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 25 of 33 Research Studies DisplayedAbraham J, Meng A, Holzer KJ
Exploring patient perspectives on telemedicine monitoring within the operating room.
The authors sought to identify participant-rated items contributing to patient attitudes, beliefs, and level of comfort with electronic OR (eOR) monitoring and to highlight barriers and facilitators to eOR use. They found that participants expressed significant support for intraoperative telemedicine use and greater comfort with local telemedicine systems instead of long-distance telemedicine systems. They further found that reservations centered on organizational policies, procedures, environment, culture; people; workflow and communication; and hardware and software.
Citation: Abraham J, Meng A, Holzer KJ .
Exploring patient perspectives on telemedicine monitoring within the operating room.
Int J Med Inform 2021 Dec;156:104595. doi: 10.1016/j.ijmedinf.2021.104595..
Keywords: Telehealth, Health Information Technology (HIT), Surgery, Patient Experience
Mueller SK, Shannon E, Dalal A
Patient and physician experience with interhospital transfer: a qualitative study.
This qualitative study explored patients’ and involved physicians’ experience with interhospital transfer (IHT) to understand specific factors that may impact the quality and safety of this care transition. Individual interviews were conducted with adult patients transferred to cardiology, general medicine, and oncology services at a tertiary care academic medical center, as well as their transferring physician, accepting attending physician, and accepting/admitting resident physician. Participants included 10 adults (6 cardiology, 2 medicine, and 2 oncology), 9 accepting attending physicians, 12 accepting and/or admitting resident physicians, and 5 transferring physicians. Emergent themes demonstrated that participants held a shared understanding for the reason for the transfer and relayed a general dissatisfaction regarding the timing and lack of advanced notification of transfer. The authors found distinct differences in IHT experience by stakeholder group - with physicians relaying discontent on intrahospital chains of communication and interhospital information exchange, and patient participants focused more readily on the physical aspects of IHT.
AHRQ-funded; HS023331.
Citation: Mueller SK, Shannon E, Dalal A .
Patient and physician experience with interhospital transfer: a qualitative study.
J Patient Saf 2021 Dec 1;17(8):e752-e57. doi: 10.1097/pts.0000000000000501..
Keywords: Transitions of Care, Hospitals, Hospitalization, Provider: Physician, Patient Experience
Quigley DD, Qureshi N, Slaughter ME
Provider and coach perspectives on implementing shadow coaching to improve provider-patient interactions.
Healthcare organizations want to improve patient care experiences. Some use 'shadow coaching' to improve interactions between providers and patients. In this study, the investigators aimed to characterize lessons and barriers to implementing shadow coaching as a mechanism to improve interactions with patients and change organizational culture. The investigators concluded that regular messaging by leadership about the priority and purpose of shadow coaching was essential for both physician engagement and its mature implementation across the organization.
AHRQ-funded; HS025920.
Citation: Quigley DD, Qureshi N, Slaughter ME .
Provider and coach perspectives on implementing shadow coaching to improve provider-patient interactions.
J Eval Clin Pract 2021 Dec;27(6):1381-89. doi: 10.1111/jep.13575..
Keywords: Clinician-Patient Communication, Patient Experience, Practice Improvement
Meyers DJ, Rahman M, Wilson IB
The relationship between Medicare Advantage Star Ratings and enrollee experience.
Medicare Advantage plans, private managed care plans that enrolled 34% of Medicare beneficiaries in 2019, received $6 billion in annual bonus payments on the basis of their performance on a 5-star rating system. Little is known, however, as to the extent these ratings adequately capture enrollee experience. The objective of this study was to measure the effect of exposure to higher rated Medicare Advantage contracts on enrollee experience.
AHRQ-funded; HS027051.
Citation: Meyers DJ, Rahman M, Wilson IB .
The relationship between Medicare Advantage Star Ratings and enrollee experience.
J Gen Intern Med 2021 Dec;36(12):3704-10. doi: 10.1007/s11606-021-06764-y..
