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 1430 Research Studies DisplayedMukamel DB, Ladd H, Li Y
AHRQ Author: Ngo-Metzger Q
Have racial disparities in ambulatory care sensitive admissions abated over time?
The researchers evaluated whether disparities in quality of ambulatory care have abated during the decade of 2000 by asking whether there were there differences in ambulatory care sensitive hospital admissions rates by race? In 2003 the overall Prevention Quality Indicators (PQI) admission rates were higher for African Americans (around 16.5/1000) than for whites (around 15/1000). By 2009, the overall and the chronic PQI admission rates declined significantly for whites but not for African Americans.
AHRQ-authored.
Citation: Mukamel DB, Ladd H, Li Y .
Have racial disparities in ambulatory care sensitive admissions abated over time?
Med Care 2015 Nov;53(11):931-9. doi: 10.1097/mlr.0000000000000426..
Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Quality Indicators (QIs), Racial and Ethnic Minorities, Quality of Care
Callaghan BC, Kerber KA, Pace RJ
Headache neuroimaging: routine testing when guidelines recommend against them.
The aim of this article was to determine the patient-level factors associated with headache neuroimaging in outpatient practice. It concluded that neuroimaging is routinely ordered in outpatient headache patients including populations where guidelines specifically recommend against their use (migraines, chronic headaches, no red flags).
AHRQ-funded; HS017690.
Citation: Callaghan BC, Kerber KA, Pace RJ .
Headache neuroimaging: routine testing when guidelines recommend against them.
Cephalalgia 2015 Nov;35(13):1144-52. doi: 10.1177/0333102415572918.
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Keywords: Neurological Disorders, Imaging, Decision Making, Guidelines, Diagnostic Safety and Quality
Kennedy-Hendricks A, Schwartz HL, Griffin BA
Health implications of social networks for children living in public housing.
This study sought to examine whether the health composition of the social networks of children living in subsidized housing differs from those living in public housing developments; and whether children's social network composition is associated with children's own health. The authors found no significant differences in the health characteristics of the social networks of children based on housing, but social network composition was significantly associated with several aspects of children's own health.
AHRQ-funded; HS000029.
Citation: Kennedy-Hendricks A, Schwartz HL, Griffin BA .
Health implications of social networks for children living in public housing.
Health Place 2015 Nov;36:145-51. doi: 10.1016/j.healthplace.2015.11.001.
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Keywords: Children/Adolescents, Health Status, Low-Income, Social Determinants of Health
Hahn EA, Burns JL, Jacobs EA
Health literacy and patient-reported outcomes: a cross-sectional study of underserved English- and Spanish-speaking patients with type 2 diabetes.
The investigators examined associations between patient characteristics, health behaviors, and health outcomes and explored the role of health literacy as a potential mediator of outcomes. They found that health literacy was not associated with diabetes self-care, health status, or satisfaction with communication, and it did not mediate the effects of other factors on these outcomes. Diabetes self-efficacy was significantly associated with health behaviors and outcomes. The association between Spanish language preference and poorer health was not mediated by this group's lower health literacy.
AHRQ-funded; HS019335.
Citation: Hahn EA, Burns JL, Jacobs EA .
Health literacy and patient-reported outcomes: a cross-sectional study of underserved English- and Spanish-speaking patients with type 2 diabetes.
J Health Commun 2015;20 Suppl 2:4-15. doi: 10.1080/10810730.2015.1061071.
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Keywords: Communication, Diabetes, Health Literacy, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Singal AG, El-Serag HB
Hepatocellular carcinoma from epidemiology to prevention: Translating knowledge into practice.
The effectiveness of hepatocellular carcinoma (HCC) prevention in clinical practice and at the population level has lagged behind due to patient, provider, system, and societal factors. The authors suggest that the Quality in the Continuum of Cancer Care model provides a framework for evaluating the HCC prevention processes, including potential failures that create a gap between efficacy and effectiveness.
AHRQ-funded; HS022418.
Citation: Singal AG, El-Serag HB .
Hepatocellular carcinoma from epidemiology to prevention: Translating knowledge into practice.
Clin Gastroenterol Hepatol 2015 Nov;13(12):2140-51. doi: 10.1016/j.cgh.2015.08.014.
