National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Asthma (1)
- Behavioral Health (1)
- Blood Pressure (1)
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Care Management (2)
- Children/Adolescents (1)
- Chronic Conditions (2)
- Clinician-Patient Communication (2)
- Communication (1)
- Community-Based Practice (2)
- Cultural Competence (2)
- Diabetes (1)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare Delivery (3)
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- Health Services Research (HSR) (1)
- Hospitalization (1)
- Organizational Change (3)
- (-) Patient-Centered Healthcare (17)
- Patient-Centered Outcomes Research (1)
- Patient Experience (1)
- Patient Safety (1)
- Practice Improvement (1)
- Practice Patterns (1)
- Prevention (1)
- (-) Primary Care (17)
- Primary Care: Models of Care (1)
- Provider (1)
- Public Health (1)
- Quality Measures (1)
- Racial and Ethnic Minorities (2)
- Research Methodologies (2)
- Social Determinants of Health (1)
- Teams (2)
- Vulnerable Populations (1)
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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
1 to 17 of 17 Research Studies DisplayedSmith JJ, Johnston JM, Hiratsuka VY
Medical home implementation and trends in diabetes quality measures for AN/AI primary care patients.
The researchers investigated changes in trend for type 2 diabetes mellitus (DM-II) quality indicators after patient-centered medical home (PCMH) implementation at Southcentral Foundation, a tribal health organization in Alaska. They found that rates of new DM-II diagnoses were stable prior to but increased after implementation. DM-II rates of HbA1c screening increased, though not significantly before and remained stable after implementation.
AHRQ-funded; HS019154.
Citation: Smith JJ, Johnston JM, Hiratsuka VY .
Medical home implementation and trends in diabetes quality measures for AN/AI primary care patients.
Prim Care Diabetes 2015 Apr;9(2):120-6. doi: 10.1016/j.pcd.2014.06.005..
Keywords: Diabetes, Patient-Centered Healthcare, Primary Care, Quality Measures, Racial and Ethnic Minorities
Bierman AS, Tinetti ME
AHRQ Author: Bierman AS
Precision medicine to precision care: managing multimorbidity.
Multimorbidity is the most common condition managed in practice. The authors argue that health-care delivery must be transformed to provide precision care to people with multimorbidity. Accomplishing this transition will require a change in practice, research, and policy from disease-specific to patient-centered models of care delivery.
AHRQ-authored.
Citation: Bierman AS, Tinetti ME .
Precision medicine to precision care: managing multimorbidity.
Lancet 2016 Dec 3;388(10061):2721-23. doi: 10.1016/s0140-6736(16)32232-2.
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Keywords: Healthcare Delivery, Chronic Conditions, Guidelines, Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care
Fraze T, Lewis VA, Rodriguez HP
Housing, transportation, and food: how ACOs seek to improve population health by addressing nonmedical needs of patients.
The authors examined how accountable care organizations (ACOs) addressed the nonmedical needs of their patients. They found that ACOs most commonly addressed the need for transportation, housing, and food insecurity, which they identified through the primary care visit or care transformation programs. They concluded that their findings offer insights into how health care organizations such as ACOs integrate themselves with nonmedical organizations.
AHRQ-funded; HS024792.
Citation: Fraze T, Lewis VA, Rodriguez HP .
Housing, transportation, and food: how ACOs seek to improve population health by addressing nonmedical needs of patients.
Health Aff 2016 Nov;35(11):2109-15. doi: 10.1377/hlthaff.2016.0727.
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Keywords: Social Determinants of Health, Patient-Centered Healthcare, Health Insurance, Healthcare Delivery, Primary Care, Public Health
Ferrante JM, Friedman A, Shaw EK
Lessons learned designing and using an online discussion forum for care coordinators in primary care.
In this paper, the authors comprehensively describe their experiences, from start to finish, of designing and using an asynchronous online discussion forum for collecting and analyzing information elicited from care coordinators in Patient-Centered Medical Homes across the United States. They conclude that an asynchronous online discussion forum is a feasible, efficient, and effective method to conduct a qualitative study, particularly when subjects are health professionals.
