National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Adverse Events (1)
- Alcohol Use (1)
- Arthritis (1)
- Cancer (6)
- Cancer: Breast Cancer (1)
- Cancer: Prostate Cancer (1)
- Children/Adolescents (3)
- Chronic Conditions (3)
- Comparative Effectiveness (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (2)
- Decision Making (2)
- Depression (1)
- Diabetes (2)
- Diagnostic Safety and Quality (2)
- Disabilities (1)
- Disparities (2)
- Elderly (11)
- Electronic Health Records (EHRs) (1)
- Healthcare Costs (4)
- Healthcare Delivery (1)
- Health Insurance (1)
- Health Promotion (2)
- (-) Health Status (37)
- Heart Disease and Health (1)
- Intensive Care Unit (ICU) (1)
- Kidney Disease and Health (1)
- Lifestyle Changes (1)
- Low-Income (3)
- Medicaid (2)
- Medical Expenditure Panel Survey (MEPS) (3)
- Medicare (3)
- Men's Health (1)
- Mortality (1)
- Newborns/Infants (2)
- Nursing Homes (1)
- Obesity (1)
- Obesity: Weight Management (1)
- Outcomes (4)
- Palliative Care (1)
- Patient-Centered Outcomes Research (2)
- Patient Safety (1)
- Patient Self-Management (2)
- Policy (1)
- Pregnancy (1)
- Provider: Clinician (1)
- Provider: Nurse (1)
- Provider: Physician (1)
- Provider Performance (1)
- Public Health (1)
- Quality Improvement (1)
- Quality of Care (1)
- Quality of Life (8)
- Racial and Ethnic Minorities (2)
- Research Methodologies (1)
- Risk (4)
- Screening (2)
- Sickle Cell Disease (1)
- Skin Conditions (1)
- Social Determinants of Health (9)
- Stress (1)
- Substance Abuse (1)
- Surgery (2)
- Tobacco Use (1)
- Urban Health (1)
- Vulnerable Populations (1)
- Women (2)
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 37 Research Studies DisplayedHorwood CR, Moffatt-Bruce SD, Fitzgerald M
A qualitative analysis of clinical decompensation in the surgical patient: perceptions of nurses and physicians.
This study is a quantitative analysis of nurse and physician perception of clinical decompensation in postsurgical patients. The study aims to assess how nurses and physicians perceive early warning signs that predict clinical decompensation, changes in clinical acuity, and the need for escalation of care. Many areas showed strong agreement, but there were differences between nurses and physicians in primary indicators of patient stability. There were also differences in the methods and frequency used to monitor medically unstable patients.
AHRQ-funded; HS024379.
Citation: Horwood CR, Moffatt-Bruce SD, Fitzgerald M .
A qualitative analysis of clinical decompensation in the surgical patient: perceptions of nurses and physicians.
Surgery 2018 Dec;164(6):1311-15. doi: 10.1016/j.surg.2018.06.006..
Keywords: Adverse Events, Health Status, Provider: Clinician, Provider: Nurse, Provider: Physician, Surgery
Oates GR, Hamby BW, Bae S
Bikeshare use in urban communities: individual and neighborhood factors.
This study examined factors associated with bikeshare use in a metropolitan area in the southern United States. The study found that higher neighborhood socioeconomic disadvantage was associated with higher bikeshare use. Bikeshare was a viable transportation option in low-resource neighborhoods and may be an effective tool to improve the connectivity, livability, and health of urban communities.
AHRQ-funded; HS023009.
Citation: Oates GR, Hamby BW, Bae S .
Bikeshare use in urban communities: individual and neighborhood factors.
Ethn Dis 2017 Nov 9;27(Suppl 1):303-12. doi: 10.18865/ed.27.S1.303..
Keywords: Health Status, Social Determinants of Health, Urban Health
Satchidanand N, Servoss TJ, Singh R
Development of a risk tool to support discussions of care for older adults admitted to the ICU with pneumonia.
