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
376 to 400 of 431 Research Studies DisplayedSchulz J, DeCamp M, Berkowitz SA
Medicare Shared Savings Program: public reporting and shared savings distributions.
The objectives of this paper are to determine if Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) are meeting public reporting requirements related to shared savings plans, to quantitate the composition of shared savings distribution plans, and to investigate whether early ACO success is associated with specific plan or ACO characteristics. The authors found that just over one-half of MSSP ACOs report detailed shared savings distribution plans online, and these plans vary widely. They concluded that there appears to be no single shared savings distribution plan determinate of ACO success.
AHRQ-funded; HS023684.
Citation: Schulz J, DeCamp M, Berkowitz SA .
Medicare Shared Savings Program: public reporting and shared savings distributions.
Am J Manag Care 2015 Aug;21(8):546-53.
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Keywords: Quality of Care, Payment, Policy, Medicare, Public Reporting
Toro-Diaz H, Mayorga ME, Barritt AS
Predicting liver transplant capacity using discrete event simulation.
The researchers constructed a discrete event simulation model informed by current donor characteristics to predict future liver transplant trends through the year 2030. They found that by altering assumptions about the future donor pool, their model can be used to develop policy interventions to prevent a further decline in this lifesaving therapy.
AHRQ-funded; HS019468.
Citation: Toro-Diaz H, Mayorga ME, Barritt AS .
Predicting liver transplant capacity using discrete event simulation.
Med Decis Making 2015 Aug;35(6):784-96. doi: 10.1177/0272989x14559055.
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Keywords: Access to Care, Health Services Research (HSR), Policy, Transplantation
Dusetzina SB, Ellis S, Freedman RA
How do payers respond to regulatory actions? The case of bevacizumab.
This study examined payer-specific trends in bevacizumab use after the FDA's regulatory actions in granting and revoking an approved indication for metastatic breast cancer. It concluded that although insurers varied in public statements regarding coverage intentions, bevacizumab use declined similarly among all payers, suggesting that provider decision making, rather than payer-specific coverage policies, drove reductions.
AHRQ-funded; HS0189960.
Citation: Dusetzina SB, Ellis S, Freedman RA .
How do payers respond to regulatory actions? The case of bevacizumab.
J Oncol Pract 2015 Jul;11(4):313-8. doi: 10.1200/jop.2015.004218.
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Keywords: Policy, Medication, Health Insurance, Policy
Bachhuber MA, McGinty EE, Kennedy-Hendricks A
Messaging to increase public support for naloxone distribution policies in the United States: results from a randomized survey experiment.
The investigators conducted a web-based survey (GfK Knowledge Panel) about barriers to public support for naloxone distribution. They concluded that public support for naloxone distribution can be improved through education and sympathetic portrayals of the population who stands to benefit from these policies.
AHRQ-funded; HS000029.
Citation: Bachhuber MA, McGinty EE, Kennedy-Hendricks A .
Messaging to increase public support for naloxone distribution policies in the United States: results from a randomized survey experiment.
PLoS One 2015 Jul;10(7):e0130050. doi: 10.1371/journal.pone.0130050.
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Keywords: Medication, Opioids, Policy, Substance Abuse
Feemster KA
Remembering the benefits of vaccination.
This commentary discussed the issue of vaccination and tightening exemptions for school entry. The author pointed out that events show that the success of vaccines can be fragile, as the measles cases associated with Disneyland were preceded by 644 cases in 2014. And 2012 saw more than 40,000 cases of pertussis, the largest number since 1960. These events provided a dramatic reminder that vaccines remain an important and necessary public health tool.
AHRQ-funded; HS020939.
Citation: Feemster KA .
Remembering the benefits of vaccination.
JAMA Pediatr 2015 Jul;169(7):624-6. doi: 10.1001/jamapediatrics.2015.0647.
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Keywords: Children/Adolescents, Infectious Diseases, Patient Safety, Policy, Vaccination
Herring B, Trish E
The distributional effects of the Affordable Care Act's Cadillac tax by worker income.
