National Healthcare Quality and Disparities Report
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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
176 to 200 of 1425 Research Studies DisplayedSharma H, Konetzka RT, Smieliauskas F
The relationship between reported staffing and expenditures in nursing homes.
AHRQ-funded; HS024967.
Citation: Sharma H, Konetzka RT, Smieliauskas F .
The relationship between reported staffing and expenditures in nursing homes.
Med Care Res Rev 2019 Dec 1;76(6):758-83. doi: 10.1177/1077558717739214..
Keywords: Nursing Homes, Long-Term Care, Quality Improvement, Quality of Care, Provider Performance, Medicare
McKinnell JA, Singh RD, Miller LG
The SHIELD Orange County project: multidrug-resistant organism prevalence in 21 nursing homes and long-term acute care facilities in Southern California.
The authors reported baseline multidrug-resistant organism (MDRO) prevalence in 21 nursing homes (NHs) and long-term acute care facilities (LTACs). They found that prevalence of MDROs was 65% in NHs and 80% in LTACs. They concluded that the majority of NH residents and LTAC patients harbor MDROs, and that MDRO status is frequently unknown to the facility. The high MDRO prevalence highlights the need for prevention efforts in NHs/LTACs as part of regional efforts to control MDRO spread.
AHRQ-funded; HS023317.
Citation: McKinnell JA, Singh RD, Miller LG .
The SHIELD Orange County project: multidrug-resistant organism prevalence in 21 nursing homes and long-term acute care facilities in Southern California.
Clin Infect Dis 2019 Oct 15;69(9):1566-73. doi: 10.1093/cid/ciz119.
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Keywords: Nursing Homes, Long-Term Care, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Patient Safety
Papaleontiou M, Chen DW, Banerjee M
Thyrotropin suppression for papillary thyroid cancer: a physician survey study.
AHRQ-funded; HS024512.
Citation: Papaleontiou M, Chen DW, Banerjee M .
Thyrotropin suppression for papillary thyroid cancer: a physician survey study.
Thyroid 2021 Sep;31(9):1383-90. doi: 10.1089/thy.2021.0033..
Keywords: Cancer, Diagnostic Safety and Quality
Gray DT, Mizrahi T
AHRQ Author: Gray DT, Mizrahi T
Trends in appendicitis and perforated appendicitis prevalence in children in the United States, 2001-2015,
This cross-sectional study examined trends in appendicitis and perforated appendicitis in children in the United States from 2001 to 2015 using State Inpatient Databases (SIDS) HCUP data. Investigators found that rates of perforated appendicitis rose during that time period.
AHRQ-authored.
Citation: Gray DT, Mizrahi T .
Trends in appendicitis and perforated appendicitis prevalence in children in the United States, 2001-2015,
JAMA Netw Open 2020 Oct;3(10):e2023484. doi: 10.1001/jamanetworkopen.2020.23484..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Diagnostic Safety and Quality
Goins RT, Jones J, Schure M
Type 2 diabetes management among older American Indians: beliefs, attitudes, and practices.
This study’s purpose was to examine beliefs, attitudes, and practices of older Native Americans regarding type 2 diabetes mellitus (T2DM) management. This disease is one the leading causes of morbidity and mortality among Native Americans, and they are twice as likely to have T2DM, and over three times the mortality rate from T2DM as Whites. Semi-structured in-depth qualitative interviews were conducted with 28 participants with a mean age of 73 years, with 57% female. Participants’ mean confidence score of their T2DM management was 8.0 on a scale of 1 to 10 and their mean Hb1Ac was 7.3.%. Overall 5 themes were discussed: sociocultural factors, causes and consequences, cognitive and affective assessment, diet and exercise, and medical management.
AHRQ-funded; HS000078.
Citation: Goins RT, Jones J, Schure M .
Type 2 diabetes management among older American Indians: beliefs, attitudes, and practices.
Ethn Health 2020 Nov;25(8):1055-71. doi: 10.1080/13557858.2018.1493092..