The purpose of this study was to develop a 30-day mortality prediction tool for older patients in intensive care unit (ICU) with pneumonia that will initiate palliative care earlier in hospital course. The authors suggest that their risk tool can help care teams make more informed decisions among care options by identifying a patient group for whom a careful review of goals of care is indicated both during and after hospitalization.
AHRQ-funded; HS023656.
Citation: Satchidanand N, Servoss TJ, Singh R .
Development of a risk tool to support discussions of care for older adults admitted to the ICU with pneumonia.
Am J Hosp Palliat Care 2018 Sep;35(9):1201-06. doi: 10.1177/1049909118764093..
Keywords: Decision Making, Elderly, Health Status, Intensive Care Unit (ICU), Palliative Care, Risk
Hays RD, Mallett JS, Haas A
Associations of CAHPS composites with global ratings of the doctor vary by Medicare beneficiaries' health status.
This study examines whether the association of care coordination with global ratings of one's personal doctor varies by number of chronic conditions and self-rated health. Results were consistent with the hypothesis that patients in worse health weigh care coordination more heavily in global physician assessments than patients in better health. Emphasis on improving care coordination, especially for patients in poorer health, may improve patients' overall assessments of their providers.
AHRQ-funded; HS016980; HS025920.
Citation: Hays RD, Mallett JS, Haas A .
Associations of CAHPS composites with global ratings of the doctor vary by Medicare beneficiaries' health status.
Med Care 2018 Aug;56(8):736-39. doi: 10.1097/mlr.0000000000000942..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Health Status, Medicare, Provider Performance
Mian HS, Wildes TM, Fiala MA
Development of a Medicare health outcomes survey deficit-accumulation frailty index and its application to older patients with newly diagnosed multiple myeloma.
JCO Clinical Cancer Informatics 2018; 2):1-13. doi: 10.1200/cci.18.00043.
This study’s objective was to develop a frailty index for older patients and apply it to a subset of patients newly diagnosed with multiple myeloma. The study used the Rockwood Accumulation of Deficits approach for the Medicare Health Outcomes Study (MHOS). Data from over 2 million patients without cancer older than 66 years of age from SEER-MHOS linked databases were compared to the cohort with multiple myeloma. It was found that among patients without cancer, each 10% increase in the frailty index was associated with a 40% increased risk of death. For the multiple myeloma cohort, each 10% increase in the frailty index was associated with a 16% increased risk for death. Median time for overall survival was only 26.8 months for patients considered frail, compared with 43.7 months for those who were not. This frailty index could be used a predictor of overall survival in older multiple myeloma patients.
This study’s objective was to develop a frailty index for older patients and apply it to a subset of patients newly diagnosed with multiple myeloma. The study used the Rockwood Accumulation of Deficits approach for the Medicare Health Outcomes Study (MHOS). Data from over 2 million patients without cancer older than 66 years of age from SEER-MHOS linked databases were compared to the cohort with multiple myeloma. It was found that among patients without cancer, each 10% increase in the frailty index was associated with a 40% increased risk of death. For the multiple myeloma cohort, each 10% increase in the frailty index was associated with a 16% increased risk for death. Median time for overall survival was only 26.8 months for patients considered frail, compared with 43.7 months for those who were not. This frailty index could be used a predictor of overall survival in older multiple myeloma patients.
AHRQ-funded; HS019455.
Citation: Mian HS, Wildes TM, Fiala MA .
Development of a Medicare health outcomes survey deficit-accumulation frailty index and its application to older patients with newly diagnosed multiple myeloma.
JCO Clin Cancer Inform 2018;2. doi: 10.1200/cci.18.00043..
Keywords: Cancer, Diagnostic Safety and Quality, Elderly, Health Status, Medicare
Downing J, Conron K, Herman JL
Transgender and cisgender US veterans have few health differences.
The authors used population-level data for 2014-2016 from the Behavioral Risk Factor Surveillance System to compare the health of transgender and cisgender veterans and civilians. They found that, while transgender civilians had worse health than cisgender civilians across most indicators, very few differences existed among veterans. They conclude that their findings largely suggest that transgender veterans do not have worse health than cisgender veterans.
AHRQ-funded; HS022241.
