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Topics
- Ambulatory Care and Surgery (2)
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- Elderly (2)
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- Health Status (1)
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- Kidney Disease and Health (1)
- Low-Income (1)
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- Mortality (1)
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- (-) Patient Experience (30)
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- Quality of Care (14)
- Quality of Life (1)
- Racial and Ethnic Minorities (6)
- Research Methodologies (1)
- Social Determinants of Health (1)
- Substance Abuse (1)
- Transitions of Care (1)
- Urban Health (1)
- Vulnerable Populations (2)
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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 25 of 30 Research Studies DisplayedMcMurtry CL, Findling MG, Casey LS
Discrimination in the United States: experiences of Asian Americans.
This study examined the prevalence of racial discrimination among Asian Americans and its impact on health outcomes. A nationally representative, probability-based telephone survey was conducted comparing 500 Asian and 902 white US adults from January to April 2017. Thirteen percent of Asians reported discrimination in healthcare encounters, and at least one in four experienced discrimination in employment, housing, and experienced microaggressions (35%) or racial slurs (32%). This resulted in Asians having higher odds than whites of reporting avoiding health care due to discrimination concerns.
AHRQ-funded; HS000055.
Citation: McMurtry CL, Findling MG, Casey LS .
Discrimination in the United States: experiences of Asian Americans.
Health Serv Res 2019 Dec;54(Suppl2):1419-30. doi: 10.1111/1475-6773.13225..
Keywords: Racial and Ethnic Minorities, Disparities, Social Determinants of Health, Patient Experience
Evensen CT, Yost KJ, Keller S
Development and testing of the CAHPS Cancer Care Survey.
In order to develop the CAHPS Cancer Care Survey instrument, the authors conducted cognitive tests of the instrument as well as field tests at six cancer centers and four community oncology practices; the survey was then finalized and obtained the CAHPS trademark. The authors recommend mail-only, mail-telephone mixed-mode, and Web-mail mixed-mode data collection methods.
AHRQ-funded; 290200600019I.
Citation: Evensen CT, Yost KJ, Keller S .
Development and testing of the CAHPS Cancer Care Survey.
J Oncol Pract 2019 Nov;15(11):e969-e78. doi: 10.1200/jop.19.00039..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Cancer, Patient Experience, Quality of Care
Haldar S, Mishra SR, Kim Y
Use and impact of an online community for hospital patients.
This study examined the impact of a technology resembling an online health community for hospitalized patients to exchange advice and provide each other support during their hospitalization. It was deployed at 1 pediatric and 1 adult hospital. Thirty participants were recruited and were interviewed bedside and were observed how they used the technology, along with follow-up phone interviews. It was found to be helpful to patients and that most (64%) of the shared advice was positive in nature. They also reported positive impacts to their quality, safety, and hospital experience due to the inpatient peer support community.
AHRQ-funded; HS022894.
Citation: Haldar S, Mishra SR, Kim Y .
Use and impact of an online community for hospital patients.
J Am Med Inform Assoc 2020 Apr;27(4):549-57. doi: 10.1093/jamia/ocz212..
Keywords: Health Information Technology (HIT), Hospitals, Patient and Family Engagement, Patient Experience
Cho H, Flynn G, Saylor M
Use of the FITT framework to understand patients' experiences using a real-time medication monitoring pill bottle linked to a mobile-based HIV self-management app: a qualitative study.
This study examined the usefulness of a mobile app linked to a real-time medication monitoring pill bottle that reminds HIV patients to take their medication. Thirty-eight randomized patients living with HIV who were aged 18 and older, owned a smartphone and were mostly medication-compliant were selected. The majority were African-American, had a high school education or less, and had a median income of less than $20,000. The Fit between Individuals, Task and Technology (FITT) framework was used to determine the fit between the individuals and the technology. Hindrances to the technology included: ease of use, HIV-related stigma and disclosure of HIV status, customized alert of medication time windows, and preference for device design.
AHRQ-funded; HS025071.
Citation: Cho H, Flynn G, Saylor M .
