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
101 to 125 of 134 Research Studies DisplayedLaccetti AL, Pruitt SL, Xuan L
Prior cancer does not adversely affect survival in locally advanced lung cancer: a national SEER-Medicare analysis.
Researchers identified patients > 65 years of age diagnosed 1992-2009 with locally advanced lung cancer in the Surveillance, Epidemiology, and End Results-Medicare linked dataset. They found that, for patients with locally advanced lung cancer, prior cancer does not adversely impact clinical outcomes. Patients with locally advanced lung cancer and a history of prior cancer should not be excluded from clinical trials.
AHRQ-funded; HS022418.
Citation: Laccetti AL, Pruitt SL, Xuan L .
Prior cancer does not adversely affect survival in locally advanced lung cancer: a national SEER-Medicare analysis.
Lung Cancer 2016 Aug;98:106-13. doi: 10.1016/j.lungcan.2016.05.029.
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Keywords: Elderly, Cancer: Lung Cancer, Medicare, Mortality, Patient-Centered Outcomes Research
Colantonio LD, Kent ST, Kilgore ML
Agreement between Medicare pharmacy claims, self-report, and medication inventory for assessing lipid-lowering medication use.
This paper analyzed the agreement between Medicare claims for lipid-lowering medication (LLM) and LLM use. Many Medicare beneficiaries reporting LLM use or having LLMs in a medication inventory have no claims for these medications.
AHRQ-funded; HS018517.
Citation: Colantonio LD, Kent ST, Kilgore ML .
Agreement between Medicare pharmacy claims, self-report, and medication inventory for assessing lipid-lowering medication use.
Pharmacoepidemiol Drug Saf 2016 Jul;25(7):827-35. doi: 10.1002/pds.3970.
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Keywords: Medicare, Medication, Elderly, Racial and Ethnic Minorities, Data
Wang Y, Eldridge N, Metersky ML
AHRQ Author: Eldridge N
Association between hospital performance on patient safety and 30-day mortality and unplanned readmission for Medicare fee-for-service patients with acute myocardial infarction.
The researchers studied the relationship between hospital performance on adverse event rates and hospital performance on 30-day mortality and unplanned readmission rates for Medicare fee-for-service patients hospitalized for acute myocardial infarction (AMI). They found that for Medicare fee-for-service patients discharged with AMI, hospitals with poorer patient safety performance were also more likely to have poorer performance on 30-day all-cause mortality and on unplanned readmissions.
AHRQ-authored.
Citation: Wang Y, Eldridge N, Metersky ML .
Association between hospital performance on patient safety and 30-day mortality and unplanned readmission for Medicare fee-for-service patients with acute myocardial infarction.
J Am Heart Assoc 2016 Jul;5(7):pii: e003731. doi: 10.1161/jaha.116.003731.
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Keywords: Adverse Events, Hospital Readmissions, Hospitals, Medicare, Mortality, Heart Disease and Health, Patient Safety, Provider Performance
Coulam R, Kralewski J, Dowd B
The role of medical group practice administrators in the adoption and implementation of Medicare's physician quality reporting system.
The purpose of this study was to gain insights into the role these administrators play in quality assurance programs. It found that administrators conducted due diligence on Medicare's physician quality reporting system, influenced how the issue was presented to physicians for adoption, and managed implementation thereafter. Administrators' recommendations were heavily influenced by practice characteristics, financial incentives, and practice commitments to early adoption of quality improvement innovations.
AHRQ-funded; HS019964.
Citation: Coulam R, Kralewski J, Dowd B .
The role of medical group practice administrators in the adoption and implementation of Medicare's physician quality reporting system.
Health Care Manage Rev 2016 Apr-Jun;41(2):145-54. doi: 10.1097/hmr.0000000000000061.
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Keywords: Medicare, Provider Performance, Quality Improvement, Quality of Care, Public Reporting
Chen J, Hsieh AF, Dharmarajan K
National trends in heart failure hospitalization after acute myocardial infarction for Medicare beneficiaries: 1998-2010.
This study used a complete national sample of 2 789 943 AMI hospitalizations of Medicare fee-for-service beneficiaries from 1998 through 2010, we evaluated annual changes in the incidence of subsequent heart failure (HF) hospitalization and mortality using Poisson and survival analysis models. It found that HF hospitalization after AMI decreased from 1998 to 2010, which may indicate improvements in the management of AMI.
AHRQ-funded; HS018781.
