National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Care Coordination (1)
- Children/Adolescents (2)
- Clinician-Patient Communication (3)
- Communication (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (9)
- Education: Continuing Medical Education (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (1)
- Health Systems (1)
- Hospital Discharge (1)
- Hospitalization (1)
- Hospitals (7)
- Implementation (1)
- Inpatient Care (2)
- Maternal Care (1)
- Medicare (2)
- Nursing Homes (2)
- Patient-Centered Healthcare (3)
- Patient and Family Engagement (4)
- (-) Patient Experience (19)
- Patient Safety (2)
- Pregnancy (1)
- Primary Care (2)
- Primary Care: Models of Care (2)
- Provider (1)
- Provider: Physician (1)
- Provider Performance (3)
- Public Reporting (1)
- Quality Improvement (7)
- Quality Indicators (QIs) (3)
- Quality Measures (3)
- (-) Quality of Care (19)
- Sleep Problems (1)
- Social Determinants of Health (1)
- Surgery (1)
- Transitions of Care (1)
- Transplantation (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 19 of 19 Research Studies DisplayedHeinze K, Suwanabol PA, Vitous CA
A survey of patient perspectives on approach to health care: focus on physician competency and compassion.
This study is a cross-sectional survey of 764 patients to gain insight into perceptions of physician qualities of compassion and competence. The participants response rate was 85%, with mean age 52.4, 70.8% female, and 84% identified as white. Predictors of compassion over competence included female gender and whether the respondent had a personal connection to the vignette used. Preferences were found to be influenced by: 1) explicit beliefs regarding the value of physician compassion and competence; 2) impact of emotional and mental health on medical experiences; 3) type and frequency of health care exposure, and; 4) perceived role of the physician in various clinical vignettes.
AHRQ-funded; HS026772.
Citation: Heinze K, Suwanabol PA, Vitous CA .
A survey of patient perspectives on approach to health care: focus on physician competency and compassion.
J Patient Exp 2020 Dec;7(6):1044-53. doi: 10.1177/2374373520968447..
Keywords: Provider: Physician, Provider, Patient Experience, Provider Performance, Quality of Care
Quigley DD, Qureshi N, Masarweh LA
Practice leaders report targeting several types of changes in care experienced by patients during patient-centered medical home transformation.
This study looked at how primary care practices implemented changes during the transition to becoming a patient-centered medical home (PCMH). The authors examined 105 primary care practice leader experiences during PCMH transformation using semi-structured interviews. Practices most commonly targeted changes in care coordination (30%), access to care (25%), and provider communication (24%). Reported areas for PCMH transformation were measured by Clinician & Group CAHPS, PCMH CAHPS, or supplemental CAHPS survey items, including team-based care (35%), providing more on-site services (28%), care management (22%), patient-centered culture (18%), and chronic condition health education (13%). Many PCMH changes are captured by CAHPS survey items, but some are not.
AHRQ-funded; HS025920.
Citation: Quigley DD, Qureshi N, Masarweh LA .
Practice leaders report targeting several types of changes in care experienced by patients during patient-centered medical home transformation.
J Patient Exp 2020 Dec;7(6):1509-18. doi: 10.1177/2374373520934231..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare, Patient Experience, Care Coordination, Quality Improvement, Quality of Care, Implementation
Aysola J, Xu C, Huo H
The relationships between patient experience and quality and utilization of primary care services.
This study examined the associations between visit-triggered patient-reported experience measures and both quality of care measures and the number of missed primary care appointments. A cross-sectional analysis of 8355 primary care patients from 22 primary care practices was conducted. Outcomes measured included: smoking cessation discussion, diabetes eye examination referral, mammography, colonoscopy screening, current smoking status, diabetes control hemoglobin A1c, blood pressure control, cholesterol control LDL among patients with diabetes, and visit no shows 2 and 5 years after the index visit. The authors found that patient experience can be an important stand-alone metric of care quality, although it may not relate to clinical outcomes or process measures in the outpatient setting.
AHRQ-funded; HS021706.
Citation: Aysola J, Xu C, Huo H .
The relationships between patient experience and quality and utilization of primary care services.
J Patient Exp 2020 Dec;7(6):1678-84. doi: 10.1177/2374373520924190..
