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
- Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cardiovascular Conditions (4)
- Care Coordination (2)
- Caregiving (1)
- Care Management (1)
- Chronic Conditions (3)
- Clinician-Patient Communication (1)
- Colonoscopy (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Disparities (1)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (5)
- Healthcare Delivery (3)
- Health Information Technology (HIT) (2)
- Heart Disease and Health (2)
- Hospital Readmissions (1)
- Hospitals (1)
- Implementation (3)
- (-) Patient-Centered Healthcare (14)
- Patient-Centered Outcomes Research (3)
- Patient and Family Engagement (1)
- Patient Experience (2)
- Patient Safety (2)
- Patient Self-Management (1)
- Primary Care (9)
- Primary Care: Models of Care (6)
- Provider (1)
- Provider: Clinician (1)
- Provider: Physician (1)
- Provider Performance (1)
- Quality Improvement (12)
- Quality Measures (1)
- (-) Quality of Care (14)
- Racial and Ethnic Minorities (1)
- Risk (1)
- Screening (1)
- Surgery (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 14 of 14 Research Studies DisplayedQureshi N, Quigley DD, Hays RD
Nationwide qualitative study of practice leader perspectives on what it takes to transform into a patient-centered medical home.
The purpose of this study was to examine reasons practices obtained and maintained patient-centered medical home (PCMH) recognition and what resources were needed. The investigators concluded that PCMH efforts necessitated support and assistance to frontline, on-site practice leaders leading care delivery changes. They suggested that change efforts should include financial incentives (e.g., direct payment or additional reimbursement), leadership direction and support, and internal or external staff with experience with the PCMH application process, implementation changes, and QI expertise in monitoring process and outcome data.
AHRQ-funded; HS016980.
Citation: Qureshi N, Quigley DD, Hays RD .
Nationwide qualitative study of practice leader perspectives on what it takes to transform into a patient-centered medical home.
J Gen Intern Med 2020 Dec;35(12):3501-09. doi: 10.1007/s11606-020-06052-1..
Keywords: Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Quality Improvement, Quality of Care, Healthcare Delivery
Quigley DD, Qureshi N, Masarweh LA
Practice leaders report targeting several types of changes in care experienced by patients during patient-centered medical home transformation.
This study looked at how primary care practices implemented changes during the transition to becoming a patient-centered medical home (PCMH). The authors examined 105 primary care practice leader experiences during PCMH transformation using semi-structured interviews. Practices most commonly targeted changes in care coordination (30%), access to care (25%), and provider communication (24%). Reported areas for PCMH transformation were measured by Clinician & Group CAHPS, PCMH CAHPS, or supplemental CAHPS survey items, including team-based care (35%), providing more on-site services (28%), care management (22%), patient-centered culture (18%), and chronic condition health education (13%). Many PCMH changes are captured by CAHPS survey items, but some are not.
AHRQ-funded; HS025920.
Citation: Quigley DD, Qureshi N, Masarweh LA .
Practice leaders report targeting several types of changes in care experienced by patients during patient-centered medical home transformation.
J Patient Exp 2020 Dec;7(6):1509-18. doi: 10.1177/2374373520934231..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare, Patient Experience, Care Coordination, Quality Improvement, Quality of Care, Implementation
Aysola J, Xu C, Huo H
The relationships between patient experience and quality and utilization of primary care services.
This study examined the associations between visit-triggered patient-reported experience measures and both quality of care measures and the number of missed primary care appointments. A cross-sectional analysis of 8355 primary care patients from 22 primary care practices was conducted. Outcomes measured included: smoking cessation discussion, diabetes eye examination referral, mammography, colonoscopy screening, current smoking status, diabetes control hemoglobin A1c, blood pressure control, cholesterol control LDL among patients with diabetes, and visit no shows 2 and 5 years after the index visit. The authors found that patient experience can be an important stand-alone metric of care quality, although it may not relate to clinical outcomes or process measures in the outpatient setting.
AHRQ-funded; HS021706.