Citation: Chen J, Hsieh AF, Dharmarajan K .
National trends in heart failure hospitalization after acute myocardial infarction for Medicare beneficiaries: 1998-2010.
Circulation 2013 Dec 17;128(24):2577-84. doi: 10.1161/circulationaha.113.003668..
Keywords: Hospitalization, Medicare, Heart Disease and Health, Mortality
Silber JH, Satopaa VA, Mukherjee N
Improving Medicare's Hospital Compare mortality model.
The researchers sought to improve the predictions provided by Medicare's Hospital Compare (HC) to facilitate better informed decisions regarding hospital choice by the public. Their model produces very different predictions from the current HC model, with higher predicted mortality rates at hospitals with lower volume and worse characteristics. The expanded model would advise patients against seeking treatment at the smallest hospitals with worse technology and staffing.
AHRQ-funded; HS021854.
Citation: Silber JH, Satopaa VA, Mukherjee N .
Improving Medicare's Hospital Compare mortality model.
Health Serv Res 2016 Jun;51 Suppl 2:1229-47. doi: 10.1111/1475-6773.12478.
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Keywords: Hospitals, Mortality, Medicare
Goedken AM, Lund BC, Cook EA
Application of a framework for determining number of drugs.
The purpose of the study was to propose a framework and illustrate how that framework can be used to create and succinctly describe various approaches to counting the number of drugs used by patients and to examine the impact of varying individual components of the framework on the resulting drug count.
AHRQ-funded; HS018381.
Citation: Goedken AM, Lund BC, Cook EA .
Application of a framework for determining number of drugs.
BMC Res Notes 2016 May 13;9:272. doi: 10.1186/s13104-016-2076-5.
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Keywords: Medication, Research Methodologies, Heart Disease and Health, Medicare
Das A, Norton EC, Miller DC
Adding a spending metric to Medicare's value-based purchasing program rewarded low-quality hospitals.
In fiscal year 2015 the Centers for Medicare and Medicaid Services expanded its Hospital Value-Based Purchasing program by rewarding or penalizing hospitals for their performance on both spending and quality. Using data from 2,679 US hospitals that participated in the program in fiscal years 2014 and 2015, researchers found that the new emphasis on spending rewarded not only low-spending hospitals but some low-quality hospitals as well.
AHRQ-funded; HS020671.
Citation: Das A, Norton EC, Miller DC .
Adding a spending metric to Medicare's value-based purchasing program rewarded low-quality hospitals.
Health Aff 2016 May;35(5):898-906. doi: 10.1377/hlthaff.2015.1190.
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Keywords: Medicare, Provider Performance, Payment, Hospitals, Healthcare Costs, Quality of Care
Kim EH, Vetter JM, Kuxhausen AN
Limited use of surveillance imaging following nephrectomy for renal cell carcinoma.
The researchers evaluated the utilization of follow-up imaging after nephrectomy for renal cell carcinoma (RCC) in nationally representative data. Using Surveillance, Epidemiology, End Results (SEER) data, they found that, in the Medicare population, surveillance imaging is performed in a limited number of patients following nephrectomy for RCC but that increasing tumor stage is predictive of both increased chest and abdominal imaging surveillance.
AHRQ-funded; HS019455.
Citation: Kim EH, Vetter JM, Kuxhausen AN .
Limited use of surveillance imaging following nephrectomy for renal cell carcinoma.
Urol Oncol 2016 May;34(5):237.e11-8. doi: 10.1016/j.urolonc.2015.11.017.
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Keywords: Cancer, Healthcare Utilization, Imaging, Medicare
Callaghan BC, Burke JF, Skolarus LE
Medicare's reimbursement reduction for nerve conduction studies: effect on use and payments.
The purpose of this research letter was to investigate the effect of the sharp reduction in Medicare reimbursement for electromyography (EMG) while the reimbursement for nerve conduction studies (NCS) remained unchanged. They found that the use of EMG by neurologists and physiatrists changed little, whereas a decrease in its use among other health care providers was observed. They concluded that the pattern of change in use of EMG and NCS suggests findings similar to those in past studies of Medicare reimbursement with regard to reducing inappropriate, but not appropriate, testing and treatment.
AHRQ-funded; HS022258.
Citation: Callaghan BC, Burke JF, Skolarus LE .
Medicare's reimbursement reduction for nerve conduction studies: effect on use and payments.