Use of the FITT framework to understand patients' experiences using a real-time medication monitoring pill bottle linked to a mobile-based HIV self-management app: a qualitative study.
Int J Med Inform 2019 Nov;131:103949. doi: 10.1016/j.ijmedinf.2019.08.009..
Keywords: Patient Experience, Patient Adherence/Compliance, Medication, Patient Self-Management, Health Information Technology (HIT)
Martino SC, Grob R, Davis S
Choosing doctors wisely: can assisted choice enhance patients' selection of clinicians?
In this study, the investigators conducted a simulated clinician-choice experiment, comparing choices and decision-making processes of participants (N = 688) randomized among four experimental arms: a conventional website reporting only quantitative performance information, a website reporting both qualitative (patient comments) and quantitative information, the second website augmented by a decision aid (labeling of patient comments), and the decision-aided website further augmented by the presence of a trained navigator.
AHRQ-funded; HS016978.
Citation: Martino SC, Grob R, Davis S .
Choosing doctors wisely: can assisted choice enhance patients' selection of clinicians?
Med Care Res Rev 2019 Oct;76(5):572-96. doi: 10.1177/1077558717743822..
Keywords: Patient Experience, Decision Making
Howard SD, Lee KL, Nathan AG
Healthcare experiences of transgender people of color.
Researchers investigated how transgender people of color (TPOC) healthcare experiences are shaped by both race/ethnicity and gender identity. Using interviews and focus groups with participants in the Chicago area, they found that all participants described healthcare experiences where providers responded negatively to their race/ethnicity and/or gender identity. A majority of participants sought out healthcare locations designated as lesbian, gay, bisexual, and transgender-friendly in an effort to avoid discrimination, but feared experiencing racism there. When describing positive healthcare experiences, participants were most likely to highlight providers' respect for their gender identity. The researchers concluded that TPOC have different experiences compared with white transgender or cisgender racial/ethnic minorities and recommended that providers improve understanding of intersectional experiences of TPOC to improve quality of care.
AHRQ-funded; HS023050.
Citation: Howard SD, Lee KL, Nathan AG .
Healthcare experiences of transgender people of color.
J Gen Intern Med 2019 Oct;34(10):2068-74. doi: 10.1007/s11606-019-05179-0..
Keywords: Patient Experience, Vulnerable Populations, Cultural Competence, Racial and Ethnic Minorities, Primary Care, Ambulatory Care and Surgery
Hargraves JL, Cosenza C, Elliott MN, et al.
The effect of different sampling and recall periods in the CAHPS Clinician & Group (CG-CAHPS) survey.
Researchers examined the effect of changing the sampling and reference periods for the CAHPS((R)) Clinician & Group Survey from 12 to 6 months. They found that shortening the reference reduced the proportion of respondents reporting a blood test, X-ray, or other tests, and the most positive response was selected more often on the 6-month survey for 12 out of 13 questions. They concluded that surveys using a 6-month recall period may yield slightly higher scores than surveys with a 12-month recall period.
AHRQ-funded; HS016978.
Citation: Hargraves JL, Cosenza C, Elliott MN, et al..
The effect of different sampling and recall periods in the CAHPS Clinician & Group (CG-CAHPS) survey.
Health Serv Res 2019 Oct;54(5):1036-44. doi: 10.1111/1475-6773.13173..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Quality of Care, Research Methodologies
Beckett MK, Elliott MN, Burkhart Q
The effects of survey version on patient experience scores and plan rankings.
Researchers assessed the effect of changing survey questions on plan-level patient experience measures and ratings. Using CAHPS data, they concluded that their analyses illustrated how to assess the impact of seemingly minor survey modifications for other national surveys considering changes and highlighted the importance of screeners in instrument design.
AHRQ-funded; HS016978.
Citation: Beckett MK, Elliott MN, Burkhart Q .
The effects of survey version on patient experience scores and plan rankings.
