National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Blood Pressure (1)
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Caregiving (1)
- (-) Care Management (24)
- Case Study (1)
- Children/Adolescents (2)
- Chronic Conditions (4)
- Clinical Decision Support (CDS) (1)
- Communication (1)
- Community-Based Practice (4)
- Comparative Effectiveness (1)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Dialysis (1)
- Education: Patient and Caregiver (1)
- Electronic Health Records (EHRs) (2)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (2)
- Guidelines (1)
- Healthcare Delivery (4)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (3)
- Health Insurance (1)
- Health Promotion (1)
- Heart Disease and Health (2)
- Hospital Readmissions (1)
- Human Immunodeficiency Virus (HIV) (1)
- Inpatient Care (2)
- Kidney Disease and Health (2)
- Medicaid (1)
- Medicare (2)
- Medication (6)
- Newborns/Infants (1)
- Obesity (2)
- Obesity: Weight Management (2)
- Outcomes (3)
- Pain (3)
- Palliative Care (1)
- Patient-Centered Healthcare (3)
- Patient Adherence/Compliance (3)
- Patient Safety (1)
- Practice Patterns (2)
- Prevention (2)
- Primary Care (3)
- Primary Care: Models of Care (1)
- Provider: Pharmacist (3)
- Quality of Care (3)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (1)
- Risk (1)
- Screening (1)
- Surgery (1)
- Young Adults (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 24 of 24 Research Studies DisplayedMichelson KA, Ho T, Pelletier A
A mobile, collaborative, real time task list for inpatient environments.
The researchers created a mobile, collaborative, real-time task list application on the iOS platform. They then described their experience designing and piloting the application with an inpatient pediatric ward team at an academic pediatric hospital. They found that physicians preferred the immediacy and familiarity of paper, and did not experience an efficiency benefit when using the electronic tasklist.
AHRQ-funded; HS000063.
Citation: Michelson KA, Ho T, Pelletier A .
A mobile, collaborative, real time task list for inpatient environments.
Appl Clin Inform 2015 Nov 18;6(4):677-83. doi: 10.4338/aci-2015-05-cr-0050.
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Keywords: Care Management, Communication, Health Information Technology (HIT), Inpatient Care, Health Information Technology (HIT)
Tataris KL, Mercer MP, Govindarajan P
Prehospital aspirin administration for acute coronary syndrome (ACS) in the USA: an EMS quality assessment using the NEMSIS 2011 database.
The researchers sought to determine (1) the proportion of patients with suspected cardiac ischaemia who received aspirin and (2) patient and prehospital characteristics that independently predicted administration of aspirin. Patients living in the Southern region of the USA and patients with governmental (federally administered such as Veteran's Health Care, but not Medicare or Medicaid) insurance had the lowest odds of receiving aspirin.
AHRQ-funded; HS017965.
Citation: Tataris KL, Mercer MP, Govindarajan P .
Prehospital aspirin administration for acute coronary syndrome (ACS) in the USA: an EMS quality assessment using the NEMSIS 2011 database.
Emerg Med J 2015 Nov;32(11):876-81. doi: 10.1136/emermed-2014-204299.
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Keywords: Cardiovascular Conditions, Care Management, Emergency Medical Services (EMS), Heart Disease and Health, Healthcare Delivery, Medication
Jung HY, Trivedi AN, Grabowski DC
Integrated Medicare and Medicaid managed care and rehospitalization of dual eligibles.
The objective of this study was to conduct an early evaluation of an innovative program that coordinates benefits for elderly dual eligibles. The authors found no statistically significant effect of senior care options on rehospitalization. They concluded that coordinating the financing and delivery of services through an integrated managed program may not sufficiently address the problems of inefficiency and fragmentation in care for hospitalized dual eligible enrollees.
AHRQ-funded; HS020756.
Citation: Jung HY, Trivedi AN, Grabowski DC .
Integrated Medicare and Medicaid managed care and rehospitalization of dual eligibles.
Am J Manag Care 2015 Oct;21(10):711-7.
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Keywords: Healthcare Delivery, Care Management, Medicaid, Medicare, Hospital Readmissions
Alexander JA, Markowitz AR, Paustian ML
Implementation of patient-centered medical homes in adult primary care practices.
