National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Blood Pressure (1)
- Children's Health Insurance Program (CHIP) (7)
- Children/Adolescents (9)
- Chronic Conditions (2)
- Clinical Decision Support (CDS) (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Dental and Oral Health (1)
- Diabetes (3)
- Education: Continuing Medical Education (1)
- Elderly (1)
- Electronic Health Records (EHRs) (4)
- Emergency Department (1)
- Healthcare Delivery (2)
- Health Information Exchange (HIE) (1)
- Health Information Technology (HIT) (1)
- Health Services Research (HSR) (6)
- Hospital Readmissions (2)
- Hospitals (2)
- Medicaid (1)
- Medicare (1)
- Medication (1)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (1)
- Nursing Homes (1)
- Outcomes (1)
- Palliative Care (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (1)
- Patient Experience (2)
- Patient Safety (3)
- Primary Care (1)
- Provider Performance (5)
- Quality Improvement (6)
- Quality Indicators (QIs) (8)
- (-) Quality Measures (28)
- Quality of Care (16)
- Shared Decision Making (1)
- Surgery (2)
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
1 to 25 of 28 Research Studies DisplayedSchmittdiel J, Raebel M, Dyer W
Medicare Star excludes diabetes patients with poor CVD risk factor control.
This study is designed to improve understanding of novel CMS quality measures (adherence to antihypertensives, antihyperlipidemics, and oral antihyperglycemics) by assessing the proportion of Medicare patients with diabetes who are excluded from the Medicare Star medication adherence metrics due to early nonadherence and insulin use. Medicare’s STAR measures are used to evaluate the performance of Medicare Advantage plans.
AHRQ-funded; HS019859
Citation: Schmittdiel J, Raebel M, Dyer W .
Medicare Star excludes diabetes patients with poor CVD risk factor control.
Am J Manag Care. 2014 Dec; 20(12):e573-81..
Keywords: Medicare, Diabetes, Quality Measures, Patient Adherence/Compliance
Einbinder J, Hebel E, Wright A
The number needed to remind: a measure for assessing CDS effectiveness.
The purpose of this paper is to provide a better understanding of population based clinical decision support (CDS) performance measurement, to identify best practices for designing and implementing CDS, and to introduce two new quality measures, titled Reminder Performance (RP) and the Number Needed to Remind (NNR) for evaluating the effectiveness of clinical reminders in the context of the CDS Dashboards.
AHRQ-funded; 290200810010.
Citation: Einbinder J, Hebel E, Wright A .
The number needed to remind: a measure for assessing CDS effectiveness.
AMIA Annu Symp Proc 2014 Nov 14;2014:506-15..
Keywords: Shared Decision Making, Clinical Decision Support (CDS), Quality Measures, Quality of Care
Garg N, Kuperman G, Onyile A
Validating health information exchange (HIE) data for quality measurement across four hospitals.
The study objective was to validate the secondary use of HIE data for two emergency department (ED) quality measures: identification of frequent ED users and early (72-hour) ED returns in four hospitals. It found that there was no significant difference in the total counts for frequent ED users or early ED returns for any of the four hospitals.
AHRQ-funded; HS021261.
Citation: Garg N, Kuperman G, Onyile A .
Validating health information exchange (HIE) data for quality measurement across four hospitals.
AMIA Annu Symp Proc 2014 Nov 14;2014:573-9..
Keywords: Electronic Health Records (EHRs), Emergency Department, Quality of Care, Health Information Exchange (HIE), Quality Measures
Lucas JA, Chakravarty S, Bowblis JR
Antipsychotic medication use in nursing homes: a proposed measure of quality.
There is an important need for a more specific measure of quality related to antipsychotic medication (APM) use. This paper proposes such a measure, compares it with the APM quality measure introduced by CMS in 2012 and examines variation in these two measures across resident and facility characteristics using a multi-state case demonstration of long-stay NH residents.
AHRQ-funded; HS021112.
Citation: Lucas JA, Chakravarty S, Bowblis JR .
Antipsychotic medication use in nursing homes: a proposed measure of quality.
Int J Geriatr Psychiatry 2014 Oct;29(10):1049-61. doi: 10.1002/gps.4098..
Keywords: Medication, Nursing Homes, Elderly, Quality Measures, Quality Measures
Anhang Price R, Elliott MN, Zaslavsky AM
Examining the role of patient experience surveys in measuring health care quality.