Citation: Aysola J, Xu C, Huo H .
The relationships between patient experience and quality and utilization of primary care services.
J Patient Exp 2020 Dec;7(6):1678-84. doi: 10.1177/2374373520924190..
Keywords: Patient Experience, Primary Care, Primary Care: Models of Care, Patient-Centered Healthcare, Quality Improvement, Quality of Care
Swietek KE, Gaynes BN, Jackson GL
Effect of the patient-centered medical home on racial disparities in quality of care.
Research demonstrates that the patient-centered medical home (PCMH) is associated with improved clinical outcomes and quality of care, and the populations that can most benefit from this model require long-term management, e.g., persons with chronic illness and behavioral health conditions. The objective of this study was to estimate the association between enrollment in National Committee for Quality Assurance (NCQA)-recognized PCMHs and racial disparities in quality of care for adults with major depressive disorder (MDD) and comorbid medical conditions.
AHRQ-funded; HS025562.
Citation: Swietek KE, Gaynes BN, Jackson GL .
Effect of the patient-centered medical home on racial disparities in quality of care.
J Gen Intern Med 2020 Aug;35(8):2304-13. doi: 10.1007/s11606-020-05729-x.
.
.
Keywords: Patient-Centered Healthcare, Disparities, Racial and Ethnic Minorities, Quality of Care, Chronic Conditions
Singer SJ, Kerrissey M, Friedberg M
A comprehensive theory of integration.
Efforts to transform health care delivery to improve care have increasingly focused on care integration. However, variation in how integration is defined has complicated efforts to design, synthesize, and compare studies of integration in health care. Drawing on previous work, in this study the investigators presented a comprehensive theoretical model of relationships between types of integration and proposed how to measure them.
AHRQ-funded; HS024067.
Citation: Singer SJ, Kerrissey M, Friedberg M .
A comprehensive theory of integration.
Med Care Res Rev 2020 Apr;77(2):196-207. doi: 10.1177/1077558718767000..
Keywords: Healthcare Delivery, Patient-Centered Healthcare, Quality of Care
Nguyen AM, Cuthel A, Padgett DK
How practice facilitation strategies differ by practice context.
The purpose of this study was to identify contextual factors that drive facilitators' strategies to meet practice improvement goals, and how these strategies are tailored to practice context. This study was conducted as part of a larger study, HealthyHearts New York City, which evaluated the impact of practice facilitation on adoption of cardiovascular disease prevention and treatment guidelines.
AHRQ-funded; HS023922.
Citation: Nguyen AM, Cuthel A, Padgett DK .
How practice facilitation strategies differ by practice context.
J Gen Intern Med 2020 Mar;35(3):824-31. doi: 10.1007/s11606-019-05350-7..
Keywords: Quality Improvement, Evidence-Based Practice, Heart Disease and Health, Cardiovascular Conditions, Primary Care, Quality of Care, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care: Models of Care
Businger AC, Fuller TE, Schnipper JL
Lessons learned implementing a complex and innovative patient safety learning laboratory project in a large academic medical center.
This paper describes the challenges, recommendations and lessons learned while developing and implementing a Patient Safety Learning Laboratory (PSLL) project, which is comprised of a suite of HIT tools integrated with a newly implemented Electronic Health Record (EHR) vendor system in the acute care setting of a large academic medical center. The PSLL Administrative Core engaged stakeholders and study personnel throughout all phases of the project. Challenges to implementation included stakeholder engagement, project scope and complexity, technology and governance, and team structure. Some changes were implemented during the trial and others were labeled as lessons learned for future iterative interventions. A willingness to think outside of current workflows and processes to change health system culture around adverse event prevention was one of the keys to success.
AHRQ-funded; HS023535.
Citation: Businger AC, Fuller TE, Schnipper JL .
Lessons learned implementing a complex and innovative patient safety learning laboratory project in a large academic medical center.
J Am Med Inform Assoc 2020 Feb;27(2):301-07. doi: 10.1093/jamia/ocz193.
.
.
