National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Ambulatory Care and Surgery (1)
- Behavioral Health (1)
- Burnout (1)
- Care Coordination (1)
- Caregiving (1)
- Children/Adolescents (4)
- Chronic Conditions (1)
- Clinician-Patient Communication (1)
- Communication (1)
- Community-Based Practice (1)
- (-) Consumer Assessment of Healthcare Providers and Systems (CAHPS) (29)
- Disparities (1)
- Education: Continuing Medical Education (2)
- Education: Patient and Caregiver (1)
- Emergency Department (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Health Insurance (1)
- Health Literacy (1)
- Health Services Research (HSR) (1)
- Health Status (3)
- Hospital Discharge (1)
- Hospitalization (3)
- Hospital Readmissions (3)
- Hospitals (9)
- Inpatient Care (2)
- Medicare (4)
- Nursing (2)
- Nursing Homes (1)
- Opioids (1)
- Pain (1)
- Patient-Centered Healthcare (3)
- Patient and Family Engagement (1)
- Patient Experience (21)
- Patient Safety (1)
- Practice Patterns (1)
- Prevention (1)
- Primary Care (1)
- Provider Performance (1)
- Quality Improvement (7)
- Quality Indicators (QIs) (2)
- Quality Measures (7)
- Quality of Care (16)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (1)
- Training (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 25 of 29 Research Studies DisplayedHays RD, Mallett JS, Haas A
Associations of CAHPS composites with global ratings of the doctor vary by Medicare beneficiaries' health status.
This study examines whether the association of care coordination with global ratings of one's personal doctor varies by number of chronic conditions and self-rated health. Results were consistent with the hypothesis that patients in worse health weigh care coordination more heavily in global physician assessments than patients in better health. Emphasis on improving care coordination, especially for patients in poorer health, may improve patients' overall assessments of their providers.
AHRQ-funded; HS016980; HS025920.
Citation: Hays RD, Mallett JS, Haas A .
Associations of CAHPS composites with global ratings of the doctor vary by Medicare beneficiaries' health status.
Med Care 2018 Aug;56(8):736-39. doi: 10.1097/mlr.0000000000000942..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Health Status, Medicare, Provider Performance
Quigley DD, Elliott MN, Setodji CM
Quantifying magnitude of group-level differences in patient experiences with health care.
The purpose of this paper is to review approaches for assessing magnitude of differences in patient experience scores between different providers. The authors suggest routine estimation of magnitude in patient experience research. More work is needed documenting magnitude of differences between providers to make patient experience data more interpretable and usable.
AHRQ-funded; HS016980.
Citation: Quigley DD, Elliott MN, Setodji CM .
Quantifying magnitude of group-level differences in patient experiences with health care.
Health Serv Res 2018 Aug;53 Suppl 1:3027-51. doi: 10.1111/1475-6773.12828..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Services Research (HSR), Patient Experience, Patient Experience, Quality Measures
Parast L, Burkhart Q, Gidengil C
Validation of new care coordination quality measures for children with medical complexity.
The purpose of this paper was to validate new caregiver-reported quality measures assessing care coordination services for children with medical complexity (CMC). Results showed that 19 newly-developed Family Experiences with Coordination of Care quality measures demonstrated convergent validity with previously-validated CAHPS measures. These new measures are valid for assessing the quality of care coordination services provided to CMC and may be useful for evaluating new models of care focused on improving these services.
AHRQ-funded; HS020506.
Citation: Parast L, Burkhart Q, Gidengil C .
Validation of new care coordination quality measures for children with medical complexity.
Acad Pediatr 2018 Jul;18(5):581-88. doi: 10.1016/j.acap.2018.03.006..
Keywords: Care Coordination, Children/Adolescents, Chronic Conditions, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care
Al Danaf J, Chang BH, Shaear M
Surfacing and addressing hospitalized patients' needs: proactive nurse rounding as a tool.
This paper reported on rounding interventions employed at high performing hospitals, and provided three case studies on how proactive nurse rounding was successfully implemented to improve patient-centredness. The investigators concluded that proactive rounding interventions are a feasible approach to help surface and address hospitalized patients' needs in a timely manner.
AHRQ-funded; HS021921.
Citation: Al Danaf J, Chang BH, Shaear M .
