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
26 to 42 of 42 Research Studies DisplayedBaker AW, Nehls N, Ilies I
Use of optimised dual statistical process control charts for early detection of surgical site infection outbreaks.
This study analyzed the use of optimized dual statistical process control (SPC) charts to predict surgical site infection (SSI) outbreaks. The researchers retrospectively applied an optimized pair of moving average (MA) SPC charts to all 30 SSI outbreaks previously identified and investigated from 2007 to 2015 in the Duke Infection Control Outreach Network (DICON), which is a network of more than 50 community hospitals. The dual MA SPC chart approach detected all 30 outbreaks at a median of 16 months prior to traditional surveillance detection.
AHRQ-funded; HS23821.
Citation: Baker AW, Nehls N, Ilies I .
Use of optimised dual statistical process control charts for early detection of surgical site infection outbreaks.
BMJ Qual Saf 2020 Jun;29(6):517-20. doi: 10.1136/bmjqs-2019-010586..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Patient Safety, Hospitals, Public Health, Infectious Diseases
Jones KM, Mantey J, Mills JP
COVID-19 preparedness in Michigan nursing homes.
The objectives of this study were to understand preparedness among Michigan nursing homes (NHs) in the midst of an ongoing pandemic and to compare with a 2007 survey on pandemic influenza preparedness in Michigan NHs. Findings showed that, in 2020, NHs were able to make policy and procedure changes within 1 week in response to urgent guidance from CMS and the CDC, which likely helped the facilities prepare for the COVID-19 pandemic. Most NHs had a dedicated staff member responsible for preparedness and were willing to accept patients from hospitals to assist in their surge capacity planning, particularly for non-COVID patients. NHs did express concerns about staffing shortages and PPE supply constraints as cases rose.
AHRQ-funded; HS025451.
Citation: Jones KM, Mantey J, Mills JP .
COVID-19 preparedness in Michigan nursing homes.
J Am Geriatr Soc 2020 May;68(5):937-39. doi: 10.1111/jgs.16490..
Keywords: COVID-19, Elderly, Nursing Homes, Long-Term Care, Emergency Preparedness, Public Health
Shaker MS, Oppenheimer J, Grayson M
COVID-19: pandemic contingency planning for the allergy and immunology clinic.
In the event of a global infectious pandemic, drastic measures may be needed that limit or require adjustment of ambulatory allergy services. However, no rationale for how to prioritize service shut down and patient care exists. A consensus-based ad-hoc expert panel of allergy/immunology specialists from the United States and Canada developed a service and patient prioritization schematic to temporarily triage allergy/immunology services. This paper describes the process, recommendations and feedback.
AHRQ-funded; HS024599.
Citation: Shaker MS, Oppenheimer J, Grayson M .
COVID-19: pandemic contingency planning for the allergy and immunology clinic.
J Allergy Clin Immunol Pract 2020 May;8(5):1477-88.e5. doi: 10.1016/j.jaip.2020.03.012..
Keywords: COVID-19, Respiratory Conditions, Emergency Preparedness, Public Health, Healthcare Delivery, Ambulatory Care and Surgery, Infectious Diseases
Steuart R, Huang FS, Schaffzin JK
Finding the value in personal protective equipment for hospitalized patients during a pandemic and beyond.
Innovative protocols have been conceptualized and used to conserve PPE in hospitals. Conservation protocols often fail to identify missed opportunities to improve the value of personal protective equipment (PPE) that already exist in hospital care. By defining the value of inpatient PPE, hospitals can identify opportunities for value improvement. Changes implemented now will maximize PPE value and preserve supply during this pandemic and beyond. In this article, the authors discuss the value in PPE for hospitalized patients during a pandemic and beyond.
AHRQ-funded; HS025138.
Citation: Steuart R, Huang FS, Schaffzin JK .
Finding the value in personal protective equipment for hospitalized patients during a pandemic and beyond.
