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
7851 to 7875 of 12214 Research Studies DisplayedHartzler AL, Osterhage K, Demiris G
Understanding views on everyday use of personal health information: insights from community dwelling older adults.
As a first step in formulating the role of personal health information management (PHIM) in healthy aging, researchers explored the perspectives of older adults on health and health information used in their everyday lives. Participants expressed wellness from a position of personal strength by focusing on wellness activities for staying healthy through: (1) personal health practices, (2) social network support, and (3) residential community engagement.
AHRQ-funded; HS022106.
Citation: Hartzler AL, Osterhage K, Demiris G .
Understanding views on everyday use of personal health information: insights from community dwelling older adults.
Inform Health Soc Care 2017 Sep;43(3):1-14. doi: 10.1080/17538157.2017.1297815.
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Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient and Family Engagement, Health Status
Angier H, Hoopes M, Marino M
Uninsured primary care visit disparities under the Affordable Care Act.
The researchers aimed to assess changes in insurance coverage at community health center (CHC) visits after the Patient Protection and Affordable Care Act (ACA) Medicaid expansion by race and ethnicity. After the ACA was implemented, uninsured visit rates decreased for all racial and ethnic groups. Hispanic patients experienced the greatest increases in Medicaid-insured visit rates after ACA implementation in expansion states.
AHRQ-funded; HS024270.
Citation: Angier H, Hoopes M, Marino M .
Uninsured primary care visit disparities under the Affordable Care Act.
Ann Fam Med 2017 Sep;15(5):434-42. doi: 10.1370/afm.2125.
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Keywords: Uninsured, Primary Care, Disparities, Healthcare Utilization, Access to Care
Handley MA, Quan J, Chao MT
Use of complementary health approaches among diverse primary care patients with type 2 diabetes and association with cardiometabolic outcomes: from the SF Bay Collaborative Research Network (SF Bay CRN).
The purpose of this study is to describe use of complementary health approaches (CHAs) among patients with type 2 diabetes, and independent associations between CHA use and Hemoglobin A1c (A1C) and lower-density lipoprotein (LDL) cholesterol. The study concluded that CHA use is common among patients with type 2 diabetes and may be associated with poor cardiometabolic control and medication adherence.
AHRQ-funded; HS022561.
Citation: Handley MA, Quan J, Chao MT .
Use of complementary health approaches among diverse primary care patients with type 2 diabetes and association with cardiometabolic outcomes: from the SF Bay Collaborative Research Network (SF Bay CRN).
J Am Board Fam Med 2017 Sep-Oct;30(5):624-31. doi: 10.3122/jabfm.2017.05.170030..
Keywords: Heart Disease and Health, Complementary and Alternative Medicine, Diabetes, Outcomes, Patient Self-Management
Patterson BW, Smith MA, Repplinger MD
Using chief complaint in addition to diagnosis codes to identify falls in the emergency department.
The researchers compared incidence of falls in an emergency department (ED) cohort using a traditional International Classification of Diseases, Ninth Revision (ICD-9) code-based scheme and an expanded definition that included chief complaint information. They concluded that identifying individuals in the ED who have fallen based on diagnosis codes underestimates the true burden of falls.
AHRQ-funded; HS024558.
Citation: Patterson BW, Smith MA, Repplinger MD .
Using chief complaint in addition to diagnosis codes to identify falls in the emergency department.
J Am Geriatr Soc 2017 Sep;65(9):E135-E40. doi: 10.1111/jgs.14982.
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Keywords: Falls, Emergency Medical Services (EMS), Emergency Department
Neuman MI, Hall M, Lipsett SC
Utility of blood culture among children hospitalized with community-acquired pneumonia.
The researchers sought to determine the prevalence of bacteremia and characterize the microbiology and penicillin-susceptibility patterns of positive blood culture results among children hospitalized with community-acquired pneumonia (CAP). Among children without comorbidities hospitalized with CAP in a non-ICU setting, the rate of bacteremia was low, and isolated pathogens were usually susceptible to penicillin. Blood cultures may not be needed for most children hospitalized with CAP.
AHRQ-funded; HS022342; HS019862.
Citation: Neuman MI, Hall M, Lipsett SC .
Utility of blood culture among children hospitalized with community-acquired pneumonia.
Pediatrics 2017 Sep;140(3):pii: e20171013. doi: 10.1542/peds.2017-1013.