This study examined the following research questions: Is the level of, and change in, implementation of patient-centered medical home (PCMH) associated with medical surgical cost, preventive services utilization, and quality of care in the following year? Results showed that both level and amount of change are independently and positively associated with measures of quality of care and use of preventive services.
AHRQ-funded; HS019147.
Citation: Alexander JA, Markowitz AR, Paustian ML .
Implementation of patient-centered medical homes in adult primary care practices.
Med Care Res Rev 2015 Aug;72(4):438-67. doi: 10.1177/1077558715579862.
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Keywords: Care Management, Quality of Care, Patient-Centered Healthcare, Primary Care
Erickson KF, Mell M, Winkelmayer WC
Provider visits and early vascular access placement in maintenance hemodialysis.
This study examined whether patients seen more frequently by their nephrologist or advanced practitioner in the first 90 days of hemodialysis were more likely to undergo surgery to create an AV fistula or place an AV graft during that period. It concluded that patients seen more frequently by care providers in the first 90 days of hemodialysis undergo earlier AV fistula creation or graft placement.
AHRQ-funded; HS019178.
Citation: Erickson KF, Mell M, Winkelmayer WC .
Provider visits and early vascular access placement in maintenance hemodialysis.
J Am Soc Nephrol 2015 Aug;26(8):1990-7. doi: 10.1681/asn.2014050464..
Keywords: Care Management, Kidney Disease and Health, Healthcare Utilization, Outcomes
Magnan EM, Palta M, Pandhi N
The relationship of individual comorbid chronic conditions to diabetes care quality.
The aim of this study was to determine which chronic conditions were related to lack of achievement or achievement of diabetes care quality goals to determine potential targets for future interventions. It found that 62 chronic conditions varied in their relationships to diabetes care goal achievement for specific care goals. For example, congestive heart failure was related to lack of achievement of cholesterol management goals.
AHRQ-funded; HS018368; HS021899.
Citation: Magnan EM, Palta M, Pandhi N .
The relationship of individual comorbid chronic conditions to diabetes care quality.
BMJ Open Diabetes Res Care 2015 Jul 23;3(1):e000080. doi: 10.1136/bmjdrc-2015-000080..
Keywords: Care Management, Chronic Conditions, Diabetes, Quality of Care
Van Cleave J, Boudreau AA, McAllister J
Care coordination over time in medical homes for children with special health care needs.
This study explored how care coordination changes conceptually and practically in primary care practices when implementing the medical home and to identify reasons for different types of changes. They found that in high-performing medical homes, care coordination activities changed from being mostly reactive to patients’ episodic needs to being more systematically proactive and comprehensive.
AHRQ-funded; HS019157.
Citation: Van Cleave J, Boudreau AA, McAllister J .
Care coordination over time in medical homes for children with special health care needs.
Pediatrics 2015 Jun;135(6):1018-26. doi: 10.1542/peds.2014-1067..
Keywords: Care Coordination, Care Management, Patient-Centered Healthcare, Primary Care
Hartley KA, Miller CS, Gephart SM
Facilitated tucking to reduce pain in neonates: evidence for best practice.
The researchers investigated the effect of facilitated tucking on pain behaviors in those who received the intervention compared with those who did not, and what alternative interventions for nonpharmacologic pain reduction are supported by strong research evidence? Their review demonstrated that facilitated tucking reduces the expression of pain in premature infants.
AHRQ-funded; HS022908.
Citation: Hartley KA, Miller CS, Gephart SM .
Facilitated tucking to reduce pain in neonates: evidence for best practice.
Adv Neonatal Care 2015 Jun;15(3):201-8. doi: 10.1097/anc.0000000000000193..
Keywords: Care Management, Evidence-Based Practice, Newborns/Infants, Pain
Juckett DA, Davis FN, Gostine M
Patient-reported outcomes in a large community-based pain medicine practice: evaluation for use in phenotype modeling.
The researchers aimed to build a phenotype-to-outcome model targeting chronic pain to be used to drive clinical decision support for pain medicine in the community setting. Exploratory factor analysis of the intake Pain Health Assessment revealed 15 orthogonal factors representing pain levels; physical, social, and emotional functions; the effects of pain on these functions; vitality and health; and measures of outcomes and satisfaction.
AHRQ-funded; HS022335.
Citation: Juckett DA, Davis FN, Gostine M .
