National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Antibiotics (2)
- Care Management (1)
- Chronic Conditions (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Dementia (1)
- Diabetes (2)
- Diagnostic Safety and Quality (1)
- Education: Patient and Caregiver (3)
- Elderly (9)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (1)
- Falls (1)
- Health Information Technology (HIT) (4)
- Home Healthcare (1)
- Hospital Discharge (1)
- Hospitalization (2)
- Hospital Readmissions (2)
- Hospitals (1)
- Injuries and Wounds (3)
- Long-Term Care (8)
- Medicare (1)
- Medication (5)
- (-) Nursing Homes (24)
- Organizational Change (1)
- Outcomes (1)
- Patient-Centered Outcomes Research (1)
- Patient Experience (4)
- Patient Safety (3)
- Pneumonia (1)
- Policy (1)
- Prevention (1)
- Provider Performance (1)
- Public Reporting (1)
- Quality Improvement (1)
- Quality Indicators (QIs) (4)
- Quality Measures (1)
- Quality of Care (4)
- Racial and Ethnic Minorities (2)
- Risk (1)
- Telehealth (1)
- Web-Based (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 24 of 24 Research Studies DisplayedMukamel DB, Amin A, Weimer DL
Personalizing nursing home compare and the discharge from hospitals to nursing homes.
This study tested whether use of a personalized report card, Nursing Home Compare Plus (NHCPlus), embedded in a reengineered discharge process, can lead to better outcomes than the usual discharge process from hospitals to nursing homes. It found that about 85 percent of users indicated satisfaction with NHCPlus. Compared to controls, intervention patients were more satisfied with the choice process.
AHRQ-funded; R21 HS021844.
Citation: Mukamel DB, Amin A, Weimer DL .
Personalizing nursing home compare and the discharge from hospitals to nursing homes.
Health Serv Res 2016 Dec;51(6):2076-94. doi: 10.1111/1475-6773.12588.
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Keywords: Hospital Discharge, Hospitals, Nursing Homes, Patient Experience, Quality Indicators (QIs)
Wang Y, Pandolfi MM, Fine J
Community level association between home health and nursing home performance on quality and hospital 30-day readmissions for Medicare patients.
Using CMS data from 2010 to 2012, the researchers evaluated whether community-level home health agencies and nursing home performance is associated with community-level hospital 30-day all-cause risk-standardized readmission rates for Medicare patients. They found that increasing nursing home performance by one star for all of its 4 measures and home health performance by 10 points for all of its 6 measures is associated with decreases in community-level risk-standardized readmission rates.
AHRQ-funded; HS023000.
Citation: Wang Y, Pandolfi MM, Fine J .
Community level association between home health and nursing home performance on quality and hospital 30-day readmissions for Medicare patients.
Home Health Care Manag Pract 2016 Nov;28(4):201-08. doi: 10.1177/1084822316639032.
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Keywords: Quality of Care, Hospital Readmissions, Home Healthcare, Nursing Homes, Provider Performance
Zullo AR, Dore DD, Gutman R
National glucose-lowering treatment complexity is greater in nursing home residents than community-dwelling adults.
This letter describes common glucose-lowering medication usage patterns for a national cross-section of U.S. adults aged 65 and older residing in nursing home (NH) and community settings from 2007 to 2010. The study results suggest that continued efforts are warranted to improve glucose-lowering medication management and simplify treatment regimens in the NH; that the relative importance of CER questions regarding specific glucose-lowering treatments may differ according to the care setting; and that CER studies of glucose-lowering treatments in older adults must address the combination use of medications, especially in NH residents.
AHRQ-funded; HS022998.
Citation: Zullo AR, Dore DD, Gutman R .
National glucose-lowering treatment complexity is greater in nursing home residents than community-dwelling adults.
J Am Geriatr Soc 2016 Nov;64(11):e233-e35. doi: 10.1111/jgs.14485.
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Keywords: Care Management, Chronic Conditions, Diabetes, Elderly, Medication, Nursing Homes
Berry SD, Lee Y, Zullo AR
Incidence of hip fracture in U.S. nursing homes.
The researchers described the incidence rate (IR) of hip fracture according to age, sex, and race in a nationwide sample of long-stay nursing home residents. They found that the mean age was 84 years, 74.5% were women, 83.9% were white, and 12.0% were black. The overall IR of hip fracture was 2.3/100 person years, which was similar in men and women across age groups. The IR of hip fracture was highest in Native Americans aged 85 years or older, in whites, and during the first 100 days of institutionalization, while the.IRs of hip fracture were lowest in blacks.