J Hosp Med 2020 May;15(5):295-98. doi: 10.12788/jhm.3429..
Keywords: COVID-19, Emergency Preparedness, Public Health, Hospitals, Patient Safety
Dixon BE, Zhang Z, Amo JN
Improving notifiable disease case reporting through electronic information exchange-facilitated decision support: a controlled before-and-after trial.
This study examined the results of implementing an electronic, prepopulated notifiable disease report form on case reporting rates by ambulatory care clinics to public health authorities. They conducted a 2-year controlled before-and-after trial of a health information exchange (HIE) in Indiana. Data was analyzed from electronic prepopulated reports and paper and fax reports submitted to a local health department for 7 conditions by using a difference-in-differences model. Provider reporting rates for chlamydia and gonorrhea increased significantly during the baseline period. During the intervention period they decreased significantly in control clinics. Completion and timeliness improved for both intervention and control clinics.
AHRQ-funded; HS020909.
Citation: Dixon BE, Zhang Z, Amo JN .
Improving notifiable disease case reporting through electronic information exchange-facilitated decision support: a controlled before-and-after trial.
Public Health Rep 2020 May/Jun;135(3):401-10. doi: 10.1177/0033354920914318..
Keywords: Health Information Exchange (HIE), Health Information Technology (HIT), Electronic Health Records (EHRs), Public Health, Public Reporting, Ambulatory Care and Surgery
Kang JX, Levanon Seligson A, Dragan KL
Identifying New York City neighborhoods at risk of being overlooked for interventions.
Public health agencies are often faced with difficult decisions about where and how to allocate funding and resources. In this study, the investigators walked readers through a process of identifying needs across different neighborhoods in New York City (NYC) by examining community district-level health outcomes using data from published Community Health Profile reports released by the NYC Department of Health and Mental Hygiene (DOHMH) in 2015.
AHRQ-funded; HS000055.
Citation: Kang JX, Levanon Seligson A, Dragan KL .
Identifying New York City neighborhoods at risk of being overlooked for interventions.
Prev Chronic Dis 2020 Apr 23;17:E32. doi: 10.5888/pcd17.190325..
Keywords: Public Health, Disparities, Urban Health, Vulnerable Populations
Dixon BE, Wen C, French T
Extending an open-source tool to measure data quality: case report on Observational Health Data Science and Informatics (OHDSI).
The authors extended the open-source software Observational Health Data Sciences and Informatics (OHDSI) to incorporate new functions useful for population health. They developed and tested methods to measure the completeness, timeliness and entropy of information; timeliness was not adopted as its context did not fit with the existing OHDSI domains. The case report examined the process and reasons for acceptance and rejection of ideas proposed to an open-source community like OHDSI.
AHRQ-funded; HS025502.
Citation: Dixon BE, Wen C, French T .
Extending an open-source tool to measure data quality: case report on Observational Health Data Science and Informatics (OHDSI).
BMJ Health Care Inform 2020 Mar;27(1). doi: 10.1136/bmjhci-2019-100054..
Keywords: Public Health, Data
McHaney-Lindstrom M, Hebert C, Miller H
Network analysis of intra-hospital transfers and hospital onset Clostridium difficile infection.
This paper explores how social network analysis (SNA) software can be used to analyze intra-hospital networks of individuals with a healthcare associated infection (HAI) for further analysis in a GIS environment. The SNA analysis compared cases to controls which highlighted significant differences in the overall structure of the networks.
AHRQ-funded; HS024379.
Citation: McHaney-Lindstrom M, Hebert C, Miller H .
Network analysis of intra-hospital transfers and hospital onset Clostridium difficile infection.
Health Info Libr J 2020 Mar;37(1):26-34. doi: 10.1111/hir.12274..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Public Health
Adams C, Young D, Gastanaduy PA
Quantifying the roles of vomiting, diarrhea, and residents vs. staff in norovirus transmission in U.S. nursing home outbreaks.
