National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Blood Clots (1)
- Cardiovascular Conditions (2)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (2)
- Data (1)
- Decision Making (3)
- Dementia (1)
- Disparities (1)
- Education: Patient and Caregiver (3)
- Elderly (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Health Services Research (HSR) (1)
- Heart Disease and Health (1)
- Hospital Readmissions (1)
- Hospitals (3)
- Maternal Care (1)
- Medicare (2)
- Medication (1)
- Nursing Homes (3)
- Outcomes (5)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (1)
- Patient Experience (1)
- Policy (1)
- Pregnancy (1)
- Primary Care (1)
- Provider: Health Personnel (1)
- Provider Performance (4)
- (-) Public Reporting (19)
- Quality Improvement (2)
- Quality Indicators (QIs) (2)
- Quality Measures (3)
- Quality of Care (12)
- Racial and Ethnic Minorities (1)
- Surgery (3)
- Vulnerable Populations (1)
- Web-Based (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 19 of 19 Research Studies DisplayedHefele JG, Ritter GA, Bishop CE
Examining racial and ethnic differences in nursing home quality.
The authors measured within-facility differences for a range of publicly reported nursing home quality measures. They found that, on average, care is delivered equally across all racial/ethnic groups in the same nursing home. They concluded that nursing home providers should attempt to identify racial/ethnic within-facility differences in care.
AHRQ-funded; HS021891.
Citation: Hefele JG, Ritter GA, Bishop CE .
Examining racial and ethnic differences in nursing home quality.
Jt Comm J Qual Patient Saf 2017 Nov;43(11):554-64. doi: 10.1016/j.jcjq.2017.06.003.
.
.
Keywords: Disparities, Quality of Care, Nursing Homes, Racial and Ethnic Minorities, Public Reporting
Ban KA, Cohen ME, Ko CY
Evaluation of the ProPublica surgeon scorecard "Adjusted Complication Rate" measure specifications.
The authors sought to (1) determine the proportion of cases excluded by ProPublica's specifications, (2) assess the proportion of inpatient complications excluded from ProPublica's measure, and (3) examine the validity of ProPublica's outcome measure by comparing performance on the measure to well-established postoperative outcome measures. They found that ProPublica's outcome measure specifications exclude 82% of cases, miss 84% of postoperative complications, and correlate poorly with well-established postoperative outcomes.
AHRQ-funded; HS021857.
Citation: Ban KA, Cohen ME, Ko CY .
Evaluation of the ProPublica surgeon scorecard "Adjusted Complication Rate" measure specifications.
Ann Surg 2016 Oct;264(4):566-74. doi: 10.1097/sla.0000000000001858.
.
.
Keywords: Adverse Events, Outcomes, Public Reporting, Quality Measures, Surgery
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.
.
.
Keywords: Decision Making, Quality of Care, Public Reporting, Quality Indicators (QIs), Vulnerable Populations
Bangalore S, Guo Y, Xu J
Rates of invasive management of cardiogenic shock in New York before and after exclusion from public reporting.
The purpose of the study was to evaluate whether the referral rates for cardiac catheterization, percutaneous coronary intervention (PCI), or coronary artery bypass graft have improved in New York since cardiogenic shock was excluded from public reporting in 2008 and compare them with corresponding rates in Michigan, New Jersey, and California. Although rates of PCI, invasive management, and revascularization have increased substantially after the exclusion of cardiogenic shock from public reporting in New York, these rates remain consistently lower than those observed in other states without public reporting.
AHRQ-funded; HS023683.
Citation: Bangalore S, Guo Y, Xu J .
Rates of invasive management of cardiogenic shock in New York before and after exclusion from public reporting.
JAMA Cardiol 2016 Sep 1;1(6):640-7. doi: 10.1001/jamacardio.2016.0785..
Keywords: Healthcare Cost and Utilization Project (HCUP), Public Reporting, Surgery, Cardiovascular Conditions
Nguyen OK, Halm EA, Makam AN
Relationship between hospital financial performance and publicly reported outcomes.
This study assessed the relationship between hospital financial performance and publicly reported outcomes of care, and whether improved outcome metrics affect subsequent hospital financial performance. It found that, among 279 hospitals, there was no consistent relationship between measures of financial performance in 2008 and publicly reported outcomes from 2008 to 2011 for acute myocardial infarction and pneumonia.
AHRQ-funded; HS022418.
Citation: Nguyen OK, Halm EA, Makam AN .
Relationship between hospital financial performance and publicly reported outcomes.
J Hosp Med 2016 Jul;11(7):481-8. doi: 10.1002/jhm.2570.
.
.
Keywords: Public Reporting, Hospitals, Outcomes
Coulam R, Kralewski J, Dowd B
The role of medical group practice administrators in the adoption and implementation of Medicare's physician quality reporting system.
