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
- Access to Care (1)
- Behavioral Health (1)
- Cancer (1)
- Cardiovascular Conditions (2)
- Chronic Conditions (1)
- Communication (1)
- Community-Based Practice (1)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (4)
- Guidelines (1)
- (-) Healthcare Delivery (15)
- Health Services Research (HSR) (1)
- Heart Disease and Health (1)
- Implementation (2)
- Organizational Change (1)
- Patient-Centered Healthcare (10)
- Patient-Centered Outcomes Research (3)
- Patient Experience (1)
- Policy (2)
- Practice Improvement (1)
- Prevention (3)
- (-) Primary Care (15)
- Primary Care: Models of Care (2)
- Provider (1)
- Quality Improvement (4)
- Quality of Care (4)
- Substance Abuse (1)
- Teams (3)
- Vulnerable Populations (1)
- Workforce (2)
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 15 of 15 Research Studies DisplayedChan B, Edwards ST, Devoe M
The SUMMIT ambulatory-ICU primary care model for medically and socially complex patients in an urban federally qualified health center: study design and rationale.
Medically complex urban patients experiencing homelessness comprise a disproportionate number of high-cost, high-need patients. There are few studies of interventions to improve care for these populations; their social complexity makes them difficult to study and requires clinical and research collaboration. In this paper, the authors present a protocol for a trial of the streamlined unified meaningfully managed interdisciplinary team (SUMMIT) team, an ambulatory ICU (A-ICU) intervention to improve utilization and patient experience that uses control populations to address limitations of prior research.
AHRQ-funded; HS022981.
Citation: Chan B, Edwards ST, Devoe M .
The SUMMIT ambulatory-ICU primary care model for medically and socially complex patients in an urban federally qualified health center: study design and rationale.
Addict Sci Clin Pract 2018 Dec 14;13(1):27. doi: 10.1186/s13722-018-0128-y..
Keywords: Primary Care, Healthcare Delivery, Patient-Centered Healthcare, Vulnerable Populations, Chronic Conditions
Tamblyn R, Meyers D, Kratzmann M
AHRQ Author: Meyers D, Bierman AS
Shared vision for primary care delivery and research in Canada and the United States: highlights from the cross-border symposium.
This paper discusses highlights from a cross-border symposium between Canada and the United States on primary care. This symposium brought together more than 150 leaders in primary care delivery to exchange cross-border stories in primary care transformation, develop a binational research agenda to support primary care transformation, and support cross-border learning and collaboration.
AHRQ-authored.
Citation: Tamblyn R, Meyers D, Kratzmann M .
Shared vision for primary care delivery and research in Canada and the United States: highlights from the cross-border symposium.
Can Fam Physician 2018 Dec;64(12):930-34..
Keywords: Healthcare Delivery, Primary Care
Meyers D, LeRoy L, Bailit M
AHRQ Author: Meyers D, Zhan C
Workforce configurations to provide high-quality, comprehensive primary care: a mixed-method exploration of staffing for four types of primary care practices.
The aim of this study was to explore the team configurations and associated costs required to deliver high-quality, comprehensive primary care. The study estimates provided health care decision-makers with needed guideposts for considering primary care staffing and financing and informed broader discussions on primary care innovations and the necessary resources to provide high-quality, comprehensive primary care in the USA.
AHRQ-authored; AHRQ-funded; 290201000004I; 29032009T.
Citation: Meyers D, LeRoy L, Bailit M .
Workforce configurations to provide high-quality, comprehensive primary care: a mixed-method exploration of staffing for four types of primary care practices.
J Gen Intern Med 2018 Oct;33(10):1774-79. doi: 10.1007/s11606-018-4530-7..
Keywords: Healthcare Delivery, Quality of Care, Primary Care, Workforce, Teams
Davis MM, Gunn R, Gowen LK
A qualitative study of patient experiences of care in integrated behavioral health and primary care settings: more similar than different.
In this study, the authors examined, using qualitative methods, patients' experiences of care in integrated settings. The study included 24 patients receiving care across five practices participating in Advancing Care Together (ACT)-a 4-year demonstration project (2010-2014) of primary care and community mental health centers (CMHCs) integrating care. The investigators found that patients in both primary care and CMHCs perceived similar benefits from integrated care related to personal growth, improved quality, and access to care.
AHRQ-funded; HS022981.
Citation: Davis MM, Gunn R, Gowen LK .
A qualitative study of patient experiences of care in integrated behavioral health and primary care settings: more similar than different.
Transl Behav Med 2018 Sep 8;8(5):649-59. doi: 10.1093/tbm/ibx001..
Keywords: Community-Based Practice, Healthcare Delivery, Behavioral Health, Patient Experience, Primary Care
Fraze TK, Fisher ES, Tomaino MR
Comparison of populations served in hospital service areas with and without comprehensive primary care plus medical homes.
