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
1 to 10 of 10 Research Studies DisplayedCiotoli C, Smith AJ, Keeling RP
Call to action: better care, better health, and greater value in college health.
This report aims to inspire, motivate, and challenge college health professionals and their colleagues, campus leaders, and national entities to take both immediate and sustainable steps to bring quality improvement (QI) to the forefront of college health practice - and, by doing so, to elevate care, health, and value of college health as a key pathway to advancing student success.
AHRQ-funded; HS022520.
Citation: Ciotoli C, Smith AJ, Keeling RP .
Call to action: better care, better health, and greater value in college health.
J Am Coll Health 2018 Oct;66(7):625-39. doi: 10.1080/07448481.2018.1431908..
Keywords: Education, Quality of Care, Quality Improvement
de la Guardia FH, Hwang J, Adams JL
https://doi.org/10.1007/s10742-018-0179-2
Loss function-based evaluation of physician report cards.
The authors specified loss functions and evaluated the potential cost of misclassification for physician report card designs. They found that misclassification cost depends on how performance information will be used and by whom; selecting the lowest-cost design for a given stakeholder could maximize the usefulness of physician performance data. They conlcuded that misclassification cost could guide report card design, improving the usefulness of a report card for one stakeholder without disadvantaging others.
AHRQ-funded; HS021860.
Citation: de la Guardia FH, Hwang J, Adams JL .
Loss function-based evaluation of physician report cards.
Health Services and Outcomes Research Methodology 2018 Jun;18(2):96-108. doi: 10.1007/s10742-018-0179-2.
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Keywords: Quality of Care, Provider Performance, Quality Measures
Henriksen K, Rodrick D, Grace EN
AHRQ Author: Henriksen K, Rodrick D, Grace EN, Brady PJ
Challenges in health care simulation: are we learning anything new?
Simulation training is considered a promising approach for improving the safety and quality of health services delivery. While it takes time for any new approach to gain momentum and learn from past efforts, it also will require addressing a systematic range of essential questions to improve existing knowledge on the optimal use of simulation, and to realize similar gains in safety that other high-risk industries have made.
AHRQ-authored.
Citation: Henriksen K, Rodrick D, Grace EN .
Challenges in health care simulation: are we learning anything new?
Acad Med 2018 May;93(5):705-08. doi: 10.1097/acm.0000000000001891.
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Keywords: Healthcare Delivery, Quality of Care, Patient Safety, Training
Nuckols TK, Keeler E, Anderson LJ
Economic evaluation of quality improvement interventions designed to improve glycemic control in diabetes: a systematic review and weighted regression analysis.
This study systematically reviewed economic evaluations of quality improvement (QI) interventions for glycemic control among adults with type 1 or type 2 diabetes. Using English-language studies from high-income countries that evaluated organizational changes and reported program and utilization-related costs, the researchers extracted data regarding intervention, study design, change in HbA1c, time horizon, perspective, incremental net cost, incremental cost-effectiveness ratio, and study quality. They conclude that diverse and multifaceted QI interventions which lower HbA1c appear to be a fair-to-good value, relative to usual care.
AHRQ-funded; HS022644.
Citation: Nuckols TK, Keeler E, Anderson LJ .
Economic evaluation of quality improvement interventions designed to improve glycemic control in diabetes: a systematic review and weighted regression analysis.
Diabetes Care 2018 May;41(5):985-93. doi: 10.2337/dc17-1495..
Keywords: Diabetes, Healthcare Costs, Quality of Care, Quality Improvement
Chen LM, Ryan AM, Shih T
Medicare's acute care episode demonstration: effects of bundled payments on costs and quality of surgical care.
This study evaluated whether participation in Medicare's Acute Care Episode (ACE) Demonstration Program-an early, small, voluntary episode-based payment program-was associated with a change in expenditures or quality of care. Participation in Medicare's ACE Demonstration Program was not associated with a change in 30-day episode-based Medicare payments or 30-day mortality for cardiac or orthopedic surgery, but it was associated with lower total 30-day post-acute care payments.
AHRQ-funded; HS018546; HS024698; HS020671.
Citation: Chen LM, Ryan AM, Shih T .
Medicare's acute care episode demonstration: effects of bundled payments on costs and quality of surgical care.
Health Serv Res 2018 Apr;53(2):632-48. doi: 10.1111/1475-6773.12681.