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Keywords: Cancer, Implementation, Prevention, Social Determinants of Health
Ananth P, Melvin P, Feudtner C
Hospital use in the last year of life for children with life-threatening complex chronic conditions.
The researchers assessed hospital resource use in children by type and number of life-threatening complex chronic conditions (LT-CCCs). They found that hospital use for children with LT-CCCs in the last year of life varies significantly across the type and number of conditions. Children with hematologic/ immunologic or multiple conditions have the greatest hospital use.
AHRQ-funded; HS023092.
Citation: Ananth P, Melvin P, Feudtner C .
Hospital use in the last year of life for children with life-threatening complex chronic conditions.
Pediatrics 2015 Nov;136(5):938-46. doi: 10.1542/peds.2015-0260..
Keywords: Chronic Conditions, Children/Adolescents, Hospitalization, Palliative Care
Donnelly JP, Wang HE, Locke JE
Hospital-onset Clostridium difficile infection among solid organ transplant recipients.
The researchers examined hospital-onset Clostridium difficile infection (CDI) from 2012 to 2014 among transplant recipients in the University HealthSystem Consortium, which includes academic medical center-affiliated hospitals in the United States. They found that factors associated with CDI among transplant recipients included transplant type, risk of mortality, comorbidities, and inpatient complications.
AHRQ-funded; HS013852.
Citation: Donnelly JP, Wang HE, Locke JE .
Hospital-onset Clostridium difficile infection among solid organ transplant recipients.
Am J Transplant 2015 Nov;15(11):2970-7. doi: 10.1111/ajt.13491.
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Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Transplantation, Adverse Events, Mortality
Carayon P, Weinger MB, Brown R
How do residents spend their time in the intensive care unit?
The researchers described the work of residents and the distribution of their time in 6 intensive care units (ICUs) of 2 medical centers (MCs). The found that residents spent most time performing direct patient care and care coordination activities. The distribution of activities, which varied across MCs and across ICUs, highlights the need to consider the local context on residents' work in ICUs.
AHRQ-funded; HS015274.
Citation: Carayon P, Weinger MB, Brown R .
How do residents spend their time in the intensive care unit?
Am J Med Sci 2015 Nov;350(5):403-8. doi: 10.1097/maj.0000000000000520.
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Keywords: Education: Continuing Medical Education, Intensive Care Unit (ICU), Provider, Training
Blecker S, Goldfeld K, Park H
Impact of an intervention to improve weekend hospital care at an academic medical center: an observational study.
The purpose of this study was to evaluate the impact of a weekend hospital intervention on processes of care and clinical outcomes. The multifaceted intervention included expanded weekend diagnostic services, improved weekend discharge processes, and increased physician and care management services on weekends. The intervention was associated with a reduction in length of stay and an increase in weekend discharges.
AHRQ-funded; HS023683.
Citation: Blecker S, Goldfeld K, Park H .
Impact of an intervention to improve weekend hospital care at an academic medical center: an observational study.
J Gen Intern Med 2015 Nov;30(11):1657-64. doi: 10.1007/s11606-015-3330-6.
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Keywords: Quality Improvement, Quality of Care, Hospitals, Hospital Discharge, Hospital Readmissions, Healthcare Delivery, Outcomes, Patient-Centered Outcomes Research
Pfoh E, Mojtabai R, Bailey J
Impact of Medicare annual wellness visits on uptake of depression screening.
This study assessed whether patients with an initial annual wellness visit (AWV) were more likely to be screened for depression than those with a primary care visit. Fifteen percent of patients with non-AWVs and 10 percent of patients with AWVs received depression screening. After accounting for clustering, there was no statistically significant difference in depression screening by visit type.
AHRQ-funded; HS000029.
Citation: Pfoh E, Mojtabai R, Bailey J .
Impact of Medicare annual wellness visits on uptake of depression screening.
Psychiatr Serv 2015 Nov;66(11):1207-12. doi: 10.1176/appi.ps.201400524.
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Keywords: Depression, Screening, Medicare, Elderly, Primary Care
Schussler-Fiorenza Rose SM, Gangnon RE, Chewning B
Increasing discussion rates of incontinence in primary care: a randomized controlled trial.