The purpose of this comparative cross sectional study was to describe practices that joined the Comprehensive Primary Care Plus (CPC+) model and compare hospital service areas with and without CPC+ practices. The authors concluded that according to this study, although a diverse set of practices joined the CPC+ program, practices in areas characterized by patient populations with greater advantage were more likely to join, which may affect access to advanced primary care medical home models such as CPC+, by vulnerable populations.
AHRQ-funded; HS024075.
Citation: Fraze TK, Fisher ES, Tomaino MR .
Comparison of populations served in hospital service areas with and without comprehensive primary care plus medical homes.
JAMA Netw Open 2018 Sep 7;1(5):e182169. doi: 10.1001/jamanetworkopen.2018.2169..
Keywords: Primary Care, Patient-Centered Healthcare, Primary Care: Models of Care, Healthcare Delivery, Access to Care
Skinner D, Franz B, Howard J
The politics of primary care expansion: lessons from cancer survivorship and substance abuse.
The purpose of this study was to understand the perspectives of primary care innovators treating patient populations not traditionally considered to be within the purview of primary care. The authors indicated that their study findings suggested that the politics surrounding entrenched professional identities contributed to barriers faced by conference participants in their efforts to provide innovative care for these nontraditional populations. Specifically, obstacles surfaced in relation to sharing patients across disciplinary boundaries, which resulted in issues of possessiveness, a questioning of provider qualifications, and a lack of interprofessional trust.
AHRQ-funded; HS021287.
Citation: Skinner D, Franz B, Howard J .
The politics of primary care expansion: lessons from cancer survivorship and substance abuse.
J Healthc Manag 2018 Sep-Oct;63(5):323-36. doi: 10.1097/jhm-d-16-00030..
Keywords: Primary Care, Primary Care: Models of Care, Patient-Centered Healthcare, Cancer, Substance Abuse, Policy, Healthcare Delivery, Organizational Change, Quality of Care
Howard J, Miller WL, Willard-Grace R
Creating and sustaining care teams in primary care: perspectives from innovative patient-centered medical homes.
The purpose of this study was to learn from the experiences of innovative primary care practices that have successfully developed care teams. The authors assert that team-based care is possible and valuable in primary care but that it is difficult to develop and sustain, and requires dedicated time and resources. They suggest that the challenges described by the highly motivated practices, in their paper, raised the question of feasibility for more average practices in the current funding environment.
AHRQ-funded.
Citation: Howard J, Miller WL, Willard-Grace R .
Creating and sustaining care teams in primary care: perspectives from innovative patient-centered medical homes.
Qual Manag Health Care 2018 Jul/Sep;27(3):123-29. doi: 10.1097/qmh.0000000000000176..
Keywords: Primary Care, Patient-Centered Healthcare, Teams, Healthcare Delivery
Annis AM, Harris M, Kim HM
Trends in primary care encounters across professional roles in PCMH.
Evaluation measures of team-based care models are often reported at a clinic or primary care provider (PCP) level, creating challenges in describing and analyzing the use and impact of non-PCP clinician team members. This study aimed to measure clinician-specific care delivery trends and determine whether trends were responsive to system wide patient centered medical home implementation.
AHRQ-funded;
Citation: Annis AM, Harris M, Kim HM .
Trends in primary care encounters across professional roles in PCMH.
Am J Manag Care 2018 Jul;24(7):e222-e29..
Keywords: Healthcare Delivery, Patient-Centered Healthcare, Primary Care, Teams
Chou AF, Homco JB, Nagykaldi Z
Disseminating, implementing, and evaluating patient-centered outcomes to improve cardiovascular care using a stepped-wedge design: healthy hearts for Oklahoma.
The Healthy Hearts for Oklahoma (H2O) Study proposes to build a quality improvement (QI) infrastructure by (1) constructing a sustainable Oklahoma Primary Healthcare Improvement Collaborative (OPHIC) to support dissemination and implementation (D&I) of QI methods; and (2) providing QI support in primary care practices to better manage patients at risk for cardiovascular disease (CVD) events. H2O has 263 small primary care practices across Oklahoma that receive the bundled QI intervention to improve ABCS (aspirin therapy, blood pressure control, cholesterol management, and smoking cessation) performance. The infrastructure established as a result of this funding will help reach medically underserved Oklahomans, particularly among rural and tribal populations.
AHRQ-funded; HS023919.
Citation: Chou AF, Homco JB, Nagykaldi Z .
Disseminating, implementing, and evaluating patient-centered outcomes to improve cardiovascular care using a stepped-wedge design: healthy hearts for Oklahoma.
BMC Health Serv Res 2018 Jun 4;18(1):404. doi: 10.1186/s12913-018-3189-4.
.
.
Keywords: Cardiovascular Conditions, Communication, Heart Disease and Health, Healthcare Delivery, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Prevention, Quality of Care, Quality Improvement
Halle AD, Mroz TM, Fogelberg DJ
Occupational therapy and primary care: updates and trends.
