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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 72 Research Studies DisplayedCohen GR, Jones DJ, Heeringa J
AHRQ Author: Furukawa MF, Miller D
Leveraging diverse data sources to identify and describe U.S. health care delivery systems.
Health care delivery systems are a growing presence in the U.S., yet research is hindered by the lack of universally agreed-upon criteria to denote formal systems. This study assesses available data sources to identify and describe systems, including system members and relationships among the members.
AHRQ-authored.
Citation: Cohen GR, Jones DJ, Heeringa J .
Leveraging diverse data sources to identify and describe U.S. health care delivery systems.
eGEMS 2017 Dec 15;5(3):9. doi: 10.5334/egems.200..
Keywords: Healthcare Delivery, Data, Health Services Research (HSR), System Design
Raffo JE, Lloyd C, Collier M
Defining the role of the community health worker within a federal healthy start care coordination team.
The Strong Beginnings program worked to define community health worker (CHW) interventions, a core service of the program to improve maternal and child health. The workgroup identified seven core functions and 28 maternal and child health risk topics to be addressed by the CHW. The process resulted in a detailed document of program interventions that the CHWs use to guide care.
AHRQ-funded; HS020208.
Citation: Raffo JE, Lloyd C, Collier M .
Defining the role of the community health worker within a federal healthy start care coordination team.
Matern Child Health J 2017 Dec;21(Suppl 1):93-100. doi: 10.1007/s10995-017-2379-8.
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Keywords: Care Coordination, Children/Adolescents, Health Promotion, Health Services Research (HSR), Maternal Care
Serang S, Jacobucci R, Brimhall KC
Exploratory mediation analysis via regularization.
The researchers propose a two-stage approach called exploratory mediation analysis via regularization (XMed). They demonstrate that this approach is able to correctly identify mediators more often than conventional approaches and that its estimates are unbiased. Finally, their approach is illustrated through an empirical example examining the relationship between college acceptance and enrollment.
AHRQ-funded; HS024650.
Citation: Serang S, Jacobucci R, Brimhall KC .
Exploratory mediation analysis via regularization.
Struct Equ Modeling 2017;24(5):733-44. doi: 10.1080/10705511.2017.1311775.
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Keywords: Health Services Research (HSR), Research Methodologies
Oakes AH, Garmo VS, Bone LR
Identifying and prioritizing the barriers and facilitators to the self-management of type 2 diabetes mellitus: a community-centered approach.
The researchers sought to develop and test an instrument to identify and quantify the barriers and facilitators to self-management of type 2 diabetes. The study concluded that factors impacting self-management can be quantified and categorized as barriers and facilitators. Further refinement to some factors and investigation into alternative prioritization methods is necessary.
AHRQ-funded; HS000029.
Citation: Oakes AH, Garmo VS, Bone LR .
Identifying and prioritizing the barriers and facilitators to the self-management of type 2 diabetes mellitus: a community-centered approach.
Patient 2017 Dec;10(6):773-83. doi: 10.1007/s40271-017-0248-6..
Keywords: Diabetes, Health Services Research (HSR), Patient-Centered Healthcare, Patient Self-Management
Rundell SD, Gold LS, Hansen RN
Impact of co-morbidities on resource use and adherence to guidelines among commercially insured adults with new visits for back pain.
The purpose of this study was to assess if co-morbidity is associated with higher use of back-related care and adherence to back pain guidelines. The investigators found that co-morbidity burden and the presence of specific chronic conditions, such as musculoskeletal conditions, were associated with high long-term use of back-related care and care inconsistent with guidelines.
AHRQ-funded; HS022982.
Citation: Rundell SD, Gold LS, Hansen RN .
Impact of co-morbidities on resource use and adherence to guidelines among commercially insured adults with new visits for back pain.
J Eval Clin Pract 2017 Dec;23(6):1218-26. doi: 10.1111/jep.12763..
Keywords: Back Health and Pain, Guidelines, Health Services Research (HSR), Healthcare Utilization, Patient Adherence/Compliance
Senathirajah Y, Wang J, Borycki E
Mapping the electronic health record: a method to study display fragmentation.
