National Healthcare Quality and Disparities Report
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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
126 to 141 of 141 Research Studies DisplayedMcDonald MV, Feldman PH, Barron-Vaya Y
Outcomes of clinical decision support (CDS) and correlates of CDS use for home care patients with high medication regimen complexity: a randomized trial.
The researchers assessed the outcomes of a clinical decision support (CDS) intervention designed for home care patients with high medication regimen complexity (MRC) and examined correlates of CDS use. They found that eighty-two percent of intervention nurses used the CDS but for only 42 percent of their patients. Among intervention patients, CDS use (vs. non-use) was associated with reduced MRC and hospitalization.
AHRQ-funded; HS017837.
Citation: McDonald MV, Feldman PH, Barron-Vaya Y .
Outcomes of clinical decision support (CDS) and correlates of CDS use for home care patients with high medication regimen complexity: a randomized trial.
J Eval Clin Pract 2015 May 26;22(1):10-19. doi: 10.1111/jep.12383.
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Keywords: Clinical Decision Support (CDS), Home Healthcare, Medication, Risk
Baier RR, Cooper E, Wysocki A
Using qualitative methods to create a home health web application user interface for patients with low computer proficiency.
The researchers undertook a multi-phased approach to create a consumer-facing home health web application in Rhode Island. This included reviewing the evidence base to identify design recommendations and then creating a paper prototype and wireframe. They performed qualitative research to iteratively test their proposed user interface with two user groups, home health consumers and hospital case managers and t]hen refined their design to create the final web application.
AHRQ-funded; HS021879
Citation: Baier RR, Cooper E, Wysocki A .
Using qualitative methods to create a home health web application user interface for patients with low computer proficiency.
eGEMS. 2015 May 13;3(2):1166. doi: 10.13063/2327-9214.1166..
Keywords: Home Healthcare, Health Information Technology (HIT), Quality of Care, Education: Patient and Caregiver
Baier RR, Wysocki A, Gravenstein S
A qualitative study of choosing home health care after hospitalization: the unintended consequences of 'patient choice' requirements.
The purpose of this qualitative study is to learn how quality reports are used when choosing home care. Focus groups with 13 home health consumers and interviews with 28 hospital case managers from five hospitals revealed that both groups were unaware of public reports about home care quality.
AHRQ-funded; HS021879
Citation: Baier RR, Wysocki A, Gravenstein S .
A qualitative study of choosing home health care after hospitalization: the unintended consequences of 'patient choice' requirements.
J Gen Intern Med. 2015 May;30(5):634-40. doi: 10.1007/s11606-014-3164-7..
Keywords: Decision Making, Elderly, Home Healthcare, Hospital Discharge, Transitions of Care
Uronis HE, Ekstrom MP, Currow DC
Oxygen for relief of dyspnoea in people with chronic obstructive pulmonary disease who would not qualify for home oxygen: a systematic review and meta-analysis.
The researchers conducted a systematic review and meta-analysis to determine whether oxygen therapy provides symptomatic relief in COPD patients with breathlessness who do not qualify currently for long-term oxygen. They concluded that continuous oxygen during exertion, but not short-burst therapy, reduced dyspnoea in mildly- and non-hypoxemic people with COPD who would not otherwise qualify for home oxygen therapy.
AHRQ-funded; HS000079.
Citation: Uronis HE, Ekstrom MP, Currow DC .
Oxygen for relief of dyspnoea in people with chronic obstructive pulmonary disease who would not qualify for home oxygen: a systematic review and meta-analysis.
Thorax 2015 May;70(5):492-4. doi: 10.1136/thoraxjnl-2014-205720..
Keywords: Comparative Effectiveness, Home Healthcare, Respiratory Conditions
Wellman BR, Frail CK, Zillich AJ
Pharmacists' experiences with a telephonic medication therapy management program for home health care patients.
This qualitative study involved interviewing four pharmacists on their experiences with a telephone medication therapy management (MTM) program. Several themes emerged from the analysis, including: communication and relationships, coordinating care and patient self-management, logistics, professional fulfillment, service delivery and content, and training opportunities. The researchers concluded that their study provides possible strategies to overcome barriers and facilitate service provision for future telephonic MTM services.
