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
Topics
- Adverse Events (3)
- Blood Clots (1)
- Cardiovascular Conditions (1)
- Caregiving (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (3)
- Decision Making (4)
- Disparities (1)
- Education: Patient and Caregiver (4)
- Elderly (2)
- Emergency Department (1)
- Falls (1)
- Healthcare Costs (1)
- Health Services Research (HSR) (1)
- Heart Disease and Health (2)
- Hospitals (3)
- Injuries and Wounds (1)
- Long-Term Care (1)
- Maternal Care (1)
- Medical Errors (2)
- Medicare (2)
- Nursing Homes (4)
- Outcomes (2)
- Palliative Care (1)
- Patient and Family Engagement (1)
- Patient Experience (2)
- Patient Safety (2)
- Payment (2)
- Policy (4)
- Pregnancy (1)
- Primary Care (2)
- Provider: Health Personnel (1)
- Provider Performance (8)
- (-) Public Reporting (24)
- Quality Improvement (5)
- Quality Indicators (QIs) (5)
- Quality Measures (5)
- (-) Quality of Care (24)
- Racial and Ethnic Minorities (1)
- Surgery (3)
- Vulnerable Populations (1)
- Web-Based (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 24 of 24 Research Studies DisplayedSanghavi P, Pan S, Caudry D
Assessment of nursing home reporting of major injury falls for quality measurement on Nursing Home Compare.
The purpose of this study was to assess the accuracy of nursing home self-report of major injury falls on the Minimum Data Set (MDS). They linked inpatient claims for major injury falls with MDS assessments. The investigators concluded that the nursing home-reported data used for the Nursing Home Compare (NHC) falls measure may be highly inaccurate.
AHRQ-funded; HS026957.
Citation: Sanghavi P, Pan S, Caudry D .
Assessment of nursing home reporting of major injury falls for quality measurement on Nursing Home Compare.
Health Serv Res 2020 Apr;55(2):201-10. doi: 10.1111/1475-6773.13247..
Keywords: Falls, Nursing Homes, Quality Measures, Quality Indicators (QIs), Quality of Care, Elderly, Public Reporting, Injuries and Wounds
Schlesinger MJ, Rybowski L, Shaller D
Americans' growing exposure to clinician quality information: insights and implications.
The authors of this article examined the impact of changes in the growth of consumer information seeking and the availability of patient narratives about care on consumer awareness of quality information and sociodemographic differences. Public exposure to quality information of any type doubled between 2010 and 2015, ad exposure to patient narratives and experience surveys tripled. Minority consumers were better informed than whites consistently over this period, although there were differences across subgroups regarding the types of information encountered. An education-related gradient in quality awareness also emerged. The authors conclude that public policy should respond to these emerging trends in information exposure by establishing standards for rigorous elicitation of narratives and assisting consumer learning via a combination of narratives and quantified clinician quality metrics.
AHRQ-funded; HS016978; HS016980; HS021858.
Citation: Schlesinger MJ, Rybowski L, Shaller D .
Americans' growing exposure to clinician quality information: insights and implications.
Health Aff 2019 Mar;38(3):374-82. doi: 10.1377/hlthaff.2018.05006..
Keywords: Policy, Provider Performance, Public Reporting, Quality of Care, Quality Measures
Hefele JG, Ritter GA, Bishop CE
Examining racial and ethnic differences in nursing home quality.
The authors measured within-facility differences for a range of publicly reported nursing home quality measures. They found that, on average, care is delivered equally across all racial/ethnic groups in the same nursing home. They concluded that nursing home providers should attempt to identify racial/ethnic within-facility differences in care.
AHRQ-funded; HS021891.
Citation: Hefele JG, Ritter GA, Bishop CE .
Examining racial and ethnic differences in nursing home quality.
Jt Comm J Qual Patient Saf 2017 Nov;43(11):554-64. doi: 10.1016/j.jcjq.2017.06.003.
.
.
Keywords: Disparities, Quality of Care, Nursing Homes, Racial and Ethnic Minorities, Public Reporting
Goff SL, Mazor KM, Pekow PS
Patient navigators and parent use of quality data: a randomized trial.
The authors explored the effectiveness of strategies to overcome barriers in vulnerable populations. They found that an intervention to reduce barriers to using publicly reported health care quality data had a modest effect on patient choice, suggesting that factors other than performance on common publicly reported quality metrics have a stronger influence on which pediatric practices women choose.