AHRQ-funded; HS022998.
Citation: Berry SD, Lee Y, Zullo AR .
Incidence of hip fracture in U.S. nursing homes.
J Gerontol A Biol Sci Med Sci 2016 Sep;71(9):1230-4. doi: 10.1093/gerona/glw034.
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Keywords: Elderly, Injuries and Wounds, Long-Term Care, Nursing Homes, Racial and Ethnic Minorities
Abrahamson K, Davila H, Rehkamp N
Is there a business case for nursing home quality improvement?
The objective of this study was to investigate the economic or business perspective surrounding QI participation by exploring nursing home leader perceptions regarding market-based motivations for improvements, or a business case for engaging in a quality improvement project.
AHRQ-funded; HS018464.
Citation: Abrahamson K, Davila H, Rehkamp N .
Is there a business case for nursing home quality improvement?
Nurs Econ 2016 Sep-Oct;34(5):224-9, 35..
Keywords: Long-Term Care, Nursing Homes, Quality Improvement
Bali V, Chatterjee S, Johnson ML
Comparative risk of hip fractures in elderly nursing home patients with depression using paroxetine and other selective serotonin reuptake inhibitors.
The researchers evaluated comparative safety of paroxetine and other selective serotonin reuptake inhibitors (SSRIs) for the risk of hip fractures. They found no differential risk of hip fractures between paroxetine and other SSRIs.
AHRQ-funded; HS021264.
Citation: Bali V, Chatterjee S, Johnson ML .
Comparative risk of hip fractures in elderly nursing home patients with depression using paroxetine and other selective serotonin reuptake inhibitors.
J Comp Eff Res 2016 Aug;5(5):461-73. doi: 10.2217/cer-2016-0009.
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Keywords: Medication, Elderly, Injuries and Wounds, Nursing Homes, Patient Safety
Alexander GL, Madsen RW, Miller E
A national report of nursing home information technology adoption and quality measures.
The purpose of this article is to describe a national model being used as a guiding framework to assess trends in nursing home IT adoption, called IT sophistication, and quality measures. Through this model, the authors answer the following research question: Do relationships exist between nursing home IT sophistication and quality measures?
AHRQ-funded; HS022497.
Citation: Alexander GL, Madsen RW, Miller E .
A national report of nursing home information technology adoption and quality measures.
J Nurs Care Qual 2016 Jul-Sep;31(3):201-6. doi: 10.1097/ncq.0000000000000187.
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Keywords: Nursing Homes, Health Information Technology (HIT), Quality Measures
Zullo AR, Dore DD, Daiello L
National trends in treatment initiation for nursing home residents with diabetes mellitus, 2008 to 2010.
The authors studied trends in initiation of glucose-lowering medications in a national cohort of nursing home residents. They found that, between 2008 and 2010, there were substantial decreases in the use of oral glucose-lowering agents and corresponding increases in the use of insulin among long-term residents of US nursing homes.
AHRQ-funded; HS022998.
Citation: Zullo AR, Dore DD, Daiello L .
National trends in treatment initiation for nursing home residents with diabetes mellitus, 2008 to 2010.
J Am Med Dir Assoc 2016 Jul;17(7):602-8. doi: 10.1016/j.jamda.2016.02.023.
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Keywords: Diabetes, Elderly, Long-Term Care, Medication, Nursing Homes
Chatterjee S, Bali V, Carnahan RM
Anticholinergic medication use and risk of dementia among elderly nursing home residents with depression.
The purpose of this study was to examine the risk of dementia with anticholinergic use among elderly nursing home residents with depression. The study concluded that use of clinically significant anticholinergic medications was associated with a 26% increase in risk of dementia among elderly nursing home residents with depression. With increasing safety concerns, there is a significant need to optimize anticholinergic use, especially for those who are at risk for dementia.
AHRQ-funded; HS021264.
Citation: Chatterjee S, Bali V, Carnahan RM .
Anticholinergic medication use and risk of dementia among elderly nursing home residents with depression.
Am J Geriatr Psychiatry 2016 Jun;24(6):485-95. doi: 10.1016/j.jagp.2015.12.011..
Keywords: Adverse Drug Events (ADE), Dementia, Elderly, Medication, Nursing Homes
Werner RM, Konetzka RT, Polsky D
Changes in consumer demand following public reporting of summary quality ratings: an evaluation in nursing homes.