AHRQ-funded; HS020682.
Citation: Ferrante JM, Friedman A, Shaw EK .
Lessons learned designing and using an online discussion forum for care coordinators in primary care.
Qual Health Res 2016 Nov;26(13):1851-61. doi: 10.1177/1049732315609567..
Keywords: Care Coordination, Health Services Research (HSR), Patient-Centered Healthcare, Primary Care, Research Methodologies
Rodriguez HP, Chen X, Martinez AE
Availability of primary care team members can improve teamwork and readiness for change.
Researchers conducted a survey of adult primary care providers and staff in California safety net practices to assess primary care team structure (team size, team member availability, and access to interdisciplinary expertise), teamwork, and readiness for change. Greater team member availability was associated with greater readiness for change, but the relationship was stronger for staff than for primary care providers.
AHRQ-funded; HS020120.
Citation: Rodriguez HP, Chen X, Martinez AE .
Availability of primary care team members can improve teamwork and readiness for change.
Health Care Manage Rev 2016 Oct-Dec;41(4):286-95. doi: 10.1097/hmr.0000000000000082.
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Keywords: Primary Care, Teams, Patient-Centered Healthcare, Organizational Change, Practice Improvement
Gao Y, Nocon RS, Gunter KE
AHRQ Author: Ngo-Metzger Q
Characteristics associated with patient-centered medical home capability in health centers: a cross-sectional analysis.
The patient-centered medical home (PCMH) model is being implemented in health centers (HCs) that provide comprehensive primary care to vulnerable populations. The researchers identified characteristics associated with HCs' PCMH capability. EHR adoption likely played a role in HCs' improvement in PCMH capability. Other factors include a greater number of types of financial performance incentives, more types of hospital-HC affiliations, and state-level support and payment for PCMH activities.
AHRQ-authored; AHRQ-funded; HS000084.
Citation: Gao Y, Nocon RS, Gunter KE .
Characteristics associated with patient-centered medical home capability in health centers: a cross-sectional analysis.
J Gen Intern Med 2016 Sep;31(9):1041-51. doi: 10.1007/s11606-016-3729-8.
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Keywords: Patient-Centered Healthcare, Electronic Health Records (EHRs), Primary Care, Community-Based Practice, Vulnerable Populations
Hung D, Chung S, Martinez M
Effect of organizational culture on patient access, care continuity, and experience of primary care.
The authors examined relationships between organizational culture and patient-centered outcomes in primary care. They found that, compared with a "Group-oriented" culture, a "Rational" culture type was associated with longer appointment wait times, and both "Hierarchical" and "Developmental" culture types were associated with less care continuity, but better patient experiences with care.
AHRQ-funded; HS019815; HS019167.
Citation: Hung D, Chung S, Martinez M .
Effect of organizational culture on patient access, care continuity, and experience of primary care.
J Ambul Care Manage 2016 Jul-Sep;39(3):242-52. doi: 10.1097/jac.0000000000000116.
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Keywords: Access to Care, Organizational Change, Patient-Centered Healthcare, Patient Experience, Primary Care
Cohen DJ, Balasubramanian BA, Gordon L
A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol.
This paper describes the study protocol for the EvidenceNOW national evaluation, which is called Evaluating System Change to Advance Learning and Take Evidence to Scale (ESCALATES). Quantitative, qualitative, and mixed methods analyses will be conducted to examine how Cooperatives organize to provide external support to practices, to compare effectiveness of the dissemination and implementation approaches they implement, and to examine how regional variations and other organization and contextual factors influence implementation and effectiveness.
AHRQ-funded; HS022981; HS023940.
Citation: Cohen DJ, Balasubramanian BA, Gordon L .
A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol.
Implement Sci 2016 Jun 29;11(1):86. doi: 10.1186/s13012-016-0449-8.
