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
8526 to 8550 of 12139 Research Studies DisplayedFord JH, 2nd, Oliver KA, Giles M
Maintenance of certification: how performance in practice changes improve tobacco cessation in addiction psychiatrists' practice.
This study reports on findings from a Maintenance of Certification (MOC) Performance in Practice (PIP) module designed and evaluated by addiction psychiatrists who are members of the American Academy of Addiction Psychiatry. It found that simple change projects designed to improve clinical practice led to substantial changes in self-reported chart documentation for the selected measure.
AHRQ-funded; HS021962.
Citation: Ford JH, 2nd, Oliver KA, Giles M .
Maintenance of certification: how performance in practice changes improve tobacco cessation in addiction psychiatrists' practice.
Am J Addict 2017 Jan;26(1):34-41. doi: 10.1111/ajad.12480.
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Keywords: Behavioral Health, Education: Continuing Medical Education, Provider: Health Personnel, Quality Improvement, Tobacco Use
Pierce R, Lessler J, Popoola VO
Meticillin-resistant Staphylococcus aureus (MRSA) acquisition risk in an endemic neonatal intensive care unit with an active surveillance culture and decolonization programme.
The researchers measured the association between colonization pressure from decolonized and non-decolonized neonates and methicillin-resistant staphylococcus aureus (MRSA) and MRSA acquisition to inform use of this strategy for control of endemic MRSA. They concluded that untreated MRSA carriers were an important reservoir for transmission. Decolonized patients on contact isolation posed no detectable transmission threat, supporting the hypothesis that decolonization may reduce patient-to-patient transmission.
AHRQ-funded; HS022872.
Citation: Pierce R, Lessler J, Popoola VO .
Meticillin-resistant Staphylococcus aureus (MRSA) acquisition risk in an endemic neonatal intensive care unit with an active surveillance culture and decolonization programme.
J Hosp Infect 2017 Jan;95(1):91-97. doi: 10.1016/j.jhin.2016.10.022.
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Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Neonatal Intensive Care Unit (NICU), Prevention, Newborns/Infants
Flory JH, Roy J, Gagne JJ
Missing laboratory results data in electronic health databases: implications for monitoring diabetes risk.
Researchers assessed the value of lab results added to diagnosis codes and dispensing claims to identify incident diabetes. Inclusion of lab results increased the number of diabetes outcomes identified by 21 percent. In settings where capture of lab results was relatively complete, the absence of lab results was associated with implausibly low rates of the outcome.
AHRQ-funded; HS023898.
Citation: Flory JH, Roy J, Gagne JJ .
Missing laboratory results data in electronic health databases: implications for monitoring diabetes risk.
J Comp Eff Res 2017 Jan;6(1):25-32. doi: 10.2217/cer-2016-0033.
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Keywords: Diabetes, Diagnostic Safety and Quality, Electronic Health Records (EHRs)
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.
AHRQ-funded; HS021854.
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.
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Keywords: Hospitals, Medicare, Mortality, Provider Performance
Decker SL, Lipton BJ
AHRQ Author: Decker SL, Lipton BJ
Most newly insured people in 2014 were long-term uninsured.
This study found that in 2014-after the implementation of most of the Affordable Care Act provisions, including Medicaid expansions in some states and subsidies to purchase Marketplace coverage in all states-adults who had been uninsured for more than three years represented a larger share of the newly insured, compared to adults who had been insured for shorter periods of time.
AHRQ-authored.
Citation: Decker SL, Lipton BJ .
Most newly insured people in 2014 were long-term uninsured.
Health Aff 2017 Jan;36(1):16-20. doi: 10.1377/hlthaff.2016.0984.
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Keywords: Health Insurance, Uninsured, Medicaid, Policy
Leland NE, Fogelberg DJ, Halle AD
Occupational therapy and management of multiple chronic conditions in the context of health care reform.
One in four individuals living in the United States has multiple chronic conditions (MCCs), and the already high prevalence of MCCs continues to grow. Occupational therapy is uniquely positioned to contribute to more efficient, effective, client-centered management of care. By integrating findings from the literature with current policy and practice, the authors aim to highlight the potential role for occupational therapy in managing MCCs within the evolving health care system.
AHRQ-funded; HS022907.
Citation: Leland NE, Fogelberg DJ, Halle AD .
Occupational therapy and management of multiple chronic conditions in the context of health care reform.
