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
9501 to 9525 of 12195 Research Studies DisplayedQato DM, Trivedi AN, Mor V
Disparities in discontinuing rosiglitazone following the 2007 FDA safety alert.
The researchers compared time to discontinuation of rosiglitazone after the safety alert between black and white elderly persons, and across sociodemographic and economic subgroups. They found that white race and a history of low personal income modestly predicted later discontinuation of rosiglitazone after the FDA's safety advisory in 2007.
AHRQ-funded; HS019657.
Citation: Qato DM, Trivedi AN, Mor V .
Disparities in discontinuing rosiglitazone following the 2007 FDA safety alert.
Med Care 2016 Apr;54(4):406-13. doi: 10.1097/mlr.0000000000000502..
Keywords: Medication, Disparities, Elderly, Social Determinants of Health, Vulnerable Populations
Nadpara PA, Madhavan SS, Tworek C
Disparities in lung cancer care and outcomes among elderly in a medically underserved state population-a cancer registry-linked database study.
The purpose of this study was to evaluate the patterns of lung cancer care and associated health outcomes among elderly residing in a rural and medically underserved area. The authors found that delays in diagnosis and treatment varied significantly: survival outcomes significantly improved with appropriate care but did not improve with timely care. They concluded that their study highlights the critical need to address disparities in receipt of guideline-concordant lung cancer care among the elderly residing in rural and medically underserved areas.
AHRQ-funded; HS018622.
Citation: Nadpara PA, Madhavan SS, Tworek C .
Disparities in lung cancer care and outcomes among elderly in a medically underserved state population-a cancer registry-linked database study.
Popul Health Manag 2016 Apr;19(2):109-19. doi: 10.1089/pop.2015.0027.
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Keywords: Disparities, Elderly, Cancer: Lung Cancer, Outcomes, Vulnerable Populations
Kinasz K, Accurso EC, Kass AE
Does sex matter in the clinical presentation of eating disorders in youth?
The authors compared demographic and clinical characteristics of child and adolescent males and females who presented for eating disorder treatment. They found that males presented at a significantly younger age and were more likely to be nonwhite, while females showed more severe pathology across the Eating Disorder Examination subscales. They suggested further exploration into why the sexes present differently.
AHRQ-funded; HS000078.
Citation: Kinasz K, Accurso EC, Kass AE .
Does sex matter in the clinical presentation of eating disorders in youth?
J Adolesc Health 2016 Apr;58(4):410-6. doi: 10.1016/j.jadohealth.2015.11.005.
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Keywords: Children/Adolescents, Behavioral Health, Nutrition, Sex Factors
Farris KB, Salgado TM, Aneese N
Effect of clinical and attitudinal characteristics on obtaining comprehensive medication reviews.
The researchers sought to quantify the association between attitudinal and clinical factors with intention and predict future behavior to obtain a comprehensive medication reviews (CMR) among Medicare Part D beneficiaries. They found that worrying about medications doing more harm than good, number of pharmacies where participants obtained their medications from, number of medications, and number of medical conditions predicted intention to obtain a CMR.
AHRQ-funded; HS018353.
Citation: Farris KB, Salgado TM, Aneese N .
Effect of clinical and attitudinal characteristics on obtaining comprehensive medication reviews.
J Manag Care Spec Pharm 2016 Apr;22(4):388-95. doi: 10.18553/jmcp.2016.22.4.388.
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Keywords: Medication, Medicare, Elderly, Medication: Safety, Patient Adherence/Compliance
Harrison MI, Paez K, Carman KL
AHRQ Author: Harrison MI
Effects of organizational context on Lean implementation in five hospital systems.
In order to help reduce gaps in knowledge of effects of intraorganizational context, the authors researched Lean implementation initiatives in five organizations and examined 12 of their Lean rapid improvement projects. They identified intraorganizational characteristics including CEO commitment to Lean and active support for it, prior organizational capacity for quality improvement-based performance improvement, and alignment of the Lean initiative with the organizational mission.
AHRQ-authored.
Citation: Harrison MI, Paez K, Carman KL .
Effects of organizational context on Lean implementation in five hospital systems.
Health Care Manage Rev 2016 Apr-Jun;41(2):127-44. doi: 10.1097/hmr.0000000000000049..
