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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 25 of 41 Research Studies Displayed
Dixon BE, Zhang Z, Amo JN
Improving notifiable disease case reporting through electronic information exchange-facilitated decision support: a controlled before-and-after trial.
This study examined the results of implementing an electronic, prepopulated notifiable disease report form on case reporting rates by ambulatory care clinics to public health authorities. They conducted a 2-year controlled before-and-after trial of a health information exchange (HIE) in Indiana. Data was analyzed from electronic prepopulated reports and paper and fax reports submitted to a local health department for 7 conditions by using a difference-in-differences model. Provider reporting rates for chlamydia and gonorrhea increased significantly during the baseline period. During the intervention period they decreased significantly in control clinics. Completion and timeliness improved for both intervention and control clinics.
Citation: Dixon BE, Zhang Z, Amo JN . Improving notifiable disease case reporting through electronic information exchange-facilitated decision support: a controlled before-and-after trial. Public Health Rep 2020 May/Jun;135(3):401-10. doi: 10.1177/0033354920914318..
Keywords: Health Information Exchange (HIE), Health Information Technology (HIT), Electronic Health Records (EHRs), Public Health, Public Reporting, Ambulatory Care and Surgery
Sanghavi 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.
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
Carey K, Dor A
Hospital response to CMS public reports of hospital charge information.
This study examined trends in charge increases for Medicare inpatients treated in approximately 3400 hospitals after the Centers for Medicare and Medicaid Services (CMS) began reporting charges online in 2013 for Medicare inpatients. The investigators applied difference-in-differences analysis to comprehensive inpatient charge data from New York and Florida for the years 2011-2016. After public reporting was implemented the growth in reported charges in New York hospitals was 4-9% lower than unreported diagnosis-related groups and in Florida it was 2-8% lower.
Citation: Carey K, Dor A . Hospital response to CMS public reports of hospital charge information. Med Care 2020 Jan;58(1):70-73. doi: 10.1097/mlr.0000000000001232..
Keywords: Hospitals, Healthcare Costs, Public Reporting, Medicare, Hospitalization
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
Pogorzelska-Maziarz M, de Cordova PB, Herzig M, de Cordova PB, Herzig CTA
Perceived impact of state-mandated reporting on infection prevention and control departments.
Currently, most US states have adopted legislation requiring hospitals to submit health care-associated infection (HAI) data. In this study, the authors evaluated the perceived impact of state HAI laws on infection prevention and control (IPC) departments. They concluded that respondents in states with laws reported negative effects on their IPC department, beyond what was required by federal mandates.
Citation: Pogorzelska-Maziarz M, de Cordova PB, Herzig M, de Cordova PB, Herzig CTA . Perceived impact of state-mandated reporting on infection prevention and control departments. Am J Infect Control 2019 Feb;47(2):118-22. doi: 10.1016/j.ajic.2018.08.012..
Keywords: Public Reporting, Policy, Public Health, Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Hospitals
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.
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 / Ethnic Minorities, Public Reporting
George EI, Ročková V, Rosenbaum PR
Mortality rate estimation and standardization for public reporting: Medicare’s Hospital Compare.
The authors calibrated Bayesian recommendation systems by checking, out of sample, whether predictions aggregate to give correct general advice derived from another sample. Their process leads to substantial revisions in the Hospital Compare model for acute myocardial infarction mortality. They found that indirect standardization, as currently used by Hospital Compare, fails to adequately control for differences in patient risk factors and systematically underestimates mortality rates at the low volume hospitals. They proposed direct standardization instead.
Citation: George EI, Ročková V, Rosenbaum PR . Mortality rate estimation and standardization for public reporting: Medicare’s Hospital Compare. Journal of the American Statistical Association 2017;112(519):933-47. doi: 10.1080/01621459.2016.1276021.
Keywords: Hospitals, Medicare, Mortality, Public Reporting, Value
Ban KA, Cohen ME, Ko CY
Evaluation of the ProPublica surgeon scorecard "Adjusted Complication Rate" measure specifications.
The authors sought to (1) determine the proportion of cases excluded by ProPublica's specifications, (2) assess the proportion of inpatient complications excluded from ProPublica's measure, and (3) examine the validity of ProPublica's outcome measure by comparing performance on the measure to well-established postoperative outcome measures. They found that ProPublica's outcome measure specifications exclude 82% of cases, miss 84% of postoperative complications, and correlate poorly with well-established postoperative outcomes.
Citation: Ban KA, Cohen ME, Ko CY . Evaluation of the ProPublica surgeon scorecard "Adjusted Complication Rate" measure specifications. Ann Surg 2016 Oct;264(4):566-74. doi: 10.1097/sla.0000000000001858.
Keywords: Adverse Events, Outcomes, Public Reporting, Quality Measures, Surgery
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.
