National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (4)
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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 25 of 52 Research Studies DisplayedChisolm DJ, Dugan JA, Figueroa JF
Improving health equity through health care systems research.
This study’s objective was to describe health equity research priorities for health care delivery systems and delineate a research and action agenda that generates evidence-based solutions to persistent racial and ethnic inequities in health outcomes. This project was conducted as a component of the AHRQ stakeholder engaged process to develop an Equity Agenda and Action Plan to guide priority setting to advance health equity. The stakeholders included experts from academia, health care organizations, industry, and government. Five priority themes were derived iteratively through experts from academia, health care organizations, industry, and government. They identified six priority themes for research; (1) institutional leadership, culture, and workforce; (2) data-driven, culturally tailored care; (3) health equity targeted performance incentives; (4) health equity-informed approaches to health system consolidation and access; (5) whole person care; (6) and whole community investment. They also suggested cross-cutting themes regarding research workforce and research timelines.
AHRQ-funded.
Citation: Chisolm DJ, Dugan JA, Figueroa JF .
Improving health equity through health care systems research.
Health Serv Res 2023 Dec; 58(suppl 3):289-99. doi: 10.1111/1475-6773.14192..
Keywords: Health Systems, Disparities, Social Determinants of Health, Healthcare Delivery
Bierman AS, Mistry KB
AHRQ Author: Bierman AS, Mistry KB
Commentary: Achieving health equity - the role of learning health systems.
The article discussed learning health systems and their role in achieving health equity. Issues considered were prioritization of health equity, development and implementation of models of care, partnerships with patients and communities, research on the effectiveness of interventions across diverse populations, integration strategies, and multisector collaborations to address social needs. The authors concluded that by considering these issues, learning health systems can play a pivotal role in eliminating health inequities.
AHRQ-authored.
Citation: Bierman AS, Mistry KB .
Commentary: Achieving health equity - the role of learning health systems.
Healthc Policy 2023 Nov; 19(2):21-27. doi: 10.12927/hcpol.2023.27236..
Keywords: Learning Health Systems, Health Systems, Disparities
Ganguli I, Mackwood MB, Yang CW
Racial differences in low value care among older adult Medicare patients in US health systems: retrospective cohort study.
The objective of this retrospective cohort study was to characterize racial differences in receipt of low-value care among older Medicare beneficiaries overall and within U.S. health systems. Medicare fee-for-service administrative data was used for Black and White Medicare patients who were at least 65 as of 2016. Findings showed that, of the 40 low value services examined, Black patients had a higher adjusted receipt of 9 services and lower receipt of 20 services than White patients. Differences were generally small and largely due to differential care within health systems, but the authors concluded that their findings suggested potential factors that researchers, policymakers, and health system leaders might investigate to improve health care quality and equity.
AHRQ-funded; HS024930.
Citation: Ganguli I, Mackwood MB, Yang CW .
Racial differences in low value care among older adult Medicare patients in US health systems: retrospective cohort study.
BMJ 2023 Oct 25; 383:e074908. doi: 10.1136/bmj-2023-074908..
Keywords: Elderly, Racial and Ethnic Minorities, Medicare, Health Systems
Kim B, Cruden G, Crable EL
A structured approach to applying systems analysis methods for examining implementation mechanisms.
This article delineated a structured approach to applying systems analysis methods to examining implementation mechanisms. This approach included steps for selecting, tailoring, and evaluating an implementation strategy. The authors illustrated the approach by using an example case, then discussed the strengths and limitations of this approach, when each step might be appropriate. They suggested work that might extend systems analysis methods to the implementation mechanisms research.
AHRQ-funded; HS025632.
Citation: Kim B, Cruden G, Crable EL .
A structured approach to applying systems analysis methods for examining implementation mechanisms.
Implement Sci Commun 2023 Oct 19; 4(1):127. doi: 10.1186/s43058-023-00504-5..
Keywords: Implementation, Evidence-Based Practice, Health Systems
Simpson SA, Loh R, Elliott L
A mortality surveillance collaboration between a health system and public health department.
The authors described a collaboration between a health system and public health department to create a mortality surveillance system that enabled the health system to identify more than six times the number of deaths identified through local system medical records. They concluded that this epidemiological process that combined nuanced data captured through clinical care in health systems with subsequent data on mortality can be of particular benefit to underserved communities.
AHRQ-funded; HS027389.
