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
251 to 275 of 3101 Research Studies DisplayedMcKernan LC, Finn MTM, Carr ER
Personality and affect when the central nervous system is sensitized: an analysis of central sensitization syndromes in a substance use disorder population.
This article examined the impact of central sensitivity syndromes (CSS) on the clinical presentation of individuals presenting to treatment for a substance use disorder (SUD), with an emphasis on personality and emotional functioning. Exploratory analyses indicated which personality traits most strongly predicted the presence of CSS. The authors discuss these findings using descriptive psychopathology literature, with recommendations for future research.
AHRQ-funded; HS022990.
Citation: McKernan LC, Finn MTM, Carr ER .
Personality and affect when the central nervous system is sensitized: an analysis of central sensitization syndromes in a substance use disorder population.
Psychodyn Psychiatry 2017 Fall;45(3):385-409. doi: 10.1521/pdps.2017.45.3.385..
Keywords: Anxiety, Behavioral Health, Chronic Conditions, Substance Abuse
Zenga J, Suko J, Kallogjeri D
Postoperative hemorrhage and hospital revisit after transoral robotic surgery.
The researchers investigated the incidence and complications related to postoperative hemorrhage (POH) after transoral robotic surgery (TORS). Using HCUP data, they found that the incidence of POH after TORS was low, and few of these patients had a severe complication related to this event. Medical comorbidity and tonsillar subsite may be independent risk factors for POH.
AHRQ-funded; HS019455.
Citation: Zenga J, Suko J, Kallogjeri D .
Postoperative hemorrhage and hospital revisit after transoral robotic surgery.
Laryngoscope 2017 Oct;127(10):2287-92. doi: 10.1002/lary.26626.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Adverse Events, Risk
McBride NM, Johnco C, Salloum A
Prevalence and clinical differences of suicidal thoughts and behaviors in a community sample of youth receiving cognitive-behavioral therapy for anxiety.
This study examined the incidence of suicidal thoughts and behaviors in youth with anxiety before initiating cognitive behavioral therapy, as well as the emergence of suicidal thoughts and behaviors during treatment. Findings suggest that the assessment of suicidality at a single time-point and from one informant is not sufficient to identify at-risk youth. Ongoing assessment of suicidal risk during treatment is important in this population.
AHRQ-funded; HS018665.
Citation: McBride NM, Johnco C, Salloum A .
Prevalence and clinical differences of suicidal thoughts and behaviors in a community sample of youth receiving cognitive-behavioral therapy for anxiety.
Child Psychiatry Hum Dev 2017 Oct;48(5):705-13. doi: 10.1007/s10578-016-0696-6..
Keywords: Anxiety, Behavioral Health, Children/Adolescents, Depression
Sobotka SA, Agarwal RK, Msall ME
Prolonged hospital discharge for children with technology dependency: a source of health care disparities.
As the population of children who use medical technology such as long-term ventilation increases, it is important to critically evaluate the systems for preparing families for home life. The authors discuss the complication of hospital discharge and how it contributes to health and developmental disparities. They also describe a hospital-to-home transitional care model, which presents a home-like environment to provide developmental support while focusing on parental training, home nursing, and public-funding arrangements.
AHRQ-funded; HS023007.
Citation: Sobotka SA, Agarwal RK, Msall ME .
Prolonged hospital discharge for children with technology dependency: a source of health care disparities.
Pediatr Ann 2017 Oct;46(10):e365-e70. doi: 10.3928/19382359-20170919-01.
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Keywords: Children/Adolescents, Disparities, Home Healthcare, Hospital Discharge, Medical Devices
Finn Davis K, Napolitano N, Li S
Promoters and barriers to implementation of tracheal intubation airway safety bundle: a mixed-method analysis.
This study describes promoters and barriers to implementation of an airway safety quality improvement bundle from the perspective of interdisciplinary frontline clinicians and ICU quality improvement leaders. Both early and late adopters identified similar promoter and barrier themes. Early adopter sites customized the quality improvement bundle and had an interdisciplinary quality improvement team approach.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Finn Davis K, Napolitano N, Li S .
Promoters and barriers to implementation of tracheal intubation airway safety bundle: a mixed-method analysis.