Keywords: Organizational Change, Hospitals, Quality Improvement, Quality of Care, Healthcare Delivery, Implementation
Macapagal K, Greene GJ, Andrews R
Evaluating the relationship-oriented information, motivation, and behavioral skills model of HIV preventive behaviors in young men who have sex with men.
The researchers examined links among the Relationship-Oriented Information- Motivation-Behavioral Skills (RELO-IMB) model, relationship characteristics, and HIV risk in 96 young men who have sex with men (YMSM). They concluded that the RELO-IMB model can be used to understand HIV risk in relationships and points to targets for relationship-specific HIV prevention education for YMSM.
AHRQ-funded; HS000078.
Citation: Macapagal K, Greene GJ, Andrews R .
Evaluating the relationship-oriented information, motivation, and behavioral skills model of HIV preventive behaviors in young men who have sex with men.
AIDS Educ Prev 2016 Apr;28(2):165-79. doi: 10.1521/aeap.2016.28.2.165.
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Keywords: Education: Patient and Caregiver, Human Immunodeficiency Virus (HIV), Prevention
Kayle M, Brennan-Cook J, Carter BM
Evaluation of a sickle cell disease educational website for emergency providers.
Electronic surveys were used to conduct a formal evaluation of the accuracy and relevance of the website's content, as well as the effectiveness of the education modules in improving knowledge among health care providers. Both sickle cell disease experts and ED providers agreed that the module content was clear and easy to understand, accurate, comprehensive, relevant, and met module objectives.
AHRQ-funded; HS019646.
Citation: Kayle M, Brennan-Cook J, Carter BM .
Evaluation of a sickle cell disease educational website for emergency providers.
Adv Emerg Nurs J 2016 Apr-Jun;38(2):123-32. doi: 10.1097/tme.0000000000000099.
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Keywords: Education: Continuing Medical Education, Emergency Department, Health Information Technology (HIT), Provider, Sickle Cell Disease
Bauer NS, Carroll AE, Saha C
Experience with decision support system and comfort with topic predict clinicians' responses to alerts and reminders.
The researchers examined factors associated with clinician response to computer decision support system (CDSS) prompts as part of a larger, ongoing quality improvement effort to optimize CDSS use. They found that clinicians were more likely to respond to topics rated as "easy" to discuss. The position of the prompt on the page, clinician gender, and the patient's age, race/ethnicity, and preferred language were also predictive of prompt response rate.
AHRQ-funded; HS017939; HS020640; HS022681.
Citation: Bauer NS, Carroll AE, Saha C .
Experience with decision support system and comfort with topic predict clinicians' responses to alerts and reminders.
J Am Med Inform Assoc 2016 Apr;23(e1):e125-30. doi: 10.1093/jamia/ocv148.
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Keywords: Clinical Decision Support (CDS), Patient Safety, Children/Adolescents, Health Information Technology (HIT), Children/Adolescents
Wang RC, Rodriguez RM, Moghadassi M
External validation of the STONE score, a clinical prediction rule for ureteral stone: an observational multi-institutional study.
The STONE score is a clinical decision rule that classifies patients with suspected nephrolithiasis into low-, moderate-, and high-score groups, with corresponding probabilities of ureteral stone. The researchers evaluated the STONE score compared with physician gestalt. They concluded that in its present form, the STONE score lacks sufficient accuracy to allow clinicians to defer CT scan for suspected ureteral stone.
AHRQ-funded; HS021281; HS019312.
Citation: Wang RC, Rodriguez RM, Moghadassi M .
External validation of the STONE score, a clinical prediction rule for ureteral stone: an observational multi-institutional study.
Ann Emerg Med 2016 Apr;67(4):423-32.e2. doi: 10.1016/j.annemergmed.2015.08.019.
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Keywords: Shared Decision Making, Diagnostic Safety and Quality, Imaging, Kidney Disease and Health, Practice Patterns
Bernard D, Selden T, Yeh S
AHRQ Author: Bernard D, Selden T
Financial burdens and barriers to care among nonelderly adults: the role of functional limitations and chronic conditions.
The researchers examined the financial burdens and barriers to care among nonelderly adults, focusing on the role of functional limitations and chronic conditions. Functional limitations and chronic conditions were associated with increased prevalence of burdens and financial barriers in all insurance categories, with the exception that an association between functional limitations and the prevalence of burdens was not observed for public coverage.
