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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 13 of 13 Research Studies Displayed
Elliott MN, Cohea CW, Lehrman WG
Accelerating improvement and narrowing gaps: trends in patients' experiences with hospital care reflected in HCAHPS public reporting.
The researchers describe the experiences of over 4 million patients discharged from hospitals that participated in the second and fifth years of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) public reporting and assess the changes in HCAHPS scores across different types of hospital and patient groups. They found that HCAHPS scores increased by 2.8 percentage points from 2008 to 2011 in the most positive response category.
Citation: Elliott MN, Cohea CW, Lehrman WG . Accelerating improvement and narrowing gaps: trends in patients' experiences with hospital care reflected in HCAHPS public reporting. Health Serv Res 2015 Dec;50(6):1850-67. doi: 10.1111/1475-6773.12305..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Quality of Care, Public Reporting
Liang C, Gong Y
Enhancing patient safety event reporting by K-nearest neighbor classifier.
The debate on structured or unstructured data entry reveals not only a trade-off problem among data accuracy, completeness, and timeliness, but also a technical gap on text mining. The reesarchers suggested a text classification method for predicting subject categories. Their results demonstrated the feasibility of their system and indicated the advantage of such an application to raise data quality and clinical decision support in reporting patient safety events.
Citation: Liang C, Gong Y . Enhancing patient safety event reporting by K-nearest neighbor classifier. Stud Health Technol Inform 2015;218:40603.
Keywords: Adverse Events, Medical Errors, Patient Safety, Public Reporting, Clinical Decision Support (CDS), Health Information Technology (HIT), Data
Schlesinger M, Grob R, Shaller D
Using patient-reported information to improve clinical practice.
The purposes of this study were to assess what is known about the relationship between patient experience measures and incentives designed to improve care, and to identify how public policy and medical practices can promote patient-valued outcomes in health systems with strong financial incentives. It concluded that unless public policies are attentive to patients' perspectives, stronger financial incentives for clinicians can threaten aspects of care that patients most value.
Citation: Schlesinger M, Grob R, Shaller D . Using patient-reported information to improve clinical practice. Health Serv Res 2015 Dec;50 Suppl 2:2116-54. doi: 10.1111/1475-6773.12420.
Keywords: Quality Improvement, Quality of Care, Patient Experience, Provider Performance, Policy, Value, Payment, Public Reporting
Okafor NG, Doshi PB, Miller SK
Voluntary medical incident reporting tool to improve physician reporting of medical errors in an emergency department.
A web-based, password-protected tool was developed by members of a quality assurance committee for ED providers to report incidents that they believe could impact patient safety. The researchers found that the utilization of this system in one residency program with two academic sites resulted in an increase from 81 reported incidents in 2009, the first year of use, to 561 reported incidents in 2012.
Citation: Okafor NG, Doshi PB, Miller SK . Voluntary medical incident reporting tool to improve physician reporting of medical errors in an emergency department. West J Emerg Med 2015 Dec;16(7):1073-8. doi: 10.5811/westjem.2015.8.27390.
Keywords: Emergency Department, Adverse Events, Medical Errors, Patient Safety, Public Reporting, Quality of Care
He D, Konetzka RT
Public reporting and demand rationing: evidence from the nursing home industry.
The authors examined a consequence of public reporting: the potential for demand rationing. They found that high-quality nursing homes facing capacity constraints reduced admissions of less profitable Medicaid residents while increasing the more profitable Medicare and private-pay admissions, relative to low-quality nursing homes facing no capacity constraints.
Citation: He D, Konetzka RT . Public reporting and demand rationing: evidence from the nursing home industry. Health Econ 2015 Nov;24(11):1437-51. doi: 10.1002/hec.3097.
Keywords: Public Reporting, Medicare, Nursing Homes, Value
Mukamel DB, Ye Z, Glance LG
Does mandating nursing home participation in quality reporting make a difference? Evidence from Massachusetts.
This study investigated one of the mechanisms that may detract from the effectiveness of quality report cards: voluntary versus mandatory participation of nursing homes in public quality reporting. It found that once reporting became mandatory, nonvolunteers improved more than volunteers in all but 2 staffing measures.
Citation: Mukamel DB, Ye Z, Glance LG . Does mandating nursing home participation in quality reporting make a difference? Evidence from Massachusetts. Med Care 2015 Aug;53(8):713-9. doi: 10.1097/mlr.0000000000000390..
Keywords: Nursing Homes, Long-Term Care, Public Reporting, Provider Performance, Quality Improvement, Quality of Care, Quality Indicators (QIs), Quality Measures, Elderly
Schulz J, DeCamp M, Berkowitz SA
Medicare Shared Savings Program: public reporting and shared savings distributions.
The objectives of this paper are to determine if Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) are meeting public reporting requirements related to shared savings plans, to quantitate the composition of shared savings distribution plans, and to investigate whether early ACO success is associated with specific plan or ACO characteristics. The authors found that just over one-half of MSSP ACOs report detailed shared savings distribution plans online, and these plans vary widely. They concluded that there appears to be no single shared savings distribution plan determinate of ACO success.