AHRQ-funded; HS022119.
Citation: Wellman BR, Frail CK, Zillich AJ .
Pharmacists' experiences with a telephonic medication therapy management program for home health care patients.
Consult Pharm 2015 Mar;30(3):163-74. doi: 10.4140/TCP.n.2015.163..
Keywords: Home Healthcare, Medication, Provider: Pharmacist, Patient Self-Management
Prvu Bettger J, McCoy L, Smith EE
Contemporary trends and predictors of postacute service use and routine discharge home after stroke.
The authors examined trends in discharge to inpatient rehabilitation facilities, skilled nursing facilities, home with home health, and home without services for patients with ischemic or hemorrhagic stroke at hospitals participating in Get With The Guidelines-Stroke. They found that four in 10 stroke patients are discharged home without postacute care services. They recommended further research to explain the shift in service use by type and its effect on outcomes.
AHRQ-funded; HS019479.
Citation: Prvu Bettger J, McCoy L, Smith EE .
Contemporary trends and predictors of postacute service use and routine discharge home after stroke.
J Am Heart Assoc 2015 Feb 23;4(2). doi: 10.1161/jaha.114.001038.
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Keywords: Critical Care, Hospital Discharge, Home Healthcare, Stroke
Nasarwanji N, Werner NE, Carl K
Identifying challenges associated with the care transition workflow from hospital to skilled home health care: perspectives of home health care agency providers.
The authors studied the workflow for transitioning older adults from the hospital to skilled home health care (SHHC). They found three overarching challenges to optimal care transitions: information access, coordination, and communication/teamwork. They recommended that future investigations test whether redesigning the transition from hospital to SHHC improves workflow and care quality.
AHRQ-funded; HS022916.
Citation: Nasarwanji N, Werner NE, Carl K .
Identifying challenges associated with the care transition workflow from hospital to skilled home health care: perspectives of home health care agency providers.
Home Health Care Serv Q 2015;34(3-4):185-203. doi: 10.1080/01621424.2015.1092908.
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Keywords: Care Coordination, Elderly, Home Healthcare, Hospital Discharge, Transitions of Care
Casper GR, Flatley Brennan P, Perreault JO
vizHOME--a context-based home assessment: preliminary implications for informatics.
The focus of this paper is on the first phase of the vizHOME study, specifically on the exploration and documentation of the individual’s performance of self-management tasks including such things as medication management and use of a monitoring device. The researchers learned from the participants that while the tools may perform satisfactorily in usability assessment, they may not meet the needs of many users.
AHRQ-funded; HS022548.
Citation: Casper GR, Flatley Brennan P, Perreault JO .
vizHOME--a context-based home assessment: preliminary implications for informatics.
Stud Health Technol Inform 2015;216:842-6..
Keywords: Diabetes, Patient Self-Management, Home Healthcare, Health Information Technology (HIT), Medication
Kendall L, Eschler J, Lozano P
Engineering for reliability in at-home chronic disease management.
The researchers examined how individuals responsible for managing their own or others’ chronic conditions integrate reminders and notification systems into their daily routines. Based on the participants’ experiences, they contend that many self-management failures should be viewed as systems failures, rather than individual failures and non-compliance.
AHRQ-funded; HS021590.
Citation: Kendall L, Eschler J, Lozano P .
Engineering for reliability in at-home chronic disease management.
AMIA Annu Symp Proc 2014 Nov 14;2014:777-86..
Keywords: Chronic Conditions, Patient Self-Management, Home Healthcare, Patient Adherence/Compliance
Smucker DR, Regan S, Elder NC
Patient safety incidents in home hospice care: the experiences of hospice interdisciplinary team members.
The study objective was to explore the types and characteristics of patient safety incidents in home hospice care from the experiences of hospice interdisciplinary team members. Based on interviews of 19 experienced hospice leaders, the most commonly described categories of patient harm were injuries from falls and inadequate symptom control.
AHRQ-funded; HS018245
Citation: Smucker DR, Regan S, Elder NC .
Patient safety incidents in home hospice care: the experiences of hospice interdisciplinary team members.
