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 13 of 13 Research Studies DisplayedHubley S, Uebelacker LA, Nash J
Open trial of integrated primary care consultation for medically unexplained symptoms.
In this study, a behavioral consultation intervention for primary care patients with medically unexplained symptoms (n = 10) was developed and assessed. Notwithstanding the limitations of open trial designs, the findings demonstrated high feasibility for a behavioral health consultation treatment model for patients with medically unexplained symptoms and highlight the need for further research.
AHRQ-funded; HS022401.
Citation: Hubley S, Uebelacker LA, Nash J .
Open trial of integrated primary care consultation for medically unexplained symptoms.
J Behav Health Serv Res 2017 Oct;44(4):590-601. doi: 10.1007/s11414-016-9528-5..
Keywords: Behavioral Health, Primary Care, Primary Care: Models of Care
Fiscella K, Mauksch L, Bodenheimer T
Improving care teams' functioning: recommendations from team science.
In this paper, the authors examine the application of team science to developing and sustaining primary care teams. They highlight six core team elements and conclude that implementation of effective team-based models in primary care requires adaptation of core team science elements coupled with relevant, practical training and organizational support, including adequate time to train, plan, and debrief.
AHRQ-funded; HS022440.
Citation: Fiscella K, Mauksch L, Bodenheimer T .
Improving care teams' functioning: recommendations from team science.
Jt Comm J Qual Patient Saf 2017 Jul;43(7):361-68. doi: 10.1016/j.jcjq.2017.03.009..
Keywords: Teams, Primary Care: Models of Care, Primary Care, Quality Improvement, Quality of Care, Provider
Applequist J, Miller-Day M, Cronholm PF
“In principle we have agreement, but in practice it is a bit more difficult”: obtaining organizational buy-in to patient-centered medical home transformation.
The patient-centered medical home (PCMH) is a model of care that emphasizes the coordination of patient treatment among health care providers. Practice transformation to this model, however, presents a number of challenges. One of these challenges is getting the buy-in of all personnel to commit to making organizational changes in the journey to becoming a nationally recognized medical home. This study, grounded in stakeholder theory, investigated internal messages of buy-in as communicated by practices transitioning to this type of care.
AHRQ-funded; HS019150.
Citation: Applequist J, Miller-Day M, Cronholm PF .
“In principle we have agreement, but in practice it is a bit more difficult”: obtaining organizational buy-in to patient-centered medical home transformation.
Qual Health Res 2017 May;27(6):909-22. doi: 10.1177/1049732316680601..
Keywords: Patient-Centered Healthcare, Organizational Change, Primary Care: Models of Care, Primary Care
Frasso R, Golinkoff A, Klusaritz H
How nurse-led practices perceive implementation of the patient-centered medical home.
The purpose of this study was to investigate the implementation of a Patient-Centered Medical Home (PCMH) model in nurse-led primary care practices and to identify facilitators and barriers to the implementation of this model. The investigators indicate that their data suggest two categories of processes that facilitate the integration of PCMH in the nurse-led practice setting: patient-oriented facilitators and organizational facilitators.
AHRQ-funded; HS019150.
Citation: Frasso R, Golinkoff A, Klusaritz H .
How nurse-led practices perceive implementation of the patient-centered medical home.
Appl Nurs Res 2017 Apr;34:34-39. doi: 10.1016/j.apnr.2017.02.005.
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Keywords: Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care, Provider, Provider: Nurse, Quality of Care
Kass AE, Balantekin KN, Fitzsimmons-Craft EE
The economic case for digital interventions for eating disorders among United States college students.
This article aimed to estimate the costs, in United States (US) dollars, of a stepped care model for online prevention and treatment among US college students to inform meaningful decisions regarding resource allocation and adoption of efficient care delivery models for EDs on college campuses. A stepped care model was estimated to achieve modest cost savings compared to standard care, but these estimates need to be tested with sensitivity analyses.
AHRQ-funded; HS000078.
Citation: Kass AE, Balantekin KN, Fitzsimmons-Craft EE .
The economic case for digital interventions for eating disorders among United States college students.
Int J Eat Disord 2017 Mar;50(3):250-58. doi: 10.1002/eat.22680.
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Keywords: Behavioral Health, Healthcare Delivery, Healthcare Costs, Prevention, Primary Care: Models of Care, Telehealth, Young Adults, Web-Based
Korthuis PT, McCarty D, Weimer M
Primary care-based models for the treatment of opioid use disorder: a scoping review.
This article summarizes findings of a technical report for AHRQ describing medication-assisted treatment (MAT) models of care for opioid use disorder, based on a literature review and interviews with key informants in the field. The report describes 12 representative models of care for integrating MAT into primary care settings that could be considered for adaptation across diverse health care settings.
AHRQ-funded; 290201500009I.
Citation: Korthuis PT, McCarty D, Weimer M .
Primary care-based models for the treatment of opioid use disorder: a scoping review.
Ann Intern Med 2017 Feb 21;166(4):268-78. doi: 10.7326/m16-2149.
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Keywords: Opioids, Primary Care, Primary Care: Models of Care, Substance Abuse, Medication
O'Malley D, Hudson SV, Nekhlyudov L
Learning the landscape: implementation challenges of primary care innovators around cancer survivorship care.
This study describes the experiences of early implementers of primary care-focused cancer survivorship delivery models. Implementation challenges included (1) lack of key stakeholder buy-in; (2) practice resources allocated to competing (non-survivorship) change efforts; and (3) competition with higher priority initiatives incentivized by payers.
AHRQ-funded; HS021287.
