National Healthcare Quality and Disparities Report
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- Asthma (1)
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- Children/Adolescents (1)
- Chronic Conditions (1)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- (-) Disparities (9)
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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 9 of 9 Research Studies DisplayedAgniel D, Cabreros I, Damberg CL
A formal framework for incorporating equity into health care quality measurement.
This paper examines how tying incentives on the basis of stratification or disparities in quality measurement may have unintended consequences or limited effects. Addressing one aspect of equity may be in competition with addressing others. The authors proposed equity weighting, a new measurement framework to advance equity on multiple fronts that addresses the shortcomings of existing approaches and explicitly calibrates incentives to align with equity goals. They used colorectal cancer screening data derived from 2017 Medicare claims to illustrate how equity weighting fixes unintended consequences in other methods and how it can be adapted to policy goals.
AHRQ-funded; HS024067.
Citation: Agniel D, Cabreros I, Damberg CL .
A formal framework for incorporating equity into health care quality measurement.
Health Aff 2023 Oct; 42(10):1383-91. doi: 10.1377/hlthaff.2022.01483..
Keywords: Quality Measures, Quality Improvement, Quality of Care, Disparities
Griesemer I, Birken SA, Rini C
Mechanisms to enhance racial equity in health care: developing a model to facilitate translation of the ACCURE intervention.
The purpose of this study was to explore the Accountability for Cancer Care through Undoing Racism and Equity (ACCURE) program, which altered systems of care at two United States cancer centers and eliminated the Black-White racial disparity in treatment completion in patients with early-stage breast and lung cancer. The study objective was to identify and document critical characteristics of ACCURE to enable translation of the intervention to other care settings. The researchers conducted semi-structured interviews with 18 participants who were involved in the design and implementation of ACCURE. The study found that participants described transparency and accountability as mechanisms of change that were operationalized through ACCURE's key features. Intervention features were designed to improve either institutional transparency or accountability of the care system to community values and patient needs for minimally biased, tailored communication, and support.
AHRQ-funded; HS000032.
Citation: Griesemer I, Birken SA, Rini C .
Mechanisms to enhance racial equity in health care: developing a model to facilitate translation of the ACCURE intervention.
SSM Qual Res Health 2023 Jun; 3:100204. doi: 10.1016/j.ssmqr.2022.100204..
Keywords: Racial and Ethnic Minorities, Disparities, Quality Improvement, Quality of Care
Radhakrishnan A, Reyes-Gastelum D, Abrahamse P
Physician specialties involved in thyroid cancer diagnosis and treatment: implications for improving health care disparities.
The authors sought to characterize providers involved in diagnosing and treating thyroid cancer. Patients with differentiated thyroid cancer from the Georgia and Los Angeles County Surveillance, Epidemiology and End Results registries were surveyed. The authors found that, among thyroid cancer patients, 40.6% reported being informed of their diagnosis by their surgeon, 37.9% by their endocrinologist, and 13.5% by their primary care physician (PCP). The researchers concluded that PCPs were involved in thyroid cancer diagnosis and treatment, and their involvement was greater among older patients and patients of minority race/ethnicity.
AHRQ-funded; HS024512.
Citation: Radhakrishnan A, Reyes-Gastelum D, Abrahamse P .
Physician specialties involved in thyroid cancer diagnosis and treatment: implications for improving health care disparities.
J Clin Endocrinol Metab 2022 Feb 17;107(3):e1096-e105. doi: 10.1210/clinem/dgab781..
Keywords: Cancer, Disparities, Diagnostic Safety and Quality, Practice Patterns, Quality Improvement, Quality of Care
O'Kane M, Agrawal S, Binder L
AHRQ Author: Meyers D
An equity agenda for the field of health care quality improvement.
The authors of this paper assert that the U.S. health system must take action to centralize equity, particularly racial equity (including ethnicity), in discussions of quality. In this discussion paper, the authors provide an analysis and delineation of the key elements of their racial equity agenda for the field of health care quality improvement.
AHRQ-authored.
Citation: O'Kane M, Agrawal S, Binder L .
An equity agenda for the field of health care quality improvement.
NAM Perspect 2021 Sep 15;2021. doi: 10.31478/202109b..
Keywords: Quality Improvement, Quality of Care, Racial and Ethnic Minorities, Disparities, Social Determinants of Health
Markovitz AA, Ayanian JZ, Warrier A
Medicare Advantage plan double bonuses drive racial disparity in payments, yield no quality or enrollment improvements.