Pediatr Crit Care Med 2017 Oct;18(10):965-72. doi: 10.1097/pcc.0000000000001251.
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Keywords: Critical Care, Intensive Care Unit (ICU), Patient Safety, Quality Improvement, Respiratory Conditions
Braun D, Gorfine M, Parmigiani G
Propensity scores with misclassified treatment assignment: a likelihood-based adjustment.
The researchers show that misclassification of treatment assignment can impact three distinct stages of a propensity score analysis. They examine how error in the treatment assignment impacts each stage in the context of three common propensity score implementations: subclassification, matching, and inverse probability of treatment weighting (IPTW). They propose a two-step likelihood-based approach which fully adjusts for treatment misclassification bias under subclassification
AHRQ-funded; HS021991.
Citation: Braun D, Gorfine M, Parmigiani G .
Propensity scores with misclassified treatment assignment: a likelihood-based adjustment.
Biostatistics 2017 Oct 1;18(4):695-710. doi: 10.1093/biostatistics/kxx014.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies
Ndefo UA, Moultry AM, Davis PN
Provision of medication therapy management by pharmacists to patients with type-2 diabetes mellitus in a federally qualified health center.
This article describes a medication therapy management (MTM) pilot program that was implemented at a federally qualified health center. This program was implemented at three clinics involving patients with uncontrolled diabetes, defined as hemoglobin A1c (HbA1c) greater than 8 percent. Fifty-seven patients met the established criteria and were enrolled in the six-month program. Thirty-seven patients completed the program and had an average 15 percent reduction in HbA1c.
AHRQ-funded; 290201100001C.
Citation: Ndefo UA, Moultry AM, Davis PN .
Provision of medication therapy management by pharmacists to patients with type-2 diabetes mellitus in a federally qualified health center.
P&T 2017 Oct;42(10):632-37.
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Keywords: Diabetes, Medication, Chronic Conditions, Patient-Centered Healthcare, Provider: Pharmacist
Gonzales G, Golberstein E, Hill SC
AHRQ Author: Hill, SC; Zuvekas, SH
Psychological distress and enrollment in Medicaid.
Adults with poor mental health may want and need insurance to obtain care, but symptoms may impede enrollment into public health insurance. The enrollment response to Medicaid expansions prior to the Affordable Care Act was stronger for adults symptomatic of psychological distress compared with adults without distress and compared to adults with chronic physical health problems.
AHRQ-authored.
Citation: Gonzales G, Golberstein E, Hill SC .
Psychological distress and enrollment in Medicaid.
J Behav Health Serv Res 2017 Oct;44(4):523-35. doi: 10.1007/s11414-016-9532-9.
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Keywords: Access to Care, Policy, Medicaid, Medical Expenditure Panel Survey (MEPS), Behavioral Health
Mosaly PR, Mazur LM, Marks LB
Quantification of baseline pupillary response and task-evoked pupillary response during constant and incremental task load.
The objective of this study was to assess variability in baseline pupil size and task-evoked pupillary response (TEPR) during two basic working memory tasks: constant load of 3-letters memorization-recall (10 trials), and incremental load memorization-recall. It concluded that quantification of TEPR can be affected by shifts in baseline pupil size that are most likely affected by non-cognitive factors when other external factors are kept constant.
AHRQ-funded; HS023458; HS024062.
Citation: Mosaly PR, Mazur LM, Marks LB .
Quantification of baseline pupillary response and task-evoked pupillary response during constant and incremental task load.
Ergonomics 2017 Oct;60(10):1369-75. doi: 10.1080/00140139.2017.1288930.
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Keywords: Health Information Technology (HIT), Provider: Health Personnel, Patient Safety
Goyal MK, Johnson TJ, Chamberlain JM
Racial and ethnic differences in antibiotic use for viral illness in emergency departments.
The researchers sought to investigate whether patient race and ethnicity was associated with differences in antibiotic prescribing for viral acute respiratory tract infections (ARTIs) in the pediatric emergency department (PED). They found that compared with non-Hispanic (NH) white children, NH black and Hispanic children were less likely to receive antibiotics for viral ARTIs in the PED.
AHRQ-funded; HS020270.
Citation: Goyal MK, Johnson TJ, Chamberlain JM .