Keywords: Medicare, Patient Experience
Whitebird RR, Solberg LI, Ziegenfuss JY
Personalized outcomes for hip and knee replacement: the patients point of view.
Patient reported outcome measures (PROMs) are increasingly being incorporated into clinical and surgical care for assessing outcomes. This study examined outcomes important to patients in their decision to have hip or knee replacement surgery, their perspectives on PROMs and shared decision-making, and factors they considered important for postoperative care.
AHRQ-funded; HS025618.
Citation: Whitebird RR, Solberg LI, Ziegenfuss JY .
Personalized outcomes for hip and knee replacement: the patients point of view.
J Patient Rep Outcomes 2021 Nov 4;5(1):116. doi: 10.1186/s41687-021-00393-z..
Keywords: Orthopedics, Surgery, Patient-Centered Outcomes Research, Patient Experience, Decision Making
Lasser EC, Heughan JA, Lai AY
Patient perceptions of safety in primary care: a qualitative study to inform care.
The authors sought to understand the patient perspective on patient safety in patient-centered medical homes (PCMHs). Using focus groups/interviews, they found overarching themes focused on (1) clear and timely communication with and between clinicians and (2) trust in the care team, including being heard, respected, and treated as a whole person. Other themes included sharing of and access to information, patient education and patient-centered medication reconciliation process, clear documentation for the diagnostic process, patient-centered comprehensive visits, and timeliness of care.
AHRQ-funded; HS024859.
Citation: Lasser EC, Heughan JA, Lai AY .
Patient perceptions of safety in primary care: a qualitative study to inform care.
Curr Med Res Opin 2021 Nov;37(11):1991-99. doi: 10.1080/03007995.2021.1976736..
Keywords: Patient Safety, Patient Experience, Primary Care, Patient-Centered Healthcare
Quigley DD, Elliott MN, Slaughter ME
Shadow coaching improves patient experience with care, but gains erode later.
Health care organizations strive to improve patient care experiences. Some use one-on-one provider counseling (shadow coaching) to identify and target modifiable provider behaviors. In this study, the investigators examined whether shadow coaching improved patient experience across 44 primary care practices in a large urban Federally Qualified Health Center. The investigators concluded that shadow coaching improved providers' overall performance and communication immediately after being coached.
AHRQ-funded; HS025920.
Citation: Quigley DD, Elliott MN, Slaughter ME .
Shadow coaching improves patient experience with care, but gains erode later.
Med Care 2021 Nov;59(11):950-60. doi: 10.1097/mlr.0000000000001629..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Provider Performance, Quality Improvement, Quality of Care, Primary Care
Roberts ET, Song Z, Ding L
Changes in patient experiences and assessment of gaming among large clinician practices in precursors of the merit-based incentive payment system.
Medicare's Merit-Based Incentive Payment System (MIPS), a public reporting and pay-for-performance program, adjusts clinician payments based on publicly reported measures that are chosen primarily by clinicians or their practices. Within precursor programs of the MIPS, this study examined 1) practices' selection of Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient experience measures for quality scoring under pay-for-performance and 2) the association between mandated public reporting on CAHPS measures and performance on those measures.
AHRQ-funded; HS026727.
Citation: Roberts ET, Song Z, Ding L .
Changes in patient experiences and assessment of gaming among large clinician practices in precursors of the merit-based incentive payment system.
JAMA Health Forum 2021 Oct;2(10). doi: 10.1001/jamahealthforum.2021.3105..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Medicare, Provider Performance, Payment, Quality Improvement, Quality of Care
Armstrong MJ, Gamez N, Alliance S
Clinical care and unmet needs of individuals with dementia with Lewy bodies and caregivers: an interview study.
Investigators researched the clinical care preferences of individuals living with dementia and caregivers, particularly dementia with Lewy bodies (DLB). Twenty individuals with DLB and 25 caregivers were interviewed via a semistructured questionnaire. The investigators concluded that improving care for individuals with DLB and their families will require a multipronged strategy including education for non-specialist care providers, increasing specialty care access, improved clinical care services, research to support disease prognosis and treatment decisions, and local and national strategies for enhanced caregiver support.
