National Healthcare Quality and Disparities Report
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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
1 to 25 of 167 Research Studies DisplayedScally CP, Yin H, Birkmeyer JD
Comparing perioperative processes of care in high and low mortality centers performing pancreatic surgery.
The researchers compared high and low mortality hospitals in order to identify differences in patient care impacting safety. They concluded that high and low mortality hospitals both have high compliance with common quality measures; however, high mortality hospitals performed worse in other areas of perioperative care, indicating possible targets for quality improvement efforts.
AHRQ-funded; HS020937.
Citation: Scally CP, Yin H, Birkmeyer JD .
Comparing perioperative processes of care in high and low mortality centers performing pancreatic surgery.
J Surg Oncol 2015 Dec;112(8):866-71. doi: 10.1002/jso.24085.
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Keywords: Surgery, Mortality, Quality Improvement, Outcomes, Patient Safety
DeLia D, Wang HE, Kutzin J
Prehospital transportation to therapeutic hypothermia centers and survival from out-of-hospital cardiac arrest.
This study provides a real world evaluation of the effectiveness of post-arrest care in therapeutic hypothermia (TH) centers during a time of growing TH dissemination in the state of New Jersey. It concluded that post-arrest outcomes are more favorable at TH centers but these improved outcomes are not apparent until after hospital discharge.
AHRQ-funded; HS020097.
Citation: DeLia D, Wang HE, Kutzin J .
Prehospital transportation to therapeutic hypothermia centers and survival from out-of-hospital cardiac arrest.
BMC Health Serv Res 2015 Dec 2;15:533. doi: 10.1186/s12913-015-1199-z.
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Keywords: Cardiovascular Conditions, Comparative Effectiveness, Emergency Medical Services (EMS), Outcomes
Decker SL, Lipton BJ
AHRQ Author: Decker SL
Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health.
This article examines the effect of Medicaid adult dental coverage on use of dental care and dental health outcomes using state-level variation in dental coverage during 2000-2012. Its findings imply that dental coverage is associated with an increase in the likelihood of a recent dental visit, with the size of the effect increasing with Medicaid payment rates to dentists, and a reduction in the likelihood of untreated dental caries.
AHRQ-authored.
Citation: Decker SL, Lipton BJ .
Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health.
J Health Econ 2015 Dec;44:212-25. doi: 10.1016/j.jhealeco.2015.08.009.
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Keywords: Access to Care, Dental and Oral Health, Health Insurance, Healthcare Utilization, Medicaid, Outcomes
Grainger R, Dalbeth N, Keen H
Imaging as an outcome measure in gout studies: Report from the OMERACT Gout Working Group.
Discussion in the Outcome Measures in Rheumatology (OMERACT) working group was focused to consider (1) features of gout that should be recorded using imaging, (2) best methods of measuring these features, and (3) joints that should be imaged. The working group identified 3 relevant domains for imaging in gout studies: urate deposition (tophus burden), joint inflammation, and structural joint damage.
AHRQ-funded; HS021110.
Citation: Grainger R, Dalbeth N, Keen H .
Imaging as an outcome measure in gout studies: Report from the OMERACT Gout Working Group.
J Rheumatol 2015 Dec;42(12):2460-4. doi: 10.3899/jrheum.141164..
Keywords: Imaging, Patient-Centered Outcomes Research, Outcomes, Chronic Conditions
Hersh WR, Totten AM, Eden KB
Outcomes from health information exchange: systematic review and future research needs.
The authors systematically reviewed the available research on health information exchange (HIE) outcomes and analyzed future research needs. After analyzing 34 studies on outcomes of HIE, they found that although the evidence supports benefits of HIE in reducing the use of specific resources and improving the quality of care, the full impact of HIE on clinical outcomes and potential harms are inadequately studied.
AHRQ-funded; 290201200014I.
Citation: Hersh WR, Totten AM, Eden KB .
Outcomes from health information exchange: systematic review and future research needs.
JMIR Med Inform 2015 Dec 15;3(4):e39. doi: 10.2196/medinform.5215.