Electronic health records have often been criticized for poor interaction design. The authors describe a method for evaluating and depicting the extent of display fragmentation and discuss its potential uses in comparing systems, identifying navigation pathways and information juxtaposition, and improving EHR interaction design.
AHRQ-funded; HS023708.
Citation: Senathirajah Y, Wang J, Borycki E .
Mapping the electronic health record: a method to study display fragmentation.
Stud Health Technol Inform 2017;245:1138-42.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR)
Kumar K, Holscher CM, Luo X
Persistent regional and racial disparities in nondirected living kidney donation.
Nondirected living donors (NDLDs) are an important and growing source of kidneys to help reduce the organ shortage. The authors of this study hypothesized that the initial geographic clustering and racial disparities may have improved due to an increase in NDLDs. The authors found that despite the increased number of NDLDs, racial disparities have worsened and the center-level distribution of NDLD transplants has narrowed in recent years.
AHRQ-funded; HS024600.
Citation: Kumar K, Holscher CM, Luo X .
Persistent regional and racial disparities in nondirected living kidney donation.
Clin Transplant 2017 Dec;31(12). doi: 10.1111/ctr.13135..
Keywords: Disparities, Health Services Research (HSR), Policy, Transplantation, Racial and Ethnic Minorities
Attanasio LB, Hardeman RR, Kozhimannil KB
Prenatal attitudes toward vaginal delivery and actual delivery mode: variation by race/ethnicity and socioeconomic status.
This study examined whether women's prenatal attitudes toward vaginal delivery differed by race/ethnicity or socioeconomic status, and whether attitudes were differently related to delivery mode depending on race/ethnicity or socioeconomic status. The study concluded that there are racial/ethnic differences in chances of cesarean delivery, and these differences are not explained by birth attitudes. Findings also suggested that white and high-socioeconomic status women may be more able to realize their preferences in childbirth.
AHRQ-funded; HS024215.
Citation: Attanasio LB, Hardeman RR, Kozhimannil KB .
Prenatal attitudes toward vaginal delivery and actual delivery mode: variation by race/ethnicity and socioeconomic status.
Birth 2017 Dec;44(4):306-14. doi: 10.1111/birt.12305..
Keywords: Health Services Research (HSR), Labor and Delivery, Pregnancy, Racial and Ethnic Minorities, Social Determinants of Health
Henderson ML, Thomas AG, Shaffer A
The national landscape of living kidney donor follow-up in the United States.
The purpose of this study was to understand the impact of the 2013 policy the Organ Procurement and Transplantation Network/United Network for Organ Sharing issued. The policy required that transplant centers collect data on living kidney donors (LKDs) at 6 months, 1 year, and 2 years postdonation, with policy-defined thresholds for the proportion of complete living donor follow-up data submitted in a timely manner (60 days before or after the expected visit date).
AHRQ-funded; HS024600.
Citation: Henderson ML, Thomas AG, Shaffer A .
The national landscape of living kidney donor follow-up in the United States.
Am J Transplant 2017 Dec;17(12):3131-40. doi: 10.1111/ajt.14356..
Keywords: Health Services Research (HSR), Patient-Centered Outcomes Research, Policy, Registries, Transplantation
Ji X, Machiraju R, Ritter A
Visualizing article similarities via sparsified article network and map projection for systematic reviews.
In this study, the authors visualized article similarities to extend its utilization in practical settings for SR researchers, aiming to promote human comprehension of article distributions and hidden patterns. To prompt an effective visualization in an interpretable, intuitive, and scalable way, they implemented a graph-based network visualization with three network sparsification approaches and a distance-based map projection via dimensionality reduction.
AHRQ-funded; HS025047.
Citation: Ji X, Machiraju R, Ritter A .
Visualizing article similarities via sparsified article network and map projection for systematic reviews.
Stud Health Technol Inform 2017;245:422-26.
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Keywords: Data, Evidence-Based Practice, Health Services Research (HSR), Research Methodologies
Schaffhausen CR, Bruin MJ, Chesley D
What patients and members of their support networks ask about transplant program data.
This study used qualitative document research methods to review 678 detailed Scientific Registry of Transplant Recipients (SRTR) entries and summary counts of 55 362 United Network for Organ Sharing (UNOS) entries to provide a better understanding of what was asked and what requests were most common. Patients sought a wide range of information about outcomes, waiting times, program volumes, and willingness to perform transplants in candidates with specific diseases or demographics.
