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
251 to 275 of 326 Research Studies DisplayedHefele JG, Acevedo A, Nsiah-Jefferson L
Choosing a nursing home: what do consumers want to know, and do preferences vary across race/ethnicity?
The researchers sought to identify what consumers want to know about nursing homes (NHs) before choosing one and to determine whether information preferences vary across race/ethnicity. They found that participants wanted detailed information on the facility, policies, staff, and residents, such as location, staff treatment of residents, and resident conditions. Participants also wanted a sense of the NH gestalt and were interested in feedback/reviews from residents/families.
AHRQ-funded; HS021891.
Citation: Hefele JG, Acevedo A, Nsiah-Jefferson L .
Choosing a nursing home: what do consumers want to know, and do preferences vary across race/ethnicity?
Health Serv Res 2016 Jun;51 Suppl 2:1167-87. doi: 10.1111/1475-6773.12457.
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Keywords: Nursing Homes, Education: Patient and Caregiver, Racial and Ethnic Minorities
Simmons SF, Schnelle JF, Sathe NA
Defining safety in the nursing home setting: Implications for future research.
AHRQ’s Common Format for nursing homes (NHs) accommodates voluntary reporting for 4 adverse events: falls with injury, pressure ulcers, medication errors, and infections. In 2015, AHRQ funded a technical brief to describe the state of the science related to safety in the NH setting to inform a research agenda. Thirty-six recent systematic reviews evaluated NH safety-related interventions to address these 4 adverse events and reported mostly mixed evidence about effective approaches to ameliorate them.
AHRQ-funded; 290201500003I.
Citation: Simmons SF, Schnelle JF, Sathe NA .
Defining safety in the nursing home setting: Implications for future research.
J Am Med Dir Assoc 2016 Jun;17(6):473-81. doi: 10.1016/j.jamda.2016.03.005..
Keywords: Nursing Homes, Long-Term Care, Adverse Events, Patient Safety, Evidence-Based Practice
Driessen J, Bonhomme A, Chang W
Nursing home provider perceptions of telemedicine for reducing potentially avoidable hospitalizations.
The goal of this study was to survey a nationally representative sample of nursing home physicians and advanced practice providers to quantify provider perceptions and desired functionality of telemedicine in nursing homes to reduce potentially avoidable hospitalizations. The authors found that there is a high degree of confidence in the potential for a telemedicine solution and concrete views about its features, concluding that further research is needed to study the impact of successful implementations.
AHRQ-funded; HS018721; HS022989; HS022465; HS023779.
Citation: Driessen J, Bonhomme A, Chang W .
Nursing home provider perceptions of telemedicine for reducing potentially avoidable hospitalizations.
J Am Med Dir Assoc 2016 Jun;17(6):519-24. doi: 10.1016/j.jamda.2016.02.004.
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Keywords: Health Information Technology (HIT), Hospital Readmissions, Hospitalization, Nursing Homes, Telehealth
Schapira MM, Shea JA, Duey KA
The Nursing Home Compare report card: perceptions of residents and caregivers regarding quality ratings and nursing home choice.
The researchers evaluated the perceived usefulness of publicly reported nursing home quality indicators. They found that star ratings, clinical quality measures, and benchmarking information were salient to decision making, with preferred formats varying across participants. Participants desired additional information on the source of quality data. Confusion was evident regarding the relationship between domain-specific and overall star quality ratings.
AHRQ-funded; HS02861.
Citation: Schapira MM, Shea JA, Duey KA .
The Nursing Home Compare report card: perceptions of residents and caregivers regarding quality ratings and nursing home choice.
Health Serv Res 2016 Jun;51 Suppl 2:1212-28. doi: 10.1111/1475-6773.12458.
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Keywords: Nursing Homes, Quality Indicators (QIs), Patient Experience, Patient Experience, Quality of Care
Alexander GL, Madsen RW, Miller EL
The state of nursing home information technology sophistication in rural and nonrural US markets.
This study tested for significant differences in information technology sophistication (ITS) in US nursing homes (NH) based on location. It found that for every health care domain (resident care, clinical support, and administrative activities) statistical differences in facility ITS occurred. This study represents the most current national assessment of NH IT since 2004.
AHRQ-funded; HS022497.
Citation: Alexander GL, Madsen RW, Miller EL .
The state of nursing home information technology sophistication in rural and nonrural US markets.