The authors reviewed the literature on the association between patient experiences and other measures of health care quality. They concluded that patient experience measures that are collected using psychometrically sound instruments, employing recommended sample sizes and adjustment procedures, and implemented according to standard protocols are intrinsically meaningful and are appropriate complements for clinical process and outcome measures in public reporting and pay-for-performance programs.
AHRQ-funded; HS016980; HS016978.
Citation: Anhang Price R, Elliott MN, Zaslavsky AM .
Examining the role of patient experience surveys in measuring health care quality.
Med Care Res Rev 2014 Oct;71(5):522-54. doi: 10.1177/1077558714541480.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Quality of Care, Quality Improvement, Quality Measures
Bailey LC, Mistry KB, Tinoco A
AHRQ Author: Mistry KB
Addressing electronic clinical information in the construction of quality measures.
The authors draw on the experience of Centers of Excellence to review both structural and pragmatic considerations in e-measurement. They suggest that addressing these challenges will require investment by vendors, researchers, and clinicians alike in developing better pediatric content for standard terminologies and data models, encouraging wider adoption of technical standards that support reliable quality measurement, better harmonizing data collection with clinical work flow in EHRs, and better understanding the behavior and potential of e-measures.
AHRQ-authored.
Citation: Bailey LC, Mistry KB, Tinoco A .
Addressing electronic clinical information in the construction of quality measures.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S82-9. doi: 10.1016/j.acap.2014.06.006.
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Keywords: Children's Health Insurance Program (CHIP), Electronic Health Records (EHRs), Quality Improvement, Quality Indicators (QIs), Quality Measures
Mistry KB, Chesley F, Llanos K
AHRQ Author: Mistry KB, Chesley F, Dougherty D.
Advancing children's health care and outcomes through the pediatric quality measures program.
This article focuses on the Pediatric Quality Measures Program and provides an overview of the program's goals and related activities, lessons learned, and future opportunities.
AHRQ-authored.
Citation: Mistry KB, Chesley F, Llanos K .
Advancing children's health care and outcomes through the pediatric quality measures program.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S19-26. doi: 10.1016/j.acap.2014.06.025.
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Keywords: Children's Health Insurance Program (CHIP), Quality of Care, Health Services Research (HSR), Children/Adolescents, Quality Measures
Kuhlthau KA, Mistry KB, Forrest CB
AHRQ Author: Mistry KB, Dougherty D
Advancing the science of measurement in pediatric quality of care.
This overview describes the articles in this supplement as falling into 3 broad themes: the value of pediatric quality measures to stakeholders; the scope of the CHIPRA Pediatric Quality Measures Program measurement initiative; and challenges in developing and testing pediatric quality measures. It concludes that the articles illustrate the considerations necessary for creating good measure sets and provide strategies for overcoming challenges encountered in the measurement development process.
AHRQ-authored; AHRQ-funded; HS020408.
Citation: Kuhlthau KA, Mistry KB, Forrest CB .
Advancing the science of measurement in pediatric quality of care.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S1-3. doi: 10.1016/j.acap.2014.06.016..
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Children/Adolescents, Quality Measures, Quality Measures
Dougherty D, Mistry KB, Llanos K
AHRQ Author: Dougherty D, Mistry KB, Chesley F
An AHRQ and CMS perspective on the pediatric quality measures program.
This article describes the Pediatric Quality Measures Program (PQMP). The PQMP has worked to close gaps in children’s health care quality by increasing the portfolio of new measures and methods as envisioned by the CHIPRA legislation. It is the adoption and use of these measures that can lead to improvements in the quality of care and elimination of disparities in health care for children over time.
AHRQ-authored.
Citation: Dougherty D, Mistry KB, Llanos K .
An AHRQ and CMS perspective on the pediatric quality measures program.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S17-8. doi: 10.1016/j.acap.2014.06.017.
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Keywords: Children's Health Insurance Program (CHIP), Quality of Care, Health Services Research (HSR), Children/Adolescents, Quality Measures
Lorch SA, Passarella M, Zeigler A
Challenges to measuring variation in readmission rates of neonatal intensive care patients.
The authors examined the viability of a hospital readmission quality metric for infants requiring neonatal intensive care. They found that the California cohort showed significant variation in hospital-level readmission rates, supporting the premise that readmission rates of prematurely born infants may reflect care quality. However, state data did not include term and early term infants requiring neonatal intensive care, and there were extensive missing data in the few states with sufficient information on managed care patients to calculate state-level measures. They concluded that constructing a valid readmission measure for NICU care across diverse states and regions requires improved data collection.
