National Healthcare Quality and Disparities Report
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Topics
- Access to Care (4)
- Ambulatory Care and Surgery (1)
- Asthma (1)
- Behavioral Health (1)
- Cancer (5)
- Cancer: Breast Cancer (1)
- Cancer: Cervical Cancer (1)
- Cancer: Colorectal Cancer (2)
- Cancer: Ovarian Cancer (1)
- Cancer: Prostate Cancer (1)
- Care Coordination (1)
- Care Management (1)
- Children/Adolescents (2)
- Chronic Conditions (3)
- Clinician-Patient Communication (1)
- Community-Based Practice (2)
- Critical Care (1)
- Cultural Competence (1)
- Dementia (1)
- Dialysis (1)
- Disparities (3)
- Elderly (2)
- Emergency Department (2)
- Emergency Medical Services (EMS) (1)
- Genetics (1)
- Healthcare Costs (2)
- (-) Healthcare Delivery (24)
- (-) Healthcare Utilization (24)
- Health Information Technology (HIT) (2)
- Health Insurance (1)
- Health Services Research (HSR) (1)
- Hospital Discharge (1)
- Hospitalization (3)
- Hospital Readmissions (1)
- Hospitals (4)
- Implementation (1)
- Intensive Care Unit (ICU) (1)
- Kidney Disease and Health (1)
- Medicaid (2)
- Medical Expenditure Panel Survey (MEPS) (2)
- Medicare (2)
- Medication (1)
- Mortality (1)
- Neurological Disorders (1)
- Outcomes (1)
- Palliative Care (2)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (1)
- Patient Adherence/Compliance (1)
- Policy (1)
- Practice Patterns (1)
- Pregnancy (2)
- Prevention (3)
- Primary Care (1)
- Primary Care: Models of Care (1)
- Provider (1)
- Provider: Nurse (1)
- Quality of Care (2)
- Racial and Ethnic Minorities (2)
- Screening (3)
- Shared Decision Making (1)
- Social Determinants of Health (1)
- Surgery (1)
- Telehealth (2)
- Transitions of Care (2)
- Transplantation (1)
- Treatments (1)
- Uninsured (1)
- Vulnerable Populations (1)
- Women (3)
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 24 of 24 Research Studies DisplayedChang E, Ali R, Seibert J
Interventions to improve outcomes for high-need, high-cost patients: a systematic review and meta-analysis.
The authors of this article reviewed evidence on the effectiveness of complex interventions designed to change the healthcare of high-need, high-cost patients. They found limited evidence of intervention effectiveness in relation to cost and use, but note that additional evidence is needed to strengthen their confidence in these findings. Few studies reported clinical/functional or social risk factor outcomes or sufficient details for determining why individual interventions work. They conclude that future evaluations could provide additional insights in assessing the impact of complex interventions.
AHRQ-funded; 290201500011I.
Citation: Chang E, Ali R, Seibert J .
Interventions to improve outcomes for high-need, high-cost patients: a systematic review and meta-analysis.
J Gen Intern Med 2023 Jan; 38(1):185-94. doi: 10.1007/s11606-022-07809-6..
Keywords: Healthcare Costs, Healthcare Delivery, Chronic Conditions, Healthcare Utilization
Grove LR, Gertner AK, Swietek KE
Effect of enhanced primary care for people with serious mental illness on service use and screening.
This retrospective cohort study compared healthcare use and screening receipt of people with serious mental illness (SMI) newly receiving enhanced primary care to people with SMI newly receiving usual primary care. Outcome measures included outpatient visits, emergency department (ED) visits, inpatient stays and dates, and recommended screenings 18 months after the initial visit. Enhanced primary care was associated with an increase of 1.2 primary care visits in the 18 months after the initial visit and decreases of 0.33 non-psychiatric inpatient days and 3.0 non-psychiatric inpatient days. There was no significant effect on psychiatric service and ED visits. Enhanced primary care increased the probability of preventive screenings such as glucose and HIV, decreased the probability of lipid screening, and had no effect on hemoglobin A1c and colorectal cancer screening.