Citation: Simpson SA, Loh R, Elliott L .
A mortality surveillance collaboration between a health system and public health department.
Am J Public Health 2023 Sep; 113(9):943-46. doi: 10.2105/ajph.2023.307335..
Keywords: Public Health, Health Systems
Johnson PT, Conway SJ, Berkowitz SA
Transforming health care from volume to value: a health system implementation road map.
The mission of the High Value Practice Academic Alliance is to 1) rapidly disseminate effective value-based performance improvement processes to safely decrease the cost of care for patients, and 2) train the next generation of physicians in principles of high value practice. The organization convened 100 academic medical center partners, and after 5 years of practice, opened membership to any medical center and became the High Value Practice Alliance. In 2021 and 2022, directors of the alliance devoted educational programs of the annual conference to developing a care delivery roadmap identifying the strategies and programs required to maximize resource use, clinical effectiveness, and care coordination. The group is now publishing the “playbook” as a series of focused articles, a comprehensive framework to improve the health care value in a delivery system. This playbook includes 3 performance improvement approaches: 1) resource focused, 2) infrastructure focused, and 3) condition focused. The Transforming Healthcare from Volume to Value: a Health System Implementation RoadMap manuscript series will address each of the strategies and relevant programs.
AHRQ-funded; HS029151; HS026350.
Citation: Johnson PT, Conway SJ, Berkowitz SA .
Transforming health care from volume to value: a health system implementation road map.
Am J Med 2023 Aug; 136(8):763-67. doi: 10.1016/j.amjmed.2023.04.030..
Keywords: Health Systems, Implementation, Healthcare Delivery
Ong T, Albon D, Amin RS
Establishing a Cystic Fibrosis Learning Network: interventions to promote collaboration and data-driven improvement at scale.
This paper describes the Cystic Fibrosis Learning Network (CFLN), which was designed to improve medical outcomes and quality of life through an intentional focus on achieving reliable evidence-based chronic care delivery and creating a system for data-driven collaborative learning. The authors described the development and growth of the CFLN considering six domains of a Network Maturity Grid: system leadership; governance and policy management; quality improvement (QI); engagement and community building; data and analytics; and research. The CFLN represents 36 accredited care centers in the CF Foundation Care Center Network caring for over 6300 patients, with 77% of 6779 patient clinical care visits/quarter entering into the Registry within 30 days. Almost all CFLN teams (94%) have a patient/family partner (PFP), and 74% of PFPs indicate they are actively participating, taking ownership of, or leading QI initiatives with the interdisciplinary care team. In 2022, most (97%) centers reported completing 1-13 improvement cycles per month, and 82% contributed to monthly QI progress reports to share learning.
AHRQ-funded; HS02639.
Citation: Ong T, Albon D, Amin RS .
Establishing a Cystic Fibrosis Learning Network: interventions to promote collaboration and data-driven improvement at scale.
Learn Health Syst 2023 Jul; 7(3):e10354. doi: 10.1002/lrh2.10354..
Keywords: Learning Health Systems, Health Systems
Harrison MI, Borsky AE
AHRQ Author: Harrison MI
How alignment between health systems and their embedded research units contributes to system learning.
This AHRQ-authored paper examined the organization of learning health system (LHS) research units and conditions affecting their contributions to system improvement and learning. The authors conducted 12 key-informant and 44 semi-structured interviews in six delivery systems engaged in LHS research. Using rapid qualitative analysis, they identified themes and compared successful versus challenging projects; LHS units and other research units in the same system; and LHS units in different systems. They found that LHS units operate both independently and as subunits within larger research centers. Key alignment factors identified were availability of internal (system) funding directing researchers' work toward system priorities; researchers' skills and experiences that fit a system's operational needs; LHS unit subculture supporting system improvement and collaboration with clinicians and other internal stakeholders; applications of external funding to system priorities; and executive leadership for system-wide learning. Direct consultation between LHS unit leaders and system executives and engagement of researchers in clinical and operational activities fostered mutual understanding and collaboration between researchers, clinicians, and leaders.
AHRQ-authored.
Citation: Harrison MI, Borsky AE .
How alignment between health systems and their embedded research units contributes to system learning.
Healthc 2023 Jun; 11(2):100688. doi: 10.1016/j.hjdsi.2023.100688..
Keywords: Health Systems, Learning Health Systems
Beaulieu ND, Chernew ME, McWilliams JM
Organization and performance of US health systems.
