National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Antibiotics (1)
- Anxiety (1)
- (-) Asthma (23)
- Behavioral Health (1)
- Care Management (3)
- Case Study (1)
- (-) Children/Adolescents (23)
- Chronic Conditions (4)
- Depression (1)
- Diagnostic Safety and Quality (1)
- Digestive Disease and Health (1)
- Education (1)
- Education: Patient and Caregiver (1)
- Emergency Department (7)
- Evidence-Based Practice (3)
- Guidelines (3)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Delivery (2)
- Health Information Technology (HIT) (1)
- Health Status (1)
- Hospital Discharge (2)
- Hospitalization (3)
- Hospitals (1)
- Implementation (1)
- Influenza (1)
- Inpatient Care (3)
- Medication (8)
- Medication: Safety (1)
- Newborns/Infants (1)
- Outcomes (2)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (2)
- Patient and Family Engagement (1)
- Patient Safety (1)
- Patient Self-Management (1)
- Practice Patterns (2)
- Primary Care (2)
- Provider (1)
- Provider: Physician (1)
- Quality Improvement (3)
- Quality of Care (3)
- Quality of Life (1)
- Registries (1)
- Respiratory Conditions (12)
- Risk (3)
- Screening (1)
- Shared Decision Making (1)
- Social Determinants of Health (1)
- Teams (1)
- Transitions of Care (2)
- Treatments (1)
- Urban Health (1)
- Web-Based (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 23 of 23 Research Studies DisplayedHarder VS, Shaw JS, McCulloch CE
Statewide asthma learning collaborative participation and asthma-related emergency department use.
This study looked at outcomes from participation of pediatric practices in a quality improvement (QI) collaborative to decrease asthma-related emergency department (ED) visits. A statewide network of practices participated in the collaborative from 2015 to 2016. Asthma-related ED visit rates per 100 child-years for children ages 3 to 21 was evaluated using the state’s all-payer claims databases. The authors found that in the postintervention year (2017) participating practices’ ED visit rate decreased by 5.8 per 100 child-years, compared to an increase of 1.8 per 100 child-years in non-participating practices. There were no statistically significant differences in asthma-related ED visit rates during 2016, which indicated that it took some time for QI elements to be successfully implemented in pediatric practices.
AHRQ-funded; HS025297.
Citation: Harder VS, Shaw JS, McCulloch CE .
Statewide asthma learning collaborative participation and asthma-related emergency department use.
Pediatrics 2020 Dec;146(6):e20200213. doi: 10.1542/peds.2020-0213..
Keywords: Children/Adolescents, Asthma, Emergency Department, Quality Improvement, Quality of Care, Primary Care, Guidelines
Cotter JM, Tyler A, Reese J
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
This study looked at pediatric emergency department (ED) inpatient use of dexamethasone versus prednisone by providers for asthma treatment. A survey was distributed to providers who care for inpatient asthmatics. Ninety-two providers completed the survey. When patients received dexamethasone in the ED, 44% continued dexamethasone, 14% switched to prednisone, 2% stopped steroid use, and 40% said it depended on the circumstances. Hospitalists were significantly more likely to continue dexamethasone than pulmonologists (61% versus 15%). Switching to prednisone included factors such as severity of exacerbation (73%) and asthma history (47%). Just over half of providers (5f1%) felt uncomfortable using dexamethasone because of “minimal data to support [its] use inpatient.”
AHRQ-funded; HS026512.
Citation: Cotter JM, Tyler A, Reese J .