Citation: O'Malley D, Hudson SV, Nekhlyudov L .
Learning the landscape: implementation challenges of primary care innovators around cancer survivorship care.
J Cancer Surviv 2017 Feb;11(1):13-23. doi: 10.1007/s11764-016-0555-2.
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Keywords: Primary Care, Cancer, Healthcare Delivery, Primary Care: Models of Care, Mortality
Bierman AS, Tinetti ME
AHRQ Author: Bierman AS
Precision medicine to precision care: managing multimorbidity.
Multimorbidity is the most common condition managed in practice. The authors argue that health-care delivery must be transformed to provide precision care to people with multimorbidity. Accomplishing this transition will require a change in practice, research, and policy from disease-specific to patient-centered models of care delivery.
AHRQ-authored.
Citation: Bierman AS, Tinetti ME .
Precision medicine to precision care: managing multimorbidity.
Lancet 2016 Dec 3;388(10061):2721-23. doi: 10.1016/s0140-6736(16)32232-2.
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Keywords: Healthcare Delivery, Chronic Conditions, Guidelines, Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care
Luo Z, Chen Q, Annis AM
A comparison of health plan- and provider-delivered chronic care management models on patient clinical outcomes.
Two contrasting strategies of chronic care management include provider-delivered care management (PDCM) and health plan-delivered care management (HPDCM). The researchers aimed to compare the effectiveness of PDCM vs. HPDCM on improving clinical outcomes for patients with chronic diseases. They found that in a commercially insured population, neither PDCM nor HPDCM resulted in substantial improvement in patients' clinical indicators in the first year.
AHRQ-funded; HS020108.
Citation: Luo Z, Chen Q, Annis AM .
A comparison of health plan- and provider-delivered chronic care management models on patient clinical outcomes.
J Gen Intern Med 2016 Jul;31(7):762-70. doi: 10.1007/s11606-016-3617-2.
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Keywords: Chronic Conditions, Care Management, Primary Care: Models of Care, Primary Care, Healthcare Delivery, Comparative Effectiveness, Patient-Centered Outcomes Research, Health Insurance
Stults CD, McClellan S, Panattoni L
Estimating the human resource costs of developing and implementing shared medical appointments in primary care.
The authors conducted interviews to estimate the human resource costs for developing and implementing a program to support shared medical appointments (SMAs) and an additional SMA on cancer survivorship. They found that introducing new providers or a new type of SMA may require relatively modest incremental organizational resources and provider time. They concluded that time and cost could possibly be further decreased by leveraging relevant materials from existing SMAs.
AHRQ-funded; HS022631.
Citation: Stults CD, McClellan S, Panattoni L .
Estimating the human resource costs of developing and implementing shared medical appointments in primary care.
J Ambul Care Manage 2016 Jan-Mar;39(1):23-31. doi: 10.1097/jac.0000000000000084.
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Keywords: Primary Care: Models of Care, Primary Care, Healthcare Delivery, Implementation
Solberg LI, Crain AL, Tillema JO
Challenges of medical home transformation reported by 118 patient-centered medical home (PCMH) leaders.
The authors surveyed newly-certified medical homes in Minnesota to determine the most important organizational factors and strategies for transforming primary clinics into patient-centered medical homes (PCMHs). They found that many items in the survey about transformation seem to have face validity for leaders of certified PCMHs and to be associated with the extent to which their clinics have made systems changes.
AHRQ-funded; HS019161.
Citation: Solberg LI, Crain AL, Tillema JO .
Challenges of medical home transformation reported by 118 patient-centered medical home (PCMH) leaders.
J Am Board Fam Med 2014 Jul-Aug;27(4):449-57. doi: 10.3122/jabfm.2014.04.130303.
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Keywords: Patient-Centered Healthcare, Practice Improvement, Primary Care: Models of Care, Primary Care, Organizational Change, Quality of Care
Wexler RK
Invited letter: the evolving model of health care in the United States: system change is not enough.
In this letter, the author argues that the spread of new health care delivery models such as the Patient-Centered Medical Home and Accountable Care Organizations are necessary to improve population health but do not fully address the need for a fundamental change in how patients think about and access care. He calls for raising patient awareness of how the health care delivery system works and draws attention to practitioners’ concerns about patient satisfaction as a definitive marker of quality.
AHRQ-funded; HS020693
Citation: Wexler RK .
Invited letter: the evolving model of health care in the United States: system change is not enough.
Adv Health Care Manag. 2014;16:173-6..
Keywords: Access to Care, Healthcare Delivery, Patient-Centered Healthcare, Patient Experience, Primary Care, Primary Care: Models of Care
Bleser WK, Miller-Day M, Naughton D
Strategies for achieving whole-practice engagement and buy-in to the patient-centered medical home.
In this paper the authors describe strategies for obtaining organizational buy-in to and whole-staff engagement of patient-centered medical home (PCMH) transformation and practice improvement. The investigators suggest that their study provides a list of strategies useful for facilitating PCMH transformation in primary care. They assert that these strategies could be investigated empirically in future research, used to guide medical practices undergoing or considering PCMH transformation, and used to inform health care policy makers.
AHRQ-funded; HS019150.
Citation: Bleser WK, Miller-Day M, Naughton D .
Strategies for achieving whole-practice engagement and buy-in to the patient-centered medical home.
Ann Fam Med 2014 Jan-Feb;12(1):37-45. doi: 10.1370/afm.1564..
Keywords: Patient-Centered Healthcare, Organizational Change, Primary Care: Models of Care, Primary Care, Practice Improvement, Provider: Nurse, Provider: Physician, Provider: Clinician, Provider