AHRQ-funded; HS021864.
Citation: Goff SL, Mazor KM, Pekow PS .
Patient navigators and parent use of quality data: a randomized trial.
Pediatrics 2016 Oct;138(4). doi: 10.1542/peds.2016-1140.
.
.
Keywords: Decision Making, Quality of Care, Public Reporting, Quality Indicators (QIs), Vulnerable Populations
Coulam R, Kralewski J, Dowd B
The role of medical group practice administrators in the adoption and implementation of Medicare's physician quality reporting system.
The purpose of this study was to gain insights into the role these administrators play in quality assurance programs. It found that administrators conducted due diligence on Medicare's physician quality reporting system, influenced how the issue was presented to physicians for adoption, and managed implementation thereafter. Administrators' recommendations were heavily influenced by practice characteristics, financial incentives, and practice commitments to early adoption of quality improvement innovations.
AHRQ-funded; HS019964.
Citation: Coulam R, Kralewski J, Dowd B .
The role of medical group practice administrators in the adoption and implementation of Medicare's physician quality reporting system.
Health Care Manage Rev 2016 Apr-Jun;41(2):145-54. doi: 10.1097/hmr.0000000000000061.
.
.
Keywords: Medicare, Provider Performance, Quality Improvement, Quality of Care, Public Reporting
Maurer M, Firminger K, Dardees P
Understanding consumer perceptions and awareness of hospital-based maternity care quality measures.
This study explored factors that may influence use of comparative public reports for hospital maternity care. It found that, when describing high-quality maternity care, participants focused on interactions with providers, including respect for preferences and communication. The importance of quality measures was influenced by the extent to which they focused on babies' health, were perceived as the hospital's responsibility, and were perceived as representing "standard care."
AHRQ-funded; HS021873.
Citation: Maurer M, Firminger K, Dardees P .
Understanding consumer perceptions and awareness of hospital-based maternity care quality measures.
Health Serv Res 2016 Jun;51 Suppl 2:1188-211. doi: 10.1111/1475-6773.12472.
.
.
Keywords: Maternal Care, Pregnancy, Patient Experience, Quality Measures, Quality of Care, Public Reporting
McConnell KJ, Lindrooth RC, Wholey DR
Modern management practices and hospital admissions.
The researchers investigated whether the modern management practices and publicly reported performance measures are associated with choice of hospital for patients with acute myocardial infarction (AMI). They found that, overall, a one standard deviation change in management practice scores is associated with an 8% increase in AMI admissions.
AHRQ-funded; HS018466.
Citation: McConnell KJ, Lindrooth RC, Wholey DR .
Modern management practices and hospital admissions.
Health Econ 2016 Apr;25(4):470-85. doi: 10.1002/hec.3171.
.
.
Keywords: Hospitals, Heart Disease and Health, Cardiovascular Conditions, Quality Indicators (QIs), Quality Measures, Quality of Care, Public Reporting, Provider Performance
Konetzka RT, Perraillon MC
Use of Nursing Home Compare website appears limited by lack of awareness and initial mistrust of the data.
The researchers used a qualitative assessment of how consumers select nursing homes and of the role of information about quality, using semistructured interviews of people who recently placed a family member or friend in a nursing home. They found that consumers had a positive reaction when shown Nursing Home Compare; however, its use appeared to be limited by lack of awareness and, to some extent, initial lack of trust of the data.
AHRQ-funded; HS021877.
Citation: Konetzka RT, Perraillon MC .
Use of Nursing Home Compare website appears limited by lack of awareness and initial mistrust of the data.
Health Aff 2016 Apr;35(4):706-13. doi: 10.1377/hlthaff.2015.1377.
.
.
Keywords: Nursing Homes, Public Reporting, Web-Based, Quality of Care, Education: Patient and Caregiver
Elliott MN, Cohea CW, Lehrman WG
Accelerating improvement and narrowing gaps: trends in patients' experiences with hospital care reflected in HCAHPS public reporting.
The researchers describe the experiences of over 4 million patients discharged from hospitals that participated in the second and fifth years of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) public reporting and assess the changes in HCAHPS scores across different types of hospital and patient groups. They found that HCAHPS scores increased by 2.8 percentage points from 2008 to 2011 in the most positive response category.
