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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
26 to 50 of 237 Research Studies DisplayedSchuttner L, Lee JR, Hockett Sherlock S
Primary care physician perspectives on the influence of patient values, health priorities, and preferences on clinical decision-making for complex patients with multimorbidity: a qualitative study.
The purpose of this study was to explore primary care physician (PCP) perspectives on the influence of patients' values, health priorities and goals, and preferences on clinical decisions for patients with multimorbidity and higher psychosocial complexity. Between May and July 2020 the researchers utilized semi-structured telephone interviews with 23 PCPs in patient-centered medical home teams in a nationally integrated health system in the United States. The study found three major themes: (1) The personal values of patients were rarely directly discussed in routine clinical encounters but informed more typically discussed constructs of patient preferences, goals, and priorities; (2) Patient preferences, goals, and priorities were sources of conflicting perspectives about care plans between healthcare teams, patients, and families; (3) Physicians used direct strategies to communicate and negotiate about patient preferences, goals, and priorities when developing care plans. The researchers concluded that during clinical decision-making for complex patients with multimorbidity, primary care physicians perceive patient values, preferences, health priorities and goals as influential.
AHRQ-funded; HS026369.
Citation: Schuttner L, Lee JR, Hockett Sherlock S .
Primary care physician perspectives on the influence of patient values, health priorities, and preferences on clinical decision-making for complex patients with multimorbidity: a qualitative study.
Risk Manag Healthc Policy 2022 Nov 16; 15:2135-46. doi: 10.2147/rmhp.S380021..
Keywords: Primary Care, Provider: Physician, Shared Decision Making, Chronic Conditions
Rodriguez HP, Kyalwazi MJ, Lewis VA
Adoption of patient-reported outcomes by health systems and physician practices in the USA.
This study examined the extent of patient-reported outcome (PRO) measure adoption among health systems and physician practices nationally and examines the organizational capabilities associated with more extensive PRO adoption. A total of 323 US health system and 2,190 physician practices responded to one of two nationally representative surveys. Survey results found that pain (50.6%) and depression (43.8%) PROs were more commonly adopted by all hospitals and medical groups within health systems compared to disability PROs (26.5%). Systems with more advanced health IT functions were more likely to use disability and depression PROs than systems with less advanced health IT. Practice-level advanced health IT was positively associated with use of depression PRO, but not disability or pain PRO use. The three PROs were more likely to be adopted in practices with more chronic care management processes, broader medical and social risk screening, and more processes to support patient responsiveness. Also, compared to independent physician practices, system-owned practices and community health centers were less likely to adopt PROs.
AHRQ-funded; HS024075.
Citation: Rodriguez HP, Kyalwazi MJ, Lewis VA .
Adoption of patient-reported outcomes by health systems and physician practices in the USA.
J Gen Intern Med 2022 Nov;37(15):3885-92. doi: 10.1007/s11606-022-07631-0..
Keywords: Health Systems, Provider: Physician, Patient-Centered Healthcare
Maganty A, Hollenbeck BK, Kaufman SR
Implications of the merit-based incentive payment system for urology practices.
The purpose of this cross-sectional study was to analyze urologist performance in the Medicare merit-based incentive payment system (MIPS) for urology practices for 2017 and 2019 using Medicare data. MIPS scores were estimated by practice organization. The study found that urologists from small practices performed worse in MIPS and had a significantly lower adjusted odds ratio of receiving bonus payments in both 2017 and 2019 compared to larger group practices. Urologists who received penalties in 2017 had greater rates of consolidation by 2019 compared to those who were not penalized. The researchers concluded that smaller urology practices and urology practices caring for a greater percentage of dual eligible beneficiaries typically performed worse in the Medicare merit-based incentive payment system.
AHRQ-funded; HS025707.
Citation: Maganty A, Hollenbeck BK, Kaufman SR .
Implications of the merit-based incentive payment system for urology practices.
Urology 2022 Nov;169:84-91. doi: 10.1016/j.urology.2022.05.052..
Keywords: Payment, Provider Performance, Provider: Physician
Dorr DA, Richardson JE, Bobo M
Provider perspectives on patient- and provider-facing high blood pressure clinical decision support.
