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
1 to 17 of 17 Research Studies DisplayedMao Y, Li Y, McGarry B
Are online reviews of assisted living communities associated with patient-centered outcomes?
The purpose of this study was to explore the relationship between assisted living (AL) online quality review ratings and AL residents' home time. The researchers identified Medicare beneficiaries who entered AL communities in 2018, with the main outcome of resident home time in the year after AL admission. Additional outcomes were the percentage of time spent in emergency room, inpatient hospital, nursing home, and inpatient hospice. The study sample included 59,831 residents in 12,143 ALs. AL online Google reviews for 2013-2017 were linked to 2018-2019 Medicare data. AL average rating score and rating status were generated using Google reviews. The study found that from 2013 to 2017, ALs received an average rating of 4.1 on Google, with a standard deviation of 1.1. Each one-unit increase in the AL's average online rating was associated with an increase in residents' risk-adjusted home time by 0.33 percentage points. Residents in high-rated ALs had a 0.64 pp increase in home time compared with residents in ALs without ratings. Thet study concluded that higher online rating scores were positively associated with residents' home time, and a lack of ratings was related with decreased home time.
AHRQ-funded; HS026893.
Citation: Mao Y, Li Y, McGarry B .
Are online reviews of assisted living communities associated with patient-centered outcomes?
J Am Geriatr Soc 2023 May; 71(5):1505-14. doi: 10.1111/jgs.18192..
Keywords: Elderly, Long-Term Care, Patient-Centered Healthcare, Nursing Homes, Provider Performance, Medicare, Medicaid
Ortiz D, Perkins AJ, Fuchita M
Pre-existing anxiety and depression in injured older adults: an under-recognized comorbidity with major health implications.
The purpose of this retrospective post-hoc analysis study was to evaluate variations in baseline depression and anxiety screenings between older injured patients with pre-existing diagnoses and those without. Data from the Trauma Medical Home, a multicenter randomized controlled trial was used for analysis. The study found that almost 50% of the patients screened positive for at least mild depressive symptoms as measured by the Patient Health Questionnaire-9, and 41% of the patients screened positive for at least mild anxiety symptoms as measured by the Generalized Anxiety Disorder Scale. Female patients with a history of concurrent anxiety and depression, greater injury severity scores, and higher Charlson scores were more likely to have mild anxiety at the baseline assessment. Patients with a history of depression only, a prior history of depression and concurrent anxiety, and higher Charlson scores (greater medical comorbidity) were more likely to have experienced at least mild depression at the time of hospital discharge after traumatic injury.
AHRQ-funded; HS026390.
Citation: Ortiz D, Perkins AJ, Fuchita M .
Pre-existing anxiety and depression in injured older adults: an under-recognized comorbidity with major health implications.
Ann Surg Open 2022 Dec; 3(4):e217. doi: 10.1097/as9.0000000000000217..
Keywords: Elderly, Anxiety, Depression, Behavioral Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Injuries and Wounds
Evans E, Kosar CM, Thomas KS
Positive beliefs and the likelihood of successful community discharge from skilled nursing facilities.
This retrospective cohort study examined the association of patient and direct-care staff beliefs about patients’ probabilities of a successful discharge to the community after a skilled nursing facility (SNF) stay. 100% Medicare inpatient claims and Minimum Data Set resident assessment data was used to identify a cohort of 526,432 Medicare beneficiaries aged 66 or older who were discharged to an SNF after hospitalization for stroke, hip fracture, or traumatic brain injury. A successful discharge was considered to be patients who were discharged alive 90 or more days after hospitalization and remained in the community for at least 30 days without dying or health care facility readmission. A positive patient attitude was found to increase probability of successful discharge without or without positive staff beliefs. However, the difference in successful discharge probability between patients with positive and negative beliefs was larger when staff had positive beliefs.
AHRQ-funded; HS000011.
Citation: Evans E, Kosar CM, Thomas KS .
Positive beliefs and the likelihood of successful community discharge from skilled nursing facilities.
Arch Phys Med Rehabil 2021 Mar;102(3):480-87. doi: 10.1016/j.apmr.2020.09.375..
Keywords: Elderly, Nursing Homes, Patient-Centered Healthcare
Ortiz D, Meagher AD, Lindroth H
A trauma medical home, evaluating collaborative care for the older injured patient: study protocol for a randomized controlled trial.
