National Healthcare Quality and Disparities Report
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Topics
- Ambulatory Care and Surgery (1)
- Arthritis (1)
- Asthma (1)
- Blood Pressure (1)
- Cardiovascular Conditions (2)
- Care Coordination (2)
- Children/Adolescents (4)
- (-) Chronic Conditions (11)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Diabetes (3)
- Emergency Department (2)
- Evidence-Based Practice (1)
- Healthcare Delivery (1)
- Healthcare Utilization (1)
- Health Services Research (HSR) (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Patient Experience (1)
- Primary Care (2)
- Provider Performance (1)
- Quality Improvement (4)
- Quality Indicators (QIs) (3)
- (-) Quality Measures (11)
- Quality of Care (9)
- Registries (1)
- Risk (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 11 of 11 Research Studies DisplayedCabana MD, Robinson K, Plavin J
Partnering to improve pediatric asthma quality.
The purpose of this article was to explore the need for partnering between emergency departments (Eds) and primary care physicians (PCPs) to improve asthma quality measures, practice level improvements for both PCPs and EDs, and ultimately improve outcomes for children with asthma. Proper and timely management of asthma is thought to prevent ED visits, and the responsibility for addressing improvements in PCP performance should be shared by the PCP practices and health care payors and plans. The ability to measure the drivers of asthma-related visits to the ED may be outside of what a PCP practice can address, and so practices must be able to partner with health plans to successfully measure and develop system-wide interventions for quality and outcomes improvement. Although a child’s asthma may be managed in their PCP office, treatment of asthma issues often takes place in an ED setting or urgent care clinic that may be completely isolated from the patient’s PCP provider and system. Health plans can fill in the missing pieces to provide feedback on performance which can reduce ED visits, improve medication adherence and management, and provide actionable and timely data about hospital visits and discharge to PCP practices for quality improvements. Social determinants and comorbidities play a role in addressing ED visits for asthma. Health plan, public health systems, and provider coordination, integration, and partnerships are required to effectively address those issues and improve outcomes. The authors conclude that a systems approach and thoughtful partnerships across disciplines will be required beyond the PCP practice level to improve the outcomes of children with asthma.
AHRQ-funded; HS025297.
Citation: Cabana MD, Robinson K, Plavin J .
Partnering to improve pediatric asthma quality.
Acad Pediatr 2022 Apr;22(3S):S73-S75. doi: 10.1016/j.acap.2021.06.013..
Keywords: Children/Adolescents, Asthma, Chronic Conditions, Emergency Department, Quality Measures, Quality Improvement, Quality of Care
Schmajuk G, Li J, Evans M
Quality of care for patients with systemic lupus erythematosus: data from the American College of Rheumatology RISE Registry.
Although multiple national quality measures focus on the management and safety of rheumatoid arthritis, few measures address the care of patients with systemic lupus erythematosus (SLE). In this study, the objective was to apply a group of quality measures relevant to the care of patients with SLE, and use the American College of Rheumatology's Rheumatology Informatics System for Effectiveness (RISE) registry to assess nationwide variations in care.
AHRQ-funded; HS024412.
Citation: Schmajuk G, Li J, Evans M .
Quality of care for patients with systemic lupus erythematosus: data from the American College of Rheumatology RISE Registry.
Arthritis Care Res 2022 Feb;74(2):179-86. doi: 10.1002/acr.24446..
Keywords: Chronic Conditions, Quality Measures, Quality of Care
Izadi Z, Schmajuk G, Gianfrancesco M
Significant gains in rheumatoid arthritis quality measures among RISE Registry practices.
This study examined performance on rheumatoid arthritis (RA) quality measures and assessed the association between practice characteristics and changes in performance over time among participating practices. The authors analyzed data from practices enrolled in the American College of Rheumatology Rheumatology Informatics System for Effectiveness (RISE) registry from 2015 to 2017. Eight quality measures in the areas of RA disease management, cardiovascular risk reduction, and patient safety were analyzed. Data from 59,986 patients from 54 practices were examined. Cohort characteristics were a mean age of 62 years, 77% female, 69% Caucasian, and most patients (46%) were seen in a single-specialty group practice. Measures related to RA functional status and disease activity assessment improved over time, with single-specialty group practices having the fastest rates of improvement across all measures.
AHRQ-funded; HS025638; HS024412.
Citation: Izadi Z, Schmajuk G, Gianfrancesco M .
Significant gains in rheumatoid arthritis quality measures among RISE Registry practices.
Arthritis Care Res 2022 Feb;74(2):219-28. doi: 10.1002/acr.24444..
Keywords: Arthritis, Chronic Conditions, Quality Measures, Quality Indicators (QIs), Registries, Quality of Care
Parchman ML, Anderson ML, Dorr DA
A randomized trial of external practice support to improve cardiovascular risk factors in primary care.
Researchers conducted a randomized controlled trial to compare the effectiveness of adding various forms of enhanced external support to practice facilitation on primary care practices' clinical quality measure (CQM) performance. They concluded that, although they found no significant differences in CQM performance across study arms, the ability of a practice to reach a target level of performance may be enhanced by adding both educational outreach visits and shared learning to practice facilitation.
AHRQ-funded; HS023908.
Citation: Parchman ML, Anderson ML, Dorr DA .
A randomized trial of external practice support to improve cardiovascular risk factors in primary care.
Ann Fam Med 2019 Aug 12;17(Suppl 1):S40-s49. doi: 10.1370/afm.2407..
Keywords: Cardiovascular Conditions, Primary Care, Quality Improvement, Provider Performance, Quality Measures, Quality of Care, Risk, Evidence-Based Practice, Patient-Centered Healthcare, Chronic Conditions
Simon TD, Haaland W, Hawley K
Development and validation of the Pediatric Medical Complexity Algorithm (PMCA) Version 3.0.