Norovirus transmissibility is poorly understood and the goal of this study was to examine transmission via vomiting, diarrhea, and patient exposures. Six nursing home outbreaks in South Carolina were examined from 2014 to 2016. Vomiting infected 2.12 times the number of individuals as non-vomiters, diarrhea 1.39 times, and resident cases infected 1.53 times the number of individuals as staff cases. This finding is important for not just nursing homes, but other sites of norovirus outbreaks such as cruise ships.
AHRQ-funded; HS025987.
Citation: Adams C, Young D, Gastanaduy PA .
Quantifying the roles of vomiting, diarrhea, and residents vs. staff in norovirus transmission in U.S. nursing home outbreaks.
PLoS Comput Biol 2020 Mar;16(3):e1007271. doi: 10.1371/journal.pcbi.1007271..
Keywords: Elderly, Nursing Homes, Long-Term Care, Infectious Diseases, Healthcare-Associated Infections (HAIs), Prevention, Public Health
Bartsch SM, Asti L, Stokes-Cawley OJ
The potential economic value of a Zika vaccine for a woman of childbearing age.
The authors mapped the Zika vaccine and vaccination characteristic thresholds at which vaccination becomes cost effective, highly cost effective, and cost saving. They developed a Markov model to simulate a woman of childbearing age to follow the potential risk and clinical course of a Zika infection. They found that, in some cases, the vaccine was cost effective when the risk was as low as 0.015%, the cost was as high as $7,500, the efficacy was as low as 25%, and the duration of protection was 1 year. They concluded that the thresholds at which vaccination becomes cost effective and cost saving can provide targets for Zika vaccine development and implementation.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Asti L, Stokes-Cawley OJ .
The potential economic value of a Zika vaccine for a woman of childbearing age.
Am J Prev Med 2020 Mar;58(3):370-77. doi: 10.1016/j.amepre.2019.10.023..
Keywords: Vaccination, Women, Infectious Diseases, Public Health, Healthcare Costs, Prevention
Feldman AG, Hsu EK, Mack CL
The importance of prioritizing pre and posttransplant immunizations in an era of vaccine refusal and epidemic outbreaks.
This paper discusses the prevalence of vaccine-preventable outbreaks occurring both nationally and internationally. Rates of vaccine hesitancy and refusal have been increasing which leads to decreased herd immunity. This poses greater risk to immunosuppressed transplant recipients, and currently 1 in 6 pediatric solid organ transplant recipients are hospitalized with a vaccine-preventable infection in the first 5 years posttransplant. This often results in significant morbidity, mortality, and increased hospitalization costs. Surprisingly, many transplant recipients are not up-to-date on age appropriate immunizations at the time of transplant and thereafter. The authors feel that immunizations must be prioritized in both pre and posttransplant care. They call for more research to understand how to monitor immune response to vaccines in immunosuppressed patients and when to optimally immunize patients posttransplant. They also recommend reexamination of the administration of live vaccines posttransplant.
AHRQ-funded; HS026510.
Citation: Feldman AG, Hsu EK, Mack CL .
The importance of prioritizing pre and posttransplant immunizations in an era of vaccine refusal and epidemic outbreaks.
Transplantation 2020 Jan;104(1):33-38. doi: 10.1097/tp.0000000000002936..
Keywords: Vaccination, Medication, Emergency Preparedness, Public Health, Transplantation
Klann JG, Buck MD, Brown J
Query Health: standards-based, cross-platform population health surveillance.
The Office of the National Coordinator for Health Information Technology (ONC) Query Health Initiative is a collaboration to develop a national architecture for distributed, population-level health queries across diverse clinical systems with disparate data models. The authors review Query Health activities, including a standards-based methodology, an open-source reference implementation, and three pilot projects.
AHRQ-funded; HS019912.
Citation: Klann JG, Buck MD, Brown J .
Query Health: standards-based, cross-platform population health surveillance.
