HS021860
Citation: Paddock SM .
Statistical benchmarks for health care provider performance assessment: a comparison of standard approaches to a hierarchical Bayesian histogram-based method.
Health Serv Res. 2014 Jun;49(3):1056-73. doi: 10.1111/1475-6773.12149..
Keywords: Quality of Care, Quality Measures, Provider Performance
Gibson G, Jurasic MM, Wehler CJ
Longitudinal outcomes of using a fluoride performance measure for adults at high risk of experiencing caries.
In this paper, the authors hypothesized that after the implementation of a performance measure regarding appropriate fluoride use, veterans at high risk of experiencing caries would require fewer new dental restorations than in the past. They found that, after use of the performance measure for four years, there were 8.6 percent fewer patients needing two or more restorations, a 10.8 percent decrease in the mean number of restorations, and a modest 3.4 percent fewer patients at high risk of experiencing caries who required new restorations after the initial 12-month period.
AHRQ-funded; HS019527.
Citation: Gibson G, Jurasic MM, Wehler CJ .
Longitudinal outcomes of using a fluoride performance measure for adults at high risk of experiencing caries.
J Am Dent Assoc 2014 May;145(5):443-51. doi: 10.14219/jada.2013.53.
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Keywords: Dental and Oral Health, Healthcare Delivery, Provider Performance, Quality Indicators (QIs), Quality Measures