AHRQ-authored.
Citation: Bernard D, Selden T, Yeh S .
Financial burdens and barriers to care among nonelderly adults: the role of functional limitations and chronic conditions.
Disabil Health J 2016 Apr;9(2):256-64. doi: 10.1016/j.dhjo.2015.09.003.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Chronic Conditions, Access to Care, Health Services Research (HSR)
Lyles CR, Seligman HK, Parker MM
Financial strain and medication adherence among diabetes patients in an integrated health care delivery system: The Diabetes Study of Northern California (DISTANCE).
The researchers examined self-reported financial strain in relation to pharmacy utilization adherence data. Their analysis of survey, administrative, and electronic medical data from Kaiser Permanente Northern California found that 8 percent and 9 percent reported general and medication-specific financial strain. In adjusted models, general strain was significantly associated with primary nonadherence and refilling late and medication-specific strain was ssociated with primary nonadherence.
AHRQ-funded; HS022408.
Citation: Lyles CR, Seligman HK, Parker MM .
Financial strain and medication adherence among diabetes patients in an integrated health care delivery system: The Diabetes Study of Northern California (DISTANCE).
Health Serv Res 2016 Apr;51(2):610-24. doi: 10.1111/1475-6773.12346.
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Keywords: Diabetes, Medication, Patient Adherence/Compliance, Healthcare Costs, Healthcare Delivery
Plasek JM, Goss FR, Lai KH
Food entries in a large allergy data repository.
This study examined, encoded, and grouped foods that caused any adverse sensitivity in a large allergy repository using natural language processing and standard terminologies. It identified 158,552 food allergen records (2,140 unique terms) in the Partners repository, corresponding to 672 food allergen concepts. High-frequency groups included shellfish (19.3 percent), fruits or vegetables (18.4 percent), dairy (9.0 percent), and peanuts (8.5 percent).
AHRQ-funded; HS022728.
Citation: Plasek JM, Goss FR, Lai KH .
Food entries in a large allergy data repository.
J Am Med Inform Assoc 2016 Apr;23(e1):e79-87. doi: 10.1093/jamia/ocv128.
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Keywords: Data, Health Information Technology (HIT), Electronic Health Records (EHRs), Patient Safety
Rocque GB, Taylor RA, Acemgil A
Guiding lay navigation in geriatric patients with cancer using a distress assessment tool.
This study assessed the feasibility and impact of using distress assessments to frame lay navigator interactions with geriatric patients with cancer who were enrolled in navigation between January 1, 2014, and December 31, 2014. It concluded that lay navigators were able to routinely screen for patient distress at a high degree of penetration using a structured distress assessment.
AHRQ-funded; HS013852.
Citation: Rocque GB, Taylor RA, Acemgil A .
Guiding lay navigation in geriatric patients with cancer using a distress assessment tool.
J Natl Compr Canc Netw 2016 Apr;14(4):407-14.
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Keywords: Elderly, Cancer, Tools & Toolkits, Stress, Behavioral Health
Hassol A, Deitz D, Goldberg H
Health information exchange: perspectives from home healthcare.
Home health agencies (HHAs) often lack the timely and accurate patient information that they require for transition planning. The authors argue that health information exchanges (HIEs) offer information that supports timely visit scheduling, safe and appropriate care planning, coding and documentation, and HHA efficiency.
AHRQ-funded; HS018865.
Citation: Hassol A, Deitz D, Goldberg H .
Health information exchange: perspectives from home healthcare.
Comput Inform Nurs 2016 Apr;34(4):145-50. doi: 10.1097/cin.0000000000000240.
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Keywords: Health Information Exchange (HIE), Health Information Technology (HIT), Home Healthcare
Sheetz KH, Dimick JB, Ghaferi AA
Impact of hospital characteristics on failure to rescue following major surgery.
This study determined the effect of hospital characteristics on failure to rescue after high-risk surgery in Medicare beneficiaries. It found that although several hospital characteristics are associated with lower failure to rescue rates, these macrosystem factors explain a small proportion of the variability between hospitals. This suggests that microsystem characteristics may play a larger role in improving a hospital's ability to manage postoperative complications.
AHRQ-funded; HS023621.