AHRQ-funded; HS000032.
Citation: Grove LR, Gertner AK, Swietek KE .
Effect of enhanced primary care for people with serious mental illness on service use and screening.
J Gen Intern Med 2021 Apr;36(4):970-77. doi: 10.1007/s11606-020-06429-2..
Keywords: Behavioral Health, Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare, Screening, Healthcare Utilization, Healthcare Delivery
Feldman AG, Marsh R, Kempe A
Barriers to pretransplant immunization: a qualitative interview study of pediatric solid organ transplant stakeholders.
Investigators described the experiences and beliefs of pediatric transplant stakeholders regarding factors that contribute to low pre-transplant immunization rates. Five central themes emerged: gaps in knowledge about timing and safety of pre-transplant immunizations; lack of communication, coordination, and follow-up between team members; lack of centralized immunization records; subspecialty clinics functioning as the medical home for transplant candidates, but not able to provide all needed immunizations; and differences between organ type in prioritization and completion of pre-transplant immunization. The authors recommended new tools to overcome these barriers and to increase immunization rates in transplant candidates.
AHRQ-funded; HS026510.
Citation: Feldman AG, Marsh R, Kempe A .
Barriers to pretransplant immunization: a qualitative interview study of pediatric solid organ transplant stakeholders.
J Pediatr 2020 Dec;227:60-68. doi: 10.1016/j.jpeds.2020.07.038..
Keywords: Children/Adolescents, Transplantation, Surgery, Healthcare Delivery, Healthcare Utilization
Kubi B, Enumah ZO, Lee KT
Theory-based development of an implementation intervention using community health workers to increase palliative care use.
This study used the Behavior Change Wheel and Theoretical Domains Framework models to help design an implementation intervention using community health workers (CHWs) to increase palliative care use in African American communities. There were two phases to the study. In Phase 1, focus group sessions were conducted to identify barriers and facilitators of palliative care use. Phase 2 consisted of a stakeholder meeting to select intervention content and prioritize modes of delivery after applying the framework. There were 15 stakeholders total that participated in the study. Interventions identified were designed to improve patient capability and motivation, physician capability and motivation, and increase patient opportunities to use palliative care services. The strategies were all facilitated by CHWs and included creation and dissemination of brochures, empowerment and activation of patients to initiate goals-of-care discussions, outreach to community churches, and expanding patient social support.
AHRQ-funded; HS024736.
Citation: Kubi B, Enumah ZO, Lee KT .
Theory-based development of an implementation intervention using community health workers to increase palliative care use.
J Pain Symptom Manage 2020 Jul;60(1):10-19. doi: 10.1016/j.jpainsymman.2020.02.009..
Keywords: Community-Based Practice, Palliative Care, Healthcare Utilization, Racial and Ethnic Minorities, Implementation, Disparities, Healthcare Delivery
Darney BG, Fuentes-Rivera E, Polo G
Con la ley y sin la ley/With and without the law: utilization of abortion services and case fatality in Mexico, 2000-2016.
This study examined abortion and case-fatality rate trends in Mexico and Mexico City from 2000 to 2016. The rate nationally was 6.7 per 1000 in 2000, peaked in 2011, and plateaued in 2016. In Mexico City the utilization rate peaked in 2014 and then plateaued. Nationwide and in Mexico City (where abortion was legalized in 2007) case-fatality rates declined over time. After abortion became legal in Mexico City, the rate decreased more rapidly than in the other states of Mexico.
AHRQ-funded.
Citation: Darney BG, Fuentes-Rivera E, Polo G .
Con la ley y sin la ley/With and without the law: utilization of abortion services and case fatality in Mexico, 2000-2016.
Int J Gynaecol Obstet 2020 Mar;148(3):369-74. doi: 10.1002/ijgo.13077..
Keywords: Pregnancy, Healthcare Utilization, Women, Healthcare Delivery
Ellis RJ, Schlick CJR, Feinglass J
Failure to administer recommended chemotherapy: acceptable variation or cancer care quality blind spot?