J Am Med Inform Assoc. 2014 Jul-Aug;21(4):650-6. doi: 10.1136/amiajnl-2014-002707..
Keywords: Public Health, Education: Patient and Caregiver, Health Information Technology (HIT)
Dixon BE, Vreeman DJ, Grannis SJ
The long road to semantic interoperability in support of public health: experiences from two states.
This article illustrates the current state of semantic interoperability using a case example drawn from public health and discusses three policy strategies for strengthening interoperability. It also presents recommendations for improving the use of clinical data and information for public health, including disease surveillance, community assessment and measurement of care quality.
AHRQ-funded; HS020909
Citation: Dixon BE, Vreeman DJ, Grannis SJ .
The long road to semantic interoperability in support of public health: experiences from two states.
J Biomed Inform. 2014 Jun;49:3-8. doi: 10.1016/j.jbi.2014.03.011..
Keywords: Public Health, Data, Quality of Care
Khazeni N, Hutton DW, Collins CI
Health and economic benefits of early vaccination and nonpharmaceutical interventions for a human influenza A (H7N9) pandemic: a modeling study.
In order to determine how quickly vaccination should be completed to reduce infections, deaths, and health care costs in a severe influenza pandemic in a large metropolitan area, researchers used a dynamic transmission model. They found that vaccination in an influenza-A (H7N9) pandemic would need to be completed much faster than in the 2009 pandemic to substantially reduce morbidity, mortality, and health care costs.
AHRQ-funded; HS019816
Citation: Khazeni N, Hutton DW, Collins CI .
Health and economic benefits of early vaccination and nonpharmaceutical interventions for a human influenza A (H7N9) pandemic: a modeling study.
Ann Intern Med. 2014 May 20;160(10):684-94. doi: 10.7326/M13-2071..
Keywords: Vaccination, Influenza, Mortality, Healthcare Costs, Public Health
Greer SL, Lillvis DF
Beyond leadership: political strategies for coordination in health policies.
The objective of this article is to utilize the political science and public administration literatures to document the problems that serve as obstacles to intersectoral governance– and therefore, the implementation of a Health in All Policies (HiAP) approach–as well as solutions to overcome these obstacles.
AHRQ-funded; HS000053.
Citation: Greer SL, Lillvis DF .
Beyond leadership: political strategies for coordination in health policies.
Health Policy 2014 May;116(1):12-7. doi: 10.1016/j.healthpol.2014.01.019..
Keywords: Policy, Public Health, Policy
Hsuan C, Rodriguez HP
The adoption and discontinuation of clinical services by local health departments.
The researchers identified factors associated with local health department (LHD) adoption and discontinuation of clinical services. They found that most LHDs are discontinuing clinical services over time. Those that cover a wide range of core public health functions are less likely to discontinue services when residents lack care access.
AHRQ-funded; AHRQ Predoctoral Traineeship.
Citation: Hsuan C, Rodriguez HP .
The adoption and discontinuation of clinical services by local health departments.
Am J Public Health 2014 Jan;104(1):124-33. doi: 10.2105/ajph.2013.301426..
Keywords: Public Health, Access to Care, Health Services Research (HSR)
Leeman J, Teal R, Jernigan J
What evidence and support do state-level public health practitioners need to address obesity prevention.
This study describes interview and survey findings that detail how public health practitioners characterize the obesity prevention task, the types of evidence and support they find most helpful, and their needs for additional evidence and support. The researchers conducted 10 in-depth interviews with public health practitioners and project officers followed by an online survey completed by 62 practitioners.
AHRQ-funded; HS019468.
Citation: Leeman J, Teal R, Jernigan J .
What evidence and support do state-level public health practitioners need to address obesity prevention.
Am J Health Promot 2014 Jan-Feb;28(3):189-96. doi: 10.4278/ajhp.120518-QUAL-266..
Keywords: Obesity, Prevention, Public Health