Keywords: Patient Experience, Primary Care, Primary Care: Models of Care, Patient-Centered Healthcare, Quality Improvement, Quality of Care
Short MN, Ho V
Weighing the effects of vertical integration versus market concentration on hospital quality.
Provider organizations are increasing in complexity, as hospitals acquire physician practices and physician organizations grow in size. At the same time, hospitals are merging with each other to improve bargaining power with insurers. In this study, the investigators analyzed 29 quality measures reported to the Center for Medicare and Medicaid Services' Hospital Compare database for 2008 to 2015 to test whether vertical integration between hospitals and physicians or increases in hospital market concentration influenced patient outcomes.
AHRQ-funded; HS024727.
Citation: Short MN, Ho V .
Weighing the effects of vertical integration versus market concentration on hospital quality.
Med Care Res Rev 2020 Dec;77(6):538-48. doi: 10.1177/1077558719828938.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Patient Experience, Hospitals, Medicare, Provider Performance, Health Systems
Schlesinger M, Grob R, Shaller D
A rigorous approach to large-scale elicitation and analysis of patient narratives.
Patient narratives have emerged as promising vehicles for making health care more responsive by helping clinicians to better understand their patients' expectations, perceptions, or concerns and encouraging consumers to engage with information about quality. In this article, the investigators offer the first empirical test of the proposition that patient narratives can be elicited rigorously and reliably using a five-question protocol that can be incorporated into large-scale patient experience surveys.
AHRQ-funded; HS021858; HS016978; HS016980; HS025920.
Citation: Schlesinger M, Grob R, Shaller D .
A rigorous approach to large-scale elicitation and analysis of patient narratives.
Med Care Res Rev 2020 Oct;77(5):416-27. doi: 10.1177/1077558718803859..
Keywords: Patient Experience, Quality Improvement, Quality of Care
Mouch CA, Baskin AS, Yearling R CA, Baskin AS, Yearling R
Sleep patterns and quality among inpatients recovering from elective surgery: a mixed-method study.
This study examined sleep quality and barriers to sleep among adult hospital inpatients recovering from elective surgery. A quantitative survey was used followed by a qualitative phone interview with a subsample of participants. Of 113 eligible patients, 102 (90%) completed the survey. Less than half reported sleeping well the night prior to surgery and 93% reported less sleep in the hospital compared to home. A median of 5 (4-7) interruptions were reported each night. Patients with more than three interruptions were likely to report poor sleep compared with those who had three or less. Barriers to sleep included staff interruptions and roommate noise but not pain. Patients interviewed suggested improved timing and knowledge of interruptions or use of noise-reduction aids that would facilitate sleep.
AHRQ-funded; HS026030.
Citation: Mouch CA, Baskin AS, Yearling R CA, Baskin AS, Yearling R .
Sleep patterns and quality among inpatients recovering from elective surgery: a mixed-method study.
J Surg Res 2020 Oct;254:268-74. doi: 10.1016/j.jss.2020.04.032..
Keywords: Sleep Problems, Surgery, Quality Improvement, Quality of Care, Inpatient Care, Hospitals, Patient Experience
Fisher KA, Gallagher TH, Smith KM
Communicating with patients about breakdowns in care: a national randomised vignette-based survey.
This study examined the impact of an apology when problems occur in patient care breakdowns occur at hospitals. Breakdowns included slow response to call bell, rude aide, and unanswered questions. A national online survey of 1188 adults aged 35 years or older were sampled from an online panel representative of the entire US population, created and maintained by GfK. Twice as many participants receiving an in-depth prompt about care breakdowns would recommend the hospital compared with those receiving no prompt (18.4% vs 8.8%). Almost three times as many participants who received a full apology would probably/definitely recommend the hospital compared with those receiving no apology (34.1% vs 13.6%). The survey also asked whether the respondent would speak up, with feeling upset being a strong determinant of greater intent to speak up.
AHRQ-funded; HS024596; HS022757.
Citation: Fisher KA, Gallagher TH, Smith KM .
Communicating with patients about breakdowns in care: a national randomised vignette-based survey.
BMJ Qual Saf 2020 Apr;29(4):313-19. doi: 10.1136/bmjqs-2019-009712..
Keywords: Clinician-Patient Communication, Communication, Patient Experience, Patient and Family Engagement, Quality Improvement, Quality of Care, Hospitals
Fahrenbach J, Chin MH, Huang ES
Neighborhood disadvantage and hospital quality ratings in the Medicare Hospital Compare Program.