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Keywords: Hospitalization, Children/Adolescents, Children/Adolescents, Medication
Holland DE, Brandt C, Targonski PV
Validating performance of a hospital discharge planning decision tool in community hospitals.
The researchers aimed to determine the predictive performance of the Early Screen for Discharge Planning (ESDP) in a rural regional community hospital practice setting. Patients with high ESDP scores reported more problems after discharge, reported lower quality of life, had longer length of stays, and used post-acute care services more than patients with low ESDP scores.
AHRQ-funded; HS022923.
Citation: Holland DE, Brandt C, Targonski PV .
Validating performance of a hospital discharge planning decision tool in community hospitals.
Prof Case Manag 2017 Sep/Oct;22(5):204-13. doi: 10.1097/ncm.0000000000000233.
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Keywords: Shared Decision Making, Hospital Discharge, Outcomes, Rural Health, Tools & Toolkits
Jorgensen SM, Carnahan RM, Weckmann MT
Validity of the delirium observation screening scale in identifying delirium in home hospice patients.
The Delirium Observation Screening Scale (DOS) was developed to improve delirium recognition but has yet to be validated in the home hospice setting. This pilot study aimed to explore the accuracy of the DOS for identifying delirium in home hospice patients. It concluded that the DOS appears to be an accurate way to screen for delirium in home hospice patients.
AHRQ-funded; HS022666.
Citation: Jorgensen SM, Carnahan RM, Weckmann MT .
Validity of the delirium observation screening scale in identifying delirium in home hospice patients.
Am J Hosp Palliat Care 2017 Sep;34(8):744-47. doi: 10.1177/1049909116658468.
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Keywords: Diagnostic Safety and Quality, Elderly, Home Healthcare, Neurological Disorders, Palliative Care
Calderwood MS, Huang SS, Keller V
Variable case detection and many unreported cases of surgical-site infection following colon surgery and abdominal hysterectomy in a statewide validation.
This study assesses hospital surgical-site infection (SSI) identification and reporting following colon surgery and abdominal hysterectomy via a statewide external validation. The authors concluded that claims-based surveillance is a standardized approach that hospitals can use to augment traditional surveillance methods and health departments can use for external validation.
AHRQ-funded; HS021424.
Citation: Calderwood MS, Huang SS, Keller V .
Variable case detection and many unreported cases of surgical-site infection following colon surgery and abdominal hysterectomy in a statewide validation.
Infect Control Hosp Epidemiol 2017 Sep;38(9):1091-97. doi: 10.1017/ice.2017.134..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Injuries and Wounds, Patient Safety, Women, Adverse Events, Diagnostic Safety and Quality, Hospitals
Ahluwalia SC, Damberg CL, Silverman M
What defines a high-performing health care delivery system: a systematic review.
A systematic review was conducted to determine if there is a commonly used, agreed-on definition of what constitutes a "high-performing" health care delivery system. No consistent definition of a high-performing health care system or organization was identified. High performance was variably defined across different dimensions, including quality (93 percent of articles), cost (67 percent), access (35 percent), equity (26 percent), patient experience (21 percent), and patient safety (18 percent).
AHRQ-funded; HS024067.
Citation: Ahluwalia SC, Damberg CL, Silverman M .
What defines a high-performing health care delivery system: a systematic review.
Jt Comm J Qual Patient Saf 2017 Sep;43(9):450-59. doi: 10.1016/j.jcjq.2017.03.010.
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Keywords: Healthcare Delivery, Quality of Care, Policy, Quality Measures
Gong Y, Kang H, Wu X
Enhancing patient safety event reporting. a systematic review of system design features.
Electronic patient safety event reporting (e-reporting) is an effective mechanism to learn from errors and enhance patient safety. This paper aimed at revealing the current status of system features, detecting potential gaps in system design, and accordingly proposing suggestions for future design and implementation of the system. Three literature databases were searched for publications that contain informative descriptions of e-reporting systems. In addition, both online publicly accessible reporting forms and systems were investigated. The authors concluded that the current e-reporting systems are at an immature stage in their development, and discussed their future development direction toward efficient and effective systems to improve patient safety.
AHRQ-funded; HS022895.
Citation: Gong Y, Kang H, Wu X .
Enhancing patient safety event reporting. a systematic review of system design features.