Keywords: Patient Safety, Implementation, Health Information Technology (HIT), Quality Improvement, Quality of Care, Patient-Centered Healthcare, Electronic Health Records (EHRs), Evidence-Based Practice
Schuttner L, Wong ES, Rosland AM
Association of the patient-centered medical home implementation with chronic disease quality in patients with multimorbidity.
The purpose of this retrospective cohort study was to examine the association of Patient-Aligned Care Team (PACT) implementation, the Veterans Health Administration (VA) PCMH model, and care quality for multimorbid patients enrolled in VA primary care from 2012 to 2014. The investigators found that for one-third of metrics (5/15), greater implementation of PACT in 2012 was associated with higher predicted probability of meeting the quality metric in 2013-2014. This association persisted for only two metrics among patients with > 5 chronic diseases.
AHRQ-funded; HS026369.
Citation: Schuttner L, Wong ES, Rosland AM .
Association of the patient-centered medical home implementation with chronic disease quality in patients with multimorbidity.
J Gen Intern Med 2020 Oct;35(10):2932-38. doi: 10.1007/s11606-020-06076-7..
Keywords: Patient-Centered Healthcare, Implementation, Chronic Conditions, Primary Care: Models of Care, Primary Care, Quality Improvement, Quality of Care
Keller SC, Cosgrove SE, Arbaje AI
Roles and role ambiguity in patient- and caregiver-performed outpatient parenteral antimicrobial therapy.
This study examined roles and role ambiguity in patient- and caregiver-performed outpatient parenteral antimicrobial therapy (OPAT). A qualitative study of patients and caregivers was conducted using 40 semistructured telephone interviews and 20 contextual inquiries for patients and caregivers. The participants had been discharged from two academic medical centers and put on OPAT. Four main roles were identified: communicator, advocate, learner-trainer, and lay health care worker. There was ambiguity shown among health care workers as well as patients and caregivers. Clearer delineation of roles as to who performs which tasks was indicated in the study.
AHRQ-funded; HS025782.
Citation: Keller SC, Cosgrove SE, Arbaje AI .
Roles and role ambiguity in patient- and caregiver-performed outpatient parenteral antimicrobial therapy.
Jt Comm J Qual Patient Saf 2019 Nov;45(11):763-71. doi: 10.1016/j.jcjq.2019.07.003..
Keywords: Patient-Centered Healthcare, Quality Improvement, Healthcare Delivery, Patient Self-Management, Care Management, Caregiving, Quality of Care, Patient Safety
Smith AB, Mueller D, Garren B
Using qualitative research to reduce readmissions and optimize perioperative cystectomy care.
This study examined the need for qualitative research on meaningful patient-reported outcomes (PROs) to prevent complications and readmissions after cystectomy. The investigators looked at the potential use of mobile communication devices (mHealth) to capture patients’ experiences and to improve outcomes. Interviews were conducted with 15 readmitted patients and 10 of their partners over 45 semi-structured in-depth interviews. The most common perspectives were that patients and their caregivers were overloaded with cystectomy education; they need to know what are normal post-operative symptoms; and that using mHealth would help with patient and caregiver education.
AHRQ-funded; HS024134.
Citation: Smith AB, Mueller D, Garren B .
Using qualitative research to reduce readmissions and optimize perioperative cystectomy care.
Cancer 2019 Oct 15;125(20):3545-53. doi: 10.1002/cncr.32362..
Keywords: Hospital Readmissions, Surgery, Health Information Technology (HIT), Quality Improvement, Quality of Care, Hospitals, Patient-Centered Healthcare
Parchman ML, Anderson ML, Dorr DA
A randomized trial of external practice support to improve cardiovascular risk factors in primary care.
Researchers conducted a randomized controlled trial to compare the effectiveness of adding various forms of enhanced external support to practice facilitation on primary care practices' clinical quality measure (CQM) performance. They concluded that, although they found no significant differences in CQM performance across study arms, the ability of a practice to reach a target level of performance may be enhanced by adding both educational outreach visits and shared learning to practice facilitation.