Citation: Downing J, Conron K, Herman JL .
Transgender and cisgender US veterans have few health differences.
Health Aff 2018 Jul;37(7):1160-68. doi: 10.1377/hlthaff.2018.0027..
Keywords: Health Status, Healthcare Delivery, Vulnerable Populations
Roy B, Riley C, Herrin J
Identifying county characteristics associated with resident well-being: a population based study.
The authors aimed to identify county attributes that are independently associated with a comprehensive, multi-dimensional assessment of individual well-being. They identified twelve county-level factors that were independently associated with individual well-being scores. Collectively, these twelve factors explained 91% of the variance in individual well-being scores, and they represent four conceptually distinct categories: demographic; social and economic; clinical care; and physical environment.
AHRQ-funded; HS023000.
Citation: Roy B, Riley C, Herrin J .
Identifying county characteristics associated with resident well-being: a population based study.
PLoS One 2018 May 23;13(5):e0196720. doi: 10.1371/journal.pone.0196720.
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Keywords: Health Status, Quality of Life, Social Determinants of Health
Skube SJ, Lindemann EA, Arsoniadis EG
Characterizing functional health status of surgical patients in clinical notes.
The researchers of this study hypothesize that important functional status data is contained in clinical notes. They found that several categories of phrases related to functional status including diagnoses, activity and care assessments, physical exam, functional scores, assistive equipment, symptoms, and surgical history were important factors. They conducted a chart review and compared functional health status level terms from the chart review to National Surgical Quality Improvement Program determinations.
AHRQ-funded; HS024532.
Citation: Skube SJ, Lindemann EA, Arsoniadis EG .
Characterizing functional health status of surgical patients in clinical notes.
AMIA Jt Summits Transl Sci Proc 2018 May 18;2017:379-88..
Keywords: Health Status, Patient Safety, Risk, Surgery, Electronic Health Records (EHRs)
Ogarek JA, McCreedy EM, Thomas KS
Minimum data set changes in health, end-stage disease and symptoms and signs scale: a revised measure to predict mortality in nursing home residents.
The purpose of this study was to revise the Minimum Data Set (MDS) Changes in Health, End-stage disease and Symptoms and Signs (CHESS) scale, an MDS 2.0-based measure widely used to predict mortality in institutional settings, in response to the release of MDS 3.0. The MDS-CHESS 3.0 predicts mortality in newly admitted and long-stay nursing home populations. The additional relationship to hospitalizations and successful discharges to community increases the utility of this scale as a potential risk adjustment tool.
AHRQ-funded; HS000011.
Citation: Ogarek JA, McCreedy EM, Thomas KS .
Minimum data set changes in health, end-stage disease and symptoms and signs scale: a revised measure to predict mortality in nursing home residents.
J Am Geriatr Soc 2018 May;66(5):976-81. doi: 10.1111/jgs.15305..
Keywords: Decision Making, Elderly, Health Status, Mortality, Nursing Homes
Misra-Hebert AD, Hu B, Le PH
Effect of health plan financial incentive offering on employees with prediabetes.
Researchers studied the effect of employee health plan financial incentives on health outcomes for employees with prediabetes. They found that employees who participated in disease management lost more weight than those who did not. A worksite wellness program offering health plan financial incentives for participation and outcomes was associated with improvements not only in weight but also in HbA1c.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Hu B, Le PH .
Effect of health plan financial incentive offering on employees with prediabetes.
Am J Med 2018 Mar;131(3):293-99. doi: 10.1016/j.amjmed.2017.09.024.
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Keywords: Healthcare Costs, Patient-Centered Outcomes Research, Patient Self-Management, Obesity: Weight Management, Diabetes, Health Status
Sterling MR, Lin FR, Jannat-Khah DP
Hearing loss among older adults with heart failure in the United States: data from the National Health and Nutrition Examination Survey.
The researchers examined the prevalence and correlates of hearing loss among older adults with and without heart failure (HF) in the United States. Overall, 75 percent of adults 70 years or older with HF have hearing loss. Although hearing loss was more common among adults with HF compared with those without it, HF was not independently associated with hearing loss after accounting for demographic and clinical characteristics.