The objectives of this evidence review were to identify and describe health systems in the US, to assess differences between physicians and hospitals in and outside of health systems, and to compare quality and cost of care delivered by physicians and hospitals in and outside of health systems. A total of 580 health systems in a great variety of sizes were identified; prices for physician, hospital services, and total spending were assessed in 2018 commercial claims data. Health system physicians and hospitals were shown to deliver a large portion of medical services. Clinical quality performance and patient experience measures were slightly better in systems; however, spending and prices were significantly higher, especially in small practices. The authors concluded that slight quality differentials in combination with large price differentials suggested that health systems have not realized their potential for better care at equal or lower cost.
AHRQ-funded; HS024072.
Citation: Beaulieu ND, Chernew ME, McWilliams JM .
Organization and performance of US health systems.
JAMA 2023 Jan 24; 329(4):325-35. doi: 10.1001/jama.2022.24032..
Keywords: Health Systems, Healthcare Delivery, Provider Performance, Quality Measures, Quality of Care, Hospitals
Sirkin JT, Flanagan E, Tong ST
AHRQ Author: Tong ST, McNellis RJ, Bierman AS
Primary care's challenges and responses in the face of the COVID-19 pandemic: insights from AHRQ's learning community.
The purpose of this paper was to review the Agency for Healthcare Research and Quality’s (AHRQ) learning community organized to engage and support primary care in responding to COVID-19 and provide an opportunity for participants to communicate learning and peer support, improve understanding of the stressors and challenges faced by practices, determine needs, and identify possible solutions to challenges of the pandemic. The researchers identified challenges, responses, and innovations that occurred through the engagement and information sharing of the learning community and categorized them across 5 domains, including: patient-centeredness, clinician and practice, systems and infrastructure, community and public health; and health equity which cut across each of the other domains. The authors concluded that the learning community provided valuable insights for future research and policy, primary care delivery improvement, and ensuring greater preparedness for future challenges.
AHRQ-authored.
Citation: Sirkin JT, Flanagan E, Tong ST .
Primary care's challenges and responses in the face of the COVID-19 pandemic: insights from AHRQ's learning community.
Ann Fam Med 2023 Jan-Feb; 21(1):76-82. doi: 10.1370/afm.2904..
Keywords: COVID-19, Primary Care, Learning Health Systems, Health Systems, Evidence-Based Practice, Public Health
Henriksen K, Rodrick D, Grace EN
AHRQ Author: Henriksen K, Rodrick D, Grace EN, Shofer M, Brady, JP
Pursuing patient safety at the intersection of design, systems engineering, and health care delivery research: an ongoing assessment.
This article describes a grant initiative undertaken by AHRQ that brings design, systems engineering, and health care delivery research together to test new ideas that could make health care safer. Based on feedback received from project teams, lessons learned are emerging that find considerable variation among project teams in deploying the methodology and a longer-than-anticipated amount of time in bringing team members from different disciplines together where they learn to communicate and function as a team. Three narratives are generated in terms of what success might look like.
AHRQ-authored.
Citation: Henriksen K, Rodrick D, Grace EN .
Pursuing patient safety at the intersection of design, systems engineering, and health care delivery research: an ongoing assessment.
J Patient Saf 2021 Dec 1;17(8):e1685-e90. doi: 10.1097/pts.0000000000000577..
Keywords: Patient Safety, Healthcare Delivery, Learning Health Systems, Health Systems
Chhabra KR, Sheetz KH, Regenbogen SE
Wide variation in surgical spending within hospital systems: a missed opportunity for bundled payment success.
Researchers sought to measure the extent of variation in episode spending around total hip replacement for fee-for-service Medicare patients within and across hospital systems identified in the American Hospital Association Annual Survey. They found that average episode payments varied nearly as much within hospital systems as they did between the lowest- and highest-cost quintiles of systems, with variation driven by post-acute care utilization.
AHRQ-funded; HS000053.
Citation: Chhabra KR, Sheetz KH, Regenbogen SE .
Wide variation in surgical spending within hospital systems: a missed opportunity for bundled payment success.
Ann Surg 2021 Dec 1;274(6):e1078-e84. doi: 10.1097/sla.0000000000003741..
Keywords: Surgery, Health Systems, Medicare, Healthcare Costs, Hospitals
Baskin AS, Wang T, Miller J
A health systems ethical framework for de-implementation in health care.