Citation: Armstrong MJ, Gamez N, Alliance S .
Clinical care and unmet needs of individuals with dementia with Lewy bodies and caregivers: an interview study.
Alzheimer Dis Assoc Disord 2021 Oct-Dec;35(4):327-34. doi: 10.1097/wad.0000000000000459..
Keywords: Dementia, Caregiving, Chronic Conditions, Neurological Disorders, Patient Experience
Prasad T, Buta E, Cleary PD
Is patient-physician gender concordance related to the quality of patient care experiences?
There is great interest in identifying factors that are related to positive patient experiences such as physician communication style. Documented gender-specific physician communication and patient behavior differences raise the question of whether gender concordant relationships (i.e., both the provider and patient share the same gender) might affect patient experiences. The objective of this study was to assess whether patient experiences were more positive in gender concordant primary care relationships.
AHRQ-funded; HS016978.
Citation: Prasad T, Buta E, Cleary PD .
Is patient-physician gender concordance related to the quality of patient care experiences?
J Gen Intern Med 2021 Oct;36(10):3058-63. doi: 10.1007/s11606-020-06411-y..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience
Shintani Smith S, Cheng BT, Kern RC
Publicly reported patient satisfaction scores in academic otolaryngology departments.
Despite controversy regarding their impact and validity, there is a rising national focus on patient satisfaction scores (PSS). In this retrospective cross-sectional study the investigators described the landscape of online PSS as posted by academic otolaryngology practices. The investigators concluded that patient satisfaction with otolaryngology providers at academic institutions was consistently high, as demonstrated by high online PSS with little variability.
AHRQ-funded; HS023011.
Citation: Shintani Smith S, Cheng BT, Kern RC .
Publicly reported patient satisfaction scores in academic otolaryngology departments.
Laryngoscope 2021 Oct;131(10):2204-10. doi: 10.1002/lary.29557..
Keywords: Patient Experience, Quality of Care, Provider Performance
Quigley DD, Slaughter ME, Gidengil C
Usefulness of child HCAHPS survey data for improving inpatient pediatric care experiences.
Quality improvement (QI) requires data, indicators, and national benchmarks. Knowledge about the usefulness of Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS) data are lacking. In this study the investigators examined quality leader and frontline staff perceptions about patient experience measurement and use of Child HCAHPS data for QI. The investigators surveyed children's hospital leaders and staff about their use of Child HCAHPS for QI, including measures from other studies. They compared scale and item means for leaders and staff and compared means to other studies.
AHRQ-funded; HS025920.
Citation: Quigley DD, Slaughter ME, Gidengil C .
Usefulness of child HCAHPS survey data for improving inpatient pediatric care experiences.
Hosp Pediatr 2021 Oct;11(10):e199-e214. doi: 10.1542/hpeds.2020-004283..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Hospitals, Patient Experience, Quality Improvement, Quality Measures, Quality of Care
Quigley DD, Qureshi N, AlMasarweh L
Using CAHPS patient experience data for patient-centered medical home transformation.
The purpose of this study was to examine how primary care practices used the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and its patient-centered medical home (PCMH) items during their PCMH transition. The investigators concluded that CAHPS surveys were considered actionable for PCMH transformation and used in standardizing and coordinating care. The CAHPS PCMH items were considered integral to the continuous QI needed for moving beyond formal PCMH recognition and maximizing transformation.
AHRQ-funded; HS016980; HS025920.
Citation: Quigley DD, Qureshi N, AlMasarweh L .
Using CAHPS patient experience data for patient-centered medical home transformation.
Am J Manag Care 2021 Sep;27(9):e322-e29. doi: 10.37765/ajmc.2021.88745..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Patient-Centered Healthcare, Primary Care, Practice Improvement, Healthcare Delivery, Quality Improvement, Quality of Care
Johnson CL, Schwartz H, Greenberg A
Patient perceptions on barriers and facilitators to accessing low-acuity surgery during COVID-19 pandemic.
