National Healthcare Quality and Disparities Report
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Topics
- Ambulatory Care and Surgery (1)
- Blood Pressure (3)
- Cardiovascular Conditions (1)
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- Chronic Conditions (8)
- Decision Making (1)
- (-) Diabetes (14)
- Education: Patient and Caregiver (1)
- Electronic Health Records (EHRs) (4)
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- Hospital Readmissions (1)
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- Provider Performance (1)
- Quality Improvement (3)
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- (-) Quality of Care (14)
- Teams (1)
- Vulnerable Populations (1)
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 14 of 14 Research Studies DisplayedJiang DH, Mundell BF, Shah ND
Impact of high deductible health plans on diabetes care quality and outcomes: systematic review.
The authors sought to provide a systematic literature review of the impact of high deductible health plans (HDHPs) on the utilizations of services required for optimal management of diabetes and subsequent health outcomes. They found that, although HDHPs reduce some health care utilization and costs, they appear to do so at the expense of limiting high-value care and medication adherence.
AHRQ-funded; HS025517; HS024075; HS025164; HS025402.
Citation: Jiang DH, Mundell BF, Shah ND .
Impact of high deductible health plans on diabetes care quality and outcomes: systematic review.
Endocr Pract 2021 Nov;27(11):1156-64. doi: 10.1016/j.eprac.2021.07.001..
Keywords: Health Insurance, Diabetes, Chronic Conditions, Outcomes, Quality of Care, Patient-Centered Outcomes Research
Rodríguez HP, Fulton BD, Phillips AZ
The early impact of the Centers for Medicare & Medicaid Services State Innovation Models Initiative on 30-day hospital readmissions among adults with diabetes.
The Centers for Medicare & Medicaid Services (CMS) State Innovation Models (SIM) Initiative funds states to accelerate delivery system and payment reforms. All SIM states focus on improving diabetes care, but SIM's effect on 30-day readmissions among adults with diabetes remains unclear. In this study, the investigators found no evidence that SIM reduced 30-day readmission rates among adults with diabetes during the first 2 years of round 1 implementation, even among CMS beneficiaries.
AHRQ-funded; HS022241.
Citation: Rodríguez HP, Fulton BD, Phillips AZ .
The early impact of the Centers for Medicare & Medicaid Services State Innovation Models Initiative on 30-day hospital readmissions among adults with diabetes.
Med Care 2020 Jun;58(6 Suppl 1):S22-s30. doi: 10.1097/mlr.0000000000001276..
Keywords: Diabetes, Chronic Conditions, Hospital Readmissions, Quality Improvement, Quality of Care
Althoff KN, Wong C, Hogan B
Mind the gap: observation windows to define periods of event ascertainment as a quality control method for longitudinal electronic health record data.
Under the hypothesis that use of electronic health records in health research may lead to false assumptions of complete event ascertainment, the authors of this article estimated "observation windows" (OWs) as a quality-control approach to reduce the likelihood of false assumption. The impact of OWs on estimating rates of type II diabetes mellitus from HIV clinical cohorts are demonstrated. Data from 16 HIV clinical cohorts to the NA-ACCORD were used to identify and evaluate OWs for an operationalized definition of diabetes occurrence. The authors conclude that OWs have utility as a quality-control approach to complete event ascertainment and help to improve the accuracy of estimates.
AHRQ-funded; 90047713.
Citation: Althoff KN, Wong C, Hogan B .
Mind the gap: observation windows to define periods of event ascertainment as a quality control method for longitudinal electronic health record data.
Ann Epidemiol 2019 May;33:54-63. doi: 10.1016/j.annepidem.2019.01.015..
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Quality of Care
Wu SS, Chan KS, Bae J
Electronic clinical reminder and quality of primary diabetes care.
The goal of this retrospective cohort study was to examine the association of EMR's clinical reminder use with a comprehensive set of diabetes quality metrics in office-based physicians and within solo- versus multi-physician practices. Data on visits made by adults with diabetes were identified from the National Ambulatory Medical Care Survey and a multiple logistic regression was used to test for associations between clinical reminder use and recommended services by the American Diabetes Association. The researchers found no statistically significant relationship that suggests clinical reminder use improves diabetes process guidelines for solo practices, and they conclude that other resource efforts are needed to reduce gaps in primary diabetes care.
AHRQ-funded; HS000029.
Citation: Wu SS, Chan KS, Bae J .
Electronic clinical reminder and quality of primary diabetes care.
Prim Care Diabetes 2019 Apr;13(2):150-57. doi: 10.1016/j.pcd.2018.08.007..
Keywords: Care Management, Chronic Conditions, Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Quality of Care
Fink JT, Magnan EM, Johnson HM
Blood pressure control and other quality of care metrics for patients with obesity and diabetes: a population-based cohort study.
In this observational population-based cohort study, the investigators sought to examine the relationship between the extent of obesity and the achievement of guideline-recommended blood pressure goals and other quality of care metrics among patients with diabetes. The investigators suggest that although the cardiovascular risk for patients with obesity and diabetes is greater than for non-obese patients with diabetes, they found that patients with obesity are even further behind in achieving blood pressure control.
AHRQ-funded; HS021899.
Citation: Fink JT, Magnan EM, Johnson HM .
Blood pressure control and other quality of care metrics for patients with obesity and diabetes: a population-based cohort study.
High Blood Press Cardiovasc Prev 2018 Dec;25(4):391-99. doi: 10.1007/s40292-018-0284-x..
Keywords: Blood Pressure, Diabetes, Quality of Care, Obesity
Fraze TK, Lewis VA, Tierney E
Quality of care improves for patients with diabetes in Medicare shared savings accountable care organizations: organizational characteristics associated with performance.
This study analyzed secondary data retrospectively to examine Medicare Shared Savings Program (MSSP) Accountable Care Organizations’ performance on diabetes metrics in the first 2 years of ACO contracts in order to determine how ACO organizational characteristics - such as composition, staffing, care management, and experiences with health reform - were associated with quality of care delivered to patients with diabetes.
AHRQ-funded; HS024075.
Citation: Fraze TK, Lewis VA, Tierney E .
Quality of care improves for patients with diabetes in Medicare shared savings accountable care organizations: organizational characteristics associated with performance.
Popul Health Manag 2018 Oct;21(5):401-08. doi: 10.1089/pop.2017.0102..
Keywords: Diabetes, Quality of Care, Medicare, Provider Performance, Quality Improvement
Nuckols TK, Keeler E, Anderson LJ
Economic evaluation of quality improvement interventions designed to improve glycemic control in diabetes: a systematic review and weighted regression analysis.
This study systematically reviewed economic evaluations of quality improvement (QI) interventions for glycemic control among adults with type 1 or type 2 diabetes. Using English-language studies from high-income countries that evaluated organizational changes and reported program and utilization-related costs, the researchers extracted data regarding intervention, study design, change in HbA1c, time horizon, perspective, incremental net cost, incremental cost-effectiveness ratio, and study quality. They conclude that diverse and multifaceted QI interventions which lower HbA1c appear to be a fair-to-good value, relative to usual care.
AHRQ-funded; HS022644.
Citation: Nuckols TK, Keeler E, Anderson LJ .
Economic evaluation of quality improvement interventions designed to improve glycemic control in diabetes: a systematic review and weighted regression analysis.
Diabetes Care 2018 May;41(5):985-93. doi: 10.2337/dc17-1495..
Keywords: Diabetes, Healthcare Costs, Quality of Care, Quality Improvement
Magnan EM, Bolt DM, Greenlee RT
Stratifying patients with diabetes into clinically relevant groups by combination of chronic conditions to identify gaps in quality of care.
The purpose of this paper was to find clinically relevant combinations of chronic conditions among patients with diabetes and to examine their relationships with six diabetes quality metrics. The researchers analyzed 12 conditions that were concordant with diabetes care to define five mutually exclusive combinations of conditions based on condition co-occurrence. They found the following condition classes: severe cardiac, cardiac, noncardiac vascular, risk factors, and no concordant comorbidities. They concluded that patients had distinct quality metric achievement by condition class, and those in less severe classes were less likely to achieve diabetes metrics.
AHRQ-funded; HS021899; HS018368.
Citation: Magnan EM, Bolt DM, Greenlee RT .
Stratifying patients with diabetes into clinically relevant groups by combination of chronic conditions to identify gaps in quality of care.
Health Serv Res 2018 Feb;53(1):450-68. doi: 10.1111/1475-6773.12607.
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Keywords: Cardiovascular Conditions, Chronic Conditions, Diabetes, Quality of Care, Quality Measures
Gunter KE, Nocon RS, Gao Y
Medical home characteristics and quality of diabetes care in safety net clinics.
The researchers examined associations between patient-centered medical home (PCMH) characteristics and quality of diabetes care in 15 safety net clinics in five states. They found that PCMH characteristics had mixed, inconsistent associations with the quality of diabetes care. The PCMH model may require refinement in design and implementation to improve diabetes care among vulnerable populations.
