National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (4)
- Behavioral Health (1)
- Cancer (1)
- Cardiovascular Conditions (3)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Communication (2)
- (-) COVID-19 (15)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Disabilities (1)
- Disparities (1)
- Emergency Department (1)
- Healthcare Delivery (5)
- Health Information Technology (HIT) (15)
- Hospitalization (1)
- Hospitals (1)
- Maternal Care (1)
- Patient-Centered Healthcare (1)
- Patient Adherence/Compliance (1)
- Policy (1)
- Practice Patterns (2)
- Pregnancy (1)
- Primary Care (1)
- Stroke (2)
- Surgery (1)
- (-) Telehealth (15)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 15 of 15 Research Studies DisplayedKalwani NM, Wang KM, Johnson AN
Application of the quadruple aim to evaluate the operational impact of a telemedicine program.
This study compared the operational impact of a telemedicine program called CardioClick at a preventive cardiology clinic compared to traditional clinic visits. The authors examined data for 134 patients enrolled in CardioClick with 181 video follow-up visits and 276 patients enrolled in the clinic’s traditional program with 694 in-person follow-up visits. The Quadruple Aim was used to evaluate CardioClick. Both cohorts were similar in characteristics in terms of age, gender balance, and baseline clinical characteristics. Video follow-up visits were shorter in time for clinicians (median 22 vs 30 minutes) than in-person visits and total clinic time (median 22 vs 68 minutes). Video visits were more likely to end on time than in-person visits as well. Physicians more often completed video visit documentation on the day of the visit.
AHRQ-funded; HS026128.
Citation: Kalwani NM, Wang KM, Johnson AN .
Application of the quadruple aim to evaluate the operational impact of a telemedicine program.
Healthc 2021 Dec;9(4):100593. doi: 10.1016/j.hjdsi.2021.100593..
Keywords: Telehealth, Health Information Technology (HIT), Cardiovascular Conditions, COVID-19
Hayden EM, Davis C, Clark S
Telehealth in emergency medicine: a consensus conference to map the intersection of telehealth and emergency medicine.
Through the 2020 Society for Academic Emergency Medicine's annual consensus conference, experts in emergency medicine (EM) and telehealth created a research agenda to explore how EM should intersect with telehealth. The multiyear process resulted in consensus with a final set of 24 important research questions. The primary finding from the process was the breadth of gaps in the evidence for telehealth in EM and telehealth in general. The consensus process identified priority research questions for the use of and evaluation of telehealth in EM to fill the current knowledge gaps.
AHRQ-funded; HS027528.
Citation: Hayden EM, Davis C, Clark S .
Telehealth in emergency medicine: a consensus conference to map the intersection of telehealth and emergency medicine.
Acad Emerg Med 2021 Dec;28(12):1452-74. doi: 10.1111/acem.14330..
Keywords: Telehealth, Health Information Technology (HIT), Emergency Department, COVID-19
Hsueh L, Huang J, Millman AK
Disparities in use of video telemedicine among patients with limited English proficiency during the COVID-19 pandemic.
The authors hypothesized that limited English proficiency (LEP) would be associated with lower video use compared with telephone, especially among patients without prior video visit experience. They found that one-third of patients with LEP scheduled a visit by video instead of telephone. Patients with LEP chose video less often than patients without LEP, even after adjusting for technology factors. However, among patients with prior video visit experience, no significant difference in video visit use by LEP was found.
AHRQ-funded; HS025189.
Citation: Hsueh L, Huang J, Millman AK .
Disparities in use of video telemedicine among patients with limited English proficiency during the COVID-19 pandemic.
JAMA Netw Open 2021 Nov;4(11):e2133129. doi: 10.1001/jamanetworkopen.2021.33129..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Disparities, Communication
Cibrian FL, Monteiro E, Ankrah E
Parents' perspectives on a smartwatch intervention for children with ADHD: rapid deployment and feasibility evaluation of a pilot intervention to support distance learning during COVID-19.