Citation: Sheetz KH, Dimick JB, Ghaferi AA .
Impact of hospital characteristics on failure to rescue following major surgery.
Ann Surg 2016 Apr;263(4):692-7. doi: 10.1097/sla.0000000000001414.
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Keywords: Surgery, Elderly, Adverse Events, Disparities, Mortality
Kondo KK, Damberg CL, Mendelson A
Implementation processes and pay for performance in healthcare: A systematic review.
The authors conducted a systematic review and key informant (KI) interviews to better understand the implementation factors that modify the effectiveness of pay for performance (P4P). They concluded that P4P programs should undergo regular evaluation and should target areas of poor performance, and also that measures and incentives should align with organizational priorities, and programs should allow for changes over time in response to data and provider input.
AHRQ-funded; HS022981.
Citation: Kondo KK, Damberg CL, Mendelson A .
Implementation processes and pay for performance in healthcare: A systematic review.
J Gen Intern Med 2016 Apr;31 Suppl 1:61-9. doi: 10.1007/s11606-015-3567-0.
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Keywords: Healthcare Delivery, Provider Performance, Payment, Quality of Care
Flieger SP
Implementing the patient-centered medical home in complex adaptive systems: becoming a relationship-centered patient-centered medical home.
The purpose of this study is to apply complex adaptive systems theory and relationship-centered organizations theory to explore how nine diverse primary care practices in New Hampshire implemented the patient-centered medical homes (PCMH) model and to offer insights for how primary care practices can move from a structural PCMH to a relationship-centered PCMH. It found that becoming a relationship-centered PCMH requires attention to reflection, sensemaking, learning, and collaboration.
AHRQ-funded; HS021385.
Citation: Flieger SP .
Implementing the patient-centered medical home in complex adaptive systems: becoming a relationship-centered patient-centered medical home.
Health Care Manage Rev 2016 Apr/Jun;42(2):112-21. doi: 10.1097/hmr.0000000000000100.
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Keywords: Patient-Centered Healthcare, Primary Care, Clinician-Patient Communication
Croft L, Ladd J, Doll M
Inappropriate antibiotic use and gastric acid suppression preceding Clostridium difficile infection.
To understand how often Clostridium difficile infection (CDI) is related to inappropriate medication use, the researchers evaluated appropriateness of antimicrobial therapy and gastric acid suppression preceding CDI acquired. Of all CDI episodes, 38.0 percent (27 of 71) were preceded by inappropriate gastric acid suppressant medications. For the 40 episodes in which gastric acid suppressant medications were used prior to CDI, 27 (67.5 percent) were inappropriately treated.
AHRQ-funded; HS018111.
Citation: Croft L, Ladd J, Doll M .
Inappropriate antibiotic use and gastric acid suppression preceding Clostridium difficile infection.
Infect Control Hosp Epidemiol 2016 Apr;37(4):494-5. doi: 10.1017/ice.2016.2.
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Keywords: Adverse Drug Events (ADE), Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Medication: Safety, Medication
Lavallee DC, Chenok KE, Love RM
Incorporating patient-reported outcomes into health care to engage patients and enhance care.
The authors examine the opportunities for using patient-reported outcomes to enhance care delivery and outcomes as health care information needs and technology platforms change. They highlight emerging practices in which patient-reported outcomes provide value to patients and clinicians and improve care delivery. Finally, they examine present and future challenges to maximizing the use of patient-reported outcomes in the clinic.
AHRQ-funded; HS022789.
Citation: Lavallee DC, Chenok KE, Love RM .
Incorporating patient-reported outcomes into health care to engage patients and enhance care.
Health Aff 2016 Apr;35(4):575-82. doi: 10.1377/hlthaff.2015.1362.
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Keywords: Healthcare Delivery, Shared Decision Making, Patient-Centered Outcomes Research, Patient and Family Engagement, Quality Improvement
Ismail MD, Luo T, McNamara S
Long-term carriage of ciprofloxacin-resistant Escherichia coli Isolates in high-risk nursing home residents.
This paper's objective was to characterize the incidence and duration of carriage of ciprofloxacin-resistant Escherichia coli (CipREc) in nursing homes and to identify those in the O25b-ST131 lineage. The authors found that CipREc occurred frequently in nursing home residents and is carried for long durations, and that reacquisition following clearance is common.
