National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (5)
- Ambulatory Care and Surgery (2)
- Blood Clots (1)
- Burnout (2)
- Cancer (3)
- Cancer: Breast Cancer (3)
- Cardiovascular Conditions (7)
- Care Management (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (3)
- Children/Adolescents (2)
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- Diabetes (1)
- Diagnostic Safety and Quality (4)
- Disabilities (1)
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- Education: Continuing Medical Education (8)
- Elderly (5)
- Electronic Health Records (EHRs) (6)
- Emergency Department (3)
- Emergency Medical Services (EMS) (2)
- Evidence-Based Practice (3)
- Healthcare-Associated Infections (HAIs) (6)
- Healthcare Cost and Utilization Project (HCUP) (3)
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- Intensive Care Unit (ICU) (1)
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- Medicaid (1)
- Medical Errors (1)
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- Mortality (7)
- Nursing Homes (6)
- Obesity (2)
- Obesity: Weight Management (1)
- Orthopedics (2)
- Outcomes (5)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (1)
- Patient Experience (3)
- Patient Safety (19)
- Payment (18)
- Pneumonia (1)
- Practice Patterns (1)
- Prevention (4)
- Primary Care (1)
- Provider (7)
- Provider: Nurse (1)
- Provider: Physician (4)
- (-) Provider Performance (94)
- Public Reporting (3)
- Quality Improvement (14)
- Quality Indicators (QIs) (11)
- Quality Measures (22)
- Quality of Care (51)
- Racial and Ethnic Minorities (1)
- Registries (1)
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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
76 to 94 of 94 Research Studies DisplayedVarban OA, Greenberg CC, Schram J
Surgical skill in bariatric surgery: Does skill in one procedure predict outcomes for another?
Whether skill for one bariatric procedure can predict outcomes for another related procedure is unknown. This study found that video ratings of surgical skill with laparoscopic gastric bypass do not predict outcomes of laparoscopic sleeve gastrectomy. Evaluation of surgical skill with one procedure may not apply to other related procedures and may require independent assessment of surgical technical proficiency.
AHRQ-funded; R01 HS023597.
Citation: Varban OA, Greenberg CC, Schram J .
Surgical skill in bariatric surgery: Does skill in one procedure predict outcomes for another?
Surgery 2016 Nov;160(5):1172-81. doi: 10.1016/j.surg.2016.04.033.
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Keywords: Surgery, Obesity: Weight Management, Obesity, Outcomes, Provider Performance
Barsuk JH, Cohen ER, Williams MV
The effect of simulation-based mastery learning on thoracentesis referral patterns.
This study aimed to (1) assess the effect of simulation-based mastery learning (SBML) on internal medicine residents' simulated thoracentesis skills and (2) compare thoracentesis referral patterns, self-confidence, and reasons for referral between traditionally trained residents (non-SBML-trained), SBML-trained residents, and hospitalist physicians. This study identified confidence and time as reasons physicians refer thoracenteses rather than perform them at the bedside.
AHRQ-funded; HS021202.
Citation: Barsuk JH, Cohen ER, Williams MV .
The effect of simulation-based mastery learning on thoracentesis referral patterns.
J Hosp Med 2016 Nov;11(11):792-95. doi: 10.1002/jhm.2623..
Keywords: Education: Continuing Medical Education, Provider Performance, Training
Mazur LM, Mosaly PR, Moore C
Toward a better understanding of task demands, workload, and performance during physician-computer interactions.
The researchers assessed the relationship between (1) task demands and workload, (2) task demands and performance, and (3) workload and performance, all during physician-computer interactions in a simulated environment. Two experiments were performed in 2 different electronic medical record environments: WebCIS and Epic. Results suggest that task demands as experienced by participants are related to participants' performance.
AHRQ-funded; HS023458; HS024062.
Citation: Mazur LM, Mosaly PR, Moore C .
Toward a better understanding of task demands, workload, and performance during physician-computer interactions.
J Am Med Inform Assoc 2016 Nov;23(6):1113-20. doi: 10.1093/jamia/ocw016.
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Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Provider Performance
Klerman EB, Beckett SA, Landrigan CP
Applying mathematical models to predict resident physician performance and alertness on traditional and novel work schedules.
Using a mathematical model of the effects of circadian rhythms and length of time awake on objective performance and subjective alertness, the researchers compared predictions for traditional intern schedules to those that limit work to </= 16 consecutive hours. Their model predicted fewer hours with poor performance and alertness, especially during night-time work hours, for all three novel schedules than for either of the two traditional schedules.