This study tried to partly address the challenge of developing a patient-facing clinician decision support (CDS) for persistent high blood pressure (HBP). The authors sought to understand provider variations and rationales related to HBP guideline recommendations and perceptions regarding patient role and use of digital tools. They implemented a pilot and final survey for hypertension experts and primary care physicians. Five clinical cases were presented that queried clinicians' attitudes related to actions; variations; prioritization; patient input; importance; and barriers for HBP diagnosis, monitoring, and treatment. Fifteen hypertension experts and 14 providers took the pilot and final versions of the survey. The majority (over 80%) of providers felt the recommendations were important yet found them difficult to follow-up to 90% of the time. Provider perceptions of relative amounts of patient input and patient work for effective HBP management ranged from 22 to 100%. Reasons for variation provided included adverse effects of treatment, patient comorbidities, shared decision-making, and health care cost and access issues. Respondents were generally positive toward patient use of electronic CDS applications but worried about access to health care, nuance of recommendations, and patient understanding of the tools.
AHRQ-funded; HS26849.
Citation: Dorr DA, Richardson JE, Bobo M .
Provider perspectives on patient- and provider-facing high blood pressure clinical decision support.
Appl Clin Inform 2022 Oct;13(5):1131-40. doi: 10.1055/a-1926-0199..
Keywords: Blood Pressure, Clinical Decision Support (CDS), Shared Decision Making, Provider: Physician
Miller-Rosales C, Lewis VA, Shortell SM
Adoption of patient engagement strategies by physician practices in the United States.
Researchers analyzed data collected from the National Survey of Healthcare Organizations and Systems (NSHOS) on physician practice adoption of patient engagement strategies. They found modest adoption of shared decision-making and motivational interviewing, and low adoption of shared medical appointments. They noted that risk-based payment reform has the potential to motivate greater practice-level patient engagement, but the extent to which it occurs may depend on internal practice capabilities.
AHRQ-funded; HS024075.
Citation: Miller-Rosales C, Lewis VA, Shortell SM .
Adoption of patient engagement strategies by physician practices in the United States.
Med Care 2022 Sep;60(9):691-99. doi: 10.1097/mlr.0000000000001748..
Keywords: Patient and Family Engagement, Provider: Physician, Shared Decision Making
Khouja T, Polk DE, Suda KJ
Opioid prescribing by oral and maxillofacial surgeons in the United States, 2016-2019.
The objective of this study was to describe opioid prescribing trends among oral and maxillofacial surgeons (OMFS). The IQVIA Longitudinal Prescription Dataset, 2016-2019, was used to identify prescriptions written by OMFS. The results indicated that while OMFS-prescribed hydrocodone and oxycodone decreased in most states, 12 percent of states showed increases. Tramadol and codeine prescriptions also increased. From these findings, the authors concluded that targeted interventions are warranted in some areas.
AHRQ-funded; HS025177.
Citation: Khouja T, Polk DE, Suda KJ .
Opioid prescribing by oral and maxillofacial surgeons in the United States, 2016-2019.
J Public Health Dent 2022 Sep;82(4):491-94. doi: 10.1111/jphd.12544..
Keywords: Opioids, Medication, Practice Patterns, Orthopedics, Surgery, Dental and Oral Health, Provider: Physician
Damberg CL, Tom A, Reid RO
Physician organizations' use of behavioral nudges to influence physician behavior.
The purpose of this mixed-methods study design study was to examine the adoption of behavioral nudges by health system-affiliated physician organizations (POs), determine the types of nudges being used, assess PO leader perceptions of nudge effectiveness, and explore implementation challenges. The researchers collected data from a purposive sample of 30 health system-affiliated POs from 4 states between October 2017 and June 2019. A initial survey asked PO leaders to report their organization's use of 5 categories of nudges to influence primary and specialty physicians' actions. Semi structured phone interviews were then conducted to confirm survey responses, obtain examples of the nudges that POs reported utilizing, explore how nudges were structured, and identify challenges to implementation. The study found that almost all study POs reported utilizing nudges. The types of nudges most typically used were clinical templates, patient action lists, and altered order entry. PO leaders reported that the utilization of nudges was limited, not widespread across the organization, and structured in the form of suggestions and not default actions or hard stops. The researchers concluded that the utilization of nudges continues to be limited in practice.