AHRQ-funded; HS000066.
Citation: Sterling MR, Lin FR, Jannat-Khah DP .
Hearing loss among older adults with heart failure in the United States: data from the National Health and Nutrition Examination Survey.
JAMA Otolaryngol Head Neck Surg 2018 Mar;144(3):273-75. doi: 10.1001/jamaoto.2017.2979.
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Keywords: Elderly, Health Status, Heart Disease and Health, Risk
Gianfrancesco MA, Yazdany J, Schmajuk G
The impact of smoking on disease measures in rheumatoid arthritis: the need for appropriate adjustment of time-varying confounding.
In a recent publication, Quintana-Dunque et al. studied patients with early onset rheumatoid arthritis (RA) and showed that baseline smoking status was inversely associated with disease activity and disability at 36 months. This paper argues that the authors failed to highlight several limitations of study design and analysis, including time-varying confounding, which may have had a direct impact on results and corresponding conclusions.
AHRQ-funded; HS024412.
Citation: Gianfrancesco MA, Yazdany J, Schmajuk G .
The impact of smoking on disease measures in rheumatoid arthritis: the need for appropriate adjustment of time-varying confounding.
Rheumatol Int 2018 Feb;38(2):313-14. doi: 10.1007/s00296-017-3902-3.
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Keywords: Health Status, Lifestyle Changes, Arthritis, Tobacco Use
Berdahl T, McQuillan J
AHRQ Author: Berdahl T
Self-rated health trajectories among married Americans: do disparities persist over 20 years?
The purpose of this study is to understand self-rated health (SRH) trajectories by social location (race/ethnicity by gender by social class) among married individuals in the United States. It found that women are less healthy than men; people of color are less healthy than whites; lower educated individuals are less healthy than higher educated individuals. Women's health declined slower than men's but did not differ by race/ethnicity or education
AHRQ-authored.
Citation: Berdahl T, McQuillan J .
Self-rated health trajectories among married Americans: do disparities persist over 20 years?
J Aging Res 2018 Jan 11;2018:1208598. doi: 10.1155/2018/1208598.
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Keywords: Disparities, Health Status, Social Determinants of Health
McDonald ML, Huang A, Proudfoot JA
Association of obesity, BMI, and Hispanic ethnicity on ambulatory status in children with spinal dysraphism followed near the California-Mexico border.
This study evaluated the relationship between body mass index (BMI), overweight status (OW), or obesity (OB) and ambulatory status in a predominantly Hispanic population of children with spinal dysraphism (SD). It found that,despite no difference in ambulatory status, increasing BMI and OW / OB are associated with Hispanic ethnicity and increasing age.
AHRQ-funded; HS022404.
Citation: McDonald ML, Huang A, Proudfoot JA .
Association of obesity, BMI, and Hispanic ethnicity on ambulatory status in children with spinal dysraphism followed near the California-Mexico border.
J Health Care Poor Underserved 2016;27(4):1956-69. doi: 10.1353/hpu.2016.0173.
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Keywords: Obesity, Racial and Ethnic Minorities, Racial and Ethnic Minorities, Children/Adolescents, Health Status
Kenzik KM, Kent EE, Martin MY
Chronic condition clusters and functional impairment in older cancer survivors: a population-based study.
The purpose of this study was to identify chronic condition clusters at pre- and post-cancer diagnosis, evaluate predictors of developing clusters post-cancer, and examine the impact on functional impairment among older cancer survivors. It found that distinct condition clusters of two or more chronic conditions are prevalent among older cancer survivors. Cluster prevalence increases from pre- to post-cancer diagnosis.
AHRQ-funded; HS023009; HS013852.
Citation: Kenzik KM, Kent EE, Martin MY .
Chronic condition clusters and functional impairment in older cancer survivors: a population-based study.
J Cancer Surviv 2016 Dec;10(6):1096-103. doi: 10.1007/s11764-016-0553-4.
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Keywords: Chronic Conditions, Cancer, Elderly, Research Methodologies, Health Status
Arora A, Spatz E, Herrin J
Population well-being measures help explain geographic disparities in life expectancy at the county level.