AHRQ-funded; HS024527.
Citation: Schaffhausen CR, Bruin MJ, Chesley D .
What patients and members of their support networks ask about transplant program data.
Clin Transplant 2017 Dec;31(12). doi: 10.1111/ctr.13125.
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Keywords: Education: Patient and Caregiver, Decision Making, Health Services Research (HSR), Registries, Transplantation
Colla CH, Mainor AJ
Choosing Wisely Campaign: valuable for providers who knew about it, but awareness remained constant, 2014-17.
The Choosing Wisely campaign has codified recommendations of which health care services' use should be questioned and discussed with patients. The ABIM Foundation administered surveys in 2014 and 2017 to examine physicians' attitudes toward and awareness of the use of low-value care. There were no significant changes between 2014 and 2017 in awareness of the campaign among physicians or physician-reported difficulty in talking to patients about avoiding a low-value service.
AHRQ-funded; HS023812.
Citation: Colla CH, Mainor AJ .
Choosing Wisely Campaign: valuable for providers who knew about it, but awareness remained constant, 2014-17.
Health Aff 2017 Nov;36(11):2005-11. doi: 10.1377/hlthaff.2017.0945.
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Keywords: Decision Making, Guidelines, Quality of Care, Health Services Research (HSR), Clinician-Patient Communication
Hessels AJ, Darby SW, Simpser E
National testing of the nursing-kids intensity of care survey for pediatric long-term care.
The purpose of this study is to test the Nursing-Kids Intensity of Care, a measure of the intensity of nursing care needs, defined as the quantity and type of direct and indirect care activities performed by caregivers in a national sample. The authors concluded that additional testing to further establish psychometric sufficiency and expanded use to quantify the intensity of nursing care needs of children with complex medical conditions in pediatric long-term care settings is recommended.
AHRQ-funded; HS021470.
AHRQ-funded; HS021470.
AHRQ-funded; HS021470.
Citation: Hessels AJ, Darby SW, Simpser E .
National testing of the nursing-kids intensity of care survey for pediatric long-term care.
J Pediatr Nurs 2017 Nov/Dec;37:86-90. doi: 10.1016/j.pedn.2017.08.026..
Keywords: Children/Adolescents, Health Services Research (HSR), Long-Term Care, Nursing, Children/Adolescents
Fairbrother G, Dougherty D, Pradhananga R
AHRQ Author: Dougherty D
Road to the future: priorities for child health services research.
The researchers sought to develop and disseminate a robust, domestically focused, policy-oriented health services research agenda. Among the six priority domains identified for future research, including both enduring and emerging emphases were: 1) framing children's health issues so that they are compelling to policy-makers; 2) addressing poverty and other social determinants of child health and wellbeing; and 3) promoting equity in population health and health care.
AHRQ-authored; AHRQ-funded.
Citation: Fairbrother G, Dougherty D, Pradhananga R .
Road to the future: priorities for child health services research.
Acad Pediatr 2017 Nov - Dec;17(8):814-24. doi: 10.1016/j.acap.2017.04.015.
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Keywords: Children/Adolescents, Health Services Research (HSR), Health Services Research (HSR), Policy
Hiratsuka VY, Beans JA, Robinson RF
Self-determination in health research: an Alaska native example of tribal ownership and research regulation.
Southcentral Foundation (SCF), an Alaska Native-owned and operated health care organization, is transforming the relationship between researchers and the tribal community by making trust and accountability required features of health research in Alaska Native (AN) and American Indian (AI) communities. This review evaluates research through the lens of tribal principles, practices, and priorities. The SCF example provides a framework for other tribes and organizations seeking to reshape the future of health research in AN/AI communities.
AHRQ-funded; HS000079.
Citation: Hiratsuka VY, Beans JA, Robinson RF .
Self-determination in health research: an Alaska native example of tribal ownership and research regulation.
Int J Environ Res Public Health 2017 Oct 31;14(11). doi: 10.3390/ijerph14111324.