AHRQ-funded; HS024067.
Citation: Damberg CL, Tom A, Reid RO .
Physician organizations' use of behavioral nudges to influence physician behavior.
Am J Manag Care 2022 Sep;28(9):473-76. doi: 10.37765/ajmc.2022.89223..
Keywords: Provider: Physician, Shared Decision Making
Mitchell JM, Gresenz CR
The influence of practice structure on urologists' treatment of men with low-risk prostate cancer.
Researchers examined the influence of type of practice structure, and by implication the financial incentives associated with each structure, on treatment received among men newly diagnosed with low-risk prostate cancer. They found that physician practice structure attributes were significantly associated with type of treatment received but few studies controlled for such factors. Their findings - coupled with the observation that urologist practice structure shifted substantially over this time period due to mergers of small urology groups - provided one explanation for the limited uptake of active surveillance among men with low-risk disease in the US.
AHRQ-funded; HS024972.
Citation: Mitchell JM, Gresenz CR .
The influence of practice structure on urologists' treatment of men with low-risk prostate cancer.
Med Care 2022 Sep;60(9):665-72. doi: 10.1097/mlr.0000000000001746..
Keywords: Cancer: Prostate Cancer, Cancer, Practice Patterns, Men's Health, Provider: Physician
Livaudais M, Deng D, Frederick T
Perceived value of the electronic health record and its association with physician burnout.
The objective of this study was to investigate how seniority/years of practice, gender, and screened burnout status were associated with opinions of electronic health record (EHR) use on quality, cost, and efficiency of care. Ambulatory primary care and subspecialty clinicians at three different institutions were surveyed. Findings showed that burnout status was significantly associated with clinicians' perceived value of EHR technologies, while years of practice and gender were not.
AHRQ-funded; HS022065.
Citation: Livaudais M, Deng D, Frederick T .
Perceived value of the electronic health record and its association with physician burnout.
Appl Clin Inform 2022 Aug;13(4):778-84. doi: 10.1055/s-0042-1755372..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Burnout, Provider: Physician
Hughes DT, Reyes-Gastelum D, Ward KC DT, Reyes-Gastelum D, Ward KC
Barriers to the use of active surveillance for thyroid cancer results of a physician survey.
This study’s aim was to determine physician-reported use of and barriers to active surveillance for thyroid cancer. Surgeons and endocrinologists who were identified by thyroid cancer patients from the SEER registries of Georgia and Los Angeles County were surveyed between 2018 and 2019. Of the 654 eligible physicians identified, 448 responded to the survey. The majority (76%) believed that active surveillance was an appropriate management option, but only 44% provided that surveillance. Physicians who stated that active surveillance was appropriate management but did not use it tended to have more years in practice (>10 years) and higher patient volume (11-30 patients per year or >50 patients per year) compared to doctors with less than 10 years in practice, with no significant difference in seeing 31 to 50 patients. Barriers reported to active surveillance included patients that did not want it (80.3%), loss to follow-up concern (78.4%), more patient worry (57.6%), and malpractice lawsuit concern (50.9%).
AHRQ-funded; HS024512.
Citation: Hughes DT, Reyes-Gastelum D, Ward KC DT, Reyes-Gastelum D, Ward KC .
Barriers to the use of active surveillance for thyroid cancer results of a physician survey.
Ann Surg 2022 Jul 1;276(1):e40-e47. doi: 10.1097/sla.0000000000004417..
Keywords: Cancer, Provider: Physician
Post B, Norton EC, Hollenbeck BK
Hospital-physician integration and risk-coding intensity.
This study analyzed whether hospital-physician integration affects providers' coding of patient severity, because greater diagnostic severity will increase practices’ payment under risk-based arrangements. The authors used a two-way fixed effects model, an event study, and a stacked difference-in-differences analysis of 5 million patient-year observations from 2010 to 2015. They found that the integration of a patient's primary care doctor is associated with a robust 2%-4% increase in coded severity, the risk-score equivalent of aging a physician's patients by 4-8 months. This effect wasn’t driven by physicians treating different patients nor by physicians seeing patients more often. Their evidence is consistent with the hypothesis that hospitals share organizational resources with acquired physician practices to increase the measured clinical severity of patients. They believe that increases in the intensity of coding will improve vertically-integrated practices' performance in alternative payment models and pay-for-performance programs while raising overall health care spending.
