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 (64)
- Adverse Drug Events (ADE) (26)
- Adverse Events (95)
- Alcohol Use (7)
- Ambulatory Care and Surgery (26)
- Antibiotics (36)
- Antimicrobial Stewardship (16)
- Anxiety (7)
- Arthritis (14)
- Asthma (15)
- Autism (5)
- Back Health and Pain (7)
- Behavioral Health (98)
- Blood Clots (7)
- Blood Pressure (10)
- Blood Thinners (3)
- Brain Injury (6)
- Breast Feeding (2)
- Burnout (11)
- Cancer (100)
- Cancer: Breast Cancer (19)
- Cancer: Cervical Cancer (5)
- Cancer: Colorectal Cancer (15)
- Cancer: Lung Cancer (5)
- Cancer: Ovarian Cancer (1)
- Cancer: Prostate Cancer (12)
- Cancer: Skin Cancer (1)
- Cardiovascular Conditions (99)
- Care Coordination (16)
- Caregiving (45)
- Care Management (47)
- Case Study (17)
- Catheter-Associated Urinary Tract Infection (CAUTI) (5)
- Central Line-Associated Bloodstream Infections (CLABSI) (7)
- Children/Adolescents (172)
- Chronic Conditions (80)
- Clinical Decision Support (CDS) (15)
- Clinician-Patient Communication (42)
- Clostridium difficile Infections (7)
- Colonoscopy (4)
- Communication (56)
- Community-Acquired Infections (13)
- Community-Based Practice (13)
- Community Partnerships (1)
- Comparative Effectiveness (28)
- Complementary and Alternative Medicine (3)
- Comprehensive Unit-based Safety Program (CUSP) (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (11)
- COVID-19 (1)
- Critical Care (24)
- Cultural Competence (12)
- Data (13)
- Decision Making (72)
- Dementia (21)
- Dental and Oral Health (6)
- Depression (40)
- Diabetes (28)
- Diagnostic Safety and Quality (65)
- Dialysis (3)
- Digestive Disease and Health (11)
- Disabilities (10)
- Disparities (53)
- Domestic Violence (4)
- Ear Infections (1)
- Education (4)
- Education: Academic (2)
- Education: Continuing Medical Education (27)
- Education: Curriculum (1)
- Education: Patient and Caregiver (29)
- Elderly (116)
- Electronic Health Records (EHRs) (101)
- Electronic Prescribing (E-Prescribing) (4)
- Emergency Department (73)
- Emergency Medical Services (EMS) (5)
- Emergency Preparedness (2)
- Evidence-Based Practice (138)
- Eye Disease and Health (3)
- Falls (12)
- Family Health and History (8)
- Genetics (9)
- Guidelines (38)
- Healthcare-Associated Infections (HAIs) (54)
- Healthcare Cost and Utilization Project (HCUP) (45)
- Healthcare Costs (95)
- Healthcare Delivery (84)
- Healthcare Utilization (60)
- Health Information Exchange (HIE) (5)
- Health Information Technology (HIT) (188)
- Health Insurance (52)
- Health Literacy (18)
- Health Promotion (8)
- Health Services Research (HSR) (35)
- Health Status (20)
- Health Systems (12)
- Heart Disease and Health (66)
- Hepatitis (4)
- Home Healthcare (28)
- Hospital Discharge (29)
- Hospitalization (76)
- Hospital Readmissions (36)
- Hospitals (129)
- Human Immunodeficiency Virus (HIV) (50)
- Imaging (32)
- Implementation (24)
- Infectious Diseases (53)
- Influenza (6)
- Injuries and Wounds (28)
- Inpatient Care (36)
- Intensive Care Unit (ICU) (33)
- Kidney Disease and Health (27)
- Labor and Delivery (17)
- Learning Health Systems (5)
- Lifestyle Changes (14)
- Long-Term Care (28)
- Low-Income (22)
- Maternal Care (26)
- Medicaid (41)
- Medical Devices (5)
- Medical Errors (24)
- Medical Expenditure Panel Survey (MEPS) (18)