AHRQ-funded; HS017357.
Citation: Klerman EB, Beckett SA, Landrigan CP .
Applying mathematical models to predict resident physician performance and alertness on traditional and novel work schedules.
BMC Med Educ 2016 Sep 13;16(1):239. doi: 10.1186/s12909-016-0751-9.
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Keywords: Education: Continuing Medical Education, Patient Safety, Provider Performance, Workforce
Taylor LK, Thomas GW, Karam MD
Assessing wire navigation performance in the operating room.
The researchers sought to develop meaningful, objective measures of wire navigation performance in the operating room. They concluded that several video-based metrics were consistent across the 4 video reviewers and are likely to be useful for performance assessment. The tip-apex distance (TAD) measurement was less reliable than previous reports have suggested, but remains a valuable metric of performance.
AHRQ-funded; HS022077.
Citation: Taylor LK, Thomas GW, Karam MD .
Assessing wire navigation performance in the operating room.
J Surg Educ 2016 Sep-Oct;73(5):780-7. doi: 10.1016/j.jsurg.2016.03.018.
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Keywords: Surgery, Provider Performance, Injuries and Wounds, Orthopedics
Lau BD, Haut ER, Hobson DB
ICD-9 code-based venous thromboembolism performance targets fail to measure up.
Suboptimal prevention practices have prompted payers to consider hospital-associated Venous thromboembolism (VTE) as a potentially preventable condition for which financial incentives or penalties exist to drive practice improvement. The authors reviewed a subset of hospital-associated VTE that were identified by ICD-9 codes used by a state-run pay-for-performance quality improvement program and discuss their findings.
AHRQ-funded; HS017952.
Citation: Lau BD, Haut ER, Hobson DB .
ICD-9 code-based venous thromboembolism performance targets fail to measure up.
Am J Med Qual 2016 Sep;31(5):448-53. doi: 10.1177/1062860615583547.
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Keywords: Healthcare-Associated Infections (HAIs), Quality Indicators (QIs), Prevention, Hospitals, Quality Improvement, Blood Clots, Payment, Provider Performance
Ellimoottil C, Ryan AM, Hou H
Medicare's new bundled payment for joint replacement may penalize hospitals that treat medically complex patients.
Using Medicare claims for patients in Michigan who underwent lower extremity joint replacement in the period 2011-13, the researchers applied payment methods analogous to those CMS intends to use in determining annual bonuses or penalties (reconciliation payments) to hospitals. Their findings suggest that CMS should include risk adjustment in the Comprehensive Care for Joint Replacement program and in future bundled payment programs.
AHRQ-funded; HS024193; HS018546.
Citation: Ellimoottil C, Ryan AM, Hou H .
Medicare's new bundled payment for joint replacement may penalize hospitals that treat medically complex patients.
Health Aff 2016 Sep;35(9):1651-7. doi: 10.1377/hlthaff.2016.0263.
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Keywords: Medicare, Payment, Healthcare Costs, Orthopedics, Provider Performance
Rosenthal MB, Landrum MB, Robbins JA
Pay for performance in Medicaid: evidence from three natural experiments.
This study examined the impact of pay for performance in Medicaid on the quality and utilization of care. Primary outcomes of interest were Healthcare Effectiveness Data and Information Set (HEDIS)-like process measures of quality, utilization by service category, and ambulatory care-sensitive admissions and emergency department visits. Its findings were mixed, with no measurable quality improvements across the three states (Pennsylvania, Minnesota, Alabama), but reductions in hospital admissions in two programs.
AHRQ-funded.
Citation: Rosenthal MB, Landrum MB, Robbins JA .
Pay for performance in Medicaid: evidence from three natural experiments.
Health Serv Res 2016 Aug;51(4):1444-66. doi: 10.1111/1475-6773.12426.
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Keywords: Medicaid, Payment, Provider Performance, Healthcare Utilization, Quality of Care, Hospitalization, Emergency Department
Wang Y, Eldridge N, Metersky ML
AHRQ Author: Eldridge N
Association between hospital performance on patient safety and 30-day mortality and unplanned readmission for Medicare fee-for-service patients with acute myocardial infarction.
The researchers studied the relationship between hospital performance on adverse event rates and hospital performance on 30-day mortality and unplanned readmission rates for Medicare fee-for-service patients hospitalized for acute myocardial infarction (AMI). They found that for Medicare fee-for-service patients discharged with AMI, hospitals with poorer patient safety performance were also more likely to have poorer performance on 30-day all-cause mortality and on unplanned readmissions.
