National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Asthma (1)
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- Comparative Effectiveness (1)
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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
1 to 6 of 6 Research Studies DisplayedCallejo-Black A, Wagner DV, Ramanujam K
A systematic review of external validity in pediatric integrated primary care trials.
This study used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to conduct a systematic review of external validity reporting in integrated primary care (IPC) interventions for mental health concerns. A literature search was conducted to identify relevant literature from 1998 to 2018 reporting on open, randomized or quasi-randomized trials of IPC interventions that targeted child (ages 0-18 years) psychological symptoms. The authors included 39 publications describing 25 studies in the review. Publications rarely reported indicators of external validity, including the representatives of participants (12%), rate of adoption clinics or providers (16%), cost of implementation (8%), or evidence of maintenance (16%). Few studies also included key pragmatic factors such as cost or organizational change processes related to implementation and maintenance.
AHRQ-funded; HS022981.
Citation: Callejo-Black A, Wagner DV, Ramanujam K .
A systematic review of external validity in pediatric integrated primary care trials.
J Pediatr Psychol 2020 Oct 1;45(9):1039-52. doi: 10.1093/jpepsy/jsaa068..
Keywords: Children/Adolescents, Primary Care, Behavioral Health, Healthcare Delivery, Evidence-Based Practice, Health Services Research (HSR), Research Methodologies
Kaiser SV, Johnson MD, Walls TA
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
This quality improvement study’s aim was to determine the effects of pediatric asthma pathway implementation in a diverse, national sample of emergency departments (EDs). Desired outcomes included systemic corticosteroid administration within 60 minutes (primary), assessment of severity at ED triage, chest radiograph use, hospital admission or transfer for higher level of care, and ED length of stay. Charts were reviewed each month by EDs for children ages 2-17 years with a primary diagnosis of asthma. A total of 83 EDs were enrolled, with 37 of them children’s hospitals, and 46 community hospitals. Seventy-three percent completed the study (n = 22,963). There was a significant increase in systematic corticosteroid administration within 60 minutes of arrival as well as increased odds of severity assessment at triage and decreased rate of change in odds of hospital admission/transfer. Chest radiograph or ED length of stay was not associated with pathway implementation.
AHRQ-funded; HS024592.
Citation: Kaiser SV, Johnson MD, Walls TA .
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
J Pediatr 2020 Aug;223:100-07.e2. doi: 10.1016/j.jpeds.2020.02.080..
Keywords: Children/Adolescents, Emergency Department, Asthma, Quality Improvement, Quality of Care, Care Management, Healthcare Delivery, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Friedman Peahl A, Heisler M, Essenmacher LK
A comparison of international prenatal care guidelines for low-risk women to inform high-value care.
The authors compared U.S. to international prenatal care consensus guidelines for low-risk women to inform care delivery reforms. They found that U.S. and peer-country guidelines recommended similar prenatal education and psychosocial services for low-risk women; however, peer countries generally recommended fewer visits, longer intervals between visits, and less reliance on obstetrician-gynecologists for routine, low-risk prenatal care. They recommended that further investigation evaluate associations between recommended care and actual practice, as well as the effects of different components of prenatal care and delivery models on maternal-infant outcomes, patient-centeredness, and health care expenditures in the U.S.
AHRQ-funded; HS025465.
Citation: Friedman Peahl A, Heisler M, Essenmacher LK .
A comparison of international prenatal care guidelines for low-risk women to inform high-value care.
Am J Obstet Gynecol 2020 May;222(5):505-07. doi: 10.1016/j.ajog.2020.01.021..
Keywords: Maternal Care, Pregnancy, Women, Guidelines, Evidence-Based Practice, Healthcare Delivery
Persell SD, Liss DT, Walunas TL
Effects of 2 forms of practice facilitation on cardiovascular prevention in primary care: a practice-randomized, comparative effectiveness trial.
Effective quality improvement (QI) strategies are needed for small practices. The objective of this study was to compare practice facilitation implementing point-of-care (POC) QI strategies alone versus facilitation implementing point-of-care plus population management (POC+PM) strategies on preventive cardiovascular care. The investigators concluded that facilitator-led QI promoting population management approaches plus POC improvement strategies was not clearly superior to POC strategies alone.
AHRQ-funded; HS023921.
Citation: Persell SD, Liss DT, Walunas TL .
Effects of 2 forms of practice facilitation on cardiovascular prevention in primary care: a practice-randomized, comparative effectiveness trial.
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Keywords: Cardiovascular Conditions, Prevention, Primary Care: Models of Care, Primary Care, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Quality Improvement, Quality of Care, Care Management, Healthcare Delivery
Sweeney SM, Hemler JR, Baron AN
Dedicated workforce required to support large-scale practice improvement.
Facilitation is an effective approach for helping practices implement sustainable evidence-based practice improvements. Few studies examine the facilitation infrastructure and support needed for large-scale dissemination and implementation initiatives. In this paper, the authors discuss a project by the Agency for Health care Research and Quality in which it funded 7 Cooperatives, each of which worked with over 200 primary care practices to rapidly disseminate and implement improvements in cardiovascular preventive care.
AHRQ-funded; HS023940.
Citation: Sweeney SM, Hemler JR, Baron AN .
Dedicated workforce required to support large-scale practice improvement.
J Am Board Fam Med 2020 Mar-Apr;33(2):230-39. doi: 10.3122/jabfm.2020.02.190261..
Keywords: Practice Improvement, Primary Care, Cardiovascular Conditions, Healthcare Delivery, Quality Improvement, Quality of Care, Prevention, Implementation, Evidence-Based Practice
Guise JM, Reid E, Fiordalisi CV
AHRQ Author: Borsky A, Chang S
AHRQ series on improving translation of evidence: progress and promise in supporting learning health systems.
The authors discuss the articles in the AHRQ EPC series published in this journal over the past six months. They state that satisfaction, care, and costs would all improve if health care delivery were as efficient and effective as possible given current knowledge. They conclude that millions of health decisions must be made by clinicians, patients, and health care systems, and they believe better decisions will be made with evidence.
AHRQ-authored; AHRQ-funded; 290201700003C.
Citation: Guise JM, Reid E, Fiordalisi CV .
AHRQ series on improving translation of evidence: progress and promise in supporting learning health systems.
Jt Comm J Qual Patient Saf 2020 Jan;46(1):51-52. doi: 10.1016/j.jcjq.2019.10.008..
Keywords: Implementation, Evidence-Based Practice, Learning Health Systems, Health Systems, Healthcare Delivery, Decision Making