AHRQ-funded; HS016978.
Citation: Elliott MN, Cohea CW, Lehrman WG .
Accelerating improvement and narrowing gaps: trends in patients' experiences with hospital care reflected in HCAHPS public reporting.
Health Serv Res 2015 Dec;50(6):1850-67. doi: 10.1111/1475-6773.12305..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Quality of Care, Public Reporting
Schlesinger M, Grob R, Shaller D
Using patient-reported information to improve clinical practice.
The purposes of this study were to assess what is known about the relationship between patient experience measures and incentives designed to improve care, and to identify how public policy and medical practices can promote patient-valued outcomes in health systems with strong financial incentives. It concluded that unless public policies are attentive to patients' perspectives, stronger financial incentives for clinicians can threaten aspects of care that patients most value.
AHRQ-funded.
Citation: Schlesinger M, Grob R, Shaller D .
Using patient-reported information to improve clinical practice.
Health Serv Res 2015 Dec;50 Suppl 2:2116-54. doi: 10.1111/1475-6773.12420.
.
.
Keywords: Quality Improvement, Quality of Care, Patient Experience, Provider Performance, Policy, Payment, Public Reporting
Okafor NG, Doshi PB, Miller SK
Voluntary medical incident reporting tool to improve physician reporting of medical errors in an emergency department.
A web-based, password-protected tool was developed by members of a quality assurance committee for ED providers to report incidents that they believe could impact patient safety. The researchers found that the utilization of this system in one residency program with two academic sites resulted in an increase from 81 reported incidents in 2009, the first year of use, to 561 reported incidents in 2012.
AHRQ-funded; HS017586.
Citation: Okafor NG, Doshi PB, Miller SK .
Voluntary medical incident reporting tool to improve physician reporting of medical errors in an emergency department.
West J Emerg Med 2015 Dec;16(7):1073-8. doi: 10.5811/westjem.2015.8.27390.
.
.
Keywords: Emergency Department, Adverse Events, Medical Errors, Patient Safety, Public Reporting, Quality of Care
Mukamel DB, Ye Z, Glance LG
Does mandating nursing home participation in quality reporting make a difference? Evidence from Massachusetts.
This study investigated one of the mechanisms that may detract from the effectiveness of quality report cards: voluntary versus mandatory participation of nursing homes in public quality reporting. It found that once reporting became mandatory, nonvolunteers improved more than volunteers in all but 2 staffing measures.
AHRQ-funded; HS021844.
Citation: Mukamel DB, Ye Z, Glance LG .
Does mandating nursing home participation in quality reporting make a difference? Evidence from Massachusetts.
Med Care 2015 Aug;53(8):713-9. doi: 10.1097/mlr.0000000000000390..
Keywords: Nursing Homes, Long-Term Care, Public Reporting, Provider Performance, Quality Improvement, Quality of Care, Quality Indicators (QIs), Quality Measures, Elderly
Schulz J, DeCamp M, Berkowitz SA
Medicare Shared Savings Program: public reporting and shared savings distributions.
The objectives of this paper are to determine if Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) are meeting public reporting requirements related to shared savings plans, to quantitate the composition of shared savings distribution plans, and to investigate whether early ACO success is associated with specific plan or ACO characteristics. The authors found that just over one-half of MSSP ACOs report detailed shared savings distribution plans online, and these plans vary widely. They concluded that there appears to be no single shared savings distribution plan determinate of ACO success.
AHRQ-funded; HS023684.
Citation: Schulz J, DeCamp M, Berkowitz SA .
Medicare Shared Savings Program: public reporting and shared savings distributions.
Am J Manag Care 2015 Aug;21(8):546-53.
.
.
Keywords: Quality of Care, Payment, Policy, Medicare, Public Reporting
Crane S, Sloane PD, Elder N
Reporting and using near-miss events to improve patient safety in diverse primary care practices: a collaborative approach to learning from our mistakes.
This study assessed the feasibility of a near-miss reporting system in primary care practices and to describe initial reports and practice responses to them. It found that all 7 practices successfully implemented the system, reporting 632 near-miss events in 9 months and initiating 32 quality improvement projects based on the reports.
AHRQ-funded; HS019558.
