National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (7)
- Ambulatory Care and Surgery (1)
- Blood Clots (1)
- Cancer (1)
- Cardiovascular Conditions (3)
- Children's Health Insurance Program (CHIP) (3)
- Children/Adolescents (7)
- Chronic Conditions (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Data (1)
- Decision Making (1)
- Dental and Oral Health (1)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Disparities (3)
- Education: Continuing Medical Education (1)
- Education: Patient and Caregiver (1)
- Elderly (3)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Cost and Utilization Project (HCUP) (5)
- Healthcare Delivery (1)
- Health Insurance (1)
- Heart Disease and Health (1)
- Home Healthcare (1)
- Hospital Discharge (1)
- Hospitalization (4)
- Hospital Readmissions (8)
- Hospitals (9)
- Injuries and Wounds (2)
- Intensive Care Unit (ICU) (1)
- Labor and Delivery (1)
- Long-Term Care (1)
- Medicaid (2)
- Medicare (1)
- Medication (1)
- Mortality (2)
- Neonatal Intensive Care Unit (NICU) (1)
- Neurological Disorders (1)
- Newborns/Infants (1)
- Nursing (1)
- Nursing Homes (5)
- Orthopedics (1)
- Outcomes (6)
- Palliative Care (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (4)
- Patient Experience (4)
- Patient Safety (12)
- Payment (2)
- Pneumonia (1)
- Pressure Ulcers (1)
- Prevention (3)
- Provider (1)
- Provider Performance (8)
- Public Reporting (2)
- Quality Improvement (7)
- (-) Quality Indicators (QIs) (51)
- Quality Measures (17)
- Quality of Care (29)
- Racial and Ethnic Minorities (3)
- Rehabilitation (1)
- Research Methodologies (3)
- Respiratory Conditions (1)
- Risk (1)
- Rural Health (1)
- Surgery (9)
- Urban Health (1)
- Vulnerable Populations (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 51 Research Studies DisplayedWang Y, Spatz ES, Tariq M
Home health agency performance in the United States: 2011-15.
This review’s evaluation of home health agency quality performance included 11,462 Medicare-certified home health agencies that served 92.4 percent of all ZIP codes nationwide, accounting for 315.2 million people. It found that home health agency performance on several quality indicators varied, and many agencies were persistently in the lowest quartile of performance.
AHRQ-funded; HS023000.
Citation: Wang Y, Spatz ES, Tariq M .
Home health agency performance in the United States: 2011-15.
J Am Geriatr Soc 2017 Dec;65(12):2572-79. doi: 10.1111/jgs.14987.
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Keywords: Quality of Care, Home Healthcare, Quality Indicators (QIs), Quality Measures
Gray, 2nd DM, Hefner JL, Nguyen MC
The link between clinically validated patient safety indicators and clinical outcomes.
The authors performed a retrospective analysis of patient discharges from an academic medical center comprising 6 hospitals from July 2012 to June 2014. The study demonstrated a strong association between clinically validated PSIs and patient outcomes. The findings have important implications in policy and practice as health care reform dictates improvement in the experience of care, health of populations, and per capita costs.
AHRQ-funded; HS024379.
Citation: Gray, 2nd DM, Hefner JL, Nguyen MC .
The link between clinically validated patient safety indicators and clinical outcomes.
Am J Med Qual 2017 Nov/Dec;32(6):583-90. doi: 10.1177/1062860616683014..
Keywords: Outcomes, Patient Safety, Quality Indicators (QIs)
Davies S, Schultz E, Raven M
AHRQ Author: Stocks C
Development and validation of the Agency for Healthcare Research and Quality Measures of Potentially Preventable Emergency Department (ED) Visits: the ED Prevention Quality Indicators for general health conditions.
The researchers sought to develop and validate rates of potentially preventable emergency department (ED) visits as indicators of community health. ED Prevention Quality Indicators (PQI) rates varied widely across U.S. communities. Indicator rates were significantly associated with county-level poverty, median income, Medicaid insurance, and levels of uninsurance. A few indicators were significantly associated with PCP density, with higher rates in areas with greater density.