Racial and ethnic differences in antibiotic use for viral illness in emergency departments.
Pediatrics 2017 Oct;140(4). doi: 10.1542/peds.2017-0203.
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Keywords: Racial and Ethnic Minorities, Emergency Department, Children/Adolescents, Disparities, Practice Patterns
Leeds IL, Alimi Y, Hobson DR
Racial and socioeconomic differences manifest in process measure adherence for enhanced recovery after surgery pathway.
This study aims to demonstrate the association between recovery pathway implementation, process measures, and short-term surgical outcomes by population subgroup. It concluded that differences in outcomes by race and socioeconomic status did not arise following implementation of an enhanced recovery pathway. Differences in process measures by population subgroups highlight differences in care that require further investigation.
AHRQ-funded; HS024736; HS024547.
Citation: Leeds IL, Alimi Y, Hobson DR .
Racial and socioeconomic differences manifest in process measure adherence for enhanced recovery after surgery pathway.
Dis Colon Rectum 2017 Oct;60(10):1092-101. doi: 10.1097/dcr.0000000000000879.
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Keywords: Racial and Ethnic Minorities, Social Determinants of Health, Surgery, Outcomes, Adverse Events
Keohane LM, Trivedi AN, Mor V
Recent health care use and Medicaid entry of Medicare beneficiaries.
The purpose of this study was to examine the relationship between Medicaid entry and recent health care use among Medicare beneficiaries. Although recent health care use predicted greater likelihood of Medicaid entry, half of new Medicaid participants used no hospital or nursing home care during the study period.
AHRQ-funded; HS023016.
Citation: Keohane LM, Trivedi AN, Mor V .
Recent health care use and Medicaid entry of Medicare beneficiaries.
Gerontologist 2017 Oct 1;57(5):977-86. doi: 10.1093/geront/gnw189..
Keywords: Elderly, Healthcare Utilization, Health Services Research (HSR), Medicaid, Medicare
Kamal AH
Redesigning oncology care delivery: Early wins, lessons learned, and a roadmap.
This editorial, discusses oncology care delivery and comments on an article by Colligan, et al., published, in 2017, in Medical Care, entitled “Two innovative cancer care programs have potential to reduce utilization and spending.”
AHRQ-funded; HS023681.
Citation: Kamal AH .
Redesigning oncology care delivery: Early wins, lessons learned, and a roadmap.
Med Care 2017 Oct;55(10):871-72. doi: 10.1097/mlr.00000000000.
Keywords: Cancer, Healthcare Delivery, Patient-Centered Outcomes Research
Chen J, Vargas-Bustamante A, Novak P
Reducing young adults' health care spending through the ACA expansion of dependent coverage.
The researchers estimated health care expenditure trends among young adults ages 19-25 before and after the 2010 implementation of the Affordable Care Act (ACA) provision that extended eligibility for dependent private health insurance coverage. They found that increased health insurance enrollment as a consequence of the ACA provision for dependent coverage has successfully reduced spending and catastrophic expenditures, providing financial protections for young adults.
AHRQ-funded; HS022135.
Citation: Chen J, Vargas-Bustamante A, Novak P .
Reducing young adults' health care spending through the ACA expansion of dependent coverage.
Health Serv Res 2017 Oct;52(5):1835-57. doi: 10.1111/1475-6773.12555.
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Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Healthcare Costs, Policy, Young Adults
Cottrell EK, Hall JD, Kautz G
Reporting from the front lines: implementing Oregon's alternative payment methodology in federally qualified health centers.
Alternative payment models have been proposed as a way to facilitate patient-centered medical home model implementation, yet little is known about how payment reform translates into changes in care delivery. This study conducted site visits, observed operations, and conducted interviews within 3 Federally Qualified Health Center organizations. They identified several care delivery changes during the early stages of implementation, as well as challenges associated with this new model of payment.
AHRQ-funded; HS022651.
Citation: Cottrell EK, Hall JD, Kautz G .
Reporting from the front lines: implementing Oregon's alternative payment methodology in federally qualified health centers.
J Ambul Care Manage 2017 Oct/Dec;40(4):339-46. doi: 10.1097/jac.0000000000000198..