It is estimated that 55 million adults will be 65 years and older in the USA by 2020. These older adults are at increased risk for injury and their recovery is multi-faceted. A collaborative care model may improve psychological and functional outcomes of the non-neurologically impaired older trauma patient and reduce health care costs. The investigators discussed the proposed study protocol which would evaluate a collaborative care model to help maximize psychological and functional recovery for non-neurologically injured older patients at four level one trauma centers in the Midwest.
AHRQ-funded; HS026390.
Citation: Ortiz D, Meagher AD, Lindroth H .
A trauma medical home, evaluating collaborative care for the older injured patient: study protocol for a randomized controlled trial.
Trials 2020 Jul 16;21(1):655. doi: 10.1186/s13063-020-04582-x..
Keywords: Elderly, Patient-Centered Healthcare, Injuries and Wounds, Care Coordination, Nursing Homes, Care Management
Popejoy LL, Vogelsmeier AA, Wakefield BJ
Adapting Project RED to skilled nursing facilities.
This article described the investigator recommendations for adapting hospital-based RED (Reengineered Discharge) processes to skilled nursing facilities (SNFs). Using focus groups, the SNFs' discharge processes were assessed twice additionally, research staff then recorded field notes documenting discussions about facility discharge processes as they related to RED processes. Data were systematically analyzed using thematic analysis to identify recommendations for adapting RED to the SNF setting.
AHRQ-funded; HS022140.
Citation: Popejoy LL, Vogelsmeier AA, Wakefield BJ .
Adapting Project RED to skilled nursing facilities.
Clin Nurs Res 2020 Mar;29(3):149-56. doi: 10.1177/1054773818819261..
Keywords: Nursing Homes, Elderly, Transitions of Care, Patient-Centered Healthcare
Bravo RI, Kietzman KG, Toy P
Linking primary care and community organizations to increase colorectal cancer screening rates: the HAPPI project.
This paper describes the Healthy Aging Partnerships in Prevention Initiative (HAPPI) which aims to increase colorectal cancer screening and other preventive services among underserved Latinos and African-Americans in South Los Angeles who are 50 years and older. It uses an evidence-based model (SPARC) to leverage existing resources and has multi-sectoral partnerships among different agencies, community health centers (CHCs), and a university. The authors engaged five CHCs in quality improvement activities and eight non-governmental organizations in networking and programming to increase awareness of these preventive services.
AHRQ-funded; HS010858.
Citation: Bravo RI, Kietzman KG, Toy P .
Linking primary care and community organizations to increase colorectal cancer screening rates: the HAPPI project.
Salud Publica Mex 2019 Jul-Aug;61(4):427-35. doi: 10.21149/9450..
Keywords: Cancer: Colorectal Cancer, Cancer, Screening, Prevention, Primary Care: Models of Care, Primary Care, Elderly, Racial and Ethnic Minorities, Vulnerable Populations, Patient-Centered Healthcare
Mentias A, Briasoulis A, Shantha G
Impact of heart failure type on thromboembolic and bleeding risk in patients with atrial fibrillation on oral anticoagulation.
Differential impact of heart failure (HF) category on thromboembolic and bleeding risk in atrial fibrillation (AF) patients on oral anticoagulation (OAC) is unknown. In this study, the investigators used Medicare data for beneficiaries with new AF diagnosed between 2011 and 2013 to identify patients with HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), and no HF. The investigators concluded that in AF patients, HFrEF and HFpEF are both associated with higher risk of ischemic stroke, HF and AMI admissions, even after adjusting for OAC use, compared with patients without HF.
AHRQ-funded; HS023104.
Citation: Mentias A, Briasoulis A, Shantha G .
Impact of heart failure type on thromboembolic and bleeding risk in patients with atrial fibrillation on oral anticoagulation.
Am J Cardiol 2019 May 15;123(10):1649-53. doi: 10.1016/j.amjcard.2019.02.027..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Blood Thinners, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Elderly, Patient-Centered Healthcare, Registries
Powell KR, Alexander GL, Madsen R
A national assessment of access to technology among nursing home residents: a secondary analysis.
