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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
9351 to 9375 of 12139 Research Studies DisplayedBaker AW, Dicks KV, Durkin MJ
Epidemiology of surgical site infection in a community hospital network.
The researchers described the epidemiology of complex surgical site infection (SSI) following commonly performed surgical procedures in community hospitals and to characterize trends of SSI prevalence rates over time for MRSA and other common pathogens. They found that the prevalence of MRSA SSI decreased from 2008 to 2012. This decrease in MRSA SSI prevalence led to an overall decrease in SSI prevalence.
AHRQ-funded; HS023866.
Citation: Baker AW, Dicks KV, Durkin MJ .
Epidemiology of surgical site infection in a community hospital network.
Infect Control Hosp Epidemiol 2016 May;37(5):519-26. doi: 10.1017/ice.2016.13.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Injuries and Wounds, Adverse Events, Risk, Hospitals
Rosas LG, Lv N, Xiao L
Evaluation of a culturally-adapted lifestyle intervention to treat elevated cardiometabolic risk of Latino adults in primary care (Vida Sana): a randomized controlled trial.
The authors discussed the 5-year Vida Sana study, which tests a culturally adapted and technology-enhanced group-based Diabetes Prevention Program intervention in a randomized controlled trial with overweight/obese Latino adults who have metabolic syndrome and/or pre-diabetes. The main goal was to determine the effectiveness of the intervention. The authors hypothesized that the intervention will lead to a greater mean reduction in weight at 24 months vs. usual care.
AHRQ-funded; HS022702.
Citation: Rosas LG, Lv N, Xiao L .
Evaluation of a culturally-adapted lifestyle intervention to treat elevated cardiometabolic risk of Latino adults in primary care (Vida Sana): a randomized controlled trial.
Contemp Clin Trials 2016 May;48:30-40. doi: 10.1016/j.cct.2016.03.003.
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Keywords: Cultural Competence, Lifestyle Changes, Racial and Ethnic Minorities, Primary Care, Racial and Ethnic Minorities
McElroy LM, Khorzad R, Nannicelli AP
Failure mode and effects analysis: a comparison of two common risk prioritisation methods.
The investigators compared a simplified scoring method with the traditional scoring method to determine the degree of congruence in identifying high-risk failures. They found that the simplified method did not result in the same degree of discrimination in the ranking of failures offered by the traditional method.
AHRQ-funded; HS000078.
Citation: McElroy LM, Khorzad R, Nannicelli AP .
Failure mode and effects analysis: a comparison of two common risk prioritisation methods.
BMJ Qual Saf 2016 May;25(5):329-36. doi: 10.1136/bmjqs-2015-004130.
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Keywords: Adverse Events, Intensive Care Unit (ICU), Outcomes, Patient Safety, Risk
Byczkowski TL, Gillespie GL, Kennebeck SS
Family-centered pediatric emergency care: a framework for measuring what parents want and value.
The objective of this study was to identify dimensions of family-centered care important to parents in pediatric emergency care and compare them to those currently defined. The authors concluded that the resulting dimensions provide a framework for measuring and improving the delivery of family-centered pediatric emergency care.
AHRQ-funded; HS019037.
Citation: Byczkowski TL, Gillespie GL, Kennebeck SS .
Family-centered pediatric emergency care: a framework for measuring what parents want and value.
Acad Pediatr 2016 May-Jun;16(4):327-35. doi: 10.1016/j.acap.2015.08.011.
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Keywords: Healthcare Delivery, Children/Adolescents, Emergency Medical Services (EMS), Patient Experience, Children/Adolescents
Snyder ME, Frail CK, Gernant SA
Fellowships in community pharmacy research: experiences of five schools and colleges of pharmacy.
The researchers described common facilitators, challenges, and lessons learned in 5 schools and colleges of pharmacy in establishing community pharmacy research fellowships. They found that common characteristics across the programs include length of training, prerequisites, graduate coursework, mentoring structure, and immersion into a pharmacist patient care practice. A common challenge has been recruitment, with many programs experiencing at least one year without filling the fellowship position.
AHRQ-funded; HS022119.
Citation: Snyder ME, Frail CK, Gernant SA .
Fellowships in community pharmacy research: experiences of five schools and colleges of pharmacy.