Surfacing and addressing hospitalized patients' needs: proactive nurse rounding as a tool.
J Nurs Manag 2018 Jul;26(5):540-47. doi: 10.1111/jonm.12580..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitalization, Hospitals, Inpatient Care, Nursing, Patient-Centered Healthcare, Patient Experience, Quality Improvement
Hatfield LA, Zaslavsky AM
Separable covariance models for health care quality measures across years and topics.
Public quality reports for Medicare Advantage health plans include 11 measures of patient experiences reported in the annual Consumer Assessment of Healthcare Providers and Systems surveys. To summarize associations among measures and years, the authors model the variance-covariance matrix governing the plan-level vectors of yearly quality measures as a Kronecker product of an across-measure matrix and an across-year matrix, or a sum of such Kronecker products.
AHRQ-funded; HS016978.
Citation: Hatfield LA, Zaslavsky AM .
Separable covariance models for health care quality measures across years and topics.
Stat Med 2018 May 30;37(12):2053-66. doi: 10.1002/sim.7656..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality Measures, Quality of Care, Patient Experience, Medicare
Parast L, Bardach NS, Burkhart Q
Development of new quality measures for hospital-based care of suicidal youth.
This study researched the value of 4 new quality measures developed to assess hospital-based care for suicidal youth. The four quality measures focused on counseling caregivers about restricting access to lethal means of self-harm, and the benefits and risks of antidepressant medications. They were divided into measures for the emergency department (ED) and inpatient measures. Survey field tests were conducted with caregivers of youth who were admitted to the ED or inpatient care for suicidality at 1 of 2 children’s hospitals between July 2013 and June 2014. Most caregivers did receive counseling about restricting their child’s access to lethal means of self-harm and also reported higher rates of counseling of benefits on antidepressants both in the ED and in the inpatient setting than the risks.
AHRQ-funded; HS020506.
Citation: Parast L, Bardach NS, Burkhart Q .
Development of new quality measures for hospital-based care of suicidal youth.
Acad Pediatr 2018 Apr;18(3):248-55. doi: 10.1016/j.acap.2017.09.017..
Keywords: Caregiving, Children/Adolescents, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Education: Patient and Caregiver, Emergency Department, Hospitalization, Hospitals, Inpatient Care, Behavioral Health, Prevention, Quality of Care, Quality Measures
Shaikh U, Yin HS, Mistry KB
AHRQ Author: Mistry KB
Leveraging medical conferences and webinars for hands-on clinical quality improvement: an intervention to improve health literacy-informed communication in pediatrics.
In this article, the authors describe the process and results with integrating a hands-on quality improvement learning session at the 2016 American Academy of Pediatrics meeting supplemented with virtual peer and expert support through webinars. Their results indicate that this process provided participants with the opportunity to improve clinical care through the use of health literacy–informed communication strategies.
AHRQ-authored.
Citation: Shaikh U, Yin HS, Mistry KB .
Leveraging medical conferences and webinars for hands-on clinical quality improvement: an intervention to improve health literacy-informed communication in pediatrics.
Am J Med Qual 2018 Mar/Apr;33(2):213-15. doi: 10.1177/1062860617719129.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Education: Continuing Medical Education, Health Literacy, Children/Adolescents, Quality Improvement
Yang L, Liu C, Huang C
Patients' perceptions of interactions with hospital staff are associated with hospital readmissions: a national survey of 4535 hospitals.
The researchers examined the extent to which patients' experience with hospital care is related to hospital readmission. Their finding suggests that hospitals with better staff responsiveness were significantly more likely to have lower 30-day readmissions for all conditions. The effect size depended on the baseline readmission rates, with the largest effect on hospitals in the upper 75th quartile.
AHRQ-funded; HS021844.
Citation: Yang L, Liu C, Huang C .
Patients' perceptions of interactions with hospital staff are associated with hospital readmissions: a national survey of 4535 hospitals.
BMC Health Serv Res 2018 Jan 29;18(1):50. doi: 10.1186/s12913-018-2848-9.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Patient Experience, Patient Experience, Hospital Readmissions
Ndumele CD, Cohen MS, Cleary PD
Association of state access standards with accessibility to specialists for Medicaid managed care enrollees.
