National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Cultural Competence (1)
- Disparities (4)
- Elderly (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Hospitals (1)
- Long-Term Care (1)
- Nursing Homes (1)
- Patient Experience (1)
- Pressure Ulcers (1)
- Quality Improvement (1)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- (-) Quality of Care (5)
- (-) Racial and Ethnic Minorities (5)
- Social Determinants of Health (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 5 of 5 Research Studies DisplayedGriesemer I, Birken SA, Rini C
Mechanisms to enhance racial equity in health care: developing a model to facilitate translation of the ACCURE intervention.
The purpose of this study was to explore the Accountability for Cancer Care through Undoing Racism and Equity (ACCURE) program, which altered systems of care at two United States cancer centers and eliminated the Black-White racial disparity in treatment completion in patients with early-stage breast and lung cancer. The study objective was to identify and document critical characteristics of ACCURE to enable translation of the intervention to other care settings. The researchers conducted semi-structured interviews with 18 participants who were involved in the design and implementation of ACCURE. The study found that participants described transparency and accountability as mechanisms of change that were operationalized through ACCURE's key features. Intervention features were designed to improve either institutional transparency or accountability of the care system to community values and patient needs for minimally biased, tailored communication, and support.
AHRQ-funded; HS000032.
Citation: Griesemer I, Birken SA, Rini C .
Mechanisms to enhance racial equity in health care: developing a model to facilitate translation of the ACCURE intervention.
SSM Qual Res Health 2023 Jun; 3:100204. doi: 10.1016/j.ssmqr.2022.100204..
Keywords: Racial and Ethnic Minorities, Disparities, Quality Improvement, Quality of Care
Sanghavi P, Chen Z
Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings.
The purpose of this study was to evaluate the relationship between nursing home characteristics and reporting of 2 of 3 specific clinical outcomes reported by the Nursing Home Care Compare (NHCC) website: major injury falls and pressure ulcers. The researchers of this quality improvement study utilized hospitalization data for all Medicare fee-for-service beneficiaries between January 1, 2011, and December 31, 2017. Hospital admission claims for major injury falls and pressure ulcers were linked with facility-reported evaluations at the nursing home resident level. For each linked hospital claim, it was determined whether the nursing home had reported the event and rates of reporting were computed. To evaluate whether nursing homes reported similarly on both measures, the researchers estimated the relationship between reporting of major injury falls and pressure ulcers within a nursing home, and explored racial and ethnic disparities that could otherwise explain the associations. The study sample included 13,179 nursing homes where 131,000 residents experienced major injury fall or pressure ulcer hospitalizations. Of the 98,669 major injury fall hospitalizations, 60.0% were reported, and of the 39,894 stage 3 or 4 pressure ulcer hospitalizations, 67.7% were reported. Underreporting for both conditions was pervasive, with 69.9% and 71.7% of nursing homes having reporting rates less than 80% for major injury fall and pressure ulcer hospitalizations, respectively. Lower reporting rates had few correlations with facility characteristics other than racial and ethnic composition. Facilities with high vs low fall reporting rates had significantly more White residents (86.9% vs 73.3%), and facilities with high vs low pressure ulcer reporting rates had significantly fewer White residents (69.7% vs 74.9%).
AHRQ-funded; HS026957.
Citation: Sanghavi P, Chen Z .
Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings.
JAMA Netw Open 2023 May; 6(5):e2314822. doi: 10.1001/jamanetworkopen.2023.14822..
Keywords: Quality Measures, Quality of Care, Elderly, Disparities, Racial and Ethnic Minorities, Nursing Homes, Pressure Ulcers, Healthcare-Associated Infections (HAIs), Quality Indicators (QIs), Long-Term Care
Hegland TA, Owens PL, Selden TM
AHRQ Author: Hegland TA, Owens PL, Selden TM
New evidence on geographic disparities in United States hospital capacity.
The purpose of this study was to describe hospital capacity across the United States. The researchers combined American Hospital Association Survey, Hospital Compare, and American Community Survey data with the 2017 near-census of U.S. hospital inpatient discharges from the Healthcare Cost and Utilization Project (HCUP). The study found that 0.11 more beds per 1000 population were supplied to zip codes where Non-Hispanic individuals live than zip codes where non-Hispanic White individuals live. However, the hospitals supplying this capacity have 0.36 fewer staff per bed and perform worse on many care quality measures. Zip codes in the most urban parts of America have the least hospital capacity (2.11 beds per 1000 persons) from across the rural-urban continuum. While more rural areas have higher capacity levels, urban areas have advantages in staff and capital per bed. The researchers did not find systematic differences in care quality between rural and urban areas. The study concluded that lower hospital care quality and resource intensity plays a key role in racial, ethnic, and income disparities in hospital care related outcomes.
AHRQ-authored.
Citation: Hegland TA, Owens PL, Selden TM .
New evidence on geographic disparities in United States hospital capacity.
Health Serv Res 2022 Oct;57(5):1006-19. doi: 10.1111/1475-6773.14010..
Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Hospitals, Quality of Care, Racial and Ethnic Minorities
Fowler FJ, Brenner PS, Cosenza C
How responding in Spanish affects CAHPS results.
The purpose of this study was to examine the associations of language and ethnicity with responses to CAHPS surveys and assess the effect of responding to CAHPS surveys in Spanish. The researchers surveyed patients who had received care at a Connecticut community health center within 6 or 12 months of being sent a CAHPS survey that asks about care experiences. Three hypotheses were tested: 1. Spanish speakers are more likely to choose extreme response options. 2. The meaning of the Spanish translation is different than the English version of the questions, with Spanish speakers providing different answers because of meaning differences. 3. Spanish speakers have different expectations regarding their health care than those who answer in English. Researchers evaluated any differences by ethnicity and language. The study found that those answering in Spanish gave significantly more positive reports than the other two groups on three of the five measures, and higher than the non-Hispanic respondents on a fourth. The study concluded that subjects answering in Spanish gave more positive reports of their medical experiences than Hispanics and non-Hispanics answering in English.
AHRQ-funded; HS016978.
Citation: Fowler FJ, Brenner PS, Cosenza C .
How responding in Spanish affects CAHPS results.
BMC Health Serv Res 2022 Jul 8;22(1):884. doi: 10.1186/s12913-022-08262-1..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Cultural Competence, Patient Experience, Quality of Care, Racial and Ethnic Minorities
Fiscella K, Sanders MR
Racial and ethnic disparities in the quality of health care.
The annual National Healthcare Quality and Disparities Reports document widespread and persistent racial and ethnic disparities. Recent data suggest slow progress in many areas but have documented a few notable successes in eliminating these disparities. To eliminate these disparities, continued progress will require a collective national will to ensure health care equity through expanded health insurance coverage, support for primary care, and public accountability.
AHRQ-funded; HS022440.
Citation: Fiscella K, Sanders MR .
Racial and ethnic disparities in the quality of health care.
Annu Rev Public Health 2016;37:375-94. doi: 10.1146/annurev-publhealth-032315-021439.
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Keywords: Disparities, Quality of Care, Racial and Ethnic Minorities, Social Determinants of Health