AHRQ-authored; AHRQ-funded; 2902012000031.
Citation: Davies S, Schultz E, Raven M .
Development and validation of the Agency for Healthcare Research and Quality Measures of Potentially Preventable Emergency Department (ED) Visits: the ED Prevention Quality Indicators for general health conditions.
Health Serv Res 2017 Oct;52(5):1667-84. doi: 10.1111/1475-6773.12687.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Quality Indicators (QIs), Patient Safety, Prevention
Goldberg EM, Morphis B, Youssef R
An analysis of diagnoses that drive readmission: what can we learn from the hospitals in Southern New England with the highest and lowest readmission performance?
This study examined the most common diagnoses driving readmissions among fee-for-service Medicare beneficiaries in the hospitals with the highest and lowest readmission performance in Southern New England from 2014 to 2016. It found that the lowest-performing hospitals readmitted higher percentages of patients for sepsis and complications of device, implant, or graft, compared to highest-performing hospitals.
AHRQ-funded; HS000011.
Citation: Goldberg EM, Morphis B, Youssef R .
An analysis of diagnoses that drive readmission: what can we learn from the hospitals in Southern New England with the highest and lowest readmission performance?
R I Med J 2017 Aug;100(8):23-28.
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Keywords: Adverse Events, Diagnostic Safety and Quality, Hospital Readmissions, Hospitals, Quality Indicators (QIs)
Cerully JL, Martino SC, Rybowski L
Using "roll-up" measures in healthcare quality reports: perspectives of report sponsors and national alliances.
The objective of this study, which used semi-structured qualitative interview design, was to understand the views of prominent organizations in the field of healthcare quality on the topic of reporting roll-up measures that combine indicators of multiple, often disparate, dimensions of care to consumers. The investigators concluded that the results of the interviews elucidated the need for research focused on construction and reporting of roll-up measures.
AHRQ-funded; HS016980; HS016978.
Citation: Cerully JL, Martino SC, Rybowski L .
Using "roll-up" measures in healthcare quality reports: perspectives of report sponsors and national alliances.
Am J Manag Care 2017 Jun;23(6):e202-e07..
Keywords: Quality of Care, Quality Improvement, Quality Indicators (QIs), Quality Measures
Goodwin JS, Li S, Zhou J
Comparison of methods to identify long term care nursing home residence with administrative data.
Researchers compared different methods for identifying a long term care (LTC) nursing home stay, distinct from stays in skilled nursing facilities (SNFs), to the method currently used by the Center for Medicare and Medicaid Services (CMS). They concluded that using both Medicare and Minimum Data Set (MDS), data to identify LTC stays will lead to more accurate attribution of CMS nursing home quality indicators.
AHRQ-funded; HS022134.
Citation: Goodwin JS, Li S, Zhou J .
Comparison of methods to identify long term care nursing home residence with administrative data.
BMC Health Serv Res 2017 May 30;17(1):376. doi: 10.1186/s12913-017-2318-9.
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Keywords: Data, Long-Term Care, Nursing Homes, Quality Indicators (QIs)
Baernholdt M, Hinton ID, Guofen Y
A national comparison of rural/urban pressure ulcer and fall rates.
Despite recent decline in hospital acquired conditions (HACs), rates for pressure ulcers (PURs) and falls (FRs) remain at levels that require improvement. Contextual factors and care processes may impact HACs. Using the National Database of Nursing Quality Indicators (NDNQI®) this study examined differences in care processes and community, hospital, and nursing unit characteristics that influence PURs and FRs in 4238 rural and urban nursing units.
AHRQ-funded; HS023147.
Citation: Baernholdt M, Hinton ID, Guofen Y .
A national comparison of rural/urban pressure ulcer and fall rates.
Online J Issues Nurs 2017 May;22(2):1-12. doi: 10.3912/OJIN.Vol22No02PPT60..