J Am Pharm Assoc 2016 May-Jun;56(3):316-22. doi: 10.1016/j.japh.2015.11.015.
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Keywords: Community-Based Practice, Education: Continuing Medical Education, Provider: Pharmacist
Sanses TV, Schiltz NK, Couri BM
Functional status in older women diagnosed with pelvic organ prolapse.
The aim of this study was to describe the prevalence of functional limitations based on health status in older women with pelvic organ prolapse (POP). They found that the prevalence of functional limitations was 76.2% in strength, 44.9% in upper and 65.8% in lower body mobility. They further discovered that the odds of all functional limitations increased significantly with advancing age.
AHRQ-funded; HS023113.
Citation: Sanses TV, Schiltz NK, Couri BM .
Functional status in older women diagnosed with pelvic organ prolapse.
Am J Obstet Gynecol 2016 May;214(5):613.e1-7. doi: 10.1016/j.ajog.2015.11.038.
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Keywords: Elderly, Health Status, Women
Bailey SR, Marino M, Hoopes M
Healthcare utilization after a children's health insurance program expansion in Oregon.
This study used electornic health record data from 154 Oregon community health centers to evaluate children's healthcare utilization after the Children's Health Insurance Program (CHIP) expansion. The authors found that utilization among the newly-insured remained higher than the uninsured group. This finding confirms that Children's Health Insurance Program expansions are associated with increased utilization of essential pediatric primary and preventive care.
AHRQ-funded; HS021522; HS018569.
Citation: Bailey SR, Marino M, Hoopes M .
Healthcare utilization after a children's health insurance program expansion in Oregon.
Matern Child Health J 2016 May;20(5):946-54. doi: 10.1007/s10995-016-1971-7.
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Keywords: Children's Health Insurance Program (CHIP), Electronic Health Records (EHRs), Healthcare Utilization, Children/Adolescents, Access to Care
Heslin KC, Elixhauser A, Steiner CA
AHRQ Author: Heslin KC, Elixhauser A, Steiner CA
Identifying in-patient costs attributable to the clinical sequelae and comorbidities of alcoholic liver disease in a national hospital database.
The aim of this study was to compare the average costs of hospitalizations with alcoholic liver disease (ALD) and the costs of hospitalizations with other alcohol-related diagnoses that do not involve the liver. It found that costs of hospital care for patients with ALD are higher than those for patients with other alcohol-related diagnoses.
AHRQ-authored.
Citation: Heslin KC, Elixhauser A, Steiner CA .
Identifying in-patient costs attributable to the clinical sequelae and comorbidities of alcoholic liver disease in a national hospital database.
Addiction 2016 May;112(5):782-91. doi: 10.1111/add.13702.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Alcohol Use, Healthcare Costs, Nutrition, Hospitalization
Bickman L, Douglas SR, De Andrade AR
Implementing a measurement feedback system: a tale of two sites.
A randomized experiment was conducted in two outpatient clinics evaluating contextualized feedback systems. Only one of the two participating clinics had an enhanced outcome because of feedback. Clinicians' questionnaire completion rate and feedback viewing were 50 % higher at this clinic. The discussion focused on the differences in implementation at each site and how these differences may have contributed to the different outcomes of the experiment.
AHRQ-funded; HS018036.
Citation: Bickman L, Douglas SR, De Andrade AR .
Implementing a measurement feedback system: a tale of two sites.
Adm Policy Ment Health 2016 May;43(3):410-25. doi: 10.1007/s10488-015-0647-8.
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Keywords: Behavioral Health, Outcomes, Ambulatory Care and Surgery, Patient-Centered Healthcare
Bajracharya AS, Crotty BH, Kowaloff HB
Improving health care proxy documentation using a web-based interview through a patient portal.
The authors sought to develop and evaluate a web-based interview to assist patients with health care proxy documentation to be included in the patients' electronic health record. They implemented the interview within the patient portal of an academic health system and analyzed the experience of the first 200 patients to complete it. The patients found the online interview convenient and helpful in establishing a healthcare proxy.
AHRQ-funded; HS021495.
Citation: Bajracharya AS, Crotty BH, Kowaloff HB .
Improving health care proxy documentation using a web-based interview through a patient portal.
J Am Med Inform Assoc 2016 May;23(3):580-7. doi: 10.1093/jamia/ocv133.