J Rural Health 2016 Jun;33(3):266-74. doi: 10.1111/jrh.12188.
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Keywords: Long-Term Care, Nursing Homes, Health Information Technology (HIT)
Marra MV, Simmons SF, Shotwell MS
Elevated serum osmolality and total water deficit indicate impaired hydration status in residents of long-term care facilities regardless of low or high body mass index.
The researchers assessed hydration status and the adequacy of total water intake, and further determined relationships between hydration status, total water intake, and body mass index (BMI) in long-term care residents. They found that dehydration and inadequate total water intake is prevalent in long-term care residents across all BMI categories. They recommended that the type of liquid beverages, type of ONS, and type of between-meal snacks are factors that could be targeted for nutrition interventions designed to prevent or reverse dehydration.
AHRQ-funded; HS018580.
Citation: Marra MV, Simmons SF, Shotwell MS .
Elevated serum osmolality and total water deficit indicate impaired hydration status in residents of long-term care facilities regardless of low or high body mass index.
J Acad Nutr Diet 2016 May;116(5):828-36.e2. doi: 10.1016/j.jand.2015.12.011.
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Keywords: Elderly, Long-Term Care, Nursing Homes, Patient-Centered Outcomes Research
Zimmerman S, Cohen LW, Scales K
Pneumonia identification using nursing home records.
The researchers compared three established strategies for defining pneumonia using records from 1,119 residents across 16 nursing homes. They found that recorded diagnosis of pneumonia is a highly sensitive and pragmatic method to ascertain pneumonia in nursing homes, and is recommended for use in quality improvement and research.
AHRQ-funded; HS022298.
Citation: Zimmerman S, Cohen LW, Scales K .
Pneumonia identification using nursing home records.
Res Gerontol Nurs 2016 May 1;9(3):109-14. doi: 10.3928/19404921-20151218-01.
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Keywords: Antibiotics, Elderly, Diagnostic Safety and Quality, Nursing Homes, Pneumonia
Ismail MD, Luo T, McNamara S
Long-term carriage of ciprofloxacin-resistant Escherichia coli Isolates in high-risk nursing home residents.
This paper's objective was to characterize the incidence and duration of carriage of ciprofloxacin-resistant Escherichia coli (CipREc) in nursing homes and to identify those in the O25b-ST131 lineage. The authors found that CipREc occurred frequently in nursing home residents and is carried for long durations, and that reacquisition following clearance is common.
AHRQ-funded; HS019979.
Citation: Ismail MD, Luo T, McNamara S .
Long-term carriage of ciprofloxacin-resistant Escherichia coli Isolates in high-risk nursing home residents.
Infect Control Hosp Epidemiol 2016 Apr;37(4):440-7. doi: 10.1017/ice.2015.326.
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Keywords: Nursing Homes, Long-Term Care, Elderly, Antibiotics, Patient Safety
Konetzka RT, Perraillon MC
Use of Nursing Home Compare website appears limited by lack of awareness and initial mistrust of the data.
The researchers used a qualitative assessment of how consumers select nursing homes and of the role of information about quality, using semistructured interviews of people who recently placed a family member or friend in a nursing home. They found that consumers had a positive reaction when shown Nursing Home Compare; however, its use appeared to be limited by lack of awareness and, to some extent, initial lack of trust of the data.
AHRQ-funded; HS021877.
Citation: Konetzka RT, Perraillon MC .
Use of Nursing Home Compare website appears limited by lack of awareness and initial mistrust of the data.
Health Aff 2016 Apr;35(4):706-13. doi: 10.1377/hlthaff.2015.1377.
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Keywords: Nursing Homes, Public Reporting, Web-Based, Quality of Care, Education: Patient and Caregiver
Mukamel DB, Amin A, Weimer DL
When patients customize nursing home ratings, choices and rankings differ from the government's version.
Report cards currently published by the Centers for Medicare and Medicaid Services (CMS) offer composite quality measures, such as the one featured on the Nursing Home Compare website. Nursing Home Compare Plus is an alternative that allows patients and their families to create their own composite scores based on their own preferences and medical needs. When comparing Nursing Home Compare Plus to Medicare's five-star ratings, we found only minimal agreement on ranking of nursing homes.
AHRQ-funded; HS021844.
Citation: Mukamel DB, Amin A, Weimer DL .
When patients customize nursing home ratings, choices and rankings differ from the government's version.
