National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
Topics
- Adverse Events (3)
- Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cardiovascular Conditions (1)
- Diagnostic Safety and Quality (1)
- Elderly (1)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (1)
- Hospitals (4)
- Infectious Diseases (1)
- Injuries and Wounds (1)
- Medicare (1)
- Mortality (1)
- Neurological Disorders (1)
- Outcomes (5)
- Pain (1)
- Patient-Centered Outcomes Research (3)
- Patient Experience (1)
- Patient Safety (2)
- Practice Patterns (1)
- Provider Performance (5)
- Public Reporting (1)
- Quality Improvement (6)
- Quality Indicators (QIs) (3)
- (-) Quality Measures (21)
- Quality of Care (17)
- Risk (1)
- (-) Surgery (21)
- Telehealth (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 21 of 21 Research Studies DisplayedJoseph JM, Gori D, Curtin C
Gaps in standardized postoperative pain management quality measures: a systematic review.
Poor pain control in patients can lead to chronic pain, chronic opiate use or addiction, and patient suffering, making postoperative pain an important clinical issue. The researchers state that it is unclear whether measures for managing pain after surgery exist, warranting the study goal of assessment of the availability of postoperative pain management quality measures, including National Quality Forum-endorsed measures. In November 2019, the researchers conducted a systematic literature review using the National Quality Forum Quality Positioning System, the Agency for Healthcare Research and Quality Indicators, and the Centers for Medicare and Medicaid Services Measures Inventory Tool databases, to identify quality measures for the period between March 11, 2015, and March 11, 2020. The review identified 19 pain management quality measures, 5 of which were endorsed by the National Quality Forum. Three of the non-endorsed measures were specific to postoperative pain, with none of the endorsed measures specific to post-operative pain. The study concluded that there is a need for published, endorsed, rigorous postoperative pain quality measures.
AHRQ-funded; HS024096; HS027434.
Citation: Joseph JM, Gori D, Curtin C .
Gaps in standardized postoperative pain management quality measures: a systematic review.
Surgery 2022 Feb;171(2):453-58. doi: 10.1016/j.surg.2021.08.004..
Keywords: Pain, Surgery, Quality Measures, Quality of Care, Practice Patterns
Merkow RP, Massarweh NN
Looking beyond perioperative morbidity and mortality as measures of surgical quality.
The authors discussed the problems with a contemporaneous focus on morbidity and mortality as surgical quality measures and offered potential alternative options which could better refine and evolve surgical quality measurement, including process measures, value-based measures, patient-centered measures, and health equity.
AHRQ-funded; HS026385.
Citation: Merkow RP, Massarweh NN .
Looking beyond perioperative morbidity and mortality as measures of surgical quality.
Ann Surg 2022 Feb;275(2):e281-e83. doi: 10.1097/sla.0000000000004966..
Keywords: Surgery, Quality Measures, Quality of Care, Mortality
Greenberg JK, Olsen MA, Dibble CF
Comparison of cost and complication rates for profiling hospital performance in lumbar fusion for spondylolisthesis.
Investigators sought to evaluate the reliability of 90-day inpatient hospital costs, overall complications, and rates of serious complications for profiling hospital performance in lumbar fusion surgery for spondylolisthesis. Using HCUP data, they found that 90-day inpatient costs were highly reliable for assessing variation across hospitals, whereas overall and serious complications were only moderately reliable for profiling performance. They concluded that their results support the viability of emerging bundled payment programs that assume true differences in costs of care exist across hospitals.
AHRQ-funded; HS027075; HS019455.
Citation: Greenberg JK, Olsen MA, Dibble CF .
Comparison of cost and complication rates for profiling hospital performance in lumbar fusion for spondylolisthesis.
Spine J 2021 Dec;21(12):2026-34. doi: 10.1016/j.spinee.2021.06.014..
Keywords: Healthcare Costs, Hospitals, Provider Performance, Surgery, Quality Measures, Quality of Care
Dworsky JQ, Shenoy R, Childers CP
Older veterans undergoing inpatient surgery: what is the compliance with best practice guidelines?
This study’s objective was to determine the documented compliance with best practice guidelines for optimal perioperative care for the older adult surgical patient that were created by the American College of Surgeons Quality Improvement Program and the American Geriatrics Society. The guidelines include 38 measures. A retrospective chart review was conducted on 86 older adults undergoing elective inpatient coronary artery bypass graft, prostatectomy, or colectomy over a 2-year period at a single Veterans Affairs hospital. Mean reported compliance across measures was 41% ± 4%. Of the 38 analyzed measures, 10 measures were achieved for 0 patients, and only 1 patient for 7 measures. Future work is needed to understand barriers for implementation.