This study examined the relationship between neighborhood social risk factors (SRFs) and hospital ratings in Medicare's Hospital Compare Program. Results showed that lower hospital summary scores were associated with caring for neighborhoods with higher social risk. Associations between neighborhood SRFs and hospital ratings were largest in the timeliness of care, patient experience, and hospital readmission groups and smallest in the safety, efficiency, and effectiveness of care groups. Failing to account for neighborhood social risk in hospital rating systems may reinforce hidden disincentives to care for medically underserved areas in the United States.
AHRQ-funded; HS023007.
Citation: Fahrenbach J, Chin MH, Huang ES .
Neighborhood disadvantage and hospital quality ratings in the Medicare Hospital Compare Program.
Med Care 2020 Apr;58(4):376-83. doi: 10.1097/mlr.0000000000001283..
Keywords: Quality of Care, Hospitals, Medicare, Quality Indicators (QIs), Patient Experience, Social Determinants of Health
Feng JY, Toomey SL, Elliott MN
Factors associated with family experience in pediatric inpatient care.
Researchers assessed which aspects of pediatric inpatient experience have the strongest relationships with parents' willingness to recommend a hospital. Their cross-sectional study examined surveys completed by parents of children hospitalized at hospitals using the Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey. They found that child comfort and nurse-parent communication showed the strongest relationships with willingness to recommend, followed by preparing to leave the hospital, doctor-parent communication, and keeping parents informed. They recommended improvement efforts focusing on creating an age-appropriate environment, improving the effectiveness of provider interactions, and engaging parents to share their values and concerns.
AHRQ-funded; HS020513; HS025299.
Citation: Feng JY, Toomey SL, Elliott MN .
Factors associated with family experience in pediatric inpatient care.
Pediatrics 2020 Mar;145(3): e20191264. doi: 10.1542/peds.2019-1264..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Quality Measures, Quality of Care, Inpatient Care, Patient Experience, Hospitals, Hospitalization, Patient and Family Engagement, Clinician-Patient Communication
Haldar S, Mishra SR, Pollack AH
Informatics opportunities to involve patients in hospital safety: a conceptual model.
This study investigated how hospital inpatients experience undesirable events (UEs) and to see if those present opportunities for new informatics solutions. The authors surveyed 242 patients and caregivers during their hospital stay and asked them open-ended questions about their experiences with UEs. They then developed a 4-stage conceptual model which illustrates inpatient experiences: from when they first encounter UEs, and opportunities to promote inpatients’ participation and engagement in the quality and safety of their care, help healthcare systems learn from inpatient experience, and reduce those harmful events.
AHRQ-funded; HS022894.
Citation: Haldar S, Mishra SR, Pollack AH .
Informatics opportunities to involve patients in hospital safety: a conceptual model.
J Am Med Inform Assoc 2020 Feb;27(2):202-11. doi: 10.1093/jamia/ocz167.
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Keywords: Patient Safety, Hospitals, Health Information Technology (HIT), Patient and Family Engagement, Patient Experience, Quality of Care
Shen NT, Wu A, Farrell K
Patient perspectives of high-quality care on the liver transplant waiting list: a qualitative study.
The prevalence of advanced liver disease and listing for liver transplantation is increasing. Prior assessments of quality of care neither incorporate nor emphasize the patient perspective on quality of care, which may impact clinical outcomes. In this study the investigators aimed to identify patients' perceptions on what constitutes high quality of care, comparing the findings to existing frameworks and assessments to determine if a patient-derived tool assessing quality of care could facilitate efforts to improve health care.
AHRQ-funded; HS000066.
Citation: Shen NT, Wu A, Farrell K .
Patient perspectives of high-quality care on the liver transplant waiting list: a qualitative study.
Liver Transpl 2020 Feb;26(2):238-46. doi: 10.1002/lt.25645..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Transplantation, Quality of Care, Healthcare Delivery, Patient Experience
Langhoff E, Siu A, Boockvar K
The VA and Non-VA experience of tracking good care.
