National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
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AHRQ Research Studies Date
Topics
- Access to Care (2)
- Adverse Drug Events (ADE) (1)
- Behavioral Health (1)
- Blood Pressure (1)
- Care Coordination (1)
- Children/Adolescents (3)
- Diabetes (1)
- Disparities (1)
- Education: Patient and Caregiver (1)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Evidence-Based Practice (3)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (1)
- Health Information Technology (HIT) (1)
- Health Promotion (2)
- Health Services Research (HSR) (1)
- Hospital Discharge (1)
- Labor and Delivery (3)
- Low-Income (1)
- (-) Maternal Care (23)
- Medicaid (3)
- Medication (2)
- Medication: Safety (1)
- Mortality (1)
- Newborns/Infants (3)
- Nutrition (1)
- Obesity: Weight Management (2)
- Outcomes (1)
- Patient-Centered Outcomes Research (1)
- Patient Experience (2)
- Patient Safety (2)
- Practice Patterns (1)
- Pregnancy (12)
- Prevention (1)
- Public Health (1)
- Public Reporting (1)
- Quality Measures (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (3)
- Screening (1)
- Sexual Health (1)
- Social Determinants of Health (1)
- Social Media (1)
- U.S. Preventive Services Task Force (USPSTF) (2)
- Web-Based (1)
- Women (8)
- Young Adults (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 23 of 23 Research Studies DisplayedWebb J, Sorensen A, Sommerness S
AHRQ Author: Mistry K
Advancing perinatal patient safety through application of safety science principles using health IT.
Researchers used semi-structured interviews with Labor and Delivery (L&D) units participating in AHRQ's Safety Program for Perinatal Care (SPPC) to assess units' experience with program implementation. Seventy percent of the units reported the use of health IT as an enabling strategy for their local implementation. Health IT was used to improve standardization of processes, use of independent checks, and to facilitate learning from defects.
AHRQ-authored; AHRQ-funded; 2902010000241.
Citation: Webb J, Sorensen A, Sommerness S .
Advancing perinatal patient safety through application of safety science principles using health IT.
BMC Med Inform Decis Mak 2017 Dec 19;17(1):176. doi: 10.1186/s12911-017-0572-8.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Pregnancy, Maternal Care
Raffo JE, Lloyd C, Collier M
Defining the role of the community health worker within a federal healthy start care coordination team.
The Strong Beginnings program worked to define community health worker (CHW) interventions, a core service of the program to improve maternal and child health. The workgroup identified seven core functions and 28 maternal and child health risk topics to be addressed by the CHW. The process resulted in a detailed document of program interventions that the CHWs use to guide care.
AHRQ-funded; HS020208.
Citation: Raffo JE, Lloyd C, Collier M .
Defining the role of the community health worker within a federal healthy start care coordination team.
Matern Child Health J 2017 Dec;21(Suppl 1):93-100. doi: 10.1007/s10995-017-2379-8.
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Keywords: Care Coordination, Children/Adolescents, Health Promotion, Health Services Research (HSR), Maternal Care
Kemper AR, Fan T, Grossman DC
AHRQ Author: Fan T
Gaps in evidence regarding iron deficiency anemia in pregnant women and young children: summary of US Preventive Services Task Force recommendations.
The USPSTF found insufficient evidence to recommend routine iron supplementation for pregnant women or routine screening for iron deficiency anemia in pregnant women or young children. The USPSTF identified a critical evidence gap that is related to whether changing hematologic indexes in otherwise asymptomatic pregnant women or in infants within populations who are reflective of the United States leads to an improvement in maternal or child health outcomes.
AHRQ-authored.
Citation: Kemper AR, Fan T, Grossman DC .
Gaps in evidence regarding iron deficiency anemia in pregnant women and young children: summary of US Preventive Services Task Force recommendations.
Am J Clin Nutr 2017 Dec;106(Suppl 6):1555s-58s. doi: 10.3945/ajcn.117.155788.