Keywords: Healthcare Delivery, Payment, Patient-Centered Healthcare, Policy, Primary Care
Lo Re VR, Zeldow B, Kallan MJ
Risk of liver decompensation with cumulative use of mitochondrial toxic nucleoside analogues in HIV/hepatitis C virus coinfection.
This cohort study was conducted to determine if cumulative mitochondrial toxic nucleoside reverse transcriptase inhibitors (mtNRTI) use increased the risk of hepatic decompensation and death among patients coinfected with human immunodeficiency virus (HIV) and chronic hepatitis C virus (HCV). The findings suggest that cumulative mtNRTI use may increase the risk of hepatic decompensation and death in HIV/HCV coinfection and should be avoided when alternatives exist for HIV/HCV patients.
AHRQ-funded; HS018372.
Citation: Lo Re VR, Zeldow B, Kallan MJ .
Risk of liver decompensation with cumulative use of mitochondrial toxic nucleoside analogues in HIV/hepatitis C virus coinfection.
Pharmacoepidemiol Drug Saf 2017 Oct;26(10):1172-81. doi: 10.1002/pds.4258..
Keywords: Adverse Drug Events (ADE), Hepatitis, Human Immunodeficiency Virus (HIV), Medication, Patient Safety
Arbaje AI, Yu Q, Wang J J
Senior services in US hospitals and readmission risk in the Medicare population.
The purpose of this study was to determine whether hospitals' Senior Care Services Scale (SCSS) scores were associated with risk of readmission among Medicare beneficiaries. The study concluded that senior services at the hospital-level represented a modifiable risk factor with important impact. Employing organization-level characteristics in readmission risk prediction tools should be expanded.
AHRQ-funded; HS022916
Citation: Arbaje AI, Yu Q, Wang J J .
Senior services in US hospitals and readmission risk in the Medicare population.
Int J Qual Health Care 2017 Oct 1;29(6):845-52. doi: 10.1093/intqhc/mzx112..
Keywords: Elderly, Health Services Research (HSR), Hospital Readmissions, Hospitals, Medicare
Goto T, Faridi MK, Gibo K
Sex and racial/ethnic differences in the reason for 30-day readmission after COPD hospitalization.
This retrospective cohort study used 2006-2012 data from the State Inpatient Database of eight geographically-diverse US states (Arkansas, California, Florida, Iowa, Nebraska, New York, Utah, and Washington) to examine 30-day readmissions in patients hospitalized for chronic obstructive pulmonary disease (COPD). In their analysis of all-payer population-based data, the authors found sex and racial/ethnic differences in the reason for 30-day readmission in patients hospitalized for COPD.
AHRQ-funded; HS023305.
Citation: Goto T, Faridi MK, Gibo K .
Sex and racial/ethnic differences in the reason for 30-day readmission after COPD hospitalization.
Respir Med 2017 Oct;131:6-10. doi: 10.1016/j.rmed.2017.07.056..
Keywords: Respiratory Conditions, Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Hospital Readmissions, Sex Factors
Young LE, Michaels S, Jonas A
Sex behaviors as social cues motivating social venue patronage among young black men who have sex with men.
This study presents a two-mode network analysis that determines the extent that three types of sex behaviors-condomless sex, sex-drug use, and group sex-influence the patronage of different types of social venues among a population sample of young Black men who have sex with men. Its findings demonstrate that social venues can function as intermediary contexts in which relationships can form between individuals that have greater risk potential.
AHRQ-funded; HS000084.
Citation: Young LE, Michaels S, Jonas A .
Sex behaviors as social cues motivating social venue patronage among young black men who have sex with men.
AIDS Behav 2017 Oct;21(10):2924-34. doi: 10.1007/s10461-017-1679-8.
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Keywords: Lifestyle Changes, Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Substance Abuse
Bucholz EM, Strait KM, Dreyer RP
Sex differences in young patients with acute myocardial infarction: a VIRGO study analysis.
This study sought to compare young women and men at the time of acute myocardial infarction (AMI) on six domains of demographic and clinical factors in order to determine whether they have distinct profiles. The authors concluded that young women with AMI represent a distinct, higher-risk population that is different from young men.
AHRQ-funded; HS023000.
Citation: Bucholz EM, Strait KM, Dreyer RP .
Sex differences in young patients with acute myocardial infarction: a VIRGO study analysis.