Health Serv Res 2019 Oct;54(5):1016-22. doi: 10.1111/1475-6773.13172..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Medicare, Quality of Care
Flory JH, Keating S, Guelce D
Overcoming barriers to the use of metformin: patient and provider perspectives.
Researcher undertook a qualitative study of barriers to metformin use from the patient and provider perspective. A purposive sampling of patients and providers in New York State were interviewed and 1259 charts manually reviewed. The researchers found that, although metformin is positively viewed by patients and providers, gastrointestinal side effects are a barrier to its use. They recommended clinical trial research on optimal dose, formulation, and counseling for new users.
AHRQ-funded; HS023898.
Citation: Flory JH, Keating S, Guelce D .
Overcoming barriers to the use of metformin: patient and provider perspectives.
Patient Prefer Adherence 2019 Aug 22;13:1433-41. doi: 10.2147/ppa.S211614..
Keywords: Medication, Diabetes, Patient Adherence/Compliance, Patient Experience
Setodji CM, Peipert JD, Hays RD
Differential item functioning of the CAHPS(R) In-Center Hemodialysis Survey.
End-stage renal disease patients' experience of care is an integral part of the assessment of the quality of the care provided at hemodialysis centers and is needed to promote patient choice, quality improvement, and accountability. The purpose of this study was to evaluate the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH-CAHPS(R)) survey and its equivalence in different age, gender, race, and education subgroups.
AHRQ-funded; HS016980; HS016978.
Citation: Setodji CM, Peipert JD, Hays RD .
Differential item functioning of the CAHPS(R) In-Center Hemodialysis Survey.
Qual Life Res 2019 Jul 26;28(11):3117-35. doi: 10.1007/s11136-019-02250-5.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Kidney Disease and Health, Quality of Care, Patient Experience, Quality Improvement
Ahluwalia SC, Damberg CL, Haas A
How are medical groups identified as high-performing? The effect of different approaches to classification of performance.
The researchers examined how different classification approaches influence which providers are designated as "high-performers.” They found that classification of medical groups as high performing is sensitive to the domains of performance included, the classification approach, and the choice of threshold. They further suggest that the absence of a consistently applied approach to identifying high performers impedes efforts to reliably compare, select and reward high-performing providers.
AHRQ-funded; HS024067.
Citation: Ahluwalia SC, Damberg CL, Haas A .
How are medical groups identified as high-performing? The effect of different approaches to classification of performance.
BMC Health Serv Res 2019 Jul 18;19(1):500. doi: 10.1186/s12913-019-4293-9..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Provider Performance, Quality of Care, Quality Measures
Gressler LE, Natafgi NM, DeForge BR
What motivates people with substance use disorders to pursue treatment? A patient-centered approach to understanding patient experiences and patient-provider interactions.
The purpose of this study was to identify and define potential positive and negative factors in patient experiences and patient-provider interactions that are associated with the pursuit and maintenance of treatment by those suffering from substance use disorders (SUD). The investigators conducted two focus groups with patients in treatment for SUD and four in-depth interviews with healthcare providers involved in the treatment of patients with SUD.
AHRQ-funded; HS022135.
Citation: Gressler LE, Natafgi NM, DeForge BR .
What motivates people with substance use disorders to pursue treatment? A patient-centered approach to understanding patient experiences and patient-provider interactions.
J Subst Use 2019;24(6):587-99. doi: 10.1080/14659891.2019.1620891..
Keywords: Clinician-Patient Communication, Decision Making, Healthcare Utilization, Patient-Centered Healthcare, Patient Experience, Patient and Family Engagement, Substance Abuse
Chen PG, Harrison MI, Bergofsky LR
AHRQ Author: Harrison MI, Bergofsky LR
Use of internal performance measurement to guide improvement within medical groups.
The purpose of this study was to investigate how medical groups use measures of quality, cost, and patient experience of care for performance improvement. Through interviews, findings showed that strategies for using internal measurement for quality improvement included taking a gradual, iterative approach and setting clear goals with high priority, finding workable approaches to data sharing, and fostering engagement by focusing on actionable measures. Measurement was also used to check accuracy of external performance reports, clarify and manage conflicting external measurement requirements, and prepare for anticipated external measurement requirements. Most respondents did not report a need to assess costs of internal measurement or the capacity to do so.