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Keywords: Quality of Care, Health Information Exchange (HIE), Health Information Technology (HIT), Outcomes
Darger B, Gonzales N, Banuelos RC
Outcomes of patients requiring blood pressure control before thrombolysis with tPA for acute ischemic stroke.
The purpose of this study was to assess safety and efficacy of thrombolysis in the setting of aggressive blood pressure (BP) control as it compares to standard BP control or no BP control prior to thrombolysis. The researchers observed no association between BP control and adverse outcomes in ischemic stroke patients undergoing thrombolysis.
AHRQ-funded; HS017586.
Citation: Darger B, Gonzales N, Banuelos RC .
Outcomes of patients requiring blood pressure control before thrombolysis with tPA for acute ischemic stroke.
West J Emerg Med 2015 Dec;16(7):1002-6. doi: 10.5811/westjem.2015.8.27859.
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Keywords: Blood Pressure, Stroke, Medication, Outcomes
McCarthy IM
Putting the patient in patient reported outcomes: a robust methodology for health outcomes assessment.
Through a series of Monte Carlo simulations, this paper illustrates that reliance solely on the summary score may lead to biased estimates of incremental effects, and proposes a novel two-stage approach that allows for unbiased estimation of incremental effects. The proposed methodology essentially reverses the order of the analysis, from one of 'aggregate, then estimate' to one of 'estimate, then aggregate'.
AHRQ-funded; HS022431.
Citation: McCarthy IM .
Putting the patient in patient reported outcomes: a robust methodology for health outcomes assessment.
Health Econ 2015 Dec;24(12):1588-603. doi: 10.1002/hec.3113.
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Keywords: Patient-Centered Outcomes Research, Outcomes, Quality of Life, Research Methodologies
Lipton BJ, Decker SL
AHRQ Author: Decker SL
The effect of health insurance coverage on medical care utilization and health outcomes: evidence from Medicaid adult vision benefits.
The reserarchers examined the effect of vision insurance on eye care utilization and vision health outcomes by taking advantage of quasi-experimental variation in Medicaid coverage of adult vision care. They found that Medicaid beneficiaries with vision coverage are 4.4 percentage points more likely to have seen an eye doctor in the past year,and 5.3 percentage points less likely to report needing but not purchasing eyeglasses or contacts due to cost.
AHRQ-authored.
Citation: Lipton BJ, Decker SL .
The effect of health insurance coverage on medical care utilization and health outcomes: evidence from Medicaid adult vision benefits.
J Health Econ 2015 Dec;44:320-32. doi: 10.1016/j.jhealeco.2015.10.006.
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Keywords: Medicaid, Eye Disease and Health, Healthcare Utilization, Health Services Research (HSR), Outcomes
Graham JL, Shahani L, Grimes RM
The influence of trust in physicians and trust in the healthcare system on linkage, retention, and adherence to HIV care.
The present study was designed to determine if trust in physicians and the healthcare system among persons newly diagnosed with HIV infection was predictive of patients' subsequent linkage, retention, and adherence to HIV care. No significant association was found between trust-in-physicians and linkage to care or adherence to antiretroviral therapy.
AHRQ-funded; HS016093.
Citation: Graham JL, Shahani L, Grimes RM .
The influence of trust in physicians and trust in the healthcare system on linkage, retention, and adherence to HIV care.
AIDS Patient Care STDS 2015 Dec;29(12):661-7. doi: 10.1089/apc.2015.0156..
Keywords: Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Outcomes, Healthcare Utilization
Petkovic J, Epstein J, Buchbinder R
Toward ensuring health equity: Readability and cultural equivalence of OMERACT patient-reported outcome measures.
The goal of the Outcome Measures in Rheumatology (OMERACT) 12 (2014) equity working group was to determine whether and how comprehensibility of patient-reported outcome measures (PROM) should be assessed, to ensure suitability for people with low literacy and differing cultures. The results of this preconference work were presented to the equity working group participants to gain their perspectives on the importance of comprehensibility and cross-cultural adaptation for PROM.
AHRQ-funded; HS021110.
Citation: Petkovic J, Epstein J, Buchbinder R .