The purpose of this study was to gain insights into the role these administrators play in quality assurance programs. It found that administrators conducted due diligence on Medicare's physician quality reporting system, influenced how the issue was presented to physicians for adoption, and managed implementation thereafter. Administrators' recommendations were heavily influenced by practice characteristics, financial incentives, and practice commitments to early adoption of quality improvement innovations.
AHRQ-funded; HS019964.
Citation: Coulam R, Kralewski J, Dowd B .
The role of medical group practice administrators in the adoption and implementation of Medicare's physician quality reporting system.
Health Care Manage Rev 2016 Apr-Jun;41(2):145-54. doi: 10.1097/hmr.0000000000000061.
.
.
Keywords: Medicare, Provider Performance, Quality Improvement, Quality of Care, Public Reporting
Sandmeyer B, Fraser I
AHRQ Author: Sandmeyer B
New evidence on what works in effective public reporting.
The authors describe the current state of the public reporting field and provide guidance to public report producers based on the evidence. They concluded that public reports have advanced greatly in recent years, but there remains much room for improvement. They recommend that report producers should continually evaluate their reports and apply the latest evidence to maximize their usefulness and impact.
AHRQ-authored.
Citation: Sandmeyer B, Fraser I .
New evidence on what works in effective public reporting.
Health Serv Res 2016 Jun;51(Suppl 2):1159-66. doi: 10.1111/1475-6773.12502.
.
.
Keywords: Data, Provider Performance, Public Reporting
Maurer M, Firminger K, Dardees P
Understanding consumer perceptions and awareness of hospital-based maternity care quality measures.
This study explored factors that may influence use of comparative public reports for hospital maternity care. It found that, when describing high-quality maternity care, participants focused on interactions with providers, including respect for preferences and communication. The importance of quality measures was influenced by the extent to which they focused on babies' health, were perceived as the hospital's responsibility, and were perceived as representing "standard care."
AHRQ-funded; HS021873.
Citation: Maurer M, Firminger K, Dardees P .
Understanding consumer perceptions and awareness of hospital-based maternity care quality measures.
Health Serv Res 2016 Jun;51 Suppl 2:1188-211. doi: 10.1111/1475-6773.12472.
.
.
Keywords: Maternal Care, Pregnancy, Patient Experience, Quality Measures, Quality of Care, Public Reporting
McConnell KJ, Lindrooth RC, Wholey DR
Modern management practices and hospital admissions.
The researchers investigated whether the modern management practices and publicly reported performance measures are associated with choice of hospital for patients with acute myocardial infarction (AMI). They found that, overall, a one standard deviation change in management practice scores is associated with an 8% increase in AMI admissions.
AHRQ-funded; HS018466.
Citation: McConnell KJ, Lindrooth RC, Wholey DR .
Modern management practices and hospital admissions.
Health Econ 2016 Apr;25(4):470-85. doi: 10.1002/hec.3171.
.
.
Keywords: Hospitals, Heart Disease and Health, Cardiovascular Conditions, Quality Indicators (QIs), Quality Measures, Quality of Care, Public Reporting, Provider Performance
Konetzka RT, Perraillon MC
Use of Nursing Home Compare website appears limited by lack of awareness and initial mistrust of the data.
The researchers used a qualitative assessment of how consumers select nursing homes and of the role of information about quality, using semistructured interviews of people who recently placed a family member or friend in a nursing home. They found that consumers had a positive reaction when shown Nursing Home Compare; however, its use appeared to be limited by lack of awareness and, to some extent, initial lack of trust of the data.
AHRQ-funded; HS021877.
Citation: Konetzka RT, Perraillon MC .
Use of Nursing Home Compare website appears limited by lack of awareness and initial mistrust of the data.
Health Aff 2016 Apr;35(4):706-13. doi: 10.1377/hlthaff.2015.1377.
.
.
Keywords: Nursing Homes, Public Reporting, Web-Based, Quality of Care, Education: Patient and Caregiver
DeVore AD, Hammill BG, Hardy NC
Has public reporting of hospital readmission rates affected patient outcomes?: Analysis of Medicare claims data.
Following the implementation of Centers for Medicare & Medicaid Services (CMS) public reporting, this study assessed trends of 30-day readmission rates and post-discharge care for patients discharged with acute myocardial infarction (MI), heart failure (HF), or pneumonia. It found that the release of the CMS public reporting of hospital readmission rates did not change 30-day readmission trends for MI, HF, or pneumonia, but it was associated with less hospital-based acute care for HF.
AHRQ-funded; HS021092.
Citation: DeVore AD, Hammill BG, Hardy NC .