The onset of the COVID-19 pandemic led to the postponement of low-acuity surgical procedures in an effort to conserve resources and ensure patient safety. This study aimed to characterize patient-reported concerns about undergoing surgical procedures during the pandemic. The investigators concluded that eliciting patients' perspectives, adapting processes to address potential barriers, and effectively educating patients about institutional measures to minimize in-hospital transmission of COVID-19 should be integrated into surgical care.
AHRQ-funded; HS024532.
Citation: Johnson CL, Schwartz H, Greenberg A .
Patient perceptions on barriers and facilitators to accessing low-acuity surgery during COVID-19 pandemic.
J Surg Res 2021 Aug;264:30-36. doi: 10.1016/j.jss.2021.01.028..
Keywords: COVID-19, Surgery, Access to Care, Patient Experience, Public Health
Tung EL, De Marchis EH, Gottlieb LM
Patient experiences with screening and assistance for social isolation in primary care settings.
Social isolation is a known predictor of mortality that disproportionately affects vulnerable populations in the USA. Although experts began to recognize it as a public health crisis prior to 2020, the novel coronavirus pandemic has accelerated recognition of social isolation as a serious threat to health and well-being. The objectives of this study were to examine patient experiences with screening and assistance for social isolation in primary care settings, and to determine whether patient experiences with these activities were associated with the severity of reported social isolation.
AHRQ-funded; HS026664; HS026383.
Citation: Tung EL, De Marchis EH, Gottlieb LM .
Patient experiences with screening and assistance for social isolation in primary care settings.
J Gen Intern Med 2021 Jul;36(7):1951-57. doi: 10.1007/s11606-020-06484-9..
Keywords: COVID-19, Patient Experience, Primary Care
Richardson DR, Oakes AH, Crossnohere NL
Prioritizing the worries of AML patients: Quantifying patient experience using best-worst scaling.
Although patients with acute myeloid leukemia (AML) experience significant toxicities and poor outcomes, few studies have quantified patients' experience. In this study, a community-centered approach was used to develop an AML-specific best-worst scaling (BWS) instrument involving 13 items in four domains (psychological, physical, decision-making, treatment delivery) to quantify patient worry. A survey of patients and caregivers was conducted using the instrument. Data were analyzed using conditional logistic regression.
AHRQ-funded; HS000032.
Citation: Richardson DR, Oakes AH, Crossnohere NL .
Prioritizing the worries of AML patients: Quantifying patient experience using best-worst scaling.
Psychooncology 2021 Jul;30(7):1104-11. doi: 10.1002/pon.5652..
Keywords: Cancer, Patient Experience, Caregiving, Outcomes, Patient-Centered Outcomes Research
Clair K, Ijadi-Maghsoodi R, Nazinyan M
Veteran perspectives on adaptations to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic.
This paper looks at veterans’ perspectives on adaptations made to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic. Adaptations to services are described within a large residential rehabilitation program for under-resourced veterans; reports veterans’ experiences; and outlines successes and challenges encountered. Data was collected from two focus groups with nine veterans in the program. The groups highlighted experiences of inconsistent communication about residential policies, interruptions to medical and addiction services, and feelings of confinement and social isolation.
AHRQ-funded; HS026407.
Citation: Clair K, Ijadi-Maghsoodi R, Nazinyan M .
Veteran perspectives on adaptations to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic.
Community Ment Health J 2021 Jul;57(5):801-07. doi: 10.1007/s10597-021-00810-z..
Keywords: Substance Abuse, Rehabilitation, COVID-19, Healthcare Delivery, Access to Care, Patient Experience
Meyers DJ, Rahman M, Mor V
Association of Medicare Advantage Star Ratings with racial, ethnic, and socioeconomic disparities in quality of care.
