National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (4)
- Centers for Education and Research on Therapeutics (CERTs) (1)
- Clinician-Patient Communication (1)
- Communication (2)
- Decision Making (2)
- Disparities (1)
- Education: Patient and Caregiver (1)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Health Insurance (2)
- Hospital Discharge (1)
- Hospitals (1)
- Influenza (1)
- (-) Labor and Delivery (17)
- Maternal Care (3)
- Medicaid (2)
- Medical Errors (1)
- Medical Liability (1)
- Mortality (1)
- Newborns/Infants (3)
- Outcomes (3)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (3)
- Patient Experience (1)
- Patient Safety (2)
- Policy (1)
- Pregnancy (11)
- Quality Improvement (1)
- Quality Indicators (QIs) (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (1)
- Research Methodologies (1)
- Risk (1)
- Social Determinants of Health (1)
- Teams (1)
- Urban Health (1)
- Vaccination (1)
- Women (5)
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 17 of 17 Research Studies DisplayedBurstein PD, Zalenski DM, Edwards JL
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
The researchers established a multifactorial shoulder dystocia response and management protocol to promote sustainable practice change. In the first year, there was a threefold increase in shoulder dystocia reporting, which continued in years 2 and 3. In the first year, 96 percent of clinicians completed all training elements. Overall teams reached a 99 percent adoption rate of the shoulder dystocia protocol.
AHRQ-funded; HS019608.
Citation: Burstein PD, Zalenski DM, Edwards JL .
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
Health Serv Res 2016 Dec;51 Suppl 3:2472-86. doi: 10.1111/1475-6773.12589.
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Keywords: Labor and Delivery, Newborns/Infants, Adverse Events, Quality Improvement, Quality of Care, Patient Safety, Patient-Centered Outcomes Research, Outcomes, Guidelines, Evidence-Based Practice, Pregnancy, Teams
Sentell T, Chang A, Ahn HJ
Maternal language and adverse birth outcomes in a statewide analysis.
The study goal was to consider the relationship of maternal language to birth outcomes using Hawaii’s hospitalization data. It found that non-English speakers had approximately two times higher risk of having an obstetric trauma during a vaginal birth when other factors, including race/ethnicity, were controlled. Non-English speakers also had higher rates of potentially high-risk deliveries.
AHRQ-funded; HS019990; HS021903.
Citation: Sentell T, Chang A, Ahn HJ .
Maternal language and adverse birth outcomes in a statewide analysis.
Women Health 2016;56(3):257-80. doi: 10.1080/03630242.2015.1088114.
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Keywords: Adverse Events, Communication, Labor and Delivery, Outcomes
Bommarito KM, Gross GA, Willers DM
The effect of clinical chorioamnionitis on cesarean delivery in the United States.
This study examined the association of clinical chorioamnionitis on cesarean delivery in a national sample of hospital discharges. It found that women with clinical chorioamnionitis were more likely to have cesarean delivery than those without clinical chorioamnionitis. The risk of cesarean delivery varied significantly by hospital location, teaching status, and U.S. region.
AHRQ-funded; HS019455.
Citation: Bommarito KM, Gross GA, Willers DM .
The effect of clinical chorioamnionitis on cesarean delivery in the United States.
Health Serv Res 2016 Oct;51(5):1879-95. doi: 10.1111/1475-6773.12447.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Labor and Delivery, Pregnancy, Risk, Women
Salemi JL, Pathak EB, Salihu HM
Infant outcomes after elective early-term delivery compared with expectant management.
The purpose of the study was to compare the risk of neonatal morbidity and infant mortality between elective early-term deliveries and those expectantly managed and delivered at 39 weeks of gestation or greater. It concluded that the issues surrounding the timing and reasons for delivery initiation are complicated and each pregnancy unique. Furthermore, it cautions against a general avoidance of all elective early-term deliveries.
AHRQ-funded - HS019997.
Citation: Salemi JL, Pathak EB, Salihu HM .
Infant outcomes after elective early-term delivery compared with expectant management.
Obstet Gynecol 2016 Apr;127(4):657-66. doi: 10.1097/aog.0000000000001331.