Am J Occup Ther 2017 Jan/Feb;71(1):7101090010p1-10p6. doi: 10.5014/ajot.2017.711001.
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Keywords: Chronic Conditions, Policy, Patient-Centered Outcomes Research, Primary Care
Makris UE, Edwards TC, Lavallee DC
Patient priority weighting of the Roland Morris Disability Questionnaire does not change results of the lumbar epidural steroid injections for spinal stenosis trial.
The researchers reevaluated whether outcomes for older adults receiving epidural steroid injections with or without corticosteroid improve after using patient-prioritized Roland-Morris Disability Questionnaire (RDQ) items. Their findings provide additional evidence that epidural injection of corticosteroid + lidocaine offered minimal or no short-term benefit as compared with epidural injection of lidocaine alone for older adults with lumbar spinal stenosis.
AHRQ-funded; HS019222; HS022418.
Citation: Makris UE, Edwards TC, Lavallee DC .
Patient priority weighting of the Roland Morris Disability Questionnaire does not change results of the lumbar epidural steroid injections for spinal stenosis trial.
Spine 2017 Jan;42(1):42-48. doi: 10.1097/brs.0000000000001647.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Elderly, Back Health and Pain, Medication
Nabozny MJ, Kruser JM, Steffens NM
Patient-reported limitations to surgical buy-in: a qualitative study of patients facing high-risk surgery.
The researchers characterized how patients buy-in to treatments beyond the operating room and what limits they would place on additional life-supporting treatments. Their recordings of patients' pre- and post-operative conversations with surgeons showed that patients expressed trust in their surgeon to make decisions about additional treatments if a serious complication occurred. However, patients expressed a preference for significant treatment limitations that were not discussed with their surgeon preoperatively.
AHRQ-funded; HS000078.
Citation: Nabozny MJ, Kruser JM, Steffens NM .
Patient-reported limitations to surgical buy-in: a qualitative study of patients facing high-risk surgery.
Ann Surg 2017 Jan;265(1):97-102. doi: 10.1097/sla.0000000000001645.
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Keywords: Surgery, Palliative Care, Risk, Clinician-Patient Communication, Patient Safety
Stepanikova I, Oates GR
Perceived discrimination and privilege in health care: the role of socioeconomic status and race.
This study examined how perceived racial privilege and perceived racial discrimination in health care varied with race and socioeconomic status (SES). It found that in whites, higher income and education contributed to increased perceptions of privileged treatment and decreased perceptions of discrimination. The pattern was reversed in blacks, who reported more discrimination and less privilege at higher income and education levels.
AHRQ-funded; HS023009.
Citation: Stepanikova I, Oates GR .
Perceived discrimination and privilege in health care: the role of socioeconomic status and race.
Am J Prev Med 2017 Jan;52(1s1):S86-s94. doi: 10.1016/j.amepre.2016.09.024.
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Keywords: Disparities, Health Status, Racial and Ethnic Minorities, Social Determinants of Health
Doberne JW, Redd T, Lattin D
Perspectives and uses of the electronic health record among US pediatricians: a national survey.
This survey found that the electronic health record (EHR) was the most commonly used source of initial patient information. Seventy-two percent of 808 pediatricians participating reported requiring between 2 and 10 minutes to complete an initial review of the EHR. Several moderately severe information barriers were reported regarding the display of information in the EHR.
AHRQ-funded; HS022981.
Citation: Doberne JW, Redd T, Lattin D .
Perspectives and uses of the electronic health record among US pediatricians: a national survey.
J Ambul Care Manage 2017 Jan/Mar;40(1):59-68. doi: 10.1097/jac.0000000000000167.
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Keywords: Electronic Health Records (EHRs), Provider: Health Personnel, Children/Adolescents, Practice Patterns
Scherr KA, Fagerlin A, Hofer T
Physician recommendations trump patient preferences in prostate cancer treatment decisions.
This study assessed the influence of patient preferences and urologist recommendations in treatment decisions for clinically localized prostate cancer. It found that patients' initial treatment preferences did not predict receipt of active treatment versus surveillance. Instead, receipt of active treatment was predicted primarily by urologists' recommendations.
AHRQ-funded; HS021764.
Citation: Scherr KA, Fagerlin A, Hofer T .
Physician recommendations trump patient preferences in prostate cancer treatment decisions.