The study’s aim was to evaluate whether the use of an electronic pelvic floor assessment questionnaire (ePAQ-PF) improves communication about incontinence in primary care. It found that use of the ePAQ-PF prior to clinic visits increases discussion of urinary and fecal incontinence, particularly clinician-initiated discussion.
AHRQ-funded; HS017028.
Citation: Schussler-Fiorenza Rose SM, Gangnon RE, Chewning B .
Increasing discussion rates of incontinence in primary care: a randomized controlled trial.
J Womens Health 2015 Nov;24(11):940-9. doi: 10.1089/jwh.2015.5230..
Keywords: Clinician-Patient Communication, Communication, Primary Care, Women
Persell SD, Brown T, Lee JY
Individualized risk communication and outreach for primary cardiovascular disease prevention in community health centers: randomized trial.
The researchers conducted a randomized trial to determine if mailed outreach containing patients’ individualized CVD risk and uncontrolled risk factors followed by telephone discussion with trained lay health workers would improve statin use for primary prevention among community health center patients with moderately high cardiovascular risk. They found that the intervention, led to more cholesterol treatment discussions with primary care clinicians but had little impact on statin prescribing.
AHRQ-funded; HS021141.
Citation: Persell SD, Brown T, Lee JY .
Individualized risk communication and outreach for primary cardiovascular disease prevention in community health centers: randomized trial.
Circ Cardiovasc Qual Outcomes 2015 Nov;8(6):560-6. doi: 10.1161/circoutcomes.115.001723..
Keywords: Cardiovascular Conditions, Prevention, Community-Based Practice, Clinician-Patient Communication, Risk
Kennedy-Hendricks A, Schwartz H, Thornton RJ
Intergenerational social networks and health behaviors among children living in public housing.
The researchers investigated whether caretakers' social networks are linked with children's health status. They found that caretaker social networks are independently associated with certain aspects of child health, suggesting the importance of the broader social environment for low-income children's health.
AHRQ-funded; HS023009.
Citation: Kennedy-Hendricks A, Schwartz H, Thornton RJ .
Intergenerational social networks and health behaviors among children living in public housing.
Am J Public Health 2015 Nov;105(11):2291-7. doi: 10.2105/ajph.2015.302663.
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Keywords: Caregiving, Children/Adolescents, Family Health and History, Health Status, Low-Income
Werner NE, Holden RJ
Interruptions in the wild: development of a sociotechnical systems model of interruptions in the emergency department through a systematic review.
After a systematic review and synthesis of the literature and drawing on ergonomic concepts, the authors present a sociotechnical model of interruptions in complex settings that motivates new directions in research and design. The model conceptualizes interruptions as a process, not a single event, that occurs within and is shaped by an interacting socio-technical system and that results in a variety of interrelated outcomes.
AHRQ-funded; HS022916.
Citation: Werner NE, Holden RJ .
Interruptions in the wild: development of a sociotechnical systems model of interruptions in the emergency department through a systematic review.
Appl Ergon 2015 Nov;51:244-54. doi: 10.1016/j.apergo.2015.05.010..
Keywords: Emergency Department, Emergency Medical Services (EMS)
Britt RC, Scerbo MW, Montano M
Intracorporeal suturing: transfer from fundamentals of laparoscopic surgery to cadavers results in substantial increase in mental workload.
The researchers hypothesized that laparoscopic suturing on genuine bowel would be more challenging than on the Fundamentals of Laparoscopic Surgery (FLS)-simulated bowel as reflected in differences on both suturing and secondary task scores. They found that the increase in mental workload is indexed by both an increase in suturing times and a decrease in the ability to attend to the secondary task.
AHRQ-funded; HS020386.
Citation: Britt RC, Scerbo MW, Montano M .
Intracorporeal suturing: transfer from fundamentals of laparoscopic surgery to cadavers results in substantial increase in mental workload.
Surgery 2015 Nov;158(5):1428-33. doi: 10.1016/j.surg.2015.03.032..
Keywords: Surgery, Patient Safety, Simulation, Training
Wright A, Sittig DF, Ash JS
Lessons learned from implementing service-oriented clinical decision support at four sites: a qualitative study.
This study identified challenges, lessons learned and best practices for service-oriented clinical decision support, based on the results of the Clinical Decision Support Consortium, a multi-site study which developed, implemented and evaluated clinical decision support services in a diverse range of electronic health records. Based on the challenges and lessons learned, there were eight best practices for developers and implementers of service-oriented clinical decision support.
