National Healthcare Quality and Disparities Report
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Topics
- Access to Care (2)
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- Blood Pressure (1)
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- Communication (3)
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- Comparative Effectiveness (5)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Depression (3)
- Diabetes (9)
- Diagnostic Safety and Quality (2)
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- Education: Continuing Medical Education (2)
- Education: Patient and Caregiver (1)
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- Electronic Health Records (EHRs) (13)
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- Quality Indicators (QIs) (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 25 of 90 Research Studies DisplayedCampbell-Voytal K, Daly JM, Nagykaldi ZJ
Team science approach to developing consensus on research good practices for practice-based research networks: A case study.
Using peer learning strategies, seven experienced practice-based research networks (PBRNs) working in collaborative teams articulated procedures for PBRN Research Good Practices (PRGPs). The PRGPs is a PBRN-specific resource to facilitate PBRN management and staff training, to promote adherence to study protocols, and to increase validity and generalizability of study findings. This paper describes the team science processes which culminated in the PRGPs.
AHRQ-funded; HS016713; HS019601.
Citation: Campbell-Voytal K, Daly JM, Nagykaldi ZJ .
Team science approach to developing consensus on research good practices for practice-based research networks: A case study.
Clin Transl Sci 2015 Dec;8(6):632-7. doi: 10.1111/cts.12363.
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Keywords: Primary Care: Models of Care, Practice-Based Research Network (PBRN), Primary Care, Teams, Implementation
Graetz I, Huang J, Brand R
The impact of electronic health records and teamwork on diabetes care quality.
The researchers examined whether team cohesion among primary care team members changed the association between EHR use and changes in clinical outcomes for patients with diabetes. They found that patients cared for by higher cohesion primary care teams experienced modest but statistically significantly greater EHR-related health outcome improvements, compared with patients cared for by providers practicing in lower cohesion teams.
AHRQ-funded; HS015280; HS021082.
Citation: Graetz I, Huang J, Brand R .
The impact of electronic health records and teamwork on diabetes care quality.
Am J Manag Care 2015 Dec;21(12):878-84.
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Keywords: Diabetes, Electronic Health Records (EHRs), Quality of Care, Primary Care, Teams
Jones AL, Cochran SD, Leibowitz A
Usual primary care provider characteristics of a patient-centered medical home and mental health service use.
This study sought to examine qualities of a usual provider that align with the patient-centered medical home (PCMH) goals of access, comprehensiveness, and patient-centered care, It concluded that access to a usual provider is associated with increased receipt of needed mental health services. Patients who have a usual provider with PCMH qualities are more likely to receive mental health counseling.
AHRQ-funded; HS021721.
Citation: Jones AL, Cochran SD, Leibowitz A .
Usual primary care provider characteristics of a patient-centered medical home and mental health service use.
J Gen Intern Med 2015 Dec;30(12):1828-36. doi: 10.1007/s11606-015-3417-0.
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Keywords: Patient-Centered Healthcare, Behavioral Health, Primary Care
Weiner BJ, Pignone MP, DuBard CA
Advancing heart health in North Carolina primary care: the Heart Health NOW study protocol.
The objective of Heart Health NOW (HHN) is to determine if primary care practice support a comprehensive evidence-based quality improvement strategy involving practice facilitation, academic detailing, technology support, and regional learning collaboratives—accelerates widespread dissemination and implementation of evidence-based guidelines for cardiovascular disease (CVD) prevention in small- to medium-sized primary care practices.
AHRQ-funded; HS023912.
Citation: Weiner BJ, Pignone MP, DuBard CA .
Advancing heart health in North Carolina primary care: the Heart Health NOW study protocol.
Implement Sci 2015 Nov 14;10:160. doi: 10.1186/s13012-015-0348-4..
Keywords: Cardiovascular Conditions, Evidence-Based Practice, Prevention, Primary Care
El-Shami K, Oeffinger KC, Erb NL
American Cancer Society colorectal cancer survivorship care guidelines.
Communication and coordination of care between the treating oncologist and the primary care clinician is critical to effectively and efficiently manage the long-term care of colorectal cancer (CRC) survivors. The guidelines in this article are intended to assist primary care clinicians in delivering risk-based health care for CRC survivors who have completed active therapy.
AHRQ-funded; HS020937.
Citation: El-Shami K, Oeffinger KC, Erb NL .