JAMA Intern Med 2016 May;176(5):697-9. doi: 10.1001/jamainternmed.2016.0162.
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Keywords: Diagnostic Safety and Quality, Healthcare Costs, Payment, Medicare
Singh G, Zhang W, Kuo YF
Association of psychological disorders with 30-day readmission rates in patients with COPD.
Using a 5 percent sample of Medicare beneficiaries, the researchers examined the association of psychological disorders such as depression, anxiety, psychosis, alcohol abuse and drug abuse with early readmission for patients with COPD. They found that psychological disorders like depression, anxiety, psychosis, alcohol abuse and drug abuse are independently associated with higher all-cause 30-day readmission rates for Medicare beneficiaries with COPD.
AHRQ-funded; HS020642; HS022134.
Citation: Singh G, Zhang W, Kuo YF .
Association of psychological disorders with 30-day readmission rates in patients with COPD.
Chest 2016 Apr;149(4):905-15. doi: 10.1378/chest.15-0449..
Keywords: Behavioral Health, Hospital Readmissions, Medicare, Respiratory Conditions
Mukamel DB, White LM, Nocon RS
AHRQ Author: Ngo-Metzger Q
Comparing the cost of caring for Medicare beneficiaries in federally funded health centers to other care settings.
The purpose of this study was to compare total annual costs for Medicare beneficiaries receiving primary care in federally funded health centers (HCs) to Medicare beneficiaries in physician offices and outpatient clinics. It found that total median annual costs (at $2,370) for HC Medicare patients were lower by 10 percent compared to patients in physician offices ($2,667) and by 30 percent compared to patients in outpatient clinics ($3,580).
AHRQ-authored.
Citation: Mukamel DB, White LM, Nocon RS .
Comparing the cost of caring for Medicare beneficiaries in federally funded health centers to other care settings.
Health Serv Res 2016 Apr;51(2):625-44. doi: 10.1111/1475-6773.12339..
Keywords: Medicare, Healthcare Costs, Primary Care
Farris KB, Salgado TM, Aneese N
Effect of clinical and attitudinal characteristics on obtaining comprehensive medication reviews.
The researchers sought to quantify the association between attitudinal and clinical factors with intention and predict future behavior to obtain a comprehensive medication reviews (CMR) among Medicare Part D beneficiaries. They found that worrying about medications doing more harm than good, number of pharmacies where participants obtained their medications from, number of medications, and number of medical conditions predicted intention to obtain a CMR.
AHRQ-funded; HS018353.
Citation: Farris KB, Salgado TM, Aneese N .
Effect of clinical and attitudinal characteristics on obtaining comprehensive medication reviews.
J Manag Care Spec Pharm 2016 Apr;22(4):388-95. doi: 10.18553/jmcp.2016.22.4.388.
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Keywords: Medication, Medicare, Elderly, Medication: Safety, Patient Adherence/Compliance
Keohane LM, Rahman M, Mor V
Reforming access: trends in Medicaid enrollment for new Medicare beneficiaries, 2008-2011.
This study evaluated whether aligning the Part D low-income subsidy and Medicaid program enrollment pathways in 2010 increased Medicaid participation among new Medicare beneficiaries. It found that the percentage of beneficiaries enrolling in limited Medicaid at the start of Medicare coverage increased in 2010 by 0.3 percentage points for individuals aging into Medicare and by 1.3 percentage points for those qualifying due to disability.
AHRQ-funded; HS000011.
Citation: Keohane LM, Rahman M, Mor V .
Reforming access: trends in Medicaid enrollment for new Medicare beneficiaries, 2008-2011.
Health Serv Res 2016 Apr;51(2):550-69. doi: 10.1111/1475-6773.12349.
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Keywords: Medicare, Medicaid, Policy, Access to Care, Social Determinants of Health
Nguyen OK, Makam AN, Halm EA
National use of safety-net clinics for primary care among adults with non-Medicaid insurance in the United States.
This study described the prevalence, characteristics, and predictors of safety-net use for primary care among non-Medicaid insured adults (i.e., those with private insurance or Medicare). It concluded that safety net clinics are important primary care delivery sites for non-Medicaid insured minority and low-income populations with a high burden of chronic illness.
AHRQ-funded; HS022418.
Citation: Nguyen OK, Makam AN, Halm EA .
National use of safety-net clinics for primary care among adults with non-Medicaid insurance in the United States.
PLoS One 2016 Mar 30;11(3):e0151610. doi: 10.1371/journal.pone.0151610.