Keywords: Injuries and Wounds, Nursing, Patient Safety, Pressure Ulcers, Quality of Care, Quality Improvement, Quality Indicators (QIs), Quality Measures, Rural Health, Urban Health
Tu JV, Maclagan LC, Ko DT
AHRQ Author: Bierman A
The Cardiovascular Health in Ambulatory Care Research Team performance indicators for the primary prevention of cardiovascular disease: a modified Delphi panel study.
The researchers developed a set of key performance indicators that can be used to measure and improve cardiovascular care in the primary care setting. A set of 28 indicators of primary prevention performance were identified, which were grouped into 5 domains: risk factor prevalence, screening, management, intermediate outcomes and long-term outcomes.
AHRQ-authored.
Citation: Tu JV, Maclagan LC, Ko DT .
The Cardiovascular Health in Ambulatory Care Research Team performance indicators for the primary prevention of cardiovascular disease: a modified Delphi panel study.
CMAJ Open 2017 Apr 25;5(2):E315-e21. doi: 10.9778/cmajo.20160139.
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Keywords: Cardiovascular Conditions, Quality of Care, Ambulatory Care and Surgery, Prevention, Quality Indicators (QIs)
Hollis RH, Graham LA, Richman JS
Hospital readmissions after surgery: how important are hospital and specialty factors?
Researchers hypothesized that hospital readmission rates for procedures within specialties were more strongly correlated than rates across specialties within the same hospital. However, they found that hospital readmission rates for orthopaedic, vascular, and general surgery were not correlated between specialties; within each of the 3 specialties, modest correlations were found between 2 procedures within 2 of these specialties.
AHRQ-funded; HS013852.
Citation: Hollis RH, Graham LA, Richman JS .
Hospital readmissions after surgery: how important are hospital and specialty factors?
J Am Coll Surg 2017 Apr;224(4):515-23. doi: 10.1016/j.jamcollsurg.2016.12.034.
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Keywords: Surgery, Hospital Readmissions, Quality Indicators (QIs), Elderly
Adirim T, Meade K, Mistry K
AHRQ Author: Mistry K
A new era in quality measurement: The development and application of quality measures.
Numerous national organizations focus on the development and application of quality measures, including the Pediatric Quality Measures Program, which is focused solely on the development and implementation of pediatric-specific measures. This policy statement provides an overview of quality measurement and describes the opportunities for pediatric health care providers to apply quality measures to improve clinical quality and performance in the delivery of pediatric health care services.
AHRQ-authored.
Citation: Adirim T, Meade K, Mistry K .
A new era in quality measurement: The development and application of quality measures.
Pediatrics 2017 Jan;139(1). doi: 10.1542/peds.2016-3442.
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Keywords: Quality Indicators (QIs), Quality Improvement, Outcomes, Children/Adolescents, Quality of Care
Lewis VA, Fraze T, Fisher ES
ACOs serving high proportions of racial and ethnic minorities lag in quality performance.
Researchers analyzed racial and ethnic disparities in health care outcomes among accountable care organizations (ACOs). Their findings suggest that ACOs with a high share of minority patients may struggle with quality performance under ACO contracts, especially during their early years of participation-maintaining or potentially exacerbating current inequities.
AHRQ-funded; HS024075.
Citation: Lewis VA, Fraze T, Fisher ES .
ACOs serving high proportions of racial and ethnic minorities lag in quality performance.
Health Aff 2017 Jan;36(1):57-66. doi: 10.1377/hlthaff.2016.0626.
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Keywords: Disparities, Racial and Ethnic Minorities, Provider Performance, Quality Indicators (QIs), Quality of Care
Campione JR, Smith SA, Mardon RE
Hospital-level factors related to 30-day readmission rates.
This study investigates the relationship between inpatient quality of care as measured by the Agency for Healthcare Research and Quality (AHRQ) patient safety indicator (PSI) composite and all-cause, hospital-wide, 30-day readmission rates. It concluded that inpatient quality of care appears to have less influence on hospital readmission rates than do clinical and socioeconomic factors.
AHRQ-funded; 290201200003I.