Citation: Schulz J, DeCamp M, Berkowitz SA . Medicare Shared Savings Program: public reporting and shared savings distributions. Am J Manag Care 2015 Aug;21(8):546-53.
Keywords: Quality of Care, Payment, Policy, Medicare, Public Reporting
Crane S, Sloane PD, Elder N
Reporting and using near-miss events to improve patient safety in diverse primary care practices: a collaborative approach to learning from our mistakes.
This study assessed the feasibility of a near-miss reporting system in primary care practices and to describe initial reports and practice responses to them. It found that all 7 practices successfully implemented the system, reporting 632 near-miss events in 9 months and initiating 32 quality improvement projects based on the reports.
Citation: Crane S, Sloane PD, Elder N . Reporting and using near-miss events to improve patient safety in diverse primary care practices: a collaborative approach to learning from our mistakes. J Am Board Fam Med 2015 Jul-Aug;28(4):452-60. doi: 10.3122/jabfm.2015.04.140050..
Keywords: Adverse Events, Medical Errors, Patient Safety, Primary Care, Public Reporting, Quality Improvement, Quality of Care
Smith B, McDuff J, Naierman N
What consumers want to know about quality when choosing a hospice provider.
This study drew on focus group and survey data collected in 5 metropolitan areas to learn more about hospice quality data. The researchers found that participants placed top priority on measures related to pain and symptom management. The National Quality Forum-approved measures resonate well with consumers, who also appear to be ready for access to data on the quality of hospice providers.
Citation: Smith B, McDuff J, Naierman N . What consumers want to know about quality when choosing a hospice provider. Am J Hosp Palliat Care 2015 Jun;32(4):393-400. doi: 10.1177/1049909114524475.
Keywords: Caregiving, Education: Patient and Caregiver, Decision Making, Palliative Care, Provider Performance, Public Reporting, Quality of Care, Quality Indicators (QIs)
Bardach NS, Hibbard JH, Greaves F
Sources of traffic and visitors' preferences regarding online public reports of quality: web analytics and online survey results.
Online public reports of quality exist, but little is known about how visitors find reports or about their purpose in visiting. To address this gap,the researchers gathered website analytics data from a national group of online public reports of hospital or physician quality and surveyed real-time visitors to those websites. They found that consumers were frequently interested in using the information to choose providers or assess the quality of their provider.
Citation: Bardach NS, Hibbard JH, Greaves F . Sources of traffic and visitors' preferences regarding online public reports of quality: web analytics and online survey results. J Med Internet Res 2015 May;17(5):e102. doi: 10.2196/jmir.3637.
Keywords: Web-Based, Public Reporting, Quality Measures, Education: Patient and Caregiver
Minami CA, Dahlke A, Bilimoria KY
Public reporting in surgery: an emerging opportunity to improve care and inform patients.
The authors reviewed the benefits and concerns surrounding public reporting and then suggested some possible solutions to these problems in a stride toward better implementation and utilization of public reporting to improve surgical outcomes. They concluded that, although there are problems with the current approach, continual refinement of public reporting systems has the potential to provide individualized, relevant data that would not only lend a sense of agency to the American public but also motivate hospitals to engage in meaningful quality improvement.
Citation: Minami CA, Dahlke A, Bilimoria KY . Public reporting in surgery: an emerging opportunity to improve care and inform patients. Ann Surg 2015 Feb;261(2):241-2. doi: 10.1097/sla.0000000000001033.
Keywords: Quality of Care, Outcomes, Public Reporting, Quality Improvement, Surgery
Dor A, Encinosa WE, Carey K
AHRQ Author: Encinosa WE
Medicare's Hospital Compare quality reports appear to have slowed price increases for two major procedures.
The researchers investigated whether public reporting of hospital quality, as done through Medicare’s public reporting initiative, Hospital Compare, has an impact on the pricing of hospital services for the privately insured. In their examination of 2 common and expensive procedures, coronary artery bypass graft and percutaneous coronary intervention, they found that Hospital Compare exerted a downward pressure on prices in States lacking quality report cards of their own.
AHRQ-authored; AHRQ-funded; HS023610
Citation: Dor A, Encinosa WE, Carey K . Medicare's Hospital Compare quality reports appear to have slowed price increases for two major procedures. Health Aff. 2015 Jan;34(1):71-7. doi: 10.1377/hlthaff.2014.0263..
Keywords: Healthcare Costs, Quality of Care, Heart Disease and Health, Public Reporting, Surgery
Sjoding MW, Cooke CR
The importance of rigorous evaluation of quality measurement programs.
The authors comment on a study evaluating a California program to determine whether public reporting of ICU mortality rates improved patient outcomes. They argue that as these programs move from public reporting to pay-for-performance as a primary mechanism for incentivizing improvement, the research community must ensure they are both fair and effective.
Citation: Sjoding MW, Cooke CR . The importance of rigorous evaluation of quality measurement programs. Ann Am Thorac Soc 2015 Jan;12(1):107-8. doi: 10.1513/AnnalsATS.201412-588ED..
Keywords: Quality Improvement, Public Reporting, Intensive Care Unit (ICU), Policy, Outcomes