Toward ensuring health equity: Readability and cultural equivalence of OMERACT patient-reported outcome measures.
J Rheumatol 2015 Dec;42(12):2448-59. doi: 10.3899/jrheum.141168.
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Keywords: Patient-Centered Outcomes Research, Outcomes, Health Literacy
Sanghavi P, Jena Newhouse, JP
Outcomes of basic versus advanced life support for out-of-hospital medical emergencies.
The researchers compared outcomes after advanced life support (ALS) and basic life support (BLS) in out-of-hospital medical emergencies. They found that advanced life support is associated with substantially higher mortality for several acute medical emergencies than BLS.
AHRQ-funded; HS022798.
Citation: Sanghavi P, Jena Newhouse, JP .
Outcomes of basic versus advanced life support for out-of-hospital medical emergencies.
Ann Intern Med 2015 Nov 3;163(9):681-90. doi: 10.7326/m15-0557..
Keywords: Elderly, Medicare, Emergency Medical Services (EMS), Outcomes
Gabayan GZ, Derose SF, Chiu VY
Emergency department crowding and outcomes after emergency department discharge.
The researchers assess whether a panel of emergency department (ED) crowding measures, including 2 reported by the Centers for Medicare & Medicaid Services (CMS), is associated with inpatient admission and death within 7 days of ED discharge. Their findings suggest that ED length of stay is a proxy for unmeasured differences in case mix and challenge the validity of the CMS metric as a safety measure for discharged patients.
AHRQ-funded; HS018098.
Citation: Gabayan GZ, Derose SF, Chiu VY .
Emergency department crowding and outcomes after emergency department discharge.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Hospital Discharge, Outcomes, Hospitalization
Blecker S, Goldfeld K, Park H
Impact of an intervention to improve weekend hospital care at an academic medical center: an observational study.
The purpose of this study was to evaluate the impact of a weekend hospital intervention on processes of care and clinical outcomes. The multifaceted intervention included expanded weekend diagnostic services, improved weekend discharge processes, and increased physician and care management services on weekends. The intervention was associated with a reduction in length of stay and an increase in weekend discharges.
AHRQ-funded; HS023683.
Citation: Blecker S, Goldfeld K, Park H .
Impact of an intervention to improve weekend hospital care at an academic medical center: an observational study.
J Gen Intern Med 2015 Nov;30(11):1657-64. doi: 10.1007/s11606-015-3330-6.
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Keywords: Quality Improvement, Quality of Care, Hospitals, Hospital Discharge, Hospital Readmissions, Healthcare Delivery, Outcomes, Patient-Centered Outcomes Research
Grenda TR, Revels SL, Yin H
Lung cancer resection at hospitals with high vs low mortality rates.
The objective of this study was to evaluate perioperative outcomes in patients who underwent lung cancer resection at high-mortality hospitals [HMHs] and low-mortality hospitals [LMHs]) in order to better understand the factors related to differences in mortality rates after lung cancer resection. It concluded that failure-to-rescue rates are higher at HMHs, which may explain the large differences between hospitals in mortality rates following lung cancer resection.
AHRQ-funded; HS000053; HS020937.
Citation: Grenda TR, Revels SL, Yin H .
Lung cancer resection at hospitals with high vs low mortality rates.
JAMA Surg 2015 Nov;150(11):1034-40. doi: 10.1001/jamasurg.2015.2199..
Keywords: Cancer: Lung Cancer, Surgery, Mortality, Outcomes, Patient Safety
Bangalore S, Ogedegbe G, Gyamfi J
Outcomes with angiotensin-converting enzyme inhibitors vs other antihypertensive agents in hypertensive blacks.
The study’s objective was to evaluate the effectiveness of angiotensin-converting enzyme inhibitors when compared with other antihypertensive agents in hypertensive blacks. It found that in a large cohort of hypertensive blacks, angiotensin-converting enzyme inhibitors were associated with less benefit when compared with calcium channel blockers or thiazide diuretics.
AHRQ-funded; HS018589.
Citation: Bangalore S, Ogedegbe G, Gyamfi J .