AHRQ-funded; HS025707;HS027044.
Citation: Post B, Norton EC, Hollenbeck BK .
Hospital-physician integration and risk-coding intensity.
Health Econ 2022 Jul; 31(7):1423-37. doi: 10.1002/hec.4516..
Keywords: Hospitals, Provider: Physician, Payment
Semere W, Cemballi AG, Schillinger D
"We need to bring them out from the shadows:" a qualitative study of safety net physician leaders' perspectives on caregivers.
The purpose of the study was to examine the perspectives of physician leaders on methods and priorities for interacting with patient caregivers. The researchers interviewed 15 primary care physicians from 3 California safety net systems, all of whom were in care management leadership, to evaluate their experiences managing complex patients with caregivers. Interview transcripts were analyzed using thematic analysis, and a research team approach was utilized to derive major themes. The themes included: challenges uncovering caregiver identities, engaging caregivers in patient care, recognizing variation in caregivers' roles, adapting visit communication strategies to include caregivers, and caring for the caregiver. The study concluded that health systems do not tend to recognize caregiver participation in patient care, must overcome language and literacy barriers when attempting to include caregivers in visit communications; all these issues create challenges when attempting to engage caregivers. The researchers advised that outcomes for patients could be improved if methods and processes were developed to identify and communicate with caregivers.
AHRQ-funded; HS027844; HS022408.
Citation: Semere W, Cemballi AG, Schillinger D .
"We need to bring them out from the shadows:" a qualitative study of safety net physician leaders' perspectives on caregivers.
Patient Educ Couns 2022 Jun;105(6):1663-70. doi: 10.1016/j.pec.2021.10.019..
Keywords: Caregiving, Provider: Physician
Khan A, Baird J, Kelly MM
Family safety reporting in medically complex children: parent, staff, and leader perspectives.
This qualitative study examined parent, staff, and hospital leader perspectives about family safety reporting in children with medical complexity (CMC) to inform future interventions. The study was conducted at 2 tertiary care children’s hospitals with dedicated inpatient complex care services. Hour-long semi-structured, individual interviews were conducted with English and Spanish-speaking parents of CMC, physicians, nurses, and hospital leaders. A total of 80 participants (34 parents, 19 nurses and allied health professionals, 11 physicians, and 16 hospital leaders) were interviewed. Four themes related to family safety reporting emerged: (1) unclear, nontransparent, and variable existing processes, (2) a continuum of staff and leadership buy-in, (3) a family decision-making calculus about whether to report, and (4) misaligned staff and parent priorities and expectations. The authors also identified potential strategies for engaging families and staff in family reporting.
AHRQ-funded; HS025781.
Citation: Khan A, Baird J, Kelly MM .
Family safety reporting in medically complex children: parent, staff, and leader perspectives.
Pediatrics 2022 Jun; 149(6). doi: 10.1542/peds.2021-053913..
Keywords: Children/Adolescents, Family Health and History, Chronic Conditions, Provider: Physician, Patient Safety, Medical Errors, Adverse Events, Inpatient Care
Cross WF, West JC, Crean HF
Measurement of primary care providers' suicide prevention skills following didactic education.
This study’s objective was to determine if didactic training by medical residents and nurse practitioner (NP) trainees increased their skills to assess and manage patients’ suicidal ideation, intent, and behaviors. Online didactic training was provided to 127 medical resident and NP trainees followed by a standardized patient interaction conducted to assess demonstrated suicide prevention skills (i.e., assessment of risk factors, protective factors, suicidal ideation and behavior, safety planning). Participants demonstrated only about half of the possible total skills in most domains and were least competent in assessing potential risk for suicide. Residents were rated significantly higher than NPs on observed skills.
AHRQ-funded; HS024224.
Citation: Cross WF, West JC, Crean HF .
Measurement of primary care providers' suicide prevention skills following didactic education.