Patient-reported outcomes in a large community-based pain medicine practice: evaluation for use in phenotype modeling.
BMC Med Inform Decis Mak 2015 May 28;15:41. doi: 10.1186/s12911-015-0164-4..
Keywords: Care Management, Chronic Conditions, Community-Based Practice, Electronic Health Records (EHRs), Health Information Technology (HIT), Outcomes, Pain
Annis AM, Holtrop JS, Tao M
Comparison of provider and plan-based targeting strategies for disease management.
The researchers described and contrasted the targeting methods and engagement outcomes for health plan-delivered disease management with those of a provider-delivered care management program. They concluded that both provide advantages and that an optimal model may be to combine the strengths of each approach to maximize benefits in care management.
AHRQ-funded; HS020108.
Citation: Annis AM, Holtrop JS, Tao M .
Comparison of provider and plan-based targeting strategies for disease management.
Am J Manag Care 2015 May;21(5):344-51.
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Keywords: Care Management, Primary Care, Health Insurance, Healthcare Delivery
Nykiel-Bailey SM, McAllister JD, Schrock CR
Difficult airway consultation service for children: steps to implement and preliminary results.
The article demonstrates how to implement a consultative service focusing on difficult airway (DAW) identification, management and education. The initial 3-month experience confirmed that a majority of pediatric DAW events are associated with congenital or acquired abnormalities. Through appropriate consultation and leadership, the Difficult Airway Service was able to physically and electronically identify pediatric patients with a DAW and provide management.
AHRQ-funded; HS022265.
Citation: Nykiel-Bailey SM, McAllister JD, Schrock CR .
Difficult airway consultation service for children: steps to implement and preliminary results.
Paediatr Anaesth 2015 Apr;25(4):363-71. doi: 10.1111/pan.12625..
Keywords: Care Management, Children/Adolescents, Respiratory Conditions, Patient Safety, Risk
Maynard G, Kulasa K, Ramos P
Impact of a hypoglycemia reduction bundle and a systems approach to inpatient glycemic management.
In order to improve inpatient glycemic management in a 550-bed academic medical center, the researchers implemented a hypoglycemia reduction bundle, proactive surveillance of glycemic outliers, and an interdisciplinary data-driven approach to glycemic management. By using this approach with multiple mutually reinforcing interventions, they were able to cut severe inpatient hypoglycemia by more than half, while simultaneously improving glycemic control.
AHRQ-funded; HS020594
Citation: Maynard G, Kulasa K, Ramos P .
Impact of a hypoglycemia reduction bundle and a systems approach to inpatient glycemic management.
Endocr Pract. 2015 Apr;21(4):355-67. doi: 10.4158/ep14367.or..
Keywords: Care Management, Inpatient Care, Prevention
Snyder ME, Earl TR, Gilchrist S
Collaborative drug therapy management: case studies of three community-based models of care.
The objectives of this study were to understand how collaborative drug therapy management (CDTM) practices were implemented in 3 community settings and to identify common and unique facilitators and barriers to implementing CDTM. The authors believe that the models described in this study could be used to strengthen clinical–community linkages through team-based care, particularly for chronic disease prevention and management.
AHRQ-funded; HS022119.
Citation: Snyder ME, Earl TR, Gilchrist S .
Collaborative drug therapy management: case studies of three community-based models of care.
Prev Chronic Dis 2015 Mar 26;12:E39. doi: 10.5888/pcd12.140504..
Keywords: Care Management, Case Study, Community-Based Practice, Medication, Primary Care: Models of Care, Provider: Pharmacist
Agwu AL, Lee L, Fleishman JA
AHRQ Author: Fleishman JA
Aging and loss to follow-up among youth living with human immunodeficiency virus in the HIV Research Network.
The researchers sought to evaluate loss to follow-up in the year after each birthday from the 18th through the 25th in a large multisite HIV cohort in the United States. Among the 647 21-year-old youth who were engaged in care, 20 percent were lost to follow-up in the year after their 21st birthday.
AHRQ-authored; AHRQ-funded; 2901100007.
Citation: Agwu AL, Lee L, Fleishman JA .
Aging and loss to follow-up among youth living with human immunodeficiency virus in the HIV Research Network.
J Adolesc Health 2015 Mar;56(3):345-51. doi: 10.1016/j.jadohealth.2014.11.009..