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
J Asthma 2020 Sep;57(9):942-48. doi: 10.1080/02770903.2019.1622713..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Medication, Inpatient Care, Care Management, Hospitalization, Emergency Department, Practice Patterns, Provider: Physician, Provider
Kaiser SV, Johnson MD, Walls TA
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
This quality improvement study’s aim was to determine the effects of pediatric asthma pathway implementation in a diverse, national sample of emergency departments (EDs). Desired outcomes included systemic corticosteroid administration within 60 minutes (primary), assessment of severity at ED triage, chest radiograph use, hospital admission or transfer for higher level of care, and ED length of stay. Charts were reviewed each month by EDs for children ages 2-17 years with a primary diagnosis of asthma. A total of 83 EDs were enrolled, with 37 of them children’s hospitals, and 46 community hospitals. Seventy-three percent completed the study (n = 22,963). There was a significant increase in systematic corticosteroid administration within 60 minutes of arrival as well as increased odds of severity assessment at triage and decreased rate of change in odds of hospital admission/transfer. Chest radiograph or ED length of stay was not associated with pathway implementation.
AHRQ-funded; HS024592.
Citation: Kaiser SV, Johnson MD, Walls TA .
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
J Pediatr 2020 Aug;223:100-07.e2. doi: 10.1016/j.jpeds.2020.02.080..
Keywords: Children/Adolescents, Emergency Department, Asthma, Quality Improvement, Quality of Care, Care Management, Healthcare Delivery, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Kaiser SV, Lam Cabana, MD
Best practices in implementing inpatient pediatric asthma pathways: a qualitative study.
The objective of this study was to identify potential best practices in pathway implementation. Building upon a previous observational study in which the researchers identified higher and lower performing children's hospitals based on hospital-level changes in asthma patient length of stay after implementation of a pathway, they conducted semi-structured interviews with a sample of healthcare providers involved in pathway implementation at these hospitals. They identified several potential best practices to support pathway implementation. They recommended that hospitals implementing pathways consider applying these strategies to ensure success in improving quality of asthma care for children.
AHRQ-funded; HS024592.
Citation: Kaiser SV, Lam Cabana, MD .
Best practices in implementing inpatient pediatric asthma pathways: a qualitative study.
J Asthma 2020 Jul;57(7):744-54. doi: 10.1080/02770903.2019.1606237..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Hospitals, Inpatient Care, Guidelines, Evidence-Based Practice, Implementation, Quality Improvement, Quality of Care
Kaiser SV, Jennings B, Rodean J
Pathways for improving inpatient pediatric asthma care (PIPA): a multicenter, national study.
This study examined whether implementation of a pathway strategy for inpatient pediatric asthma patients improve outcomes for these patients. Outcomes measured included length of stay (LOS), early administration of metered-dose inhalers, screening for secondhand tobacco exposure and referral to cessation resources, and 7-day hospital readmissions or emergency revisits. Eighty-five hospitals were enrolled and 68 completed the study with (n=12,013) admissions. Pathways were associated with increases in early administration of metered-dose inhalers, and referral to smoking cessation resources, but no statistically significant changes in the other outcomes were observed. Most hospitals did improve in at least one outcome.
AHRQ-funded; HS024592; HS024554.
Citation: Kaiser SV, Jennings B, Rodean J .
Pathways for improving inpatient pediatric asthma care (PIPA): a multicenter, national study.
Pediatrics 2020 Jun;145(6):e20193026. doi: 10.1542/peds.2019-3026..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Inpatient Care, Patient-Centered Outcomes Research, Outcomes, Hospitalization, Care Management
Johnson MD, Zorc JJ, Nelson DS
Intravenous magnesium in asthma pharmacotherapy: variability in use in the PECARN Registry.
Researchers examined the use, efficacy, and safety of intravenous magnesium sulfate (IVMg) in children with asthma whose emergency department (ED) management is recorded in the Pediatric Emergency Care Applied Research Network (PECARN) Registry. They found that, in PECARN Registry EDs, administration of IVMg occurred late in ED treatment, for a minority of the children likely to benefit, with variation between sites, which suggested the current clinical role for IVMg in preventing hospitalization was limited. Discharge after IVMg administration would likely be safe. They recommended further research to assess the efficacy and safety of early IVMg administration.
AHRQ-funded; HS020270.