Keywords: Diabetes, Chronic Conditions, Elderly, Racial and Ethnic Minorities, Patient Self-Management, Care Management
Haldar S, Mishra SR, Kim Y
Use and impact of an online community for hospital patients.
This study examined the impact of a technology resembling an online health community for hospitalized patients to exchange advice and provide each other support during their hospitalization. It was deployed at 1 pediatric and 1 adult hospital. Thirty participants were recruited and were interviewed bedside and were observed how they used the technology, along with follow-up phone interviews. It was found to be helpful to patients and that most (64%) of the shared advice was positive in nature. They also reported positive impacts to their quality, safety, and hospital experience due to the inpatient peer support community.
AHRQ-funded; HS022894.
Citation: Haldar S, Mishra SR, Kim Y .
Use and impact of an online community for hospital patients.
J Am Med Inform Assoc 2020 Apr;27(4):549-57. doi: 10.1093/jamia/ocz212..
Keywords: Health Information Technology (HIT), Hospitals, Patient and Family Engagement, Patient Experience
Bersani K, Fuller TE, Garabedian P
Use, perceived usability, and barriers to implementation of a patient safety dashboard integrated within a vendor EHR.
This study analyzed the use, perceived usability, and barriers to implementation of a patient safety dashboard integrated within a vendor electronic health record (EHR) system. The goal of this dashboard was to help improve compliance with evidence-based safety practices to prevent adverse events in the hospital. A Patient Safety Dashboard was implemented into a cluster-randomized stepped wedge trial on 12 units in neurology, oncology, and general medicine services over an 18-month period. It was most used in general medicine units, with nurses logging in throughout the day. On neurology units, it was mostly physician assistants who logged in. It was rarely used on oncology units. The tool was given highest ratings for perceived ease of use and lowest rating for quality of work life, with nurses rating the tool lowest.
AHRQ-funded; HS023535.
Citation: Bersani K, Fuller TE, Garabedian P .
Use, perceived usability, and barriers to implementation of a patient safety dashboard integrated within a vendor EHR.
Appl Clin Inform 2020 Jan;11(1):34-45. doi: 10.1055/s-0039-3402756..
Keywords: Electronic Health Records (EHRs), Patient Safety, Health Information Technology (HIT)
Berry SD, Zullo AR, Zhang T
Validation of the FRAiL model to predict non-vertebral and hip fractures in nursing home residents.
This study created a tool to assess non-vertebral and hip fracture risk in long-term nursing home (NH) residents called FRAiL (Fracture Risk Assessment in Long term care). The objective of this retrospective cohort study was to assess the performance of the model to predict 2-year risk of fractures in a separate large cohort of NH residents. The study included most long-stay NH residents in the United States (n = 896,840). Fractures were identified using Medicare claims. The mean age of NH residents was 83.8 years and 70.7% were women. Over the 2-year follow-up period 4.6% were hospitalized with non-vertebral fractures, the majority being hip fractures. In the fully adjusted model, 14 out of 15 model characteristics remained significant predictors of non-vertebral fractures. Female sex, wandering, and falls were strongly associated with non-vertebral fractures.
AHRQ-funded; HS022998.
Citation: Berry SD, Zullo AR, Zhang T .
Validation of the FRAiL model to predict non-vertebral and hip fractures in nursing home residents.
Bone 2019 Nov;128:115050. doi: 10.1016/j.bone.2019.115050..
Keywords: Elderly, Nursing Homes, Long-Term Care, Injuries and Wounds
Ellis RJ, Zhang LM, Ko CY
Variation in hospital utilization of minimally invasive distal pancreatectomy for localized pancreatic neoplasms.
The objectives of this study were to identify factors associated with use of minimally invasive distal pancreatectomy (MIDP) for localized neoplasms and to assess hospital variation in MIDP utilization. Results showed that utilization of MIDP for localized pancreatic neoplasms is highly variable; while some patient-level factors are associated with MIDP use, hospital adoption of MIDP appears to be the primary driver of utilization. Monitoring hospital-level use of MIDP may be a useful quality measure to monitor uptake of emerging techniques in pancreatic surgery.