This paper explores how smartwatch technology, including timing notifications, can support children with ADHD during distance learning due to COVID-19. The researchers used a Digital Health Intervention which included a smartwatch and a smartphone. Their results demonstrated that children successfully adopted the use of the smartwatch, and parents believed that the intervention was helpful, especially in supporting the development of organizational skills in their children. The authors included suggestions to help professionals teach children with ADHD to use smartwatches to improve organization and task completion, especially as it applies to supporting remote instruction.
AHRQ-funded; HS026058.
Citation: Cibrian FL, Monteiro E, Ankrah E .
Parents' perspectives on a smartwatch intervention for children with ADHD: rapid deployment and feasibility evaluation of a pilot intervention to support distance learning during COVID-19.
PLoS One 2021 Oct 27;16(10):e0258959. doi: 10.1371/journal.pone.0258959..
Keywords: Children/Adolescents, COVID-19, Behavioral Health, Telehealth, Health Information Technology (HIT), Patient Adherence/Compliance
Zachrison KS, Yan Z, Schwamm LH
Changes in virtual and in-person health care utilization in a large health system during the COVID-19 pandemic.
This cross-sectional study evaluates how the growth of virtual care has impacted health care utilization in an integrated delivery network.
AHRQ-funded; HS024561.
Citation: Zachrison KS, Yan Z, Schwamm LH .
Changes in virtual and in-person health care utilization in a large health system during the COVID-19 pandemic.
JAMA Netw Open 2021 Oct;4(10):e2129973. doi: 10.1001/jamanetworkopen.2021.29973.
.
.
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Healthcare Delivery
Portney DS, Zhu Z, Chen EM
COVID-19 and use of teleophthalmology (CUT Group): trends and diagnoses.
The coronavirus disease 2019 (COVID-19) pandemic altered how clinicians care for patients. Ophthalmologists saw an estimated 81% drop in volume, the most of any specialty during the initial pandemic and public health restrictions. This study demonstrates the characteristics of telehealth use in ophthalmology on a large scale with primary data before and during the COVID-19 pandemic.
AHRQ-funded; HS027632.
Citation: Portney DS, Zhu Z, Chen EM .
COVID-19 and use of teleophthalmology (CUT Group): trends and diagnoses.
Ophthalmology 2021 Oct;128(10):1483-85. doi: 10.1016/j.ophtha.2021.02.010..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Healthcare Delivery
Zachrison KS, Sharma R, Wang Y
National trends in telestroke utilization in a US commercial platform prior to the COVID-19 pandemic.
In this study, the objective was to describe characteristics of telestroke consultations among a national sample of telestroke sites on one of the most commonly used common vendor platforms, prior to the COVID-19 public health emergency. The investigators concluded that among spoke sites using a commercial telestroke platform over a seven-year time horizon, times to consult start and alteplase bolus decreased over time. Similar to academic networks, duration of telestroke participation in this commercial network was associated with faster alteplase delivery, suggesting practice improves performance.
AHRQ-funded; HS024561.
Citation: Zachrison KS, Sharma R, Wang Y .
National trends in telestroke utilization in a US commercial platform prior to the COVID-19 pandemic.
J Stroke Cerebrovasc Dis 2021 Oct;30(10):106035. doi: 10.1016/j.jstrokecerebrovasdis.2021.106035..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Stroke, Cardiovascular Conditions, Practice Patterns
Misra-Hebert AD, Hu B, Pantalone KM
Primary care health care use for patients with type 2 diabetes during the COVID-19 pandemic.
This study sought to examine factors associated with total and virtual primary care use for patients with type 2 diabetes (T2D) during the COVID-19 pandemic. This study used electronic medical records in the Cleveland Clinic Health System comparing prepandemic use from August 2019 to March 2020 (baseline period 0) to two pandemic periods: March to June 2020 (period 1) when in-person visits were converted to virtual; and July to November 2020 when in-person visits resumed (period 2). Demographic characteristics were obtained including age, sex, race, insurance type, median income estimated by zip code and baseline HbA1C. The study included 76,015 patients with T2D who completed a primary care visit in baseline period 0. Cohort median age was 66.2 years, 50.7% women, 21.7% Black, 71.0% White and 7.4 Other. Insurance distribution was 43.2% private, 46.5% Medicare, and 9.5% Medicaid. Median income was estimated at $59,000 and baseline HbA1C was ≤ 7% for 59.6% of patients. There were higher odds of Black patients, those with uncontrolled T2D, and those with Medicare and Medicare using virtual visits during the 2 postpandemic periods suggesting that virtual visits may be a preference for those groups. Older and male patients had lower odds of visit completion.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Hu B, Pantalone KM .