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Keywords: Web-Based, Electronic Health Records (EHRs), Health Information Technology (HIT)
Shy BD, Kim EY, Genes NG
Increased identification of emergency department 72-hour returns using multihospital health information exchange.
The authors tested the use of a health information exchange (HIE) to improve identification of 72-hour return visits compared to individual hospitals' site-specific data. They found that HIE increased the identification ability of 72-hour ED return analyses by a mean of 11.16% compared with site-specific (no HIE) analyses. They concluded that their analysis demonstrates incremental improvements in the ability to identify early ED returns using increasing levels of HIE data aggregation.
AHRQ-funded; HS021261.
Citation: Shy BD, Kim EY, Genes NG .
Increased identification of emergency department 72-hour returns using multihospital health information exchange.
Acad Emerg Med 2016 May;23(5):645-9. doi: 10.1111/acem.12954.
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Keywords: Emergency Department, Health Information Exchange (HIE), Hospital Discharge, Hospital Readmissions
La EM, Lich KH, Wells R
Increasing access to state psychiatric hospital beds: exploring supply-side solutions.
The objective of this study was to identify supply-side interventions to reduce state psychiatric hospital admission delays. The investigators suggest that without more robust community-based hospital and residential capacity, major increases in state psychiatric hospital inpatient capacity are necessary to ensure timely admission of people in crisis.
AHRQ-funded; HS000032.
Citation: La EM, Lich KH, Wells R .
Increasing access to state psychiatric hospital beds: exploring supply-side solutions.
Psychiatr Serv 2016 May;67(5):523-8. doi: 10.1176/appi.ps.201400570..
Keywords: Access to Care, Behavioral Health
Wysham NG, Kamal AH
Integrating palliative care in the intensive care unit. evidence gaps and quality gaps.
The authors discuss Mularski and colleagues in the same issue, stating that this study provides an important advancement in measuring palliative care quality in the ICU. They commend Mularski and colleagues for advancing the candidate measures of ICU-based palliative care and conclude that this report draws attention to important and persistent deficiencies in comprehensive, patient-centered critical care delivery that needs to be addressed in research and in practice.
AHRQ-funded; HS023681.
Citation: Wysham NG, Kamal AH .
Integrating palliative care in the intensive care unit. evidence gaps and quality gaps.
Ann Am Thorac Soc 2016 May;13(5):595-7. doi: 10.1513/AnnalsATS.201601-061ED.
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Keywords: Evidence-Based Practice, Intensive Care Unit (ICU), Palliative Care, Patient-Centered Outcomes Research, Quality of Care
Vargas GM, Sieloff EP, Parmar AD
Laparoscopy decreases complications for obese patients undergoing elective rectal surgery.
This paper's goal was to determine whether obese patients undergoing laparoscopic rectal surgery experienced the same benefits as non-obese patients. The researchers found that laparoscopic rectal surgery is associated with fewer complications when compared to open rectal surgery in both obese and non-obese patients, and that obesity was an independent risk factor for postoperative complications.
AHRQ-funded; HS022134.
Citation: Vargas GM, Sieloff EP, Parmar AD .
Laparoscopy decreases complications for obese patients undergoing elective rectal surgery.
Surg Endosc 2016 May;30(5):1826-32. doi: 10.1007/s00464-015-4463-8.
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Keywords: Adverse Events, Obesity, Risk, Surgery
Prochaska JJ, Michalek AK, Brown-Johnson C
Likelihood of unemployed smokers vs nonsmokers attaining reemployment in a one-year observational study.
The researchers examined the differences in reemployment by smoking status in a 12-month period. This study, the first to prospectively track reemployment success by smoking status, concluded that smokers had a lower likelihood of reemployment at 1 year and were paid significantly less than nonsmokers when reemployed.
AHRQ-funded; HS022192.
Citation: Prochaska JJ, Michalek AK, Brown-Johnson C .
Likelihood of unemployed smokers vs nonsmokers attaining reemployment in a one-year observational study.
JAMA Intern Med 2016 May;176(5):662-70. doi: 10.1001/jamainternmed.2016.0772.
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Keywords: Tobacco Use, Racial and Ethnic Minorities, Lifestyle Changes, Risk
Kim EH, Vetter JM, Kuxhausen AN
Limited use of surveillance imaging following nephrectomy for renal cell carcinoma.