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Keywords: Health Services Research (HSR), Racial and Ethnic Minorities, Patient-Centered Outcomes Research, Policy, Racial and Ethnic Minorities
Jones CD, Jones J, RIchard A
"Connecting the Dots": a qualitative study of home health nurse perspectives on coordinating care for recently discharged patients.
This study described home health care (HHC) nurse perspectives about challenges and solutions to coordinating care for recently discharged patients. HHC nurses described challenges and solutions within domains of Accountability, Communication, Assessing Needs & Goals, and Medication Management. One additional domain of Safety, for both patients and HHC nurses, emerged from the analysis.
AHRQ-funded; HS024569.
Citation: Jones CD, Jones J, RIchard A .
"Connecting the Dots": a qualitative study of home health nurse perspectives on coordinating care for recently discharged patients.
J Gen Intern Med 2017 Oct;32(10):1114-21. doi: 10.1007/s11606-017-4104-0.
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Keywords: Care Coordination, Elderly, Home Healthcare, Health Services Research (HSR), Hospital Discharge
Zachrison KS, Hayden EM, Schwamm LH
Characterizing New England emergency departments by telemedicine use.
The primary objective of this study was to describe the prevalence of telemedicine use in New England EDs and the clinical applications of use. It concluded that telemedicine is commonly used in New England EDs. In 2014, use was more common among rural EDs and EDs with limited neurology consultant availability. In contrast, telemedicine use was less common among very low-volume EDs.
AHRQ-funded; HS024561.
Citation: Zachrison KS, Hayden EM, Schwamm LH .
Characterizing New England emergency departments by telemedicine use.
West J Emerg Med 2017 Oct;18(6):1055-60. doi: 10.5811/westjem.2017.8.34880.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Healthcare Delivery, Health Services Research (HSR), Telehealth
Keohane LM, Trivedi AN, Mor V
Recent health care use and Medicaid entry of Medicare beneficiaries.
The purpose of this study was to examine the relationship between Medicaid entry and recent health care use among Medicare beneficiaries. Although recent health care use predicted greater likelihood of Medicaid entry, half of new Medicaid participants used no hospital or nursing home care during the study period.
AHRQ-funded; HS023016.
Citation: Keohane LM, Trivedi AN, Mor V .
Recent health care use and Medicaid entry of Medicare beneficiaries.
Gerontologist 2017 Oct 1;57(5):977-86. doi: 10.1093/geront/gnw189..
Keywords: Elderly, Healthcare Utilization, Health Services Research (HSR), Medicaid, Medicare
Arbaje AI, Yu Q, Wang J J
Senior services in US hospitals and readmission risk in the Medicare population.
The purpose of this study was to determine whether hospitals' Senior Care Services Scale (SCSS) scores were associated with risk of readmission among Medicare beneficiaries. The study concluded that senior services at the hospital-level represented a modifiable risk factor with important impact. Employing organization-level characteristics in readmission risk prediction tools should be expanded.
AHRQ-funded; HS022916
Citation: Arbaje AI, Yu Q, Wang J J .
Senior services in US hospitals and readmission risk in the Medicare population.
Int J Qual Health Care 2017 Oct 1;29(6):845-52. doi: 10.1093/intqhc/mzx112..
Keywords: Elderly, Health Services Research (HSR), Hospital Readmissions, Hospitals, Medicare
Schoenbaum M, Sutherland JM, Chappel A
AHRQ Author: Sutherland JM
Twelve-month health care use and mortality in commercially insured young people with incident psychosis in the United States.
This study assessed 12-month mortality and patterns of outpatient and inpatient treatment among young people experiencing an incident episode of psychosis in the United States. The hugely elevated mortality observed, when compared to the general population, underscores that young people experiencing psychosis warrant intensive clinical attention-yet the researchers found low rates of pharmacotherapy and limited use of psychosocial treatment.
AHRQ-authored.
Citation: Schoenbaum M, Sutherland JM, Chappel A .
Twelve-month health care use and mortality in commercially insured young people with incident psychosis in the United States.
Schizophr Bull 2017 Oct;43(6):1262-72. doi: 10.1093/schbul/sbx009.
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Keywords: Healthcare Utilization, Health Insurance, Health Services Research (HSR), Behavioral Health, Young Adults
Aarons GA, Sklar M, Mustanski B
"Scaling-out" evidence-based interventions to new populations or new health care delivery systems.