American Cancer Society colorectal cancer survivorship care guidelines.
CA Cancer J Clin 2015 Nov-Dec;65(6):428-55. doi: 10.3322/caac.21286.
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Keywords: Cancer, Cancer: Colorectal Cancer, Care Coordination, Guidelines, Primary Care
Wexler R, Hefner JL, Sieck C
Connecting emergency department patients to primary care.
The researchers developed and evaluated a system change innovation designed to remove system barriers to primary care access for Medicaid patients. The intervention did not decrease ED visits nor increase primary care use over the 12 months of the study period. The qualitative results provide insight into nonurgent ED utilization by patients with Medicaid, suggesting potential future interventions.
AHRQ-funded; HS020693.
Citation: Wexler R, Hefner JL, Sieck C .
Connecting emergency department patients to primary care.
J Am Board Fam Med 2015 Nov-Dec;28(6):722-32. doi: 10.3122/jabfm.2015.06.150044.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Primary Care, Health Information Technology (HIT), Healthcare Utilization
Pfoh E, Mojtabai R, Bailey J
Impact of Medicare annual wellness visits on uptake of depression screening.
This study assessed whether patients with an initial annual wellness visit (AWV) were more likely to be screened for depression than those with a primary care visit. Fifteen percent of patients with non-AWVs and 10 percent of patients with AWVs received depression screening. After accounting for clustering, there was no statistically significant difference in depression screening by visit type.
AHRQ-funded; HS000029.
Citation: Pfoh E, Mojtabai R, Bailey J .
Impact of Medicare annual wellness visits on uptake of depression screening.
Psychiatr Serv 2015 Nov;66(11):1207-12. doi: 10.1176/appi.ps.201400524.
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Keywords: Depression, Screening, Medicare, Elderly, Primary Care
Schussler-Fiorenza Rose SM, Gangnon RE, Chewning B
Increasing discussion rates of incontinence in primary care: a randomized controlled trial.
The study’s aim was to evaluate whether the use of an electronic pelvic floor assessment questionnaire (ePAQ-PF) improves communication about incontinence in primary care. It found that use of the ePAQ-PF prior to clinic visits increases discussion of urinary and fecal incontinence, particularly clinician-initiated discussion.
AHRQ-funded; HS017028.
Citation: Schussler-Fiorenza Rose SM, Gangnon RE, Chewning B .
Increasing discussion rates of incontinence in primary care: a randomized controlled trial.
J Womens Health 2015 Nov;24(11):940-9. doi: 10.1089/jwh.2015.5230..
Keywords: Clinician-Patient Communication, Communication, Primary Care, Women
VanGompel EC, Jerant AF, Franks PM
Primary care attributes associated with receipt of preventive care services: a national study.
This study explored whether primary care attributes (PCAs) encompassed by patient-centered medical homes increase receipt of preventive care. Based ,on a nationally representative sample, greater reported exposure to key primary care attributes, with the exception of enhanced access, was associated with increased preventive care. These findings may inform best practices for maximizing preventive care delivery.
AHRQ-funded; HS022236.
Citation: VanGompel EC, Jerant AF, Franks PM .
Primary care attributes associated with receipt of preventive care services: a national study.
J Am Board Fam Med 2015 Nov-Dec;28(6):733-41. doi: 10.3122/jabfm.2015.06.150092.
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Keywords: Patient-Centered Healthcare, Patient and Family Engagement, Prevention, Primary Care
LeBlanc A, Herrin J, Williams MD
Shared decision making for antidepressants in primary care: a cluster randomized trial.
The researchers estimated the effect of the Depression Medication Choice (DMC) encounter decision aid on quality of the decision‐making process and depression outcomes. They found that the DMC decision aid helped primary care clinicians and patients with moderate to severe depression select antidepressants together, improving the decision-making process without extending the visit.
AHRQ-funded; HS019214.
Citation: LeBlanc A, Herrin J, Williams MD .
Shared decision making for antidepressants in primary care: a cluster randomized trial.
JAMA Intern Med 2015 Nov;175(11):1761-70. doi: 10.1001/jamainternmed.2015.5214..
Keywords: Medication, Comparative Effectiveness, Shared Decision Making, Primary Care
Litvin CB, Ornstein SM, Wessell AM
"Meaningful" clinical quality measures for primary care physicians.