AHRQ-funded; HS018661; HS020508.
Citation: Lorch SA, Passarella M, Zeigler A .
Challenges to measuring variation in readmission rates of neonatal intensive care patients.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S47-53. doi: 10.1016/j.acap.2014.06.010.
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Keywords: Neonatal Intensive Care Unit (NICU), Newborns/Infants, Quality Indicators (QIs), Quality Measures, Hospital Readmissions
Forrest CB, Silber JH
Concept and measurement of pediatric value.
The authors investigate providing information on pediatric value, which will require new investments in data collection systems that include outcomes that matter to children and families and costs measured at the level of the child. They discuss analysis of these data to account for the perspective of the user of the information. They recommend that, in the case of families, direct standardization be used to contrast care in one health care system with another according to the unique characteristics of each family and child.
AHRQ-funded; HS020408.
Citation: Forrest CB, Silber JH .
Concept and measurement of pediatric value.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S33-8. doi: 10.1016/j.acap.2014.03.013.
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Keywords: Children/Adolescents, Health Services Research (HSR), Quality Measures, Quality Measures, Children/Adolescents
Byron SC, Gardner W, Kleinman LC
Developing measures for pediatric quality: methods and experiences of the CHIPRA pediatric quality measures program grantees.
The authors described the processes used by the Pediatric Quality Measures Program (PQMP) grantees to develop measures to assess the health care of children and adolescents in Medicaid and the Children's Health Insurance Program. They found that PQMP grantees faced common challenges, including the limited evidence base, data systems difficult or unsuited for measures reporting, and conflicting stakeholder priorities. Grantees were able to explore innovative methods to overcome measurement challenges, resulting in new quality measures for pediatric care.
AHRQ-funded; HS020513; HS020498; HS020516; HS020506; HS020518; HS020508; HS020503.
Citation: Byron SC, Gardner W, Kleinman LC .
Developing measures for pediatric quality: methods and experiences of the CHIPRA pediatric quality measures program grantees.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S27-32. doi: 10.1016/j.acap.2014.06.013.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Quality of Care, Children/Adolescents, Quality Measures
Nakamura MM, Toomey SL, Zaslavsky AM
Measuring pediatric hospital readmission rates to drive quality improvement.
The investigators sought to describe the importance of readmissions in children and the challenges of developing readmission quality measures. They found that the policy focus on readmissions has motivated widespread efforts by hospitals and outpatient providers to evaluate and reengineer care processes.
AHRQ-funded; HS020513; HS020508.
Citation: Nakamura MM, Toomey SL, Zaslavsky AM .
Measuring pediatric hospital readmission rates to drive quality improvement.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S39-46. doi: 10.1016/j.acap.2014.06.012.
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Keywords: Children/Adolescents, Quality Improvement, Quality Indicators (QIs), Quality Measures, Hospital Readmissions
Bevans KB, Moon J, Carle AC
Patient reported outcomes as indicators of pediatric health care quality.
The authors described and illustrated in case examples the functions, benefits, and challenges of patient-reported outcomes applications. They concluded that pediatric patient-reported outcomes are increasingly recognized as valuable indicators of health care quality in the clinical environment and as measures of organization- and provider-level performance.
AHRQ-funded; HS020408.
Citation: Bevans KB, Moon J, Carle AC .
Patient reported outcomes as indicators of pediatric health care quality.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S90-6. doi: 10.1016/j.acap.2014.06.002..
Keywords: Children/Adolescents, Quality of Care, Children/Adolescents, Quality Indicators (QIs), Quality Measures, Provider Performance
Dougherty D, Mistry KB, Lindly O
AHRQ Author: Dougherty D, Mistry KB, Desoto M, Chesley F
Systematic evidence-based quality measurement life-cycle approach to measure retirement in CHIPRA.
The authors assessed selected child core set (CCS) measures for potential retirement. The Subcommittee of the National Advisory Council on Healthcare Research and Quality recommended 3 measures for retirement: access to primary care; testing for strep before recommending antibiotics for pharyngitis; and annual HbA1c testing of children with diabetes. CMS recommended that state Medicaid and CHIP programs retire 2 of the recommended measures from the CCS, but retained the access to primary care measure.
AHRQ-authored.
Citation: Dougherty D, Mistry KB, Lindly O .