The authors discuss a provision of the ACA that will introduce a 40 percent excise tax on health benefits exceeding a $10,200 threshold for single coverage and a $27,500 threshold for family coverage, annually. They argue that the low-income workers receive a relatively smaller subsidy to offset a portion of the Cadillac tax while the high-income workers receive a relatively larger subsidy to offset a portion of the Cadillac tax. All this adds up to a regressive effect.
AHRQ-funded; HS000046.
Citation: Herring B, Trish E .
The distributional effects of the Affordable Care Act's Cadillac tax by worker income.
AMA J Ethics 2015 Jul;17(7):672-9. doi: 10.1001/journalofethics.2015.17.7.sect1-1507..
Keywords: Healthcare Costs, Health Insurance, Policy
Shih T, Chen LM, Nallamothu BK
Will bundled payments change health care? Examining the evidence thus far in cardiovascular care.
The authors explore bundled payment initiatives and their potential advantages and disadvantages, focusing their review on previous and current bundled payment programs for cardiovascular conditions. They conclude by discussing what implications these programs might have as healthcare reform takes further shape in the coming years.
AHRQ-funded; HS020671.
Citation: Shih T, Chen LM, Nallamothu BK .
Will bundled payments change health care? Examining the evidence thus far in cardiovascular care.
Circulation 2015 Jun 16;131(24):2151-8. doi: 10.1161/circulationaha.114.010393..
Keywords: Healthcare Costs, Evidence-Based Practice, Cardiovascular Conditions, Policy
Lee BY, Schreiber B, Wateska AR
The Benin experience: how computational modeling can assist major vaccine policy changes in low and middle income countries.
The authors discuss some of the key steps and lessons learned in their Benin experience that helped computational modeling inform and lead to major policy change. The key steps are: engagement of Ministry of Health, identifying in-country “champions,” directed and efficient data collection, defining a finite set of realistic scenarios, making the study methodology transparent, presenting the results in a clear manner, and facilitating decision-making and advocacy.
AHRQ-funded; HS023317.
Citation: Lee BY, Schreiber B, Wateska AR .
The Benin experience: how computational modeling can assist major vaccine policy changes in low and middle income countries.
Vaccine 2015 Jun 9;33(25):2858-61. doi: 10.1016/j.vaccine.2015.04.022..
Keywords: Genetics, Policy, Vaccination
Atkins DN, Bradford WD
Association between increased emergency contraception availability and risky sexual practices.
The researchers use a national survey of youth to explore the relationship between increased emergency contraception (EC) availability and the probability of risky sexual practices for women over age 18. They found that FDA approval of behind the counter sales of an EC pill was associated with a reduction in the probability of sexual activity, and in the likelihood of reporting multiple partnerships; however, there was no relationship between the new policy and unprotected sexual activity.
AHRQ-funded; HS011326
Citation: Atkins DN, Bradford WD .
Association between increased emergency contraception availability and risky sexual practices.
Health Serv Res. 2015 Jun;50(3):809-29. doi: 10.1111/1475-6773.12251.
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Keywords: Women, Sexual Health, Young Adults, Policy
Kim HS, Anderson JD, Saghafi O
Cyclic vomiting presentations following marijuana liberalization in Colorado.
This paper's primary objective was to determine the prevalence of patients presenting with cyclic vomiting before and after the liberalization of medical marijuana in Colorado in 2009. Its secondary objective was to describe the odds of marijuana use among cyclic vomiting visits in these same time periods. The researchers found that the prevalence of cyclic vomiting presentations nearly doubled after the liberalization of medical marijuana, with said patients more likely to endorse marijuana use.
AHRQ-funded; HS000078.
Citation: Kim HS, Anderson JD, Saghafi O .
Cyclic vomiting presentations following marijuana liberalization in Colorado.
Acad Emerg Med 2015 Jun;22(6):694-9. doi: 10.1111/acem.12655.