AHRQ-funded; HS000084.
Citation: Gunter KE, Nocon RS, Gao Y .
Medical home characteristics and quality of diabetes care in safety net clinics.
J Community Health 2017 Apr;42(2):303-11. doi: 10.1007/s10900-016-0256-9.
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Keywords: Diabetes, Patient-Centered Healthcare, Quality of Care, Chronic Conditions
Longo DR, Crabtree BF, Pellerano MB
A qualitative study of vulnerable patient views of type 2 diabetes consumer reports.
This study aims to identify whether vulnerable populations with type 2 diabetes perceive consumer reports as helpful in making decisions about diabetes care. It found that participants in 18 focus groups expressed minimal interest in currently available consumer reports. They instead listed personal referrals and interpersonal interactions among the most important factors when choosing a physician.
AHRQ-funded; HS021902.
Citation: Longo DR, Crabtree BF, Pellerano MB .
A qualitative study of vulnerable patient views of type 2 diabetes consumer reports.
Patient 2016 Jun;9(3):231-40. doi: 10.1007/s40271-015-0146-8..
Keywords: Education: Patient and Caregiver, Decision Making, Diabetes, Quality of Care, Vulnerable Populations
Graetz I, Huang J, Brand R
The impact of electronic health records and teamwork on diabetes care quality.
The researchers examined whether team cohesion among primary care team members changed the association between EHR use and changes in clinical outcomes for patients with diabetes. They found that patients cared for by higher cohesion primary care teams experienced modest but statistically significantly greater EHR-related health outcome improvements, compared with patients cared for by providers practicing in lower cohesion teams.
AHRQ-funded; HS015280; HS021082.
Citation: Graetz I, Huang J, Brand R .
The impact of electronic health records and teamwork on diabetes care quality.
Am J Manag Care 2015 Dec;21(12):878-84.
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Keywords: Diabetes, Electronic Health Records (EHRs), Quality of Care, Primary Care, Teams
Magnan EM, Palta M, Pandhi N
The relationship of individual comorbid chronic conditions to diabetes care quality.
The aim of this study was to determine which chronic conditions were related to lack of achievement or achievement of diabetes care quality goals to determine potential targets for future interventions. It found that 62 chronic conditions varied in their relationships to diabetes care goal achievement for specific care goals. For example, congestive heart failure was related to lack of achievement of cholesterol management goals.
AHRQ-funded; HS018368; HS021899.
Citation: Magnan EM, Palta M, Pandhi N .
The relationship of individual comorbid chronic conditions to diabetes care quality.
BMJ Open Diabetes Res Care 2015 Jul 23;3(1):e000080. doi: 10.1136/bmjdrc-2015-000080..
Keywords: Care Management, Chronic Conditions, Diabetes, Quality of Care
Benkert R, Dennehy P, White J
Diabetes and hypertension quality measurement in four safety-net sites: lessons learned after implementation of the same commercial electronic health record.
The authors described what implementation of a commercially available EHR with built-in quality query algorithms showed us about our care for diabetes and hypertension populations in four safety net clinics. They found that utilizing a shared EHR, a Regional Extension Center-like partnership model, and similar quality query algorithms allowed safety-net clinics to benchmark and improve the quality of care across differing patient populations and health care delivery models.
AHRQ-funded; HS017191.
Citation: Benkert R, Dennehy P, White J .
Diabetes and hypertension quality measurement in four safety-net sites: lessons learned after implementation of the same commercial electronic health record.
Appl Clin Inform 2014 Aug 20;5(3):757-72. doi: 10.4338/aci-2014-03-ra-0019.
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Keywords: Diabetes, Blood Pressure, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality of Care, Chronic Conditions
Navar-Boggan AM, Fanaroff A, Swaminathan A
The impact of a measurement and feedback intervention on blood pressure control in ambulatory cardiology practice.
This study evaluated the impact of a targeted provider feedback intervention on rates of blood pressure control. Providers received quarterly provider-specific reports over a period of one year for a group of 300 patients treated in outpatient cardiology clinic practices. These reports as a stand-alone intervention did not affect overall BP control rates in cardiology clinics.
AHRQ-funded; HS021092
Citation: Navar-Boggan AM, Fanaroff A, Swaminathan A .
The impact of a measurement and feedback intervention on blood pressure control in ambulatory cardiology practice.
Am Heart J. 2014 Apr;167(4):466-71. doi: 10.1016/j.ahj.2013.12.015..
Keywords: Blood Pressure, Ambulatory Care and Surgery, Diabetes, Chronic Conditions, Quality Measures, Quality of Care