Systematic evidence-based quality measurement life-cycle approach to measure retirement in CHIPRA.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S97-s103. doi: 10.1016/j.acap.2014.06.015.
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Keywords: Children's Health Insurance Program (CHIP), Quality of Care, Health Services Research (HSR), Children/Adolescents, Quality Measures
Gidengil C, Mangione-Smith R, Bailey LC
Using Medicaid and CHIP claims data to support pediatric quality measurement: lessons from 3 centers of excellence in measure development.
The investigators sought to explore the claims data-related issues relevant to quality measure development for Medicaid and the Children's Health Insurance Program (CHIP), illustrating the challenges encountered and solutions developed around 3 distinct performance measure topics: care coordination for children with complex needs, quality of care for high-prevalence conditions, and hospital readmissions. Their three Centers of Excellence in pediatric quality measurement used innovative methods to develop algorithms that use Medicaid claims data to identify children with complex needs; to overcome some shortcomings of existing data for measuring quality of care for common conditions such as otitis media; and to identify readmissions after hospitalizations for lower respiratory infections.
AHRQ-funded; HS020513; HS020506; HS020508.
Citation: Gidengil C, Mangione-Smith R, Bailey LC .
Using Medicaid and CHIP claims data to support pediatric quality measurement: lessons from 3 centers of excellence in measure development.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S76-81. doi: 10.1016/j.acap.2014.06.014.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Medicaid, Quality Indicators (QIs), Quality Measures, Quality of Care
Maggard-Gibbons M
The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program.
This review summarized the history of American College of Surgeons National Surgical Quality Improvement Project and its components, and described the evidence that feeding outcomes back to providers, along with real-time comparisons with other hospital rates, leads to quality improvement, better patient outcomes, cost savings and overall improved patient safety.
AHRQ-funded; 2902007100621.
Citation: Maggard-Gibbons M .
The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program.
BMJ Qual Saf 2014 Jul;23(7):589-99. doi: 10.1136/bmjqs-2013-002223..
Keywords: Quality Improvement, Quality Indicators (QIs), Quality Measures, Quality of Care, Surgery, Patient Safety, Outcomes, Patient-Centered Outcomes Research, Provider Performance
Hirsch AG, Scheck McAlearney A
Measuring diabetes care performance using electronic health record data: the impact of diabetes definitions on performance measure outcomes.
The authors examined the use of electronic health record (EHR) data for diabetes performance measurement. They found that diabetes performance measures are influenced by the data elements used to identify patients. They recommended that as EHR data are used increasingly to measure performance, continuing to improve our understanding of how EHR data are collected and used will be critical.
AHRQ-funded; HS020165.
Citation: Hirsch AG, Scheck McAlearney A .
Measuring diabetes care performance using electronic health record data: the impact of diabetes definitions on performance measure outcomes.
Am J Med Qual 2014 Jul-Aug;29(4):292-9. doi: 10.1177/1062860613500808.
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Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Measures
Arora VM, Berhie S, Horwitz LI
Using standardized videos to validate a measure of handoff quality: the handoff mini-clinical examination exercise.
The researchers report the results of the development of a shorter Handoff Mini-Clinical Examination Exercise (CEX), along with the formal establishment of its construct validity, namely its ability to distinguish between levels of performance in 3 domains of handoff quality. They were able to demonstrate evidence that the Handoff Mini-CEX can draw reliable and valid conclusions regarding handoff performance by physicians in U.S. hospitals.
AHRQ-funded; HS018278
Citation: Arora VM, Berhie S, Horwitz LI .
Using standardized videos to validate a measure of handoff quality: the handoff mini-clinical examination exercise.
J Hospital Med. 2014 Jul;9(7):441-6. doi: 10.1002/jhm.2185.
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Keywords: Provider Performance, Quality Measures, Quality Improvement, Quality of Care, Education: Continuing Medical Education, Patient Safety
Bilimoria KY, Cella D, Butt Z
Current challenges in using patient-reported outcomes for surgical care and performance measurement: everybody wants to hear from the patient, but are we ready to listen?
This viewpoint article discussed patient-reported outcomes (PROs). It concludes that PROs undoubtedly capture some of the most important aspects of how successful an operation is, and PRO scores may be the best measure of patient-centered care, but considerable logistical and methodological issues must be addressed before PROs are ready for widespread national implementation.
AHRQ-funded; HS021857.
Citation: Bilimoria KY, Cella D, Butt Z .