The study’s objective was to evaluate consumer response to summary measures in the setting of nursing homes. It found that the star rating system was associated with a significant change in consumer demand for low- and high-scoring facilities. After the star-based rating system was released, 1-star facilities typically lost 8 percent of their market share and 5-star facilities gained over 6 percent of their market share.
AHRQ-funded; HS021861.
Citation: Werner RM, Konetzka RT, Polsky D .
Changes in consumer demand following public reporting of summary quality ratings: an evaluation in nursing homes.
Health Serv Res 2016 Jun;51 Suppl 2:1291-309. doi: 10.1111/1475-6773.12459.
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Keywords: Nursing Homes, Quality Indicators (QIs), Education: Patient and Caregiver
Hefele JG, Acevedo A, Nsiah-Jefferson L
Choosing a nursing home: what do consumers want to know, and do preferences vary across race/ethnicity?
The researchers sought to identify what consumers want to know about nursing homes (NHs) before choosing one and to determine whether information preferences vary across race/ethnicity. They found that participants wanted detailed information on the facility, policies, staff, and residents, such as location, staff treatment of residents, and resident conditions. Participants also wanted a sense of the NH gestalt and were interested in feedback/reviews from residents/families.
AHRQ-funded; HS021891.
Citation: Hefele JG, Acevedo A, Nsiah-Jefferson L .
Choosing a nursing home: what do consumers want to know, and do preferences vary across race/ethnicity?
Health Serv Res 2016 Jun;51 Suppl 2:1167-87. doi: 10.1111/1475-6773.12457.
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Keywords: Nursing Homes, Education: Patient and Caregiver, Racial and Ethnic Minorities
Simmons SF, Schnelle JF, Sathe NA
Defining safety in the nursing home setting: Implications for future research.
AHRQ’s Common Format for nursing homes (NHs) accommodates voluntary reporting for 4 adverse events: falls with injury, pressure ulcers, medication errors, and infections. In 2015, AHRQ funded a technical brief to describe the state of the science related to safety in the NH setting to inform a research agenda. Thirty-six recent systematic reviews evaluated NH safety-related interventions to address these 4 adverse events and reported mostly mixed evidence about effective approaches to ameliorate them.
AHRQ-funded; 290201500003I.
Citation: Simmons SF, Schnelle JF, Sathe NA .
Defining safety in the nursing home setting: Implications for future research.
J Am Med Dir Assoc 2016 Jun;17(6):473-81. doi: 10.1016/j.jamda.2016.03.005..
Keywords: Nursing Homes, Long-Term Care, Adverse Events, Patient Safety, Evidence-Based Practice
Driessen J, Bonhomme A, Chang W
Nursing home provider perceptions of telemedicine for reducing potentially avoidable hospitalizations.
The goal of this study was to survey a nationally representative sample of nursing home physicians and advanced practice providers to quantify provider perceptions and desired functionality of telemedicine in nursing homes to reduce potentially avoidable hospitalizations. The authors found that there is a high degree of confidence in the potential for a telemedicine solution and concrete views about its features, concluding that further research is needed to study the impact of successful implementations.
AHRQ-funded; HS018721; HS022989; HS022465; HS023779.
Citation: Driessen J, Bonhomme A, Chang W .
Nursing home provider perceptions of telemedicine for reducing potentially avoidable hospitalizations.
J Am Med Dir Assoc 2016 Jun;17(6):519-24. doi: 10.1016/j.jamda.2016.02.004.
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Keywords: Health Information Technology (HIT), Hospital Readmissions, Hospitalization, Nursing Homes, Telehealth
Schapira MM, Shea JA, Duey KA
The Nursing Home Compare report card: perceptions of residents and caregivers regarding quality ratings and nursing home choice.
The researchers evaluated the perceived usefulness of publicly reported nursing home quality indicators. They found that star ratings, clinical quality measures, and benchmarking information were salient to decision making, with preferred formats varying across participants. Participants desired additional information on the source of quality data. Confusion was evident regarding the relationship between domain-specific and overall star quality ratings.
AHRQ-funded; HS02861.
Citation: Schapira MM, Shea JA, Duey KA .
The Nursing Home Compare report card: perceptions of residents and caregivers regarding quality ratings and nursing home choice.
Health Serv Res 2016 Jun;51 Suppl 2:1212-28. doi: 10.1111/1475-6773.12458.
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Keywords: Nursing Homes, Quality Indicators (QIs), Patient Experience, Patient Experience, Quality of Care
Alexander GL, Madsen RW, Miller EL
The state of nursing home information technology sophistication in rural and nonrural US markets.