Appl Clin Inform 2017 Aug 30;8(3):893-909. doi: 10.4338/aci-2016-02-r-0023..
Keywords: Adverse Events, Medical Errors, Health Information Technology (HIT), Patient Safety, System Design
Bowen ME, Merchant Z, Abdullah K
Patient, provider, and system factors associated with failure to follow-up elevated glucose results in patients without diagnosed diabetes.
Patient, provider, and system factors associated with failure to follow-up elevated glucose values in electronic medical records (EMRs) are not well described. The researchers conducted a chart review in a comprehensive EMR with a patient portal and results management features but found no associations between patient characteristics, diabetes risk factors, or provider characteristics and follow-up failures.
AHRQ-funded; HS022418.
Citation: Bowen ME, Merchant Z, Abdullah K .
Patient, provider, and system factors associated with failure to follow-up elevated glucose results in patients without diagnosed diabetes.
Health Serv Res Manag Epidemiol 2017 Aug 29;4:2333392817721647. doi: 10.1177/2333392817721647.
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Keywords: Diabetes, Electronic Health Records (EHRs), Web-Based, Patient-Centered Healthcare, Diagnostic Safety and Quality
Miake-Lye IM, Chuang E, Rodriguez HP
Random or predictable?: Adoption patterns of chronic care management practices in physician organizations.
This exploratory paper leverages the natural variation in uptake to describe inter-organizational patterns in adoption of care management practices (CMPs) and to better understand how adoption choices may be related to one another. Within disease focus scales, patient reminders were ranked as the most adoptable CMP, while clinician feedback and patient education were ranked the least adoptable.
AHRQ-funded; HS024176.
Citation: Miake-Lye IM, Chuang E, Rodriguez HP .
Random or predictable?: Adoption patterns of chronic care management practices in physician organizations.
Implement Sci 2017 Aug 24;12(1):106. doi: 10.1186/s13012-017-0639-z.
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Keywords: Care Management, Chronic Conditions, Practice Patterns
Liotta EM, Prabhakaran S, Sangha RS
Magnesium, hemostasis, and outcomes in patients with intracerebral hemorrhage.
The researchers tested the hypothesis that admission serum magnesium levels are associated with hematoma volume, hematoma growth, and functional outcomes in patients with intracerebral hemorrhage (ICH). Their findings support the hypothesis that magnesium exerts a clinically meaningful influence on hemostasis in patients with ICH.
AHRQ-funded; HS023437.
Citation: Liotta EM, Prabhakaran S, Sangha RS .
Magnesium, hemostasis, and outcomes in patients with intracerebral hemorrhage.
Neurology 2017 Aug 22;89(8):813-19. doi: 10.1212/wnl.0000000000004249..
Keywords: Patient-Centered Outcomes Research, Treatments, Outcomes, Brain Injury
Chhatre S, Cook R, Mallik E
Trends in substance use admissions among older adults.
Researchers sought to analyze the trends in admissions for substance abuse treatment among older adults (aged 55 and older). Substantial changes in the demographic, substance use pattern, and treatment characteristics for the older adult admissions were noted. The proportion of admissions for following primary substances showed increase: cocaine/crack, marijuana/hashish, heroin, non-prescription methadone, and other opiates and synthetics.
AHRQ-funded; HS024106.
Citation: Chhatre S, Cook R, Mallik E .
Trends in substance use admissions among older adults.
BMC Health Serv Res 2017 Aug 22;17(1):584. doi: 10.1186/s12913-017-2538-z.
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Keywords: Behavioral Health, Elderly, Hospitalization, Opioids, Substance Abuse
Robinson JC, Whaley CM, Brown TT
Association of reference pricing with drug selection and spending.
This study used difference-in-differences multivariable regression methods to analyze changes in prescriptions and pricing for 1,302 drugs in 78 therapeutic classes in the United States, before and after implementation of reference pricing by an alliance of private employers. It concluded that mplementation of reference pricing was associated with a higher rate of copayment by patients than in the comparison group.
AHRQ-funded; HS22098.
Citation: Robinson JC, Whaley CM, Brown TT .
Association of reference pricing with drug selection and spending.
N Engl J Med 2017 Aug 17;377(7):658-65. doi: 10.1056/NEJMsa1700087.