De-implementation is the ethical obligation to eliminate health care practices which are unnecessary, lacking in evidence, harmful, and/ or prevent the spending of resources on more beneficial services. The purpose of this study was to apply Krubiner and Hyder’s bioethical framework for health systems activity to the analysis of de-implementation ethics in the broader context of health care systems. The focus was specifically on ethics principles relevant to de-implementation which serve to call for or facilitate low value surgery. The authors identified the 5 health systems principles from Krubiner and Hyder’s 11 most relevant to the topic of de-implementation. These included: evidence and effectiveness, transparency and public engagement, efficiency, responsiveness, and collaboration. The study concluded that a health-systems framework allows for consideration of the factors which impact de-implementation, and gives providers to ability to think about new ways to address barriers to the reduction of low-value care.
AHRQ-funded; HS026030.
Citation: Baskin AS, Wang T, Miller J .
A health systems ethical framework for de-implementation in health care.
J Surg Res 2021 Nov;267:151-58. doi: 10.1016/j.jss.2021.05.006..
Keywords: Health Systems, Healthcare Delivery
Ganguli I, Morden NE, Yang CW
Low-value care at the actionable level of individual health systems.
This study measured and reported low-value care use across and within individual health systems and to identify system characteristics associated with higher use using Medicare administrative data. This retrospective cohort study was conducted using 11,637,763 Medicare beneficiaries in 556 health systems in the AHRQ Compendium of US Health Systems. These Medicare beneficiaries were enrolled in Medicare Parts A and B for at least 12 months in 2016 or 2017. The most common low-value services include preoperative laboratory testing, prostate-specific antigen testing in men older than 70 years, and use of antipsychotic medications in patients with dementia. Forty-one low-value services were measured based on the Milliman MedInsight Health Waste Calculator. In multivariable analysis, the health system characteristics associated with higher use of low-value care were a smaller proportion of primary care physicians for systems with less than the median percentage of primary care physicians vs -0.16 for those with more than the median percentage of primary care physicians; no major teaching hospital without a teaching hospital vs -0.18 with a teaching hospital; larger proportion of non-White patients for systems with >20% of non-White beneficiaries vs -0.06 for systems with ≤20% of non-White beneficiaries; headquartered in the South or West for the South and 0.22 for the West compared with -0.09 for the Northeast and -0.44 for the Midwest;, and serving areas with more health care spending for areas above the median level of spending vs -0.24 for areas below the median level of spending.
AHRQ-funded; HS024075.
Citation: Ganguli I, Morden NE, Yang CW .
Low-value care at the actionable level of individual health systems.
JAMA Intern Med 2021 Nov;181(11):1490-500. doi: 10.1001/jamainternmed.2021.5531..
Keywords: Health Systems, Primary Care
Atkinson MK, Singer SJ
Managing organizational constraints in innovation teams: a qualitative study across four health systems.
This study examined how interdisciplinary teams are affected by and manage external constraints over the lifecycle of their innovation project. The authors used a multimethod qualitative approach consisting of over 3 years of participant observation data to analyze how four interdisciplinary teams across different health system experienced and managed constraints as they pursued process innovations. Their findings point to several practical implications concerning innovation processes in healthcare: 1) how conditions in the organizational context, or constraints, can impede team progress at different stages of innovation; and 2) the collective efforts, or tactics, teams use to manage or work around those constraints to further progress on their innovations.
AHRQ-funded; HS024453.
Citation: Atkinson MK, Singer SJ .
Managing organizational constraints in innovation teams: a qualitative study across four health systems.
Med Care Res Rev 2021 Oct;78(5):521-36. doi: 10.1177/1077558720925993..
Keywords: Learning Health Systems, Health Systems, Teams
Khodyakov D, Buttorff C, Xenakis L
Alignment between objective and subjective assessments of health system performance: findings from a mixed-methods study.
This study was a survey of health system executives to examine whether their performance assessments match objective performance assessments and qualitatively explore ways to achieve high performance. Interviews were conducted with 138 C-suite executives of 24 health systems in California, Minnesota, Washington, and Wisconsin between 2017 and 2019. The interviews were focused on executives’ perceptions of their own health system’s performance and factors they perceived generally contributed to high performance. The authors grouped health systems based on objective performance levels used in sampling and compared the ratings to executives’ subjective performance assessments. There was poor agreement between objective and subjective performance assessments. Executives whose views were inconsistent with objective assessments did not cite clinical care quality as their basis for their assessment but focused instead on market competition, financial performance, and high customer satisfaction and loyalty. Executives who cited clinical quality metrics had subjective ratings consistent with objective ratings.
