National Healthcare Quality and Disparities Report
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- Access to Care (1)
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- (-) Diabetes (13)
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- Patient-Centered Outcomes Research (1)
- Patient Adherence/Compliance (3)
- Patient and Family Engagement (1)
- Patient Self-Management (1)
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- Racial and Ethnic Minorities (2)
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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 13 of 13 Research Studies DisplayedMisra-Hebert AD, Hu B, Pantalone KM
Primary care health care use for patients with type 2 diabetes during the COVID-19 pandemic.
This study sought to examine factors associated with total and virtual primary care use for patients with type 2 diabetes (T2D) during the COVID-19 pandemic. This study used electronic medical records in the Cleveland Clinic Health System comparing prepandemic use from August 2019 to March 2020 (baseline period 0) to two pandemic periods: March to June 2020 (period 1) when in-person visits were converted to virtual; and July to November 2020 when in-person visits resumed (period 2). Demographic characteristics were obtained including age, sex, race, insurance type, median income estimated by zip code and baseline HbA1C. The study included 76,015 patients with T2D who completed a primary care visit in baseline period 0. Cohort median age was 66.2 years, 50.7% women, 21.7% Black, 71.0% White and 7.4 Other. Insurance distribution was 43.2% private, 46.5% Medicare, and 9.5% Medicaid. Median income was estimated at $59,000 and baseline HbA1C was ≤ 7% for 59.6% of patients. There were higher odds of Black patients, those with uncontrolled T2D, and those with Medicare and Medicare using virtual visits during the 2 postpandemic periods suggesting that virtual visits may be a preference for those groups. Older and male patients had lower odds of visit completion.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Hu B, Pantalone KM .
Primary care health care use for patients with type 2 diabetes during the COVID-19 pandemic.
Diabetes Care 2021 Sep;44(9):e173-e74. doi: 10.2337/dc21-0853..
Keywords: COVID-19, Diabetes, Primary Care, Telehealth, Health Information Technology (HIT), Healthcare Delivery, Access to Care, Chronic Conditions
Sutherland BL, Pecanac K, Bartels CM
Expect delays: poor connections between rural and urban health systems challenge
Rural Americans with diabetic foot ulcers (DFUs) face a 50% increased risk of major amputation compared to their urban counterparts. In this study, the investigators sought to identify health system barriers contributing to this disparity. The investigators concluded that poor connections across rural and urban healthcare systems were described as the primary health system barrier driving the rural disparity in major amputations.
AHRQ-funded; HS026279.
Citation: Sutherland BL, Pecanac K, Bartels CM .
Expect delays: poor connections between rural and urban health systems challenge
J Foot Ankle Res 2020 Jun 16;13(1):32. doi: 10.1186/s13047-020-00395-y..
Keywords: Rural Health, Health Systems, Disparities, Diabetes, Chronic Conditions, Healthcare Delivery
Barry-Menkhaus SA, Wagner DV, Riley AR
Small interventions for big change: brief strategies for distress and self-management amongst youth with type 1 diabetes.
In this article, the authors review existing evidence for brief interventions, describe several untested clinical strategies, and make recommendations for accelerating the translational study of brief interventions among youth with type 1 diabetes.
AHRQ-funded; HS022981.
Citation: Barry-Menkhaus SA, Wagner DV, Riley AR .
Small interventions for big change: brief strategies for distress and self-management amongst youth with type 1 diabetes.
Curr Diab Rep 2020 Jan 30;20(1):3. doi: 10.1007/s11892-020-1290-7..
Keywords: Diabetes, Patient-Centered Healthcare, Patient Self-Management, Patient Adherence/Compliance, Care Management, Patient-Centered Outcomes Research, Healthcare Delivery, Children/Adolescents
Fulton BD, Hong N, Rodriguez HP
Early impact of the state innovation models initiative on diagnosed diabetes prevalence among adults and hospitalizations among diagnosed adults.