J Palliat Med. 2014 May;17(5):540-4. doi: 10.1089/jpm.2013.0111..
Keywords: Patient Safety, Home Healthcare, Falls, Chronic Conditions
Huckfeldt PJ, Sood N, Escarce JJ
Effects of Medicare payment reform: evidence from the home health interim and prospective payment systems.
The researchers contrasted the effects of two Medicare payment reforms for home health agencies: the interim payment system (IPS) and the prospective payment system (PPS). The 1997 IPS reform lowered payments for both fee-for-service and episode-based care, as predicted by their conceptual model. The PPS in 2000 raised average but lowered marginal payment.
AHRQ-funded; HS018541
Citation: Huckfeldt PJ, Sood N, Escarce JJ .
Effects of Medicare payment reform: evidence from the home health interim and prospective payment systems.
J Health Econ. 2014 Mar;34:1-18. doi: 10.1016/j.jhealeco.2013.11.005..
Keywords: Medicare, Healthcare Costs, Home Healthcare
Thomas KS
The relationship between Older Americans Act in-home services and low-care residents in nursing homes.
This study examining the relationship between the proportion of older adults in a State who receive in-home services funded by the Older Americans Act and the proportion of residents in nursing homes finds that for every additional 1 percent of the 65+ population that receives personal care services, there is a 0.8% decrease in the proportion of low-care residents in nursing homes.
AHRQ-funded; HS00011
Citation: Thomas KS .
The relationship between Older Americans Act in-home services and low-care residents in nursing homes.
J Aging Health. 2014 Mar;26(2):250-60. doi: 10.1177/0898264313513611..
Keywords: Elderly, Long-Term Care, Home Healthcare, Nursing Homes, Healthcare Delivery
Sockolow PS, Bowles KH, Adelsberger MC
Challenges and facilitators to adoption of a point-of-care electronic health record in home care.
In order to identify challenges to the adoption of electronic health records (EHR) in the home care setting, the researchers assessed clinician satisfaction, informed by workflow and patient outcomes. Using a combination of surveys, observations, and interviews in an agency with 137 clinicians, the researchers found that adoption challenges included: (a) hardware problems coupled with lack of field support; (b) inadequate training; and (c) mismatch of EHR usability/functionality and workflow.
AHRQ-funded; HS021008.
Citation: Sockolow PS, Bowles KH, Adelsberger MC .
Challenges and facilitators to adoption of a point-of-care electronic health record in home care.
Home Health Care Serv Q 2014;33(1):14-35. doi: 10.1080/01621424.2013.870098..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Home Healthcare
Sockolow PS, Bowles KH, Adelsberger MC
Impact of homecare electronic health record on timeliness of clinical documentation, reimbursement, and patient outcomes.
The study objective was to assess the impact of attaining efficiency and health goals of a point-of-care EHR in home care. To realize this objective, the researchers compared clinical documentation workflow, financial time-to-billing and patient physiological and behavioral outcomes to evaluate its impact. The findings indicate that EHR use significantly improved the timeliness of clinical documentation and billing for reimbursement but had limited impact on improving patient outcomes.
AHRQ-funded; HS021008.
Citation: Sockolow PS, Bowles KH, Adelsberger MC .
Impact of homecare electronic health record on timeliness of clinical documentation, reimbursement, and patient outcomes.
Appl Clin Inform 2014;5(2):445-62. doi: 10.4338/aci-2013-12-ra-0106..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Home Healthcare
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
Huckfeldt PJ, Sood NB, Romley JA
Medicare payment reform and provider entry and exit in the post-acute care market.
The researchers examined the impact of Medicare payment reform on the entry and exit of post-acute providers (home health agencies and skilled nursing facilities). They found that payment reforms reducing average and marginal payments reduced entries and increased exits from the market, with entries more likely to be affected.
AHRQ-funded; HS018541
Citation: Huckfeldt PJ, Sood NB, Romley JA .
Medicare payment reform and provider entry and exit in the post-acute care market.
Health Serv Res. 2013 Oct;48(5):1557-80. doi: 10.1111/1475-6773.12059..
Keywords: Medicare, Critical Care, Healthcare Costs, Home Healthcare, Long-Term Care