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Keywords: Newborns/Infants, Mortality, Pregnancy, Labor and Delivery, Adverse Events
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
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
Rokicki S, Montana L, Fink G
Impact of migration on fertility and abortion: evidence from the household and welfare study of Accra.
The researchers used detailed pregnancy and migration histories collected as part of the Household and Welfare Study of Accra (HAWS) to examine the association between migration and pregnancy outcomes among women residing in the urban slums of Accra, Ghana. They found that the completed fertility patterns of lifetime Accra residents are remarkably similar to those of residents who migrated.
AHRQ-funded; HS000055.
Citation: Rokicki S, Montana L, Fink G .
Impact of migration on fertility and abortion: evidence from the household and welfare study of Accra.
Demography 2014 Dec;51(6):2229-54. doi: 10.1007/s13524-014-0339-0..
Keywords: Pregnancy, Urban Health, Social Determinants of Health, Labor and Delivery
Lorch SA, Martin AE, Ranade R
Lessons for providers and hospitals from Philadelphia's obstetric services closures and consolidations, 1997-2012.
The researchers examined the experience of Philadelphia County, Pennsylvania, where thirteen of nineteen hospital obstetric units closed between 1997 and 2012, and they conducted interviews at eleven hospitals whose obstetric units remained open. Interviewees reported sharp surges in delivery volume and an increase in the proportion of patients with public insurance or no insurance. The authors concluded that their study supports the need for policy makers to anticipate reductions in supply and monitor patient outcomes.
AHRQ-funded; HS018661.
Citation: Lorch SA, Martin AE, Ranade R .
Lessons for providers and hospitals from Philadelphia's obstetric services closures and consolidations, 1997-2012.
Health Aff 2014 Dec;33(12):2162-9. doi: 10.1377/hlthaff.2014.0136.
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Keywords: Labor and Delivery, Pregnancy, Hospitals
Henke RM, Wier LM, Marder WD
AHRQ Author: Friedman BS, Wong HS
Geographic variation in cesarean delivery in the United States by payer.
This study aimed (1) to determine whether the geographic variation in cesarean delivery rate is consistent for private insurance and Medicaid, and (2) to identify the patient, population, and market factors associated with cesarean rate and determine if these factors vary by payer. It concluded that factors associated with geographic variation in cesarean delivery, a frequent and high-resource inpatient procedure, vary somewhat by payer.
AHRQ-authored; AHRQ-funded; 290200600009C.
Citation: Henke RM, Wier LM, Marder WD .
Geographic variation in cesarean delivery in the United States by payer.
BMC Pregnancy Childbirth 2014 Nov 19;14:387. doi: 10.1186/s12884-014-0387-x.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Health Insurance, Labor and Delivery, Medicaid, Pregnancy
Ahrens KA, Louik C, Kerr S
Seasonal influenza vaccination during pregnancy and the risks of preterm delivery and small for gestational age birth.
The researchers examined the associations between seasonal influenza vaccination during pregnancy and the risks of PTD and SGA among a multiyear retrospective cohort of pregnancies. With the exception of pre-term delivery (PTD) associated with the 2009–10 seasonal vaccine, they found no meaningful increases in PTD or small for gestational age risks associated with seasonal trivalent influenza vaccination during pregnancy.
AHRQ-funded; HS018463.
Citation: Ahrens KA, Louik C, Kerr S .
Seasonal influenza vaccination during pregnancy and the risks of preterm delivery and small for gestational age birth.
Paediatr Perinat Epidemiol 2014 Nov;28(6):498-509. doi: 10.1111/ppe.12152..
Keywords: Influenza, Vaccination, Pregnancy, Labor and Delivery
Dublin S, Johnson KE, Walker RL
Trends in elective labor induction for six United States health plans, 2001-2007.
The authors sought to describe trends in labor induction, including elective induction, from 2001 to 2007 for six U.S. health plans and to examine the validity of induction measures derived from birth certificate and health plan data. They found that induction prevalence rose from 28% in 2001 to 32% in 2005, then declined to 29% in 2007, with the trend being similar for subgroups by parity and gestational age. Elective induction prevalence varied considerably across plans.
AHRQ-funded; HS016955.
Citation: Dublin S, Johnson KE, Walker RL .
Trends in elective labor induction for six United States health plans, 2001-2007.