This paper introduces a new concept for implementation called "scaling-out" when evidence-based interventions are adapted either to new populations or new delivery systems, or both. Using existing external validity theories and multilevel mediation modeling, the authors provide a logical framework for determining what new empirical evidence is required for an intervention to retain its evidence-based standard in this new context.
AHRQ-funded; HS024192.
Citation: Aarons GA, Sklar M, Mustanski B .
"Scaling-out" evidence-based interventions to new populations or new health care delivery systems.
Implement Sci 2017 Sep 6;12(1):111. doi: 10.1186/s13012-017-0640-6..
Keywords: Healthcare Delivery, Evidence-Based Practice, Health Services Research (HSR)
Mortensen ML, Adam GP, Trikalinos TA
An exploration of crowdsourcing citation screening for systematic reviews.
This study explored the use of crowdsourcing (distributing tasks to untrained workers via the web) to reduce the cost of screening citations. Crowdworkers completed screening in 4 to 17 days, costing $460 to $2220, a cost reduction of up to 88 percent compared to trained experts. Crowdsourcing may represent a useful approach to reducing the cost of identifying literature for systematic reviews.
AHRQ-funded; HS025024.
Citation: Mortensen ML, Adam GP, Trikalinos TA .
An exploration of crowdsourcing citation screening for systematic reviews.
Res Synth Methods 2017 Sep;8(3):366-86. doi: 10.1002/jrsm.1252.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Research Methodologies
Markowitz S, Adams EK, Lewitt MJ
Competitive effects of scope of practice restrictions: public health or public harm?
This paper examined the case of scope of practice (SOP) restrictions for certified nurse midwives and evaluated the effects of changes in states' SOP laws on markets for CNMs and on maternal and infant outcomes. The authors found that SOP laws are neither helpful nor harmful in regards to health outcomes but states that have no SOP-based barriers have lower rates of induced labor and Cesarean section births.
AHRQ-funded; HS024530.
Citation: Markowitz S, Adams EK, Lewitt MJ .
Competitive effects of scope of practice restrictions: public health or public harm?
J Health Econ 2017 Sep;55:201-18. doi: 10.1016/j.jhealeco.2017.07.004..
Keywords: Health Services Research (HSR), Labor and Delivery, Pregnancy, Public Health, Policy
Wey A, Salkowski N, Kasiske BL
Influence of kidney offer acceptance behavior on metrics of allocation efficiency.
This study investigated associations of deceased donor kidney offer acceptance with likelihood of the kidney being discarded, cold ischemia time at transplant (CIT), and likelihood of the kidney being exported outside the donation service area (DSA). The authors suggest that improving lower-than-expected offer acceptance would likely reduce discards, CIT, and exports.
AHRQ-funded; HS024527.
Citation: Wey A, Salkowski N, Kasiske BL .
Influence of kidney offer acceptance behavior on metrics of allocation efficiency.
Clin Transplant 2017 Sep;31(9). doi: 10.1111/ctr.13057..
Keywords: Health Services Research (HSR), Registries, Transplantation
Friedman S, Xu H, Harwood JM
The Mental Health Parity and Addiction Equity Act evaluation study: impact on specialty behavioral healthcare utilization and spending among enrollees with substance use disorders.
The purpose of this study was to determine whether Mental Health Parity and Addiction Equity Act (MHPAEA) was associated with increased behavioral health expenditures and utilization among a population with substance use disorder (SUD) diagnoses. The investigators found that MHPAEA was associated with modest increases in total, plan, and patient out-of-pocket spending and outpatient and inpatient utilization.
AHRQ-funded; HS024866.
Citation: Friedman S, Xu H, Harwood JM .
The Mental Health Parity and Addiction Equity Act evaluation study: impact on specialty behavioral healthcare utilization and spending among enrollees with substance use disorders.
J Subst Abuse Treat 2017 Sep;80:67-78. doi: 10.1016/j.jsat.2017.06.006..
Keywords: Behavioral Health, Healthcare Costs, Healthcare Utilization, Health Insurance, Policy, Health Services Research (HSR), Substance Abuse