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Keywords: Children/Adolescents, Evidence-Based Practice, Maternal Care, U.S. Preventive Services Task Force (USPSTF)
Roman LA, Raffo JE, Dertz K
Understanding perspectives of African American Medicaid-insured women on the process of perinatal care: an opportunity for systems improvement.
The purpose of this study was to explore the perspectives of Medicaid-insured women about their experiences of perinatal care across a continuum of clinical and community-based services. It found that many women experienced difficulties engaging in early care, getting more help, and understanding and communicating with their providers, with some reporting socio-economic and racial bias in care.
AHRQ-funded; HS020208.
Citation: Roman LA, Raffo JE, Dertz K .
Understanding perspectives of African American Medicaid-insured women on the process of perinatal care: an opportunity for systems improvement.
Matern Child Health J 2017 Dec;21(Suppl 1):81-92. doi: 10.1007/s10995-017-2372-2.
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Keywords: Access to Care, Maternal Care, Medicaid, Pregnancy, Racial and Ethnic Minorities
Robinson A, Fiechtner L, Roche B
Association of maternal gestational weight gain with the infant fecal microbiota.
The researchers aimed to examine associations of maternal gestational weight gain with infant fecal microbiota composition, bacterial community richness, and Shannon diversity index. Their prospective cohort study of healthy infants concluded that maternal gestational weight gain was associated with the infant fecal microbiota profiles, bacterial community richness, and Shannon diversity index.
AHRQ-funded; HS022986.
Citation: Robinson A, Fiechtner L, Roche B .
Association of maternal gestational weight gain with the infant fecal microbiota.
J Pediatr Gastroenterol Nutr 2017 Nov;65(5):509-15. doi: 10.1097/mpg.0000000000001566.
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Keywords: Maternal Care, Pregnancy, Obesity: Weight Management
Attanasio L, Kozhimannil KB
Health care engagement and follow-up after perceived discrimination in maternity care.
The authors sought to determine if perceived discrimination during the birth hospitalization is associated with postpartum follow-up care. Using data from the Listening to Mothers III survey, they found that women who experienced perceived discrimination (race/ethnicity, insurance type, difference of opinion with provider about care) had more than twice the odds of postpartum visit nonattendance, after adjusting for socioeconomic and medical characteristics.
AHRQ-funded; HS024215.
Citation: Attanasio L, Kozhimannil KB .
Health care engagement and follow-up after perceived discrimination in maternity care.
Med Care 2017 Sep;55(9):830-33. doi: 10.1097/mlr.0000000000000773.
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Keywords: Access to Care, Maternal Care, Patient Experience, Racial and Ethnic Minorities, Social Determinants of Health
Brousseau EC, Danilack V, Cai F
Emergency department visits for postpartum hypertension.
The purpose of this study was to describe the characteristics of women diagnosed with postpartum hypertension in an emergency department (ED) to better inform postpartum care. The investigators compared women with an ED diagnosis of hypertension to women with all other ED diagnoses and concluded that postpartum surveillance may not prevent readmission for hypertension.
AHRQ-funded; HS025013.
Citation: Brousseau EC, Danilack V, Cai F .
Emergency department visits for postpartum hypertension.
Hypertens Pregnancy 2017 May;36(2):212-16. doi: 10.1080/10641955.2017.1299171..
Keywords: Emergency Department, Blood Pressure, Maternal Care, Women
Metz TD, Rovner P, Hoffman MC
Maternal deaths from suicide and overdose in Colorado, 2004-2012.
This study ascertained demographic and clinical characteristics of maternal deaths from self-harm (accidental overdose or suicide) and to identify opportunities for prevention. It found that in seventeen percent (n=10) of maternal deaths there had been a known substance use disorder. Prior psychiatric diagnoses were documented in 54 percent (n=32) and prior suicide attempts in 10 percent (n=6).
AHRQ-funded; HS022143.
Citation: Metz TD, Rovner P, Hoffman MC .
Maternal deaths from suicide and overdose in Colorado, 2004-2012.
Obstet Gynecol 2016 Dec;128(6):1233-40. doi: 10.1097/aog.0000000000001695.