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
Bangalore S, Guo Y, Xu J
Rates of invasive management of cardiogenic shock in New York before and after exclusion from public reporting.
The purpose of the study was to evaluate whether the referral rates for cardiac catheterization, percutaneous coronary intervention (PCI), or coronary artery bypass graft have improved in New York since cardiogenic shock was excluded from public reporting in 2008 and compare them with corresponding rates in Michigan, New Jersey, and California. Although rates of PCI, invasive management, and revascularization have increased substantially after the exclusion of cardiogenic shock from public reporting in New York, these rates remain consistently lower than those observed in other states without public reporting.
Citation: Bangalore S, Guo Y, Xu J . Rates of invasive management of cardiogenic shock in New York before and after exclusion from public reporting. JAMA Cardiol 2016 Sep 1;1(6):640-7. doi: 10.1001/jamacardio.2016.0785..
Keywords: Healthcare Cost and Utilization Project (HCUP), Public Reporting, Surgery, Cardiovascular Conditions
Nguyen OK, Halm EA, Makam AN
Relationship between hospital financial performance and publicly reported outcomes.
This study assessed the relationship between hospital financial performance and publicly reported outcomes of care, and whether improved outcome metrics affect subsequent hospital financial performance. It found that, among 279 hospitals, there was no consistent relationship between measures of financial performance in 2008 and publicly reported outcomes from 2008 to 2011 for acute myocardial infarction and pneumonia.
Citation: Nguyen OK, Halm EA, Makam AN . Relationship between hospital financial performance and publicly reported outcomes. J Hosp Med 2016 Jul;11(7):481-8. doi: 10.1002/jhm.2570.
Keywords: Public Reporting, Hospitals, Outcomes
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.
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."
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
Sandmeyer B, Fraser I
AHRQ Author: Sandmeyer B
New evidence on what works in effective public reporting.
The authors describe the current state of the public reporting field and provide guidance to public report producers based on the evidence. They concluded that public reports have advanced greatly in recent years, but there remains much room for improvement. They recommend that report producers should continually evaluate their reports and apply the latest evidence to maximize their usefulness and impact.
Citation: Sandmeyer B, Fraser I . New evidence on what works in effective public reporting. Health Serv Res 2016 Jun;51(Suppl 2):1159-66. doi: 10.1111/1475-6773.12502.
Keywords: Data, Provider Performance, Public Reporting
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.
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
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.
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
DeVore AD, Hammill BG, Hardy NC
Has public reporting of hospital readmission rates affected patient outcomes?: Analysis of Medicare claims data.
Following the implementation of Centers for Medicare & Medicaid Services (CMS) public reporting, this study assessed trends of 30-day readmission rates and post-discharge care for patients discharged with acute myocardial infarction (MI), heart failure (HF), or pneumonia. It found that the release of the CMS public reporting of hospital readmission rates did not change 30-day readmission trends for MI, HF, or pneumonia, but it was associated with less hospital-based acute care for HF.
Citation: DeVore AD, Hammill BG, Hardy NC . Has public reporting of hospital readmission rates affected patient outcomes?: Analysis of Medicare claims data. J Am Coll Cardiol 2016 Mar 1;67(8):963-72. doi: 10.1016/j.jacc.2015.12.037.
Keywords: Public Reporting, Hospital Readmissions, Outcomes, Medicare, Patient-Centered Outcomes Research
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.
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
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.
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
Liang C, Gong Y
Enhancing patient safety event reporting by K-nearest neighbor classifier.
The debate on structured or unstructured data entry reveals not only a trade-off problem among data accuracy, completeness, and timeliness, but also a technical gap on text mining. The reesarchers suggested a text classification method for predicting subject categories. Their results demonstrated the feasibility of their system and indicated the advantage of such an application to raise data quality and clinical decision support in reporting patient safety events.
Citation: Liang C, Gong Y . Enhancing patient safety event reporting by K-nearest neighbor classifier. Stud Health Technol Inform 2015;218:40603.
Keywords: Adverse Events, Medical Errors, Patient Safety, Public Reporting, Clinical Decision Support (CDS), Health Information Technology (HIT), Data
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.
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, Value, Payment, Public Reporting
He D, Konetzka RT
Public reporting and demand rationing: evidence from the nursing home industry.
The authors examined a consequence of public reporting: the potential for demand rationing. They found that high-quality nursing homes facing capacity constraints reduced admissions of less profitable Medicaid residents while increasing the more profitable Medicare and private-pay admissions, relative to low-quality nursing homes facing no capacity constraints.
Citation: He D, Konetzka RT . Public reporting and demand rationing: evidence from the nursing home industry. Health Econ 2015 Nov;24(11):1437-51. doi: 10.1002/hec.3097.
Keywords: Public Reporting, Medicare, Nursing Homes, Value
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.
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.
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.
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