AHRQ-funded; HS000046.
Citation: Dworsky JQ, Shenoy R, Childers CP .
Older veterans undergoing inpatient surgery: what is the compliance with best practice guidelines?
Surgery 2021 Feb;169(2):356-61. doi: 10.1016/j.surg.2020.08.033..
Keywords: Elderly, Surgery, Guidelines, Evidence-Based Practice, Quality Improvement, Quality of Care, Quality Measures
Schlick CJR, Khorfan R, Odell DD
Adequate lymphadenectomy as a quality measure in esophageal cancer: is there an association with treatment approach?
In this study, the authors’ objectives were to (1) explore trends in adequate lymphadenectomy rates over time; (2) evaluate unadjusted lymphadenectomy yield by treatment characteristics; and (3) identify independent factors associated with adequate lymphadenectomy. The investigators found that despite increases over time, only 50% of patients underwent adequate lymphadenectomy during esophageal cancer resection. They also found that adequate lymphadenectomy was not associated with neoadjuvant therapy.
AHRQ-funded; HS026385.
Citation: Schlick CJR, Khorfan R, Odell DD .
Adequate lymphadenectomy as a quality measure in esophageal cancer: is there an association with treatment approach?
Ann Surg Oncol 2020 Oct;27(11):4443-56. doi: 10.1245/s10434-020-08578-4..
Keywords: Cancer, Surgery, Quality Measures, Quality of Care, Quality Improvement
Sheetz KH, Ryan A
Accuracy of quality measurement for the hospital acquired conditions reduction program.
Accuracy of quality measurement for the hospital acquired conditions reduction program.
AHRQ-funded; HS026244; HS000053.
Citation: Sheetz KH, Ryan A .
Accuracy of quality measurement for the hospital acquired conditions reduction program.
BMJ Qual Saf 2020 Jul;29(7):605-07. doi: 10.1136/bmjqs-2019-009747..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Quality Measures, Quality Improvement, Quality of Care, Surgery, Infectious Diseases
Shetty KD, Robbins M, Aragaki D
The quality of electrodiagnostic tests for carpal tunnel syndrome: Implications for surgery, outcomes, and expenditures.
The quality of electrodiagnostic tests may influence treatment decisions, particularly regarding surgery, affecting health outcomes and health-care expenditures. In this study, the investigators evaluated test quality among 338 adults with workers' compensation claims for carpal tunnel syndrome. The investigators found that in simulations, suboptimal quality tests rendered surgery inappropriate for 99 of 309 patients (+32 percentage points). They also found that test quality was not associated with overall health, actual receipt of surgery, or expenditures.
AHRQ-funded; HS018982.
Citation: Shetty KD, Robbins M, Aragaki D .
The quality of electrodiagnostic tests for carpal tunnel syndrome: Implications for surgery, outcomes, and expenditures.
Muscle Nerve 2020 Jul;62(1):60-69. doi: 10.1002/mus.26874..
Keywords: Diagnostic Safety and Quality, Neurological Disorders, Surgery, Quality Indicators (QIs), Quality Measures, Quality of Care
Spatz ES, Suter LG, George E
An instrument for assessing the quality of informed consent documents for elective procedures: development and testing.
The objective of this mixed qualitative-quantitative study was to develop a nationally applicable tool for assessing the quality of informed consent documents for elective procedures. The investigators identified key quality elements of an informed consent document and operationalised the highest-priority elements to define a minimum standard for informed consent documents. They assert that this tool is a starting point that can enable hospitals and other providers to evaluate and improve the quality of informed consent.
AHRQ-funded; HS023000.
Citation: Spatz ES, Suter LG, George E .
An instrument for assessing the quality of informed consent documents for elective procedures: development and testing.
BMJ Open 2020 May 19;10(5):e033297. doi: 10.1136/bmjopen-2019-033297..
Keywords: Surgery, Quality Measures, Quality of Care
Spatz ES, Bao H, Herrin J
Quality of informed consent documents among US. hospitals: a cross-sectional study.
The purpose of this study was to determine whether informed consent for surgical procedures performed in US hospitals met a minimum standard of quality. The investigators developed and tested a quality measure of informed consent documents. The investigators concluded that all hospitals performed poorly on a measure of informed consent document quality, though there was some variation across hospitals. They indicated that measuring the quality of hospital's informed consent documents can serve as a first step in driving attention to gaps in quality.
AHRQ-funded; HS023000.
Citation: Spatz ES, Bao H, Herrin J .
Quality of informed consent documents among US. hospitals: a cross-sectional study.