The objective of this study was to examine the association of early State Innovation Models (SIM) implementation and diagnosed diabetes prevalence among adults and hospitalization rates among diagnosed adults. The investigators concluded that SIM Round 1 was associated with higher diagnosed diabetes prevalence among adults after a year of implementation, likely because of SIM's emphasis on detection and care management; SIM was not associated with lower hospitalization rates among adults diagnosed with diabetes, but the authors recommended that SIM's long-term impact on hospitalizations should be assessed.
AHRQ-funded; HS022241.
Citation: Fulton BD, Hong N, Rodriguez HP .
Early impact of the state innovation models initiative on diagnosed diabetes prevalence among adults and hospitalizations among diagnosed adults.
Med Care 2019 Sep;57(9):710-17. doi: 10.1097/mlr.0000000000001161..
Keywords: Healthcare Cost and Utilization Project (HCUP), Diabetes, Hospitalization, Healthcare Delivery
Thomas T, Samuel-Hodge CD, Porterfield DS
Scaling up diabetes prevention programs in North Carolina: perceptions of demand from potential program recipients and providers.
The purpose of this study was to assess factors that influence demand for the Diabetes Prevention Program (DPP) guided by a conceptual framework conducted with potential DPP participants and providers and taken from their perspective. Providers considered prediabetes to be an important health problem. Potential DPP participants expressed less urgency related to a diagnosis of prediabetes and felt they were more likely to adopt a diabetes prevention program if it were affordable and convenient. Both participants and providers cited existing barriers to the use of these programs such as transportation, cost, and health insurance reimbursement.
AHRQ-funded; HS000032.
Citation: Thomas T, Samuel-Hodge CD, Porterfield DS .
Scaling up diabetes prevention programs in North Carolina: perceptions of demand from potential program recipients and providers.
Diabetes Educ 2019 Feb;45(1):116-24. doi: 10.1177/0145721718811564..
Keywords: Diabetes, Healthcare Delivery, Prevention
Rodriguez HP, Friedberg MW, Vargas-Bustamante A
The impact of integrating medical assistants and community health workers on diabetes care management in community health centers.
The purpose of this study was to compare the impact of implementing team-based diabetes care management involving community health workers (CHWs) vs. medical assistants (MA) in community health centers (CHCs) on diabetes care processes, intermediate outcomes, and patients' experiences of chronic care. The investigators found that diabetes care improved in CHCs integrating CHWs and MAs onto primary care teams, but the improvements were no different than improvements observed among matched control group patients.
AHRQ-funded; HS02012001.
Citation: Rodriguez HP, Friedberg MW, Vargas-Bustamante A .
The impact of integrating medical assistants and community health workers on diabetes care management in community health centers.
BMC Health Serv Res 2018 Nov 20;18(1):875. doi: 10.1186/s12913-018-3710-9..
Keywords: Community-Based Practice, Diabetes, Healthcare Delivery, Teams
Brown SD, Grijalva CS, Ferrara A
Leveraging EHRs for patient engagement: perspectives on tailored program outreach.
Electronic health records (EHRs) present healthcare delivery systems with scalable, cost-effective opportunities to promote lifestyle programs among patients at high risk for type 2 diabetes, yet little consensus exists on strategies to enhance patient engagement. In this study, the investigators explored patient perspectives on program outreach messages containing content tailored to EHR-derived diabetes risk factors--a theory-driven strategy to increase the persuasiveness of health communications.
AHRQ-funded; HS019367.
Citation: Brown SD, Grijalva CS, Ferrara A .
Leveraging EHRs for patient engagement: perspectives on tailored program outreach.
Am J of Manag Care 2017 Jul;23(7):e223-e30..
Keywords: Diabetes, Communication, Education: Patient and Caregiver, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Lifestyle Changes, Patient and Family Engagement
Karter AJ, Lipska KJ, O'Connor PJ
High rates of severe hypoglycemia among African American patients with diabetes: the Surveillance, Prevention, and Management of Diabetes Mellitus (SUPREME-DM) network.
This seven-year surveillance study (2005-2011) evaluated race/ethnic differences in the trends in rates of severe hypoglycemia (SH) in a population of insured, at-risk adults with diabetes. Annual SH rates ranged from 1.8 percent to 2.1 percent during this 7-year observation period. African Americans had consistently higher SH rates compared with Whites, while Latinos and Asians had consistently lower rates compared with Whites in each of the 7 years.