AHRQ-authored.
Citation: Wang Y, Eldridge N, Metersky ML .
Association between hospital performance on patient safety and 30-day mortality and unplanned readmission for Medicare fee-for-service patients with acute myocardial infarction.
J Am Heart Assoc 2016 Jul;5(7):pii: e003731. doi: 10.1161/jaha.116.003731.
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Keywords: Adverse Events, Hospital Readmissions, Hospitals, Medicare, Mortality, Heart Disease and Health, Patient Safety, Provider Performance
Jiang HJ, Reiter KL, Wang J
AHRQ Author: Jiang HJ
Measuring mortality performance: How did safety-net hospitals compare with other hospitals?
This study assessed mortality performance of safety-net hospitals (SNHs) using all-payer databases and measures for a broad range of conditions and procedures. It found small differences in risk-adjusted mortality rates between SNHs and non-SNHs only among teaching hospitals. After controlling for hospital factors, these differences were substantially reduced and remained significant only for surgical mortality rates.
AHRQ-authored.
Citation: Jiang HJ, Reiter KL, Wang J .
Measuring mortality performance: How did safety-net hospitals compare with other hospitals?
Med Care 2016 Jul;54(7):648-56. doi: 10.1097/mlr.0000000000000540.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitals, Mortality, Provider Performance
Coulam R, Kralewski J, Dowd B
The role of medical group practice administrators in the adoption and implementation of Medicare's physician quality reporting system.
The purpose of this study was to gain insights into the role these administrators play in quality assurance programs. It found that administrators conducted due diligence on Medicare's physician quality reporting system, influenced how the issue was presented to physicians for adoption, and managed implementation thereafter. Administrators' recommendations were heavily influenced by practice characteristics, financial incentives, and practice commitments to early adoption of quality improvement innovations.
AHRQ-funded; HS019964.
Citation: Coulam R, Kralewski J, Dowd B .
The role of medical group practice administrators in the adoption and implementation of Medicare's physician quality reporting system.
Health Care Manage Rev 2016 Apr-Jun;41(2):145-54. doi: 10.1097/hmr.0000000000000061.
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Keywords: Medicare, Provider Performance, Quality Improvement, Quality of Care, Public Reporting
Sandmeyer B, Fraser I
AHRQ Author: Sandmeyer B
New evidence on what works in effective public reporting.
The authors describe the current state of the public reporting field and provide guidance to public report producers based on the evidence. They concluded that public reports have advanced greatly in recent years, but there remains much room for improvement. They recommend that report producers should continually evaluate their reports and apply the latest evidence to maximize their usefulness and impact.
AHRQ-authored.
Citation: Sandmeyer B, Fraser I .
New evidence on what works in effective public reporting.
Health Serv Res 2016 Jun;51(Suppl 2):1159-66. doi: 10.1111/1475-6773.12502.
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Keywords: Data, Provider Performance, Public Reporting
Encinosa W, Hsiao CJ, Firminger K
AHRQ Author: Encinosa W, Hsiao CJ
What performance measures do consumers find useful when selecting marketplace health plans?
This study explored consumers’ ability to use measures from eValue8, the leading tool that large employers use to compare and select health plans. It found that consumers have different views of health plan measures compared with employers. For example, consumers care most about measures indicating how well plans support long-term patient–physician relationships—many plan measures were seen to be intrusive in this relationship.
AHRQ-authored.
Citation: Encinosa W, Hsiao CJ, Firminger K .
What performance measures do consumers find useful when selecting marketplace health plans?
Am J Accountable Care 2016 Jun;4(2):10-16.
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Keywords: Health Insurance, Provider Performance, Quality Measures
Das A, Norton EC, Miller DC
Adding a spending metric to Medicare's value-based purchasing program rewarded low-quality hospitals.
In fiscal year 2015 the Centers for Medicare and Medicaid Services expanded its Hospital Value-Based Purchasing program by rewarding or penalizing hospitals for their performance on both spending and quality. Using data from 2,679 US hospitals that participated in the program in fiscal years 2014 and 2015, researchers found that the new emphasis on spending rewarded not only low-spending hospitals but some low-quality hospitals as well.
AHRQ-funded; HS020671.
Citation: Das A, Norton EC, Miller DC .