AHRQ-funded; HS024067.
Citation: Khodyakov D, Buttorff C, Xenakis L .
Alignment between objective and subjective assessments of health system performance: findings from a mixed-methods study.
J Healthc Manag 2021 Sep-Oct;66(5):380-94. doi: 10.1097/jhm-d-20-00249..
Keywords: Health Systems, Quality of Care, Practice Improvement, Provider Performance
Siddique SM, Tipton K, Leas B
Interventions to reduce hospital length of stay in high-risk populations: a systematic review.
Many strategies to reduce hospital length of stay (LOS) have been implemented, but few studies have evaluated hospital-led interventions focused on high-risk populations. The Agency for Healthcare Research and Quality (AHRQ) Learning Health System panel commissioned this study to further evaluate system-level interventions for LOS reduction. The objective of this study was to identify and synthesize evidence regarding potential systems-level strategies to reduce LOS for patients at high risk for prolonged LOS.
AHRQ-funded; 75Q80120D00002.
Citation: Siddique SM, Tipton K, Leas B .
Interventions to reduce hospital length of stay in high-risk populations: a systematic review.
JAMA Netw Open 2021 Sep;4(9):e2125846. doi: 10.1001/jamanetworkopen.2021.25846..
Keywords: Learning Health Systems, Health Systems, Evidence-Based Practice, Hospital Discharge, Risk, Inpatient Care, Care Management
Kandel ZK, Rittenhouse DR, Bibi S
The CMS State Innovation Models Initiative and improved health information technology and care management capabilities of physician practices.
The Centers for Medicare and Medicaid Services' (CMS) State Innovation Models (SIMs) initiative funded 17 states to implement health care payment and delivery system reforms to improve health system performance. The authors investigated whether SIM improved health information technology (HIT) and care management capabilities of physician practices. They found that the CMS SIM Initiative did not accelerate the adoption of ten foundational physician practice capabilities beyond national trends.
AHRQ-funded; HS024075.
Citation: Kandel ZK, Rittenhouse DR, Bibi S .
The CMS State Innovation Models Initiative and improved health information technology and care management capabilities of physician practices.
Med Care Res Rev 2021 Aug;78(4):350-60. doi: 10.1177/1077558719901217..
Keywords: Health Information Technology (HIT), Healthcare Delivery, Payment, Health Systems
Shi Y, Amill-Rosario A, Rudin RS
Barriers to using clinical decision support in ambulatory care: do clinics in health systems fare better?
In this study, the investigators quantified the use of clinical decision support (CDS) and the specific barriers reported by ambulatory clinics and examined whether CDS utilization and barriers differed based on clinics' affiliation with health systems, providing a benchmark for future empirical research and policies related to this topic.
AHRQ-funded; HS024067.
Citation: Shi Y, Amill-Rosario A, Rudin RS .
Barriers to using clinical decision support in ambulatory care: do clinics in health systems fare better?
J Am Med Inform Assoc 2021 Jul 30;28(8):1667-75. doi: 10.1093/jamia/ocab064..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Ambulatory Care and Surgery, Health Information Technology (HIT), Health Systems
Yano EM, Resnick A, Gluck M
AHRQ Author: Kwon H, Mistry KB
Accelerating learning healthcare system development through embedded research: career trajectories, training needs, and strategies for managing and supporting embedded researchers.
Health systems and organizations seeking to achieve learning healthcare system principles are increasingly relying on embedded research teams to optimize delivery of evidence-based, high-quality care that improves patient and staff experience alike. In February 2018, 115 attendees from multiple agencies, institutions and professional societies participated in a conference to accelerate development of learning healthcare systems through embedded research. This paper describes the process.
AHRQ-authored.
Citation: Yano EM, Resnick A, Gluck M .
Accelerating learning healthcare system development through embedded research: career trajectories, training needs, and strategies for managing and supporting embedded researchers.
Healthc 2021 Jun;8(Suppl 1):100479. doi: 10.1016/j.hjdsi.2020.100479..