AHRQ-funded; 290200810010.
Citation: Wright A, Sittig DF, Ash JS .
Lessons learned from implementing service-oriented clinical decision support at four sites: a qualitative study.
Int J Med Inform 2015 Nov;84(11):901-11. doi: 10.1016/j.ijmedinf.2015.08.008.
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Keywords: Clinical Decision Support (CDS), Electronic Health Records (EHRs), Decision Making, Health Information Technology (HIT)
Jarvik JG, Comstock BA, James KT
Lumbar Imaging with Reporting of Epidemiology (LIRE)--protocol for a pragmatic cluster randomized trial.
The researchers will conduct a pragmatic cluster randomized clinical trial to test the hypothesis that inserting data on the prevalence of incidental imaging findings into lumbar spine imaging reports for studies ordered by primary care providers will reduce subsequent spine-related interventions. Their primary outcome will be spine-related intervention intensity based on Relative Value Units (RVUs) during the following year.
AHRQ-funded; HS022982.
Citation: Jarvik JG, Comstock BA, James KT .
Lumbar Imaging with Reporting of Epidemiology (LIRE)--protocol for a pragmatic cluster randomized trial.
Contemp Clin Trials 2015 Nov;45(Pt B):157-63. doi: 10.1016/j.cct.2015.10.003.
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Keywords: Imaging, Back Health and Pain, Patient-Centered Outcomes Research
Grenda TR, Revels SL, Yin H
Lung cancer resection at hospitals with high vs low mortality rates.
The objective of this study was to evaluate perioperative outcomes in patients who underwent lung cancer resection at high-mortality hospitals [HMHs] and low-mortality hospitals [LMHs]) in order to better understand the factors related to differences in mortality rates after lung cancer resection. It concluded that failure-to-rescue rates are higher at HMHs, which may explain the large differences between hospitals in mortality rates following lung cancer resection.
AHRQ-funded; HS000053; HS020937.
Citation: Grenda TR, Revels SL, Yin H .
Lung cancer resection at hospitals with high vs low mortality rates.
JAMA Surg 2015 Nov;150(11):1034-40. doi: 10.1001/jamasurg.2015.2199..
Keywords: Cancer: Lung Cancer, Surgery, Mortality, Outcomes, Patient Safety
Liu H, Mattke S, Predmore ZS
Medicare coverage of anesthesia services during screening colonoscopies for patients at low risk of sedation-related complications.
The authors examined the costs and potential benefit of the Medicare rule change that waived patient cost sharing for anesthesia services during screening colonoscopies. Their results cast doubt on the value associated with Medicare coverage of anesthesia services during screening colonoscopies for patients at low risk of sedation-related complications. They recommended that payers create payment bundles for endoscopy procedures that include anesthesia services in a fixed fee.
AHRQ-funded; HS000029.
Citation: Liu H, Mattke S, Predmore ZS .
Medicare coverage of anesthesia services during screening colonoscopies for patients at low risk of sedation-related complications.
JAMA Intern Med 2015 Nov;175(11):1848-50. doi: 10.1001/jamainternmed.2015.4585.
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Keywords: Adverse Drug Events (ADE), Cancer: Colorectal Cancer, Colonoscopy, Medicare, Medication
Chen LM, Meara E, Birkmeyer JD
Medicare's Bundled Payments for Care Improvement initiative: expanding enrollment suggests potential for large impact.
The researchers examined the cross-sectional association between Bundled Payments for Care Improvement (BPCI) participation and providers' structural and cost characteristics. Overall participation in BPCI increased from about 400 in October 2013 to more than 2000 in June 2014. The authors concluded that growing participation in BPCI suggests strong interest in bundled payments.
AHRQ-funded; HS020671.
Citation: Chen LM, Meara E, Birkmeyer JD .
Medicare's Bundled Payments for Care Improvement initiative: expanding enrollment suggests potential for large impact.
Am J Manag Care 2015 Nov;21(11):814-20.
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Keywords: Healthcare Costs, Payment, Medicare, Quality Improvement
Ajmera M, Sambamoorthi U, Metzger A
Multimorbidity and COPD Medication receipt among Medicaid beneficiaries with newly diagnosed COPD.