Citation: Johnson MD, Zorc JJ, Nelson DS .
Intravenous magnesium in asthma pharmacotherapy: variability in use in the PECARN Registry.
J Pediatr 2020 May;220:165-74.e2. doi: 10.1016/j.jpeds.2020.01.062..
Keywords: Children/Adolescents, Asthma, Medication, Emergency Department, Registries, Treatments, Patient Safety, Medication: Safety
Donovan BM, Abreo A, Ding T
Dose, timing, and type of infant antibiotic use and the risk of childhood asthma.
This study examined the association between dose, timing and type of infant antibiotic use and the risk of childhood asthma. The study examined a cohort of 152,622 children enrolled in the Tennessee Medicaid Program. At least 79% had at least one antibiotic prescription fill during infancy. There was a 20% increase in odds of childhood asthma for each additional antibiotic filled. There was no significant association between timing, formulation, anaerobic coverage and class of antibiotics and childhood asthma. However, broad spectrum antibiotic fills increased the odds of development of childhood asthma compared to narrow spectrum only fills.
AHRQ-funded; HS018454.
Citation: Donovan BM, Abreo A, Ding T .
Dose, timing, and type of infant antibiotic use and the risk of childhood asthma.
Clin Infect Dis 2020 Apr 10;70(8):1658-65. doi: 10.1093/cid/ciz448..
Keywords: Newborns/Infants, Children/Adolescents, Antibiotics, Medication, Asthma, Respiratory Conditions, Risk, Chronic Conditions
Cushing AM, Bucholz E, Michelson KA
Trends in regionalization of emergency care for common pediatric conditions.
This study examined trends in regionalization of emergency care for common pediatric conditions. The authors sought to determine how the likelihood of definitive care has changed for 3 common conditions: asthma, croup, and gastroenteritis. They used the National Emergency Department Sample Database to study children from 2008 to 2016 who presented to emergency departments with those primary diagnoses, excluding critically ill patients. Researchers conducted analyses by stratification of annual emergency department pediatric volume categorized by quartiles. Referral rates increased for all conditions in all volume quartiles, with referral rates greatest in the lowest pediatric volume quartile.
AHRQ-funded; HS026503.
Citation: Cushing AM, Bucholz E, Michelson KA .
Trends in regionalization of emergency care for common pediatric conditions.
Pediatrics 2020 Apr;145(4). doi: 10.1542/peds.2019-2989..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Asthma, Respiratory Conditions, Digestive Disease and Health, Healthcare Delivery
Parikh K, Perry K, Pantor C
Multidisciplinary engagement increases medications in-hand for patients hospitalized with asthma.
Asthma exacerbations in children are a leading cause of missed school days and health care use. Patients discharged from the hospital often do not fill discharge prescriptions and are at risk for future exacerbations. In this study, a multidisciplinary team aimed to increase the percentage of patients discharged from the hospital after an asthma exacerbation with their medications in-hand from 15% to 80%.
AHRQ-funded; HS024554.
Citation: Parikh K, Perry K, Pantor C .
Multidisciplinary engagement increases medications in-hand for patients hospitalized with asthma.
Pediatrics 2019 Dec;144(6). doi: 10.1542/peds.2019-0674..
Keywords: Children/Adolescents, Asthma, Medication, Patient Adherence/Compliance, Teams, Hospital Discharge, Transitions of Care
Jones YO, Hubbell BB, Thomson J
Things we do for no reason: systemic corticosteroids for wheezing in preschool-aged children.
This installment of the “Things We Do For No Reason” series presents and discusses a case study concerning the administration of systemic corticosteroids in a 4-year-old child presenting with wheezing, tachypnea, and respiratory distress. The authors conclude that current evidence does not support the routine use of systemic corticosteroids for preschool-aged children admitted for mild to moderate wheezing episodes, and that the patient in the introductory case would likely receive no clinical benefit from dexamethasone treatment.