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Keywords: Cardiovascular Conditions, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention, Primary Care, Research Methodologies
Fiks AG, DuRivage N, Mayne SL
Adoption of a portal for the primary care management of pediatric asthma: a mixed-methods implementation study.
The researchers evaluated the feasibility of using a patient portal for pediatric asthma in primary care. Fewer than three percent of those families invited to enroll used the portal. The authors found that although use of the portal was associated with higher treatment engagement, their results suggested that achieving widespread portal adoption is unlikely in the short term.
AHRQ-funded; HS021645; HS022689.
Citation: Fiks AG, DuRivage N, Mayne SL .
Adoption of a portal for the primary care management of pediatric asthma: a mixed-methods implementation study.
J Med Internet Res 2016 Jun 29;18(6):e172. doi: 10.2196/jmir.5610.
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Keywords: Web-Based, Primary Care, Children/Adolescents, Patient-Centered Healthcare, Asthma
Robinson JD, Tate A, Heritage J
Agenda-setting revisited: when and how do primary-care physicians solicit patients' additional concerns?
The authors assessed the distribution, content, and effectiveness of physicians' post-chief-complaint, agenda-setting questions. They found that physicians' questions designed to solicit concerns additional to chief concerns occurred in only 32% of visits. Further, those that were formatted so as to allow for 'concerns' were significantly more likely to generate some type of agenda item.
AHRQ-funded; HS010922; HS013343.
Citation: Robinson JD, Tate A, Heritage J .
Agenda-setting revisited: when and how do primary-care physicians solicit patients' additional concerns?
Patient Educ Couns 2016 May;99(5):718-23. doi: 10.1016/j.pec.2015.12.009.
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Keywords: Communication, Primary Care, Patient-Centered Healthcare, Patient Safety, Clinician-Patient Communication
Tucker CM, Wall WA, Wippold G
Development of an inventory for health-care office staff to self-assess their patient-centered cultural sensitivity.
The researchers sought to determine the psychometric properties of the Tucker-Culturally Sensitive Health Care Office Staff Inventory-Self-Assessment Form (T-CSHCOSI-SAF). They found that this inventory has 2 factors with high internal consistency reliability. They concluded that the T-CSHCOSI-SAF is a useful inventory for health-care office staff to assess their own level of patient-centered cultural sensitivity and that it can be used in the development and implementation of trainings to promote patient-centered cultural sensitivity of health-care office staff.
AHRQ-funded; HS013151; HS010726.
Citation: Tucker CM, Wall WA, Wippold G .
Development of an inventory for health-care office staff to self-assess their patient-centered cultural sensitivity.
Health Serv Res Manag Epidemiol 2016 Apr 27;3. doi: 10.1177/2333392816629600.
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Keywords: Healthcare Delivery, Cultural Competence, Patient-Centered Healthcare, Primary Care, Provider
Flieger SP
Implementing the patient-centered medical home in complex adaptive systems: becoming a relationship-centered patient-centered medical home.
The purpose of this study is to apply complex adaptive systems theory and relationship-centered organizations theory to explore how nine diverse primary care practices in New Hampshire implemented the patient-centered medical homes (PCMH) model and to offer insights for how primary care practices can move from a structural PCMH to a relationship-centered PCMH. It found that becoming a relationship-centered PCMH requires attention to reflection, sensemaking, learning, and collaboration.
AHRQ-funded; HS021385.
Citation: Flieger SP .
Implementing the patient-centered medical home in complex adaptive systems: becoming a relationship-centered patient-centered medical home.
Health Care Manage Rev 2016 Apr/Jun;42(2):112-21. doi: 10.1097/hmr.0000000000000100.
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Keywords: Patient-Centered Healthcare, Primary Care, Clinician-Patient Communication
Hernandez SE, Taylor L, Grembowski D
A first look at PCMH implementation for minority veterans: room for improvement.
The researchers sought to determine if the degree of Patient Aligned Care Teams (a patient-centered medical home model), implementation at Veterans Health Administration hospital-based and community-based primary care facilities varied with the percentage of minority veteran patients at each facility. They found that overall implementation of the care teams varied with respect to the racial/ethnic composition of a facility, with medium and high minority facilities having lower implementation scores.