The aim of this study was to examine the association between multimorbidity and chronic obstructive pulmonary disease ( COPD) medication receipt among Medicaid beneficiaries with newly diagnosed COPD. It found that in this group 81.9 percen had at least one co-occurring chronic condition. After controlling for subject characteristics, adults with multimorbidity were less likely to receive COPD medications compared with those without any inflammation-related multimorbidity.
AHRQ-funded; HS022444.
Citation: Ajmera M, Sambamoorthi U, Metzger A .
Multimorbidity and COPD Medication receipt among Medicaid beneficiaries with newly diagnosed COPD.
Respir Care 2015 Nov;60(11):1592-602. doi: 10.4187/respcare.03788.
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Keywords: Chronic Conditions, Respiratory Conditions, Medication, Medicaid
Ellis MC, Paugh TA, Dickinson TA
Nadir hematocrit on bypass and rates of acute kidney injury: does sex matter?
Recent literature has suggested that women, although more often exposed to lower nadir hematocrit (Hct), have a lower risk of postoperative renal dysfunction. The researchers assessed whether this relationship held across a large multicenter registry. They found that lower nadir Hct was associated with an increased risk of AKI, and the effect appears to be stronger among men than women.
AHRQ-funded; HS022535; HS022909.
Citation: Ellis MC, Paugh TA, Dickinson TA .
Nadir hematocrit on bypass and rates of acute kidney injury: does sex matter?
Ann Thorac Surg 2015 Nov;100(5):1549-54; discussion 54-5. doi: 10.1016/j.athoracsur.2015.05.080..
Keywords: Risk, Cardiovascular Conditions, Surgery, Adverse Events, Patient Safety
Olfson M, Wang S, Blanco C
National trends in hospital-treated self-harm events among middle-aged adults.
This study assessed national trends in hospital-treated self-harm events focusing on adults aged 45-64years. Between 2001 and 2011, there was a disproportionate national increase in hospital-treated self-harm events among middle-aged adults that mirrored national trends in suicide. The increase was largely accounted for by an overall increase in mental health hospitalizations of middle-aged adults.
AHRQ-funded; HS021112.
Citation: Olfson M, Wang S, Blanco C .
National trends in hospital-treated self-harm events among middle-aged adults.
Gen Hosp Psychiatry 2015 Nov-Dec;37(6):613-9. doi: 10.1016/j.genhosppsych.2015.08.004.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Behavioral Health, Hospitalization
Bangalore S, Ogedegbe G, Gyamfi J
Outcomes with angiotensin-converting enzyme inhibitors vs other antihypertensive agents in hypertensive blacks.
The study’s objective was to evaluate the effectiveness of angiotensin-converting enzyme inhibitors when compared with other antihypertensive agents in hypertensive blacks. It found that in a large cohort of hypertensive blacks, angiotensin-converting enzyme inhibitors were associated with less benefit when compared with calcium channel blockers or thiazide diuretics.
AHRQ-funded; HS018589.
Citation: Bangalore S, Ogedegbe G, Gyamfi J .
Outcomes with angiotensin-converting enzyme inhibitors vs other antihypertensive agents in hypertensive blacks.
Am J Med 2015 Nov;128(11):1195-203. doi: 10.1016/j.amjmed.2015.04.034..
Keywords: Blood Pressure, Racial and Ethnic Minorities, Medication, Outcomes, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Comparative Effectiveness
Polage CR, Gyorke CE, Kennedy MA
Overdiagnosis of Clostridium difficile infection in the molecular test era.
This study determined the natural history and need for treatment of patients who are toxin immunoassay negative and polymerase chain reaction (PCR) positive (Tox−/PCR+) for Clostridium difficile Infection ( CDI). They found that among hospitalized adults with suspected CDI, virtually all CDI-related complications and deaths occurred in patients with positive toxin immunoassay test results.
AHRQ-funded; HS022236.
Citation: Polage CR, Gyorke CE, Kennedy MA .
Overdiagnosis of Clostridium difficile infection in the molecular test era.
JAMA Intern Med 2015 Nov;175(11):1792-801. doi: 10.1001/jamainternmed.2015.4114..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Genetics