AHRQ-funded; HS025138.
Citation: Jones YO, Hubbell BB, Thomson J .
Things we do for no reason: systemic corticosteroids for wheezing in preschool-aged children.
J Hosp Med 2019 Dec;14(12):774-76. doi: 10.12788/jhm.3255..
Keywords: Children/Adolescents, Respiratory Conditions, Asthma, Case Study, Shared Decision Making, Medication
Volerman A, Fierstein J, Boon K
Factors associated with effective inhaler technique among children with moderate to severe asthma.
Guidelines recommend that children and families receive education about and demonstration of effective inhaler technique as part of asthma self-management education. For youth, improved inhaler technique is associated with better quality of life and decreased health care use, yet technique remains suboptimal. To understand potential reasons for differences in inhaler skills, this study examined individual- and health care-level factors associated with effective inhaler technique among children.
AHRQ-funded; HS026385.
Citation: Volerman A, Fierstein J, Boon K .
Factors associated with effective inhaler technique among children with moderate to severe asthma.
Ann Allergy Asthma Immunol 2019 Nov;123(5):511-12.e1. doi: 10.1016/j.anai.2019.08.017.
.
.
Keywords: Children/Adolescents, Asthma, Chronic Conditions, Patient Self-Management, Education: Patient and Caregiver, Medication, Quality of Life
Goldstein E, Finelli L, O'Halloran A
AHRQ Author: Karaca Z, Steiner C
Hospitalizations associated with respiratory syncytial virus and influenza in children, including children diagnosed with asthma.
This study examined hospitalization rates in children associated with respiratory syncytial virus (RSV) and influenza, including children with asthma. HCUP hospitalization data and additional data to estimate RSV and influenza-associated hospitalization with a respiratory cause was analyzed in different subpopulations of US children between 2003 and 2010. Annual rates of RSV-associated hospitalization was highest in infants and young children, and declined rapidly with age. Influenza hospitalizations also were highest in young children and declined by age 12-17 years. Higher rates of RSV-related and influenza hospitalization in the youngest children with a prior diagnosis of asthma was also found.
AHRQ-authored.
Citation: Goldstein E, Finelli L, O'Halloran A .
Hospitalizations associated with respiratory syncytial virus and influenza in children, including children diagnosed with asthma.
Epidemiology 2019 Nov;30(6):918-26. doi: 10.1097/ede.0000000000001092..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Asthma, Influenza, Respiratory Conditions, Hospitalization, Chronic Conditions
Bardach NS, Neel C, Kleinman LC
Depression, anxiety, and emergency department use for asthma.
This study examined whether pediatric patients with asthma who use the emergency department (ED) experience increased depression and anxiety in the same way that adult asthma patients do. Out of 65,342 patients identified from the Massachusetts All-Payer Claims Database for 2014 to 2015 who had ED visits, 24.7% had a diagnosis of anxiety, depression, or both. Asthma rates were shown to be higher than those of patients who had no diagnosis of anxiety or depression.
AHRQ-funded; HS025297; HS020518.
Citation: Bardach NS, Neel C, Kleinman LC .
Depression, anxiety, and emergency department use for asthma.
Pediatrics 2019 Oct;144(4). doi: 10.1542/peds.2019-0856..
Keywords: Asthma, Depression, Anxiety, Children/Adolescents, Emergency Department, Behavioral Health
Toy D, Braga MS, Greenhawt M
An update on allergic emergencies.
The purpose of this review was to provide an updated framework of management for allergic emergencies. The authors suggest that although fatalities resulting from anaphylaxis and asthma are rare, patient education serves an important role in preparing for unexpected emergencies, instituting prompt and appropriate treatment, and incorporating effective strategies into the lives of children and families.
AHRQ-funded; HS024599.
Citation: Toy D, Braga MS, Greenhawt M .
An update on allergic emergencies.