The researchers compared ratings of access to specialists for adult Medicaid and commercial enrollees before and after the implementation of specialty access standards. Overall, there was no significant improvement in timely access to specialty services for Medicaid managed care enrollees in the period following implementation of standard(s) nor was there any impact of access standards on insurance-based disparities in access.
AHRQ-funded; HS016978; HS017589.
Citation: Ndumele CD, Cohen MS, Cleary PD .
Association of state access standards with accessibility to specialists for Medicaid managed care enrollees.
JAMA Intern Med 2017 Oct;177(10):1445-51. doi: 10.1001/jamainternmed.2017.3766.
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Keywords: Access to Care, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Health Insurance, Patient Experience
Hatfield LA, Zaslavsky AM
Implications of variation in the relationships between beneficiary characteristics and Medicare Advantage CAHPS measures.
The researchers studied how differences in quality score adjustments across Medicare Advantage contracts change comparisons for individuals and contracts. They found that, for average consumers, standard adjustment is sufficient to represent variation in contract quality standardized to a common population. For people with characteristics far from average, personalized reporting using their characteristics and contract-specific coefficients can substantially change the expected quality measures across contracts.
AHRQ-funded; HS016978.
Citation: Hatfield LA, Zaslavsky AM .
Implications of variation in the relationships between beneficiary characteristics and Medicare Advantage CAHPS measures.
Health Serv Res 2017 Aug;52(4):1310-29. doi: 10.1111/1475-6773.12544.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Medicare, Health Status, Patient Experience, Quality of Care, Quality Improvement, Quality Measures
Rinne ST, Castaneda J, Lindenauer PK
Chronic obstructive pulmonary disease readmissions and other measures of hospital quality.
This study examined the association between COPD readmissions and other quality measures. There were modest correlations between COPD readmission rates and readmission rates for other medical conditions, including heart failure , acute myocardial infarction, pneumonia, and stroke . In contrast, it also found low correlations between COPD readmission rates and readmission rates for surgical conditions, as well as mortality rates for all measured conditions.
AHRQ-funded; HS016978.
Citation: Rinne ST, Castaneda J, Lindenauer PK .
Chronic obstructive pulmonary disease readmissions and other measures of hospital quality.
Am J Respir Crit Care Med 2017 Jul 1;196(1):47-55. doi: 10.1164/rccm.201609-1944OC.
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Keywords: Respiratory Conditions, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Hospital Readmissions, Hospitals
Khatri N, Gupta V, Varma A
The relationship between HR capabilities and quality of patient care: the mediating role of proactive work behaviors.
The researchers developed a multidimensional construct of human resource (HR) capabilities and tested its relationship with quality of patient care using a national sample of U.S. hospitals. Their analyses using structural equation modeling suggest that the positive relationship of HR capabilities with quality of patient care is mediated by proactive behaviors of health care workers. Implications of the study findings for research and practice are discussed.
AHRQ-funded; HS017549.
Citation: Khatri N, Gupta V, Varma A .
The relationship between HR capabilities and quality of patient care: the mediating role of proactive work behaviors.
Hum Resour Manage 2017 Jul-Aug;56(4):673-91. doi: 10.1002/hrm.21794.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Quality of Care, Patient Experience, Patient Experience
Henke RM, Karaca Z, Jackson P
AHRQ Author: Karaca Z; Wong HS
Discharge planning and hospital readmissions.
This study examines the association between the quality of hospital discharge planning and all-cause 30-day readmissions and same-hospital readmissions. Discharge-planning quality was associated with (a) lower rates of 30-day hospital readmissions and (b) higher rates of same-hospital readmissions for heart failure, pneumonia, and total hip or joint replacement. These results suggest that by improving inpatient discharge planning, hospitals may be able to influence their 30-day readmissions.
AHRQ-authored; AHRQ-funded.
Citation: Henke RM, Karaca Z, Jackson P .
Discharge planning and hospital readmissions.
Med Care Res Rev 2017 Jun;74(3):345-68. doi: 10.1177/1077558716647652.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospital Discharge, Hospital Readmissions, Hospitals, Hospitalization
Lee JS, Hu HM, Brummett CM
Postoperative opioid prescribing and the pain scores on Hospital Consumer Assessment of Healthcare Providers and Systems Survey.