- Medical Liability (1)
- Medicare (80)
- Medication (214)
- Medication: Safety (26)
- Men's Health (15)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (10)
- Mortality (56)
- Neonatal Intensive Care Unit (NICU) (2)
- Neurological Disorders (36)
- Newborns/Infants (32)
- Nursing (15)
- Nursing Homes (43)
- Nutrition (16)
- Obesity (27)
- Obesity: Weight Management (16)
- Opioids (36)
- Organizational Change (9)
- Orthopedics (18)
- Osteoporosis (2)
- Outcomes (128)
- Pain (26)
- Palliative Care (15)
- Patient-Centered Healthcare (49)
- Patient-Centered Outcomes Research (142)
- Patient Adherence/Compliance (32)
- Patient and Family Engagement (43)
- Patient Experience (30)
- Patient Safety (176)
- Patient Self-Management (10)
- Payment (25)
- Pneumonia (11)
- Policy (58)
- Practice Improvement (1)
- Practice Patterns (37)
- Pregnancy (47)
- Pressure Ulcers (3)
- Prevention (98)
- Primary Care (81)
- Primary Care: Models of Care (18)
- Provider (92)
- Provider: Clinician (22)
- Provider: Health Personnel (1)
- Provider: Nurse (20)
- Provider: Pharmacist (10)
- Provider: Physician (52)
- Provider Performance (31)
- Public Health (17)
- Public Reporting (2)
- Quality Improvement (90)
- Quality Indicators (QIs) (16)
- Quality Measures (26)
- Quality of Care (142)
- Quality of Life (21)
- Racial and Ethnic Minorities (80)
- Registries (21)
- Rehabilitation (8)
- Research Methodologies (52)
- Respiratory Conditions (47)
- Risk (93)
- Rural Health (14)
- Screening (59)
- Sepsis (25)
- Sex Factors (9)
- Sexual Health (17)
- Sickle Cell Disease (4)
- Simulation (10)
- Skin Conditions (16)
- Sleep Problems (9)
- Social Determinants of Health (49)
- Social Media (12)
- Social Stigma (16)
- Stress (14)
- Stroke (16)
- Substance Abuse (37)
- Surgery (165)
- Surveys on Patient Safety Culture (5)
- System Design (1)
- Teams (23)
- TeamSTEPPS (4)
- Telehealth (21)
- Tobacco Use (12)
- Tobacco Use: Smoking Cessation (5)
- Tools & Toolkits (7)
- Training (20)
- Transitions of Care (33)
- Transplantation (28)
- Trauma (24)
- Treatments (19)
- U.S. Preventive Services Task Force (USPSTF) (27)
- Uninsured (9)
- Urban Health (15)
- Urinary Tract Infection (UTI) (12)
- Vaccination (19)
- Vulnerable Populations (42)
- Web-Based (2)
- Women (85)
- Workflow (8)
- Workforce (10)
- Young Adults (18)
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
126 to 150 of 1425 Research Studies DisplayedBadawy SM, Payne AB
Association between clinical outcomes and metformin use in adults with sickle cell disease and diabetes mellitus.
This study tested the hypothesis that metformin use for treatment of diabetes mellitus is associated with fewer sickle cell disease (SCD) adverse outcomes and lower health care utilization among patients with SCD and diabetes mellitus. This retrospective cohort study used data from MarketScan Medicaid claims for 2006 to 2016. SCD patients who were metformin users and nonusers were compared. Patients on hydroxyurea, insulin, or iron chelation were excluded. Metformin was found to be associated with significantly fewer inpatient and emergency department encounters in adults with SCD and diabetes mellitus.
AHRQ-funded; HS023011.
Citation: Badawy SM, Payne AB .
Association between clinical outcomes and metformin use in adults with sickle cell disease and diabetes mellitus.
Blood Adv 2019 Nov 12;3(21):3297-306. doi: 10.1182/bloodadvances.2019000838..
Keywords: Sickle Cell Disease, Diabetes, Chronic Conditions, Medication, Outcomes, Patient-Centered Outcomes Research
Feldman AG, Sundaram SS, Beaty BL
Immunization status at the time of liver transplant in children and adolescents.
In this research letter, the authors quantified the percentage of patients at Society of Pediatric Liver Transplantation centers who were up to date for their age on immunizations at the time of transplant, and determined whether demographic and clinical factors were associated with immunization status at the time of transplant. They concluded that further research is needed to understand barriers to immunization in the pediatric transplant population and called for novel tools that provide pretransplant vaccine education and enhance communication between primary care and subspecialty clinicians.
AHRQ-funded; HS026510.
Citation: Feldman AG, Sundaram SS, Beaty BL .
Immunization status at the time of liver transplant in children and adolescents.
JAMA 2019 Nov 12;322(18):1822-24. doi: 10.1001/jama.2019.14386..
Keywords: Transplantation, Children/Adolescents, Vaccination, Surgery
Kundi H, Strom JB, Valsdottir LR
Trends in isolated surgical aortic valve replacement according to hospital-based transcatheter aortic valve replacement volumes.
This research analyzed trends in isolated surgical aortic valve replacement (SAVR) procedures with the advent of the transcatheter aortic valve replacement (TAVR) procedure. Hospitalizations of adults from January 2011 through December 2014 was analyzed with data from the Medicare Provider Analysis and Review database using ICD-9 Revision-Clinical Modification procedure codes. The annual value of isolated SAVR went down as TAVR volumes increased which also decreased short- and long-term mortality over the study period.
AHRQ-funded; HS024520.
Citation: Kundi H, Strom JB, Valsdottir LR .
Trends in isolated surgical aortic valve replacement according to hospital-based transcatheter aortic valve replacement volumes.
JACC Cardiovasc Interv 2018 Nov 12;11(21):2148-56. doi: 10.1016/j.jcin.2018.07.002..
Keywords: Surgery, Heart Disease and Health, Cardiovascular Conditions, Hospitals
Neal JL, Carlson NS, Phillippi JC
Midwifery presence in United States medical centers and labor care and birth outcomes among low-risk nulliparous women: a Consortium on Safe Labor study.
This study compared labor care and birth outcomes between medical centers with interprofessional care (midwives and physicians) versus noninterprofessional care (physicians only). A retrospective cohort study was conducted using Consortium on Safe labor data from low-risk nulliparous women who birthed in interprofessional (7393) or noninterprofessional (6982). Women at interprofessional medical centers were 74% less likely to undergo labor induction and 75% less likely to have oxytocin augmentation. In addition, the cesarean rate was 12% lower.
AHRQ-funded; HS024733.
Citation: Neal JL, Carlson NS, Phillippi JC .
Midwifery presence in United States medical centers and labor care and birth outcomes among low-risk nulliparous women: a Consortium on Safe Labor study.
Birth 2019 Nov 11;46(3):475-86. doi: 10.1111/birt.12407..
Keywords: Labor and Delivery, Pregnancy, Maternal Care, Women, Outcomes
Cai Y, Huang J, Ning J
Two-sample test for correlated data under outcome-dependent sampling with an application to self-reported weight loss data.
This research conducted simulation studies to evaluate a proposed score test to eliminate type I errors when applied to longitudinal or clustered data. The proposed score test’s purpose is to capture differences in the mean and variance between two groups simultaneously. The simulation used was to compare self-reported weight loss data in a friends’ referral group.
AHRQ-funded; HS022900.
Citation: Cai Y, Huang J, Ning J .
Two-sample test for correlated data under outcome-dependent sampling with an application to self-reported weight loss data.
Stat Med 2019 Nov 10;38(25):4999-5009. doi: 10.1002/sim.8346..
Keywords: Research Methodologies
Barker LT, Bond WF, Vincent AL
A novel in situ simulation framework for introduction of a new technology: the 3-Act-3-Debrief model.
Researchers studied a simulation-based introduction to new technologies in order to address specific factors that influence adoption. They found that a novel 3-stage simulation-debriefing structure positively targeted factors influencing the adoption of new healthcare technologies.
AHRQ-funded; HS024027.
Citation: Barker LT, Bond WF, Vincent AL .
A novel in situ simulation framework for introduction of a new technology: the 3-Act-3-Debrief model.
Adv Simul 2020 Sep 25;5:25. doi: 10.1186/s41077-020-00145-x..
Keywords: Telehealth, Health Information Technology (HIT), Implementation, Simulation
Sun EC, Mello MM, Moshfegh J
Assessment of out-of-network billing for privately insured patients receiving care in in-network hospitals.
This retrospective analysis used data from the Clinformatics Data Mart database (Optum) to examine out-of-network billing among privately insured patients with an inpatient admission or emergency department (ED) visit at in-network hospitals. The investigators found that out-of-network billing appeared to have become common for privately insured patients even when they soughttreatment at in-network hospitals. They indicated that the mean amounts billed appeared to be sufficiently large that they may create financial strain for a substantial proportion of patients.
AHRQ-funded; HS026128.
Citation: Sun EC, Mello MM, Moshfegh J .
Assessment of out-of-network billing for privately insured patients receiving care in in-network hospitals.
JAMA Intern Med 2019 Nov;179(11):1453-612. doi: 10.1001/jamainternmed.2019.3451..
Keywords: Health Insurance, Healthcare Costs, Payment, Hospitals, Emergency Department
Khan A, Yin HS, Brach C
AHRQ Author: Brach C
Association between parent comfort with English and adverse events among hospitalized children.
The purpose of this study was to examine the association between parents’ limited comfort with English (LCE) and adverse events in a cohort of hospitalized children. Participants included Arabic-, Chinese-, English-, and Spanish-speaking parents of patients 17 years and younger in the pediatric units of seven North American hospitals. Findings showed that hospitalized children of parents expressing LCE were twice as likely to experience harms due to medical care. Targeted strategies are needed to improve communication and safety for this vulnerable group of children.
AHRQ-authored; AHRQ-funded; HS022986.
Citation: Khan A, Yin HS, Brach C .
Association between parent comfort with English and adverse events among hospitalized children.
JAMA Pediatr 2020 Dec;174(12):e203215. doi: 10.1001/jamapediatrics.2020.3215..
Keywords: Children/Adolescents, Caregiving, Cultural Competence, Clinician-Patient Communication, Communication, Adverse Events, Patient Safety, Inpatient Care, Hospitalization
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
Quan VL, Erickson T, Daftary K
Atopic dermatitis across shades of skin.
This narrative review discussed key terminology related to atopic dermatitis (AD) across shades of skin, including modern definitions of 'race', 'ethnicity', and 'skin of color (SOC)'. Current literature describing disparities in AD prevalence, disease recognition, and burden was synthesized alongside data regarding genetic and immunologic findings across SOC populations. The authors highlighted key concomitant social determinants of health, including environmental factors, socioeconomic status, and access to care, within the context of these findings. They also discussed future efforts to move toward a more inclusive understanding of AD that encompasses all shades of skin and ensures equitable representation of diverse populations in high impact research.
AHRQ-funded; HS026385.
Citation: Quan VL, Erickson T, Daftary K .
Atopic dermatitis across shades of skin.
Am J Clin Dermatol 2023 Sep; 24(5):731-51. doi: 10.1007/s40257-023-00797-1..
Keywords: Skin Conditions, Racial and Ethnic Minorities
Henderson JT, Senger CA, Henninger M
Behavioral counseling interventions to prevent sexually transmitted infections: updated evidence report and systematic review for the US Preventive Services Task Force.
This updated evidence report and systematic review accompanied the USPSTF final recommendation for behavioral counseling interventions to prevent sexually transmitted infections (STIs) in adults and adolescents, which was published in August 2020. Studies from the previous 2014 review and literature from January 2013 through May 2019 was reviewed to find good- and fair-quality randomized and nonrandomized controlled intervention studies conducted in primary care settings. The review included 37 randomized trials and 2 nonrandomized controlled intervention studies. The study populations were mostly heterosexual adolescents and young adults, females, and racial and ethnic minorities at increased risk for STIs. Thirty-four trials reported behavioral change outcomes after interventions. The largest reductions in STI incidence were reported after group or individual counseling sessions lasting more than 2 hours. Evidence was limited on interventions of shorter duration persisting beyond 1 year.
AHRQ-funded; 2902015000017I.
Citation: Henderson JT, Senger CA, Henninger M .
Behavioral counseling interventions to prevent sexually transmitted infections: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Aug 18;324(7):682-99. doi: 10.1001/jama.2020.10371..
Keywords: U.S. Preventive Services Task Force (USPSTF), Infectious Diseases, Sexual Health, Evidence-Based Practice, Guidelines
Kapoor A, Field T, Handler S
Characteristics of long-term care residents that predict adverse events after hospitalization.
This study examined the characteristics of long-term care (LTC) residents that predict adverse events (AEs) after discharge from recent hospitalization. This cohort study looked at AEs that occurred at 32 nursing homes from six New England states. AE incidents involving a total of 555 LTC residents with 762 transitions from the hospital back to LTC were reviewed. The association between all AEs and preventable AEs developing in the 45 days following discharge back to LTC was measured. There were 283 discharges with one or more AEs and 212 with preventable AEs. Characteristics independently associated with higher risk of AEs included hospital length of stay (LOS) 9 or more days, 18 or more regularly scheduled medications, and 19 and above on the dependency in activities of daily living (ADL) scale.
AHRQ-funded; HS024422.
Citation: Kapoor A, Field T, Handler S .
Characteristics of long-term care residents that predict adverse events after hospitalization.
J Am Geriatr Soc 2020 Nov;68(11):2551-57. doi: 10.1111/jgs.16770..
Keywords: Elderly, Long-Term Care, Nursing Homes, Hospitalization, Adverse Events, Transitions of Care, Hospital Discharge, Risk
Lacson R, Gujrathi I, Healey M
Closing the loop on unscheduled diagnostic imaging orders: a systems-based approach.
This study looked at the impact of implementing a tool called SCORE (System for Coordinating Orders for Radiology Exams), whose objective is to manage unscheduled orders for outpatient diagnostic imaging in an electronic health record (EHR) with embedded computerized physician order entry. The rate of unscheduled imaging orders was compared before SCORE (October 2017 to September 2018) and after (October 2018 to June 2019). There was a 49% reduction in unscheduled orders after SCORE implementation at a large academic institution.
AHRQ-funded; HS024722.
Citation: Lacson R, Gujrathi I, Healey M .
Closing the loop on unscheduled diagnostic imaging orders: a systems-based approach.
J Am Coll Radiol 2021 Jan;18(1 Pt A):60-67. doi: 10.1016/j.jacr.2020.09.031..
Keywords: Imaging, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Hua CL, Thomas KS
Coronavirus Disease 19 (COVID-19) restrictions and loneliness among residents in long-term care communities: data from the National Health and Aging Trends Study.
Loneliness has been associated with increased morbidity and mortality among older adults, especially among residents of long-term care (LTC) facilities. COVID-19 disproportionately contributed to deaths in LTC communities during pandemic, especially before the introduction of vaccines. Restrictive measures were instituted in many LTC facilities to try to slow the spread of COVID-19. This report examines whether these restrictive measures were associated with increased loneliness among older adults in LTC communities during the pandemic. Data from the 2020 National Health and Aging Trends Study (NHATS) COVID-19 supplement, a representative sample of Medicare beneficiaries (age 65 and older) was used, with 234 residents participating. Surveys completed by proxies were excluded because loneliness measures were not available. Approximately 28.7% of residents in LTC communities were lonelier during the pandemic than pre-pandemic. Residents who could not leave their rooms appeared to show increased loneliness.
AHRQ-funded; HS000011.
Citation: Hua CL, Thomas KS .
Coronavirus Disease 19 (COVID-19) restrictions and loneliness among residents in long-term care communities: data from the National Health and Aging Trends Study.
J Am Med Dir Assoc 2021 Sep;22(9):1860-61. doi: 10.1016/j.jamda.2021.06.029..
Keywords: COVID-19, Elderly, Long-Term Care, Nursing Homes
Chiotos K, Rock C, Schweizer ML
Current infection prevention and antibiotic stewardship program practices: a survey of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN).
This survey compares results with a similar 2013 survey that characterizes contemporary infection prevention and antibiotic stewardship program practices across 64 healthcare facilities. There was decreased frequency of active surveillance for MRSA, frequent active surveillance for carbapenem-resistant Enterobacteriaceae, and increased support for antibiotic stewardship programs.
AHRQ-funded; HS026393.
Citation: Chiotos K, Rock C, Schweizer ML .
Current infection prevention and antibiotic stewardship program practices: a survey of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN).
Infect Control Hosp Epidemiol 2019 Sep;40(9):1046-49. doi: 10.1017/ice.2019.172.
.
.
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Practice Patterns
Levy AE, Shah NR, Matheny ME
Determining post-test risk in a national sample of stress nuclear myocardial perfusion imaging reports: implications for natural language processing tools.
The authors investigated whether Natural Language Processing (NLP) tools could potentially help estimate myocardial perfusion imaging (MPI) risk. Subjects were VA patients who underwent stress MPI and coronary angiography 2009-11; stress test reports were randomly selected for analysis. The authors found that post-test ischemic risk was determinable but rarely reported in this sample of stress MPI reports. They conclude that this supports the potential use of NLP to help clarify risk and recommend further study of NLP in this context.
AHRQ-funded; HS022998.
Citation: Levy AE, Shah NR, Matheny ME .
Determining post-test risk in a national sample of stress nuclear myocardial perfusion imaging reports: implications for natural language processing tools.
J Nucl Cardiol 2019 Dec;26(6):1878-85. doi: 10.1007/s12350-018-1275-y..
Keywords: Imaging, Risk, Clinical Decision Support (CDS), Health Information Technology (HIT), Diagnostic Safety and Quality, Cardiovascular Conditions, Heart Disease and Health
Evensen CT, Yost KJ, Keller S
Development and testing of the CAHPS Cancer Care Survey.
In order to develop the CAHPS Cancer Care Survey instrument, the authors conducted cognitive tests of the instrument as well as field tests at six cancer centers and four community oncology practices; the survey was then finalized and obtained the CAHPS trademark. The authors recommend mail-only, mail-telephone mixed-mode, and Web-mail mixed-mode data collection methods.
AHRQ-funded; 290200600019I.
Citation: Evensen CT, Yost KJ, Keller S .
Development and testing of the CAHPS Cancer Care Survey.
J Oncol Pract 2019 Nov;15(11):e969-e78. doi: 10.1200/jop.19.00039..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Cancer, Patient Experience, Quality of Care
Calthorpe LM, Pantell MS
Differences in the prevalence of childhood adversity by geography in the 2017-18 National Survey of Children's Health.
This study examined differences in childhood exposures to adverse childhood experiences (ACEs) by geography and determined whether geography moderates the relationship between ACE exposure and health outcomes including overall health, asthma, ADHD, and special health care needs. Cross-sectional data from 2017-2017 National Survey of Children’s Health (NSCH) was analyzed. Rural residency was associated with 1.29 times increased odds of exposure to 4+ ACEs compared to suburban residency. Urban residency status was observed to increase the association between ACEs and asthma.