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Keywords: Primary Care, Health Insurance, Medicare, Low-Income, Healthcare Delivery
Fonarow GG, Liang L, Thomas L
Assessment of home-time after acute ischemic stroke in Medicare beneficiaries.
The researchers evaluated home-time as a patient-centered outcome in Medicare beneficiaries with ischemic stroke in comparison with modified Rankin Scale (mRS) score at 90 days and at 1 year post event. They concluded that in a population of older patients with ischemic stroke, home-time was readily available from administrative data and associated with mRS at 90 days and 1 year.
AHRQ-funded; HS019479; HS016964.
Citation: Fonarow GG, Liang L, Thomas L .
Assessment of home-time after acute ischemic stroke in Medicare beneficiaries.
Stroke 2016 Mar;47(3):836-42. doi: 10.1161/strokeaha.115.011599.
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Keywords: Medicare, Stroke, Elderly, Home Healthcare, Patient-Centered Outcomes Research
Chen LM, Norton EC, Birkmeyer JD
Comparing approaches to controlling Medicare spending.
For 3 common surgical procedures (coronary artery bypass grafting (CABG), prostatectomy, and hip replacement), the researchers compared the relative influence of procedure rates versus episode payments (among those with procedures) on total Medicare expenditures. Using complete Part A and B Medicare claims data, they found that reducing procedure rates lowers total Medicare spending substantially more than reducing episode payments.
AHRQ-funded; HS020671.
Citation: Chen LM, Norton EC, Birkmeyer JD .
Comparing approaches to controlling Medicare spending.
J Hosp Med 2016 Mar;11(3):215-6. doi: 10.1002/jhm.2527.
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Keywords: Medicare, Healthcare Costs, Surgery
Driessen J, Baik SH, Zhang Y
Explaining improved use of high-risk medications in Medicare between 2007 and 2011.
The researchers explored the reasons for the great decline in the use of high-risk medications between 2007 and 2011. They found that the FDA’s ban on propoxyphene beginning in 2010 led to the huge decrease in high-risk prescribing. For non-propoxyphene drugs included in the high-risk measure, the rate of prescribing showed minimal improvement, decreasing from 21.0 percent to 18.6 percent from 2007 to 2011.
AHRQ-funded; HS018657.
Citation: Driessen J, Baik SH, Zhang Y .
Explaining improved use of high-risk medications in Medicare between 2007 and 2011.
J Am Geriatr Soc 2016 Mar;64(3):674-6. doi: 10.1111/jgs.14000.
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Keywords: Medication, Medicare
DeVore AD, Hammill BG, Hardy NC
Has public reporting of hospital readmission rates affected patient outcomes?: Analysis of Medicare claims data.
Following the implementation of Centers for Medicare & Medicaid Services (CMS) public reporting, this study assessed trends of 30-day readmission rates and post-discharge care for patients discharged with acute myocardial infarction (MI), heart failure (HF), or pneumonia. It found that the release of the CMS public reporting of hospital readmission rates did not change 30-day readmission trends for MI, HF, or pneumonia, but it was associated with less hospital-based acute care for HF.
AHRQ-funded; HS021092.
Citation: DeVore AD, Hammill BG, Hardy NC .
Has public reporting of hospital readmission rates affected patient outcomes?: Analysis of Medicare claims data.
J Am Coll Cardiol 2016 Mar 1;67(8):963-72. doi: 10.1016/j.jacc.2015.12.037.
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Keywords: Public Reporting, Hospital Readmissions, Outcomes, Medicare, Patient-Centered Outcomes Research
Berry SA, Fleishman JA, Moore RD
AHRQ Author: Fleishman JA
Thirty-day hospital readmissions for adults with and without HIV infection.
This study compared 30-day readmission rates by HIV status in a multi-state sample with planned subgroup comparisons by insurance and diagnostic categories. After adjustment for age, gender, race, insurance, and diagnostic category, HIV infection was associated with 1.5 times higher odds of readmission. Predicted, adjusted readmission rates were higher for persons living with HIV within every insurance category, including Medicaid.
AHRQ-authored.
Citation: Berry SA, Fleishman JA, Moore RD .
Thirty-day hospital readmissions for adults with and without HIV infection.
HIV Med 2016 Mar;17(3):167-77. doi: 10.1111/hiv.12287.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Human Immunodeficiency Virus (HIV), Hospital Readmissions, Medicaid, Medicare
Wang SY, Hall J, Pollack CE
Trends in end-of-life cancer care in the Medicare program.