The researchers sought to evaluate the association between the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) pain measures and postoperative opioid prescribing in surgical patients, which accounts for nearly 40 percent of surgical prescriptions. They found that postoperative opioid prescribing was not correlated with HCAHPS pain measures.
AHRQ-funded; HS023313.
Citation: Lee JS, Hu HM, Brummett CM .
Postoperative opioid prescribing and the pain scores on Hospital Consumer Assessment of Healthcare Providers and Systems Survey.
JAMA 2017 May 16;317(19):2013-15. doi: 10.1001/jama.2017.2827.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Opioids, Pain, Patient Experience
Roberts ET, Mehrotra A, McWilliams JM
High-price and low-price physician practices do not differ significantly on care quality or efficiency.
The researchers examined the relationship between physician practice prices for outpatient services and practices' quality and efficiency of care. Patients of high-price practices reported significantly higher scores on some measures of care coordination and management but did not differ meaningfully in their overall care ratings, receipt of preventive services, acute care use, or total Medicare spending.
AHRQ-funded; HS024072.
Citation: Roberts ET, Mehrotra A, McWilliams JM .
High-price and low-price physician practices do not differ significantly on care quality or efficiency.
Health Aff 2017 May;36(5):855-64. doi: 10.1377/hlthaff.2016.1266.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Healthcare Costs, Practice Patterns
Toomey SL, Elliott MN, Zaslavsky AM
Variation in family experience of pediatric inpatient care as measured by child HCAHPS.
Making national comparisons of family experience of inpatient pediatric care has been limited by the lack of a publicly available survey. A new survey developed by AHRQ and the Centers for Medicare & Medicaid Services makes use of 18 measures. It found that family experience of pediatric inpatient care shows substantial room for improvement and varies considerably across hospitals and measures.
AHRQ-funded; HS020513.
Citation: Toomey SL, Elliott MN, Zaslavsky AM .
Variation in family experience of pediatric inpatient care as measured by child HCAHPS.
Pediatrics 2017 Apr;139(4):e20163372. doi: 10.1542/peds.2016-3372.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Patient Experience, Patient Experience, Quality of Care
Martino SC, Shaller D, Schlesinger M
CAHPS and comments: how closed-ended survey questions and narrative accounts interact in the assessment of patient experience.
The authors investigated whether content from patient narratives explains variation in patients' primary care provider (PCP) ratings beyond information from the closed-ended questions of CAHPS Clinician and Group Survey and whether the relative placement of closed- and open-ended survey questions affects either the content of narratives or the CAHPS composite scores. They found that incorporating a protocol for eliciting narratives into a patient experience survey resulted in minimal distortion of patient feedback, and narratives from sicker patients helped explain variation in provider ratings.
AHRQ-funded; HS016980; HS016978; HS021858.
Citation: Martino SC, Shaller D, Schlesinger M .
CAHPS and comments: how closed-ended survey questions and narrative accounts interact in the assessment of patient experience.
J Patient Exp 2017 Mar;4(1):37-45. doi: 10.1177/2374373516685940.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Primary Care, Quality of Care, Quality Measures
Oladeru OA, Hamadu M, Cleary PD
House staff communication training and patient experience scores.
The purpose of this study was to assess whether communication training for housestaff via role-playing exercises (1) was well-received and (2) improved patient experience scores in housestaff clinics. Forty-four of a possible 45 housestaff (97.8%) participated, with 31 (70.5%) indicating that the role-playing exercise increased their perception of the 5-step strategy the study emphasized.
AHRQ-funded; HS016978.
Citation: Oladeru OA, Hamadu M, Cleary PD .
House staff communication training and patient experience scores.
J Patient Exp 2017 Mar 1;4(1):28-36. doi: 10.1177/2374373517694533..
Keywords: Communication, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Patient Experience, Training
Martsolf GR, Gibson TB, Benevent R
AHRQ Author: Jiang HJ, Stocks C
An examination of hospital nurse staffing and patient experience with care: Differences between cross-sectional and longitudinal estimates.
The researchers studied the association between hospital nurse staffing and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. After controlling for unobserved hospital characteristics, they found that the positive influences of increased nurse staffing levels and skill mix were relatively small in size and limited to a few measures of patients' inpatient experience.
AHRQ-authored.
Citation: Martsolf GR, Gibson TB, Benevent R .