Adding a spending metric to Medicare's value-based purchasing program rewarded low-quality hospitals.
Health Aff 2016 May;35(5):898-906. doi: 10.1377/hlthaff.2015.1190.
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Keywords: Medicare, Provider Performance, Payment, Hospitals, Healthcare Costs, Quality of Care
Kondo KK, Damberg CL, Mendelson A
Implementation processes and pay for performance in healthcare: A systematic review.
The authors conducted a systematic review and key informant (KI) interviews to better understand the implementation factors that modify the effectiveness of pay for performance (P4P). They concluded that P4P programs should undergo regular evaluation and should target areas of poor performance, and also that measures and incentives should align with organizational priorities, and programs should allow for changes over time in response to data and provider input.
AHRQ-funded; HS022981.
Citation: Kondo KK, Damberg CL, Mendelson A .
Implementation processes and pay for performance in healthcare: A systematic review.
J Gen Intern Med 2016 Apr;31 Suppl 1:61-9. doi: 10.1007/s11606-015-3567-0.
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Keywords: Healthcare Delivery, Provider Performance, Payment, Quality of Care
McConnell KJ, Lindrooth RC, Wholey DR
Modern management practices and hospital admissions.
The researchers investigated whether the modern management practices and publicly reported performance measures are associated with choice of hospital for patients with acute myocardial infarction (AMI). They found that, overall, a one standard deviation change in management practice scores is associated with an 8% increase in AMI admissions.
AHRQ-funded; HS018466.
Citation: McConnell KJ, Lindrooth RC, Wholey DR .
Modern management practices and hospital admissions.
Health Econ 2016 Apr;25(4):470-85. doi: 10.1002/hec.3171.
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Keywords: Hospitals, Heart Disease and Health, Cardiovascular Conditions, Quality Indicators (QIs), Quality Measures, Quality of Care, Public Reporting, Provider Performance
Calaman S, Hepps JH, Bismilla Z
The creation of standard-setting videos to support faculty observations of learner performance and entrustment decisions.
The authors report their experience developing videos that represent five levels of performance for an entrustable professional activities (EPA) for patient handoffs. They describe a process that begins with mapping the EPA to the critical competencies needed to make an entrustment decision. Each competency is then defined by five milestones (behavioral descriptors of performance at five advancing levels).
AHRQ-funded; HS019456.
Citation: Calaman S, Hepps JH, Bismilla Z .
The creation of standard-setting videos to support faculty observations of learner performance and entrustment decisions.
Acad Med 2016 Feb;91(2):204-9. doi: 10.1097/acm.0000000000000853..
Keywords: Education: Continuing Medical Education, Provider Performance, Patient Safety, Quality of Care
Walkey AJ, Weinberg J, Wiener RS
Association of do-not-resuscitate orders and hospital mortality rate among patients with pneumonia.
The researchers evaluated the effect of analytic approaches accounting for do-not-resuscitate (DNR) status on risk-adjusted hospital mortality rates and performance rankings. They found that after accounting for patient DNR status and between-hospital variation in the association between DNR status and mortality, hospitals with higher DNR rates had lower mortality.
AHRQ-funded; HS020672.
Citation: Walkey AJ, Weinberg J, Wiener RS .
Association of do-not-resuscitate orders and hospital mortality rate among patients with pneumonia.
JAMA Intern Med 2016 Jan;176(1):97-104. doi: 10.1001/jamainternmed.2015.6324.
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Keywords: Hospitals, Mortality, Quality of Care, Quality Indicators (QIs), Quality Measures, Pneumonia, Provider Performance, Respiratory Conditions
Das A, Norton EC, Miller DC
Association of postdischarge spending and performance on new episode-based spending measure.
The Centers for Medicare and Medicaid Services recently added the Medicare Spending per Beneficiary (MSPB) metric to its Hospital Value-Based Purchasing (HVBP) program. The researchers evaluated whether hospital performance was driven by spending before, during, or after hospitalization. They found that compared with low-cost hospitals, high-cost hospitals had significantly higher preadmission and index admission spending, but the largest differences were in postdischarge spending.
AHRQ-funded; HS020671.
Citation: Das A, Norton EC, Miller DC .
Association of postdischarge spending and performance on new episode-based spending measure.
JAMA Intern Med 2016 Jan;176(1):117-9. doi: 10.1001/jamainternmed.2015.6261.
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Keywords: Healthcare Costs, Medicare, Hospitals, Provider Performance, Hospitalization, Payment, Hospital Discharge