Suicide Life Threat Behav 2022 Jun;52(3):373-82. doi: 10.1111/sltb.12827..
Keywords: Behavioral Health, Primary Care, Prevention, Education: Continuing Medical Education, Provider: Physician, Training
Kerrissey M, Tietschert M, Novikov Z
Social features of integration in health systems and their relationship to provider experience, care quality and clinical integration.
The purpose of this study was to explore the social features of health system integration -elements of normative integration (alignment of norms) and interpersonal integration (collaboration among professionals and with patients). The researchers administered surveys to practice managers and 1,360 staff and physicians at 59 practice sites within 17 health systems, with a 61% response rate of 828. The study found that the variables of normative and interpersonal integration were both consistently related to better provider experience, perceived care quality, and clinical integration. Variance in social features of integration may help explain why some health systems are better at integrating care, highlighting normative and interpersonal integration as possible resources for improvement.
AHRQ-funded; HS024067.
Citation: Kerrissey M, Tietschert M, Novikov Z .
Social features of integration in health systems and their relationship to provider experience, care quality and clinical integration.
Med Care Res Rev 2022 Jun; 79(3):359-70. doi: 10.1177/10775587211024796..
Keywords: Burnout, Provider: Physician, Health Systems
Escarce JJ, Wozniak GD, Tsipas S
The Affordable Care Act Medicaid expansion, social disadvantage, and the practice location choices of new general internists.
This study’s objective was to examine the level of social disadvantage of the areas of Medicaid expansion states from the ACA that gained new physicians and the areas of nonexpansion states that lost them. The authors used American Community Survey data to classify commuting zones as high, medium, or low social disadvantage. The AMA Physician Masterfile data from 2009-2019 was used to compare where 32,102 new general internists located during the 6 years following the expansion to where they located during the 5 years preceding the expansion. They estimated that between 2014 and 2019 nonexpansion states lost 371 new general internists to expansion states. However, 62.5% of the physicians lost by nonexpansion states were lost from high disadvantage areas although those areas only account for 17.9% of the population of nonexpansion states. This potentially compromises access for all residents irrespective of insurance coverage.
AHRQ-funded; HS025750.
Citation: Escarce JJ, Wozniak GD, Tsipas S .
The Affordable Care Act Medicaid expansion, social disadvantage, and the practice location choices of new general internists.
Med Care 2022 May;60(5):342-50. doi: 10.1097/mlr.0000000000001703..
Keywords: Medicaid, Policy, Provider: Physician, Health Insurance
Valdez S, Jacobson M
Assessing the quality of SK&A's office-based physician database for identifying oncologists.
Investigators assessed the quality of SK&A's office-based physician database by capturing oncologists who bill the Medicare fee-for-service program. Using 2017 data, they found that nearly 74% of the oncologists in Medicare claims can be found in the SK&A data, with higher rates when weighted by patients, service volume, or spending.
AHRQ-funded; HS000046.
Citation: Valdez S, Jacobson M .
Assessing the quality of SK&A's office-based physician database for identifying oncologists.
Med Care Res Rev 2022 Apr;79(2):317-27. doi: 10.1177/10775587211013628..
Keywords: Medicare, Provider: Physician
Fraiman YS, Cheston CC, Cabral HJ
Effect of a novel mindfulness curriculum on burnout during pediatric internship: a cluster randomized clinical trial.
This study examined the effectiveness of a monthly mindfulness curriculum (Mindfulness Intervention for New Interns) for medical interns on emotional exhaustion (EE) as measured by the Maslach Burnout Inventory 9-question EE subscale as well as secondary outcomes of depersonalization, personal accomplishment, and burnout. This was a randomized clinical trial of 340 pediatric interns participating in 15 US pediatric training programs from June 2017 to February 2019. The intervention included 7 hour-long sessions and a monthly mindfulness refresher implemented during internship. The active control arm also included monthly 1-hour social lunches. Follow-up was done at 6 months and at month 15. Both arms’ EE scores were higher at 6 and 15 months than at baseline, but EE did not significantly differ by arm in multivariable analyses. There were also no significant differences in the 6 secondary outcomes at month 6 or month 15.