The purpose of this study was to report findings from a secondary analysis of data from a national nursing home study of information technology (IT) adoption, called IT sophistication. The investigators found that resident access to technology was a significant predictor of the nursing home IT sophistication (P<.001). The inclusion of covariates-nursing home location, bed size, and ownership-with their interactions produced a nonsignificant effect in the model.
AHRQ-funded; HS022497.
Citation: Powell KR, Alexander GL, Madsen R .
A national assessment of access to technology among nursing home residents: a secondary analysis.
JMIR Aging 2019 Mar 5;2(1):e11449. doi: 10.2196/11449..
Keywords: Elderly, Health Information Technology (HIT), Nursing Homes, Patient and Family Engagement, Patient-Centered Healthcare
Quintana Y, Crotty B, Fahy D
Information sharing across generations and environments (InfoSAGE): study design and methodology protocol.
This open prospective cohort study aimed to assess a novel, Internet based, family-centric communication and collaboration platform created to address the information needs of elders and their informal caregivers in a community setting. It used a mixed methods approach, utilizing qualitative survey data along with website usage analytic data.
AHRQ-funded; HS021495.
Citation: Quintana Y, Crotty B, Fahy D .
Information sharing across generations and environments (InfoSAGE): study design and methodology protocol.
BMC Med Inform Decis Mak 2018 Nov 20;18(1):105. doi: 10.1186/s12911-018-0697-4.
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BMC Med Inform Decis Mak 2018 Nov 20;18(1):105. doi: 10.1186/s12911-018-0697-4.
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Keywords: Caregiving, Communication, Shared Decision Making, Elderly, Health Information Technology (HIT), Patient-Centered Healthcare, Clinician-Patient Communication, Web-Based
Hall SF, Wright NC, Wolinsky FD
The prevalence of overtreatment of osteoporosis: results from the PAADRN trial.
There is a robust body of literature addressing undertreatment in osteoporosis, but limited data addressing overtreatment. In this study, the investigators sought to understand overtreatment as this understanding is important to minimizing harm and decrease costs. The investigators found that in their sample of older adults, overuse of osteoporosis pharmacotherapy was only 8.1%. Nevertheless, they concluded, overtreatment exposed patients to possible risk with negligible chance of benefit and should be minimized.
AHRQ-funded; HS023009.
Citation: Hall SF, Wright NC, Wolinsky FD .
The prevalence of overtreatment of osteoporosis: results from the PAADRN trial.
Arch Osteoporos 2018 Sep 28;13(1):103. doi: 10.1007/s11657-018-0517-6..
Keywords: Osteoporosis, Shared Decision Making, Medication, Elderly, Patient-Centered Healthcare, Patient and Family Engagement, Care Management
Cary MP, Prvu Bettger J, Jarvis JM
Successful community discharge following postacute rehabilitation for Medicare beneficiaries: analysis of a patient-centered quality measure.
The purpose of this study was to determine the sociodemographic and clinical characteristics as well as health services use associated with successful community discharge. The investigators retrospectively examined 167,664 Medicare beneficiaries discharged from inpatient rehabilitation facilities (IRFs) in 2013 to determine the sociodemographic and clinical characteristics as well as health services use associated with successful community discharge.
AHRQ-funded; HS022134.
Citation: Cary MP, Prvu Bettger J, Jarvis JM .
Successful community discharge following postacute rehabilitation for Medicare beneficiaries: analysis of a patient-centered quality measure.
Health Serv Res 2018 Aug;53(4):2470-82. doi: 10.1111/1475-6773.12796..
Keywords: Elderly, Medicare, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Rehabilitation, Quality Indicators (QIs), Quality Measures
Hoff T, DePuccio M
Medical home implementation gaps for seniors: perceptions and experiences of primary care medical practices.
The study objective was to better understand specific implementation gaps for various aspects of patient-centered medical home (PCMH) care delivered to seniors. The study illuminates the physician and staff experience by focusing on how individuals make sense of and respond behaviorally to aspects of PCMH implementation.
AHRQ-funded; HS020931.
Citation: Hoff T, DePuccio M .
Medical home implementation gaps for seniors: perceptions and experiences of primary care medical practices.
J Appl Gerontol 2018 Jul;37(7):817-39. doi: 10.1177/0733464816637850..
Keywords: Elderly, Patient-Centered Healthcare, Primary Care
McCreedy EM, Kane RL, Gollust SE
Patient-centered guidelines for geriatric diabetes care: potential missed opportunities to avoid harm.