Citation: Campione JR, Smith SA, Mardon RE .
Hospital-level factors related to 30-day readmission rates.
Am J Med Qual 2017 Jan/Feb;32(1):48-57. doi: 10.1177/1062860615612158.
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Keywords: Quality of Care, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Quality Indicators (QIs), Quality Measures
Nuckols T, Conlon C, Robbins M
Quality of care for work-associated carpal tunnel syndrome.
This study evaluated the quality of care provided to individuals with workers' compensation claims related to carpal tunnel syndrome and identified patient characteristics associated with receiving better care. Overall, 81.6 percent of care adhered to recommended standards. Patients with classic/probable Katz diagrams, positive electrodiagnostic tests, and higher incomes received better care. However, age, sex, and race/ethnicity were not associated with quality.
AHRQ-funded; HS018982.
Citation: Nuckols T, Conlon C, Robbins M .
Quality of care for work-associated carpal tunnel syndrome.
J Occup Environ Med 2017 Jan;59(1):47-53. doi: 10.1097/jom.0000000000000916.
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Keywords: Guidelines, Quality of Care, Neurological Disorders, Patient-Centered Healthcare, Quality Indicators (QIs)
Calderwood MS, Kleinman K, Huang SS
Surgical site infections: volume-outcome relationship and year-to-year stability of performance rankings.
The researchers evaluated the volume-outcome relationship as well as the year-to-year stability of performance rankings following coronary artery bypass graft (CABG) surgery and hip arthroplasty. They concluded that aggregate surgical site infection risk is highest in hospitals with low annual procedure volumes. Even for higher volume hospitals, year-to-year random variation makes past experience an unreliable estimator of current performance.
AHRQ-funded; HS021424.
Citation: Calderwood MS, Kleinman K, Huang SS .
Surgical site infections: volume-outcome relationship and year-to-year stability of performance rankings.
Med Care 2017 Jan;55(1):79-85. doi: 10.1097/mlr.0000000000000620.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Injuries and Wounds, Hospitals, Provider Performance, Quality Indicators (QIs), Quality of Care, Patient Safety, Elderly
Patel HD, Iyoha E, Pierorazio PM
A systematic review of research gaps in the evaluation and management of localized renal masses.
The authors conducted a systematic review to summarize research gaps for the evaluation of composite models for predicting malignancy; use of percutaneous renal sampling for diagnosis; and comparative effectiveness of surgery, thermal ablation, and active surveillance. They recommended incorporation of emerging biomarkers into validated composite models, standardization of biopsy protocols, standard reporting of clinical stage, and performance of prospective studies with objective selection criteria.
AHRQ-funded; 290201200007I.
Citation: Patel HD, Iyoha E, Pierorazio PM .
A systematic review of research gaps in the evaluation and management of localized renal masses.
Urology 2016 Dec;98:14-20. doi: 10.1016/j.urology.2016.08.013.
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Keywords: Cancer, Evidence-Based Practice, Patient-Centered Outcomes Research, Quality Indicators (QIs), Research Methodologies
Mukamel DB, Amin A, Weimer DL
Personalizing nursing home compare and the discharge from hospitals to nursing homes.
This study tested whether use of a personalized report card, Nursing Home Compare Plus (NHCPlus), embedded in a reengineered discharge process, can lead to better outcomes than the usual discharge process from hospitals to nursing homes. It found that about 85 percent of users indicated satisfaction with NHCPlus. Compared to controls, intervention patients were more satisfied with the choice process.
AHRQ-funded; R21 HS021844.
Citation: Mukamel DB, Amin A, Weimer DL .
Personalizing nursing home compare and the discharge from hospitals to nursing homes.
Health Serv Res 2016 Dec;51(6):2076-94. doi: 10.1111/1475-6773.12588.
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Keywords: Hospital Discharge, Hospitals, Nursing Homes, Patient Experience, Quality Indicators (QIs)
Gounder PP, Seeman SM, Holman RC
AHRQ Author: Steiner CA
Potentially preventable hospitalizations for acute and chronic conditions in Alaska, 2010-2012.