Citation: Crane S, Sloane PD, Elder N .
Reporting and using near-miss events to improve patient safety in diverse primary care practices: a collaborative approach to learning from our mistakes.
J Am Board Fam Med 2015 Jul-Aug;28(4):452-60. doi: 10.3122/jabfm.2015.04.140050..
Keywords: Adverse Events, Medical Errors, Patient Safety, Primary Care, Public Reporting, Quality Improvement, Quality of Care
Smith B, McDuff J, Naierman N
What consumers want to know about quality when choosing a hospice provider.
This study drew on focus group and survey data collected in 5 metropolitan areas to learn more about hospice quality data. The researchers found that participants placed top priority on measures related to pain and symptom management. The National Quality Forum-approved measures resonate well with consumers, who also appear to be ready for access to data on the quality of hospice providers.
AHRQ-funded; HS021870.
Citation: Smith B, McDuff J, Naierman N .
What consumers want to know about quality when choosing a hospice provider.
Am J Hosp Palliat Care 2015 Jun;32(4):393-400. doi: 10.1177/1049909114524475.
.
.
Keywords: Caregiving, Education: Patient and Caregiver, Decision Making, Palliative Care, Provider Performance, Public Reporting, Quality of Care, Quality Indicators (QIs)
Minami CA, Dahlke A, Bilimoria KY
Public reporting in surgery: an emerging opportunity to improve care and inform patients.
The authors reviewed the benefits and concerns surrounding public reporting and then suggested some possible solutions to these problems in a stride toward better implementation and utilization of public reporting to improve surgical outcomes. They concluded that, although there are problems with the current approach, continual refinement of public reporting systems has the potential to provide individualized, relevant data that would not only lend a sense of agency to the American public but also motivate hospitals to engage in meaningful quality improvement.
AHRQ-funded; HS021857.
Citation: Minami CA, Dahlke A, Bilimoria KY .
Public reporting in surgery: an emerging opportunity to improve care and inform patients.
Ann Surg 2015 Feb;261(2):241-2. doi: 10.1097/sla.0000000000001033.
.
.
Keywords: Quality of Care, Outcomes, Public Reporting, Quality Improvement, Surgery
Dor A, Encinosa WE, Carey K
AHRQ Author: Encinosa WE
Medicare's Hospital Compare quality reports appear to have slowed price increases for two major procedures.
The researchers investigated whether public reporting of hospital quality, as done through Medicare’s public reporting initiative, Hospital Compare, has an impact on the pricing of hospital services for the privately insured. In their examination of 2 common and expensive procedures, coronary artery bypass graft and percutaneous coronary intervention, they found that Hospital Compare exerted a downward pressure on prices in States lacking quality report cards of their own.
AHRQ-authored; AHRQ-funded; HS023610
Citation: Dor A, Encinosa WE, Carey K .
Medicare's Hospital Compare quality reports appear to have slowed price increases for two major procedures.
Health Aff. 2015 Jan;34(1):71-7. doi: 10.1377/hlthaff.2014.0263..
Keywords: Healthcare Costs, Quality of Care, Heart Disease and Health, Public Reporting, Surgery
Mukamel DB, Haeder SF, Weimer DL
Top-down and bottom-up approaches to health care quality: the impacts of regulation and report cards.
The authors reviewed the extant literature on regulation and report cards. They found evidence of both functional and dysfunctional effects and identified the areas in which additional research would most likely be valuable.
AHRQ-funded; HS021844.
Citation: Mukamel DB, Haeder SF, Weimer DL .
Top-down and bottom-up approaches to health care quality: the impacts of regulation and report cards.
Annu Rev Public Health 2014;35:477-97. doi: 10.1146/annurev-publhealth-082313-115826.
.
.
Keywords: Quality of Care, Policy, Policy, Public Reporting
Schlesinger M, Kanouse DE, Martino SC
Complexity, public reporting, and choice of doctors: a look inside the blackest box of consumer behavior.
The authors identified four pathways through which complexity may impair consumer choice. They examined these pathways using data from an experiment in which consumers hypothetically selected a primary care physician. They found that some of the loss of decision quality accompanying more complex choice sets can be explained by consumers' skills and decision-making style, but even after accounting for these factors, complexity undermines the quality of decision making in ways that cannot be fully explained. They concluded by discussing implications for report designers, sponsors, and policy makers aspiring to promote consumer empowerment and health care quality.
