National Healthcare Quality and Disparities Report
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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
201 to 225 of 662 Research Studies DisplayedChung P, Currie B, Guo Y
Investigation to identify a resource-efficient case-control methodology for determining antibiotics associated with Clostridium difficile infection.
This study consisted of a series of case-control studies involving two groups of patients admitted to the hospital, the first group with clostridium difficile infection (CDI), and a control group without CDI. The purpose was to determine the relationship between the use of antibiotics and the presence of CDI. A simple matching strategy was found to be an efficient and feasible compromise strategy to identify high-risk antibiotics associated with CDI.
AHRQ-funded; 290200600012I
Citation: Chung P, Currie B, Guo Y .
Investigation to identify a resource-efficient case-control methodology for determining antibiotics associated with Clostridium difficile infection.
Am J Infect Control. 2014 Oct;42(10 Suppl):S264-8. doi: 10.1016/j.ajic.2014.05.001..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Antimicrobial Stewardship
Ostrowsky B, Ruiz R, Brown S
Lessons learned from implementing Clostridium difficile-focused antibiotic stewardship interventions.
The researchers sought to determine whether controlling the prescription of targeted antibiotics would translate to a measurable reduction in hospital-onset Clostridium difficile infection (CDI) rates. They found that decreases in target antibiotic consumption did not translate into reductions of hospital-onset CDI in this study, but many valuable lessons were learned.
AHRQ-funded; 290200600012I.
Citation: Ostrowsky B, Ruiz R, Brown S .
Lessons learned from implementing Clostridium difficile-focused antibiotic stewardship interventions.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S86-95. doi: 10.1086/677828.
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Keywords: Antibiotics, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety
Ali KJ, Farley DO, Speck K
Measurement of implementation components and contextual factors in a two-state healthcare quality initiative to reduce ventilator-associated pneumonia.
The authors sought to develop and field test an implementation assessment tool for assessing progress of hospital units in implementing improvements for the prevention of ventilator-associated pneumonia (VAP) in a two-state collaborative. They found that a relatively small number of barriers were found to have important negative effects on implementation progress, including barriers related to workload and time issues. They modified coaching provided to the unit teams to reinforce training in weak spots that the interviews identified.
AHRQ-funded; 290201000027I.
Citation: Ali KJ, Farley DO, Speck K .
Measurement of implementation components and contextual factors in a two-state healthcare quality initiative to reduce ventilator-associated pneumonia.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S116-23. doi: 10.1086/677832.
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Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Pneumonia, Prevention, Quality Improvement
Calderwood MS, Kleinman K, Bratzler DW
Medicare claims can be used to identify US hospitals with higher rates of surgical site infection following vascular surgery.
This study found that among Medicare patients who underwent vascular surgery at 2,512 U.S. hospitals, a patient undergoing surgery in a hospital ranked in the worst-performing decile based on claims had a 2.5 times greater likelihood of developing a chart-confirmed surgical site infection relative to a patient characteristics in a hospital in the best-performing decile.
AHRQ-funded; HS018878
Citation: Calderwood MS, Kleinman K, Bratzler DW .
Medicare claims can be used to identify US hospitals with higher rates of surgical site infection following vascular surgery.
Med Care. 2014 Oct;52(10):918-25. doi: 10.1097/MLR.0000000000000212..
Keywords: Medicare, Surgery, Healthcare-Associated Infections (HAIs), Patient Safety, Hospitals, Adverse Events
Kahvecioglu D, Ramiah K, McMaughan D
Multidrug-resistant organism infections in US nursing homes: a national study of prevalence, onset, and transmission across care settings, October 1, 2010-December 31, 2011.
The investigators sought to understand the prevalence of multidrug-resistant organism (MDRO) infections among nursing home (NH) residents and the potential for their spread between NHs and acute care hospitals (ACHs). They found that, although NHs are the most likely setting where residents would acquire MDROs after admission to an NH, a significant fraction of NH residents acquire MDRO infection at ACHs, suggesting a need for effective MDRO infection control for NH residents with simultaneous, cooperative interventions among NHs and ACHs in the same community.
AHRQ-funded; HS019989.
Citation: Kahvecioglu D, Ramiah K, McMaughan D .
Multidrug-resistant organism infections in US nursing homes: a national study of prevalence, onset, and transmission across care settings, October 1, 2010-December 31, 2011.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S48-55. doi: 10.1086/677835.