Using national data for 2008-18, investigators found that double bonuses were not associated with either improvements in plan quality or increased Medicare Advantage enrollment. Additionally, double bonuses increased payments to plans to care for Black beneficiaries by $60 per year, compared with $91 for White beneficiaries. These findings suggest that double bonuses not only fail to improve quality and enrollment but also foster a racially inequitable distribution of Medicare funds that disfavors Black beneficiaries. This study supports eliminating double bonuses, thereby saving Medicare an estimated $1.8 billion per year.
AHRQ-funded; HS000053.
Citation: Markovitz AA, Ayanian JZ, Warrier A .
Medicare Advantage plan double bonuses drive racial disparity in payments, yield no quality or enrollment improvements.
Health Aff 2021 Sep;40(9):1411-19. doi: 10.1377/hlthaff.2021.00349..
Keywords: Medicare, Health Insurance, Payment, Quality Improvement, Quality of Care, Disparities, Racial and Ethnic Minorities
Schechter SB, Pantell MS, Parikh K
Impact of a national quality collaborative on pediatric asthma care quality by insurance status.
The objective of this study was to assess whether disparities in asthma care and outcomes based on insurance type existed before a national quality improvement (QI) collaborative, and to determine the effects of the collaborative on these disparities. The investigators concluded that at baseline, children with public insurance had higher asthma health care utilization than those with private insurance, despite receiving more evidence-based care.
AHRQ-funded; HS026383; HS024554; HS024592.
Citation: Schechter SB, Pantell MS, Parikh K .
Impact of a national quality collaborative on pediatric asthma care quality by insurance status.
Acad Pediatr 2021 Aug;21(6):1018-24. doi: 10.1016/j.acap.2021.02.009..
Keywords: Children/Adolescents, Asthma, Chronic Conditions, Disparities, Quality Improvement, Quality of Care, Health Insurance
Desai NR, Udell JA, Wang Y
Trends in performance and opportunities for improvement on a composite measure of acute myocardial infarction care.
This study sought to examine trends in patient- and hospital-level performance on a composite defect-free care measure, identify disparities in the performance across sociodemographic groups, and identify opportunities to improve quality and outcomes. Using data from the Chest Pain - Myocardial Infarction Registry, the researchers found that, despite improvements in the proportion of patients with acute myocardial infarction receiving defect-free care overall and across sociodemographic groups, nearly 1 in 4 patients did not receive optimal care; absolute performance was consistently lower among older patients, women, black, and Hispanic patients. They conclude that composite measures of cardiovascular care can illuminate opportunities to improve quality of care.
AHRQ-funded; HS023000.
Citation: Desai NR, Udell JA, Wang Y .
Trends in performance and opportunities for improvement on a composite measure of acute myocardial infarction care.
Circ Cardiovasc Qual Outcomes 2019 Mar;12(3):e004983. doi: 10.1161/circoutcomes.118.004983..
Keywords: Cardiovascular Conditions, Disparities, Heart Disease and Health, Quality of Care, Quality Improvement
Brady J
AHRQ Author: Brady, J.
Why we study disparities: the human stories behind the data.
AHRQ’s Quality and Disparities Report demonstrates that great progress has been made in improving quality in the last decade—but the persistence of disparities means that this progress is uneven. The next step in improving quality should be to focus on disparities in quality as a way to drive improvement more efficiently.
AHRQ-authored.
Citation: Brady J .
Why we study disparities: the human stories behind the data.
J Nurs Care Qual 2016 Jul-Sep;31(3):197-200. doi: 10.1097/ncq.0000000000000188.
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Keywords: Disparities, Quality of Care, Quality Improvement
Zhang R, Lee JY, Jean-Jacques M
Factors influencing the increasing disparity in LDL cholesterol control between white and black patients with diabetes in a context of active quality improvement.
The authors conducted a retrospective analysis of black and white patients treated continuously between 2008 and 2010 in order to examine possible causes of an increased disparity in low-density lipoprotein (LDL) cholesterol control following a multifaceted physician-directed quality improvement (QI) initiative. They found that physician-facing, general QI interventions may be insufficient to produce equity in LDL cholesterol control, and that helping patients maintain prior success controlling cholesterol appears as important in addressing this disparity as is helping uncontrolled patients achieve control.
AHRQ-funded; HS021141.
Citation: Zhang R, Lee JY, Jean-Jacques M .
Factors influencing the increasing disparity in LDL cholesterol control between white and black patients with diabetes in a context of active quality improvement.
Am J Med Qual 2014 Jul-Aug;29(4):308-14. doi: 10.1177/1062860613498112.
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Keywords: Heart Disease and Health, Diabetes, Disparities, Quality Improvement, Racial and Ethnic Minorities