Has public reporting of hospital readmission rates affected patient outcomes?: Analysis of Medicare claims data.
J Am Coll Cardiol 2016 Mar 1;67(8):963-72. doi: 10.1016/j.jacc.2015.12.037.
.
.
Keywords: Public Reporting, Hospital Readmissions, Outcomes, Medicare, Patient-Centered Outcomes Research
Mukamel DB, Haeder SF, Weimer DL
Top-down and bottom-up approaches to health care quality: the impacts of regulation and report cards.
The authors reviewed the extant literature on regulation and report cards. They found evidence of both functional and dysfunctional effects and identified the areas in which additional research would most likely be valuable.
AHRQ-funded; HS021844.
Citation: Mukamel DB, Haeder SF, Weimer DL .
Top-down and bottom-up approaches to health care quality: the impacts of regulation and report cards.
Annu Rev Public Health 2014;35:477-97. doi: 10.1146/annurev-publhealth-082313-115826.
.
.
Keywords: Quality of Care, Policy, Policy, Public Reporting
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.
.
.
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), 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.
.
.
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Patient and Family Engagement, Public Reporting
Damberg CL, McNamara P
AHRQ Author: McNamara P
Postscript: research agenda to guide the next generation of public reports for consumers.
The authors identified five areas for additional public reporting tools research that, if addressed, could foster better design and delivery of quality and cost information to consumers.
AHRQ-authored.
Citation: Damberg CL, McNamara P .
Postscript: research agenda to guide the next generation of public reports for consumers.
Med Care Res Rev 2014 Oct;71(5 Suppl):97s-107s. doi: 10.1177/1077558714535982.
.
.
Keywords: Education: Patient and Caregiver, Decision Making, Quality of Care, Health Services Research (HSR), Public Reporting
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.
.
.
Keywords: Education: Patient and Caregiver, Quality of Care, Provider: Health Personnel, Provider Performance, Public Reporting
Ju MH, Chung JW, Kinnier CV
Association between hospital imaging use and venous thromboembolism events rates based on clinical data.
This study assessed the presence and extent of venous thromboembolism (VTE) surveillance bias using high-quality clinical data from 208 hospitals. It concluded that hospitals may be unfairly deemed poor performers for the outcome VTE measure if they have increased vigilance for VTE by performing more VTE imaging studies that result in higher VTE event rates.
AHRQ-funded; HS021857
Citation: Ju MH, Chung JW, Kinnier CV .
Association between hospital imaging use and venous thromboembolism events rates based on clinical data.
Ann Surg. 2014 Sep; 260(3):558-64; discussion 64-6. doi: 10.1097/sla.0000000000000897..
Keywords: Blood Clots, Public Reporting, Adverse Events, Outcomes, Quality of Care
Dahlke AR, Chung JW, Holl JL
Evaluation of initial participation in public reporting of American College of Surgeons NSQIP surgical outcomes on Medicare's Hospital Compare website.
The objective of this paper was to compare CMS-National Surgical Quality Improvement Program (CMS-NSQIP) participating hospitals with American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) hospitals that elected not to participate in Hospital Compare. The researchers found few measurable differences between CMS-NSQIP participating and nonparticipating hospitals.
AHRQ-funded; HS021857.
Citation: Dahlke AR, Chung JW, Holl JL .
Evaluation of initial participation in public reporting of American College of Surgeons NSQIP surgical outcomes on Medicare's Hospital Compare website.
J Am Coll Surg 2014 Mar;218(3):374-80, 80.e1-5. doi: 10.1016/j.jamcollsurg.2013.11.022.
.
.
Keywords: Hospitals, Outcomes, Public Reporting, Quality Improvement, Surgery
Konetzka RT, Brauner DJ, Shega J
The effects of public reporting on physical restraints and antipsychotic use in nursing home residents with severe cognitive impairment.
The purpose of this paper was to assess whether reductions in physical restraint use associated with quality reporting may have had the unintended consequence of increasing antipsychotic use in nursing home (NH) residents with severe cognitive impairment. Physical restraint use declined significantly from 1999 to 2008 in NH residents with severe cognitive impairment. Correspondingly, antipsychotic use in the same residents increased more in NHs that were subject to public reporting. This analysis suggests that public reporting of physical restraint use had the unintended consequence of increasing use of antipsychotics in NH residents with severe cognitive impairment.
AHRQ-funded; HS018718.
Citation: Konetzka RT, Brauner DJ, Shega J .
The effects of public reporting on physical restraints and antipsychotic use in nursing home residents with severe cognitive impairment.
J Am Geriatr Soc 2014 Mar;62(3):454-61. doi: 10.1111/jgs.12711.
.
.
Keywords: Dementia, Elderly, Medication, Nursing Homes, Public Reporting