AHRQ-funded; HS023908.
Citation: Parchman ML, Anderson ML, Dorr DA .
A randomized trial of external practice support to improve cardiovascular risk factors in primary care.
Ann Fam Med 2019 Aug 12;17(Suppl 1):S40-s49. doi: 10.1370/afm.2407..
Keywords: Cardiovascular Conditions, Primary Care, Quality Improvement, Provider Performance, Quality Measures, Quality of Care, Risk, Evidence-Based Practice, Patient-Centered Healthcare, Chronic Conditions
Rogers ES, Cuthel AM, Berry CA
Clinician perspectives on the benefits of practice facilitation for small primary care practices.
This study examined the effectiveness of practice facilitation to improve cardiovascular disease in 257 small independent primary care practices (SIPs) enrolled in the AHRQ-funded EvidenceNOW initiative called HealthyHearts. These SIPs were enrolled in HealthyHearts NYC in New York City. Interviews were conducted with SIPs with 3 or fewer office staff and their answers were compared with interviews with practices with more than 3 office staff. Three facilitation benefits were found to the most important, including 1. Creating awareness of quality gaps; 2. Connecting practices to information, resources, and strategies, and; 3. Optimizing the HER for QI goals.
AHRQ-funded; HS023922.
Citation: Rogers ES, Cuthel AM, Berry CA .
Clinician perspectives on the benefits of practice facilitation for small primary care practices.
Ann Fam Med 2019 Aug 12;17(Suppl 1):S17-s23. doi: 10.1370/afm.2427..
Keywords: Primary Care, Provider: Clinician, Provider: Physician, Provider, Quality Improvement, Quality of Care, Cardiovascular Conditions, Heart Disease and Health, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Davis MM, Gunn R, Pham R
Key collaborative factors when Medicaid Accountable Care Organizations work with primary care clinics to improve colorectal cancer screening: relationships, data, and quality improvement infrastructure.
This study focused on ways that Medicaid Accountable Care Organizations (ACOs) are implementing interventions with primary care clinics to improve colorectal cancer screening. The researchers conducted a comparative case study of 14 Medicaid ACOs in Oregon and their contracted primary care clinics. They focused on interventions that reduced structural barriers (12 ACOs), delivered provider assessment and feedback (11 ACOs), and provided patient reminders (7 ACOs). There was an unintended consequence of potential exclusion of smaller clinics and metric focus and fatigue.
AHRQ-funded; HS022981.
Citation: Davis MM, Gunn R, Pham R .
Key collaborative factors when Medicaid Accountable Care Organizations work with primary care clinics to improve colorectal cancer screening: relationships, data, and quality improvement infrastructure.
Prev Chronic Dis 2019 Aug 15;16:E107. doi: 10.5888/pcd16.180395..
Keywords: Primary Care: Models of Care, Primary Care, Screening, Colonoscopy, Cancer: Colorectal Cancer, Cancer, Quality Improvement, Quality of Care, Care Coordination, Patient-Centered Healthcare
Hall TL, Knierim KE, Nease DE
Primary care practices' implementation of patient-team partnership: findings from EvidenceNOW Southwest.
The authors reported on practice characteristics associated with greater patient-team partnership scores. Using EvidenceNOW Southwest data, they found that practices can improve efforts to partner with patients to assess social needs, gather meaningful input on practice improvement and patient experience, and offer resource connections. These findings supplement recent evidence that patient registries and evidence-based guidelines may effectively prevent and manage cardiovascular disease.
AHRQ-funded; HS023904.
Citation: Hall TL, Knierim KE, Nease DE .
Primary care practices' implementation of patient-team partnership: findings from EvidenceNOW Southwest.
J Am Board Fam Med 2019 Jul-Aug;32(4):490-504. doi: 10.3122/jabfm.2019.04.180361..
Keywords: Cardiovascular Conditions, Clinician-Patient Communication, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient and Family Engagement, Primary Care, Quality of Care, Quality Improvement