Primary care health care use for patients with type 2 diabetes during the COVID-19 pandemic.
Diabetes Care 2021 Sep;44(9):e173-e74. doi: 10.2337/dc21-0853..
Keywords: COVID-19, Diabetes, Primary Care, Telehealth, Health Information Technology (HIT), Healthcare Delivery, Access to Care, Chronic Conditions
Chao GF, Li KY, Zhu Z
Use of telehealth by surgical specialties during the COVID-19 pandemic.
This study’s objective was to determine telehealth use by surgical specialty before and during the pandemic period starting in March 2020. Insurance claims from a Michigan statewide commercial payer for new patient visits with a surgeon from 1 of 9 surgical specialties during one of the following periods: prior to the COVID-19 pandemic (period 1: January 5 to March 7, 2020), early pandemic (period 2: March 8 to June 6, 2020), and late pandemic (period 3: June 7 to September 5, 2020) were analyzed. For new patient visits, 1182 surgeons (26.8%) in any patient context used telehealth. Telehealth use peaked in April 2020 and facilitated 34.6% of all new patient visits during that week. Urology was the specialty with the highest telehealth conversion rate (14.3%).
AHRQ-funded; HS027632.
Citation: Chao GF, Li KY, Zhu Z .
Use of telehealth by surgical specialties during the COVID-19 pandemic.
JAMA Surg 2021 Jul;156(7):620-26. doi: 10.1001/jamasurg.2021.0979..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Access to Care, Practice Patterns, Surgery
Stevens JP, Mechanic O, Markson L
Telehealth use by age and race at a single academic medical center during the COVID-19 pandemic: retrospective cohort study.
During the COVID-19 pandemic, many ambulatory clinics transitioned to telehealth, but it remains unknown how this may have exacerbated inequitable access to care. Given the potential barriers faced by different populations, the authors investigated whether telehealth use was consistent and equitable across age, race, and gender. The investigators concluded that their findings indicated that the rapid implementation of telehealth did not follow prior patterns of health care disparities.
AHRQ-funded; HS024288.
Citation: Stevens JP, Mechanic O, Markson L .
Telehealth use by age and race at a single academic medical center during the COVID-19 pandemic: retrospective cohort study.
J Med Internet Res 2021 May 20;23(5):e23905. doi: 10.2196/23905..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT)
Legler S, Diehl M, Hilliard B
Evaluation of an intrahospital telemedicine program for patients admitted with COVID-19: mixed methods study.
This pilot study’s objective was to evaluate an intrahospital telemedicine program along with its impact on exposure risk and communication for patients admitted with COVID-19. Virtual care was the main primary exposure variable and patient characteristics, PPE use rates, and their association with virtual care were assessed. Out of 137 total patients in their primary analysis, 43 patients used virtual care. There were 82 inpatient days of use, and 401 inpatient days without use. Surveys of 41 patients and clinicians showed high rates of recommendation for further use. A significant reduction in PPE use and physical exam rate was associated with virtual care. However, there are limitations in usability, medical assessment, and empathetic communication.
AHRQ-funded; HS026732.
Citation: Legler S, Diehl M, Hilliard B .
Evaluation of an intrahospital telemedicine program for patients admitted with COVID-19: mixed methods study.
J Med Internet Res 2021 Apr 29;23(4):e25987. doi: 10.2196/25987..
Keywords: Telehealth, Health Information Technology (HIT), Hospitals, Hospitalization, Communication, COVID-19
Peahl AF, Powell A, Berlin H
Patient and provider perspectives of a new prenatal care model introduced in response to the coronavirus disease 2019 pandemic.