This study investigated whether population well-being - a comprehensive measure of physical, mental, and social health - helps explain geographic variation in life expectancy. At the county level, it found that for every 1-standard-deviation (4.2-point) increase in the well-being score, life expectancy was 1.9 years higher for females and 2.6 years higher for males.
AHRQ-funded; HS023000.
Citation: Arora A, Spatz E, Herrin J .
Population well-being measures help explain geographic disparities in life expectancy at the county level.
Health Aff 2016 Nov 01;35(11):2075-82. doi: 10.1377/hlthaff.2016.0715.
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Keywords: Disparities, Health Status, Low-Income, Social Determinants of Health
Goodwin JS, Sheffield K, Li S
Receipt of cancer screening is a predictor of life expectancy.
The researchers sought to determine the association between receipt of screening mammography or PSA and overall survival. They found that the subjects with prior cancer screening had actual median survivals higher than those who were not screened, with differences ranging from 1.7 to 2.1 years for women and 0.9 to 1.1 years for men.
AHRQ-funded; HS022134.
Citation: Goodwin JS, Sheffield K, Li S .
Receipt of cancer screening is a predictor of life expectancy.
J Gen Intern Med 2016 Nov;31(11):1308-14. doi: 10.1007/s11606-016-3787-y.
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Keywords: Cancer, Cancer: Breast Cancer, Cancer: Prostate Cancer, Screening, Women, Men's Health, Health Status
Hanmer J, Hess R, Sullivan S
Benchmarking health-related quality-of-life data from a clinical setting.
This paper's objective was to construct a nationally representative health-related quality of life (HRQoL) benchmark for use with a clinical sample. The results showed that HRQoL benchmarks can be created from current public datasets, and subgroups in national samples may provide more valid benchmarks for clinical populations.
AHRQ-funded; HS022989.
Citation: Hanmer J, Hess R, Sullivan S .
Benchmarking health-related quality-of-life data from a clinical setting.
Am J Manag Care 2016 Oct;22(10):669-75.
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Keywords: Health Status, Medical Expenditure Panel Survey (MEPS), Quality of Life
Kirby JS, Sisic M, Tan J
Exploring coping strategies for patients with hidradenitis suppurativa.
The authors explored the coping strategies of individuals with hidradenitis suppurativa (HS). They found that negative coping included behavioral disengagement and social isolation, while positive coping included use of humor and positive reframing as well as the support of others.
AHRQ-funded; HS024585.
Citation: Kirby JS, Sisic M, Tan J .
Exploring coping strategies for patients with hidradenitis suppurativa.
JAMA Dermatol 2016 Oct;152(10):1166-67. doi: 10.1001/jamadermatol.2016.1942.
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Keywords: Health Status, Quality of Life, Patient Self-Management, Skin Conditions
Barile JP, Horner-Johnson W, Krahn G
Measurement characteristics for two health-related quality of life measures in older adults: the SF-36 and the CDC Healthy Days items.
This study assessed the extent to which the SF-36 and the Centers for Disease Control and Prevention (CDC) Healthy Days items measure the same aspects of health. It found that the CDC Healthy Days items measure similar domains as the SF-36 but appear to assess health-related quality of life without regard to limitations in functioning.
AHRQ-funded; HS022981.
Citation: Barile JP, Horner-Johnson W, Krahn G .
Measurement characteristics for two health-related quality of life measures in older adults: the SF-36 and the CDC Healthy Days items.
Disabil Health J 2016 Oct;9(4):567-74. doi: 10.1016/j.dhjo.2016.04.008.
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Keywords: Disabilities, Elderly, Health Status, Quality of Life
Hinton CF, Homer CJ, Thompson AA
AHRQ Author: Dougherty D
A framework for assessing outcomes from newborn screening: on the road to measuring its promise.
The researchers proposed a framework for assessing outcomes for the health and well-being of children identified through newborn screening programs. As an example, they applied the framework to sickle cell disease and phenylketonuria, two diverse conditions with different outcome measures and potential sources of data. They concluded that their paper presented a customizable outcomes framework for organizing measures for newborn screening condition-specific health outcomes, and an approach to identifying sources and challenges to populating those measures.