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Keywords: Healthcare Costs, Medication
Leshem E, Tate JE, Steiner CA
AHRQ Author: Steiner. CA
National estimates of reductions in acute gastroenteritis-related hospitalizations and associated costs in US children after implementation of rotavirus vaccines.
The study compared acute gastroenteritis (AGE)-related hospitalization rates among children <5 years of age during the pre-rotavirus vaccine (2000-2006) and post-rotavirus vaccine (2008-2013) periods to estimate national reductions in AGE-related hospitalizations and associated costs.
AHRQ-authored
Citation: Leshem E, Tate JE, Steiner CA .
National estimates of reductions in acute gastroenteritis-related hospitalizations and associated costs in US children after implementation of rotavirus vaccines.
J Pediatric Infect Dis Soc 2017 Aug 17;7(3):257-60. doi: 10.1093/jpids/pix057..
Keywords: Children/Adolescents, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Vaccination
Ross JS, Bates J, Parzynski CS
Can machine learning complement traditional medical device surveillance? A case study of dual-chamber implantable cardioverter-defibrillators.
Using data from the National Cardiovascular Data Registry for implantable cardioverter-defibrillators (ICDs) linked to Medicare administrative claims for longitudinal follow-up, the researchers applied three statistical approaches to safety-signal detection for commonly used dual-chamber ICDs that used two propensity score (PS) models. The three approaches, including one machine learning method, identified important safety signals, but without exact agreement.
AHRQ-funded; HS023000.
Citation: Ross JS, Bates J, Parzynski CS .
Can machine learning complement traditional medical device surveillance? A case study of dual-chamber implantable cardioverter-defibrillators.
Med Devices 2017 Aug 16;10:165-88. doi: 10.2147/mder.s138158.
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Keywords: Medical Devices, Registries, Patient Safety, Adverse Events
Lau BD, Shaffer DL, Hobson DB
Effectiveness of two distinct web-based education tools for bedside nurses on medication administration practice for venous thromboembolism prevention: a randomized clinical trial.
Effectiveness of two distinct web-based education tools for bedside nurses on medication administration practice for venous thromboembolism prevention: a randomized clinical trial.
AHRQ-funded; HS024547.
Citation: Lau BD, Shaffer DL, Hobson DB .
Effectiveness of two distinct web-based education tools for bedside nurses on medication administration practice for venous thromboembolism prevention: a randomized clinical trial.
PLoS One 2017 Aug 16;12(8):e0181664. doi: 10.1371/journal.pone.0181664.
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Keywords: Blood Clots, Education: Continuing Medical Education, Medication, Nursing, Prevention, Provider: Nurse, Web-Based, Practice Patterns
Lee BY, Haidari LA
The importance of vaccine supply chains to everyone in the vaccine world.
The study authors detail how vaccine supply chains may affect the work and decision making of ten examples of different members of the vaccine community: preclinical vaccinologists, vaccine clinical trialists, vaccine package designers, health care workers, epidemiologists and disease surveillance experts, policy makers, storage equipment manufacturers, other technology developers, information system specialists, and funders.
AHRQ-funded; HS023317.
Citation: Lee BY, Haidari LA .
The importance of vaccine supply chains to everyone in the vaccine world.
Vaccine 2017 Aug 16;35(35 Pt A):4475-79. doi: 10.1016/j.vaccine.2017.05.096..
Keywords: Shared Decision Making, Vaccination
Qian F, Zhong Y, Hannan EL
Long-term comparative effectiveness of Endeavor zotarolimus-eluting and everolimus-eluting stents in New York.
Endeavor zotarolimus-eluting stents (E-ZES) and everolimus-eluting stents (EES) as second-generation stents were approved for use in percutaneous coronary interventions (PCIs) in 2008. The researchers aimed to evaluate the long-term outcomes of E-ZES vs. EES. They concluded that compared with patients receiving EES, patients receiving E-ZES had a significantly higher rate of 6-year all-cause mortality.
AHRQ-funded; HS022289.
Citation: Qian F, Zhong Y, Hannan EL .
Long-term comparative effectiveness of Endeavor zotarolimus-eluting and everolimus-eluting stents in New York.
Int J Cardiol 2017 Aug 15;241:437-43. doi: 10.1016/j.ijcard.2017.03.095.
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Keywords: Cardiovascular Conditions, Comparative Effectiveness, Medication, Patient-Centered Outcomes Research, Heart Disease and Health
Fan T, Amobi A
AHRQ Author: Fan T
Screening for gynecologic conditions with pelvic examination.