Health Aff 2016 Apr;35(4):714-9. doi: 10.1377/hlthaff.2015.1340.
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Keywords: Nursing Homes, Quality of Care, Quality Indicators (QIs), Patient Experience, Consumer Assessment of Healthcare Providers and Systems (CAHPS)
Marier A, Olsho LE, Rhodes W
AHRQ Author: Spector WD
Improving prediction of fall risk among nursing home residents using electronic medical records.
To identify individuals at highest risk for falls, the authors applied a repeated events survival model to analyze The Minimum Data Set ( MDS 3.0 and EMR data for 5129 residents in 13 nursing homes within a single large California chain. They found that incorporating EMR data improves ability to identify those at highest risk for falls relative to prediction using MDS data alone.
AHRQ-funded; AHRQ-authored; 290201000031I.
Citation: Marier A, Olsho LE, Rhodes W .
Improving prediction of fall risk among nursing home residents using electronic medical records.
J Am Med Inform Assoc 2016 Mar;23(2):276-82. doi: 10.1093/jamia/ocv061..
Keywords: Falls, Electronic Health Records (EHRs), Risk, Nursing Homes, Prevention
Sorkin DH, Amin A, Weimer DL
Rationale and study protocol for the Nursing Home Compare Plus (NHCPlus) randomized controlled trial: A personalized decision aid for patients transitioning from the hospital to a skilled-nursing facility.
This paper describes the design and rationale of a two-arm randomized controlled trial designed to test the effectiveness of Nursing Home Compare Plus (NHCPlus) compared to usual care only, in a sample of patients being discharged from the hospital to an SNF (N=229). Assessments were conducted within 24h prior to patient discharge and 30-days post discharge. A primary outcome to be examined was the use of NHC.
AHRQ-funded; HS021844.
Citation: Sorkin DH, Amin A, Weimer DL .
Rationale and study protocol for the Nursing Home Compare Plus (NHCPlus) randomized controlled trial: A personalized decision aid for patients transitioning from the hospital to a skilled-nursing facility.
Contemp Clin Trials 2016 Jan 7;47:139-45. doi: 10.1016/j.cct.2015.12.018.
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Keywords: Nursing Homes, Web-Based, Patient Experience, Hospitalization, Health Information Technology (HIT)
Jung HY, Trivedi AN, Grabowski DC
Does more therapy in skilled nursing facilities lead to better outcomes in patients with hip fracture?
The study objectives were: (1) to examine temporal trends in therapy hour volumes and (2) to evaluate whether more therapy hours are associated with improved patient outcomes. It concluded that increases in the quantity of therapy during the study period cannot be explained by changes in case mix at skilled nursing facility (SNF) admission.
AHRQ-funded; HS020756.
Citation: Jung HY, Trivedi AN, Grabowski DC .
Does more therapy in skilled nursing facilities lead to better outcomes in patients with hip fracture?
Phys Ther 2016 Jan;96(1):81-9. doi: 10.2522/ptj.20150090.
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Keywords: Outcomes, Injuries and Wounds, Medicare, Nursing Homes
Urick BY, Kaskie BP, Carnahan RM
Improving antipsychotic prescribing practices in nursing facilities: the role of surveyor methods and surveying agencies in upholding the Nursing Home Reform Act.
The objectives of this study were to explore surveyor observations of skilled nursing facilities/nursing facilities care practices subsequent to participation the Partnership guidance program and to use a social ecological framework to estimate how these observations were influenced by individual, organizational, and contextual factors. It found substantial variation in surveyor observations of changes to clinical care in response to the Partnership guidance initiative.
AHRQ-funded; HS019355.
Citation: Urick BY, Kaskie BP, Carnahan RM .
Improving antipsychotic prescribing practices in nursing facilities: the role of surveyor methods and surveying agencies in upholding the Nursing Home Reform Act.
Res Social Adm Pharm 2016 Jan-Feb;12(1):91-103. doi: 10.1016/j.sapharm.2015.04.006.
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Keywords: Elderly, Nursing Homes, Long-Term Care, Policy, Medication, Organizational Change
Lepore M, Leland NE
Nursing homes that increased the proportion of Medicare days saw gains in quality outcomes for long-stay residents.
The authors examined nationwide facility-level nursing home data for the period 2007-2010. They found that increasing the proportion of Medicare-covered patient days in a nursing home was significantly associated with improvements in the quality of daily pain, pressure ulcers, and performing activities of daily living.