AHRQ-funded; HS026385; HS000078.
Citation: Ellis RJ, Zhang LM, Ko CY .
Variation in hospital utilization of minimally invasive distal pancreatectomy for localized pancreatic neoplasms.
J Gastrointest Surg 2020 Dec;24(12):2780-88. doi: 10.1007/s11605-019-04414-7..
Keywords: Cancer, Surgery, Hospitals, Quality of Care
Stolldorf DP, Schnipper JL, Mixon AS
Organisational context of hospitals that participated in a multi-site mentored medication reconciliation quality improvement project (MARQUIS2): a cross-sectional observational study.
Medication reconciliation (MedRec) is an important patient safety strategy and is widespread in US hospitals and globally. Nevertheless, high quality MedRec has been difficult to implement. As part of a larger study investigating MedRec interventions, the investigators evaluated and compared organisational contextual factors and team cohesion by hospital characteristics and implementation team members' profession to better understand the environmental context and its correlates during a multi-site quality improvement (QI) initiative.
AHRQ-funded; HS025486.
Citation: Stolldorf DP, Schnipper JL, Mixon AS .
Organisational context of hospitals that participated in a multi-site mentored medication reconciliation quality improvement project (MARQUIS2): a cross-sectional observational study.
BMJ Open 2019 Nov 2;9(11):e030834. doi: 10.1136/bmjopen-2019-030834.
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Keywords: Medication, Quality Improvement, Hospitals, Medication: Safety, Patient Safety, Adverse Drug Events (ADE), Adverse Events, Medical Errors, Implementation
Chan B, Hulen E, Edwards S
"It's like riding out the chaos": caring for socially complex patients in an ambulatory intensive care unit (A-ICU).
AHRQ-funded; HS022981.
Citation: Chan B, Hulen E, Edwards S .
"It's like riding out the chaos": caring for socially complex patients in an ambulatory intensive care unit (A-ICU).
Ann Fam Med 2019 Nov;17(6):495-501. doi: 10.1370/afm.2464..
Keywords: Primary Care, Primary Care: Models of Care, Ambulatory Care and Surgery, Vulnerable Populations, Patient-Centered Healthcare, Healthcare Delivery
Rice WS, Stringer KL, Sohail M
Accessing pre-exposure prophylaxis (PrEP): perceptions of current and potential prEP users in Birmingham, Alabama.
Limited studies to date assess barriers to and facilitators of pre-exposure prophylaxis (PrEP) uptake and utilization using a patient-centered access to care framework, among diverse socio-demographic groups, or in the U.S. Deep South, an area with disproportionate HIV burden. In this study, the investigators examine perceptions of PrEP access in qualitative interviews with 44 current and potential PrEP users in Birmingham, Alabama.
AHRQ-funded; HS013852.
Citation: Rice WS, Stringer KL, Sohail M .
Accessing pre-exposure prophylaxis (PrEP): perceptions of current and potential prEP users in Birmingham, Alabama.
AIDS Behav 2019 Nov;23(11):2966-79. doi: 10.1007/s10461-019-02591-9..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Healthcare Utilization, Patient-Centered Healthcare, Racial and Ethnic Minorities, Health Literacy, Education: Patient and Caregiver, Access to Care, Health Promotion
DiBrito SR, Bowring MG, Holscher CM
Acute care surgery for transplant recipients: a national survey of surgeon perspectives and practices.
This study is a survey of acute care surgeons (ACS) and transplant surgeons on their attitudes as to who would feel comfortable operating on transplant patients for nontransplant-related issues. The researchers conducted a national survey of ACS and transplant surgeons and obtained 230 ACS responses and 240 from transplant surgeons. While both ACS and transplant surgeons felt care is better at transplant centers and if the patient requires acute surgery they should be transferred to a transplant center, the ACS still felt comfortable operating and performing laparoscopy on transplant recipients.