AHRQ-funded; HS000063.
Citation: Fraiman YS, Cheston CC, Cabral HJ .
Effect of a novel mindfulness curriculum on burnout during pediatric internship: a cluster randomized clinical trial.
JAMA Pediatr 2022 Apr;176(1):365-72. doi: 10.1001/jamapediatrics.2021.5740..
Keywords: Education: Curriculum, Burnout, Provider: Physician
Post B, Nallamothu BK, Hollenbeck B
Hospital-cardiologist integration often occurs without a practice acquisition.
This study’s objective was to determine how much of the increase in hospital-cardiologist integration comes from acquisition of physician practices compared to individual employment decisions. Data from 2011 to 2018 was used from the American Medical Association Masterfile and Medicare. In 2011 18% of cardiologists were integrated, which rose to 25% in 2016. It was found that 48% of integrations occurred without acquisitions and that physicians who had completed residencies in the past 5 years had higher rates of integration that increased over time. Rates of early career physicians joining hospital systems also rose from 25% to 32% during that time period.
AHRQ-funded; HS025707.
Citation: Post B, Nallamothu BK, Hollenbeck B .
Hospital-cardiologist integration often occurs without a practice acquisition.
Health Serv Res 2022 Apr;57(2):333-39. doi: 10.1111/1475-6773.13929..
Keywords: Hospitals, Provider: Physician, Healthcare Delivery, Workforce
Metersky ML, Eldridge N, Wang Y
AHRQ Author: Eldridge N
Rates of adverse events in hospitalized patients after summer-time resident changeover in the United States: is there a July effect?
This retrospective analysis aimed to determine whether patients in teaching hospitals are at greater risk of suffering from an adverse event during the July/August summer trainee changeover period. The Medicare Patient Safety Monitoring System was used to extract data on hospital admissions from 2010 to 2017 for acute myocardial infarction, heart failure, pneumonia, or a major surgical procedure. Adverse event rates in July and August were compared with the rest of the year. Hospitals were classified into major teaching, minor teaching, or nonteaching. The authors included 185,652 hospital admissions. The adjusted odds ratios (ORs) of suffering from at least one adverse event was not significantly different at any of the hospital types.
AHRQ-authored; AHRQ-funded; 290201800005C.
Citation: Metersky ML, Eldridge N, Wang Y .
Rates of adverse events in hospitalized patients after summer-time resident changeover in the United States: is there a July effect?
J Patient Saf 2022 Apr 1;18(3):253-59. doi: 10.1097/pts.0000000000000887..
Keywords: Adverse Events, Patient Safety, Provider: Physician
Jindal M, Mistry KB, McRae A
AHRQ Author: Mistry KB,
"It makes me a better person and doctor": a qualitative study of residents' perceptions of a curriculum addressing racism.
The purpose of this study was to explore how pediatric residents perceive the impact of a curriculum addressing racism on their knowledge, motivation, skills and behaviors and investigate the contextual factors that promote or impede the curriculum's effectiveness. Semi structured interviews were conducted at two academic medical centers among pediatric residents. Findings showed that medical education addressing racism can facilitate the perceived acquisition of foundational knowledge regarding race and racism, motivation and skill-building to combat racism, and action planning aimed at improving patient care.
AHRQ-authored.
Citation: Jindal M, Mistry KB, McRae A .
"It makes me a better person and doctor": a qualitative study of residents' perceptions of a curriculum addressing racism.
Acad Pediatr 2022 Mar;22(2):332-41. doi: 10.1016/j.acap.2021.12.012..
Keywords: Education: Curriculum, Education: Continuing Medical Education, Racial and Ethnic Minorities, Provider: Physician
Kanters AE, Evilsizer SK, Regenbogen SE
Correlation of colorectal surgical skill with patient outcomes: a cautionary tale.