Current challenges in using patient-reported outcomes for surgical care and performance measurement: everybody wants to hear from the patient, but are we ready to listen?
JAMA Surg 2014 Jun;149(6):505-6. doi: 10.1001/jamasurg.2013.5285.
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Keywords: Patient-Centered Outcomes Research, Quality Measures, Surgery
Wang JJ, Winther CH, Cha J
Patient-centered medical home and quality measurement in small practices.
In this retrospective cohort study, the investigators sought to assess performance on quality measures among small primary care practices that recently adopted an electronic health record (EHR), and how performance differs between practices that have achieved patient-centered medical home (PCMH) recognition and those that have not. They found that among small practices that have adopted EHRs, practices with PCMH recognition consistently outperformed practices without recognition on 5 out of 7 clinical quality measures over the 2-year study period.
AHRQ-funded; HS019164.
Citation: Wang JJ, Winther CH, Cha J .
Patient-centered medical home and quality measurement in small practices.
Am J Manag Care 2014 Jun;20(6):481-9.
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Keywords: Electronic Health Records (EHRs), Quality of Care, Patient-Centered Healthcare, Primary Care, Quality Measures
Paddock SM
Statistical benchmarks for health care provider performance assessment: a comparison of standard approaches to a hierarchical Bayesian histogram-based method.
The author compares histogram-based statistical benchmarking to other more widely used statistical benchmarking methods to demonstrate whether and how their performance differs, both in terms of setting a performance benchmark and also in terms of which providers are identified as exceeding the performance benchmark. Her study uses publicly available data from 3,240 hospitals on two process-of-care measures.
AHRQ-funded; HS021860
Citation: Paddock SM .
Statistical benchmarks for health care provider performance assessment: a comparison of standard approaches to a hierarchical Bayesian histogram-based method.
Health Serv Res. 2014 Jun;49(3):1056-73. doi: 10.1111/1475-6773.12149..
Keywords: Quality of Care, Quality Measures, Provider Performance
Gibson G, Jurasic MM, Wehler CJ
Longitudinal outcomes of using a fluoride performance measure for adults at high risk of experiencing caries.
In this paper, the authors hypothesized that after the implementation of a performance measure regarding appropriate fluoride use, veterans at high risk of experiencing caries would require fewer new dental restorations than in the past. They found that, after use of the performance measure for four years, there were 8.6 percent fewer patients needing two or more restorations, a 10.8 percent decrease in the mean number of restorations, and a modest 3.4 percent fewer patients at high risk of experiencing caries who required new restorations after the initial 12-month period.
AHRQ-funded; HS019527.
Citation: Gibson G, Jurasic MM, Wehler CJ .
Longitudinal outcomes of using a fluoride performance measure for adults at high risk of experiencing caries.
J Am Dent Assoc 2014 May;145(5):443-51. doi: 10.14219/jada.2013.53.
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Keywords: Dental and Oral Health, Healthcare Delivery, Provider Performance, Quality Indicators (QIs), Quality Measures
Glance LG, Mukamel DB, Osler TM
Ranking trauma center quality: can past performance predict future performance?
This study investigated whether hospital quality metrics based on prior years of data reliably predict future performance. It found that although the future performance of individual trauma centers can be predicted using 2-year-old data, the performance of individual trauma centers cannot be reliably predicted using performance reports based on data that is 3, 4, or 5 years old.
AHRQ-funded; HS016737.
Citation: Glance LG, Mukamel DB, Osler TM .
Ranking trauma center quality: can past performance predict future performance?
Ann Surg 2014 Apr;259(4):682-6. doi: 10.1097/sla.0000000000000334..
Keywords: Quality Improvement, Quality Measures, Hospitals
Weissman JS, López L, Schneider EC
The association of hospital quality ratings with adverse events.
The researchers used a survey of 2,582 patients hospitalized at 16 acute care Massachusetts hospitals to understand how patient-reported quality is related to adverse events (AEs). Although patients with AEs rated hospital quality lower than others, patients with AEs who experienced ‘service recovery’ rated their quality of care at levels similar to those not experiencing AEs.
AHRQ-funded
Citation: Weissman JS, López L, Schneider EC .
The association of hospital quality ratings with adverse events.
Int J Qual Health Care. 2014 Apr;26(2):129-35. doi: 10.1093/intqhc/mzt092..
Keywords: Adverse Events, Quality of Care, Hospitals, Patient Experience, Patient Safety, Quality Indicators (QIs), Quality Measures