This cross-sectional study looked at racial/ethnic minority and socioeconomic disparities in ratings for Medicare Advantage (MA) plans, which disproportionately enroll these populations. A total of 1,578,564 enrollees were included in this analysis that used 22 measures of quality and satisfaction at the individual enrollee level, aggregated into simulated star ratings from 2-5 stratified by socioeconomic status (SES) and race/ethnicity. Low SES enrollees had simulated stratified star ratings 0.5 stars lower than individuals with high SES in the same contract. Black enrollees had simulated star ratings that were 0.3 stars lower and Hispanic enrollees had 0.1 lower simulated star ratings than White enrollees in the same contract. There was a larger difference in ratings with 4.5 to 5-star contracts with Black and Hispanic enrollees with Whites, and no statistical difference in 2.0 to 2.5 star-rated contracts. There was only low correlation between simulated ratings for enrollees of low SES and high SES.
AHRQ-funded; HS02705101.
Citation: Meyers DJ, Rahman M, Mor V .
Association of Medicare Advantage Star Ratings with racial, ethnic, and socioeconomic disparities in quality of care.
JAMA Health Forum 2021 Jun;2(6):e210793..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Medicare, Patient Experience, Disparities, Quality Measures, Provider Performance, Quality of Care, Racial and Ethnic Minorities
Hung DY, Mujal G, Jin A
Patient experiences after implementing lean primary care redesigns.
The authors examined the effect of Lean primary care redesigns on patient satisfaction with care and timeliness of care received. After implementation of Lean redesigns, they found that patients reported a 44.8 percent increase in satisfaction with the adequacy of time spent with care providers during office visits. They also reported 71.6 percent higher satisfaction with their care provider's ability to listen to their concerns and a 55.4 percent increase in perceived staff helpfulness at the visit. The amount of time elapsed between a patient request for a routine appointment and the scheduled visit day decreased. On the day of the visit, patient wait times to be seen also decreased gradually.
AHRQ-funded; HS024529.
Citation: Hung DY, Mujal G, Jin A .
Patient experiences after implementing lean primary care redesigns.
Health Serv Res 2021 Jun;56(3):363-70. doi: 10.1111/1475-6773.13605..
Keywords: Patient Experience, Primary Care: Models of Care, Primary Care, Workflow, Quality Improvement, Quality of Care
Simmel C, Bowden CF, Neese-Todd S
Antipsychotic treatment for youth in foster care: Perspectives on improving youths' experiences in providing informed consent.
AHRQ-funded; HS026001.
Citation: Simmel C, Bowden CF, Neese-Todd S .
Antipsychotic treatment for youth in foster care: Perspectives on improving youths' experiences in providing informed consent.
Am J Orthopsychiatry 2021;91(2):258-70. doi: 10.1037/ort0000532..
Keywords: Children/Adolescents, Vulnerable Populations, Behavioral Health, Medication, Patient Experience
Aiyegbusi OL, Nair D, Peipert JD
A narrative review of current evidence supporting the implementation of electronic patient-reported outcome measures in the management of chronic diseases.
This review discusses and summarizes evidence of the impact of electronic patient-reported outcomes measures (ePROMs) on clinical parameters and outcomes relevant to chronic diseases. Various studies have demonstrated the feasibility of ePROMs in routine clinical practice with patients increasing expressing a preference for an electronic mode of administration. These ePROMs could have significant impacts on outcomes valued by patients, healthcare providers, and researchers. Recently published literature.
AHRQ-funded; HS026395.
Citation: Aiyegbusi OL, Nair D, Peipert JD .
A narrative review of current evidence supporting the implementation of electronic patient-reported outcome measures in the management of chronic diseases.
Ther Adv Chronic Dis 2021 May 24;12:20406223211015958. doi: 10.1177/20406223211015958..
Keywords: Chronic Conditions, Patient Experience, Health Information Technology (HIT), Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Evidence-Based Practice
Willard-Grace R, Knox M, Huang B
Primary care clinician burnout and engagement association with clinical quality and patient experience.