The authors systematically solicited recommendations from Meaningful Use (MU) exemplars to inform Stage 3 MU clinical quality measure (CQM) requirements. There was consensus that CQMs should be evidence-based and focus on high-priority conditions relevant to primary care providers. Participants thought the emphasis of CQMs should largely be on outcomes and that reporting of CQMs should limit the burden on providers.
AHRQ-funded; HS022701; HS018984.
Citation: Litvin CB, Ornstein SM, Wessell AM .
"Meaningful" clinical quality measures for primary care physicians.
Am J Manag Care 2015 Oct;21(10):e583-90..
Keywords: Quality Indicators (QIs), Quality Measures, Primary Care, Quality of Care
Cherrington AL, Agne AA, Lampkin Y
Diabetes Connect: developing a mobile health intervention to link diabetes community health workers with primary care.
The authors tested a model for the integration of a community health worker-delivered mobile health technology intervention to improve diabetes self-management. They found that the integration of mobile health technology into community health worker programs was successfully achieved and readily accepted.
AHRQ-funded; HS019465.
Citation: Cherrington AL, Agne AA, Lampkin Y .
Diabetes Connect: developing a mobile health intervention to link diabetes community health workers with primary care.
J Ambul Care Manage 2015 Oct-Dec;38(4):333-45. doi: 10.1097/jac.0000000000000110.
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Keywords: Education: Patient and Caregiver, Diabetes, Primary Care, Patient Self-Management, Telehealth
Kuo YF, Goodwin JS, Chen NW
Diabetes mellitus care provided by nurse practitioners vs primary care physicians.
The study objective was to compare processes and cost of care of older adults with diabetes mellitus cared for by nurse practitioners (NPs) with processes and cost of those cared for by primary care physicians (PCPs). It concluded that nurse practitioners were similar to PCPs or slightly lower in their rates of diabetes mellitus guideline–concordant care.
AHRQ-funded; HS020642; HS022134.
Citation: Kuo YF, Goodwin JS, Chen NW .
Diabetes mellitus care provided by nurse practitioners vs primary care physicians.
J Am Geriatr Soc 2015 Oct;63(10):1980-8. doi: 10.1111/jgs.13662..
Keywords: Chronic Conditions, Diabetes, Elderly, Primary Care, Practice Patterns
Yawn BP, Rank MA, Bertram SL
Obesity, low levels of physical activity and smoking present opportunities for primary care asthma interventions: an analysis of baseline data from the asthma tools study.
The researchers calculated cross-sectional frequencies of activity levels, smoking, secondhand smoke exposure and the presence of obesity, as well as rates of out-of-control asthma and asthma exacerbations. They found that tobacco smoke exposure, obesity, low activity levels, poverty, inadequately controlled asthma and high asthma-related health-care utilization were common. Across all age groups, obesity was associated with poorer asthma outcomes.
AHRQ-funded; HS018431.
Citation: Yawn BP, Rank MA, Bertram SL .
Obesity, low levels of physical activity and smoking present opportunities for primary care asthma interventions: an analysis of baseline data from the asthma tools study.
NPJ Prim Care Respir Med 2015 Oct 1;25:15058. doi: 10.1038/npjpcrm.2015.58..
Keywords: Asthma, Obesity, Tobacco Use, Primary Care, Outcomes
Radovic A, Reynolds K, McCauley HL
Parents' role in adolescent depression care: primary care provider perspectives.
This study aimed to understand how primary care providers (PCPs) perceive barriers to adolescent depression care in order to inform strategies to increase treatment engagement. PCPs perceived that parental unwillingness to accept the depression diagnosis, family dysfunction, and trauma were common barriers. PCPs contrasted this with examples of good family support they believed would enable adolescents to attend follow-up appointments and have a “life coach” at home.
AHRQ-funded; HS022989; HS019486.
Citation: Radovic A, Reynolds K, McCauley HL .
Parents' role in adolescent depression care: primary care provider perspectives.
J Pediatr 2015 Oct;167(4):911-8. doi: 10.1016/j.jpeds.2015.05.049..
Keywords: Caregiving, Children/Adolescents, Depression, Behavioral Health, Primary Care
Aysola J, Rhodes KV, Polsky D
Patient-centered medical homes and access to services for new primary care patients.