Clinicians strive to deliver individualized, patient-centered care. However, these intentions are understudied. This research explored how patient characteristics associated with a high risk-to-benefit ratio with hypoglycemia medications affected decision making by primary care clinicians. The investigators found that primary care clinicians often chose to intensify glycemic control despite individual patient factors that warranted higher glycemic targets based on existing guidelines.
AHRQ-funded; HS000011.
Citation: McCreedy EM, Kane RL, Gollust SE .
Patient-centered guidelines for geriatric diabetes care: potential missed opportunities to avoid harm.
J Am Board Fam Med 2018 Mar-Apr;31(2):192-200. doi: 10.3122/jabfm.2018.02.170141..
Keywords: Diabetes, Elderly, Patient-Centered Healthcare, Guidelines, Evidence-Based Practice, Shared Decision Making, Medication, Primary Care, Practice Patterns, Provider: Physician, Provider: Clinician, Provider
Thomas KS, Parikh RB, Zullo AR
Home-delivered meals and risk of self-reported falls: results from a randomized trial.
The purpose of this study was to evaluate whether home-delivered meals, and the frequency of delivery, reduces self-reported falls among homebound older adults. The study suggests that daily delivered meals may reduce the risk of falls. Additional work is needed to understand the effect of meals on falls, particularly among previous fallers, a high-risk subgroup.
AHRQ-funded; HS022998.
Citation: Thomas KS, Parikh RB, Zullo AR .
Home-delivered meals and risk of self-reported falls: results from a randomized trial.
J Appl Gerontol 2018 Jan;37(1):41-57. doi: 10.1177/0733464816675421..
Keywords: Elderly, Falls, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention
Khandelwal N, Curtis JR, Freedman VA
How often is end-of-life care in the United States inconsistent with patients' goals of care?
The purpose of this study was to document the proportion of bereaved respondents who reported care inconsistent with patients' wishes and characterize the predictors of end-of-life care associated with inconsistent care. The study found that one in eight respondents stated care in the last months of life was inconsistent with patients' wishes; such care was associated with worse ratings of care, pain management, and communication with clinicians.
AHRQ-funded; HS022982.
Citation: Khandelwal N, Curtis JR, Freedman VA .
How often is end-of-life care in the United States inconsistent with patients' goals of care?
J Palliat Med 2017 Dec;20(12):1400-04. doi: 10.1089/jpm.2017.0065..
Keywords: Care Management, Healthcare Delivery, Elderly, Palliative Care, Patient-Centered Healthcare, Quality of Care
Rocque GB, Pisu M, Jackson BE
Resource use and Medicare costs during lay navigation for geriatric patients with cancer.
This study examined the influence of lay navigation on health care spending and resource use among geriatric patients with cancer within The University of Alabama at Birmingham Health System Cancer Community Network. It found that, compared with a matched comparison group, the mean total costs declined by $781.29 more per quarter per navigated patient, for an estimated $19 million decline per year across the network.
AHRQ-funded; HS023009.
Citation: Rocque GB, Pisu M, Jackson BE .
Resource use and Medicare costs during lay navigation for geriatric patients with cancer.
JAMA Oncol 2017 Jun;3(6):817-25. doi: 10.1001/jamaoncol.2016.6307.
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Keywords: Elderly, Cancer, Healthcare Costs, Medicare, Patient and Family Engagement, Patient-Centered Healthcare, Healthcare Delivery
Rocque GB, Dionne-Odom JN, Sylvia Huang CH
Implementation and impact of patient lay navigator-led advance care planning conversations.
Advance care planning (ACP) improves alignment between patient preferences for life-sustaining treatment and care received at end of life (EOL). This study evaluated implementation of lay navigator-led ACP and concluded that a navigator-led ACP program was feasible and may be associated with lower rates of resource utilization near EOL.
AHRQ-funded; HS023009.
Citation: Rocque GB, Dionne-Odom JN, Sylvia Huang CH .
Implementation and impact of patient lay navigator-led advance care planning conversations.
J Pain Symptom Manage 2017 Apr;53(4):682-92. doi: 10.1016/j.jpainsymman.2016.11.012.
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Keywords: Communication, Elderly, Palliative Care, Patient-Centered Healthcare, Provider: Health Personnel