This study tested for significant differences in information technology sophistication (ITS) in US nursing homes (NH) based on location. It found that for every health care domain (resident care, clinical support, and administrative activities) statistical differences in facility ITS occurred. This study represents the most current national assessment of NH IT since 2004.
AHRQ-funded; HS022497.
Citation: Alexander GL, Madsen RW, Miller EL .
The state of nursing home information technology sophistication in rural and nonrural US markets.
J Rural Health 2016 Jun;33(3):266-74. doi: 10.1111/jrh.12188.
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Keywords: Long-Term Care, Nursing Homes, Health Information Technology (HIT)
Marra MV, Simmons SF, Shotwell MS
Elevated serum osmolality and total water deficit indicate impaired hydration status in residents of long-term care facilities regardless of low or high body mass index.
The researchers assessed hydration status and the adequacy of total water intake, and further determined relationships between hydration status, total water intake, and body mass index (BMI) in long-term care residents. They found that dehydration and inadequate total water intake is prevalent in long-term care residents across all BMI categories. They recommended that the type of liquid beverages, type of ONS, and type of between-meal snacks are factors that could be targeted for nutrition interventions designed to prevent or reverse dehydration.
AHRQ-funded; HS018580.
Citation: Marra MV, Simmons SF, Shotwell MS .
Elevated serum osmolality and total water deficit indicate impaired hydration status in residents of long-term care facilities regardless of low or high body mass index.
J Acad Nutr Diet 2016 May;116(5):828-36.e2. doi: 10.1016/j.jand.2015.12.011.
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Keywords: Elderly, Long-Term Care, Nursing Homes, Patient-Centered Outcomes Research
Zimmerman S, Cohen LW, Scales K
Pneumonia identification using nursing home records.
The researchers compared three established strategies for defining pneumonia using records from 1,119 residents across 16 nursing homes. They found that recorded diagnosis of pneumonia is a highly sensitive and pragmatic method to ascertain pneumonia in nursing homes, and is recommended for use in quality improvement and research.
AHRQ-funded; HS022298.
Citation: Zimmerman S, Cohen LW, Scales K .
Pneumonia identification using nursing home records.
Res Gerontol Nurs 2016 May 1;9(3):109-14. doi: 10.3928/19404921-20151218-01.
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Keywords: Antibiotics, Elderly, Diagnostic Safety and Quality, Nursing Homes, Pneumonia
Ismail MD, Luo T, McNamara S
Long-term carriage of ciprofloxacin-resistant Escherichia coli Isolates in high-risk nursing home residents.
This paper's objective was to characterize the incidence and duration of carriage of ciprofloxacin-resistant Escherichia coli (CipREc) in nursing homes and to identify those in the O25b-ST131 lineage. The authors found that CipREc occurred frequently in nursing home residents and is carried for long durations, and that reacquisition following clearance is common.
AHRQ-funded; HS019979.
Citation: Ismail MD, Luo T, McNamara S .
Long-term carriage of ciprofloxacin-resistant Escherichia coli Isolates in high-risk nursing home residents.
Infect Control Hosp Epidemiol 2016 Apr;37(4):440-7. doi: 10.1017/ice.2015.326.
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Keywords: Nursing Homes, Long-Term Care, Elderly, Antibiotics, Patient Safety
Konetzka RT, Perraillon MC
Use of Nursing Home Compare website appears limited by lack of awareness and initial mistrust of the data.
The researchers used a qualitative assessment of how consumers select nursing homes and of the role of information about quality, using semistructured interviews of people who recently placed a family member or friend in a nursing home. They found that consumers had a positive reaction when shown Nursing Home Compare; however, its use appeared to be limited by lack of awareness and, to some extent, initial lack of trust of the data.
AHRQ-funded; HS021877.
Citation: Konetzka RT, Perraillon MC .
Use of Nursing Home Compare website appears limited by lack of awareness and initial mistrust of the data.
Health Aff 2016 Apr;35(4):706-13. doi: 10.1377/hlthaff.2015.1377.
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Keywords: Nursing Homes, Public Reporting, Web-Based, Quality of Care, Education: Patient and Caregiver
Mukamel DB, Amin A, Weimer DL
When patients customize nursing home ratings, choices and rankings differ from the government's version.