Keywords: Learning Health Systems, Health Systems, Health Services Research (HSR)
Shortell SM, Gottlieb DJ, Martinez Camblor P
Hospital-based health systems 20 years later: a taxonomy for policy research and analysis.
Building on the original taxonomy of hospital-based health systems from 20 years ago, the investigators developed a new taxonomy to inform emerging public policy and practice developments. The study design included a cluster analysis of the 2016 AHA Annual Survey data to derive measures of differentiation, centralization, and integration to create categories or types of hospital-based health systems.
AHRQ-funded; HS024075.
Citation: Shortell SM, Gottlieb DJ, Martinez Camblor P .
Hospital-based health systems 20 years later: a taxonomy for policy research and analysis.
Health Serv Res 2021 Jun;56(3):453-63. doi: 10.1111/1475-6773.13621..
Keywords: Hospitals, Health Systems, Health Services Research (HSR), Policy
Harrison MI, Shortell SM
AHRQ Author: Harrison MI
Multi-level analysis of the learning health system: Integrating contributions from research on organizations and implementation.
The authors have developed a comprehensive, multilevel framework to inform learning health systems (LHSs) research and practice in order to enhance both research on LHSs and practical steps toward their development. Drawing on the Consolidated Framework for Implementation Research, the social-ecological framework, and the organizational change framework, their new framework can help investigators and practitioners broadly scan and then investigate forces influencing improvement and learning and may point to otherwise unnoticed interactions among influential factors.
AHRQ-authored.
Citation: Harrison MI, Shortell SM .
Multi-level analysis of the learning health system: Integrating contributions from research on organizations and implementation.
Learn Health Syst 2021 Apr;5(2):e10226. doi: 10.1002/lrh2.10226..
Keywords: Learning Health Systems, Health Systems, Implementation, Organizational Change
Diaz A, Chhabra KR, Dimick JB
Variations in surgical spending within hospital systems for complex cancer surgery.
Researchers sought to measure variations in episode spending within and across hospital systems among Medicare beneficiaries undergoing complex cancer surgery. They found wide variations in surgical episode spending both within and across hospital systems. They recommended that system leaders seek better understanding of variations in practices among their hospitals to standardize care and reduce variations in outcomes, use, and costs.
AHRQ-funded; HS024763.
Citation: Diaz A, Chhabra KR, Dimick JB .
Variations in surgical spending within hospital systems for complex cancer surgery.
Cancer 2021 Feb 15;127(4):586-97. doi: 10.1002/cncr.33299..
Keywords: Surgery, Cancer, Healthcare Costs, Health Systems, Hospitals
Lewis JA, Senft N, Chen H
Evidence-based smoking cessation treatment: a comparison by healthcare system.
The authors surveyed general medicine providers and specialists in a large academic health center (AHC) and its affiliated Veterans Health Administration (VHA) in the Mid-South in 2017 to determine the cross-sectional association of healthcare system in which the provider practiced (AHC versus VHA) with self-reported provision of evidence-based smoking cessation treatment at least once in the past 12 months. They found that VHA healthcare providers were significantly more likely to provide evidence-based smoking cessation treatment compared to AHC healthcare providers.
AHRQ-funded; HS026122.
Citation: Lewis JA, Senft N, Chen H .
Evidence-based smoking cessation treatment: a comparison by healthcare system.
BMC Health Serv Res 2021 Jan 7;21(1):33. doi: 10.1186/s12913-020-06016-5..
Keywords: Health Systems, Tobacco Use: Smoking Cessation, Tobacco Use, Evidence-Based Practice, Substance Abuse
Kimmey L, Furukawa MF, Jones DJ
AHRQ Author: Furukawa MF
Geographic variation in the consolidation of physicians into health systems, 2016-18.
The authors asked the following questions: To what extent does consolidation of physicians into vertically integrated health systems vary across markets, and how did that change from 2016 to 2018? In this article, they used AHRQ data on health systems and commercial data on physician-system affiliation to describe metropolitan statistical area-level physician consolidation and to identify differences by region and metropolitan statistical area size.
AHRQ-authored; AHRQ-funded; 290201600001C.
Citation: Kimmey L, Furukawa MF, Jones DJ .
Geographic variation in the consolidation of physicians into health systems, 2016-18.
Health Aff 2021 Jan;40(1):165-69. doi: 10.1377/hlthaff.2020.00812..
Keywords: Health Systems, Provider: Physician, Provider, Healthcare Delivery