National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Children's Health Insurance Program (CHIP) (1)
- Children/Adolescents (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Dental and Oral Health (1)
- Diagnostic Safety and Quality (1)
- Education: Patient and Caregiver (1)
- Emergency Department (2)
- Emergency Medical Services (EMS) (1)
- Healthcare Costs (5)
- Healthcare Delivery (2)
- Health Insurance (4)
- Hepatitis (1)
- Hospitals (2)
- Human Immunodeficiency Virus (HIV) (1)
- Long-Term Care (1)
- Low-Income (1)
- Medicaid (1)
- Medical Devices (1)
- Medicare (2)
- Medication (2)
- Nursing (1)
- Nursing Homes (2)
- Patient-Centered Healthcare (2)
- Patient Experience (1)
- Payment (3)
- Policy (2)
- Primary Care (1)
- Provider Performance (1)
- Quality Improvement (2)
- Quality of Care (2)
- Racial and Ethnic Minorities (2)
- Screening (1)
- Urban Health (1)
- Vulnerable Populations (1)
- Workforce (1)
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 17 of 17 Research Studies DisplayedChrisinger BW, Grossestreuer AV, Laguna MC
Characteristics of automated external defibrillator coverage in Philadelphia, PA, based on land use and estimated risk.
The authors investigated how well the likelihood of out-of-hospital cardiac arrest was met by the supply of automated external defibrillators (AED) in a dense urban environment. This article offers one method by which local officials can use spatial data to prioritize attention for AED placement and coverage.
AHRQ-funded; HS018362.
Citation: Chrisinger BW, Grossestreuer AV, Laguna MC .
Characteristics of automated external defibrillator coverage in Philadelphia, PA, based on land use and estimated risk.
Resuscitation 2016 Dec;109:9-15. doi: 10.1016/j.resuscitation.2016.09.021.
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Keywords: Medical Devices, Health Insurance, Urban Health, Cardiovascular Conditions
Eaton EF, Tamhane A, Saag M
Cost considerations in the current antiretroviral era.
The authors analyzed the relative cost-effectiveness of contemporary antiretroviral therapy in real-world clinical settings. They found that, among the participants studied, raltegravir and efavirenz-based regimens were the most cost-effective options for treatment-naive patients. They suggested that these findings are relevant given changes in recommended regimens for treatment-naive persons. The authors recommended that further data on the comparative effectiveness of efavirenz and rilpivirine are needed.
AHRQ-funded; HS013852.
Citation: Eaton EF, Tamhane A, Saag M .
Cost considerations in the current antiretroviral era.
AIDS 2016 Sep 10;30(14):2115-9. doi: 10.1097/qad.0000000000001120.
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Keywords: Healthcare Costs, Human Immunodeficiency Virus (HIV), Medication
Abrahamson K, Davila H, Rehkamp N
Is there a business case for nursing home quality improvement?
The objective of this study was to investigate the economic or business perspective surrounding QI participation by exploring nursing home leader perceptions regarding market-based motivations for improvements, or a business case for engaging in a quality improvement project.
AHRQ-funded; HS018464.
Citation: Abrahamson K, Davila H, Rehkamp N .
Is there a business case for nursing home quality improvement?
Nurs Econ 2016 Sep-Oct;34(5):224-9, 35..
Keywords: Long-Term Care, Nursing Homes, Quality Improvement
Dorr DA, Anastas T, Ramsey K
Effect of a pragmatic, cluster-randomized controlled trial on patient experience with care: The Transforming Outcomes for Patients Through Medical Home Evaluation and reDesign (TOPMED) Study.
This study's objective is to understand whether focusing on high value elements (HVEs) would improve patient experience with care. The authors found that practices targeting HVEs showed significantly more improvement in patient experience of care. However, contemporaneous trends may have affected results, leading to declines in patient experience.
AHRQ-funded; HS017832.
Citation: Dorr DA, Anastas T, Ramsey K .
Effect of a pragmatic, cluster-randomized controlled trial on patient experience with care: The Transforming Outcomes for Patients Through Medical Home Evaluation and reDesign (TOPMED) Study.
Med Care 2016 Aug;54(8):745-51. doi: 10.1097/mlr.0000000000000552.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient-Centered Healthcare, Patient Experience
Friedman AS, Schpero WL, Busch SH
Evidence suggests that the ACA's tobacco surcharges reduced insurance take-up and did not increase smoking cessation.
The authors examined the effect of tobacco surcharges on insurance status and smoking cessation in the first year of the health insurance exchanges' implementation, among adults most likely to purchase insurance from them. Their findings suggest that tobacco surcharges conflicted with a major goal of the Affordable Care Act - increased financial protection - without increasing smoking cessation.
AHRQ-funded; HS017589.
Citation: Friedman AS, Schpero WL, Busch SH .
Evidence suggests that the ACA's tobacco surcharges reduced insurance take-up and did not increase smoking cessation.
Health Aff 2016 Jul;35(7):1176-83. doi: 10.1377/hlthaff.2015.1540.