AHRQ-authored; AHRQ-funded; 233201500026I.
Citation: Chen PG, Harrison MI, Bergofsky LR .
Use of internal performance measurement to guide improvement within medical groups.
Jt Comm J Qual Patient Saf 2019 Jul;45(7):487-94. doi: 10.1016/j.jcjq.2019.02.009..
Keywords: Quality Measures, Quality Improvement, Provider Performance, Patient Experience, Quality of Care
Sheetz KH, Nathan H, Dimick JB
Patients' perceptions of hospitals affiliated with America's highest-rated medical centers.
Using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to measure how patients perceive a hospital’s overall quality and reputation, the investigators sought to determine whether HCAHPS scores increased for those affiliating with the prominent medical centers named to the U.S. News and World Report Honor Roll.
AHRQ-funded; HS023597.
Citation: Sheetz KH, Nathan H, Dimick JB .
Patients' perceptions of hospitals affiliated with America's highest-rated medical centers.
J Gen Intern Med 2019 Jun;34(6):787-88. doi: 10.1007/s11606-018-4822-y..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Hospitals, Quality Measures, Quality of Care
Tieu L, Hobbs A, Sarkar U
Adapting patient experience data collection processes for lower literacy patient populations using tablets at the point of care.
This study compared the acceptability of low-literacy tablet-based and traditional paper-based patient experience surveys in English and Spanish. The Consumer Assessment of Healthcare Providers & Systems Clinician & Group Survey (CG-CAHPS) was adapted for a pilot survey using low-literacy questions in Spanish and English. The majority of interview participants preferred the tablet version over the traditional paper-based survey. This was especially true for the younger and Latino respondents.
AHRQ-funded; HS022408.
Citation: Tieu L, Hobbs A, Sarkar U .
Adapting patient experience data collection processes for lower literacy patient populations using tablets at the point of care.
Med Care 2019 Jun;57 Suppl 6 Suppl 2:S140-s48. doi: 10.1097/mlr.0000000000001030..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Information Technology (HIT), Health Literacy, Patient Experience, Primary Care, Quality of Care, Quality Improvement, Racial and Ethnic Minorities, Urban Health
Fowler FJ, Cosenza C, Cripps LA
The effect of administration mode on CAHPS survey response rates and results: a comparison of mail and web-based approaches.
The researchers compared response rates, respondents' characteristics, and substantive results for CAHPS surveys administered using web and mail protocols. They found that response rates to surveys administered using the Internet protocols were lower than for the surveys administered by mail, but characteristics of respondents and survey answers were very similar across protocols. Respondents without email addresses tended to be older, less educated, and more likely to be male than those with email addresses, and there were a few differences in their responses.
AHRQ-funded; HS016978.
Citation: Fowler FJ, Cosenza C, Cripps LA .
The effect of administration mode on CAHPS survey response rates and results: a comparison of mail and web-based approaches.
Health Serv Res 2019 Jun;54(3):714-21. doi: 10.1111/1475-6773.13109..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Information Technology (HIT), Patient Experience, Primary Care, Quality of Care, Quality Improvement
Khoong EC, Cherian R, Matta GY
Perspectives of English, Chinese, and Spanish-speaking safety-net patients on clinician computer use: qualitative analysis.
The goal of this study was to understand how safety-net patients, including those with limited English proficiency, view clinician electronic health record (EHR) use. Through focus groups in English, Spanish, and Cantonese, results showed that linguistically diverse patients accepted the value of EHR use during outpatient visits but desired more eye contact, verbal warnings before EHR use, and screen-sharing. Support for clinicians in completing EHR-related tasks during the visit using patient-centered strategies for all patients is recommended.
AHRQ-funded; HS022561; HS023558; HS022408.
Citation: Khoong EC, Cherian R, Matta GY .