AHRQ-funded; HS026383.
Citation: Calthorpe LM, Pantell MS .
Differences in the prevalence of childhood adversity by geography in the 2017-18 National Survey of Children's Health.
Child Abuse Negl 2021 Jan;111:104804. doi: 10.1016/j.chiabu.2020.104804..
Keywords: Children/Adolescents, Social Determinants of Health, Health Status
Biener AI, Zuvekas SH
AHRQ Author: Zuvekas SH
Do racial and ethnic disparities in mental health treatment vary with underlying mental health?
AHRQ-authored.
Citation: Biener AI, Zuvekas SH .
Do racial and ethnic disparities in mental health treatment vary with underlying mental health?
Med Care Res Rev 2021 Aug;78(4):392-403. doi: 10.1177/1077558720903589..
Keywords: Medical Expenditure Panel Survey (MEPS), Behavioral Health, Disparities, Racial and Ethnic Minorities, Access to Care
Olivieri-Mui BL, Koethe B, Briesacher B
Economic barriers to antiretroviral therapy in nursing homes.
In this study, the investigators’ aim was to clarify if persons living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) have adequate economic access to antiretroviral therapy (ART) when admitted to nursing homes (NHs). They concluded that people living with HIV in NHs do not always receive lifesaving ART, but the reasons are unclear and appear unrelated to economic barriers.
AHRQ-funded; HS025662.
Citation: Olivieri-Mui BL, Koethe B, Briesacher B .
Economic barriers to antiretroviral therapy in nursing homes.
J Am Geriatr Soc 2020 Apr;68(4):777-82. doi: 10.1111/jgs.16288..
Keywords: Human Immunodeficiency Virus (HIV), Nursing Homes, Long-Term Care, Medication, Access to Care
Feinberg E, Stransky ML, Augustyn M
Effect of family navigation on participation in Part C early intervention.
This study investigated whether family navigation (FN) improved Part C Early Intervention (EI) initiation following positive primary care screening for autism compared to conventional care management (CCM). The authors conducted a randomized clinical trial among 339 families of children (ages 15-27 months) who screened as having an increased likelihood for autism at 11 urban primary care sites in 3 cities. Families were randomly assigned to FN or CCM. Families in the FN group received community-based outreach from a navigator trained to support families to overcome structural barriers to autism evaluation and services. The authors obtained EI service records from state or local agencies. The primary outcome of this study was measured as the number of days from randomization to the first EI appointment. They obtained service records for 271 children; 156 (57.6%) children were not engaged with EI at study enrollment. Children were followed for 100 days after diagnostic ascertainment or until age 3, when Part C EI eligibility ends. Families receiving FN were approximately 54% more likely to engage EI than those receiving CCM.
AHRQ-funded; HS022242.
Citation: Feinberg E, Stransky ML, Augustyn M .
Effect of family navigation on participation in Part C early intervention.
Acad Pediatr 2023 Jul; 23(5):904-12. doi: 10.1016/j.acap.2023.03.013..
Keywords: Children/Adolescents, Vulnerable Populations, Patient and Family Engagement
Turner NA, Grambow SC, Woods CW
Epidemiologic trends in Clostridioides difficile infections in a regional community hospital network.
Clostridioides difficile infection (CDI) remains a leading cause of health care facility-associated infection. A greater understanding of the regional epidemiologic profile of CDI could inform targeted prevention strategies. The objectives of this study was to assess trends in incidence of health care facility-associated and community-acquired CDI among hospitalized patients over time and to conduct a subanalysis of trends in the NAP1 strain of CDI over time.
AHRQ-funded; HS023866.
Citation: Turner NA, Grambow SC, Woods CW .
Epidemiologic trends in Clostridioides difficile infections in a regional community hospital network.
JAMA Netw Open 2019 Oct 2;2(10):e1914149. doi: 10.1001/jamanetworkopen.2019.14149..