The researchers sought to examine contemporary trends in end-of-life cancer care and geographic variation of end-of-life care aggressiveness among Medicare beneficiaries. They found that the proportion of beneficiaries receiving at least one potentially aggressive end-of-life intervention increased in repeated hospitalization, repeated ED visits, ICU admissions, and late hospice enrollment but declined in in-hospital death. End-of-life chemotherapy use did not change significantly over time. They concluded that despite growing focus on providing appropriate end-of-life care, there has not been an improvement in aggressive end-of-life cancer care in the Medicare program.
AHRQ-funded; HS023900.
Citation: Wang SY, Hall J, Pollack CE .
Trends in end-of-life cancer care in the Medicare program.
J Geriatr Oncol 2016 Mar;7(2):116-25. doi: 10.1016/j.jgo.2015.11.007.
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Keywords: Cancer, Care Management, Elderly, Medicare, Palliative Care, Outcomes, Patient-Centered Outcomes Research, Practice Patterns
Dubberke ER, Olsen MA, Stwalley D
Identification of Medicare recipients at highest risk for Clostridium difficile infection in the US by population attributable risk analysis.
This study determined the population attributable risk percent (PAR%) for Clostridium difficile infection (CDI) in various subpopulations in the Medicare 5% random sample. It found that small and identifiable subpopulations that account for relatively large proportions of CDI cases in the elderly were identified. These data can be used to target specific subpopulations for CDI prevention interventions.
AHRQ-funded; HS019455.
Citation: Dubberke ER, Olsen MA, Stwalley D .
Identification of Medicare recipients at highest risk for Clostridium difficile infection in the US by population attributable risk analysis.
PLoS One 2016 Feb 9;11(2):e0146822. doi: 10.1371/journal.pone.0146822.
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Keywords: Medicare, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Risk
Raval AD, Madhavan S, Mattes MD
Impact of prostate cancer diagnosis on noncancer hospitalizations among elderly Medicare Beneficiaries with incident prostate cancer.
The authors analyzed the impact of cancer diagnosis on noncancer hospitalizations (NCHs) by comparing these hospitalizations between the precancer and postcancer periods. They found that the rate of NCHs was higher during the postcancer period compared with the precancer period. They suggested that their study highlights the need to design interventions for reducing the excess NCHs after prostate cancer diagnosis among elderly men.
AHRQ-funded; HS018622.
Citation: Raval AD, Madhavan S, Mattes MD .
Impact of prostate cancer diagnosis on noncancer hospitalizations among elderly Medicare Beneficiaries with incident prostate cancer.
J Natl Compr Canc Netw 2016 Feb;14(2):186-94.
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Keywords: Elderly, Hospitalization, Medicare, Cancer: Prostate Cancer
Hays RD, Mallett JS, Gaillot S
Performance of the Medicare Consumer Assessment of Health Care Providers and Systems (CAHPS) physical functioning items.
This study evaluated physical functioning items in Medicare beneficiaries. It concluded that the physical functioning items target relatively easy activities, providing information for a minority of people in the sample with the lowest levels of physical functioning. Items representing higher levels of physical functioning are needed for the majority of the Medicare beneficiaries.
AHRQ-funded; HS016980.
Citation: Hays RD, Mallett JS, Gaillot S .
Performance of the Medicare Consumer Assessment of Health Care Providers and Systems (CAHPS) physical functioning items.
Med Care 2016 Feb;54(2):205-9. doi: 10.1097/mlr.0000000000000475..
Keywords: Medicare, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Status, Quality Improvement
Grenda TR, Krell RW, Dimick JB
Reliability of hospital cost profiles in inpatient surgery.
This study sought to discover whether Medicare payments for surgery can reliably compare hospital costs. It found that episode payments for inpatient surgery are a reliable measure of hospital costs for commonly performed procedures, but are less reliable for lower volume operations. These findings suggest that hospital cost profiles based on Medicare claims data may be used to benchmark efficiency, especially for more common procedures.
AHRQ-funded; HS000053.
Citation: Grenda TR, Krell RW, Dimick JB .
Reliability of hospital cost profiles in inpatient surgery.
Surgery 2016 Feb;159(2):375-80. doi: 10.1016/j.surg.2015.06.043..
Keywords: Inpatient Care, Surgery, Healthcare Costs, Medicare, Data