The Healthy Alaska 2020 initiative (HA2020) targeted reducing potentially preventable hospitalizations (PPH) for acute and chronic conditions among its health indicators. This study found that among 127,371 total hospitalizations, 4,911 and 6,721 were for acute and chronic PPH conditions, respectively. The overall crude PPH rate was 7.3 (3.1 for acute and 4.2 for chronic conditions).
AHRQ-authored.
Citation: Gounder PP, Seeman SM, Holman RC .
Potentially preventable hospitalizations for acute and chronic conditions in Alaska, 2010-2012.
Prev Med Rep 2016 Dec;4:614-21. doi: 10.1016/j.pmedr.2016.03.017.
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Keywords: Hospitalization, Healthcare Cost and Utilization Project (HCUP), Quality Indicators (QIs), Chronic Conditions, Quality of Care
Pezold ML, Pusic AL, Cohen WA
Defining a research agenda for patient-reported outcomes in surgery: using a Delphi survey of stakeholders.
The authors sought to create a research agenda to help determine future directions and advance cross-disciplinary collaboration on the use of patient-reported outcomes (PROs) in surgery. They concluded that the Patient-Reported Outcomes in Surgery Conference research agenda was created using a modified Delphi survey of stakeholders that will help researchers, surgeons, and funders identify crucial areas of future PROs research in surgery.
AHRQ-funded; HS023357; HS000066.
Citation: Pezold ML, Pusic AL, Cohen WA .
Defining a research agenda for patient-reported outcomes in surgery: using a Delphi survey of stakeholders.
JAMA Surg 2016 Oct;151(10):930-36. doi: 10.1001/jamasurg.2016.1640.
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Keywords: Patient-Centered Outcomes Research, Research Methodologies, Surgery, Quality Indicators (QIs)
Goff SL, Mazor KM, Pekow PS
Patient navigators and parent use of quality data: a randomized trial.
The authors explored the effectiveness of strategies to overcome barriers in vulnerable populations. They found that an intervention to reduce barriers to using publicly reported health care quality data had a modest effect on patient choice, suggesting that factors other than performance on common publicly reported quality metrics have a stronger influence on which pediatric practices women choose.
AHRQ-funded; HS021864.
Citation: Goff SL, Mazor KM, Pekow PS .
Patient navigators and parent use of quality data: a randomized trial.
Pediatrics 2016 Oct;138(4). doi: 10.1542/peds.2016-1140.
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Keywords: Decision Making, Quality of Care, Public Reporting, Quality Indicators (QIs), Vulnerable Populations
Chin DL, Bang H, Manickam RN
Rethinking thirty-day hospital readmissions: shorter intervals might be better indicators of quality of care.
The researchers examined risk-standardized thirty-day risk of unplanned inpatient readmission at the hospital level for Medicare patients ages sixty-five and older in four states and for three conditions: acute myocardial infarction, heart failure, and pneumonia. The hospital-level quality signal captured in readmission risk was highest on the first day after discharge and declined rapidly until it reached a nadir at seven days, as indicated by a decreasing intracluster correlation coefficient.
AHRQ-funded; HS022236.
Citation: Chin DL, Bang H, Manickam RN .
Rethinking thirty-day hospital readmissions: shorter intervals might be better indicators of quality of care.
Health Aff 2016 Oct;35(10):1867-75. doi: 10.1377/hlthaff.2016.0205.
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Keywords: Hospital Readmissions, Quality of Care, Hospitals, Quality Indicators (QIs)
Tedesco D, Hernandez-Boussard T, Carretta E
Evaluating patient safety indicators in orthopedic surgery between Italy and the USA.
The authors compared patient safety in major orthopedic procedures between an orthopedic hospital in Italy and 26 Florida hospitals of similar size. AHRQ Patient Safety Indicators (PSIs) were used to identify inpatient adverse events (AEs). They found that US patients had lower adjusted odds of developing a PSI compared to Italy for pressure ulcers, hemorrhage or hematoma, and physiologic and metabolic derangement. while Italian patients had lower odds of pulmonary embolism/deep vein thrombosis compared to US patients.