Outcomes with angiotensin-converting enzyme inhibitors vs other antihypertensive agents in hypertensive blacks.
Am J Med 2015 Nov;128(11):1195-203. doi: 10.1016/j.amjmed.2015.04.034..
Keywords: Blood Pressure, Racial and Ethnic Minorities, Medication, Outcomes, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Comparative Effectiveness
Hu Y, McMurry TL, Stukenborg GJ
Readmission predicts 90-day mortality after esophagectomy: analysis of surveillance, epidemiology, and end results registry linked to Medicare outcomes.
The purpose of this study was to characterize postesophagectomy readmissions and determine their relationship with subsequent 90-day mortality. It found that one in 5 esophagectomy patients are readmitted early after discharge. Readmitted patients have a 5-fold increase in early mortality.
AHRQ-funded; HS018049.
Citation: Hu Y, McMurry TL, Stukenborg GJ .
Readmission predicts 90-day mortality after esophagectomy: analysis of surveillance, epidemiology, and end results registry linked to Medicare outcomes.
J Thorac Cardiovasc Surg 2015 Nov;150(5):1254-60. doi: 10.1016/j.jtcvs.2015.08.071..
Keywords: Hospital Readmissions, Mortality, Outcomes, Registries, Surgery
Kramer RD, Cooke CR, Liu V
Variation in the contents of sepsis bundles and quality measures. a systematic review.
The researchers sought to determine the degree of agreement on component elements of sepsis bundles and the associated timing goals for completion of each element. They also evaluated the amount of variation between metrics associated with bundles. They found that no bundle included metrics evaluating timeliness or completeness of sepsis recognition. Also, there was a lack of consensus on component elements and timing goals across highly recognized sepsis bundles.
AHRQ-funded; HS020672.
Citation: Kramer RD, Cooke CR, Liu V .
Variation in the contents of sepsis bundles and quality measures. a systematic review.
Ann Am Thorac Soc 2015 Nov;12(11):1676-84. doi: 10.1513/AnnalsATS.201503-163BC.
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Keywords: Sepsis, Mortality, Guidelines, Antimicrobial Stewardship, Outcomes
Fritz JM, Magel JS, McFadden M
Early physical therapy vs usual care in patients with recent-onset low back pain: a randomized clinical trial.
This study evaluated whether early physical therapy (manipulation and exercise) is more effective than usual care in improving disability for patients with LBP fitting a decision rule. It concluded that among adults with recent-onset LBP, early physical therapy resulted in statistically significant improvement in disability, but the improvement was modest and did not achieve the minimum clinically important difference compared with usual care.
AHRQ-funded; HS018672.
Citation: Fritz JM, Magel JS, McFadden M .
Early physical therapy vs usual care in patients with recent-onset low back pain: a randomized clinical trial.
JAMA 2015 Oct 13;314(14):1459-67. doi: 10.1001/jama.2015.11648..
Keywords: Back Health and Pain, Comparative Effectiveness, Outcomes, Patient-Centered Outcomes Research
Chang AL, Hurwitz E, Miyamura J
Maternal risk factors and perinatal outcomes among pacific islander groups in Hawaii: a retrospective cohort study using statewide hospital data.
This study compared perinatal outcomes between Pacific Islander and White women who delivered a singleton liveborn in any Hawaii hospital from January 2010 to December 2011. Significant differences in perinatal outcomes between Pacific Islander and White women and newborns were noted. All Pacific Islander groups had an increased risk of hypertension. Native Hawaiians had the highest risk of low birthweight infants.
AHRQ-funded; HS021903.
Citation: Chang AL, Hurwitz E, Miyamura J .
Maternal risk factors and perinatal outcomes among pacific islander groups in Hawaii: a retrospective cohort study using statewide hospital data.
BMC Pregnancy Childbirth 2015 Oct 05;15:239. doi: 10.1186/s12884-015-0671-4.
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Keywords: Maternal Care, Risk, Racial and Ethnic Minorities, Outcomes, Newborns/Infants
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..