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Keywords: Adverse Drug Events (ADE), Complementary and Alternative Medicine, Emergency Medical Services (EMS), Policy, Substance Abuse
Leeman J, Myers AE, Ribisl KM
Disseminating policy and environmental change interventions: insights from obesity prevention and tobacco control.
This paper describes the approach that two projects developed to disseminate policy and environmental change interventions. The Center for Training and Research Translation (Center TRT) disseminates evidence-based interventions (EBIs) to promote physical activity and healthy eating. Counter Tobacco disseminates EBIs to counter tobacco product sales and marketing in the retail environment.
AHRQ-funded; HS019468.
Citation: Leeman J, Myers AE, Ribisl KM .
Disseminating policy and environmental change interventions: insights from obesity prevention and tobacco control.
Int J Behav Med 2015 Jun;22(3):301-11. doi: 10.1007/s12529-014-9427-1..
Keywords: Communication, Evidence-Based Practice, Obesity, Policy, Prevention, Public Health, Tobacco Use, Implementation
Padula WV, Makic MB, Wald HL
Hospital-acquired pressure ulcers at academic medical centers in the United States, 2008-2012: tracking changes since the CMS nonpayment policy.
This study was conducted to define changes in hospital-acquired pressure ulcers (HAPU) incidence and variance since 2008. It found that HAPU incidence rates decreased significantly among 210 University HealthSystems Consortium academic medical centers after the enactment of the CMS nonpayment policy. This suggests that governmental policy was a significant driver of change in clinical practice for wound care and created incentives for preventive efforts on the part of hospitals.
AHRQ-funded; HS023710.
Citation: Padula WV, Makic MB, Wald HL .
Hospital-acquired pressure ulcers at academic medical centers in the United States, 2008-2012: tracking changes since the CMS nonpayment policy.
Jt Comm J Qual Patient Saf 2015 Jun;41(6):257-63..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Policy, Pressure Ulcers, Prevention, Quality Improvement
Keohane LM, Grebla RC, Mor V
Medicare Advantage members' expected out-of-pocket spending for inpatient and skilled nursing facility services.
In 2011, new federal regulations restricted inpatient and skilled nursing facility cost sharing and mandated limits on out-of-pocket spending in Medicare Advantage (MA) plans. The authors found that some MA beneficiaries may still have difficulty affording acute and postacute care despite greater regulation of cost sharing.
AHRQ-funded; HS000011.
Citation: Keohane LM, Grebla RC, Mor V .
Medicare Advantage members' expected out-of-pocket spending for inpatient and skilled nursing facility services.
Health Aff 2015 Jun;34(6):1019-27. doi: 10.1377/hlthaff.2014.1146.
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Keywords: Healthcare Costs, Hospitalization, Policy, Medicare, Nursing Homes
Sommers BD, Maylone B, Nguyen KH
The impact of state policies on ACA applications and enrollment among low-income adults in Arkansas, Kentucky, and Texas.
The researchers surveyed nearly 3,000 low-income adults in late 2014 to compare experiences in three states with markedly different policies: Kentucky, Arkansas, and Texas. They found that application rates, successful enrollment, and positive experiences with the ACA were highest in Kentucky, followed by Arkansas, with Texas performing worst. Limited awareness remains a critical barrier: Fewer than half of adults had heard some or a lot about the coverage expansions.
AHRQ-funded; HS021291.
Citation: Sommers BD, Maylone B, Nguyen KH .
The impact of state policies on ACA applications and enrollment among low-income adults in Arkansas, Kentucky, and Texas.
Health Aff 2015 Jun;34(6):1010-8. doi: 10.1377/hlthaff.2015.0215..
Keywords: Policy, Low-Income, Medicaid, Health Insurance
Scott KW, Blendon RJ, Sommers BD
The 2014 governors' races and health care: a campaign web site analysis.
To better understand the role of health care in the recent gubernatorial elections, the researchers analyzed health policy content presented by 71 candidates for governor on their campaign Web sites. They concluded that the prominence of health care in the gubernatorial campaigns strengthens the likelihood that governors will play an influential role in the health system’s future, especially as the Affordable Care Act undergoes further federal debate.