AHRQ-funded; HS022907.
Citation: Lepore M, Leland NE .
Nursing homes that increased the proportion of Medicare days saw gains in quality outcomes for long-stay residents.
Health Aff 2015 Dec;34(12):2121-8. doi: 10.1377/hlthaff.2015.0303.
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Keywords: Long-Term Care, Medicare, Nursing Homes, Patient-Centered Outcomes Research, Quality Improvement
Bali V, Chatterjee S, Carnahan RM
Risk of dementia among elderly nursing home patients using paroxetine and other selective serotonin reuptake inhibitors.
This study evaluated the comparative risk of dementia associated with use of paroxetine and other selective serotonin reuptake inhibitors (SSRIs) among elderly nursing home patients. It found that compared with use of other SSRIs, use of paroxetine was not associated with higher risk of dementia among elderly nursing home patients with depression.
AHRQ-funded; HS021264.
Citation: Bali V, Chatterjee S, Carnahan RM .
Risk of dementia among elderly nursing home patients using paroxetine and other selective serotonin reuptake inhibitors.
Psychiatr Serv 2015 Dec;66(12):1333-40. doi: 10.1176/appi.ps.201500011.
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Keywords: Adverse Drug Events (ADE), Dementia, Elderly, Nursing Homes, Medication
Rhodes W, Olsho LE, Ward AS
AHRQ Author: Spector WD
https://link.springer.com/article/10.1007/s10742-015-0138-0
Use of Monte Carlo simulation to inform design decisions for pairwise cluster randomization.
This paper demonstrates the utility of the Monte Carlo approach in the context of a planned evaluation of an intervention to reduce falls among nursing home residents and provides recommendations for researchers on key design questions, including the choice between cluster randomization and pairwise cluster randomization, and selection of parametric or nonparametric estimators.
AHRQ-authored; AHRQ-funded; 290201000031I.
Citation: Rhodes W, Olsho LE, Ward AS .
Use of Monte Carlo simulation to inform design decisions for pairwise cluster randomization.
Health Serv Outcomes Res Method (2015) 15: 182-203. https://doi.org/10.1007/s10742-015-0138-0..
Keywords: Nursing Homes, Research Methodologies, Falls
Simmons SF, Keeler E, An R
Cost-effectiveness of nutrition intervention in long-term care.
The researchers sought to determine the cost-effectiveness of two nutrition interventions on food, beverage, and supplement intake and body weight. They found that oral liquid nutrition supplements and snack offers were efficacious in promoting caloric intake when coupled with assistance to promote consumption and a variety of options, but neither intervention resulted in significant weight gain.
AHRQ-funded; HS018580.
Citation: Simmons SF, Keeler E, An R .
Cost-effectiveness of nutrition intervention in long-term care.
J Am Geriatr Soc 2015 Nov;63(11):2308-16. doi: 10.1111/jgs.13709..
Keywords: Elderly, Long-Term Care, Nursing Homes, Nutrition, Comparative Effectiveness
He D, Konetzka RT
Public reporting and demand rationing: evidence from the nursing home industry.
The authors examined a consequence of public reporting: the potential for demand rationing. They found that high-quality nursing homes facing capacity constraints reduced admissions of less profitable Medicaid residents while increasing the more profitable Medicare and private-pay admissions, relative to low-quality nursing homes facing no capacity constraints.
AHRQ-funded; HS021877.
Citation: He D, Konetzka RT .
Public reporting and demand rationing: evidence from the nursing home industry.
Health Econ 2015 Nov;24(11):1437-51. doi: 10.1002/hec.3097.
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Keywords: Public Reporting, Medicare, Nursing Homes
Rahman M, Keohane L, Trivedi AN
High-cost patients had substantial rates of leaving Medicare Advantage and joining traditional Medicare.
The investigators examined the rates at which participants who used three high-cost services switched between Medicare Advantage and traditional Medicare. They found that the switching rate from 2010 to 2011 away from Medicare Advantage and to traditional Medicare exceeded the switching rate in the opposite direction for participants who used long-term nursing home care, short-term nursing home care, and home health care. These results were magnified among people who were enrolled in both Medicare and Medicaid.
AHRQ-funded; HS000011.
Citation: Rahman M, Keohane L, Trivedi AN .
High-cost patients had substantial rates of leaving Medicare Advantage and joining traditional Medicare.