Keywords: Care Management, Chronic Conditions, Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Young Adults
Abdelsattar ZM, Reames BN, Regenbogen SE
Critical evaluation of the scientific content in clinical practice guidelines.
The researchers sought to critically evaluate clinical practice guidelines (CPGs) on the basis of their overall development quality, the evidence base used to synthesize recommendations, and the scientific agreement between CPGs on key processes of care. They concluded that there is significant variation in CPG development processes, with associated differences in scientific content and interpretation of evidence, resulting in conflicting recommendations.
AHRQ-funded: HS000053.
Citation: Abdelsattar ZM, Reames BN, Regenbogen SE .
Critical evaluation of the scientific content in clinical practice guidelines.
Cancer 2015 Mar 1;121(5):783-9. doi: 10.1002/cncr.29124..
Keywords: Care Management, Evidence-Based Practice, Guidelines, Quality of Care
Polsky S, Donahoo WT, Lyons EE
Evaluation of care management intensity and bariatric surgical weight loss.
This study examined the effect of pre- and postoperative care management on weight loss following bariatric surgery. It found no statistically significant associations between either preoperative or postoperative care management intensity and postoperative change in body mass index at year 1 or year 2. Results were limited by heterogeneity of care management across sites and an inability to assess adherence to care management programs.
AHRQ-funded; HS019912.
Citation: Polsky S, Donahoo WT, Lyons EE .
Evaluation of care management intensity and bariatric surgical weight loss.
Am J Manag Care 2015 Mar;21(3):182-9..
Keywords: Care Management, Obesity, Obesity: Weight Management, Patient Adherence/Compliance, Surgery
Huet AL, Frail CK, Lake LM
Impact of passive and active promotional strategies on patient acceptance of medication therapy management services.
The researchers assessed the impact of passive and active promotional strategies on patient acceptance of medication therapy management (MTM) services, and identified reasons for patient acceptance or refusal. No significant differences were identified among the four promotional methods or between active and passive methods in the analyses. Patients' most frequent reasons for accepting MTM services were potential cost savings and review of how the medications were working.
AHRQ-funded; HS022119.
Citation: Huet AL, Frail CK, Lake LM .
Impact of passive and active promotional strategies on patient acceptance of medication therapy management services.
J Am Pharm Assoc 2015 Mar-Apr;55(2):178-81. doi: 10.1331/JAPhA.2015.14091.
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Keywords: Care Management, Community-Based Practice, Health Promotion, Medication, Patient Adherence/Compliance, Provider: Pharmacist
Dauw CA, Alruwaily AF, Bierlein MJ
Provider variation in the quality of metabolic stone management.
The researchers quantified the degree of variation in repeat 24-hour urine testing attributable to providers and assessed differences in repeat testing rates between specialist and primary care physicians. They found, that, while most variation in follow-up testing was attributable to the patient, the provider contribution was nontrivial (18 percent). The specialty of the ordering provider was also important.
AHRQ-funded; HS020927.
Citation: Dauw CA, Alruwaily AF, Bierlein MJ .
Provider variation in the quality of metabolic stone management.
J Urol 2015 Mar;193(3):885-90. doi: 10.1016/j.juro.2014.09.111..
Keywords: Care Management, Chronic Conditions, Practice Patterns
Snyder ME, Pater KS, Frail CK
Utility of a brief screening tool for medication-related problems.
The objective of this study was to estimate the psychometric properties of a brief self-administered scale as a screening tool for medication-related problems (MRPs). Its findings suggest scores on the nine-item scale are a statistically significant, although fairly modest, predictor of MRPs when controlling for other significant predictors of problems.
AHRQ-funded; HS022119.
Citation: Snyder ME, Pater KS, Frail CK .
Utility of a brief screening tool for medication-related problems.
Res Social Adm Pharm 2015 Mar-Apr;11(2):253-64. doi: 10.1016/j.sapharm.2014.08.005..
Keywords: Care Management, Community-Based Practice, Medication, Provider: Pharmacist, Screening
Schroeder MC, Robinson JG, Chapman CG
Use of statins by Medicare beneficiaries post myocardial infarction: poor physician quality or patient-centered care?
This study assessed whether patterns of statin use by Medicare beneficiaries post-discharge may be due to a mix of high-quality and low-quality physicians. It found that the distribution of statin fill rates across physicians was normal, with no clear distinctions in physician quality. Physicians, especially cardiologists, with relatively younger and healthier patient populations had higher rates of statin use.