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Keywords: Healthcare Costs, Payment, Quality of Care, Surgery
Parasrampuria S, Oakes AH, Wu SS
Value and performance of accountable care organizations: a cost-minimization analysis.
The goal of this study was to determine the relationship between the quality of accountable care organizations (ACOs) and their long-term reduction in healthcare costs by conducting a cost minimization analysis. Centers for Medicare and Medicaid cost and quality data was used to calculate weighted composite quality scores for each ACO and organization-level cost savings. Markov modeling was used to compute the probability that an ACO transitioned between different quality levels in successive years and Monte Carlo simulations were conducted to project long-term cost savings by quality level over a 10-year period. The authors conclude that ACOs are a mechanism for decreasing costs by improving quality of care within the current fee-for-service healthcare model; higher quality ACOs incorporate higher levels of care coordination, which is associated with greater cost savings.
AHRQ-funded; HS000029.
Citation: Parasrampuria S, Oakes AH, Wu SS .
Value and performance of accountable care organizations: a cost-minimization analysis.
Int J Technol Assess Health Care 2018 Jan;34(4):388-92. doi: 10.1017/s0266462318000399..
Keywords: Healthcare Costs, Quality of Care
Paddock SM, Damberg CL, Yanagihara D
What role does efficiency play in understanding the relationship between cost and quality in physician organizations?
Previous studies demonstrate overuse of a narrow set of services, suggesting provider inefficiency, but existing studies neither quantify inefficiency more broadly nor assess its variation across physician organizations (POs). This study found that POs had substantial variation in efficiency, producing widely differing levels of quality for the same cost.
AHRQ-funded; HS021860.
Citation: Paddock SM, Damberg CL, Yanagihara D .
What role does efficiency play in understanding the relationship between cost and quality in physician organizations?
Med Care 2017 Dec;55(12):1039-45. doi: 10.1097/mlr.0000000000000823.
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Keywords: Practice Patterns, Healthcare Costs, Quality of Care, Quality Improvement, Payment, Provider Performance
Chen LM, Epstein AM, Orav EJ
Association of practice-level social and medical risk with performance in the Medicare physician value-based payment modifier program.
The objective of this cross-sectional observational study was to compare performance in the Physician Value-Based Payment Modifier (PVBM) Program by practice characteristics. The investigators found that during the first year of the Medicare Physician Value-Based Payment Modifier Program, physician practices that served more socially high-risk patients had lower quality and lower costs, and practices that served more medically high-risk patients had lower quality and higher costs.
AHRQ-funded; HS024698.
Citation: Chen LM, Epstein AM, Orav EJ .
Association of practice-level social and medical risk with performance in the Medicare physician value-based payment modifier program.
JAMA 2017 Aug 1;318(5):453-61. doi: 10.1001/jama.2017.9643..
Keywords: Healthcare Costs, Medicaid, Medicare, Payment, Quality of Care
Schpero WL, Morden NE, Sequist TD
For selected services, blacks and Hispanics more likely to receive low-value care than whites.
US minority populations receive fewer effective health services than whites. Using Medicare administrative data for 2006-11, the researchers found no consistent, corresponding protection against the receipt of ineffective health services. Compared with whites, blacks and Hispanics were often more likely to receive the low-value services studied.
AHRQ-funded; HS017589.
Citation: Schpero WL, Morden NE, Sequist TD .
For selected services, blacks and Hispanics more likely to receive low-value care than whites.
Health Aff 2017 Jun;36(6):1065-69. doi: 10.1377/hlthaff.2016.1416.
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Keywords: Disparities, Racial and Ethnic Minorities, Quality of Care, Racial and Ethnic Minorities
Schlesinger M, Grob R
Treating, fast and slow: Americans' understanding of and responses to low-value care.
This article explores Americans’ understanding of low-value care in 2015, assesses the impact of media messaging, and tests alternative message framing. The study concluded that the public’s awareness of low-value care is incomplete, with substantial disparities related to race, ethnicity, and socioeconomic status.
AHRQ-funded; HS021858; HS016978.
Citation: Schlesinger M, Grob R .
Treating, fast and slow: Americans' understanding of and responses to low-value care.
Milbank Q 2017 Mar;95(1):70-116. doi: 10.1111/1468-0009.12246..
Keywords: Healthcare Delivery, Decision Making, Healthcare Costs, Quality of Care