AHRQ-funded; HS016978; HS016980.
Citation: Schlesinger M, Kanouse DE, Martino SC .
Complexity, public reporting, and choice of doctors: a look inside the blackest box of consumer behavior.
Med Care Res Rev 2014 Oct;71(5 Suppl):38s-64s. doi: 10.1177/1077558713496321.
.
.
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Decision Making, Quality of Care, Primary Care, Public Reporting
Shaller D, Kanouse DE, Schlesinger M
Context-based strategies for engaging consumers with public reports about health care providers.
The authors identified three key factors influencing consumer engagement and showed how they manifest in different ways and combinations for four particular choice contexts that appear to offer realistic opportunities for engagement. They also analyzed how these engagement factors play out differently in each choice context and suggest specific strategies that sponsors of public reports can use in each context.
AHRQ-funded; HS016978; HS016980.
Citation: Shaller D, Kanouse DE, Schlesinger M .
Context-based strategies for engaging consumers with public reports about health care providers.
Med Care Res Rev 2014 Oct;71(5 Suppl):17s-37s. doi: 10.1177/1077558713493118.
.
.
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Patient and Family Engagement, Public Reporting
Damberg CL, McNamara P
AHRQ Author: McNamara P
Postscript: research agenda to guide the next generation of public reports for consumers.
The authors identified five areas for additional public reporting tools research that, if addressed, could foster better design and delivery of quality and cost information to consumers.
AHRQ-authored.
Citation: Damberg CL, McNamara P .
Postscript: research agenda to guide the next generation of public reports for consumers.
Med Care Res Rev 2014 Oct;71(5 Suppl):97s-107s. doi: 10.1177/1077558714535982.
.
.
Keywords: Education: Patient and Caregiver, Decision Making, Quality of Care, Health Services Research (HSR), Public Reporting
Hussey PS, Luft HS, McNamara P
AHRQ Author: McNamara P
Public reporting of provider performance at a crossroads in the United States: summary of current barriers and recommendations on how to move forward.
The authors presented a vision statement and 10 recommendations for public reports to achieve their potential for engaging and informing consumers.
AHRQ-authored; AHRQ-funded.
Citation: Hussey PS, Luft HS, McNamara P .
Public reporting of provider performance at a crossroads in the United States: summary of current barriers and recommendations on how to move forward.
Med Care Res Rev 2014 Oct;71(5 Suppl):5s-16s. doi: 10.1177/1077558714535980.
.
.
Keywords: Education: Patient and Caregiver, Quality of Care, Provider: Health Personnel, Provider Performance, Public Reporting
Ju MH, Chung JW, Kinnier CV
Association between hospital imaging use and venous thromboembolism events rates based on clinical data.
This study assessed the presence and extent of venous thromboembolism (VTE) surveillance bias using high-quality clinical data from 208 hospitals. It concluded that hospitals may be unfairly deemed poor performers for the outcome VTE measure if they have increased vigilance for VTE by performing more VTE imaging studies that result in higher VTE event rates.
AHRQ-funded; HS021857
Citation: Ju MH, Chung JW, Kinnier CV .
Association between hospital imaging use and venous thromboembolism events rates based on clinical data.
Ann Surg. 2014 Sep; 260(3):558-64; discussion 64-6. doi: 10.1097/sla.0000000000000897..
Keywords: Blood Clots, Public Reporting, Adverse Events, Outcomes, Quality of Care
Sherman KL, Gordon EJ, Mahvi DM
Surgeons' perceptions of public reporting of hospital and individual surgeon quality.
This study (1) evaluated surgeons’ perceptions of public reporting of surgical quality; and (2) identified specific barriers to surgeons’ acceptance of public reporting. It found that surgeons are generally in favor of public reporting, but that they continue to have substantive concerns, particularly with respect to reporting individual level outcomes data.
AHRQ-funded; HS021857.
Citation: Sherman KL, Gordon EJ, Mahvi DM .
Surgeons' perceptions of public reporting of hospital and individual surgeon quality.
Med Care 2013 Dec;51(12):1069-75. doi: 10.1097/mlr.0000000000000013..
Keywords: Public Reporting, Quality of Care, Hospitals, Surgery, Provider Performance