Perspectives of English, Chinese, and Spanish-speaking safety-net patients on clinician computer use: qualitative analysis.
J Med Internet Res 2019 May 22;21(5):e13131. doi: 10.2196/13131..
Keywords: Cultural Competence, Racial and Ethnic Minorities, Patient Experience, Electronic Health Records (EHRs), Health Information Technology (HIT), Clinician-Patient Communication, Health Literacy, Communication
Hanson C, Herring B, Trish E
Do health insurance and hospital market concentration influence hospital patients' experience of care?
Researchers examined the effects of insurance and hospital market concentration on hospital patients' experience of care. They found that changes in patient satisfaction are positively associated with increases in insurance concentration and negatively associated with increases in hospital concentration. They concluded that their findings add to the evidence on the harms of hospital consolidation but suggest that insurer consolidation may improve patient experience.
AHRQ-funded; HS026333.
Citation: Hanson C, Herring B, Trish E .
Do health insurance and hospital market concentration influence hospital patients' experience of care?
Health Serv Res 2019 May 16;54(4):805-15. doi: 10.1111/1475-6773.13168..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Insurance, Hospitals, Patient Experience, Quality of Care, Quality Improvement
Sharp B, Johnson J, Hamedani AG
What are we measuring? Evaluating physician-specific satisfaction scores between emergency departments.
The goals of this study were to determine whether Press Ganey ED satisfaction scores for emergency physicians working at two different sites were consistent between sites, and to identify factors contributing to any variation. The investigators found that Press Ganey satisfaction scores for the same group of emergency physicians varied significantly between sites. They indicated that this suggests these scores are more dependent on site-specific factors, such as wait times, than a true representation of the quality of care provided by the physician.
AHRQ-funded; HS024558.
Citation: Sharp B, Johnson J, Hamedani AG .
What are we measuring? Evaluating physician-specific satisfaction scores between emergency departments.
West J Emerg Med 2019 May;20(3):454-59. doi: 10.5811/westjem.2019.4.41040..
Keywords: Emergency Department, Patient Experience, Provider: Physician, Provider
Toomey SL, Elliott MN, Zaslavsky AM
Improving response rates and representation of hard-to-reach groups in family experience surveys.
This study examined the use of an audio-enabled tablet to survey parents of children discharged from 4 units of a children’s hospital. Normal mail survey response rates are very low, especially for black, Latino, and low-income respondents. This survey was done day of discharge at the hospital and there was a response rate of 71.1% via tablet versus 16.3% for mail only. The Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was used. Tablet response rates were highest with fathers, those more likely to have a high school education or less, less likely to be white, and more likely to be publicly insured. The results are promising for future surveys using tablet administration.
AHRQ-funded; HS020513; HS025299.
Citation: Toomey SL, Elliott MN, Zaslavsky AM .
Improving response rates and representation of hard-to-reach groups in family experience surveys.
Acad Pediatr 2019 May - Jun;19(4):446-53. doi: 10.1016/j.acap.2018.07.007..
Keywords: Caregiving, Children/Adolescents, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Information Technology (HIT), Hospitals, Low-Income, Patient Experience, Quality of Care, Quality Improvement, Racial and Ethnic Minorities
Roche SD, Reichheld AM, Demosthenes N
Measuring the quality of inpatient specialist consultation in the intensive care unit: Nursing and family experiences of communication.
The purpose of this study was to document the receipt of communication by nurses and family members regarding consultations performed on their patient or loved one, and to quantify how this impacted their overall perceptions of the quality of specialty care. The investigators found that most ICU families and nurses had no interaction with specialist providers. They concluded that nurses' frequent exclusion from conversations about specialty care may pose safety risks and increase the likelihood of mixed messages for patients and families, most of whom desire some interaction with specialists.
AHRQ-funded; K08 HS024288.
Citation: Roche SD, Reichheld AM, Demosthenes N .
Measuring the quality of inpatient specialist consultation in the intensive care unit: Nursing and family experiences of communication.