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Keywords: Healthcare Costs, Health Insurance, Policy
Hefele JG, Acevedo A, Nsiah-Jefferson L
Choosing a nursing home: what do consumers want to know, and do preferences vary across race/ethnicity?
The researchers sought to identify what consumers want to know about nursing homes (NHs) before choosing one and to determine whether information preferences vary across race/ethnicity. They found that participants wanted detailed information on the facility, policies, staff, and residents, such as location, staff treatment of residents, and resident conditions. Participants also wanted a sense of the NH gestalt and were interested in feedback/reviews from residents/families.
AHRQ-funded; HS021891.
Citation: Hefele JG, Acevedo A, Nsiah-Jefferson L .
Choosing a nursing home: what do consumers want to know, and do preferences vary across race/ethnicity?
Health Serv Res 2016 Jun;51 Suppl 2:1167-87. doi: 10.1111/1475-6773.12457.
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Keywords: Nursing Homes, Education: Patient and Caregiver, Racial and Ethnic Minorities
Silber JH, Rosenbaum PR, McHugh MD
Comparison of the value of nursing work environments in hospitals across different levels of patient risk.
This study tested whether hospitals with better nursing work environments displayed better value than those with worse nursing. It found that hospitals with better nursing environments and above-average staffing levels were associated with better value (lower mortality with similar costs) compared with hospitals without nursing environment recognition and with below-average staffing, especially for higher-risk patients.
AHRQ-funded; HS018338.
Citation: Silber JH, Rosenbaum PR, McHugh MD .
Comparison of the value of nursing work environments in hospitals across different levels of patient risk.
JAMA Surg 2016 Jun;151(6):527-36. doi: 10.1001/jamasurg.2015.4908.
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Keywords: Healthcare Costs, Quality of Care, Nursing, Workforce
Frean M, Shelder S, Rosenthal MB
Health reform and coverage changes among Native Americans.
This study evaluated changes in insurance and Indian Health Service (IHS) coverage among Native Americans following the Affordable Care Act’s (ACA) implementation. It concluded that the ACA was associated with significant coverage increases for Native Americans, primarily in Medicaid expansion states, consistent with national trends for all racial/ethnic groups. Nationally, much of the coverage increase occurred among Native Americans without connections to IHS.
AHRQ-funded; HS021291.
Citation: Frean M, Shelder S, Rosenthal MB .
Health reform and coverage changes among Native Americans.
JAMA Intern Med 2016 Jun;176(6):858-60. doi: 10.1001/jamainternmed.2016.1695.
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Keywords: Policy, Health Insurance, Racial and Ethnic Minorities, Racial and Ethnic Minorities
Brown TT, Robinson JC
Reference pricing with endogenous or exogenous payment limits: impacts on insurer and consumer spending.
The authors extended reference pricing (RP) models to a hospital context focusing on insurer and consumer payments. They found that, for 2 years following RP implementation, insurer payments to high-price and low-price hospitals moved downward, consistent with endogenous RP. When the reference price was not reset to account for changes in market prices, insurer payments to low-price hospitals reverted to pre-implementation levels, consistent with exogenous RP.
AHRQ-funded; HS022098.
Citation: Brown TT, Robinson JC .
Reference pricing with endogenous or exogenous payment limits: impacts on insurer and consumer spending.
Health Econ 2016 Jun;25(6):740-9. doi: 10.1002/hec.3181.
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Keywords: Payment, Healthcare Costs, Health Insurance, Hospitals
Das A, Norton EC, Miller DC
Adding a spending metric to Medicare's value-based purchasing program rewarded low-quality hospitals.
In fiscal year 2015 the Centers for Medicare and Medicaid Services expanded its Hospital Value-Based Purchasing program by rewarding or penalizing hospitals for their performance on both spending and quality. Using data from 2,679 US hospitals that participated in the program in fiscal years 2014 and 2015, researchers found that the new emphasis on spending rewarded not only low-spending hospitals but some low-quality hospitals as well.
AHRQ-funded; HS020671.
Citation: Das A, Norton EC, Miller DC .
Adding a spending metric to Medicare's value-based purchasing program rewarded low-quality hospitals.
Health Aff 2016 May;35(5):898-906. doi: 10.1377/hlthaff.2015.1190.
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Keywords: Medicare, Provider Performance, Payment, Hospitals, Healthcare Costs, Quality of Care
Figueiredo R, Dempster L, Quinonez C
Emergency department use for dental problems among homeless individuals: a population-based cohort study.
The researchers evaluated emergency department (ED) visits for dental problems among Toronto's homeless population (Ontario, Canada). They found that over 80% of the ED visits by homeless people were for odontogenic infections, and 46% of homeless people had more than one such visit. They concluded that access to dental care is inadequate and that ED settings are ineffective for treatment of dental problems.
AHRQ-funded; HS014129.
Citation: Figueiredo R, Dempster L, Quinonez C .
Emergency department use for dental problems among homeless individuals: a population-based cohort study.
J Health Care Poor Underserved 2016;27(2):860-8. doi: 10.1353/hpu.2016.0081.
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Keywords: Access to Care, Dental and Oral Health, Emergency Department, Vulnerable Populations
Bailey M, Randall EC, Costa C
Analysis of urine, oral fluid and fingerprints by liquid extraction surface analysis coupled to high resolution MS and MS/MS - opportunities for forensic and biomedical science.