AHRQ-funded; HS019979.
Citation: Ismail MD, Luo T, McNamara S .
Long-term carriage of ciprofloxacin-resistant Escherichia coli Isolates in high-risk nursing home residents.
Infect Control Hosp Epidemiol 2016 Apr;37(4):440-7. doi: 10.1017/ice.2015.326.
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Keywords: Nursing Homes, Long-Term Care, Elderly, Antibiotics, Patient Safety
Wang RC
Managing urolithiasis.
More than 1 million patients with suspected urolithiasis present to an emergency department (ED) each year in the United States. This review describes ED evaluation, therapies and the identification of patients who require urgent urologic intervention, with recommendations based on clinical trials; on guidelines from the American College of Emergency Physicians (ACEP), American College of Radiology, and American Urologic Association; and on anecdotal experience.
AHRQ-funded; HS021281.
Citation: Wang RC .
Managing urolithiasis.
Ann Emerg Med 2016 Apr;67(4):449-54. doi: 10.1016/j.annemergmed.2015.10.021.
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Keywords: Diagnostic Safety and Quality, Emergency Department, Guidelines
Cohen GR, Adler-Milstein J
Meaningful use care coordination criteria: perceived barriers and benefits among primary care providers.
This systematic review of studies of laser treatment of infantile hemangioma concluded that the studies primarily addressed different laser modalities compared with observation or other laser modalities. Pulsed dye laser was the most commonly studied laser type, but multiple variations in treatment protocols did not allow for demonstration of superiority of a single method.
AHRQ-funded; HS022674.
Citation: Cohen GR, Adler-Milstein J .
Meaningful use care coordination criteria: perceived barriers and benefits among primary care providers.
J Am Med Inform Assoc 2016 Apr;23(e1):e146-51. doi: 10.1093/jamia/ocv147.
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Keywords: Primary Care, Care Coordination, Electronic Health Records (EHRs), Health Information Technology (HIT)
Singh H, Sittig DF
Measuring and improving patient safety through health information technology: the Health IT Safety Framework.
The authors propose a new framework, the Health IT Safety (HITS) measurement framework, to provide a conceptual foundation for health IT-related patient safety measurement, monitoring, and improvement. The HITS framework follows both Continuous Quality Improvement (CQI) and sociotechnical approaches and calls for new measures and measurement activities to address safety concerns. A long term framework goal is to enable rigorous measurement that helps achieve the safety benefits of health IT in real-world clinical settings.
AHRQ-funded; HS022087.
Citation: Singh H, Sittig DF .
Measuring and improving patient safety through health information technology: the Health IT Safety Framework.
BMJ Qual Saf 2016 Apr;25(4):226-32. doi: 10.1136/bmjqs-2015-004486.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Health Information Technology (HIT), Patient Safety, Quality Measures
McConnell KJ, Lindrooth RC, Wholey DR
Modern management practices and hospital admissions.
The researchers investigated whether the modern management practices and publicly reported performance measures are associated with choice of hospital for patients with acute myocardial infarction (AMI). They found that, overall, a one standard deviation change in management practice scores is associated with an 8% increase in AMI admissions.
AHRQ-funded; HS018466.
Citation: McConnell KJ, Lindrooth RC, Wholey DR .
Modern management practices and hospital admissions.
Health Econ 2016 Apr;25(4):470-85. doi: 10.1002/hec.3171.
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Keywords: Hospitals, Heart Disease and Health, Cardiovascular Conditions, Quality Indicators (QIs), Quality Measures, Quality of Care, Public Reporting, Provider Performance
Rising KL, Carr BG, Hess EP
Patient-centered outcomes research in emergency care: opportunities, challenges, and future directions.
The authors explored factors unique to patient-centered emergency care research and highlighted specific areas of potential alignment within each of the five national PCORI priorities.
AHRQ-funded; HS023901.
Citation: Rising KL, Carr BG, Hess EP .
Patient-centered outcomes research in emergency care: opportunities, challenges, and future directions.
Acad Emerg Med 2016 Apr;23(4):497-502. doi: 10.1111/acem.12944.
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Keywords: Emergency Department, Patient-Centered Outcomes Research, Patient-Centered Healthcare, Quality Improvement, Quality of Care, Evidence-Based Practice