This study examined hospital variation in cancer patients who did not receive recommended chemotherapy. Patients with breast, colon, and lung cancers who did not receive chemotherapy from 2000 to 2015 were identified from the National Cancer Database. A total of 183,148 patients at 1281 hospitals were included. For breast cancer, 3.5% of patients failed to receive recommended chemotherapy, and 6.6% with colon, and 10.7% with lung cancer. Sociodemographic factors showed that patients were less likely to receive chemotherapy if they were uninsured or on Medicaid, as were non-Hispanic black patients with both breast and colon cancer. There was also significant hospital variation with failure to administer as high as 21.8% for breast, 40.2% for colon, and 40.0% for lung cancer.
AHRQ-funded; HS000078; HS026385.
Citation: Ellis RJ, Schlick CJR, Feinglass J .
Failure to administer recommended chemotherapy: acceptable variation or cancer care quality blind spot?
BMJ Qual Saf 2020 Feb;29(2):103-12. doi: 10.1136/bmjqs-2019-009742..
Keywords: Treatments, Cancer, Healthcare Delivery, Access to Care, Healthcare Utilization, Social Determinants of Health, Vulnerable Populations, Uninsured, Hospitals, Quality of Care
Alexander LT, Fuentes-Rivera E, Saavedra-Avendano B
Utilisation of second-trimester spontaneous and induced abortion services in public hospitals in Mexico, 2007-2015.
This study examined data on utilization of in-facility second-trimester abortion services in Mexico. Data from Mexico’s Automated Hospital Discharge System (SAEH) from 2007-2015 was used to identify second-trimester abortions in public hospitals across Mexico’s 32 states. A total 145,956 second-trimester abortion services or 13.4% of total documented hospitalizations for abortion were identified. The rate remained constant for women aged 15-44 years. Women living in poorer socioeconomic conditions or highly marginalized municipalities were most likely to have second-trimester abortions compared to women in higher socioeconomic conditions who were able to utilize services in their first trimester.
AHRQ-funded; HS025155; HS022981.
Citation: Alexander LT, Fuentes-Rivera E, Saavedra-Avendano B .
Utilisation of second-trimester spontaneous and induced abortion services in public hospitals in Mexico, 2007-2015.
BMJ Sex Reprod Health 2019 Oct;45(4):283-89. doi: 10.1136/bmjsrh-2018-200300..
Keywords: Pregnancy, Women, Healthcare Utilization, Hospitals, Healthcare Delivery
Gillespie SM, Wasserman EB, Wood NE
High-intensity telemedicine reduces emergency department use by older adults with dementia in senior living communities.
Individuals with dementia have high rates of emergency department (ED) use for acute illnesses. In this study, the investigators evaluated the effect of a high-intensity telemedicine program that delivered care for acute illnesses on ED use rates for individuals with dementia residing in senior living communities (SLCs; independent and assisted living).
AHRQ-funded; HS018047.
Citation: Gillespie SM, Wasserman EB, Wood NE .
High-intensity telemedicine reduces emergency department use by older adults with dementia in senior living communities.
J Am Med Dir Assoc 2019 Aug;20(8):942-46. doi: 10.1016/j.jamda.2019.03.024..
Keywords: Elderly, Telehealth, Health Information Technology (HIT), Dementia, Neurological Disorders, Healthcare Delivery, Chronic Conditions, Emergency Department, Healthcare Utilization
Knerr S, Bowles EJA, Leppig KA
Trends in BRCA test utilization in an integrated health system, 2005-2015.
The authors reported 10-year trends in BRCA testing in an integrated health-care system with long-standing access to genetic services. They found that many eligible women did not receive BRCA testing despite having insurance coverage and access to specialty genetic services, thus underscoring challenges to primary and secondary hereditary cancer prevention.
AHRQ-funded; HS022982.
Citation: Knerr S, Bowles EJA, Leppig KA .
Trends in BRCA test utilization in an integrated health system, 2005-2015.
J Natl Cancer Inst 2019 Aug;111(8):795-802. doi: 10.1093/jnci/djz008..
