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 6 of 6 Research Studies DisplayedJiang HJ, Fingar KR, Liang L
AHRQ Author: Jiang HJ, Liang L
Quality of care before and after mergers and acquisitions of rural hospitals.
Researchers sought to examine changes in quality of care for patients at rural hospitals that merged compared with those that remained independent. Using HCUP data, they found that rural hospital mergers were associated with better mortality outcomes for acute myocardial infarction, heart failure, stroke, gastrointestinal hemorrhage, hip fracture, and pneumonia. They concluded that their finding is important to enhancing rural health care and reducing urban-rural disparities in quality of care.
AHRQ-authored; AHRQ-funded; 290201800001C.
Citation: Jiang HJ, Fingar KR, Liang L .
Quality of care before and after mergers and acquisitions of rural hospitals.
JAMA Netw Open 2021 Sep;4(9):e2124662. doi: 10.1001/jamanetworkopen.2021.24662..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitals, Rural Health, Quality of Care
Fagnan LJ, Ramsey K, Kline T
Place matters: closing the gap on rural primary care quality improvement capacity-the Healthy Hearts Northwest study.
This study compared rural independent and health system primary care practices with urban practices to external practice facilitation support in terms of recruitment, readiness, engagement, retention, and change in quality improvement (QI) capacity and quality metric performing. The Healthy Hearts Northwest quality improvement initiative consisting of 135 small or medium-sized primary care practices were used. The practices were stratified by geography, rural or urban, and by ownership. Changes in 3 clinical quality measures (CQMs): appropriate aspirin use, blood pressure (BP) control, and tobacco use screening, were measured at baseline in 2015 and follow-up in 2017. Rural practices were more likely to enroll than urban practices. Rural independent practices had the lowest QI capacity at baseline, making the largest gain in establishing a regular QI process. They made the greatest improvement in meeting the BP control CQM and the smoking cessation metric, from 72.3% to 86.7%.
AHRQ-funded; HS023908; HS023921.
Citation: Fagnan LJ, Ramsey K, Kline T .
Place matters: closing the gap on rural primary care quality improvement capacity-the Healthy Hearts Northwest study.
J Am Board Fam Med 2021 Jul-Aug;34(4):753-61. doi: 10.3122/jabfm.2021.04.210011..
Keywords: Rural Health, Primary Care, Primary Care: Models of Care, Practice Improvement, Quality Improvement, Quality of Care, Heart Disease and Health, Cardiovascular Conditions
CE Kranz, AM DeYoreo, M
AHRQ Author: O'Hanlon
Access, quality, and financial performance of rural hospitals following health system affiliation.
This study examined the effect of a rural hospital affiliating itself with a health system. The comparison study used data from 2008 to 2017. A propensity score-weighted set of twelve measures were used on structure, utilization, financial performance, and quality. The rural hospitals that affiliated themselves with a health system experienced a significant reduction in on-site diagnostic imaging technologies, the availability of obstetric and primary care services, and outpatient nonemergency visits as well as a significant increase in operating margins. While these affiliations may help to keep a rural hospital open, it may also reduce access to services in these rural areas.
AHRQ-funded; HS024067.
Citation: CE Kranz, AM DeYoreo, M .
Access, quality, and financial performance of rural hospitals following health system affiliation.
Health Aff 2019 Dec;38(12):2095-104. doi: 10.1377/hlthaff.2019.00918..
Keywords: Provider Performance, Quality of Care, Hospitals, Rural Health
Cole MB, Wright B, Wilson IB
Medicaid expansion and community health centers: care quality and service use increased for rural patients.
Investigators studied the impact of Medicaid expansion in rural areas. Data from 2011-2015 found that there was an 11.4% decline in uninsured patients and a 13.5% increase in Medicaid patients at community health centers (CHCs). Relative improvements were shown in patients with chronic conditions such as asthma and hypertension; and an increase in visits for mammograms and substance abuse disorders.
AHRQ-funded; HS024652.
Citation: Cole MB, Wright B, Wilson IB .
Medicaid expansion and community health centers: care quality and service use increased for rural patients.
Health Aff 2018 Jun;37(6):900-07. doi: 10.1377/hlthaff.2017.1542..
Keywords: Medicaid, Community-Based Practice, Rural Health, Access to Care, Quality of Care, Healthcare Utilization, Primary Care
Baernholdt M, Hinton ID, Guofen Y
A national comparison of rural/urban pressure ulcer and fall rates.
Despite recent decline in hospital acquired conditions (HACs), rates for pressure ulcers (PURs) and falls (FRs) remain at levels that require improvement. Contextual factors and care processes may impact HACs. Using the National Database of Nursing Quality Indicators (NDNQI®) this study examined differences in care processes and community, hospital, and nursing unit characteristics that influence PURs and FRs in 4238 rural and urban nursing units.
AHRQ-funded; HS023147.
Citation: Baernholdt M, Hinton ID, Guofen Y .
A national comparison of rural/urban pressure ulcer and fall rates.
Online J Issues Nurs 2017 May;22(2):1-12. doi: 10.3912/OJIN.Vol22No02PPT60..
Keywords: Injuries and Wounds, Nursing, Patient Safety, Pressure Ulcers, Quality of Care, Quality Improvement, Quality Indicators (QIs), Quality Measures, Rural Health, Urban Health
Zhu X, Baloh J, Ward MM
Deliberation makes a difference: preparation strategies for TeamSTEPPS implementation in small and rural hospitals.
The researchers studied the implementation of TeamSTEPPS in 14 critical access hospitals, proposing five strategic preparation steps for TeamSTEPPS. They discussed potential steps that hospitals may take to better prepare for TeamSTEPPS implementation.
AHRQ-funded; HS024112; HS018396.
Citation: Zhu X, Baloh J, Ward MM .
Deliberation makes a difference: preparation strategies for TeamSTEPPS implementation in small and rural hospitals.
Med Care Res Rev 2016 Jun;73(3):283-307. doi: 10.1177/1077558715607349.
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Keywords: TeamSTEPPS, Teams, Rural Health, Hospitals, Implementation, Quality Improvement, Quality of Care