This study’s objective was to modify the Pediatric Medical Complexity Algorithm (PMCA) to include both ICD-9-CM and ICD-10-CM code revisions as well to assess the sensitivity and specificity of the new PMCA version 3.0. The new version 3.0 was applied to data for children from the Seattle Children’s Hospital emergency department, day surgery, and/or inpatient encounter from January 2016 to June 2017. A blinded random sample of 300 children was used from 3 different classifications: those with chronic complex disease, children with noncomplex chronic disease, and no chronic disease. Sensitivity and specificity was rated as over 65% up to 93% for all classification types.
AHRQ-funded; HS020506.
Citation: Simon TD, Haaland W, Hawley K .
Development and validation of the Pediatric Medical Complexity Algorithm (PMCA) Version 3.0.
Acad Pediatr 2018 Jul;18(5):577-80. doi: 10.1016/j.acap.2018.02.010..
Keywords: Children/Adolescents, Quality Measures, Quality Improvement, Chronic Conditions, Quality of Care
Arthur KC, Mangione-Smith R, Burkhart Q
Quality of care for children with medical complexity: an analysis of continuity of care as a potential quality indicator.
The objective of this study was to examine the relationship between continuity of care for children with medical complexity (CMC) and emergency department (ED) utilization, care coordination quality, and family effects related to care coordination. The investigators measured ED utilization and primary care continuity with the Bice-Boxerman continuity of care index for 1477 CMC using administrative data from Minnesota and Washington state Medicaid agencies. They concluded that continuity of care holds promise as a quality measure for CMC because of its association with lower ED utilization and more frequent receipt of care coordination.
AHRQ-funded; HS020506.
Citation: Arthur KC, Mangione-Smith R, Burkhart Q .
Quality of care for children with medical complexity: an analysis of continuity of care as a potential quality indicator.
Acad Pediatr 2018 Aug;18(6):669-76. doi: 10.1016/j.acap.2018.04.009..
Keywords: Care Coordination, Children/Adolescents, Chronic Conditions, Emergency Department, Healthcare Utilization, Primary Care, Quality of Care, Quality Indicators (QIs), Quality Measures
Parast L, Burkhart Q, Gidengil C
Validation of new care coordination quality measures for children with medical complexity.
The purpose of this paper was to validate new caregiver-reported quality measures assessing care coordination services for children with medical complexity (CMC). Results showed that 19 newly-developed Family Experiences with Coordination of Care quality measures demonstrated convergent validity with previously-validated CAHPS measures. These new measures are valid for assessing the quality of care coordination services provided to CMC and may be useful for evaluating new models of care focused on improving these services.
AHRQ-funded; HS020506.
Citation: Parast L, Burkhart Q, Gidengil C .
Validation of new care coordination quality measures for children with medical complexity.
Acad Pediatr 2018 Jul;18(5):581-88. doi: 10.1016/j.acap.2018.03.006..
Keywords: Care Coordination, Children/Adolescents, Chronic Conditions, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care
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
Magnan EM, Palta M, Johnson HM
The impact of a patient's concordant and discordant chronic conditions on diabetes care quality measures.
The researchers sought to determine the impact of the number of concordant and discordant chronic conditions on diabetes care quality. Their findings suggest that the patients most at risk for suboptimal diabetes care are the patients with the fewest comorbidities, especially the fewest concordant comorbidities.
AHRQ-funded; HS018368; HS021899.
Citation: Magnan EM, Palta M, Johnson HM .
The impact of a patient's concordant and discordant chronic conditions on diabetes care quality measures.
J Diabetes Complications 2015 Mar;29(2):288-94. doi: 10.1016/j.jdiacomp.2014.10.003..
Keywords: Quality Measures, Diabetes, Chronic Conditions
Navar-Boggan AM, Fanaroff A, Swaminathan A
The impact of a measurement and feedback intervention on blood pressure control in ambulatory cardiology practice.
This study evaluated the impact of a targeted provider feedback intervention on rates of blood pressure control. Providers received quarterly provider-specific reports over a period of one year for a group of 300 patients treated in outpatient cardiology clinic practices. These reports as a stand-alone intervention did not affect overall BP control rates in cardiology clinics.
AHRQ-funded; HS021092
Citation: Navar-Boggan AM, Fanaroff A, Swaminathan A .
The impact of a measurement and feedback intervention on blood pressure control in ambulatory cardiology practice.
Am Heart J. 2014 Apr;167(4):466-71. doi: 10.1016/j.ahj.2013.12.015..
Keywords: Blood Pressure, Ambulatory Care and Surgery, Diabetes, Chronic Conditions, Quality Measures, Quality of Care
Leroy L, Bayliss E, Domino M
AHRQ Author: Miller T
The Agency for Healthcare Research and Quality Multiple Chronic Conditions Research Network: overview of research contributions and future priorities.
HHS developed the HHS Strategic Framework on Multiple Chronic Conditions (MCC), and AHRQ contributed by funding the MCC Research Network over 45 diverse grants. This paper described a subset of research contributions made in each topic area and made 3 recommendations for future MCC research: (1) include person-centered and person-driven measures and outcomes, (2) consider the person in the context of their relationships and community, and (3) include mental healthcare as an essential part of overall healthcare.
AHRQ-authored; AHRQ-funded; HS022444.
Citation: Leroy L, Bayliss E, Domino M .
The Agency for Healthcare Research and Quality Multiple Chronic Conditions Research Network: overview of research contributions and future priorities.
Med Care 2014 Mar;52 Suppl 3:S15-22. doi: 10.1097/mlr.0000000000000095.
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Keywords: Chronic Conditions, Healthcare Delivery, Health Services Research (HSR), Patient-Centered Outcomes Research, Quality Measures