BMJ Open 2020 May 19;10(5):e033299. doi: 10.1136/bmjopen-2019-033299..
Keywords: Hospitals, Surgery, Quality Measures, Quality of Care
King CR, Abraham J, Kannampallil TG
Protocol for the effectiveness of an anesthesiology control tower system in improving perioperative quality metrics and clinical outcomes: the TECTONICS randomized, pragmatic trial.
The primary objective of this trial was to determine whether an anesthesiology control tower (ACT) prevents clinically relevant adverse postoperative outcomes including 30-day mortality, delirium, respiratory failure, and acute kidney injury. Clinicians in operating rooms randomized to ACT support receive decision support from clinicians in the ACT. In operating rooms randomized to no intervention, the current standard of anesthesia care is delivered. The intention-to-treat principle will be followed for all analyses.
AHRQ-funded; HS024581.
Citation: King CR, Abraham J, Kannampallil TG .
Protocol for the effectiveness of an anesthesiology control tower system in improving perioperative quality metrics and clinical outcomes: the TECTONICS randomized, pragmatic trial.
F1000Res 2019 Nov 29;8:2032. doi: 10.12688/f1000research.21016.1.
.
.
Keywords: Quality Measures, Quality Improvement, Quality of Care, Surgery, Telehealth, Health Information Technology (HIT)
Spatz ES
Fostering a culture to support surgical outcome measures.
This editorial comments on the relationship of surgical skills (referring to the gentleness, tissue exposure, instrument handling, time and motion, and flow of operation) and patient outcomes
AHRQ-funded; HS023000.
Citation: Spatz ES .
Fostering a culture to support surgical outcome measures.
Circ Cardiovasc Qual Outcomes 2016 Jul;9(4):345-7. doi: 10.1161/circoutcomes.116.003038.
.
.
Keywords: Outcomes, Provider Performance, Quality Measures, Surgery
Suckow BD, Goodney PP, Columbo JA
National trends in open surgical, endovascular, and branched-fenestrated endovascular aortic aneurysm repair in Medicare patients.
Open repair effectively prevents rupture for patients with abdominal aortic aneurysm (AAA) and is commonly studied as a metric reflecting hospital and surgeon expertise in cardiovascular care. However, given recent advances in endovascular aneurysm repair (EVAR), such as branched-fenestrated EVAR, it is unknown how commonly open surgical repair is still used in everyday practice. This study analyzed trends in open AAA repair, EVAR, and branched-fenestrated EVAR for AAA in Medicare beneficiaries from 2003 to 2013.
AHRQ-funded; HS021581.
Citation: Suckow BD, Goodney PP, Columbo JA .
National trends in open surgical, endovascular, and branched-fenestrated endovascular aortic aneurysm repair in Medicare patients.
J Vasc Surg 2018 Jun;67(6):1690-97.e1. doi: 10.1016/j.jvs.2017.09.046..
Keywords: Cardiovascular Conditions, Medicare, Provider Performance, Quality Measures, Surgery
Sawyer JM, Anton NE, Korndorffer JR
Time crunch: increasing the efficiency of assessment of technical surgical skill via brief video clips.
Video review for assessment of surgical performance is gaining popularity but is time consuming for busy expert reviewers, making review delays inevitable. The study authors hypothesized that a shorter duration video clip would not affect the quality of expert ratings compared with full-length review. Their hypothesis was rejected as shorter video durations for surgical performance assessment led to inflated reviewer ratings both for expert and novice reviewers. They concluded that shortening duration of the video could not be recommended for accurate performance assessment.
AHRQ-funded; HS022080.
Citation: Sawyer JM, Anton NE, Korndorffer JR .
Time crunch: increasing the efficiency of assessment of technical surgical skill via brief video clips.
Surgery 2018 Apr;163(4):933-37. doi: 10.1016/j.surg.2017.11.011..
Keywords: Surgery, Quality of Care, Provider Performance, Quality Measures
Waljee JF, Dimick JB
Do patient-reported outcomes correlate with clinical outcomes following surgery?
This study examines whether patient-reported outcomes (PROs) correlate with clinical outcomes following surgery. PROs are distinct from clinical outcomes and represent a potential indicator of performance that can be targeted to improve quality of care. Future studies that examine the influence of measurement techniques, case mix, and disease characteristics on PROs will inform efforts to routinely and efficiently integrate these critical outcomes into existing strategies to capture treatment effectiveness and quality of care for surgical conditions.
AHRQ-funded; HS023313.
Citation: Waljee JF, Dimick JB .
Do patient-reported outcomes correlate with clinical outcomes following surgery?