Keywords: Cancer: Breast Cancer, Cancer: Ovarian Cancer, Cancer, Genetics, Screening, Prevention, Healthcare Utilization, Healthcare Delivery, Women
Barbash IJ, Wallace DJ, Kahn JM
Effects of changes in ICU bed supply on ICU utilization.
The purpose of this study was to determine the relationship between intensive care unit (ICU) bed supply and ICU admission in US hospitals. Using a difference-in-differences approach, researchers compared the risk-adjusted probability of ICU admission at hospitals that increased their ICU bed supply over time with matched hospitals that did not. Subjects were three patient groups with a low likelihood of benefiting from ICU admission: low-severity patients with acute myocardial infarction and pulmonary embolism, and high-severity patients with metastatic cancer at the end of life. Results showed that increases in ICU bed supply were associated with inconsistent changes in the probability of ICU admission that varied across patient subgroups.
AHRQ-funded; HS025455.
Citation: Barbash IJ, Wallace DJ, Kahn JM .
Effects of changes in ICU bed supply on ICU utilization.
Med Care 2019 Jul;57(7):544-50. doi: 10.1097/mlr.0000000000001137..
Keywords: Intensive Care Unit (ICU), Critical Care, Healthcare Utilization, Hospitalization, Healthcare Delivery, Hospitals
Huguet N, Angier H, Rdesinski R
Cervical and colorectal cancer screening prevalence before and after Affordable Care Act Medicaid expansion.
This study assessed changes in the prevalence of cervical and colorectal cancer screening from before and after the Affordable Care Act in Medicaid expansion and non-expansion states among patients seen in community health centers. Results showed that, despite increased prevalences of cervical and colorectal cancer screening in both expansion and non-expansion states across all race/ethnicity groups, rates remained suboptimal for this population of socioeconomically disadvantaged patients.
AHRQ-funded; HS024270.
Citation: Huguet N, Angier H, Rdesinski R .
Cervical and colorectal cancer screening prevalence before and after Affordable Care Act Medicaid expansion.
Prev Med 2019 Jul;124:91-97. doi: 10.1016/j.ypmed.2019.05.003..
Keywords: Cancer, Cancer: Cervical Cancer, Cancer: Colorectal Cancer, Healthcare Delivery, Healthcare Utilization, Medicaid, Policy, Prevention, Screening
Johnston FM, Neiman JH, Parmley LE
Stakeholder perspectives on the use of community health workers to improve palliative care use by African Americans with cancer.
This study focused on the issue of lack of palliative care for African-Americans with cancer. Stakeholder interviews and focus groups were conducted with cancer patients, caregivers, health care administrators, oncologists, and community health workers (CHWs). Participants felt that CHWs could play a central role in bridging patients with their providers, information and resources. They also felt that CHWs should either come from the community, or be familiar with the history, culture, and norms of the communities from which they operate.
AHRQ-funded; HS024736.
Citation: Johnston FM, Neiman JH, Parmley LE .
Stakeholder perspectives on the use of community health workers to improve palliative care use by African Americans with cancer.
J Palliat Med 2019 Mar;22(3):302-06. doi: 10.1089/jpm.2018.0366..
Keywords: Access to Care, Cancer, Healthcare Delivery, Healthcare Utilization, Cultural Competence, Disparities, Palliative Care, Racial and Ethnic Minorities
Zhou M, Oakes AH, Bridges JFP
Regional supply of medical resources and systemic overuse of health care among Medicare beneficiaries.
The goal of this study was to explore health care system factors associated with regional variation in overuse of resources, as measured by the Johns Hopkins Overuse Index (JHOI). Medicare fee-for-service claims data from beneficiaries age 65 was used to calculate the JHOI for 306 hospital referral regions in the U.S. Regions with a higher density of primary care physicians had a lower JHOI, which indicates less systemic overuse. Regional characteristics associated with higher JHOI included the number of acute care hospital beds per 1000 residents and number of hospital-based anesthesiologists, pathologists, and radiologists. The authors conclude that regional variations in health care resources are associated with the level of systemic overuse of health care, and that the role of primary care doctors in reducing overuse deserves further attention.