Keywords: Rehabilitation, Injuries and Wounds, Hospital Discharge, Hospital Readmissions, Outcomes
Dusetzina SB, Brookhart MA, Maciejewski ML
Control outcomes and exposures for improving internal validity of nonrandomized studies.
The authors review examples of control outcomes and exposures from prior studies and provide recommendations for conducting and reporting these analyses. They found that there is inconsistent terminology for these concepts, making study identification challenging. They recommend that the rigor of nonrandomized studies can be improved with inclusion of control outcomes and exposures for bias detection.
AHRQ-funded; HS023099; HS023085.
Citation: Dusetzina SB, Brookhart MA, Maciejewski ML .
Control outcomes and exposures for improving internal validity of nonrandomized studies.
Health Serv Res 2015 Oct;50(5):1432-51. doi: 10.1111/1475-6773.12279..
Keywords: Research Methodologies, Patient-Centered Outcomes Research, Outcomes
Feldman DS, Bollman DL, Fridman M
Do laborists improve delivery outcomes for laboring women in California community hospitals?
The researchers sought to determine the impact of the laborists staffing model on cesarean rates and maternal morbidity in California community hospitals. They were unable to demonstrate differences in cesarean and maternal childbirth complication rates in community hospitals with and without laborists.
AHRQ-funded; HS020915.
Citation: Feldman DS, Bollman DL, Fridman M .
Do laborists improve delivery outcomes for laboring women in California community hospitals?
Am J Obstet Gynecol 2015 Oct;213(4):587.e1-87.e13. doi: 10.1016/j.ajog.2015.05.051..
Keywords: Labor and Delivery, Outcomes, Patient Safety, Women
Gephart SM, Martin LB, Kijewski A
Joseph's story: a case study of late-onset necrotizing enterocolitis from early birth to recovery.
This case study presents Joseph's story about a 24-week surviving twin who developed severe necrotizing enterocolitis (NEC) at 5 months of age just days before he was to go home. Although NEC struck late and kept Joseph in the neonatal intensive care unit for 228 days, its consequences remain with this resilient child and his family.
AHRQ-funded; HS022908.
Citation: Gephart SM, Martin LB, Kijewski A .
Joseph's story: a case study of late-onset necrotizing enterocolitis from early birth to recovery.
J Perinat Neonatal Nurs 2015 Oct-Dec;29(4):345-55. doi: 10.1097/jpn.0000000000000137.
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Keywords: Case Study, Newborns/Infants, Neonatal Intensive Care Unit (NICU), Newborns/Infants, Outcomes
Wasserstein D, Huston LJ, Nwosu S
KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study.
The researchers applied three different models of Knee injury and Osteoarthritis Outcome Score (KOOS) thresholds for significant knee pain to an anterior cruciate ligament reconstruction (ACLR) cohort to identify prevalence and risk factors. They concluded that significant knee pain is prevalent after ACLR; with those who undergo subsequent ipsilateral surgery at greatest risk.
AHRQ-funded; HS016075.
Citation: Wasserstein D, Huston LJ, Nwosu S .
KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study.
Osteoarthritis Cartilage 2015 Oct;23(10):1674-84. doi: 10.1016/j.joca.2015.05.025..
Keywords: Arthritis, Surgery, Pain, Chronic Conditions, Outcomes
McNamara ER, Schaeffer AJ, Logvinenko T
Management of proximal hypospadias with 2-stage repair: 20-year experience.
The researchers describe their experience with 2-stage proximal hypospadias repair. They report outcomes, and patient and procedure characteristics associated with surgical complications. In their review of the largest cohort of patients undergoing this procedure at a single institution, they found that complications and, reoperation rates were approximately 50 percent in the setting of complex genital reconstruction.
AHRQ-funded; HS000063.
Citation: McNamara ER, Schaeffer AJ, Logvinenko T .
Management of proximal hypospadias with 2-stage repair: 20-year experience.
J Urol 2015 Oct;194(4):1080-5. doi: 10.1016/j.juro.2015.04.105..
Keywords: Newborns/Infants, Outcomes, Surgery, Adverse Events