An examination of hospital nurse staffing and patient experience with care: Differences between cross-sectional and longitudinal estimates.
Health Serv Res 2016 Dec;51(6):2221-41. doi: 10.1111/1475-6773.12462.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Nursing, Patient Experience, Patient Experience, Healthcare Cost and Utilization Project (HCUP)
Melnick ER, Powsner SM
Empathy in the time of burnout.
The authors argue that before adding empathy measurements to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, it would be wise to consider that measurement fatigue contributes to burnout. Adding empathy measurements might reduce empathy: a perverse Hawthorne effect. A health care system hoping for more substantial physician-patient relationships must invest more in the well-being of its caregivers.
AHRQ-funded; HS021271.
Citation: Melnick ER, Powsner SM .
Empathy in the time of burnout.
Mayo Clin Proc 2016 Dec;91(12):1678-79. doi: 10.1016/j.mayocp.2016.09.003.
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Keywords: Burnout, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Patient Experience
Rajaram R, Saddat L, Chung J
Impact of the 2011 ACGME resident duty hour reform on hospital patient experience and processes-of-care.
The investigators evaluated the association between resident duty hour reform and measures of processes-of-care and patient experience. They concluded that the 2011 Accreditation Council for Graduate Medical Education duty hour reform was not associated with improvements in process-of-care and patient experience measures.
AHRQ-funded; HS000078.
Citation: Rajaram R, Saddat L, Chung J .
Impact of the 2011 ACGME resident duty hour reform on hospital patient experience and processes-of-care.
BMJ Qual Saf 2016 Dec;25(12):962-70. doi: 10.1136/bmjqs-2015-004794.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Education: Continuing Medical Education, Quality of Care, Patient Experience, Patient Safety
Bilimoria KY, Barnard C
The new CMS Hospital Quality Star Ratings: the stars are not aligned.
This viewpoint paper discussed the Overall Hospital Quality Star Ratings, released by the Centers for Medicare and Medicaid Services, including issues concerning stakeholders. The authors recommended continuing vigorous work to improve the availability of meaningful measures. They concluded that current hospital rating systems do not provide comprehensive, relevant, accessible information, and current composites may mislead patients, payers, and hospitals; however, opportunities to provide meaningful hospital quality report cards are within reach.
AHRQ-funded; HS021857; HS024516.
Citation: Bilimoria KY, Barnard C .
The new CMS Hospital Quality Star Ratings: the stars are not aligned.
JAMA 2016 Nov 1;316(17):1761-62. doi: 10.1001/jama.2016.13679.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Hospitals, Quality Improvement, Quality Measures
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
Cleary PD
Evolving concepts of patient-centered care and the assessment of patient care experiences: optimism and opposition.
Improving the infrastructure supporting certain aspects of care may have broad effects because system changes can influence multiple outcomes. Thus, rather than detract from general quality improvement efforts, making changes that facilitate patient-centered care may lead to broader improvements. There is good reason to be optimistic that our health care system will increasingly be "patient centered."
AHRQ-funded; HS016978.
Citation: Cleary PD .
Evolving concepts of patient-centered care and the assessment of patient care experiences: optimism and opposition.
J Health Polit Policy Law 2016 Aug;41(4):675-96. doi: 10.1215/03616878-3620881.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient-Centered Healthcare, Patient Experience, Quality of Care, Quality Improvement
Mukamel DB, Amin A, Weimer DL
When patients customize nursing home ratings, choices and rankings differ from the government's version.
Report cards currently published by the Centers for Medicare and Medicaid Services (CMS) offer composite quality measures, such as the one featured on the Nursing Home Compare website. Nursing Home Compare Plus is an alternative that allows patients and their families to create their own composite scores based on their own preferences and medical needs. When comparing Nursing Home Compare Plus to Medicare's five-star ratings, we found only minimal agreement on ranking of nursing homes.
AHRQ-funded; HS021844.
Citation: Mukamel DB, Amin A, Weimer DL .
When patients customize nursing home ratings, choices and rankings differ from the government's version.
Health Aff 2016 Apr;35(4):714-9. doi: 10.1377/hlthaff.2015.1340.
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Keywords: Nursing Homes, Quality of Care, Quality Indicators (QIs), Patient Experience, Consumer Assessment of Healthcare Providers and Systems (CAHPS)