National Healthcare Quality and Disparities Report
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Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (1)
- (-) Cardiovascular Conditions (9)
- Chronic Conditions (1)
- Communication (2)
- Comparative Effectiveness (1)
- Diabetes (1)
- Evidence-Based Practice (5)
- Healthcare Delivery (2)
- Heart Disease and Health (6)
- Hospital Readmissions (1)
- Hospitals (1)
- Implementation (2)
- Medicare (1)
- Mortality (1)
- Outcomes (2)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (5)
- Payment (1)
- Practice Improvement (1)
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- Primary Care (6)
- Provider Performance (1)
- Quality Improvement (6)
- Quality Measures (1)
- (-) Quality of Care (9)
- Urban Health (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 9 of 9 Research Studies DisplayedMeddings J, Smith SN, Hofer TP
Mixed messages to consumers from Medicare: Hospital Compare grades versus value-based payment penalty.
This study examined the discrepancy of ratings with hospitals with low readmission grades for heart failure (HF) and acute myocardial infarction (AMI) on the Hospital Compare website, yet received penalties for excessive readmissions under the hospital Readmissions Reduction Program. A retrospective data analysis was conducted of 2956 hospitals that had publicly reported HF grades on Hospital Compare. Of those, 92% were graded as “no different” than the national rate for HD readmissions, yet included 48.6% that were scored as having excessive HF admissions and 87% received an overall readmission penalty. Of the 120 hospitals graded as “better”, none were scored as having excessive HF readmissions and 50% were penalized. There were similar results for AMI.
AHRQ-funded; HS018334; HS019767.
Citation: Meddings J, Smith SN, Hofer TP .
Mixed messages to consumers from Medicare: Hospital Compare grades versus value-based payment penalty.
Am J Manag Care 2018 Dec;24(12):e399-e403..
Keywords: Medicare, Hospital Readmissions, Heart Disease and Health, Hospitals, Quality of Care, Cardiovascular Conditions, Provider Performance, Payment
Baldwin LM, Fischer MA, Powell J
Virtual educational outreach intervention in primary care based on the principles of academic detailing.
This paper describes the efforts of the Healthy Hearts Northwest (H2N) EvidenceNOW cooperative in providing virtual outreach intervention in primary care based on the principles of academic detailing (AD). EvidenceNOW is AHRQ’s initiative to fund seven regional cooperatives to identify and implement effective strategies to improve the quality of cardiovascular care in communities across the United States. The H2N network covers three states: Oregon, Washington, and Idaho. For this initiative they recruited 259 primary care practices that had 10 full-time or fewer providers and met stage 1 electronic health record meaningful use criteria. The aim was to increase adoption of the four ABCS of heart disease prevention: Aspirin use by high-risk individuals, Blood pressure control, Cholesterol management, and Smoking cessation. Due to the long distances and staffing limitations H2N decided to develop an educational outreach program using virtual visits instead of the traditional AD program structure. The findings and outcomes of this program is described in detail in this paper.
AHRQ-funded; HS023236; HS023908.
Citation: Baldwin LM, Fischer MA, Powell J .
Virtual educational outreach intervention in primary care based on the principles of academic detailing.
J Contin Educ Health Prof 2018 Fall;38(4):269-75. doi: 10.1097/ceh.0000000000000224..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Evidence-Based Practice, Primary Care, Quality Improvement, Quality of Care, Patient-Centered Outcomes Research, Outcomes, Prevention
Ciolino JD, Jackson KL, Liss DT
Design of Healthy Hearts in the Heartland (H3): a practice-randomized, comparative effectiveness study.
The Healthy Hearts in the Heartland (H3) study is part of a nationwide effort, EvidenceNOW, seeking to better understand the ability of small primary care practices to improve "ABCS" clinical quality measures: appropriate Aspirin therapy, Blood pressure control, Cholesterol management, and Smoking cessation. In this paper, the authors describe the design and randomization of the H3 study.
AHRQ-funded; HS023921.
Citation: Ciolino JD, Jackson KL, Liss DT .
Design of Healthy Hearts in the Heartland (H3): a practice-randomized, comparative effectiveness study.
Contemp Clin Trials 2018 Aug;71:47-54. doi: 10.1016/j.cct.2018.06.004..
Keywords: Cardiovascular Conditions, Comparative Effectiveness, Evidence-Based Practice, Heart Disease and Health, Prevention, Primary Care, Quality of Care, Quality Improvement, Outcomes, Patient-Centered Outcomes Research
Chou AF, Homco JB, Nagykaldi Z
Disseminating, implementing, and evaluating patient-centered outcomes to improve cardiovascular care using a stepped-wedge design: healthy hearts for Oklahoma.
The Healthy Hearts for Oklahoma (H2O) Study proposes to build a quality improvement (QI) infrastructure by (1) constructing a sustainable Oklahoma Primary Healthcare Improvement Collaborative (OPHIC) to support dissemination and implementation (D&I) of QI methods; and (2) providing QI support in primary care practices to better manage patients at risk for cardiovascular disease (CVD) events. H2O has 263 small primary care practices across Oklahoma that receive the bundled QI intervention to improve ABCS (aspirin therapy, blood pressure control, cholesterol management, and smoking cessation) performance. The infrastructure established as a result of this funding will help reach medically underserved Oklahomans, particularly among rural and tribal populations.
AHRQ-funded; HS023919.
Citation: Chou AF, Homco JB, Nagykaldi Z .