The authors assessed the suitability of Liquid Extraction Surface Analysis (LESA) for obtaining detailed chemical profiles of fingerprints, oral fluid, and urine, which may be used in the future for rapid medical diagnostics or metabolomics studies. They also showed how LESA can be used to detect illicit drugs and their metabolites, and they showed how LESA can be used to detect the explosive material RDX in contaminated artificial fingermarks.
AHRQ-funded; HS017487.
Citation: Bailey M, Randall EC, Costa C .
Analysis of urine, oral fluid and fingerprints by liquid extraction surface analysis coupled to high resolution MS and MS/MS - opportunities for forensic and biomedical science.
Anal Methods 2016 Apr 28;2016(16):3373-82. doi: 10.1039/c6ay00782a.
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Keywords: Diagnostic Safety and Quality
Wherry LR, Kenney GM, Sommers BD
The role of public health insurance in reducing child poverty.
The researchers reviewed a growing body of evidence that public health insurance provides important financial benefits to low-income families and also reviewed the potential poverty-reducing effects of public health insurance coverage. They found that Medicaid plays a significant role in decreasing poverty for many children and families. They also reviewed emerging evidence that access to public health insurance in childhood has long-term effects for health and economic outcomes in adulthood. They concluded that the nation's public health insurance programs have many important short- and long-term poverty-reducing benefits for low-income families with children.
AHRQ-funded; HS021291.
Citation: Wherry LR, Kenney GM, Sommers BD .
The role of public health insurance in reducing child poverty.
Acad Pediatr 2016 Apr;16(3 Suppl):S98-s104. doi: 10.1016/j.acap.2015.12.011.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Low-Income, Medicaid
Donnelly JP, Franco RA, Wang HE
Emergency department screening for hepatitis C virus: geographic reach and spatial clustering in central Alabama.
Hepatitis C virus (HCV) infection is a growing problem, disproportionately affecting those born between 1945 and 1965. Here, we demonstrate the wide geographic reach and surveillance potential of emergency department-based screening and identify areas of elevated HCV infection in central Alabama that were socioeconomically disadvantaged compared with surrounding communities.
AHRQ-funded; HS013852.
Citation: Donnelly JP, Franco RA, Wang HE .
Emergency department screening for hepatitis C virus: geographic reach and spatial clustering in central Alabama.
Clin Infect Dis 2016 Mar 1;62(5):613-6. doi: 10.1093/cid/civ984.
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Keywords: Hepatitis, Screening, Emergency Department, Emergency Medical Services (EMS)
Driessen J, Baik SH, Zhang Y
Explaining improved use of high-risk medications in Medicare between 2007 and 2011.
The researchers explored the reasons for the great decline in the use of high-risk medications between 2007 and 2011. They found that the FDA’s ban on propoxyphene beginning in 2010 led to the huge decrease in high-risk prescribing. For non-propoxyphene drugs included in the high-risk measure, the rate of prescribing showed minimal improvement, decreasing from 21.0 percent to 18.6 percent from 2007 to 2011.
AHRQ-funded; HS018657.
Citation: Driessen J, Baik SH, Zhang Y .
Explaining improved use of high-risk medications in Medicare between 2007 and 2011.
J Am Geriatr Soc 2016 Mar;64(3):674-6. doi: 10.1111/jgs.14000.
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Keywords: Medication, Medicare
Friedman A, Howard J, Shaw EK
Facilitators and barriers to care coordination in patient-centered medical homes (PCMHs) from coordinators' perspectives.
This is the first study describing experiences of care coordinators across the US from their own perspectives. It concluded that while all the barriers and facilitators were important to performing coordinators' roles, relationship building was key to effective care coordination, whether with clinicians, patients, or outside organizations.
AHRQ-funded; HS020682.
Citation: Friedman A, Howard J, Shaw EK .
Facilitators and barriers to care coordination in patient-centered medical homes (PCMHs) from coordinators' perspectives.
J Am Board Fam Med 2016 Jan-Feb;29(1):90-101. doi: 10.3122/jabfm.2016.01.150175.
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Keywords: Care Coordination, Patient-Centered Healthcare, Healthcare Delivery
DeVoe JE, Stenger R
Aligning provider incentives to improve primary healthcare delivery in the United States.
This critical review uses a theoretical framework from game-theory models to discuss some of the dominant primary care provider payment models and how they create 'prisoner's dilemmas' that have stalled past reform efforts, then illustrates an escape from the dilemma. It concludes that a blend of guaranteed payment and selective incentives designed to encourage primary care providers to deliver high quality care, efficient and equitable care and to eliminate incentives towards over-servicing could reach outcomes leading to shared benefits for everyone involved.
AHRQ-funded; HS014645; HS016181.
Citation: DeVoe JE, Stenger R .
Aligning provider incentives to improve primary healthcare delivery in the United States.
OA Fam Med 2013 Jun 1;1(1):7.
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Keywords: Healthcare Delivery, Payment, Primary Care, Quality Improvement