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Keywords: Behavioral Health, Pregnancy, Prevention, Maternal Care, Mortality
Vo H, Cheng D, Cheng TL
AHRQ Author: Mistry KB
Health behaviors among women using fertility treatment.
The researchers described associated perinatal behaviors among women using fertility treatment. They concluded that a significant proportion of women using fertility treatments were not practicing recommended perinatal behaviors or receiving prenatal counseling on preventable risk factors.
AHRQ-authored.
Citation: Vo H, Cheng D, Cheng TL .
Health behaviors among women using fertility treatment.
Matern Child Health J 2016 Nov;20(11):2328-35. doi: 10.1007/s10995-016-2056-3.
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Keywords: Maternal Care, Pregnancy, Women
Upadhya KK, Jalazo ER, Connor KA
AHRQ Author: Mistry KB
Optimizing preconception health among young women: what are we missing?
This study evaluated whether receipt of specific preconception counseling topics differs between teen, young adult, and older mothers. It found that teen mothers were less than half as likely to be counseled about taking folic acid, 4 times more likely to be counseled about vaccines, and twice as likely to be counseled about mental health before pregnancy compared with adult mothers.
AHRQ-authored.
Citation: Upadhya KK, Jalazo ER, Connor KA .
Optimizing preconception health among young women: what are we missing?
J Pediatr Adolesc Gynecol 2016 Oct;29(5):464-6. doi: 10.1016/j.jpag.2016.02.010.
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Keywords: Children/Adolescents, Sexual Health, Maternal Care, Pregnancy, Women, Young Adults
Kaplan HC, Sherman SN, Cleveland C
Reliable implementation of evidence: a qualitative study of antenatal corticosteroid administration in Ohio hospitals.
The objective of this study was to understand conditions that enable delivery of antenatal corticosteroid administration (ANCS) with high reliability among hospitals participating in an Ohio Perinatal Quality Collaborative (OPQC) ANCS project. Among the major themes supporting reliable implementation of ANCS at these hospitals that emerged were: (1) presence of a high reliability culture, (2) processes that emphasize high reliability, and (3) timely and efficient administration process.
AHRQ-funded; HS021114.
Citation: Kaplan HC, Sherman SN, Cleveland C .
Reliable implementation of evidence: a qualitative study of antenatal corticosteroid administration in Ohio hospitals.
BMJ Qual Saf 2016 Jun 8;25(3):173-81. doi: 10.1136/bmjqs-2015-003984..
Keywords: Evidence-Based Practice, Patient-Centered Outcomes Research, Maternal Care
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.
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Keywords: Maternal Care, Pregnancy, Patient Experience, Quality Measures, Quality of Care, Public Reporting
Huesch MD, Galstyan A, Ong MK
Using social media, online social networks, and internet search as platforms for public health interventions: a pilot study.
The researchers analyzed public health interventions aimed at women potentially interested in maternity care via campaigns on social media (Twitter), social networks (Facebook), and online search engines (Google Search). They found that the campaigns reached a little more than 140,000 consumers each day across the three platforms, with a little more than 400 engagements each day. Facebook and Google search had broader reach, better engagement rates, and lower costs than Twitter.
AHRQ-funded; HS021868.
Citation: Huesch MD, Galstyan A, Ong MK .
Using social media, online social networks, and internet search as platforms for public health interventions: a pilot study.
Health Serv Res 2016 Jun;51 Suppl 2:1273-90. doi: 10.1111/1475-6773.12496.
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Keywords: Social Media, Web-Based, Public Health, Maternal Care, Women
Heberlein EC, Frongillo EA, Picklesimer AH
Effects of group prenatal care on food insecurity during late pregnancy and early postpartum.
The researchers compared the effects of group to individual prenatal care in late pregnancy and early postpartum on women's food security and psychosocial outcomes among food-insecure women. They found that group prenatal care provided health education and the opportunity for women to share experiences and knowledge, potentially improving food security through increasing confidence and skills in managing household food resources.
AHRQ-funded; HS021975.
Citation: Heberlein EC, Frongillo EA, Picklesimer AH .
Effects of group prenatal care on food insecurity during late pregnancy and early postpartum.