This study compared how well Department of Veterans Affairs (VA) hospitals perform against non-VA hospitals. Three widely referenced public health care ranking models: the U.S. News America’s Best Hospitals, Truven Health Analytics, and Hospital Compare along with the VA model were examined. The authors found that the metrics used across the 4 models are neither comparable nor transparent. They found there were 6-46% reporting deficiencies in reporting hospital metrics in non-VA hospitals, while VA reporting is 100% of their metrics. VA inpatient satisfaction fell far short of the private sector, but both sets of rankings increased over time.
AHRQ-funded; HS022924.
Citation: Langhoff E, Siu A, Boockvar K .
The VA and Non-VA experience of tracking good care.
Popul Health Manag 2020 Feb;23(1):92-100. doi: 10.1089/pop.2019.0039..
Keywords: Hospitals, Provider Performance, Patient Experience, Quality of Care
Desai AD, Zhou C, Simon TD
Validation of a parent-reported hospital-to-home transition experience measure.
This study examined the validity of the Pediatric Transition Experience Measure (P-TEM), which is an 8-item, parent-reported measure that globally assesses hospital-to-home transition quality from discharge through follow-up compared to other validation measures. The other measures it was compared to included the 1) Child Hospital Consumer Assessment of Healthcare Providers and Systems Discharge Composite, 2) Center of Excellence on Quality of Care Measures for Children with Complex Needs parent-reported measures, 3) change in health-related quality of life from admission to postdischarge, and 4) 30-day emergency department revisits or readmissions. The P-TEM measure compared favorably with the Child Hospital Consumer Assessment of Healthcare Providers and Systems Discharge Composite measure and the other measures as well.
AHRQ-funded; HS024299.
Citation: Desai AD, Zhou C, Simon TD .
Validation of a parent-reported hospital-to-home transition experience measure.
Pediatrics 2020 Feb;145(2):pii: e20192150. doi: 10.1542/peds.2019-2150..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Patient Experience, Transitions of Care, Hospital Discharge, Quality Improvement, Quality of Care, Quality Measures
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
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
Schapira MM, Shea JA, Duey KA
The Nursing Home Compare report card: perceptions of residents and caregivers regarding quality ratings and nursing home choice.
The researchers evaluated the perceived usefulness of publicly reported nursing home quality indicators. They found that star ratings, clinical quality measures, and benchmarking information were salient to decision making, with preferred formats varying across participants. Participants desired additional information on the source of quality data. Confusion was evident regarding the relationship between domain-specific and overall star quality ratings.
AHRQ-funded; HS02861.
Citation: Schapira MM, Shea JA, Duey KA .
The Nursing Home Compare report card: perceptions of residents and caregivers regarding quality ratings and nursing home choice.
Health Serv Res 2016 Jun;51 Suppl 2:1212-28. doi: 10.1111/1475-6773.12458.
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Keywords: Nursing Homes, Quality Indicators (QIs), Patient Experience, Patient Experience, Quality of Care
Maurer M, Firminger K, Dardees P
Understanding consumer perceptions and awareness of hospital-based maternity care quality measures.
This study explored factors that may influence use of comparative public reports for hospital maternity care. It found that, when describing high-quality maternity care, participants focused on interactions with providers, including respect for preferences and communication. The importance of quality measures was influenced by the extent to which they focused on babies' health, were perceived as the hospital's responsibility, and were perceived as representing "standard care."
AHRQ-funded; HS021873.
Citation: Maurer M, Firminger K, Dardees P .
Understanding consumer perceptions and awareness of hospital-based maternity care quality measures.
Health Serv Res 2016 Jun;51 Suppl 2:1188-211. doi: 10.1111/1475-6773.12472.
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Keywords: Maternal Care, Pregnancy, Patient Experience, Quality Measures, Quality of Care, Public Reporting
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)
Kanouse DE, Schlesinger M, Shaller D
How patient comments affect consumers' use of physician performance measures.
In order to evaluate the relationship between patient characteristics and the frequency and duration of incident steroid use, the researchers applied a 2-part hurdle model to Medicare data. Their study identified differences in predictors of frequency and duration of medication use and suggests the utility of two-part models to examine drug utilization patterns.
AHRQ-funded; HS016978; HS016980.
Citation: Kanouse DE, Schlesinger M, Shaller D .
How patient comments affect consumers' use of physician performance measures.
Med Care 2016 Jan;54(1):24-31. doi: 10.1097/mlr.0000000000000443..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Patient and Family Engagement, Patient Experience, Clinician-Patient Communication