The study objective was to determine whether patient-centered medical homes (PCMH) practices are associated with better access to new appointments for nonelderly adults by direct measurement. Callers to PCMH practices compared with non-PCMH practices were more likely to schedule a new appointment and be offered after-hour appointments.
AHRQ-funded; HS021706.
Citation: Aysola J, Rhodes KV, Polsky D .
Patient-centered medical homes and access to services for new primary care patients.
Med Care 2015 Oct;53(10):857-62. doi: 10.1097/mlr.0000000000000412..
Keywords: Comparative Effectiveness, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care
Phillips RL, Jr., Bazemore AW, DeVoe JE
A family medicine health technology strategy for achieving the triple aim for US health care.
To inform the Family Medicine for America's Health (FMAHealth) initiative, this paper explores strategies and tactics that family medicine could pursue to improve the utility of technology for primary care and to help primary care become a leader in rapid development, testing, and implementation of new technologies. These strategies were also designed with a broader stakeholder audience in mind, intending to reach beyond the work being done by FMAHealth.
AHRQ-funded; HS022583.
Citation: Phillips RL, Jr., Bazemore AW, DeVoe JE .
A family medicine health technology strategy for achieving the triple aim for US health care.
Fam Med 2015 Sep;47(8):628-35.
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Keywords: Electronic Health Records (EHRs), Healthcare Delivery, Primary Care, Health Information Technology (HIT)
Davis MM, Balasubramanian BA, Cifuentes M
Clinician staffing, scheduling, and engagement strategies among primary care practices delivering integrated care.
This study examined the interrelationship among behavioral health clinician staffing, scheduling, and a primary care practice's approach to delivering integrated care. It concluded that practices' approaches to staffing by primary care clinicians and behavioral health clinicians, scheduling, and delivery of integrated care mutually influenced each other and were shaped by the local context.
AHRQ-funded; HS022981.
Citation: Davis MM, Balasubramanian BA, Cifuentes M .
Clinician staffing, scheduling, and engagement strategies among primary care practices delivering integrated care.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S32-40. doi: 10.3122/jabfm.2015.S1.150087.
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Keywords: Behavioral Health, Patient-Centered Healthcare, Healthcare Delivery, Primary Care: Models of Care, Primary Care, Community-Based Practice
Gunn R, Davis MM, Hall J
Designing clinical space for the delivery of integrated behavioral health and primary care.
This study sought to describe features of the physical space in which practices integrating primary care and behavioral health care work and to identify the arrangements that enable integration of care. Two dominant spatial layouts emerged across practices: type-1 layouts were characterized by having primary care clinicians (PCCs) and behavioral health clinicians (BHCs) located in separate work areas, and type-2 layouts had BHCs and PCCs sharing work space.
AHRQ-funded; HS022981.
Citation: Gunn R, Davis MM, Hall J .
Designing clinical space for the delivery of integrated behavioral health and primary care.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S52-62. doi: 10.3122/jabfm.2015.S1.150053.
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Keywords: Behavioral Health, Healthcare Delivery, Patient-Centered Healthcare, Primary Care
Cifuentes M, Davis M, Fernald D
Electronic health record challenges, workarounds, and solutions observed in practices integrating behavioral health and primary care.
This article describes the electronic health record (EHR)-related experiences of practices striving to integrate behavioral health and primary care using tailored, evidenced-based strategies from 2012 to 2014; and the challenges, workarounds and initial health information technology (HIT) solutions that emerged during implementation. The researchers found that as practices gained experience with integration, they began to move beyond workarounds to more permanent HIT solutions.
AHRQ-funded; HS022981.
Citation: Cifuentes M, Davis M, Fernald D .
Electronic health record challenges, workarounds, and solutions observed in practices integrating behavioral health and primary care.
J Am Board Fam Med 2015 Sep-Oct;28(Suppl 1):S63-72. doi: 10.3122/jabfm.2015.S1.150133..
Keywords: Behavioral Health, Primary Care, Electronic Health Records (EHRs), Evidence-Based Practice
Alcantara C, Klesges LM, Resnicow K
Enhancing the evidence for behavioral counseling: a perspective from the society of behavioral medicine.
The members of the Society of Behavioral Medicine (SBM)-a multidisciplinary scientific organization committed to improving population health through behavior change- review the USPSTF mandate and current recommendations for behavioral counseling interventions and provide a perspective for the future that calls for concerted and coordinated efforts among SBM, USPSTF, and other organizations invested in the rapid and wider uptake of beneficial, feasible, and referable primary care-focused behavioral counseling interventions.