Matern Child Health J 2016 May;20(5):1014-24. doi: 10.1007/s10995-015-1886-8.
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Keywords: Pregnancy, Maternal Care, Nutrition, Education: Patient and Caregiver, Low-Income
Servan-Mori E, Sosa-Rubi SG, Najera-Leon E
Timeliness, frequency and content of antenatal care: which is most important to reducing indigenous disparities in birth weight in Mexico?
The authors estimated the potential for added weight gain among indigenous infants if their mothers received timely, frequent, and complete antenatal care (ANC). They found that the frequency of ANC was positively associated with birth weight for all women but complete ANC appears to differentially affect indigenous women at the bottom of the birth weight distribution.
AHRQ-funded; HS017582.
Citation: Servan-Mori E, Sosa-Rubi SG, Najera-Leon E .
Timeliness, frequency and content of antenatal care: which is most important to reducing indigenous disparities in birth weight in Mexico?
Health Policy Plan 2016 May;31(4):444-53. doi: 10.1093/heapol/czv082.
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Keywords: Disparities, Maternal Care, Racial and Ethnic Minorities, Newborns/Infants, Obesity: Weight Management
Cheng ER, Park H, Wisk LE
Examining the link between women's exposure to stressful life events prior to conception and infant and toddler health: the role of birth weight.
The authors suggested a pathway may exist among maternal exposure to stressful life events prior to conception (PSLEs), infant birth weight, and subsequent offspring health. Infant and toddler health outcomes were assessed at 9 and 24 months, including overall health status, special healthcare needs, and severe health conditions. The analysis suggested a chains-of-risk model in which women's exposure to PSLEs increased the risk for giving birth to a very low birth weight infant, adversely affecting infant and toddler health.
AHRQ-funded; HS000063; HS00083.
Citation: Cheng ER, Park H, Wisk LE .
Examining the link between women's exposure to stressful life events prior to conception and infant and toddler health: the role of birth weight.
J Epidemiol Community Health 2016 Mar;70(3):245-52. doi: 10.1136/jech-2015-205848.
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Keywords: Maternal Care, Women, Labor and Delivery, Newborns/Infants, Newborns/Infants
Fan T, Blitz J
AHRQ Author: Fan T
Screening for iron deficiency anemia and iron supplementation in pregnant women to improve maternal health and birth outcomes.
This case study involves a 28-year-old woman presents for a routine antepartum visit. She is 33 weeks pregnant and also has a four-year-old son. She has no particular problems, and the findings from your examination are unremarkable. She asks if her blood iron level should be tested. Based on the recommendations of the U.S. Preventive Services Task Force, the quiz asks 3 questions involving screening and treatment.
AHRQ-authored.
Citation: Fan T, Blitz J .
Screening for iron deficiency anemia and iron supplementation in pregnant women to improve maternal health and birth outcomes.
Am Fam Physician 2016 Jan 15;93(2):137-8..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Maternal Care, Women, Guidelines, Evidence-Based Practice
Parriott AM, Arah OA
Patient volumes and pre- and postdischarge postpartum infection: a retrospective cohort study.
The researchers examined the association between hospital and clinician obstetric volume and postpartum infection risk in the pre- and postdischarge periods. They found that hospital obstetric volume is positively associated with predischarge postpartum infections, whereas clinician volume may be negatively associated with those predischarge infections.
AHRQ-funded; HS000046.
Citation: Parriott AM, Arah OA .
Patient volumes and pre- and postdischarge postpartum infection: a retrospective cohort study.
Am J Infect Control 2016 Jan;44(1):30-5. doi: 10.1016/j.ajic.2015.08.018.
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Keywords: Healthcare-Associated Infections (HAIs), Hospital Discharge, Labor and Delivery, Maternal Care, Patient Safety
Fowler TT, Schiff J, Applegate MS
Early elective deliveries accounted for nearly 9 percent of births paid for by Medicaid.