Curr Opin Pediatr 2019 Jun;31(3):426-32. doi: 10.1097/mop.0000000000000769..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Emergency Department, Patient-Centered Outcomes Research, Evidence-Based Practice
Parikh K, Hinds PS, Teach SJ
Using stakeholder engagement to develop a hospital-initiated, patient-centered intervention to improve hospital-to-home transitions for children with asthma.
The authors demonstrated that multidisciplinary stakeholder engagement can meaningfully influence intervention design. They presented a model of efficient yet substantive engagement of parents and health professionals in developing a hospital-to-home transition intervention for children hospitalized with asthma. Their results suggest that multidimensional stakeholder engagement can meaningfully shape intervention development, and they hope that these tools can be used or adapted to other hospital-based quality improvement, education, or research efforts.
AHRQ-funded; HS024554.
Citation: Parikh K, Hinds PS, Teach SJ .
Using stakeholder engagement to develop a hospital-initiated, patient-centered intervention to improve hospital-to-home transitions for children with asthma.
Hosp Pediatr 2019 Jun;9(6):460-63. doi: 10.1542/hpeds.2018-0261.
.
.
Keywords: Children/Adolescents, Patient-Centered Healthcare, Patient and Family Engagement, Hospital Discharge, Transitions of Care, Asthma, Respiratory Conditions
Forrest CB, Zorc JJ, Moon J
Evaluation of the PROMIS pediatric global health scale (PGH-7) in children with asthma.
The purpose of this study was to evaluate the reliability and validity of the PROMIS Pediatric Global Health scale, a 7-item measure of perceived physical, mental, and social health, in children with asthma. The investigators concluded that the PGH-7 is a reliable and valid patient-reported outcome for assessing general health among children with asthma. It is a useful complement to other asthma-specific outcome measures.
AHRQ-funded; HS020508.
Citation: Forrest CB, Zorc JJ, Moon J .
Evaluation of the PROMIS pediatric global health scale (PGH-7) in children with asthma.
J Asthma 2019 May;56(5):534-42. doi: 10.1080/02770903.2018.1471701..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Health Status
Louisias M, Petty CR, Sheehan W
Use of a school-based survey to screen students for symptoms concerning for asthma.
Researchers sought early identification of asthma in minority children. Their goal was to determine if they could apply screening surveys to an inner-city, school-based cohort. They found a significant number of children with a positive asthma screen and no parent-reported asthma. Children with symptoms suggestive of asthma had elevated rates of hospital care for breathing problems and an atopic background. The researchers conclude that these children without known asthma, but who experience increased morbidity, can be easily identified with a school-based asthma screening survey and should be closely monitored.
AHRQ-funded; HS000063; HS022986.
Citation: Louisias M, Petty CR, Sheehan W .
Use of a school-based survey to screen students for symptoms concerning for asthma.
Clin Pediatr 2019 May;58(5):586-89. doi: 10.1177/0009922819832087..
Keywords: Children/Adolescents, Asthma, Screening, Education, Diagnostic Safety and Quality, Urban Health
Louisias M, Ramadan A, Naja AS
The effects of the environment on asthma disease activity.
This study discusses environmental factors that trigger or aggravate symptoms of asthma in children. Biological and physical factors include allergens, microbiome, endotoxin, genetics and pollution. Psychosocial environmental factors include stress, neighborhood safety, housing and discrimination. Control of these factors help to reduce prevalence and severity of asthma.
AHRQ-funded; HS022986.
Citation: Louisias M, Ramadan A, Naja AS .
The effects of the environment on asthma disease activity.
Immunol Allergy Clin North Am 2019 May;39(2):163-75. doi: 10.1016/j.iac.2018.12.005..
Keywords: Asthma, Children/Adolescents, Respiratory Conditions, Risk, Social Determinants of Health
Strom MA, Silverberg JI
Asthma, hay fever, and food allergy are associated with caregiver-reported speech disorders in US children.