AHRQ-funded; HS000055.
Citation: Scott KW, Blendon RJ, Sommers BD .
The 2014 governors' races and health care: a campaign web site analysis.
Inquiry 2015 May 5;52. doi: 10.1177/0046958015584798..
Keywords: Policy, Web-Based
Pati S, Wong AT, Calixte RE
Medicaid and CHIP retention among children in 12 states.
The authors sought to determine reproducibility of public insurance retention rates for children using 3 different metrics at the state and county level. They found that all 3 metrics demonstrated reproducible estimates at the state level. Reproducibility of relative rankings for child health insurance retention of counties within states were sensitive to county child population size and the amount of variability in retention rates within the county and at the state level.
AHRQ-funded; HS020508.
Citation: Pati S, Wong AT, Calixte RE .
Medicaid and CHIP retention among children in 12 states.
Acad Pediatr 2015 May-Jun;15(3):249-57. doi: 10.1016/j.acap.2014.09.012.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Policy, Medicaid
Abrahamson K, Miech E, Davila HW
Pay-for-performance policy and data-driven decision making within nursing homes: a qualitative study.
The researchers explored ways in which data were collected, thought about and used by nursing home employees as a result of participation in a pay-for-performance (P4P) program. Their findings indicated that participants in the Minnesota Performance-based Incentive Payment Program’s quality improvement (QI) projects perceived a change in the rate and manner in which they gathered, used, and considered data in their QI decisions.
AHRQ-funded; HS018464
Citation: Abrahamson K, Miech E, Davila HW .
Pay-for-performance policy and data-driven decision making within nursing homes: a qualitative study.
BMJ Qual Saf. 2015 May;24(5):311-7. doi: 10.1136/bmjqs-2014-003362..
Keywords: Nursing Homes, Long-Term Care, Payment, Provider Performance, Decision Making, Policy, Quality Improvement, Quality of Care
Pallas SW, Khuat TH, Le QD
The changing donor landscape of health sector aid to Vietnam: a qualitative case study.
The study objective was to identify how donors and government agencies in Vietnam responded to donor proliferation in health sector aid between 1995 and 2012. The study concludes that central government and donor agencies in Vietnam responded to donor proliferation in health sector aid by endorsing aid effectiveness policies but implementing these policies inconsistently in practice.
AHRQ-funded; HS017589.
Citation: Pallas SW, Khuat TH, Le QD .
The changing donor landscape of health sector aid to Vietnam: a qualitative case study.
Soc Sci Med 2015 May;132:165-72. doi: 10.1016/j.socscimed.2015.03.027..
Keywords: Policy, Health Services Research (HSR), Healthcare Costs
Holdsworth La E, Zhu R, Hassmiller Lich K
The effects of state psychiatric hospital waitlist policies on length of stay and time to readmission.
This study examined the effects of a waitlist policy for state psychiatric hospitals on length of stay and time to readmission. The authors found that waitlists were associated with increased length of stay and time to readmission.
AHRQ-funded; HS000032.
Citation: Holdsworth La E, Zhu R, Hassmiller Lich K .
The effects of state psychiatric hospital waitlist policies on length of stay and time to readmission.
Adm Policy Ment Health 2015 May;42(3):332-42. doi: 10.1007/s10488-014-0573-1.
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Keywords: Hospitals, Behavioral Health, Policy, Substance Abuse, Hospital Readmissions
Brennan PF, Valdez R, Alexander G
Patient-centered care, collaboration, communication, and coordination: a report from AMIA's 2013 Policy Meeting.
AMIA’s 2013 Health Policy Invitational was focused on examining existing challenges surrounding full engagement of the patient and crafting a research agenda and policy framework encouraging the use of informatics solutions to achieve this goal. This paper summarizes the meeting as well as the research agenda and policy recommendations prioritized among the invited experts and stakeholders.
AHRQ-funded; HS021825.
Citation: Brennan PF, Valdez R, Alexander G .