Eur Heart J Acute Cardiovasc Care 2017 Oct;6(7):610-22. doi: 10.1177/2048872616661847..
Keywords: Heart Disease and Health, Patient-Centered Outcomes Research, Risk, Sex Factors
Jutkowitz E, Kane RL, Gaugler JE
Societal and family lifetime cost of dementia: implications for policy.
This study estimated the cost of dementia and the extra cost of caring for someone with dementia over the cost of caring for someone without dementia. It found that the discounted total lifetime cost of care for a person with dementia was $321,780. Costs for a person with dementia over a lifetime were $184,500 greater (86% incurred by families) than for someone without dementia.
AHRQ-funded; HS024165.
Citation: Jutkowitz E, Kane RL, Gaugler JE .
Societal and family lifetime cost of dementia: implications for policy.
J Am Geriatr Soc 2017 Oct;85(10):2169-75. doi: 10.1111/jgs.15043.
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Keywords: Healthcare Costs, Dementia, Elderly, Caregiving
Balbale SN, Trivedi I, O'Dwyer LC
Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: a systematic scoping review.
In this study, the investigators conducted a systematic scoping review to describe published scientific literature on strategies to identify and reduce opioid misuse among patients with gastrointestinal (GI) symptoms and disorders. They concluded that prescription drug monitoring and self-management interventions may be promising strategies to identify and reduce opioid misuse in GI care. They suggest that rigorous, empirical research is needed to evaluate the longer-term impact of these strategies.
AHRQ-funded; HS000084.
Citation: Balbale SN, Trivedi I, O'Dwyer LC .
Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: a systematic scoping review.
Dig Dis Sci 2017 Oct;62(10):2668-85. doi: 10.1007/s10620-017-4705-9..
Keywords: Behavioral Health, Chronic Conditions, Digestive Disease and Health, Medication, Medication: Safety, Opioids, Patient Self-Management, Prevention, Substance Abuse
Nelson HD, Denneson LM, Low AR
Suicide risk assessment and prevention: a systematic review focusing on veterans.
This article reviews studies of the accuracy of methods to identify individuals at increased risk of suicide and the effectiveness and adverse effects of health care interventions relevant to U.S. veteran and military populations in reducing suicide and suicide attempts. It concludes that risk assessment methods have been shown to be sensitive predictors of suicide and suicide attempts, but the frequency of false positives limits their clinical utility.
AHRQ-funded; HS019456.
Citation: Nelson HD, Denneson LM, Low AR .
Suicide risk assessment and prevention: a systematic review focusing on veterans.
Psychiatr Serv 2017 Oct;68(10):1003-15. doi: 10.1176/appi.ps.201600384.
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Keywords: Comparative Effectiveness, Behavioral Health, Prevention, Risk
Ban KA, Gibbons MM, Ko CY
Surgical technical evidence review for colorectal surgery conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
The objective of this article is to provide a comprehensive review of the evidence supporting the surgical components of the Improving Surgical Care and Recovery (ISCR) colorectal (CR) pathway. This review will evaluate the evidence supporting CR pathways and develop an evidence-based CR protocol to help hospitals participating in the ISCR program implement evidence-based practices.
AHRQ-funded; 233201500020I.
Citation: Ban KA, Gibbons MM, Ko CY .
Surgical technical evidence review for colorectal surgery conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
J Am Coll Surg 2017 Oct;225(4):548-57.e3. doi: 10.1016/j.jamcollsurg.2017.06.017.
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Keywords: Evidence-Based Practice, Hospitals, Patient Safety, Quality Improvement, Surgery, Quality of Care, Guidelines
Fallah-Fini S, Adam A, Cheskin LJ
The additional costs and health effects of a patient having overweight or obesity: a computational model.
This paper estimates specific additional disease outcomes and costs that could be prevented by helping a patient go from an obesity or overweight category to a normal weight category at different ages.
AHRQ-funded; HS023317.
Citation: Fallah-Fini S, Adam A, Cheskin LJ .
The additional costs and health effects of a patient having overweight or obesity: a computational model.
Obesity 2017 Oct;25(10):1809-15. doi: 10.1002/oby.21965.
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Keywords: Healthcare Costs, Obesity, Outcomes