Adv Surg 2017 Sep;51(1):141-50. doi: 10.1016/j.yasu.2017.03.011..
Keywords: Quality of Care, Outcomes, Patient-Centered Outcomes Research, Surgery, Patient Experience, Quality Measures
Kanters A, Mullard AJ, Arambula J
Colorectal cancer: quality of surgical care in Michigan.
Surgery remains the cornerstone therapy for colorectal cancer (CRC). This study assesses CRC quality measures for surgical cases in Michigan with data from 30 hospitals in the Michigan Surgical Quality Collaborative (2014-2015). Adjusted process measures showed gaps in quality of care for CRC, suggesting opportunity for regional quality improvement.
AHRQ-funded; HS000053.
Citation: Kanters A, Mullard AJ, Arambula J .
Colorectal cancer: quality of surgical care in Michigan.
Am J Surg 2017 Mar;213(3):548-52. doi: 10.1016/j.amjsurg.2016.11.038.
.
.
Keywords: Cancer: Colorectal Cancer, Quality of Care, Outcomes, Quality Measures, Surgery
Ban KA, Cohen ME, Ko CY
Evaluation of the ProPublica surgeon scorecard "Adjusted Complication Rate" measure specifications.
The authors sought to (1) determine the proportion of cases excluded by ProPublica's specifications, (2) assess the proportion of inpatient complications excluded from ProPublica's measure, and (3) examine the validity of ProPublica's outcome measure by comparing performance on the measure to well-established postoperative outcome measures. They found that ProPublica's outcome measure specifications exclude 82% of cases, miss 84% of postoperative complications, and correlate poorly with well-established postoperative outcomes.
AHRQ-funded; HS021857.
Citation: Ban KA, Cohen ME, Ko CY .
Evaluation of the ProPublica surgeon scorecard "Adjusted Complication Rate" measure specifications.
Ann Surg 2016 Oct;264(4):566-74. doi: 10.1097/sla.0000000000001858.
.
.
Keywords: Adverse Events, Outcomes, Public Reporting, Quality Measures, Surgery
Minami CA, Dahlke AR, Barnard C
Association between hospital characteristics and performance on the new hospital-acquired condition reduction program's surgical site infection measures.
This research letter evaluated the association between hospital characteristics and surgical site infection (SSI) measures. The authors found that hospitals with higher hospital quality summary scores were more frequently poor performers for SSI and had higher standardized infection ratios. Hospitals were more likely to be poor performers for colon SSI and hysterectomy SSI if they were a teaching hospital, safety-net hospital, or level I trauma center. Teaching hospitals were more likely to be poor performers for colorectal SSI, but the association was not as consistent for hysterectomy.
AHRQ-funded; HS021857.
Citation: Minami CA, Dahlke AR, Barnard C .
Association between hospital characteristics and performance on the new hospital-acquired condition reduction program's surgical site infection measures.
JAMA Surg 2016 Aug;151(8):777-9. doi: 10.1001/jamasurg.2016.0408.
.
.
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Injuries and Wounds, Adverse Events, Quality Measures, Hospitals, Quality of Care
Hernandez-Boussard TM, McDonald KM, Morrison DE
Risks of adverse events in colorectal patients: population-based study.
The authors sought to assess adverse events in colorectal surgical patients. They found important differential rates of adverse events by diagnostic category, with the highest odds ratio occurring in patients undergoing surgery for ischemic colitis.
AHRQ-funded; HS018558.
Citation: Hernandez-Boussard TM, McDonald KM, Morrison DE .
Risks of adverse events in colorectal patients: population-based study.
J Surg Res 2016 May 15;202(2):328-34. doi: 10.1016/j.jss.2016.01.013.
.
.
Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Surgery, Patient Safety, Risk, Quality Indicators (QIs), Quality of Care, Quality Measures
Minami CA, Sheils CR, Bilimoria KY
Process improvement in surgery.
The authors reviewed aspects of process improvement-quality improvement that are relevant to the currently practicing surgeon. They discussed commonly used quality improvement data platforms, process improvement methodologies, examples of successful local quality improvement initiatives, the role of regional surgical improvement collaboratives, common barriers to quality improvement efforts, and potential solutions to overcome them.
AHRQ-funded; HS000078.
Citation: Minami CA, Sheils CR, Bilimoria KY .
Process improvement in surgery.
Curr Probl Surg 2016 Feb;53(2):62-96. doi: 10.1067/j.cpsurg.2015.11.001.
.
.
Keywords: Healthcare Delivery, Quality of Care, Quality Improvement, Quality Measures, Surgery
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
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.
.
.
Keywords: Patient-Centered Outcomes Research, Quality Measures, Surgery