AHRQ-funded; T32 HS000029.
Citation: Zhou M, Oakes AH, Bridges JFP .
Regional supply of medical resources and systemic overuse of health care among Medicare beneficiaries.
J Gen Intern Med 2018 Dec;33(12):2127-31. doi: 10.1007/s11606-018-4638-9..
Keywords: Access to Care, Elderly, Healthcare Delivery, Healthcare Utilization, Medicare, Practice Patterns
Auger KA, Shah SS, Tubbs-Cooley HL
Effects of a 1-time nurse-led telephone call after pediatric discharge: the H2O II randomized clinical trial.
The purpose of this study was to determine whether a single nurse-led telephone call after pediatric discharge decreased the 30-day reutilization rate for urgent care services and enhanced overall transition success. The investigators concluded that although postdischarge nurse contact did not decrease the reutilization rate of postdischarge urgent health care services, the method showed promise to bolster postdischarge education.
AHRQ-funded; HS024735.
Citation: Auger KA, Shah SS, Tubbs-Cooley HL .
Effects of a 1-time nurse-led telephone call after pediatric discharge: the H2O II randomized clinical trial.
JAMA Pediatr 2018 Sep;172(9):e181482. doi: 10.1001/jamapediatrics.2018.1482..
Keywords: Care Coordination, Children/Adolescents, Health Information Technology (HIT), Health Services Research (HSR), Healthcare Delivery, Healthcare Utilization, Hospital Discharge, Outcomes, Provider, Provider: Nurse, Telehealth, Transitions of Care
Stone C, Gebretsadik T, Lee RL
Trends in health care utilization for asthma exacerbations among diverse populations with asthma in the United States.
This article discusses trends in asthma hospitalization and outpatient visit rates from 2004 to 2010. The rates for all populations included in this study went down during the time period, in particular the population from the Tennessee Medicaid program (49%). Other populations used in the study included subjects 4 to 50 years enrolled in the US Department of Defense Military Health System (MHS), and 3 large integrated health delivery systems (IHCDS) of the Population Based Effectiveness in Asthma and Lung Diseases (PEAL) Network. The 3 PEAL health plans included Harvard Pilgrim Health Care, Kaiser Permanente Georgia, and Kaiser Permanent Northern California. A total of 473,524 subjects in those 3 study populations were identified. These downward trends are encouraging but need to continue, particularly in diverse populations.
AHRQ-funded; HS019669; HS022093.
Citation: Stone C, Gebretsadik T, Lee RL .
Trends in health care utilization for asthma exacerbations among diverse populations with asthma in the United States.
J Allergy Clin Immunol Pract 2018 Jan - Feb;6(1):295-97.e5. doi: 10.1016/j.jaip.2017.07.038..
Keywords: Asthma, Healthcare Utilization, Hospitalization, Healthcare Delivery, Chronic Conditions, Ambulatory Care and Surgery
Adrion ER, Kocher KE, Nallamothu BK
Rising use of observation care among the commercially insured may lead to total and out-of-pocket cost savings.
Using multipayer commercial claims for the period 2009-13, the investigators evaluated utilization and spending among patients admitted for six conditions that are commonly managed with either observation care or short-stay hospitalizations. In their study period, the use of observation care increased relative to that of short-stay hospitalizations. In addition, total and out-of-pocket spending were substantially lower for observation care, though both grew rapidly--and at rates much higher than spending in the inpatient setting--over the study period.
AHRQ-funded; HS000053.
Citation: Adrion ER, Kocher KE, Nallamothu BK .
Rising use of observation care among the commercially insured may lead to total and out-of-pocket cost savings.
Health Aff 2017 Dec;36(12):2102-09. doi: 10.1377/hlthaff.2017.0774..
Keywords: Health Insurance, Healthcare Costs, Healthcare Delivery, Healthcare Utilization, Hospitalization, Hospitals, Medicare
Balaban RB, Zhang F, Vialle-Valentin CE
Impact of a patient navigator program on hospital-based and outpatient utilization over 180 days in a safety-net health system.