Health Aff 2015 Oct;34(10):1675-81. doi: 10.1377/hlthaff.2015.0272.
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Keywords: Healthcare Costs, Home Healthcare, Long-Term Care, Medicare, Nursing Homes
Konetzka RT, Brauner DJ, Coca Perraillon M
The role of severe dementia in nursing home report cards.
This article examined the intended and unintended effects of quality reporting for nursing home residents with severe dementia relative to other residents, using a difference-in-differences design to examine selected reported and unreported quality measures. The results indicate that prior to public reporting, nursing home residents with severe dementia were at significantly higher risk of poor outcomes on most reported quality measures.
AHRQ-funded; HS018718.
Citation: Konetzka RT, Brauner DJ, Coca Perraillon M .
The role of severe dementia in nursing home report cards.
Med Care Res Rev 2015 Oct;72(5):562-79. doi: 10.1177/1077558715588436.
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Keywords: Dementia, Nursing Homes, Long-Term Care, Quality Measures
Culley CM, Perera S, Marcum ZA
Using a clinical surveillance system to detect drug-associated hypoglycemia in nursing home residents.
The authors determined whether a clinical surveillance system could be used to detect drug-associated hypoglycemia events and determine their incidence in nursing home (NH) residents. Their evaluation found a high incidence of drug-associated hypoglycemia in a general NH population.
AHRQ-funded; HS018721.
Citation: Culley CM, Perera S, Marcum ZA .
Using a clinical surveillance system to detect drug-associated hypoglycemia in nursing home residents.
J Am Geriatr Soc 2015 Oct;63(10):2125-9. doi: 10.1111/jgs.13648.
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Keywords: Adverse Drug Events (ADE), Elderly, Medication: Safety, Medication, Nursing Homes
Pop-Vicas A, Rahman M, Gozalo PL
Estimating the effect of influenza vaccination on nursing home residents' morbidity and mortality.
This study estimated the effect of influenza vaccination on hospitalization and mortality in nursing home (NH) residents. It found that the association between vaccine match and reduction in overall mortality and pneumonia and influenza hospitalizations was strongest for A/H3N2, the influenza strain typically responsible for the most-severe influenza cases.
AHRQ-funded; HS018462.
Citation: Pop-Vicas A, Rahman M, Gozalo PL .
Estimating the effect of influenza vaccination on nursing home residents' morbidity and mortality.
J Am Geriatr Soc 2015 Sep;63(9):1798-804. doi: 10.1111/jgs.13617..
Keywords: Influenza, Nursing Homes, Vaccination, Hospitalization
Beffa LR, Petroski GF, Kruse RL
Functional status of nursing home residents before and after abdominal aortic aneurysm repair.
The authors evaluated the effects of elective open AAA repair (OAR) and endovascular AAA repair (EVAR) and evaluated comorbidities for their impact on functional trajectories after discharge. They found that procedure type was not significantly related to postoperative function or to the subsequent rate of improvement. OAR and EVAR were associated with similar initial declines and comparable postoperative trajectories, suggesting that less invasive EVAR was not associated with improved functional preservation compared with OAR. Longer stays were associated with poorer functional trajectories.
AHRQ-funded; HS022140.
Citation: Beffa LR, Petroski GF, Kruse RL .
Functional status of nursing home residents before and after abdominal aortic aneurysm repair.
J Vasc Nurs 2015 Sep;33(3):106-11. doi: 10.1016/j.jvn.2015.02.003.
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Keywords: Adverse Events, Elderly, Nursing Homes, Patient-Centered Outcomes Research, Surgery
Crnich CJ, Jump R, Trautner B
Optimizing antibiotic stewardship in nursing homes: a narrative review and recommendations for improvement.
This review summarizes the findings of research on ways to improve antibiotic prescribing practices in nursing homes and presents ways in which antibiotic stewardship can be implemented and optimized in the nursing home setting. It concludes that implementing and sustaining antibiotic stewardship in nursing homes requires an organizational commitment and a strategy based on goal setting.
AHRQ-funded; 290201000018I; 2902010000251; HS022298; HS022465; HS019979; HS022846.
Citation: Crnich CJ, Jump R, Trautner B .
Optimizing antibiotic stewardship in nursing homes: a narrative review and recommendations for improvement.
Drugs Aging 2015 Sep;32(9):699-716. doi: 10.1007/s40266-015-0292-7..
Keywords: Patient Safety, Nursing Homes, Medication