AHRQ-funded; 290201000004I.
Citation: Alcantara C, Klesges LM, Resnicow K .
Enhancing the evidence for behavioral counseling: a perspective from the society of behavioral medicine.
Am J Prev Med 2015 Sep;49(3 Suppl 2):S184-93. doi: 10.1016/j.amepre.2015.05.015.
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Keywords: Behavioral Health, Evidence-Based Practice, Guidelines, Health Promotion, Primary Care, U.S. Preventive Services Task Force (USPSTF)
Krist AH, Baumann LJ, Holtrop JS
Evaluating feasible and referable behavioral counseling interventions.
The U.S. Preventive Services Task Force (USPSTF) convened an expert forum in 2013 to inform the evaluation of behavioral counseling intervention (BCI) feasibility. This manuscript reports on findings from the forum and proposes that researchers use several frameworks to help clinicians and the USPSTF evaluate which BCIs work under usual conditions. A key recommendation for BCI researchers is to use frameworks whose components can support dissemination and implementation efforts.
AHRQ-funded; 290201000004I.
Citation: Krist AH, Baumann LJ, Holtrop JS .
Evaluating feasible and referable behavioral counseling interventions.
Am J Prev Med 2015 Sep;49(3 Suppl 2):S138-49. doi: 10.1016/j.amepre.2015.05.009.
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Keywords: Behavioral Health, Primary Care, Evidence-Based Practice, U.S. Preventive Services Task Force (USPSTF)
Cohen DJ, Davis M, Balasubramanian BA
Integrating behavioral health and primary care: consulting, coordinating and collaborating among professionals.
This paper sought to describe how clinicians from different backgrounds interact to deliver integrated behavioral and primary health care, and the contextual factors that shape such interactions. It concluded that primary care and behavioral health clinicians, through their interactions, consult, coordinate, and collaborate with each other to solve patients' problems.
AHRQ-funded; HS022981.
Citation: Cohen DJ, Davis M, Balasubramanian BA .
Integrating behavioral health and primary care: consulting, coordinating and collaborating among professionals.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S21-31. doi: 10.3122/jabfm.2015.S1.150042.
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Keywords: Healthcare Delivery, Community-Based Practice, Shared Decision Making, Behavioral Health, Primary Care
Ludman EJ, Curry SJ
Perspectives in implementing a primary care-based intervention to reduce alcohol misuse.
This study, Options Regarding Consumption of Alcohol (ORCA), was designed to test whether a primary care-based intervention would reduce alcohol misuse among patients who screened positive for risky or hazardous drinking. This paper assesses the study features using the Pragmatic-Explanatory Continuum Indicator Summary Model domains. As a randomized trial, the study included some explanatory features (e.g., standardized follow-up surveys administered by study personnel); however, several aspects of the study were highly pragmatic.
AHRQ-funded; 290201000004I.
Citation: Ludman EJ, Curry SJ .
Perspectives in implementing a primary care-based intervention to reduce alcohol misuse.
Am J Prev Med 2015 Sep;49(3 Suppl 2):S194-9. doi: 10.1016/j.amepre.2015.05.016.
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Keywords: Alcohol Use, Behavioral Health, Prevention, Primary Care, U.S. Preventive Services Task Force (USPSTF)
Kuo YF, Chen NW, Baillargeon J
Potentially preventable hospitalizations in Medicare patients with diabetes: a comparison of primary care provided by nurse practitioners versus physicians.
The researchers compared the rates of potentially preventable hospitalizations in older diabetic patients who received primary care from nurse practitioners (NPs) only versus those who received care from primary care physicians only. Using potentially preventable hospitalizations as a quality indicator, they found that primary care provided by NPs was at least comparable with that provided by generalist physicians.
AHRQ-funded; HS020642; HS022134.
Citation: Kuo YF, Chen NW, Baillargeon J .
Potentially preventable hospitalizations in Medicare patients with diabetes: a comparison of primary care provided by nurse practitioners versus physicians.
Med Care 2015 Sep;53(9):776-83. doi: 10.1097/mlr.0000000000000406..
Keywords: Hospitalization, Primary Care, Comparative Effectiveness, Diabetes