The authors evaluated institutional-level adoption and patient and provider experiences with a coronavirus disease 2019 prenatal care model. They found that reduced visit schedules and virtual visits were rapidly integrated into real-world care, with positive experiences for many patients and providers. They recommended future research to understand the health outcomes and care experience associated with alternative approaches to prenatal care delivery across more diverse patient populations outside of the coronavirus disease 2019 pandemic to inform broader health policy decisions.
AHRQ-funded; HS025465.
Citation: Peahl AF, Powell A, Berlin H .
Patient and provider perspectives of a new prenatal care model introduced in response to the coronavirus disease 2019 pandemic.
Am J Obstet Gynecol 2021 Apr;224(4):384.e1-84.e11. doi: 10.1016/j.ajog.2020.10.008..
Keywords: Maternal Care, Pregnancy, Patient-Centered Healthcare, Telehealth, Health Information Technology (HIT), Healthcare Delivery, COVID-19
Etherton MR, Zachrison KS, Yan Z
Regional changes in patterns of stroke presentation during the COVID-19 pandemic.
The authors sought to determine the effect of the coronavirus pandemic on patterns of stroke patient presentation and quality of care. They analyzed data from 25 New England hospitals: one urban, academic, comprehensive stroke center and telestroke hub, and 24 spoke hospitals in the same telestroke network. They included all telestroke consultations from the 24 spokes, and stroke admissions to the comprehensive stroke center hub from November 2019 through April 2020. They compared rates of presentation, timeliness presentation, and quality of care pre- versus post-March 2020. They also examined trends in patient demographics, stroke severity, timeliness, diagnosis including large vessel occlusion, alteplase use, and endovascular thrombectomy among eligible subjects. Among 1248 patient presentations, telestroke consultations and ischemic stroke patient admissions decreased through the hub and spoke network. Age and stroke severity were unchanged during the study period. However, rates of adherence for the quality measures dysphagia screening, early antithrombotic initiation, and early venous thromboembolism prophylaxis were reduced during the pandemic.
AHRQ-funded; HS024561.
Citation: Etherton MR, Zachrison KS, Yan Z .
Regional changes in patterns of stroke presentation during the COVID-19 pandemic.
Stroke 2021 Apr;52(4):1398-406. doi: 10.1161/strokeaha.120.031300..
Keywords: Stroke, Cardiovascular Conditions, COVID-19, Telehealth, Health Information Technology (HIT), Healthcare Delivery
Davis K, Wilbur K, Metzger S
Symptom and needs assessment screening in oncology patients: alternate outreach methods during COVID-19.
This initiative’s goal was to develop alternate outreach methods to cancer patients without access to an electronic portal during COVID-19. The authors implemented a standardized telephone outreach process targeting patients without active electronic portal accounts to improve remote symptom monitoring. A total of 172 screens were completed, identifying 110 needs for 63 individuals. Twenty-eight patients completed patient enrollment, with outreach calls capturing a higher percentage of Black patients (34%) and older adults age 61-80 years old (69%) compared to portal users.
AHRQ-funded; HS026170.
Citation: Davis K, Wilbur K, Metzger S .
Symptom and needs assessment screening in oncology patients: alternate outreach methods during COVID-19.
J Psychosoc Oncol 2021;39(3):452-60. doi: 10.1080/07347332.2021.1890663..
Keywords: COVID-19, Cancer, Access to Care, Telehealth, Health Information Technology (HIT), Diagnostic Safety and Quality
Valdez RS, Roger CC, Claypool H
Ensuring full participation of people with disabilities in an era of telehealth.
This paper discusses the benefits and drawbacks that the widespread use of telehealth resulting from the COVID-19 pandemic has on people with disabilities. For some it may result in reduced barriers to care, but for others inadequate attention to the design, implementation, and policy dimensions may be detrimental.
AHRQ-funded; HS023849.
Citation: Valdez RS, Roger CC, Claypool H .
Ensuring full participation of people with disabilities in an era of telehealth.
J Am Med Inform Assoc 2021 Feb 15;28(2):389-92. doi: 10.1093/jamia/ocaa297..
Keywords: Disabilities, Telehealth, Health Information Technology (HIT), Access to Care, Policy, COVID-19