AHRQ-funded; HS018558.
Citation: Tedesco D, Hernandez-Boussard T, Carretta E .
Evaluating patient safety indicators in orthopedic surgery between Italy and the USA.
Int J Qual Health Care 2016 Sep;28(4):486-91. doi: 10.1093/intqhc/mzw053.
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Keywords: Adverse Events, Orthopedics, Patient Safety, Quality Indicators (QIs), Surgery
Lau BD, Haut ER, Hobson DB
ICD-9 code-based venous thromboembolism performance targets fail to measure up.
Suboptimal prevention practices have prompted payers to consider hospital-associated Venous thromboembolism (VTE) as a potentially preventable condition for which financial incentives or penalties exist to drive practice improvement. The authors reviewed a subset of hospital-associated VTE that were identified by ICD-9 codes used by a state-run pay-for-performance quality improvement program and discuss their findings.
AHRQ-funded; HS017952.
Citation: Lau BD, Haut ER, Hobson DB .
ICD-9 code-based venous thromboembolism performance targets fail to measure up.
Am J Med Qual 2016 Sep;31(5):448-53. doi: 10.1177/1062860615583547.
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Keywords: Healthcare-Associated Infections (HAIs), Quality Indicators (QIs), Prevention, Hospitals, Quality Improvement, Blood Clots, Payment, Provider Performance
Shah AY, LLanos K, Dougherty D
AHRQ Author: Dougherty D
State challenges to child health quality measure reporting and recommendations for improvement.
The authors sought to assess reporting barriers of the Children's Health Insurance Program (CHIP) and to identify potential opportunities for improvement. They found that low reporting states believed they had inadequate staffing and that data collection and extraction was too time-consuming. They concluded that possible solutions to improve reporting would include funding and staff support, refining the technical assistance provided, and creating venues for state-to-state interaction.
AHRQ-authored.
Citation: Shah AY, LLanos K, Dougherty D .
State challenges to child health quality measure reporting and recommendations for improvement.
Healthc 2016 Sep;4(3):217-24. doi: 10.1016/j.hjdsi.2016.03.001.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Quality of Care, Medicaid, Quality Indicators (QIs)
Pradarelli JC, Varban OA, Dimick JB
Hospital variation in rates of acid-reducing medication use after laparoscopic sleeve gastrectomy.
This study assessed variation in hospital performance with laparoscopic sleeve gastrectomy using rates of acid-reducing medication use at postoperative 1 year. It concluded that across Michigan hospitals, rates of new acid-reducing medication use at 1 year after laparoscopic sleeve gastrectomy varied widely and did not correlate with traditional quality indicators.
AHRQ-funded; R01 HS023597.
Citation: Pradarelli JC, Varban OA, Dimick JB .
Hospital variation in rates of acid-reducing medication use after laparoscopic sleeve gastrectomy.
Surg Obes Relat Dis 2016 Aug;12(7):1382-89. doi: 10.1016/j.soard.2015.11.016.
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Keywords: Hospitals, Medication, Surgery, Quality Indicators (QIs), Outcomes
Werner RM, Konetzka RT, Polsky D
Changes in consumer demand following public reporting of summary quality ratings: an evaluation in nursing homes.
The study’s objective was to evaluate consumer response to summary measures in the setting of nursing homes. It found that the star rating system was associated with a significant change in consumer demand for low- and high-scoring facilities. After the star-based rating system was released, 1-star facilities typically lost 8 percent of their market share and 5-star facilities gained over 6 percent of their market share.
AHRQ-funded; HS021861.
Citation: Werner RM, Konetzka RT, Polsky D .
Changes in consumer demand following public reporting of summary quality ratings: an evaluation in nursing homes.
Health Serv Res 2016 Jun;51 Suppl 2:1291-309. doi: 10.1111/1475-6773.12459.
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Keywords: Nursing Homes, Quality Indicators (QIs), Education: Patient and Caregiver