This paper identifies new initiatives and opportunities in primary care, explores common challenges to integrating occupational therapy in primary care environments, and highlights international works that can support the authors’ efforts.
AHRQ-funded; HS022907.
Citation: Halle AD, Mroz TM, Fogelberg DJ .
Occupational therapy and primary care: updates and trends.
Am J Occup Ther 2018 May/Jun;72(3):7203090010p1-10p6. doi: 10.5014/ajot.2018.723001..
Keywords: Healthcare Delivery, Primary Care, Policy, Patient-Centered Healthcare
Mold JW, Walsh M, Chou AF
The alarming rate of major disruptive events in primary care practices in Oklahoma.
This study documented the rates of major disruptive events in a cohort of primary care practices in Oklahoma. During the first year of the project, 89 major disruptive events occurred in 67 (32 percent) practices, with 20 practices experiencing multiple events. The major disruptive events reported most often during both periods were loss of personnel and implementation of electronic health records and billing systems.
AHRQ-funded; HS023919.
Citation: Mold JW, Walsh M, Chou AF .
The alarming rate of major disruptive events in primary care practices in Oklahoma.
Ann Fam Med 2018 Apr;16(Suppl 1):S52-s57. doi: 10.1370/afm.2201.
.
.
Keywords: Electronic Health Records (EHRs), Healthcare Delivery, Patient-Centered Healthcare, Primary Care, Quality Improvement
Balasubramanian BA, Marino M, Cohen DJ
Use of quality improvement strategies among small to medium-size us primary care practices.
This study examined variations in use of QI strategies among 1,181 small to medium-size primary care practices engaged in a national initiative spanning 12 US States to improve quality of care for heart health and assessed factors associated with those variations. It concluded that there is substantial variation in the use of QI strategies among small to medium-size primary care practices across 12 US States.
AHRQ-funded; HS023940.
Citation: Balasubramanian BA, Marino M, Cohen DJ .
Use of quality improvement strategies among small to medium-size us primary care practices.
Ann Fam Med 2018 Apr;16(Suppl 1):S35-s43. doi: 10.1370/afm.2172.
.
.
Keywords: Healthcare Delivery, Evidence-Based Practice, Patient-Centered Outcomes Research, Primary Care, Quality Improvement
Ono SS, Crabtree BF, Hemler JR
Taking innovation to scale in primary care practices: the functions of health care extension.
Health care extension is an approach to providing external support to primary care practices with the aim of diffusing innovation. EvidenceNOW was launched to rapidly disseminate and implement evidence-based guidelines for cardiovascular preventive care in the primary care setting. This article describes how cooperatives varied in their approaches to extension and provides early empirical evidence that health care extension is a feasible and potentially useful approach for providing quality improvement.
AHRQ-funded; HS023940.
Citation: Ono SS, Crabtree BF, Hemler JR .
Taking innovation to scale in primary care practices: the functions of health care extension.
Health Aff 2018 Feb;37(2):222-30. doi: 10.1377/hlthaff.2017.1100.
.
.
Keywords: Primary Care, Implementation, Cardiovascular Conditions, Evidence-Based Practice, Healthcare Delivery, Practice Improvement, Quality Improvement, Quality of Care, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention
Doherty JA, Crelia SJ, Smith MW
AHRQ Author: Mabry-Hernandez IR, Ngo-Metzger Q
Large health systems' prevention guideline implementation: a qualitative study.
In 2015, researchers conducted and analyzed interviews with quality leaders from eight hospital-based systems and one physician organization who explained organizational processes to adapt, adopt, disseminate, and incentivize adherence to preventive services guidelines. Nearly all have a formal process for reviewing and refining guidelines, developing clinician support, and disseminating the approved guidelines.
AHRQ-authored.
Citation: Doherty JA, Crelia SJ, Smith MW .
Large health systems' prevention guideline implementation: a qualitative study.
Am J Prev Med 2018 Jan;54(1s1):S88-s94. doi: 10.1016/j.amepre.2017.07.025.
.
.
Keywords: Primary Care, Guidelines, Evidence-Based Practice, Prevention, Implementation, Healthcare Delivery
Kim LY, Rose DE, Soban LM
Primary care tasks associated with provider burnout: findings from a Veterans Health Administration survey.
The purpose of this study was to investigate (1) the extent to which primary care providers (PCPs) share responsibility for 14 discrete primary care tasks with other team members, and (2) which, if any, of the primary care tasks performed by the PCPs (without reliance on team members) are associated with PCP burnout.
AHRQ-funded; HS000046.
Citation: Kim LY, Rose DE, Soban LM .
Primary care tasks associated with provider burnout: findings from a Veterans Health Administration survey.
J Gen Intern Med 2018 Jan;33(1):50-56. doi: 10.1007/s11606-017-4188-6..
Keywords: Healthcare Delivery, Health Services Research (HSR), Patient-Centered Healthcare, Primary Care, Provider, Workforce