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Keywords: Elderly, Healthcare-Associated Infections (HAIs), Medication, Nursing Homes, Patient Safety
Rosenman MB, Szucs KA, Finnell SM
Nascent regional system for alerting infection preventionists about patients with multidrug-resistant gram-negative bacteria: implementation and initial results.
The authors sought to build and to begin evaluating a regional automated system to notify infection preventionists (IPs) when a patient with a history of gram-negative rod multidrug-resistant organism (GNRMDRO) is admitted to an emergency department (ED) or inpatient setting. They found it feasible to create a regional microbiology-based alert system and observed substantial crossover between institutions. They concluded that this system, if it contributes to timely isolation, may help reduce the spread of GNRMDROs.
AHRQ-funded; HS020014.
Citation: Rosenman MB, Szucs KA, Finnell SM .
Nascent regional system for alerting infection preventionists about patients with multidrug-resistant gram-negative bacteria: implementation and initial results.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S40-7. doi: 10.1086/677833.
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Keywords: Emergency Department, Infectious Diseases, Inpatient Care, Patient Safety, Prevention
Chaudhry SI, Khan RF, Chen J
National trends in recurrent AMI hospitalizations 1 year after acute myocardial infarction in Medicare beneficiaries: 1999-2010.
The investigators evaluated changes in the incidence of 1-year recurrent acute myocardial infarction (AMI) hospitalization and mortality. In a national sample of Medicare beneficiaries hospitalized for AMI from 1999 to 2010, they found that hospitalization for recurrent AMI decreased, as did subsequent mortality, albeit to a lesser extent. The risk of recurrent AMI hospitalization declined less in black patients than in whites, increasing observed racial disparities by the end of the study period.
AHRQ-funded; HS018781.
Citation: Chaudhry SI, Khan RF, Chen J .
National trends in recurrent AMI hospitalizations 1 year after acute myocardial infarction in Medicare beneficiaries: 1999-2010.
J Am Heart Assoc 2014 Oct;3(5):e001197. doi: 10.1161/jaha.114.001197.
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Keywords: Hospitalization, Medicare, Mortality, Heart Disease and Health, Risk
Rothberg MB, Haessler S, Lagu T
Outcomes of patients with healthcare-associated pneumonia: worse disease or sicker patients?
The researchers sought to determine the contribution of healthcare-associated pneumonia (HCAP) criteria to case-fatality rate. They found that, after adjustment for differences in patient characteristics, HCAP was associated with greater case-fatality rate than community-acquired pneumonia, possibly due to HCAP organisms or to HCAP criteria themselves.
AHRQ-funded; HS018723.
Citation: Rothberg MB, Haessler S, Lagu T .
Outcomes of patients with healthcare-associated pneumonia: worse disease or sicker patients?
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S107-15. doi: 10.1086/677829.
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Keywords: Community-Acquired Infections, Healthcare-Associated Infections (HAIs), Mortality, Patient-Centered Outcomes Research, Pneumonia
Garfield CF, Lee Y, Kim HN
Paternal and maternal concerns for their very low-birth-weight infants transitioning from the NICU to home.
The authors examined the concerns and coping mechanisms of fathers and mothers of very low-birth-weight neonatal intensive care unit (NICU) infants as they transition to home from the NICU. They found that overriding concerns included pervasive uncertainty, lingering medical concerns, and partner-related adjustment concerns that differed by gender. They concluded that many parental concerns can be addressed with improved discharge information exchanges and anticipatory guidance.
AHRQ-funded; HS020316.
Citation: Garfield CF, Lee Y, Kim HN .
Paternal and maternal concerns for their very low-birth-weight infants transitioning from the NICU to home.
J Perinat Neonatal Nurs 2014 Oct-Dec;28(4):305-12. doi: 10.1097/jpn.0000000000000021.
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Keywords: Care Coordination, Hospital Discharge, Neonatal Intensive Care Unit (NICU), Newborns/Infants, Transitions of Care
Gupta S, Brenner AT, Ratanawongsa N
Patient trust in physician influences colorectal cancer screening in low-income patients.
The study objective was to characterize the relationship between patient trust and colorectal cancer (CRC) screening behavior among racially and ethnically diverse, low-income patients who had all received a physician recommendation for screening. After controlling for traditional factors, trust in the primary care provider remained the only significant driver of CRC screening completion.