AHRQ-authored.
Citation: Hinton CF, Homer CJ, Thompson AA .
A framework for assessing outcomes from newborn screening: on the road to measuring its promise.
Mol Genet Metab 2016 Aug;118(4):221-9. doi: 10.1016/j.ymgme.2016.05.017.
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Keywords: Children/Adolescents, Health Status, Newborns/Infants, Screening, Sickle Cell Disease
Steve SL, Tung EL, Schlichtman JJ
Social disorder in adults with type 2 diabetes: building on race, place, and poverty.
The authors reported on their narrative review of the literature that explores the associations between social disorder and diabetes-related health outcomes within vulnerable communities. They also proposed a multilevel ecosocial model for conceptualizing social disorder, specifically focusing on its role in racial disparities and its pathways to mediating diabetes outcomes.
AHRQ-funded; HS000078.
Citation: Steve SL, Tung EL, Schlichtman JJ .
Social disorder in adults with type 2 diabetes: building on race, place, and poverty.
Curr Diab Rep 2016 Aug;16(8):72. doi: 10.1007/s11892-016-0760-4.
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Keywords: Diabetes, Low-Income, Health Status, Racial and Ethnic Minorities, Social Determinants of Health
Wang SY, Hsu SH, Gross CP
Association between time since cancer diagnosis and health-related quality of life: a population-level analysis.
The purpose of this paper is to examine the association between time since cancer diagnosis and health-related quality of life (HRQOL) among cancer survivors in remission. The researchers found that most cancer survivors did not experience poorer mental health, but that survivors of prostate or cervical cancer had lower mental component summary scores after 10 years of diagnosis. They concluded that the level of HRQOL among cancer survivors depends on time since cancer diagnosis and cancer type.
AHRQ-funded; HS023900.
Citation: Wang SY, Hsu SH, Gross CP .
Association between time since cancer diagnosis and health-related quality of life: a population-level analysis.
Value Health 2016 Jul-Aug;19(5):631-8. doi: 10.1016/j.jval.2016.02.010.
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Keywords: Cancer, Diagnostic Safety and Quality, Health Status, Patient-Centered Outcomes Research, Quality of Life
Jacobs PD, Duchovny N, Lipton BJ
AHRQ Author: Jacobs PD
Changes in health status and care use after ACA expansions among the insured and uninsured.
The authors investigated average health status and use of health care following the Affordable Care Act's insurance expansion provisions in 2014, finding that Medicaid enrollees and the uninsured were both healthier in 2014 than those respective groups were in 2013, but that those with individual private insurance coverage appeared less healthy as a group.
AHRQ-authored.
Citation: Jacobs PD, Duchovny N, Lipton BJ .
Changes in health status and care use after ACA expansions among the insured and uninsured.
Health Aff 2016 Jul;35(7):1184-8. doi: 10.1377/hlthaff.2015.1539.
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Keywords: Healthcare Costs, Health Insurance, Policy, Health Status, Medicaid
Koroukian SM, Schiltz N, Warner DF
Combinations of chronic conditions, functional limitations, and geriatric syndromes that predict health outcomes.
The researchers aimed to identify combinations of chronic conditions, functional limitations, and geriatric syndromes that predict poor health outcomes. They found that functional limitations and/or geriatric syndromes were the most prominent conditions in predicting health outcomes. They concluded that accounting for chronic conditions alone may be less informative than also accounting for the co-occurrence of functional limitations and geriatric syndromes, as the latter conditions appear to drive health outcomes in older individuals.
AHRQ-funded; HS023113.
Citation: Koroukian SM, Schiltz N, Warner DF .
Combinations of chronic conditions, functional limitations, and geriatric syndromes that predict health outcomes.
J Gen Intern Med 2016 Jun;31(6):630-7. doi: 10.1007/s11606-016-3590-9.
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Keywords: Elderly, Chronic Conditions, Risk, Outcomes, Health Status