Patient-centered care, collaboration, communication, and coordination: a report from AMIA's 2013 Policy Meeting.
J Am Med Inform Assoc 2015 Apr;22(e1):e2-6. doi: 10.1136/amiajnl-2014-003176..
Keywords: Care Coordination, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Healthcare, Policy
Hollingsworth JM, Funk RJ, Owen-Smith J
Assessing the reach of health reform to outpatient surgery with social network analysis.
The researchers used the tools of social network analysis to assess the proportion of outpatient surgery currently delivered in ambulatory surgery centers (ASCs) that are largely unconnected to nearby hospitals. Their study of all Florida ASCs and hospitals found that 83% of the $4.3 billion in charges for ASC-based care originate from facilities that have substantial integration with their local health care systems.
AHRQ-funded; HS020927; HS018726.
Citation: Hollingsworth JM, Funk RJ, Owen-Smith J .
Assessing the reach of health reform to outpatient surgery with social network analysis.
Ann Surg 2015 Mar;261(3):468-72. doi: 10.1097/sla.0000000000000880..
Keywords: Ambulatory Care and Surgery, Policy, Health Services Research (HSR)
Daubresse M, Alexander GC
The uphill battle facing antiobesity drugs.
The authors argue that the barriers faced by individual anorectic products belie larger regulatory and clinical challenges to their mainstream adoption, and contribute to the irony that despite American’s penchant for high rates of pharmaceutical use, obesity drugs have fared remarkably poorly in the market.
AHRQ-funded; HS0189960.
Citation: Daubresse M, Alexander GC .
The uphill battle facing antiobesity drugs.
Int J Obes 2015 Mar;39(3):377-8. doi: 10.1038/ijo.2014.169..
Keywords: Obesity, Medication, Obesity: Weight Management, Policy
Klevens J, Barnett SB, Florence C
Exploring policies for the reduction of child physical abuse and neglect.
This article identifies 37 state policies that might have impacts on the social determinants of child maltreatment and utilizes the available data to explore effects of 11 policies. There were two policies that were significantly associated with decreased child maltreatment rates: lack of waitlists to access subsidized child care and policies that facilitate continuity of child health care.
AHRQ-funded; HS013853.
Citation: Klevens J, Barnett SB, Florence C .
Exploring policies for the reduction of child physical abuse and neglect.
Child Abuse Negl 2015 Feb;40:1-11. doi: 10.1016/j.chiabu.2014.07.013.
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Keywords: Domestic Violence, Children/Adolescents, Policy, Risk
Hill SC
AHRQ Author: Hill SC
Medicaid expansion in opt-out states would produce consumer savings and less financial burden than exchange coverage.
This study simulated potential differences in out-of-pocket spending for uninsured adults gaining eligibility for Marketplace coverage (silver plan) because their states have not used the provisions of the Affordable Care Act to expand Medicaid. Compared with having a Marketplace silver plan, being able to take advantage to expanded Medicaid would reduce average out-of-pocket spending by more than 50 percent for these adults and their families.
AHRQ-authored.
Citation: Hill SC .
Medicaid expansion in opt-out states would produce consumer savings and less financial burden than exchange coverage.
Health Aff. 2015 Feb;34(2):340-9. doi: 10.1377/hlthaff.2014.1058..
Keywords: Healthcare Costs, Health Insurance, Policy, Low-Income, Medicaid, Uninsured
DeCamp M, Lehmann LS
Guiding choice--ethically influencing referrals in ACOs.
The authors believe that accountable care organizations can influence referrals in an ethical manner that simultaneously enhances choice and improves patient outcomes if they consider three basic issues: transparency, appropriate metrics, and the right incentives. In this paper, they discuss these three issues and how they might be accomplished ethically.
AHRQ-funded; HS023684.
Citation: DeCamp M, Lehmann LS .
Guiding choice--ethically influencing referrals in ACOs.
N Engl J Med 2015 Jan 15;372(3):205-7. doi: 10.1056/NEJMp1412083.
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Keywords: Health Insurance, Policy