AHRQ-funded; HS013853; HS000032; HS022561
Citation: Gupta S, Brenner AT, Ratanawongsa N .
Patient trust in physician influences colorectal cancer screening in low-income patients.
Am J Prev Med. 2014 Oct;47(4):417-23. doi: 10.1016/j.amepre.2014.04.020..
Keywords: Screening, Racial and Ethnic Minorities, Low-Income, Primary Care
Crotty BH, Tamrat Y, Mostaghimi A
Patient-to-physician messaging: volume nearly tripled as more patients joined system, but per capita rate plateaued.
The authors investigated trends in secure e-mail messaging between physicians and patients. Analyzing messages in a large academic health system's patient portal from 2001-2010, they found that physicians in the aggregate saw a near tripling of e-mail messages during the study period. However, the number stabilized between 2005 and 2010, at an average of 18.9 messages.
AHRQ-funded; HS021495.
Citation: Crotty BH, Tamrat Y, Mostaghimi A .
Patient-to-physician messaging: volume nearly tripled as more patients joined system, but per capita rate plateaued.
Health Aff 2014 Oct;33(10):1817-22. doi: 10.1377/hlthaff.2013.1145.
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Keywords: Clinician-Patient Communication, Communication, Health Information Technology (HIT)
Damberg CL, McNamara P
AHRQ Author: McNamara P
Postscript: research agenda to guide the next generation of public reports for consumers.
The authors identified five areas for additional public reporting tools research that, if addressed, could foster better design and delivery of quality and cost information to consumers.
AHRQ-authored.
Citation: Damberg CL, McNamara P .
Postscript: research agenda to guide the next generation of public reports for consumers.
Med Care Res Rev 2014 Oct;71(5 Suppl):97s-107s. doi: 10.1177/1077558714535982.
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Keywords: Education: Patient and Caregiver, Decision Making, Quality of Care, Health Services Research (HSR), Public Reporting
Freedman JL, Faerber JI, Kang TI
Predictors of antiemetic alteration in pediatric acute myeloid leukemia.
The purpose of this study was to gain better knowledge of patient and cancer treatment factors associated with nausea/vomiting (NV) in order to enhance prophylaxis in children being treated for acute myeloid leukemia (AML). It found that treatment-related NV, as evidenced by antiemetic alterations, is more prevalent with increasing age.
AHRQ-funded; HS018425
Citation: Freedman JL, Faerber JI, Kang TI .
Predictors of antiemetic alteration in pediatric acute myeloid leukemia.
Pediatr Blood Cancer. 2014 Oct;61(10):1798-805. doi: 10.1002/pbc.25108..
Keywords: Adverse Drug Events (ADE), Adverse Events, Cancer, Children/Adolescents, Medication, Prevention
Snyder ME, Frail CK, Jaynes H
Predictors of medication-related problems among Medicaid patients participating in a pharmacist-provided telephonic medication therapy management program.
The objective of this study was to identify predictors of medication-related problems (MRPs) among Medicaid patients participating in a telephonic medication therapy management (MTM) program. The analysis of study results supports the relative importance of number of medications as a predictor of MRPs in the Medicaid population and identifies other predictors.
AHRQ-funded; HS022119.
Citation: Snyder ME, Frail CK, Jaynes H .
Predictors of medication-related problems among Medicaid patients participating in a pharmacist-provided telephonic medication therapy management program.
Pharmacotherapy 2014 Oct;34(10):1022-32. doi: 10.1002/phar.1462..
Keywords: Adverse Drug Events (ADE), Care Management, Community-Based Practice, Medicaid, Medication, Provider: Pharmacist
Cea Soriano L, Bateman BT, Garcia Rodriguez LA
Prescription of antihypertensive medications during pregnancy in the UK.
The authors aimed to describe the management of antihypertensive medications in pregnancy by general practitioners in the UK and compare it with current guidelines. Using electronic medical records from The Health Improvement Network database, they found that, in this population of UK pregnant women, prescription patterns of antihypertensive medications were dominated by recommended treatments, although some patients continued on contraindicated drugs throughout pregnancy or switched to preferred agents in a delayed fashion.
AHRQ-funded; HS018533.
Citation: Cea Soriano L, Bateman BT, Garcia Rodriguez LA .
