National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Cancer (4)
- Cancer: Lung Cancer (1)
- Care Management (1)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Disparities (1)
- Elderly (1)
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- Opioids (1)
- Outcomes (1)
- Pain (1)
- (-) Palliative Care (6)
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- (-) Practice Patterns (6)
- Racial and Ethnic Minorities (2)
- Young Adults (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 6 of 6 Research Studies DisplayedEnzinger AC, Ghosh K, Keating NL
US trends in opioid access among patients with poor prognosis cancer near the end-of-life.
This study looked at trends in opioid prescriptions for cancer patients near the end-of-life (EOL) defined as the 30 days before death or hospice enrollment. The authors looked at Medicare part D data from 2007 to 2017 for 270,632 Medicare fee-for-service decedents with poor prognosis cancers. During that time, the proportion of decedents with poor prognosis cancers receiving 1 or greater opioid prescriptions near EOL declined 15.5% and the proportion receiving 1 or greater long-acting opioid prescriptions declined 36.5% to 18.1%. The mean daily dose fell from 24.5%, from 85.6 morphine milligram equivalents per day (MMED) to 64.6. The total amount of opioids prescribed fell from 1,075 morphine milligram equivalents per decedent to 666 morphine milligram equivalents per decedents. At the same time, the proportion of patients with pain-related ED visits increase 50.8% from 13.2% to 19.9%.
AHRQ-funded; HS024072.
Citation: Enzinger AC, Ghosh K, Keating NL .
US trends in opioid access among patients with poor prognosis cancer near the end-of-life.
J Clin Oncol 2021 Sep 10;39(26):2948-58. doi: 10.1200/jco.21.00476..
Keywords: Cancer, Opioids, Palliative Care, Pain, Access to Care, Medication, Practice Patterns
Wang SY, Hsu SH, Huang S
Regional practice patterns and racial/ethnic differences in intensity of end-of-life care.
The purpose of this study was to examine whether regional practice patterns impact racial/ethnic differences in intensity of end-of-life care for cancer decedents. The investigators found that there was greater variation in intensity of end-of-life care among Hispanics, Asians, and whites in high-expenditure hospital referral regions (HRRs) than in low-expenditure HRRs.
AHRQ-funded; HS023900.
Citation: Wang SY, Hsu SH, Huang S .
Regional practice patterns and racial/ethnic differences in intensity of end-of-life care.
Health Serv Res 2018 Dec;53(6):4291-309. doi: 10.1111/1475-6773.12998..
Keywords: Cancer, Palliative Care, Practice Patterns, Racial and Ethnic Minorities
DeCourcey DD, Silverman M, Oladunjoye A
Patterns of care at the end of life for children and young adults with life-threatening complex chronic conditions.
The purpose of this study, which used a cross sectional survey, was to characterize patterns of care at the end of life for children and young adults with life-threatening complex chronic conditions (LT-CCCs) and to compare them by LT-CCC type. The investigators concluded that significant differences in patterns of care at the end of life existed depending on LT-CCC type. They suggest that attention to these patterns is important to ensure equal access to palliative care and targeted improvements in end-of-life care for these populations.
AHRQ-funded; HS022986.
Citation: DeCourcey DD, Silverman M, Oladunjoye A .
Patterns of care at the end of life for children and young adults with life-threatening complex chronic conditions.
J Pediatr 2018 Feb;193:196-203.e2. doi: 10.1016/j.jpeds.2017.09.078..
Keywords: Children/Adolescents, Chronic Conditions, Palliative Care, Practice Patterns, Young Adults
Wang SY, Hall J, Pollack CE
Trends in end-of-life cancer care in the Medicare program.
The researchers sought to examine contemporary trends in end-of-life cancer care and geographic variation of end-of-life care aggressiveness among Medicare beneficiaries. They found that the proportion of beneficiaries receiving at least one potentially aggressive end-of-life intervention increased in repeated hospitalization, repeated ED visits, ICU admissions, and late hospice enrollment but declined in in-hospital death. End-of-life chemotherapy use did not change significantly over time. They concluded that despite growing focus on providing appropriate end-of-life care, there has not been an improvement in aggressive end-of-life cancer care in the Medicare program.
AHRQ-funded; HS023900.
Citation: Wang SY, Hall J, Pollack CE .
Trends in end-of-life cancer care in the Medicare program.
J Geriatr Oncol 2016 Mar;7(2):116-25. doi: 10.1016/j.jgo.2015.11.007.
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Keywords: Cancer, Care Management, Elderly, Medicare, Palliative Care, Outcomes, Patient-Centered Outcomes Research, Practice Patterns
Du XL, Parikh RC, Lairson DR
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
The authors examined racial/ethnic and geographical disparities in cancer care and costs during the last 6 months of life for lung cancer decedents after the FDA's approval of bevacizumab. They found that there were substantial racial/ethnic and geographic disparities in the types of cancer care and costs in the last 6 months of life among lung cancer decedents, regardless of the length of survival times and hospice care status.
AHRQ-funded; HS018956.
Citation: Du XL, Parikh RC, Lairson DR .
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
Lung Cancer 2015 Dec;90(3):442-50. doi: 10.1016/j.lungcan.2015.09.017.
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Keywords: Cancer, Cancer: Lung Cancer, Disparities, Healthcare Costs, Medication, Palliative Care, Patient-Centered Outcomes Research, Practice Patterns, Racial and Ethnic Minorities
Albrecht JS, McGregor JC, Fromme EK
A nationwide analysis of antibiotic use in hospice care in the final week of life.
This study uses data form the 2007 National Home and Hospice Care Survey to estimate antibiotic utilization in hospice care patients and identify potential infectious indications and facility and patient characteristics associated with antibiotic use in this population. It found that 27 percent of hospice patients received an antibiotic during the last seven days of life, most without a documented infectious diagnosis.
AHRQ-funded; HS021068
Citation: Albrecht JS, McGregor JC, Fromme EK .
A nationwide analysis of antibiotic use in hospice care in the final week of life.
J Pain Symptom Manage. 2013 Oct;46(4):483-90. doi: 10.1016/j.jpainsymman.2012.09.010..
Keywords: Antibiotics, Antimicrobial Stewardship, Home Healthcare, Medication, Palliative Care, Practice Patterns