AHRQ-funded; HS019574.
Citation: Schroeder MC, Robinson JG, Chapman CG .
Use of statins by Medicare beneficiaries post myocardial infarction: poor physician quality or patient-centered care?
Inquiry 2015 Feb 27;52. doi: 10.1177/0046958015571131..
Keywords: Care Management, Medication, Heart Disease and Health, Medicare, Patient-Centered Healthcare, Practice Patterns
Erickson KF, Mell MW, Winkelmayer WC
Provider visit frequency and vascular access interventions in hemodialysis.
This study sought to determine whether more frequent face-to-face provider (physician and advanced practitioner) visits lead to more procedures and therapeutic interventions aimed at preserving arteriovenous fistulas and grafts and improved vascular access outcomes. It found that more frequent face-to-ace provider visits were associated with more procedures and therapeutic interventions aimed at preserving vascular accesses, but not with prolonged vascular access survival.
AHRQ-funded; HS019178.
Citation: Erickson KF, Mell MW, Winkelmayer WC .
Provider visit frequency and vascular access interventions in hemodialysis.
Clin J Am Soc Nephrol 2015 Feb 6;10(2):269-77. doi: 10.2215/cjn.05540614..
Keywords: Care Management, Dialysis, Kidney Disease and Health, Outcomes, Ambulatory Care and Surgery
Pavlik VN, Chan W, Hyman DJ
Designing and evaluating health systems level hypertension control interventions for African-Americans: lessons from a pooled analysis of three cluster randomized trials.
This study conducted a pooled analysis of three projects that aimed to evaluate clinically feasible interventions to effect changes in medical care delivery leading to an increased proportion of African American patients with controlled blood pressure (BP). The analysis of trial results to determine the magnitude of the combined intervention effect found that pooled BP did not differ significantly between intervention and control clusters.
AHRQ-funded; HS021667.
Citation: Pavlik VN, Chan W, Hyman DJ .
Designing and evaluating health systems level hypertension control interventions for African-Americans: lessons from a pooled analysis of three cluster randomized trials.
Curr Hypertens Rev 2015;11(2):123-31..
Keywords: Blood Pressure, Racial and Ethnic Minorities, Healthcare Delivery, Prevention, Care Management
Cagle JG, Zimmerman S, Cohen LW
EMPOWER: an intervention to address barriers to pain management in hospice.
The researchers tested the preliminary efficacy of the Effective Management of Pain: Overcoming Worries to Enable Relief (EMPOWER) intervention. At two weeks, caregivers in the intervention group reported better knowledge about pain management, fewer concerns about pain and pain medications, lower patient pain over the past week, and trended toward improvement in most other areas under study. EMPOWER had a greater effect for black subjects vs. whites on reducing concern about stigma. At three months, the intervention group trended better on most study outcomes. The researchers concluded that EMPOWER is a promising model to reduce barriers to pain management in hospice.
AHRQ-funded; HS019068.
Citation: Cagle JG, Zimmerman S, Cohen LW .
EMPOWER: an intervention to address barriers to pain management in hospice.
J Pain Symptom Manage 2015 Jan;49(1):1-12. doi: 10.1016/j.jpainsymman.2014.05.007.
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Keywords: Care Management, Caregiving, Comparative Effectiveness, Education: Patient and Caregiver, Medication, Pain, Palliative Care
Shaikh U, Berrong J, Nettiksimmons J
Impact of electronic health record clinical decision support on the management of pediatric obesity.
The investigators assessed the impact of electronic health record-based clinical decision support in improving the diagnosis and management of pediatric obesity. They found a statistically significant increase in the diagnosis of overweight/obesity, scheduling of follow-up appointments, frequency of ordering recommended laboratory investigations, and assessment and counseling for nutrition and physical activity.
AHRQ-funded; HS018567.
Citation: Shaikh U, Berrong J, Nettiksimmons J .
Impact of electronic health record clinical decision support on the management of pediatric obesity.
Am J Med Qual 2015 Jan-Feb;30(1):72-80. doi: 10.1177/1062860613517926.
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Keywords: Care Management, Children/Adolescents, Clinical Decision Support (CDS), Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Obesity, Obesity: Weight Management