Prescription of antihypertensive medications during pregnancy in the UK.
Pharmacoepidemiol Drug Saf 2014 Oct;23(10):1051-8. doi: 10.1002/pds.3641.
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Keywords: Blood Pressure, Pregnancy, Medication, Women, Practice Patterns
Horner-Johnson W, Fujiura GT, Goode TD
Promoting a new research agenda: health disparities research at the intersection of disability, race, and ethnicity.
This article introduces a special issue of Medical Care that seeks to bridge the gap between research on racial and ethnic disparities and research on disability-related health disparities. The papers examine evidence of racial and ethnic disparities within various populations of people with disabilities, and explore unique issues at the intersection of disability, race, and ethnicity.
AHRQ-funded; HS021920
Citation: Horner-Johnson W, Fujiura GT, Goode TD .
Promoting a new research agenda: health disparities research at the intersection of disability, race, and ethnicity.
Med Care. 2014 Oct;52(10 Suppl 3):S1-2. doi: 10.1097/MLR.0000000000000220..
Keywords: Disparities, Racial and Ethnic Minorities, Health Services Research (HSR)
Hussey PS, Luft HS, McNamara P
AHRQ Author: McNamara P
Public reporting of provider performance at a crossroads in the United States: summary of current barriers and recommendations on how to move forward.
The authors presented a vision statement and 10 recommendations for public reports to achieve their potential for engaging and informing consumers.
AHRQ-authored; AHRQ-funded.
Citation: Hussey PS, Luft HS, McNamara P .
Public reporting of provider performance at a crossroads in the United States: summary of current barriers and recommendations on how to move forward.
Med Care Res Rev 2014 Oct;71(5 Suppl):5s-16s. doi: 10.1177/1077558714535980.
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Keywords: Education: Patient and Caregiver, Quality of Care, Provider: Health Personnel, Provider Performance, Public Reporting
Bakullari A, Metersky ML, Wang Y
Racial and ethnic disparities in healthcare-associated infections in the United States, 2009-2011.
This study examined racial and ethnic disparities in the occurrence of healthcare-associated infections (HAIs) in 79,019 Medicare patients hospitalized with acute cardiovascular disease, pneumonia, and major surgery. It found that Asian and Hispanic patients, but not non-Hispanic blacks, had significantly higher rates of HAIs than white non-Hispanic patients.
AHRQ-funded; 290201200003C
Citation: Bakullari A, Metersky ML, Wang Y .
Racial and ethnic disparities in healthcare-associated infections in the United States, 2009-2011.
Infect Control Hosp Epidemiol. 2014 Oct;35 Suppl 3:S10-6. doi: 10.1086/677827..
Keywords: Healthcare-Associated Infections (HAIs), Disparities, Racial and Ethnic Minorities, Critical Care, Patient Safety
Curtin CM, Hernandez-Boussard T
Readmissions after treatment of distal radius fractures.
The authors assessed the rates and associated diagnoses of readmissions for patients having received an intervention for treatment of distal radius fracture. Using AHRQ data sets, they found that many distal radius fracture patients return to the health care system for pain-related issues, and they recommended implementation of better pain management.
AHRQ-funded; HS018558.
Citation: Curtin CM, Hernandez-Boussard T .
Readmissions after treatment of distal radius fractures.
J Hand Surg Am 2014 Oct;39(10):1926-32. doi: 10.1016/j.jhsa.2014.07.041.
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Keywords: Injuries and Wounds, Quality of Care, Healthcare Cost and Utilization Project (HCUP), Pain, Hospital Readmissions
Mannion ML, Xie F, Curtis JR
Recent trends in medication usage for the treatment of juvenile idiopathic arthritis and the influence of tumor necrosis factor inhibitors.
The researchers investigated temporal trends in medication use among children diagnosed with juvenile idiopathic arthritis (JIA). They found that the use of tumor necrosis factor inhibitors (TNFi) in the treatment of JIA increased 2- to 3-fold from 2005 to 2012. New TNFi use was associated with decreased NSAID and oral glucocorticoids use. TNFi may be replacing, rather than complementing, methotrexate in the treatment of many patients.
AHRQ-funded; HS018517.
Citation: Mannion ML, Xie F, Curtis JR .