Burnout and engagement are commonly conceptualized as opposite ends of a spectrum, and there is concern that high clinician burnout and lack of engagement may adversely impact patient care. In this study, the investigators matched self-reported data on burnout and engagement for 182 primary care clinicians with data on clinical quality (cancer screenings, hypertension and diabetes control) and patient experience (Clinician and Group Survey-Consumer Assessment of Healthcare Providers and Systems [CG-CAHPS] communication scores, overall rating, and likelihood to recommend the clinic).
AHRQ-funded; HS026067.
Citation: Willard-Grace R, Knox M, Huang B .
Primary care clinician burnout and engagement association with clinical quality and patient experience.
J Am Board Fam Med 2021 May-Jun;34(3):542-52. doi: 10.3122/jabfm.2021.03.200515..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Burnout, Patient Experience, Patient and Family Engagement, Provider: Clinician, Provider: Physician, Quality of Care, Provider: Nurse, Provider: Health Personnel
Byrnes ME, Brown CS, De Roo A
Elective surgical delays due to COVID-19: the patient lived experience.
This study looked at the effects of the COVID-19 pandemic on scheduling of elective cardiac and vascular surgery. The authors interviewed 47 individuals who experienced a postponement of surgery due to coronavirus. Patients described 3 key issues around their postponement: 1) surgery as part of a “return to normal”; 2) postponement took a toll on their physical health and mental wellbeing; and 3) many patients in their study said they would “rather die from a heart attack” than be exposed to the coronavirus.
AHRQ-funded; HS000053.
Citation: Byrnes ME, Brown CS, De Roo A .
Elective surgical delays due to COVID-19: the patient lived experience.
Med Care 2021 Apr;59(4):288-94. doi: 10.1097/mlr.0000000000001503..
Keywords: COVID-19, Surgery, Public Health, Patient Experience, Infectious Diseases
Kirby JB, Berdahl TA, Stone RA
AHRQ Author: Kirby JB, Berdahl TA
Perceptions of patient-provider communication across the six largest Asian subgroups in the USA.
Investigators sought to estimate racial/ethnic differences in perceptions of provider communication among the six largest Asian subgroups. Using MEPS data, they found that negative views of provider communication are not pervasive among all Asians but, rather, primarily reflect the perceptions of Chinese and, possibly, Vietnamese patients. They recommended that researchers, policymakers, health plan executives, and others who produce or use data on patients' experiences with health care avoid categorizing all Asians into a single group.
AHRQ-authored.
Citation: Kirby JB, Berdahl TA, Stone RA .
Perceptions of patient-provider communication across the six largest Asian subgroups in the USA.
J Gen Intern Med 2021 Apr;36(4):888-93. doi: 10.1007/s11606-020-06391-z..
Keywords: Medical Expenditure Panel Survey (MEPS), Consumer Assessment of Healthcare Providers and Systems (CAHPS), Clinician-Patient Communication, Communication, Patient Experience, Racial and Ethnic Minorities, Cultural Competence
Ahmedov M, Pourat N, Liu H
Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey of experiences with ambulatory healthcare for Asians and non-Hispanic Whites in the United States.
This paper discusses the results of the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Clinical and Group (CG-CAHPS) Adult Visit Survey 1.0 which includes data on care experiences to compare specific aspects of care of Asians and Whites. Most surveys were administered by mail with a sample comprised of 64% female, 89% White, 2% Asian, 39% 65 years or older, and 32% were high school graduates or less. Asians reported worse access, lower scores on office staff courtesy and helpfulness and rating their doctors, and were less likely to recommend their doctors to family/friends than did Whites.
AHRQ-funded; HS016980; HS016978.
Citation: Ahmedov M, Pourat N, Liu H .
Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey of experiences with ambulatory healthcare for Asians and non-Hispanic Whites in the United States.
J Patient Rep Outcomes 2021 Mar 24;5(1):29. doi: 10.1186/s41687-021-00303-3..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Racial and Ethnic Minorities, Patient Experience, Quality of Care, Ambulatory Care and Surgery