The objective of this study was to determine the effect of a care transition program using patient navigators (PNs) on health service utilization among high-risk safety-net patients over a 180-day period. The investigators concluded that a PN program serving high-risk safety-net patients differentially impacted patients based on age, and among younger patients, outcomes varied over time. The investigators suggest that their findings highlight the importance for future research to evaluate care transition programs among different subpopulations and over longer time peri
AHRQ-funded; HS020628.
Citation: Balaban RB, Zhang F, Vialle-Valentin CE .
Impact of a patient navigator program on hospital-based and outpatient utilization over 180 days in a safety-net health system.
J Gen Intern Med 2017 Sep;32(9):981-89. doi: 10.1007/s11606-017-4074-2..
Keywords: Care Management, Healthcare Delivery, Healthcare Utilization, Hospital Readmissions, Patient-Centered Healthcare, Transitions of Care
Morgan DJ, Leppin AL, Smith CD
A practical framework for understanding and reducing medical overuse: conceptualizing overuse through the patient-clinician interaction.
The authors used an iterative, expert-informed, evidence-based process to develop a framework for conceptualizing interventions to reduce medical overuse. Given the complexity of defining and identifying overused care in nuanced clinical situations and the need to define care appropriateness in the context of an individual patient, this framework conceptualizes the patient-clinician interaction as the nexus of decisions regarding inappropriate care.
AHRQ-funded; HS018111.
Citation: Morgan DJ, Leppin AL, Smith CD .
A practical framework for understanding and reducing medical overuse: conceptualizing overuse through the patient-clinician interaction.
J Hosp Med 2017 May;12(5):346-51. doi: 10.12788/jhm.2738.
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Keywords: Shared Decision Making, Healthcare Delivery, Quality of Care, Healthcare Utilization, Clinician-Patient Communication
Wang V, Maciejewski ML, Coffman CJ
Impacts of geographic distance on peritoneal dialysis utilization: refining models of treatment selection.
This study examined the relationship between distance to dialysis provider and patient selection of dialysis modality, informed by the absolute distance from a patient's home and relative distance of alternative modalities. It found a positive, nonlinear relationship between absolute distance to hemodialysis (HD) services and peritoneal dialysis (PD) use, with the magnitude of the effect increasing at greater distances.
AHRQ-funded; HS019479.
Citation: Wang V, Maciejewski ML, Coffman CJ .
Impacts of geographic distance on peritoneal dialysis utilization: refining models of treatment selection.
Health Serv Res 2017 Feb;52(1):35-55. doi: 10.1111/1475-6773.12489.
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Keywords: Dialysis, Access to Care, Healthcare Utilization, Kidney Disease and Health, Healthcare Delivery
O'Malley JP, O'Keeffe-Rosetti M, Lowe RA
Health care utilization rates after Oregon's 2008 Medicaid expansion: within-group and between-group differences over time among new, returning, and continuously insured enrollees.
The authors sought to assess changes in emergency department, primary care, mental and behavioral health care, and specialist care visit rates among individuals gaining Medicaid over 24 months postinsurance gain and also to evaluate the association of previous insurance with utilization. They found that primary care visit rates in both newly and returning insured individuals significantly exceeded those of the continuously insured in months 4 through 12, but were not significantly elevated in the second year. In contrast, emergency department utilization rates were significantly higher in returning insured compared with newly or continuously insured individuals and remained elevated over time. New visits to primary and specialist care were higher among those who gained Medicaid compared with the continuously insured throughout the study period. They concluded that expansion evaluations should allow for rate stabilization.
AHRQ-funded; HS021522.
Citation: O'Malley JP, O'Keeffe-Rosetti M, Lowe RA .
Health care utilization rates after Oregon's 2008 Medicaid expansion: within-group and between-group differences over time among new, returning, and continuously insured enrollees.
Med Care 2016 Nov;54(11):984-91. doi: 10.1097/mlr.0000000000000600.
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Keywords: Medicaid, Healthcare Delivery, Healthcare Utilization, Emergency Department, Emergency Medical Services (EMS)
Blosnich JR, Hammer J, Yu L
Health care use, health behaviors, and medical conditions among individuals in same-sex and opposite-sex partnerships: a cross-sectional observational analysis of the Medical Expenditures Panel Survey (MEPS), 2003-2011.
Thsi study's objective was to examine associations between sexual minority status and medical conditions. The researchers used MEPS data to determine measures of health risk, health services utilization, and the presence of 15 medical conditions. They found that individuals in same-sex partnerships had 67% increased odds of past-year emergency department utilization and 51% greater odds of three or more physician visits in the last year compared with opposite-sex partnered individuals.
AHRQ-funded; HS022989.
Citation: Blosnich JR, Hammer J, Yu L .
Health care use, health behaviors, and medical conditions among individuals in same-sex and opposite-sex partnerships: a cross-sectional observational analysis of the Medical Expenditures Panel Survey (MEPS), 2003-2011.
Med Care 2016 Jun;54(6):547-54. doi: 10.1097/mlr.0000000000000529.
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Keywords: Healthcare Delivery, Disparities, Healthcare Utilization, Medical Expenditure Panel Survey (MEPS)
Rashid N, Coburn BW, Wu YL
Modifiable factors associated with allopurinol adherence and outcomes among patients with gout in an integrated healthcare system.
The investigators identified modifiable patient and provider factors associated with allopurinol adherence and the achievement of a serum urate acid (SUA) goal in gout. They found that among patients with gout initiating allopurinol in their study, 68% did not reach the SUA goal and 57% were nonadherent. They concluded that modifiable factors, including allopurinol dose escalation, treatment adherence, rheumatology referral, and concomitant medication use, could be important factors to consider in efforts aimed at optimizing gout treatment outcomes.
AHRQ-funded; HS018517.
Citation: Rashid N, Coburn BW, Wu YL .
Modifiable factors associated with allopurinol adherence and outcomes among patients with gout in an integrated healthcare system.
J Rheumatol 2015 Mar;42(3):504-12. doi: 10.3899/jrheum.140588.
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Keywords: Healthcare Delivery, Healthcare Utilization, Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research
Rabin BA, Ellis JL, Steiner JF
Health-care utilization by prognosis profile in a managed care setting: using the Surveillance, Epidemiology and End Results Cancer Survival Calculator SEER*CSC.
The authors described health service utilization patterns of subgroups of prostate cancer and colorectal cancer (CRC) patients with different relative probabilities of dying of their cancer or other conditions. They found that although a new diagnosis of cancer increased utilization of cancer-related services for an extended time period, the timing of cancer diagnosis did not appear to affect other types of utilization.
AHRQ-funded; HS019520.
Citation: Rabin BA, Ellis JL, Steiner JF .
Health-care utilization by prognosis profile in a managed care setting: using the Surveillance, Epidemiology and End Results Cancer Survival Calculator SEER*CSC.
J Natl Cancer Inst Monogr 2014 Nov;2014(49):275-81. doi: 10.1093/jncimonographs/lgu023.
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Keywords: Cancer: Prostate Cancer, Cancer: Colorectal Cancer, Cancer, Healthcare Utilization, Mortality, Healthcare Delivery
Laiteerapong N, Kirby J, Gao Y
AHRQ Author: Kirby J, Ngo-Metzger Q
Health care utilization and receipt of preventive care for patients seen at federally funded health centers compared to other sites of primary care.
The investigators compared utilization and preventive care receipt among patients of federal Section 330 health centers (HCs) versus patients of other settings. They found that HC patients had fewer office visits and hospitalizations, were more likely to receive breast cancer screening, had fewer outpatient and emergency room visits, and were more likely to receive dietary advice compared to non-HC patients.
AHRQ-authored.
Citation: Laiteerapong N, Kirby J, Gao Y .
Health care utilization and receipt of preventive care for patients seen at federally funded health centers compared to other sites of primary care.
Health Serv Res 2014 Oct;49(5):1498-518. doi: 10.1111/1475-6773.12178.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Utilization, Prevention, Community-Based Practice, Healthcare Delivery