Recent trends in medication usage for the treatment of juvenile idiopathic arthritis and the influence of tumor necrosis factor inhibitors.
J Rheumatol 2014 Oct;41(10):2078-84. doi: 10.3899/jrheum.140012.
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Keywords: Children/Adolescents, Medication, Patient-Centered Outcomes Research, Practice Patterns, Arthritis
Chung S, Azar KM, Baek M
Reconsidering the age thresholds for type II diabetes screening in the U.S.
In order to examine the optimal age cut-point for opportunistic universal screening (as opposed to targeted screening), the researchers used a nationally representative sample from the National Health and Nutrition Examination Survey (2007-2010) and other resources. They found that opportunistic screening among individuals 35 years of age and older could greatly reduce the prevalence of undiagnosed diabetes or pre-diabetes.
AHRQ-funded; HS019815; HS019815.
Citation: Chung S, Azar KM, Baek M .
Reconsidering the age thresholds for type II diabetes screening in the U.S.
Am J Prev Med. 2014 Oct;47(4):375-81. doi: 10.1016/j.amepre.2014.05.012..
Keywords: Diabetes, Screening, Prevention, Chronic Conditions
Regenstein M, Andres E
Reducing hospital readmissions among Medicaid patients: a review of the literature.
This review aims to identify factors related to readmissions that are unique to Medicaid populations to inform efforts to reduce Medicaid readmissions. It concluded that much of the Medicaid readmissions literature focuses on patients with mental health or substance abuse issues, who are often high utilizers of health care within the Medicaid population.
AHRQ-funded; 290202010000301.
Citation: Regenstein M, Andres E .
Reducing hospital readmissions among Medicaid patients: a review of the literature.
Qual Manag Health Care 2014 Oct-Dec;23(4):203-25. doi: 10.1097/qmh.0000000000000043..
Keywords: Hospital Readmissions, Medicaid, Behavioral Health, Substance Abuse, Social Determinants of Health
Greene MT, Fakih MG, Fowler KE
Regional variation in urinary catheter use and catheter-associated urinary tract infection: results from a national collaborative.
The researchers explored nationwide variation in the use of urinary catheters and catheter-associated urinary tract infections (CAUTI) across a diverse set of units within acute care U.S. hospitals. Using data from 1,101 units in 726 hospitals across 34 States, they found regional differences in catheter use, appropriateness, and CAUTI rates, with possibly 30-40 percent of urinary catheters placed in non-ICU settings lacking an appropriate indication.
AHRQ-funded; HS018334; HS019767; 290201000025I; 29032001T
Citation: Greene MT, Fakih MG, Fowler KE .
Regional variation in urinary catheter use and catheter-associated urinary tract infection: results from a national collaborative.
Infect Control Hosp Epidemiol. 2014 Oct;35 Suppl 3:S99-S106. doi: 10.1086/677825..
Keywords: Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care, Catheter-Associated Urinary Tract Infection (CAUTI)
Nair R, Thapaliya D, Su Y
Resistance to zinc and cadmium in Staphylococcus aureus of human and animal origin.
The investigators determined the prevalence of zinc and cadmium resistance in S. aureus isolated in the United States. They found that resistance to zinc and cadmium was observed to be associated with MRSA, suggesting that prolonged exposure to zinc in livestock feeds and fertilizers could propagate resistance to the metal ion, hindering the use of zinc-based topical agents in treating S. aureus infections.
AHRQ-funded; HS019966.
Citation: Nair R, Thapaliya D, Su Y .
Resistance to zinc and cadmium in Staphylococcus aureus of human and animal origin.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S32-9. doi: 10.1086/677834.
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Keywords: Medication, Methicillin-Resistant Staphylococcus aureus (MRSA)
Cohen MJ, Morton S, Scholle SH
Self-management support activities in patient-centered medical home practices.
This study is a survey of small practices of fewer than 5 physicians with National Committee for Quality Assurance recognition. Practices reported a high proportion of self-management support activities, while practices that perform more of these activities have more nonindependent health care providers.
AHRQ-funded; HS019162.
Citation: Cohen MJ, Morton S, Scholle SH .
Self-management support activities in patient-centered medical home practices.
J Ambul Care Manage 2014 Oct-Dec;37(4):349-58. doi: 10.1097/jac.0000000000000040.
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Keywords: Patient-Centered Healthcare, Patient Self-Management, Primary Care