This study sought to determine whether asthma, hay fever, and food allergy are associated with speech disorder in children and whether disease severity, sleep disturbance, or ADD/ADHD modified such associations. It concluded that childhood asthma, hay fever, and food allergy are associated with increased risk of speech disorder.
AHRQ-funded; HS023011.
Citation: Strom MA, Silverberg JI .
Asthma, hay fever, and food allergy are associated with caregiver-reported speech disorders in US children.
Pediatr Allergy Immunol 2016 Sep;27(6):604-11. doi: 10.1111/pai.12580.
.
.
Keywords: Asthma, Children/Adolescents, Respiratory Conditions
Wu AC, Li L, Fung V
Mismatching among guidelines, providers, and parents on controller medication use in children with asthma.
The authors sought to assess provider prescribing patterns for asthma controller medications and to assess how frequently parental reports of children's asthma controller medicine use were mismatched with provider recommendations. They found that mismatches between parental reports and provider intentions regarding how the child was supposed to use inhaled steroids occurred for half of the children. They recommended that efforts focus on ways to reduce these mismatches.
AHRQ-funded; HS019669.
Citation: Wu AC, Li L, Fung V .
Mismatching among guidelines, providers, and parents on controller medication use in children with asthma.
J Allergy Clin Immunol Pract 2016 Sep-Oct;4(5):910-6. doi: 10.1016/j.jaip.2016.04.004.
.
.
Keywords: Asthma, Children/Adolescents, Guidelines, Medication, Practice Patterns
Fiks AG, DuRivage N, Mayne SL
Adoption of a portal for the primary care management of pediatric asthma: a mixed-methods implementation study.
The researchers evaluated the feasibility of using a patient portal for pediatric asthma in primary care. Fewer than three percent of those families invited to enroll used the portal. The authors found that although use of the portal was associated with higher treatment engagement, their results suggested that achieving widespread portal adoption is unlikely in the short term.
AHRQ-funded; HS021645; HS022689.
Citation: Fiks AG, DuRivage N, Mayne SL .
Adoption of a portal for the primary care management of pediatric asthma: a mixed-methods implementation study.
J Med Internet Res 2016 Jun 29;18(6):e172. doi: 10.2196/jmir.5610.
.
.
Keywords: Web-Based, Primary Care, Children/Adolescents, Patient-Centered Healthcare, Asthma
Johnson KB, Patterson BL, Ho YX
The feasibility of text reminders to improve medication adherence in adolescents with asthma.
The goal of this study was to assess the impact of MyMediHealth (MMH) - a website and a short messaging service (SMS)-based reminder system - on medication adherence and perceived self-efficacy in adolescents with asthma. The investigators found that MMH was associated with improved medication adherence, perceived quality of life, and self-efficacy.
AHRQ-funded; HS018168.
Citation: Johnson KB, Patterson BL, Ho YX .
The feasibility of text reminders to improve medication adherence in adolescents with asthma.
J Am Med Inform Assoc 2016 May;23(3):449-55. doi: 10.1093/jamia/ocv158..
Keywords: Asthma, Children/Adolescents, Health Information Technology (HIT), Medication, Patient Adherence/Compliance
Drury KE, Schaeffer M, Silverberg JL
Association between atopic disease and anemia in US children.
Atopic disease is associated with chronic inflammation, food allergen avoidance, and use of systemic immunosuppressant medications. All these factors have been shown to be associated with anemia. This study investigated whether atopic disease is associated with increased risk of childhood anemia. It concluded that the association between atopic disease and anemia was reproducible in multiple cohorts.
AHRQ-funded; HS023011.
Citation: Drury KE, Schaeffer M, Silverberg JL .
Association between atopic disease and anemia in US children.
JAMA Pediatr 2016 Jan;170(1):29-34. doi: 10.1001/jamapediatrics.2015.3065..
Keywords: Asthma, Children/Adolescents, Chronic Conditions, Risk