AHRQ-funded; HS019859.
Citation: Karter AJ, Lipska KJ, O'Connor PJ .
High rates of severe hypoglycemia among African American patients with diabetes: the Surveillance, Prevention, and Management of Diabetes Mellitus (SUPREME-DM) network.
J Diabetes Complications 2017 May;31(5):869-73. doi: 10.1016/j.jdiacomp.2017.02.009.
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Keywords: Chronic Conditions, Diabetes, Healthcare Delivery, Health Status, Racial and Ethnic Minorities
Maciejewski ML, Hammill BG, Bayliss EA
Prescriber continuity and disease control of older adults.
The objective of this study was to examine whether glycemic control or lipid control was associated with the number of prescribers of cardiometabolic medications. It concluded that multiple prescribers were associated with worse disease control, possibly because patients with more severe diabetes or dyslipidemia have multiple prescribers or because care fragmentation is associated with worse disease control.
AHRQ-funded; HS023085.
Citation: Maciejewski ML, Hammill BG, Bayliss EA .
Prescriber continuity and disease control of older adults.
Med Care 2017 Apr;55(4):405-10. doi: 10.1097/mlr.0000000000000658.
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Keywords: Elderly, Medication, Diabetes, Patient Adherence/Compliance, Healthcare Delivery
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
Pathak RD, Schroeder EB, Seaquist ER
Severe hypoglycemia requiring medical intervention in a large cohort of adults with diabetes receiving care in U.S. integrated health care delivery systems: 2005-2011.
The researchers quantified the burden of severe hypoglycemia requiring medical intervention in a well-defined population of insured individuals receiving care for diabetes . Annual rates of severe hypoglycemia ranged from 1.4 to 1.6 events per 100 person-years. Rates of severe hypoglycemia were higher among those with older age, chronic kidney disease, congestive heart failure, cardiovascular disease, depression, and higher A1C levels.
AHRQ-funded; HS019859.
Citation: Pathak RD, Schroeder EB, Seaquist ER .
Severe hypoglycemia requiring medical intervention in a large cohort of adults with diabetes receiving care in U.S. integrated health care delivery systems: 2005-2011.
Diabetes Care 2016 Mar;39(3):363-70. doi: 10.2337/dc15-0858.
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Keywords: Care Management, Diabetes, Healthcare Delivery, Kidney Disease and Health
Chao MT, Handley MA, Quan J
Disclosure of complementary health approaches among low income and racially diverse safety net patients with diabetes.
The authors identified sociodemographic and communication factors associated with disclosure of complementary health approaches to providers by low-income patients with diabetes. Disclosure was associated with language concordance, physicians' interpersonal communication scores, shared decision making, and explanatory-type communication.
AHRQ-funded; HS020684; HS017261; HS022561.
Citation: Chao MT, Handley MA, Quan J .
Disclosure of complementary health approaches among low income and racially diverse safety net patients with diabetes.
Patient Educ Couns 2015 Nov;98(11):1360-6. doi: 10.1016/j.pec.2015.06.011.
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Keywords: Low-Income, Diabetes, Complementary and Alternative Medicine, Racial and Ethnic Minorities, Healthcare Delivery
Taliani CA, Bricker PL, Adelman AM
Implementing effective care management in the patient-centered medical home.
The investigators explored how a disparate group of patient-centered medical homes (PCMHs) embedded care management in their team care environment to identify best practices. They concluded that PCMHs may want to ensure that care managers are available to meet with patients during visits, support patient self-management, fully leverage the electronic medical record for team messaging and patient tracking, and ensure integration into the care team with office huddles and ongoing communication.
AHRQ-funded; HS019150.
Citation: Taliani CA, Bricker PL, Adelman AM .
Implementing effective care management in the patient-centered medical home.
Am J Manag Care 2013 Dec;19(12):957-64.
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Keywords: Care Management, Diabetes, Healthcare Delivery, Patient-Centered Healthcare, Quality Improvement, Teams