The authors reported the results of a perinatal project, led by the state Medicaid medical directors, that sought to coordinate quality improvement efforts related to early elective deliveries for the Medicaid population. Using data from 22 states, they found that 8.9% of Medicaid singleton births were early elective deliveries, and they therefore estimated that there are 160,000 early elective Medicaid deliveries nationwide each year. They concluded that their study offers additional evidence and new tools for policy makers pursuing strategies to further reduce the number of such deliveries.
AHRQ-funded; 29020090015C.
Citation: Fowler TT, Schiff J, Applegate MS .
Early elective deliveries accounted for nearly 9 percent of births paid for by Medicaid.
Health Aff 2014 Dec;33(12):2170-8. doi: 10.1377/hlthaff.2014.0534.
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Keywords: Labor and Delivery, Maternal Care, Medicaid, Pregnancy
Connor KA, Cheng D, Strobino D
Preconception health promotion among Maryland women.
The objective of this study was to identify factors associated with receipt of preconception care (PCC) health promotion counseling among Maryland women and to assess whether prior birth outcome affects receipt of counseling. PCC receipt in the sample, consistent with analyses of older data, was low at 33 percent for all women and 28 percent for women with a prior live birth.
AHRQ-funded; HS017596.
Citation: Connor KA, Cheng D, Strobino D .
Preconception health promotion among Maryland women.
Matern Child Health J 2014 Dec;18(10):2437-45. doi: 10.1007/s10995-014-1482-3..
Keywords: Health Promotion, Maternal Care, Pregnancy, Women
Broussard CS, Frey MT, Hernandez-Diaz S
AHRQ Author: Collins Sharp BA
Developing a systematic approach to safer medication use during pregnancy: summary of a Centers for Disease Control and Prevention--convened meeting.
The CDC convened an expert meeting in January 2013 to inform clinical decision making for managing health conditions in pregnancy. This report summarized their discussions of best practices for formulating an expert review process, developing evidence summaries and treatment guidance, and disseminating information.
AHRQ-authored.
Citation: Broussard CS, Frey MT, Hernandez-Diaz S .
Developing a systematic approach to safer medication use during pregnancy: summary of a Centers for Disease Control and Prevention--convened meeting.
Am J Obstet Gynecol 2014 Sep;211(3):208-14.e1. doi: 10.1016/j.ajog.2014.05.040.
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Keywords: Adverse Drug Events (ADE), Maternal Care, Medication: Safety, Medication, Pregnancy
Camelo Castillo W, Boggess K, Stürmer T
Trends in glyburide compared with insulin use for gestational diabetes treatment in the United States, 2000-2011.
The researchers sought to characterize pharmacologic treatment of women with gestational diabetes (GDM) by describing trends in the use of glyburide compared with insulin over the past decade (2000-2011) and identifying predictors of initial choice of pharmacotherapy. They found that glyburide has replaced insulin as the more common pharmacotherapy for GDM among those privately insured.
AHRQ-funded; HS017950
Citation: Camelo Castillo W, Boggess K, Stürmer T .
Trends in glyburide compared with insulin use for gestational diabetes treatment in the United States, 2000-2011.
Obstet Gynecol. 2014 Jun;123(6):1177-84. doi: 10.1097/AOG.0000000000000285..
Keywords: Diabetes, Maternal Care, Medication, Practice Patterns, Pregnancy, Women
Palmsten K, Huybrechts KF, Kowal MK
Validity of maternal and infant outcomes within nationwide Medicaid data.
The researchers aimed to assess the validity of preeclampsia, congenital cardiac malformations, and persistent pulmonary hypertension of the newborn diagnoses in the U.S. Medicaid Analytic eXtract (MAX), a database that may be useful for perinatal research. The positive predictive values were conservative, particularly when restricting to infants not transferred to another facility shortly after birth because only records from a single hospitalization were reviewed.
AHRQ-funded; HS018533
Citation: Palmsten K, Huybrechts KF, Kowal MK .
Validity of maternal and infant outcomes within nationwide Medicaid data.
Pharmacoepidemiol Drug Saf 2014 Jun;23(6):646-55. doi: 10.1002/pds.3627..
Keywords: Newborns/Infants, Maternal Care, Outcomes, Medicaid