J Womens Health 2014 Nov;23(11):904-11. doi: 10.1089/jwh.2014.4779.
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Keywords: Centers for Education and Research on Therapeutics (CERTs), Health Insurance, Labor and Delivery, Pregnancy, Women
Eden KB, Perrin NA, Vesco KK
A randomized comparative trial of two decision tools for pregnant women with prior cesareans.
The authors evaluated tools to help pregnant women with prior cesareans make informed decisions about having trials of labor. They found that women in both groups felt more informed, were more clear about their birth priorities, felt more supported, and overall reported less conflict after receiving either intervention.
AHRQ-funded; HS011338; HS013959.
Citation: Eden KB, Perrin NA, Vesco KK .
A randomized comparative trial of two decision tools for pregnant women with prior cesareans.
J Obstet Gynecol Neonatal Nurs 2014 Sep-Oct;43(5):568-79. doi: 10.1111/1552-6909.12485.
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Keywords: Education: Patient and Caregiver, Decision Making, Labor and Delivery, Patient-Centered Outcomes Research
Sentell T, Chang A, Cheng Y
Maternal quality and safety outcomes for Asians and Pacific Islanders in Hawaii: an observational study from five years of statewide data.
The authors investigated maternal quality and safety outcomes across heterogeneous Asian and Pacific Islanders subgroups in the United States. They found significant variation for Asian and Pacific Islander subgroups across maternal quality and safety outcomes.
AHRQ-funded; HS019990; HS021903.
Citation: Sentell T, Chang A, Cheng Y .
Maternal quality and safety outcomes for Asians and Pacific Islanders in Hawaii: an observational study from five years of statewide data.
BMC Pregnancy Childbirth 2014 Aug 30;14:298. doi: 10.1186/1471-2393-14-298.
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Keywords: Disparities, Labor and Delivery, Patient-Centered Outcomes Research, Quality Indicators (QIs), Racial and Ethnic Minorities
Darney BG, Caughey AB
Elective induction of labor symposium: nomenclature, research methodological issues, and outcomes.
This article focuses on key method issues in studies of elective induction of labor. The authors first identify methodological concerns with the existing literature and discuss each in return. They then review existing evidence about the relationship between elective induction and cesarean delivery.
AHRQ-funded; HS017582
Citation: Darney BG, Caughey AB .
Elective induction of labor symposium: nomenclature, research methodological issues, and outcomes.
Clin Obstet Gynecol. 2014 Jun;57(2):343-62. doi: 10.1097/GRF.0000000000000029..
Keywords: Research Methodologies, Outcomes, Labor and Delivery, Women
Moore JE, Low LK, Titler MG
AHRQ Author: Moore JE
Moving toward patient-centered care: women's decisions, perceptions, and experiences of the induction of labor process.
The researchers identified factors that influence inductions from the perspective of women. They found that lack of informed decision making was cited as a barrier to optimal care; additional themes emerged from the preinduction and postinduction interviews.
AHRQ-authored.
Citation: Moore JE, Low LK, Titler MG .
Moving toward patient-centered care: women's decisions, perceptions, and experiences of the induction of labor process.
Birth 2014 Jun;41(2):138-46. doi: 10.1111/birt.12080.
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Keywords: Decision Making, Labor and Delivery, Patient-Centered Healthcare, Patient Experience, Pregnancy
Hendrich A, McCoy CK, Gale J
Ascension health's demonstration of full disclosure protocol for unexpected events during labor and delivery shows promise.
This article presents a case study concerning challenges, including physician resistance, to the establishment of a common full disclosure protocol at five labor and delivery demonstration sites. Twenty-seven months after implementation, the rate of full disclosure had increased by 221 percent. Practitioners saw a number of factors as key catalysts for change including consistent and ongoing leadership by local practitioners and hospitals.
AHRQ-funded; HS019608.
Citation: Hendrich A, McCoy CK, Gale J .
Ascension health's demonstration of full disclosure protocol for unexpected events during labor and delivery shows promise.
Health Aff 2014 Jan;33(1):39-45. doi: 10.1377/hlthaff.2013.1009..
Keywords: Adverse Events, Clinician-Patient Communication, Communication, Labor and Delivery, Medical Errors, Medical Liability, Policy, Pregnancy, Women