PLoS One 2019 Apr 11;14(4):e0214918. doi: 10.1371/journal.pone.0214918..
Keywords: Clinician-Patient Communication, Communication, Quality of Care, Intensive Care Unit (ICU), Patient Experience, Inpatient Care
Law AC, Roche S, Reichheld A
Failures in the respectful care of critically ill patients.
The emotional toll of critical illness on patients and their families can be profound and is emerging as an important target for value improvement. One source of emotional harm to patients and families may be care perceived as inadequately respectful. The prevalence and risk factors for types of emotional harms is under-studied. This prospective cohort study was conducted in nine ICUs at a tertiary care academic medical center in the United States.
AHRQ-funded; HS024288.
Citation: Law AC, Roche S, Reichheld A .
Failures in the respectful care of critically ill patients.
Jt Comm J Qual Patient Saf 2019 Apr;45(4):276-84. doi: 10.1016/j.jcjq.2018.05.008..
Keywords: Critical Care, Intensive Care Unit (ICU), Patient Experience, Clinician-Patient Communication, Communication
Ngo-Metzger Q Sharif, MZ Biegler, K Mollica, et al.
A health profile and overview of healthcare experiences of Cambodian American refugees and immigrants residing in Southern California.
This study compared the health status and healthcare experiences of Cambodian American refugees and immigrants, using data were collected via questionnaires and medical records from two community clinics in Southern California. Minimal differences in self-reported health behaviors occurred between the two groups. Refugees reported lower levels of health-related quality of life overall and self-rated health, but similar or more positive healthcare experiences than the immigrants. Refugees had higher rates of diabetes and cardiovascular disease risk, in adjusted analyses. The authors conclude that there is a need for more health promotion efforts to improve health outcomes and perceived wellbeing of Cambodian American refugees and immigrants.
AHRQ-authored.
Citation: Ngo-Metzger Q Sharif, MZ Biegler, K Mollica, et al..
A health profile and overview of healthcare experiences of Cambodian American refugees and immigrants residing in Southern California.
J Immigr Minor Health 2019 Apr;21(2):346-55. doi: 10.1007/s10903-018-0736-3..
Keywords: Disparities, Health Status, Patient Experience, Quality of Life, Racial and Ethnic Minorities, Vulnerable Populations
Cefalu MS, Elliott MN, Setodji CM
Hospital quality indicators are not unidimensional: a reanalysis of Lieberthal and Comer.
The objective of this study was to evaluate the dimensionality of hospital quality indicators treated as unidimensional in a prior publication. The investigators found that there were four underlying dimensions of hospital quality: patient experience, mortality, and two clinical process dimensions. They concluded that hospital quality should be measured using a variety of indicators reflecting different dimensions of quality.
AHRQ-funded; HS016980; HS016978.
Citation: Cefalu MS, Elliott MN, Setodji CM .
Hospital quality indicators are not unidimensional: a reanalysis of Lieberthal and Comer.
Health Serv Res 2019 Apr;54(2):502-08. doi: 10.1111/1475-6773.13056..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Patient Experience, Provider Performance, Quality of Care, Quality Indicators (QIs), Quality Measures
Fisher KA, Smith KM, Gallagher TH
We want to know: patient comfort speaking up about breakdowns in care and patient experience.
The purpose of this study was to assess patient comfort speaking up about problems during hospitalisation and to identify patients at increased risk of having a problem and not feeling comfortable speaking up. The investigators suggest that creating conditions for patients to be comfortable speaking up may result in service recovery opportunities and improved patient experience. They assert that such efforts should consider the impact of health literacy and mental health on patient engagement in patient-safety activities.
AHRQ-funded; HS024596; HS022757.
Citation: Fisher KA, Smith KM, Gallagher TH .
We want to know: patient comfort speaking up about breakdowns in care and patient experience.
BMJ Qual Saf 2019 Mar;28(3):190-97. doi: 10.1136/bmjqs-2018-008159..
Keywords: Clinician-Patient Communication, Hospitalization, Patient Experience, Quality of Care, Quality Improvement