Med Decis Making 2017 Jan;37(1):56-69. doi: 10.1177/0272989x16662841.
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Keywords: Cancer: Prostate Cancer, Decision Making, Patient and Family Engagement, Patient-Centered Healthcare, Clinician-Patient Communication
Parchman ML, Von Korff M, Baldwin LM
Primary care clinic re-design for prescription opioid management.
The researchers describe a framework comprised of 6 Building Blocks to guide efforts within the primary care clinic setting to address the use of opioids for chronic pain. In response to prescription opioid overuse and the resulting epidemic of overdose and addiction, primary care clinics are making improvements driven by a common set of best practices that address complex challenges of managing chronic opioid therapy patients in primary care settings.
AHRQ-funded; HS023750.
Citation: Parchman ML, Von Korff M, Baldwin LM .
Primary care clinic re-design for prescription opioid management.
J Am Board Fam Med 2017 Jan-Feb;30(1):44-51. doi: 10.3122/jabfm.2017.01.160183.
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Keywords: Chronic Conditions, Opioids, Pain, Substance Abuse, Teams
Ward MM, Baloh J, Zhu X
Promoting Action on Research Implementation in Health Services framework applied to TeamSTEPPS implementation in small rural hospitals.
An evidence-based program focused on quality enhancement in health care, termed TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety), has been widely promoted by AHRQ. The authors apply the Promoting Action on Research Implementation in Health Services (PARIHS) framework in studying its implementation to identify elements that are most closely related to successful implementation. The current findings provide support for the PARIHS framework.
AHRQ-funded; HS018396.
Citation: Ward MM, Baloh J, Zhu X .
Promoting Action on Research Implementation in Health Services framework applied to TeamSTEPPS implementation in small rural hospitals.
Health Care Manage Rev 2017 Jan/Mar;42(1):2-13. doi: 10.1097/hmr.0000000000000086.
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Keywords: Evidence-Based Practice, Hospitals, Rural Health, TeamSTEPPS, Implementation
Min JY, Ocampo CJ, Stevens WW
Proton pump inhibitors decrease eotaxin-3/CCL26 expression in patients with chronic rhinosinusitis with nasal polyps: possible role of the nongastric H,K-ATPase.
The researchers assessed the effect of type 2 mediators, particularly IL-13 and eotaxin-3, on tissue eosinophilia and disease severity in patients with chronic rhinosinusitis. The results demonstrated that proton pump inhibitors (PPIs) reduce IL-13-induced eotaxin-3 expression by airway epithelial cells. Furthermore, mechanistic studies suggest that the nongastric H,K-ATPase is necessary for IL-13-mediated epithelial responses.
AHRQ-funded; HS023011.
Citation: Min JY, Ocampo CJ, Stevens WW .
Proton pump inhibitors decrease eotaxin-3/CCL26 expression in patients with chronic rhinosinusitis with nasal polyps: possible role of the nongastric H,K-ATPase.
J Allergy Clin Immunol 2017 Jan;139(1):130-41.e11. doi: 10.1016/j.jaci.2016.07.020.
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Keywords: Chronic Conditions, Medication, Patient-Centered Outcomes Research, Respiratory Conditions
Kolko RP, Kass AE, Hayes JF
Provider training to screen and initiate evidence-based pediatric obesity treatment in routine practice settings: a randomized pilot trial.
This randomized pilot trial evaluated two training modalities for first-line, evidence-based pediatric obesity services (screening and goal setting) among nursing students. Both live interactive training and Web-facilitated self-study training were acceptable, with higher ratings for live training and participants with previous experience. Knowledge and skill improved from pretraining to post-training and follow-up in both conditions.
AHRQ-funded; HS000078.
Citation: Kolko RP, Kass AE, Hayes JF .
Provider training to screen and initiate evidence-based pediatric obesity treatment in routine practice settings: a randomized pilot trial.
J Pediatr Health Care 2017 Jan - Feb;31(1):16-28. doi: 10.1016/j.pedhc.2016.01.001.
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Keywords: Children/Adolescents, Evidence-Based Practice, Nursing, Obesity, Training
Nuckols T, Conlon C, Robbins M
Quality of care for work-associated carpal tunnel syndrome.
This study evaluated the quality of care provided to individuals with workers' compensation claims related to carpal tunnel syndrome and identified patient characteristics associated with receiving better care. Overall, 81.6 percent of care adhered to recommended standards. Patients with classic/probable Katz diagrams, positive electrodiagnostic tests, and higher incomes received better care. However, age, sex, and race/ethnicity were not associated with quality.
AHRQ-funded; HS018982.
Citation: Nuckols T, Conlon C, Robbins M .
Quality of care for work-associated carpal tunnel syndrome.
J Occup Environ Med 2017 Jan;59(1):47-53. doi: 10.1097/jom.0000000000000916.
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Keywords: Guidelines, Quality of Care, Neurological Disorders, Patient-Centered Healthcare, Quality Indicators (QIs)
Simon AE, Boss EF, Zelaya CE
Racial and ethnic differences in receipt of pressure equalization tubes among US children, 2014.
More than 20 years ago, differences according to race/ethnicity in the national prevalence of having had pressure equalization tubes (PETs) placed were documented. This study found that, as of 2014, nearly 9 percent of US children have had PETs placed. Non-Hispanic white children still have a greater prevalence of PET placement compared with non-Hispanic black and Hispanic children.
AHRQ-funded; HS022932.
Citation: Simon AE, Boss EF, Zelaya CE .
Racial and ethnic differences in receipt of pressure equalization tubes among US children, 2014.
Acad Pediatr 2017 Jan - Feb;17(1):88-94. doi: 10.1016/j.acap.2016.07.004.
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Keywords: Children/Adolescents, Disparities, Ear Infections, Racial and Ethnic Minorities, Surgery
Magnusson DM, Mistry KB
AHRQ Author: Mistry KB
Racial and ethnic disparities in unmet need for pediatric therapy services: the role of family-centered care.
The researchers examined whether individual elements of family-centered care (FCC) mediate racial/ethnic disparities in parent-reported unmet therapy need. Eighteen percent of children with special health care needs 0 to 5 years old with reported therapy need experienced unmet need. Black and Hispanic children were more likely than white children to have parent-reported unmet therapy need.
AHRQ-authored.
Citation: Magnusson DM, Mistry KB .
Racial and ethnic disparities in unmet need for pediatric therapy services: the role of family-centered care.
Acad Pediatr 2017 Jan - Feb;17(1):27-33. doi: 10.1016/j.acap.2016.06.010.
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Keywords: Children/Adolescents, Disparities, Racial and Ethnic Minorities, Patient and Family Engagement, Racial and Ethnic Minorities
Caldwell JT, Ford CL, Wallace SP
Racial and ethnic residential segregation and access to health care in rural areas.
This study examined the relationship between racial/ethnic residential segregation and access to health care in rural areas. In rural areas, segregation contributed to worse access to a usual source of health care but higher reports of health care needs being met among African Americans and Hispanics.
AHRQ-funded; HS000078; HS022811.
Citation: Caldwell JT, Ford CL, Wallace SP .
Racial and ethnic residential segregation and access to health care in rural areas.
Health Place 2017 Jan;43:104-12. doi: 10.1016/j.healthplace.2016.11.015.
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Keywords: Access to Care, Health Services Research (HSR), Racial and Ethnic Minorities, Rural Health, Social Determinants of Health
Martin J, Halm EA, Tiro JA
Reasons for lack of diagnostic colonoscopy after positive result on fecal immunochemical test in a safety-net health system.
This study aimed to characterize factors contributing to lack of follow-up colonoscopy in a racially diverse and socioeconomically disadvantaged cohort of patients with abnormal results on the fecal immunochemical test receiving care in an integrated safety-net health system. It concluded that lack of diagnostic evaluation is related to a combination of patient-, provider-, and system-level factors, highlighting the need for multilevel interventions to improve follow-up colonoscopy completion rates.
AHRQ-funded; HS022418.
Citation: Martin J, Halm EA, Tiro JA .
Reasons for lack of diagnostic colonoscopy after positive result on fecal immunochemical test in a safety-net health system.
Am J Med 2017 Jan;130(1):93.e1-93.e7. doi: 10.1016/j.amjmed.2016.07.028.
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Keywords: Colonoscopy, Cancer: Colorectal Cancer, Cancer, Diagnostic Safety and Quality
Carroll KN, Gebretsadik T, Escobar GJ
Respiratory syncytial virus immunoprophylaxis in high-risk infants and development of childhood asthma.
This study sought to determine whether greater adherence to immunoprophylaxis in infants at high risk for severe respiratory syncytial virus (RSV) would be associated with decreased childhood asthma in a Medicaid population. The investigation of RSV immunoprophylaxis in high-risk children primarily found nonsignificant associations on prevention of asthma in specific preterm groups .
AHRQ-funded; HS018454.
Citation: Carroll KN, Gebretsadik T, Escobar GJ .
Respiratory syncytial virus immunoprophylaxis in high-risk infants and development of childhood asthma.
J Allergy Clin Immunol 2017 Jan;139(1):66-71.e3. doi: 10.1016/j.jaci.2016.01.055.
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Keywords: Asthma, Newborns/Infants, Children/Adolescents, Respiratory Conditions, Vaccination
Goodwin JS, Zhou J, Kuo YF
Risk of jaw osteonecrosis after intravenous bisphosphonates in cancer patients and patients without cancer.
The researchers compared the risk of jaw osteonecrosis after intravenous (IV) bisphosphonate administered to patients with cancer vs patients without cancer. During follow-up, 40 (0.42 percent) out of 9,482 patients with cancer developed probable jaw osteonecrosis compared with 8 (0.05 percent) out of 16,046 patients without cancer.
AHRQ-funded; HS022134.
Citation: Goodwin JS, Zhou J, Kuo YF .
Risk of jaw osteonecrosis after intravenous bisphosphonates in cancer patients and patients without cancer.
Mayo Clin Proc 2017 Jan;92(1):106-13. doi: 10.1016/j.mayocp.2016.09.015.
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Keywords: Cancer, Osteoporosis, Risk, Medication, Patient-Centered Outcomes Research
Lu Y, Zhou S, Dreyer RP
Sex differences in lipid profiles and treatment utilization among young adults with acute myocardial infarction: results from the VIRGO study.
This study characterized sex differences in lipid profiles and treatment utilization among young adults with acute myocardial infarction (AMI). Young women with AMI had slightly favorable lipid and lipoprotein profiles compared with men, suggesting that difference in lipid and lipoprotein may not be a major contributor to sex differences in outcomes after AMI.
AHRQ-funded; HS023000.
Citation: Lu Y, Zhou S, Dreyer RP .
Sex differences in lipid profiles and treatment utilization among young adults with acute myocardial infarction: results from the VIRGO study.
Am Heart J 2017 Jan;183:74-84. doi: 10.1016/j.ahj.2016.09.012.
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Keywords: Sex Factors, Heart Disease and Health, Healthcare Utilization, Women, Patient-Centered Outcomes Research
Sohn H, Timmermans S
Social effects of health care reform: Medicaid expansion under the Affordable Care Act and changes in volunteering.
This article examined whether public health policy interventions result in pro-social behaviors. Specifically, it examined the association between Medicaid and volunteer work. Volunteerism is implicated in individuals' health and well-being yet it is highly correlated with a person's existing socioeconomic resources. The investigators found that increased volunteer work associated with Medicaid was greater among minority groups and narrowed existing ethnic differences in volunteerism in states that expanded Medicaid eligibility.
AHRQ-funded; HS000046.
Citation: Sohn H, Timmermans S .
Social effects of health care reform: Medicaid expansion under the Affordable Care Act and changes in volunteering.
Socius 2017 Jan-Dec;3. doi: 10.1177/2378023117700903..
Keywords: Medicaid, Policy, Racial and Ethnic Minorities
Oates GR, Jackson BE, Partridge EE
Sociodemographic patterns of chronic disease: how the mid-south region compares to the rest of the country.
This descriptive study examines sociodemographic differences in the distribution of chronic diseases and health-related behaviors in the Mid-South versus the rest of the U.S., identifying subgroups at increased risk of chronic disease. It finds that the Mid-South population had increased rates of chronic disease and worse health-related behaviors than the rest of the U.S. Mid-South blacks had the highest percentages of obesity, diabetes, high blood pressure, and stroke of all subgroups.
AHRQ-funded; HS023009.
Citation: Oates GR, Jackson BE, Partridge EE .
Sociodemographic patterns of chronic disease: how the mid-south region compares to the rest of the country.
Am J Prev Med 2017 Jan;52(1s1):S31-s39. doi: 10.1016/j.amepre.2016.09.004.
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Keywords: Chronic Conditions, Health Status, Lifestyle Changes, Social Determinants of Health