Some have proposed that video-based skill assessments be used as a way to measure technical skills, quality improvement, and credentialing in colorectal surgeons and other practitioners. However, it must first be determined whether video-based assessments can accurately predict patient outcomes. The researchers assembled a panel of 10 peer surgeons to evaluate videos of minimally invasive colectomy procedures submitted by 21 surgeons. Each surgeon submitted one video, and the videos were edited to highlight key steps in the procedure. The panel and the surgeon participants were all associated with the Michigan Surgical Quality Collaborative. The panel used a validated American Society of Colon and Rectal Surgeons assessment instrument to rate the surgeon’s skills. The surgeon’s ratings were then linked to a validated registry of surgical outcomes, and the researchers assessed the relationship between skill level and risk-adjusted complication rates. The researchers found that after risk-adjustment there was no statistically significant difference in complication rates between the bottom (17.5%) and top (16.8%) quartile surgeons (p=0.41). The study concluded that there was no correlation between video-based peer rating of minimally invasive colectomy and postoperative complications among specialty surgeons, and that caution should be used when utilizing video review in credentialing.
AHRQ-funded; HS025365.
Citation: Kanters AE, Evilsizer SK, Regenbogen SE .
Correlation of colorectal surgical skill with patient outcomes: a cautionary tale.
Dis Colon Rectum 2022 Mar;65(3):444-51. doi: 10.1097/dcr.0000000000002124..
Keywords: Surgery, Provider: Physician, Provider Performance, Digestive Disease and Health, Outcomes
Rodriguez HP, Ciemins EL, Rubio K
Physician practices with robust capabilities spend less on Medicare beneficiaries than more limited practices.
Researchers used data from the 2017 National Survey of Healthcare Organizations and Systems to examine the association of practice-level capabilities with process measures of quality, utilization, and spending. They found that quality and utilization did not differ by practice-level capabilities. Physician practice locations with robust capabilities spent less on Medicare fee-for-service beneficiaries but delivered quality of care comparable to the quality delivered in locations with low or mixed capabilities.
AHRQ-funded; HS024075.
Citation: Rodriguez HP, Ciemins EL, Rubio K .
Physician practices with robust capabilities spend less on Medicare beneficiaries than more limited practices.
Health Aff 2022 Mar;41(3):414-23. doi: 10.1377/hlthaff.2021.00302..
Keywords: Healthcare Costs, Medicare, Provider: Physician
Ray KN, Bohnhoff JC, Schweiberger K
Use of telemedicine for initial outpatient subspecialist consultative visit: a national survey of general pediatricians and pediatric subspecialists.
The authors performed a survey of general pediatricians and pediatric subspecialists about the use of telemedicine for patients newly referred for pediatric subspecialty care. They found that 76% of respondents thought telemedicine should be offered for some and 11% thought telemedicine should be offered for all initial subspecialist visits. Factors perceived to reduce the appropriateness of telemedicine for subspecialty consultation included the need for interpreter services and a prior history of frequent no-shows. They further found that responses from generalists and subspecialists rarely differed significantly.
AHRQ-funded; HS026393.
Citation: Ray KN, Bohnhoff JC, Schweiberger K .
Use of telemedicine for initial outpatient subspecialist consultative visit: a national survey of general pediatricians and pediatric subspecialists.
Healthc 2022 Mar;10(1):100600. doi: 10.1016/j.hjdsi.2021.100600..
Keywords: Children/Adolescents, Telehealth, Health Information Technology (HIT), Provider: Physician, Ambulatory Care and Surgery
Crist K, Lafferty M, Umberfield E
Which factors promote shared understanding between physicians and nurses in inpatient oncology care settings?: A qualitative exploration.
This qualitative secondary analysis was conducted to identify factors that contribute to shared understanding between physicians and nurses from video-recorded conversations that occurred between them during inpatient rounds on oncology units. Four factors emerged as contributors to shared understanding: engagement, clarification, confirmation, and resolution. These factors occurred in sequence with engagement occurring first and resolution occurring last, as the closure of a communication exchange. A greater awareness of body language and positioning at the start of a communication exchange may increase the effectiveness of nurse-physician communication.
AHRQ-funded; HS022305.
Citation: Crist K, Lafferty M, Umberfield E .
Which factors promote shared understanding between physicians and nurses in inpatient oncology care settings?: A qualitative exploration.
Cancer Nurs 2022 Mar-Apr;45(2):E338-E44. doi: 10.1097/ncc.0000000000000959..
Keywords: Communication, Provider: Physician, Provider: Nurse