The researchers evaluated the utilization of follow-up imaging after nephrectomy for renal cell carcinoma (RCC) in nationally representative data. Using Surveillance, Epidemiology, End Results (SEER) data, they found that, in the Medicare population, surveillance imaging is performed in a limited number of patients following nephrectomy for RCC but that increasing tumor stage is predictive of both increased chest and abdominal imaging surveillance.
AHRQ-funded; HS019455.
Citation: Kim EH, Vetter JM, Kuxhausen AN .
Limited use of surveillance imaging following nephrectomy for renal cell carcinoma.
Urol Oncol 2016 May;34(5):237.e11-8. doi: 10.1016/j.urolonc.2015.11.017.
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Keywords: Cancer, Healthcare Utilization, Imaging, Medicare
Cook BL, Kim G, Morgan KL
Measuring geographic "hot spots" of racial/ethnic disparities: an application to mental health care.
The researchers identified geographic "hot spots" of racial/ethnic disparities in mental health care access. They identified these "hot spots": Richmond, Virginia, and Columbus, Georgia, for Black-White disparities; Fresno, California, and Dallas, Texas, for Latino-White disparities; and Riverside, California, and Houston, Texas, for Asian-White mental health care disparities. They discussed the potential and limitations of these methods as tools for understanding health care disparities in other contexts.
AHRQ-funded; HS021486.
Citation: Cook BL, Kim G, Morgan KL .
Measuring geographic "hot spots" of racial/ethnic disparities: an application to mental health care.
J Health Care Poor Underserved 2016;27(2):663-84. doi: 10.1353/hpu.2016.0091.
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Keywords: Access to Care, Disparities, Behavioral Health, Racial and Ethnic Minorities
Hu T, Decker SL, Chou SY
AHRQ Author: Decker SL
Medicaid pay for performance programs and childhood immunization status.
This national study examined the effects of pay for performance (P4P) programs on childhood immunization rates. It found no overall effect of Medicaid P4P on the chance that children aged 19-35 months had completed the 4:3:1:3:3:1 vaccination series. However, there was a 4 percentage point increase in the chance that a child 19-23 months had completed the series.
AHRQ-authored.
Citation: Hu T, Decker SL, Chou SY .
Medicaid pay for performance programs and childhood immunization status.
Am J Prev Med 2016 May;50(5 Suppl 1):S51-7. doi: 10.1016/j.amepre.2016.01.012.
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Keywords: Newborns/Infants, Children/Adolescents, Medicaid, Vaccination, Payment, Health Insurance
Gray CP, Harrison MI, Hung D
AHRQ Author: Harrison MI
Medical assistants as flow managers in primary care: challenges and recommendations.
Drawing on an empirical study of a large, multispecialty delivery system engaged in reconfiguration of primary care, the authors found that using medical assistants (Mas) as flow managers required overcoming several challenges. These included entrenched social and occupational hierarchies between physicians and MAs, a lack of adequate training and mentorship, and difficulty attracting and retaining talented MAs.
AHRQ-authored; AHRQ-funded; 2902010000221.
Citation: Gray CP, Harrison MI, Hung D .
Medical assistants as flow managers in primary care: challenges and recommendations.
J Healthc Manag 2016 May-Jun;61(3):181-91.
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Keywords: Primary Care, Organizational Change, Practice Improvement, Quality Improvement, Quality of Care, Workflow, Provider
Callaghan BC, Burke JF, Skolarus LE
Medicare's reimbursement reduction for nerve conduction studies: effect on use and payments.
The purpose of this research letter was to investigate the effect of the sharp reduction in Medicare reimbursement for electromyography (EMG) while the reimbursement for nerve conduction studies (NCS) remained unchanged. They found that the use of EMG by neurologists and physiatrists changed little, whereas a decrease in its use among other health care providers was observed. They concluded that the pattern of change in use of EMG and NCS suggests findings similar to those in past studies of Medicare reimbursement with regard to reducing inappropriate, but not appropriate, testing and treatment.
AHRQ-funded; HS022258.
Citation: Callaghan BC, Burke JF, Skolarus LE .
Medicare's reimbursement reduction for nerve conduction studies: effect on use and payments.