Citation: DiBrito SR, Bowring MG, Holscher CM .
Acute care surgery for transplant recipients: a national survey of surgeon perspectives and practices.
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Keywords: Transplantation, Surgery, Provider: Physician, Provider, Practice Patterns
Borsky AE, Savitz LA, Bindman AB
AHRQ Author: Borsky AE
AHRQ series on improving translation of evidence: perceived value of translational products by the AHRQ EPC Learning Health Systems Panel.
This paper discusses the outcomes of an evaluation of translational products for clinicians and healthcare providers by an EPC (Evidence-based Practice Center) Learning Health Systems Panel convened by AHRQ. The panel, led by two national leaders and composed of key stakeholders evaluated different translational products for learning health systems and also discussed challenges in adopting evidence-based practices. They evaluated a number of different products, and decided that the one- and three-page summaries, the MAGICapp and Tableau for interactive data visualization, and clinical encounter and health system decision aids were the most useful products. As a result of their findings, the EPC Program is further developing the one- and three-page summaries and MAGICapp and Tableau data visualization products.
AHRQ-authored; AHRQ-funded; 233201500014I.
Citation: Borsky AE, Savitz LA, Bindman AB .
AHRQ series on improving translation of evidence: perceived value of translational products by the AHRQ EPC Learning Health Systems Panel.
Jt Comm J Qual Patient Saf 2019 Nov;45(11):772-78. doi: 10.1016/j.jcjq.2019.08.002..
Keywords: Implementation, Evidence-Based Practice, Patient-Centered Outcomes Research, Learning Health Systems
Reddy A, Lester CA, Stone JA
Applying participatory design to a pharmacy system intervention.
Researchers used participatory design (PD) to develop a patient-centered prototype for a community pharmacy. The stakeholders recruited for the intervention were pharmacy staff and older adult patients who received prescriptions at the pharmacy corporation involved in this study. The PD process is a series of six adaptive sessions: 1) problem identification, 2) solution generation, 3) convergence, 4) prototyping, 5) initial evaluation, and 6) formative evaluation. The sessions resulted in the development of a patient-centered community pharmacy prototype.
AHRQ-funded; HS024490.
Citation: Reddy A, Lester CA, Stone JA .
Applying participatory design to a pharmacy system intervention.
Res Social Adm Pharm 2019 Nov;15(11):1358-67. doi: 10.1016/j.sapharm.2018.11.012..
Keywords: Provider: Pharmacist, Patient-Centered Healthcare, Medication, Patient Safety
Nguyen KH, Trivedi AN
Asian American access to care in the Affordable Care Act era: findings from a population-based survey in California.
This study compared coverage and access to care between non-Hispanic White and Asian American adults after the ACA in California. The data was disaggregated into the five most populous ethnic subgroups (Chinese, Korean, Filipino, Vietnamese, and Japanese). The outcomes measured were 1) being uninsured, 2) having a usual source of care, 3) delaying necessary medical care, and 4) delaying necessary prescription medications. The sample included 19,201 non-Hispanic White and 3077 Asian American adults aged 18 to 64 in California. Koreans were significantly less likely to report a usual source of care relative to non-Hispanic whites while Chinese and Vietnamese adults were significantly less likely to delay necessary care.
AHRQ-funded; HS000011.
Citation: Nguyen KH, Trivedi AN .
Asian American access to care in the Affordable Care Act era: findings from a population-based survey in California.
J Gen Intern Med 2019 Nov;34(11):2660-68. doi: 10.1007/s11606-019-05328-5..
Keywords: Racial and Ethnic Minorities, Access to Care, Disparities, Health Insurance, Uninsured, Policy
Gartlehner G, Wagner G, Lux L
Assessing the accuracy of machine-assisted abstract screening with DistillerAI: a user study.
The goal of this project was to conduct a case study to explore a screening approach that temporarily replaces a human screener with a semi-automated screening tool. The authors used DistillerAI as a semi-automated screening tool, and a published comparative effectiveness review served as their reference standard. They found that the accuracy of DistillerAI was not yet adequate to replace a human screener temporarily during abstract screening for systematic reviews.