AHRQ-funded; HS013853; HS023376.
Citation: Hernandez SE, Taylor L, Grembowski D .
A first look at PCMH implementation for minority veterans: room for improvement.
Med Care 2016 Mar;54(3):253-61. doi: 10.1097/mlr.0000000000000512.
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Keywords: Patient-Centered Healthcare, Racial and Ethnic Minorities, Community-Based Practice, Primary Care
Howard HA, Malouin R, Callow-Rucker M
Care managers and knowledge shift in primary care patient-centered medical home transformation.
Based on a health insurance company-sponsored primary care transformation project, this study explores the perceptions of care management from the perspective of providers and practice staff to examine shifts in knowledge and their broader implications for primary care. It demonstrates how the diffusion of clinical power and knowledge production redefine primary care relationships to patients, as traditional hierarchies shift to team-based care.
AHRQ-funded; HS020046; HS01795.
Citation: Howard HA, Malouin R, Callow-Rucker M .
Care managers and knowledge shift in primary care patient-centered medical home transformation.
Hum Organ 2016 Spring;75(1):10-20..
Keywords: Care Management, Patient-Centered Healthcare, Primary Care, Practice Patterns, Teams
Domino ME, Jackson C, Beadles CA
Do primary care medical homes facilitate care transitions after psychiatric discharge for patients with multiple chronic conditions?
The purpose of this manuscript is to assess outpatient follow-up rates with primary care and mental health providers following psychiatric discharge by medical home enrollment and medical complexity. Hospitalized persons with multiple chronic conditions including serious mental illness enrolled in a medical home were more likely to receive timely outpatient follow-up with a primary care provider but not with a mental health specialist.
AHRQ-funded; HS000032; HS019659.
Citation: Domino ME, Jackson C, Beadles CA .
Do primary care medical homes facilitate care transitions after psychiatric discharge for patients with multiple chronic conditions?
Gen Hosp Psychiatry 2016 Mar-Apr;39:59-65. doi: 10.1016/j.genhosppsych.2015.11.002.
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Keywords: Primary Care, Patient-Centered Healthcare, Behavioral Health, Hospitalization, Chronic Conditions
Howard J, Etz RS, Crocker JB
Maximizing the patient-centered medical home (PCMH) by choosing words wisely.
The authors described new terminology that some innovative primary care practices are using to support the transformational culture of the PCMH. Using data from the AHRQ-funded Working Conference for PCMH Innovation 2013, they found that language innovations were used by 5 of the 10 convened practices and that participants felt that the language used was important for reinforcing substantive changes. They concluded that new terminology must represent values to which practices genuinely aspire.
AHRQ-funded; HS021287.
Citation: Howard J, Etz RS, Crocker JB .
Maximizing the patient-centered medical home (PCMH) by choosing words wisely.
J Am Board Fam Med 2016 Mar-Apr;29(2):248-53. doi: 10.3122/jabfm.2016.02.150199.
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Keywords: Cultural Competence, Patient-Centered Healthcare, Primary Care, Organizational Change
O'Donnell AJ, Bogner HR, Cronholm PF
Stakeholder perspectives on changes in hypertension care under the patient-centered medical home.
The researchers investigated changes in hypertension care under patient-centered medical home (PCMH) implementation in a large multipayer PCMH demonstration project that may have led to improvements in hypertension control. They concluded that practices undergoing PCMH transformation may consider stakeholder perspectives about patient-centered, team-based, and systems-based approaches as they work to optimize hypertension care.
AHRQ-funded; HS019150.
Citation: O'Donnell AJ, Bogner HR, Cronholm PF .
Stakeholder perspectives on changes in hypertension care under the patient-centered medical home.
Prev Chronic Dis 2016 Feb 25;13:E28. doi: 10.5888/pcd13.150383.
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Keywords: Care Management, Blood Pressure, Patient-Centered Healthcare, Primary Care