A 37-year-old woman presents to your office for her annual wellness visit. She is not due for a Papanicolaou (Pap) smear this year. She is not pregnant, reports no problems, and has no risk factors for sexually transmitted infections. She asks if she should have a pelvic examination today. The case study asks a series of three questions based on the USPSTF recommendation statement. Answers are provided.
AHRQ-authored.
Citation: Fan T, Amobi A .
Screening for gynecologic conditions with pelvic examination.
Am Fam Physician 2017 Aug 15;96(4):253-54.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Women, Case Study, Shared Decision Making, Screening
Balk EM, Lichtenstein AH
Omega-3 fatty acids and cardiovascular disease: summary of the 2016 Agency of Healthcare Research and Quality evidence review.
The authors summarize the 2016 update of the 2004 Agency of Healthcare Research and Quality's evidence review of omega-3 fatty acids and cardiovascular disease (CVD). The overall findings for the effects of marine oil supplements on intermediate CVD outcomes remain largely unchanged. The strongest effect of marine oils is on triglyceride concentrations.
AHRQ-funded; 290201500002I.
Citation: Balk EM, Lichtenstein AH .
Omega-3 fatty acids and cardiovascular disease: summary of the 2016 Agency of Healthcare Research and Quality evidence review.
Nutrients 2017 Aug 11;9(8). doi: 10.3390/nu9080865.
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Keywords: Cardiovascular Conditions, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention
McFarland M, Szasz TP, Zhou JY
Colonization with 19F and other pneumococcal conjugate vaccine serotypes in children in St. Louis, Missouri, USA.
The primary goal of this study was to determine the vaccine-type (VT) serotype prevalence of nasopharyngeal (NP) pneumococcal colonization of children residing in the St. Louis, MO, USA metropolitan area following introduction of the 13-valent pneumococcal conjugate vaccine in 2010. It concluded that children in St. Louis exhibit a higher prevalence of VT serotypes among pneumococcal carriage isolates than has been reported in other areas in the US.
AHRQ-funded; HS021736; HS024269.
Citation: McFarland M, Szasz TP, Zhou JY .
Colonization with 19F and other pneumococcal conjugate vaccine serotypes in children in St. Louis, Missouri, USA.
Vaccine 2017 Aug 3;35(34):4389-95. doi: 10.1016/j.vaccine.2017.06.047.
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Keywords: Vaccination, Children/Adolescents, Pneumonia, Infectious Diseases
Albright KC, Howard VJ, Howard G
Age and sex disparities in discharge statin prescribing in the stroke belt: evidence from the reasons for geographic and racial differences in stroke study.
This study analyzed discharge medications for participants hospitalized for an ischemic stroke during follow-up of the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study. It found that statin discharge prescribing may differ among Stroke Belt and non-Stroke Belt residents, particularly in older Americans and men.
AHRQ-funded; HS023009; HS013852.
Citation: Albright KC, Howard VJ, Howard G .
Age and sex disparities in discharge statin prescribing in the stroke belt: evidence from the reasons for geographic and racial differences in stroke study.
J Am Heart Assoc 2017 Aug 2;6(8). doi: 10.1161/jaha.117.005523.
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Keywords: Disparities, Medication, Stroke, Elderly, Sex Factors
Grande SW, Castaldo MG, Carpenter-Song E
A digital advocate? Reactions of rural people who experience homelessness to the idea of recording clinical encounters.
This study examines the reactions of homeless people to the idea of using a smartphone to record their own clinical encounter, either covertly or with permission from their physician. The researchers conducted semi-structured interviews with individuals at a temporary housing shelter in Northern New England. The study found that while many rural, disadvantaged individuals felt marginalized by the wide social distance between themselves and their clinicians, recording technology may serve as an advocate by holding both patients and doctors accountable and by permitting the burden of clinical proof to be shared.
AHRQ-funded; HS021695.
Citation: Grande SW, Castaldo MG, Carpenter-Song E .
A digital advocate? Reactions of rural people who experience homelessness to the idea of recording clinical encounters.
Health Expect 2017 Aug;20(4):618-25. doi: 10.1111/hex.12492..
Keywords: Health Information Exchange (HIE), Clinician-Patient Communication, Rural Health, Vulnerable Populations