AHRQ-funded; 290201500011I.
Citation: Gartlehner G, Wagner G, Lux L .
Assessing the accuracy of machine-assisted abstract screening with DistillerAI: a user study.
Syst Rev 2019 Nov 15;8(1):277. doi: 10.1186/s13643-019-1221-3..
Keywords: Patient-Centered Outcomes Research, Health Services Research (HSR), Research Methodologies, Evidence-Based Practice
Lewkowitz AK, Rosenbloom JI, Keller M
Association between stillbirth >/=23 weeks gestation and acute psychiatric illness within 1 year of delivery.
This study analyzed whether women experiencing a stillbirth had a higher risk of psychiatric morbidity and/or substance misuse within 1 year of delivery compared to women having a live birth. Higher risk was found for both using data from the Florida State Inpatient and State Emergency Department databases from 2005-2014. Women with an ICD-9 classification of stillbirth at or greater than 23 weeks gestation were included. Emergency department encounters or admissions with a diagnosis code of a psychiatric disorder were used.
AHRQ-funded; HS019455.
Citation: Lewkowitz AK, Rosenbloom JI, Keller M .
Association between stillbirth >/=23 weeks gestation and acute psychiatric illness within 1 year of delivery.
Am J Obstet Gynecol 2019 Nov;221(5):491.e1-91.e22. doi: 10.1016/j.ajog.2019.06.027..
Keywords: Healthcare Cost and Utilization Project (HCUP), Maternal Care, Pregnancy, Behavioral Health, Women, Labor and Delivery
Lewkowitz AK, Rosenbloom JI, Lopez JD
Association between stillbirth at 23 weeks of gestation or greater and severe maternal morbidity.
Researchers conducted this retrospective cohort study to estimate whether stillbirth at 23 weeks of gestation or more is associated with increased risk of severe maternal morbidity compared with live birth, when stratified by maternal comorbidities. Data from HCUP’s Florida State Inpatient Database was used. The researchers found that, although severe maternal morbidity is overall uncommon, delivering a stillborn fetus at 23 weeks of gestation or greater is associated with increased likelihood of severe maternal morbidity, particularly among women with comorbidities. They conclude that health care providers must be vigilant about severe maternal morbidity during stillbirth delivery.
AHRQ-funded; HS019455.
Citation: Lewkowitz AK, Rosenbloom JI, Lopez JD .
Association between stillbirth at 23 weeks of gestation or greater and severe maternal morbidity.
Obstet Gynecol 2019 Nov;134(5):964-73. doi: 10.1097/aog.0000000000003528..
Keywords: Healthcare Cost and Utilization Project (HCUP), Pregnancy, Maternal Care, Women, Adverse Events
Sheetz KH, Chhabra KR, Smith ME
Association of discretionary hospital volume standards for high-risk cancer surgery with patient outcomes and access, 2005-2016.
Various clinical societies and patient advocacy organizations continue to encourage minimum volume standards at hospitals that perform certain high-risk operations. Although many clinicians and quality and safety experts believe this can improve outcomes, the extent to which hospitals have responded to these discretionary standards remains unclear. The purpose of this study was to evaluate the association between short-term clinical outcomes and hospitals' adherence to the Leapfrog Group's minimum volume standards for high-risk cancer surgery.
AHRQ-funded; HS000053; HS023597; HS024763.
Citation: Sheetz KH, Chhabra KR, Smith ME .
Association of discretionary hospital volume standards for high-risk cancer surgery with patient outcomes and access, 2005-2016.
JAMA Surg 2019 Nov;154(11):1005-12. doi: 10.1001/jamasurg.2019.3017..
Keywords: Patient Safety, Hospitals, Outcomes, Surgery, Cancer
Singh JA, Lemay CA, Nobel L
Association of early postoperative pain trajectories with longer-term pain outcome after primary total knee arthroplasty.