Report cards currently published by the Centers for Medicare and Medicaid Services (CMS) offer composite quality measures, such as the one featured on the Nursing Home Compare website. Nursing Home Compare Plus is an alternative that allows patients and their families to create their own composite scores based on their own preferences and medical needs. When comparing Nursing Home Compare Plus to Medicare's five-star ratings, we found only minimal agreement on ranking of nursing homes.
AHRQ-funded; HS021844.
Citation: Mukamel DB, Amin A, Weimer DL .
When patients customize nursing home ratings, choices and rankings differ from the government's version.
Health Aff 2016 Apr;35(4):714-9. doi: 10.1377/hlthaff.2015.1340.
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Keywords: Nursing Homes, Quality of Care, Quality Indicators (QIs), Patient Experience, Consumer Assessment of Healthcare Providers and Systems (CAHPS)
Marier A, Olsho LE, Rhodes W
AHRQ Author: Spector WD
Improving prediction of fall risk among nursing home residents using electronic medical records.
To identify individuals at highest risk for falls, the authors applied a repeated events survival model to analyze The Minimum Data Set ( MDS 3.0 and EMR data for 5129 residents in 13 nursing homes within a single large California chain. They found that incorporating EMR data improves ability to identify those at highest risk for falls relative to prediction using MDS data alone.
AHRQ-funded; AHRQ-authored; 290201000031I.
Citation: Marier A, Olsho LE, Rhodes W .
Improving prediction of fall risk among nursing home residents using electronic medical records.
J Am Med Inform Assoc 2016 Mar;23(2):276-82. doi: 10.1093/jamia/ocv061..
Keywords: Falls, Electronic Health Records (EHRs), Risk, Nursing Homes, Prevention
Sorkin DH, Amin A, Weimer DL
Rationale and study protocol for the Nursing Home Compare Plus (NHCPlus) randomized controlled trial: A personalized decision aid for patients transitioning from the hospital to a skilled-nursing facility.
This paper describes the design and rationale of a two-arm randomized controlled trial designed to test the effectiveness of Nursing Home Compare Plus (NHCPlus) compared to usual care only, in a sample of patients being discharged from the hospital to an SNF (N=229). Assessments were conducted within 24h prior to patient discharge and 30-days post discharge. A primary outcome to be examined was the use of NHC.
AHRQ-funded; HS021844.
Citation: Sorkin DH, Amin A, Weimer DL .
Rationale and study protocol for the Nursing Home Compare Plus (NHCPlus) randomized controlled trial: A personalized decision aid for patients transitioning from the hospital to a skilled-nursing facility.
Contemp Clin Trials 2016 Jan 7;47:139-45. doi: 10.1016/j.cct.2015.12.018.
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Keywords: Nursing Homes, Web-Based, Patient Experience, Hospitalization, Health Information Technology (HIT)
Jung HY, Trivedi AN, Grabowski DC
Does more therapy in skilled nursing facilities lead to better outcomes in patients with hip fracture?
The study objectives were: (1) to examine temporal trends in therapy hour volumes and (2) to evaluate whether more therapy hours are associated with improved patient outcomes. It concluded that increases in the quantity of therapy during the study period cannot be explained by changes in case mix at skilled nursing facility (SNF) admission.
AHRQ-funded; HS020756.
Citation: Jung HY, Trivedi AN, Grabowski DC .
Does more therapy in skilled nursing facilities lead to better outcomes in patients with hip fracture?
Phys Ther 2016 Jan;96(1):81-9. doi: 10.2522/ptj.20150090.
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Keywords: Outcomes, Injuries and Wounds, Medicare, Nursing Homes
Urick BY, Kaskie BP, Carnahan RM
Improving antipsychotic prescribing practices in nursing facilities: the role of surveyor methods and surveying agencies in upholding the Nursing Home Reform Act.
The objectives of this study were to explore surveyor observations of skilled nursing facilities/nursing facilities care practices subsequent to participation the Partnership guidance program and to use a social ecological framework to estimate how these observations were influenced by individual, organizational, and contextual factors. It found substantial variation in surveyor observations of changes to clinical care in response to the Partnership guidance initiative.
AHRQ-funded; HS019355.
Citation: Urick BY, Kaskie BP, Carnahan RM .
Improving antipsychotic prescribing practices in nursing facilities: the role of surveyor methods and surveying agencies in upholding the Nursing Home Reform Act.
Res Social Adm Pharm 2016 Jan-Feb;12(1):91-103. doi: 10.1016/j.sapharm.2015.04.006.
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Keywords: Elderly, Nursing Homes, Long-Term Care, Policy, Medication, Organizational Change