JAMA Intern Med 2016 May;176(5):697-9. doi: 10.1001/jamainternmed.2016.0162.
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Keywords: Diagnostic Safety and Quality, Healthcare Costs, Payment, Medicare
Healy MA, Yin H, Wong SL
Multimodal cancer care in poor prognosis cancers: resection drives long-term outcomes.
The researchers compared effects of resection with other therapies on long-term outcomes across U.S. hospitals. They examined claims in the Surveillance, Epidemiology, and End Results (SEER) Medicare dataset for patients with esophageal and pancreatic cancers and found that a significant association exists between long-term survival and rates of cancer-directed surgery across hospitals, without variation in rates of other therapies.
AHRQ-funded; HS020937.
Citation: Healy MA, Yin H, Wong SL .
Multimodal cancer care in poor prognosis cancers: resection drives long-term outcomes.
J Surg Oncol 2016 May;113(6):599-604. doi: 10.1002/jso.24217.
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Keywords: Cancer, Outcomes, Surgery, Treatments, Disparities
Bae J, Encinosa WE
AHRQ Author: Encinosa WE
National estimates of the impact of electronic health records on the workload of primary care physicians.
This study examines whether electronic health records (EHR) is associated with increases in face time with the patient per visit and increases in the physician's patient volume per week. It found that among young physicians, EHR use is associated with a decline in weekly patient volume, while EHR use among older physicians is associated with an increase in volume, regardless of initial practice size.
AHRQ-authored.
Citation: Bae J, Encinosa WE .
National estimates of the impact of electronic health records on the workload of primary care physicians.
BMC Health Serv Res 2016 May 10;16(1):172. doi: 10.1186/s12913-016-1422-6.
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Keywords: Primary Care, Electronic Health Records (EHRs), Clinician-Patient Communication, Health Information Technology (HIT)
Hodell E, Hughes SD, Corry M
Paramedic perspectives on barriers to prehospital acute stroke recognition.
The researchers aimed to understand systematically the challenges and barriers faced by paramedics in recognizing stroke presentations in the field. They concluded that while challenges to stroke recognition in the field were slightly different for rural and urban emergency medical service providers, participants concurred that timely, systematic feedback on individual patients and case-based training would strengthen early stroke recognition skills.
AHRQ-funded; HS017965.
Citation: Hodell E, Hughes SD, Corry M .
Paramedic perspectives on barriers to prehospital acute stroke recognition.
Prehosp Emerg Care 2016 May-Jun;20(3):415-24. doi: 10.3109/10903127.2015.1115933.
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Keywords: Diagnostic Safety and Quality, Emergency Medical Services (EMS), Healthcare Delivery, Stroke, Training
Mathur MB, Epel E, Kind S
Perceived stress and telomere length: a systematic review, meta-analysis, and methodologic considerations for advancing the field.
The researchers conducted a systematic review and meta-analysis to determine the association between self-reported, perceived psychological stress (PS) and telomere length (TL). They found that increased PS was associated with a very small decrease in TL and that this relationship was similar between sexes. They concluded that the association may be stronger with known major stressors and is similar in magnitude to that noted between obesity and TL. The authors recommended that futre research assess for potential confounders and use longitudinal, multidimensional models of stress.
AHRQ-funded; HS019816.
Citation: Mathur MB, Epel E, Kind S .
Perceived stress and telomere length: a systematic review, meta-analysis, and methodologic considerations for advancing the field.
Brain Behav Immun 2016 May;54:158-69. doi: 10.1016/j.bbi.2016.02.002.
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Keywords: Evidence-Based Practice, Genetics, Stress
Balbale SN, Etingen B, Malhiot A
Perceptions of chronic illness care among veterans with multiple chronic conditions.
The purpose of this study was to use the Patient Assessment of Chronic Illness Care (PACIC) instrument to examine perceptions of chronic care among veterans with multiple chronic conditions (MCC). The authors concluded that quality improvements are needed to strengthen care continuity and coordination.
AHRQ-funded; HS000084.
Citation: Balbale SN, Etingen B, Malhiot A .
Perceptions of chronic illness care among veterans with multiple chronic conditions.
Mil Med 2016 May;181(5):439-44. doi: 10.7205/milmed-d-15-00207..
Keywords: Chronic Conditions, Patient Experience, Quality Improvement