Studies to date have not comprehensively examined pain experience after total knee arthroplasty (TKA). Discrete patterns of pain in this period might be associated with pain outcomes at 6 to 12 months after TKA. The purpose of this study was to examine patterns of individual post-TKA pain trajectories and to assess their independent associations with longer-term pain outcome after TKA.
AHRQ-funded; HS021110; HS018910.
Citation: Singh JA, Lemay CA, Nobel L .
Association of early postoperative pain trajectories with longer-term pain outcome after primary total knee arthroplasty.
JAMA Netw Open 2019 Nov;2(11):e1915105. doi: 10.1001/jamanetworkopen.2019.15105..
Keywords: Pain, Surgery, Orthopedics, Patient-Centered Outcomes Research, Outcomes
Kurian S, Baloy B, Baird J
Attitudes and perceptions of naloxone dispensing among a sample of Massachusetts community pharmacy technicians.
AHRQ-funded; HS024021.
Citation: Kurian S, Baloy B, Baird J .
Attitudes and perceptions of naloxone dispensing among a sample of Massachusetts community pharmacy technicians.
J Am Pharm Assoc 2019 Nov-Dec;59(6):824-31. doi: 10.1016/j.japh.2019.08.009..
Keywords: Medication, Medication: Safety, Opioids, Substance Abuse, Provider: Pharmacist, Provider, Patient Safety
Lambert BL, Galanter W, Liu KL
Automated detection of wrong-drug prescribing errors.
Investigators assessed the specificity of an algorithm designed to detect look-alike/sound-alike (LASA) medication prescribing errors in electronic health record (EHR) data. They found that automated detection of LASA medication errors is feasible and can reveal errors not currently detected by other means. Additionally, real-time error detection is not possible with the current system. They suggested that further development should replicate their analysis in other health systems and on a larger set of medications and should decrease clinician time spent reviewing false-positive triggers by increasing specificity.
AHRQ-funded; HS021093.
Citation: Lambert BL, Galanter W, Liu KL .
Automated detection of wrong-drug prescribing errors.
BMJ Qual Saf 2019 Nov;28(11):908-15. doi: 10.1136/bmjqs-2019-009420..
Keywords: Adverse Drug Events (ADE), Adverse Events, Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Medication, Patient Safety
Kreutzer L, Yang AD, Sansone C
Barriers to providing VTE chemoprophylaxis to hospitalized patients: a nursing-focused qualitative evaluation.
This study analyzed barriers for administration of VTE chemoprophylaxis to hospitalized patients from nurses. Researchers conducted 14 focus group interviews with nurses from five inpatient units to assess their perceptions of barriers to administration of VTE chemoprophylaxis. Barriers included nurses’ misconceptions that patients did not require chemoprophylaxis, their uncertainty when counseling patients on the importance of chemoprophylaxis, and a lack of comparative data regarding specific refusal rates.
AHRQ-funded; HS024516.
Citation: Kreutzer L, Yang AD, Sansone C .
Barriers to providing VTE chemoprophylaxis to hospitalized patients: a nursing-focused qualitative evaluation.
J Hosp Med 2019 Nov 1;14(10):668-72. doi: 10.12788/jhm.3290..
Keywords: Blood Clots, Patient Safety, Prevention, Inpatient Care, Care Management, Nursing
Goyal P, Gorodeski EZ, Marcum ZA
Cardiac rehabilitation to optimize medication regimens in heart failure.
This paper discusses the use of cardiac rehabilitation (CR) to optimize medication regimens for older adults with heart failure. Challenges in CR are discussed length and strategies were offered for leveraged CR.
AHRQ-funded; HS022982.
Citation: Goyal P, Gorodeski EZ, Marcum ZA .
Cardiac rehabilitation to optimize medication regimens in heart failure.
Clin Geriatr Med 2019 Nov;35(4):549-60. doi: 10.1016/j.cger.2019.06.001..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Rehabilitation, Medication, Patient-Centered Healthcare, Patient Adherence/Compliance, Chronic Conditions