Keywords: Clostridium difficile Infections, Community-Acquired Infections, Infectious Diseases, Hospitals
Bahr N, Meckler G, Hansen M
Evaluating pediatric advanced life support in emergency medical services with a performance and safety scoring tool.
This study used simulation to evaluate Pediatric Advanced Life Support (PALS) guideline performance in pediatric emergency medical service (EMS) care and to introduce this easy-to-use tool to score guideline compliance and patient safety. Standard pediatric resuscitation simulations with a child manikin were created. The manikin was presented as a choking 6-year-old with a complex medical history who is unconscious and apneic, with bradycardic pulse. Teams were expected to monitor vitals, initiate airway management and CPR, and establish vascular access and administer epinephrine based on PALS guidelines. The authors observed 34 EMS teams providing care in P-OHCA simulations. Teams were found to be proficient in assessing vitals, using correct-sized equipment, intubation, and confirmation of tube placement. The teams were delayed in initiating positive pressure ventilation (PPV) and chest compressions, with many teams (53%) deviating from guidelines in chest compression. Half the teams performed continuous compressions before establishing an advanced airway and one team did not perform compressions. Twenty teams also deviated from medication guidelines with 12 teams failing to administer epinephrine, six teams underdosing, and two teams overdosing by more than 20%.
AHRQ-funded; HS025590.
Citation: Bahr N, Meckler G, Hansen M .
Evaluating pediatric advanced life support in emergency medical services with a performance and safety scoring tool.
Am J Emerg Med 2021 Oct;48:301-06. doi: 10.1016/j.ajem.2021.06.061.
AHRQ-funded; HS025590..
AHRQ-funded; HS025590..
Keywords: Children/Adolescents, Emergency Medical Services (EMS), Critical Care, Cardiovascular Conditions
Grant MC, Gibbons MM, Ko CY
Evidence review conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery: focus on anesthesiology for gynecologic surgery.
This paper is an evidence review of enhanced recovery after surgery (ERAS) protocols for gynecologic surgery that will be used as part of AHRQ’s Safety Program for Improving Surgical Care and Recovery. This initiative was developed in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality. The authors conducted a literature review of the various anesthesia components which may influence outcomes and facilitate recovery after gynecological surgery. They included interventions for preoperative, intraoperative, and postoperative phases of care and then summarized the best available evidence for ERAS for gynecological surgery. The best evidence was summarized for recommendations to be used in the initiative.
Citation: Grant MC, Gibbons MM, Ko CY .
Evidence review conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery: focus on anesthesiology for gynecologic surgery.
AHRQ-funded; 233201500020I..
Keywords: Patient Safety, Surgery, Quality Improvement, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Women
Anderson AC, Akre E, Chen J
Exploring national trends of patient- and family-centered care among US children.
This study examined national trends in the receipt of high-quality patient-physician communication and patient empowerment through behavioral health counseling among children in the United States. They used Medical Expenditure Panel Survey (MEPS) data from 2010 to 2014. Two measures of patient- and family-centered care (PFCC) were analyzed: 1) a composite measure of high-quality patient-physician communication, and 2) patient empowerment through behavioral health counseling about healthy eating and exercise. There were high rates of receiving high-quality physician-patient communication (92-93%) as opposed to behavioral counseling about healthy eating (53-60%) and exercise (37-42%). There was a higher rate of high-quality physician-patient communication in 2014 than in 2010, but there was not a similar increase in receiving behavioral health counseling. Lower odds of receiving behavioral health counseling were found for parents with low income and low educational attainment as well as lack of insurance.
AHRQ-funded; HS022135.
Citation: Anderson AC, Akre E, Chen J .
Exploring national trends of patient- and family-centered care among US children.
J Child Health Care 2019 Jun;23(2):200-12. doi: 10.1177/1367493518786015..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Clinician-Patient Communication, Communication, Patient and Family Engagement, Patient-Centered Outcomes Research, Family Health and History, Lifestyle Changes