Disseminating, implementing, and evaluating patient-centered outcomes to improve cardiovascular care using a stepped-wedge design: healthy hearts for Oklahoma.
BMC Health Serv Res 2018 Jun 4;18(1):404. doi: 10.1186/s12913-018-3189-4.
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Keywords: Cardiovascular Conditions, Communication, Heart Disease and Health, Healthcare Delivery, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Prevention, Quality of Care, Quality Improvement
Silber JH, Arriaga AF, Niknam BA
Failure-to-rescue after acute myocardial infarction.
The purpose of this study is to develop a failure-to-rescue (FTR) metric modified to analyze acute myocardial infarction (AMI) outcomes. The subjects were older Medicare beneficiaries who were admitted to short-term acute-care hospitals for AMI between 2009 and 2011. Measures included thirty-day mortality and FTR rates, as well as in-hospital complication rates. The study concludes that a modified FTR metric can be created that may aid in studying the quality of care of AMI admissions and has the advantageous properties of surgical FTR.
AHRQ-funded; HS023560.
Citation: Silber JH, Arriaga AF, Niknam BA .
Failure-to-rescue after acute myocardial infarction.
Med Care 2018 May;56(5):416-23. doi: 10.1097/mlr.0000000000000904..
Keywords: Adverse Events, Cardiovascular Conditions, Quality of Care, Mortality, Heart Disease and Health
Meyers D, Miller T, Genevro J
AHRQ Author: Meyers D, Miller T, Genevro J, Zhan C, De La Mare J, Fournier A, Bennett H, McNellis RJ
EvidenceNOW: Balancing primary care implementation and implementation research.
In 2015, AHRQ invested in the largest primary care research project in its history. EvidenceNOW is a $112 million effort to disseminate and implement patient-centered outcomes research evidence in more than 1,500 primary care practices and to study how quality-improvement support can build the capacity of primary care practices to understand and apply evidence. EvidenceNOW comprises 7 implementation research grants, each funded to provide external quality-improvement support to primary care practices to implement evidence-based cardiovascular care and to conduct rigorous internal evaluations of their work.
AHRQ-authored.
Citation: Meyers D, Miller T, Genevro J .
EvidenceNOW: Balancing primary care implementation and implementation research.
Ann Fam Med 2018 Apr;16(Suppl 1):S5-s11. doi: 10.1370/afm.2196.
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Keywords: Cardiovascular Conditions, Communication, Evidence-Based Practice, Heart Disease and Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention, Primary Care, Quality of Care, Quality Improvement, Implementation
Shelley D, Blechter B, Siman N
Quality of cardiovascular disease care in small urban practices.
This study described small, independent primary care practices' performance in meeting the Million Hearts ABCSs (aspirin use, blood pressure control, cholesterol management, and smoking screening and counseling). It concluded that achieving targets for ABCS measures varied considerably across practices; however, small practices were meeting or exceeding Million Hearts goals (i.e., 70 percent or greater).
AHRQ-funded; HS023922.
Citation: Shelley D, Blechter B, Siman N .
Quality of cardiovascular disease care in small urban practices.
Ann Fam Med 2018 Apr;16(Suppl 1):S21-s28. doi: 10.1370/afm.2174.
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Keywords: Cardiovascular Conditions, Quality of Care, Primary Care, Quality Improvement, Urban Health
Magnan EM, Bolt DM, Greenlee RT
Stratifying patients with diabetes into clinically relevant groups by combination of chronic conditions to identify gaps in quality of care.
The purpose of this paper was to find clinically relevant combinations of chronic conditions among patients with diabetes and to examine their relationships with six diabetes quality metrics. The researchers analyzed 12 conditions that were concordant with diabetes care to define five mutually exclusive combinations of conditions based on condition co-occurrence. They found the following condition classes: severe cardiac, cardiac, noncardiac vascular, risk factors, and no concordant comorbidities. They concluded that patients had distinct quality metric achievement by condition class, and those in less severe classes were less likely to achieve diabetes metrics.
AHRQ-funded; HS021899; HS018368.
Citation: Magnan EM, Bolt DM, Greenlee RT .
Stratifying patients with diabetes into clinically relevant groups by combination of chronic conditions to identify gaps in quality of care.
Health Serv Res 2018 Feb;53(1):450-68. doi: 10.1111/1475-6773.12607.
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Keywords: Cardiovascular Conditions, Chronic Conditions, Diabetes, Quality of Care, Quality Measures
Ono SS, Crabtree BF, Hemler JR
Taking innovation to scale in primary care practices: the functions of health care extension.
Health care extension is an approach to providing external support to primary care practices with the aim of diffusing innovation. EvidenceNOW was launched to rapidly disseminate and implement evidence-based guidelines for cardiovascular preventive care in the primary care setting. This article describes how cooperatives varied in their approaches to extension and provides early empirical evidence that health care extension is a feasible and potentially useful approach for providing quality improvement.
AHRQ-funded; HS023940.
Citation: Ono SS, Crabtree BF, Hemler JR .
Taking innovation to scale in primary care practices: the functions of health care extension.
Health Aff 2018 Feb;37(2):222-30. doi: 10.1377/hlthaff.2017.1100.
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Keywords: Primary Care, Implementation, Cardiovascular Conditions, Evidence-Based Practice, Healthcare Delivery, Practice Improvement, Quality Improvement, Quality of Care, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention