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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 DisplayedMakam AN, Tran T, Miller ME
The clinical course after long-term acute care hospital admission among older Medicare beneficiaries.
Investigators sought to examine the clinical course after long-term acute care (LTAC) admission. They found that hospitalized older adults transferred to LTAC hospitals had poor survival, spent most of their remaining life as an inpatient, and frequently underwent life-prolonging procedures. This prognostic understanding is essential to inform goals of care discussions and to prioritize healthcare needs for these adults. Given the exceedingly low rates of palliative care consultations, they recommend future research to examine unmet palliative care needs in this population.
AHRQ-funded; HS022418.
Citation: Makam AN, Tran T, Miller ME .
The clinical course after long-term acute care hospital admission among older Medicare beneficiaries.
J Am Geriatr Soc 2019 Nov;67(11):2282-88. doi: 10.1111/jgs.16106..
Keywords: Elderly, Medicare, Palliative Care, Patient-Centered Outcomes Research, Outcomes, Care Management, Healthcare Delivery
Wang D, Ing C, Blinderman CD
Latent class analysis of specialized palliative care needs in adult intensive care units from a single academic medical center.
The purpose of this study was to use latent class analysis to separate ICU patients into different classes of palliative care needs, and to determine if these classes differ in their resource requirements. Using information from ICU patients who received specialized palliative care, researchers extracted reason(s) for consultation from the initial note and entered it into a latent class analysis model to generate mutually exclusive patient classes. Four classes were identified: Pain and Symptom Management, Goals of Care and Advance Directives (GCAD), All Needsand Supportive Care. GCAD patients were least likely to be high utilizers.
AHRQ-funded; HS022941.
Citation: Wang D, Ing C, Blinderman CD .
Latent class analysis of specialized palliative care needs in adult intensive care units from a single academic medical center.
J Pain Symptom Manage 2019 Jan;57(1):73-78. doi: 10.1016/j.jpainsymman.2018.10.270..
Keywords: Care Management, Inpatient Care, Intensive Care Unit (ICU), Palliative Care
Khandelwal N, Curtis JR, Freedman VA
How often is end-of-life care in the United States inconsistent with patients' goals of care?
The purpose of this study was to document the proportion of bereaved respondents who reported care inconsistent with patients' wishes and characterize the predictors of end-of-life care associated with inconsistent care. The study found that one in eight respondents stated care in the last months of life was inconsistent with patients' wishes; such care was associated with worse ratings of care, pain management, and communication with clinicians.
AHRQ-funded; HS022982.
Citation: Khandelwal N, Curtis JR, Freedman VA .
How often is end-of-life care in the United States inconsistent with patients' goals of care?
J Palliat Med 2017 Dec;20(12):1400-04. doi: 10.1089/jpm.2017.0065..
Keywords: Care Management, Healthcare Delivery, Elderly, Palliative Care, Patient-Centered Healthcare, Quality of Care
Schuler MS, Joyce NR, Huskamp HA
Medicare beneficiaries with advanced lung cancer experience diverse patterns of care from diagnosis to death.
Using Medicare claims data for patients diagnosed with extensive-stage small-cell lung cancer, the authors used latent class analysis to identify classes of people with different care patterns. The findings showed substantial heterogeneity in patterns of care for patients with advanced cancer, which should be accounted for in efforts to improve end-of-life care.
AHRQ-funded; HS022998.
Citation: Schuler MS, Joyce NR, Huskamp HA .
Medicare beneficiaries with advanced lung cancer experience diverse patterns of care from diagnosis to death.
Health Aff 2017 Jul;36(7):1193-200. doi: 10.1377/hlthaff.2017.0448..
Keywords: Cancer, Cancer: Lung Cancer, Care Management, Elderly, Medicare, Palliative Care
Wang SY, Hall J, Pollack CE
Trends in end-of-life cancer care in the Medicare program.
The researchers sought to examine contemporary trends in end-of-life cancer care and geographic variation of end-of-life care aggressiveness among Medicare beneficiaries. They found that the proportion of beneficiaries receiving at least one potentially aggressive end-of-life intervention increased in repeated hospitalization, repeated ED visits, ICU admissions, and late hospice enrollment but declined in in-hospital death. End-of-life chemotherapy use did not change significantly over time. They concluded that despite growing focus on providing appropriate end-of-life care, there has not been an improvement in aggressive end-of-life cancer care in the Medicare program.
AHRQ-funded; HS023900.
Citation: Wang SY, Hall J, Pollack CE .
Trends in end-of-life cancer care in the Medicare program.
J Geriatr Oncol 2016 Mar;7(2):116-25. doi: 10.1016/j.jgo.2015.11.007.
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Keywords: Cancer, Care Management, Elderly, Medicare, Palliative Care, Outcomes, Patient-Centered Outcomes Research, Practice Patterns
Cagle JG, Zimmerman S, Cohen LW
EMPOWER: an intervention to address barriers to pain management in hospice.
The researchers tested the preliminary efficacy of the Effective Management of Pain: Overcoming Worries to Enable Relief (EMPOWER) intervention. At two weeks, caregivers in the intervention group reported better knowledge about pain management, fewer concerns about pain and pain medications, lower patient pain over the past week, and trended toward improvement in most other areas under study. EMPOWER had a greater effect for black subjects vs. whites on reducing concern about stigma. At three months, the intervention group trended better on most study outcomes. The researchers concluded that EMPOWER is a promising model to reduce barriers to pain management in hospice.
AHRQ-funded; HS019068.
Citation: Cagle JG, Zimmerman S, Cohen LW .
EMPOWER: an intervention to address barriers to pain management in hospice.
J Pain Symptom Manage 2015 Jan;49(1):1-12. doi: 10.1016/j.jpainsymman.2014.05.007.
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Keywords: Care Management, Caregiving, Comparative Effectiveness, Education: Patient and Caregiver, Medication, Pain, Palliative Care