National Healthcare Quality and Disparities Report
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- Access to Care (3)
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- Social Determinants of Health (1)
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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 23 of 23 Research Studies DisplayedBrajcich BC, Benson AB, Gantt G
Management of colorectal cancer during the COVID-19 pandemic: recommendations from a statewide multidisciplinary cancer collaborative.
J Surg Oncol 2022 Mar;125(4):560-63. doi: 10.1002/jso.26758.
AHRQ-funded; HS026385.
Citation: Brajcich BC, Benson AB, Gantt G .
Management of colorectal cancer during the COVID-19 pandemic: recommendations from a statewide multidisciplinary cancer collaborative.
J Surg Oncol 2022 Mar;125(4):560-63. doi: 10.1002/jso.26758..
Keywords: COVID-19, Cancer: Colorectal Cancer, Cancer, Guidelines, Evidence-Based Practice, Healthcare Delivery
Kranz AM, Ryan J, Mahmud A, AM, Ryan J, Mahmud A
Association of primary and specialty care integration on physician communication and cancer screening in safety-net clinics.
Lack of cancer screenings are more common in community health centers (CHCs) which provide primary care to disadvantaged populations due to difficulty accessing specialty care for their patients. This study’s objective was to describe CHCs use to integrate care with specialists and examine whether strongly integrated CHCs have higher rates of screening colorectal and cervical cancers. A 2017 survey of CHCs in 12 states and the District of Columbia was used to estimate the association between a composite measure of CHC/specialist integration and cancer screening rates and 4 measures of CHC/specialist communication using multivariate regression models. More integrated CHCs had higher screening rates of colorectal and cervical cancer and had significantly higher rates of knowing that specialist visits happened, knowing visit outcomes, receiving information after visits, and timely receipt of information.
AHRQ-funded; HS024067.
Citation: Kranz AM, Ryan J, Mahmud A, AM, Ryan J, Mahmud A .
Association of primary and specialty care integration on physician communication and cancer screening in safety-net clinics.
Prev Chronic Dis 2020 Oct 29;17:E134. doi: 10.5888/pcd17.200025..
Keywords: Cancer, Screening, Communication, Prevention, Patient-Centered Healthcare, Healthcare Delivery
Knerr S, West KM, Angelo FA
Organizational readiness to implement population-based screening and genetic service delivery for hereditary cancer prevention and control.
Programs conducting population-based screening and genetic service delivery for hereditary cancer prevention and control are rare in practice. The authors interviewed individuals instrumental in implementing seven unique clinical programs conducting either universal tumor screening for Lynch Syndrome or routine family history screening and provision of genetic services for hereditary breast and ovarian cancer in the United States. Their findings suggest that developing interventions targeting change efficacy and cultivating practice change champions may be two promising ways to increase uptake of population-based hereditary cancer screening and genetic service delivery in clinical practice.
AHRQ-funded; HS022982.
Citation: Knerr S, West KM, Angelo FA .
Organizational readiness to implement population-based screening and genetic service delivery for hereditary cancer prevention and control.
J Genet Couns 2020 Oct;29(5):867-76. doi: 10.1002/jgc4.1216.
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Keywords: Cancer, Screening, Genetics, Prevention, Guidelines, Healthcare Delivery, Organizational Change, Implementation
Penedo FJ, Oswald LB, Kronenfeld JP
The increasing value of eHealth in the delivery of patient-centred cancer care.
This paper is an appraisal of peer literature over the past 10 years on patient-centered eHealth to improve cancer care delivery. Uses of eHealth include the addressal of symptom management, health-related quality of life, and other patient-reported outcomes across cancer care. Challenges of, and opportunities for accessibility, scalability, and implementation of these technologies is also discussed.
AHRQ-funded; HS026170.
Citation: Penedo FJ, Oswald LB, Kronenfeld JP .
The increasing value of eHealth in the delivery of patient-centred cancer care.
Lancet Oncol 2020 May;21(5):e240-e51. doi: 10.1016/s1470-2045(20)30021-8.
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Keywords: Cancer, Patient-Centered Healthcare, Healthcare Delivery, Telehealth, Health Information Technology (HIT), Quality of Life, Implementation
Ellis RJ, Schlick CJR, Feinglass J
Failure to administer recommended chemotherapy: acceptable variation or cancer care quality blind spot?
This study examined hospital variation in cancer patients who did not receive recommended chemotherapy. Patients with breast, colon, and lung cancers who did not receive chemotherapy from 2000 to 2015 were identified from the National Cancer Database. A total of 183,148 patients at 1281 hospitals were included. For breast cancer, 3.5% of patients failed to receive recommended chemotherapy, and 6.6% with colon, and 10.7% with lung cancer. Sociodemographic factors showed that patients were less likely to receive chemotherapy if they were uninsured or on Medicaid, as were non-Hispanic black patients with both breast and colon cancer. There was also significant hospital variation with failure to administer as high as 21.8% for breast, 40.2% for colon, and 40.0% for lung cancer.
AHRQ-funded; HS000078; HS026385.
Citation: Ellis RJ, Schlick CJR, Feinglass J .
Failure to administer recommended chemotherapy: acceptable variation or cancer care quality blind spot?
BMJ Qual Saf 2020 Feb;29(2):103-12. doi: 10.1136/bmjqs-2019-009742..
Keywords: Treatments, Cancer, Healthcare Delivery, Access to Care, Healthcare Utilization, Social Determinants of Health, Vulnerable Populations, Uninsured, Hospitals, Quality of Care
Ramsey WA, Heidelberg RE, Gilbert AM
eHealth and mHealth interventions in pediatric cancer: a systematic review of interventions across the cancer continuum.
The primary objectives of this study were to (a) identify current published research in electronic health (eHealth) and mobile health (mHealth) interventions for youth undergoing cancer treatment and child, adolescent, and young adult survivors of childhood cancer and (b) critically appraise the current scientific evidence on their effectiveness and efficacy. As an exploratory aim, the investigators identified pediatric cancer patients' and survivors' perceptions, attitudes, and concerns related to eHealth and mHealth interventions.
AHRQ-funded; HS023011.
Citation: Ramsey WA, Heidelberg RE, Gilbert AM .
eHealth and mHealth interventions in pediatric cancer: a systematic review of interventions across the cancer continuum.
Psychooncology 2020 Jan;29(1):17-37. doi: 10.1002/pon.5280..
Keywords: Children/Adolescents, Cancer, Telehealth, Health Information Technology (HIT), Healthcare Delivery, Patient-Centered Healthcare
Norton WE, Zwarenstein M, Czajkowski S
AHRQ Author: Kato E
Building internal capacity in pragmatic trials: a workshop for program scientists at the US National Cancer Institute.
This article describes a workshop put together by the authors for program scientists at the National Cancer Institute (NCI) to help them become better researchers and stewards of research funds. The workshop got good reviews from the attendees and many felt it will help them develop funding opportunities and advise grantees.
AHRQ-authored.
Citation: Norton WE, Zwarenstein M, Czajkowski S .
Building internal capacity in pragmatic trials: a workshop for program scientists at the US National Cancer Institute.
Trials 2019 Dec 27;20(1):779. doi: 10.1186/s13063-019-3934-y..
Keywords: Research Methodologies, Health Services Research (HSR), Cancer, Healthcare Delivery
Murphy CC, Lee SJC, Gerber DE
Patient and provider perspectives on delivery of oral cancer therapies.
Investigators conducted a qualitative study exploring the range of patient and provider perspectives on oral cancer therapies. Through semi-structured interviews with patients and providers at a tertiary referral center and a county safetynet hospital in Dallas, Texas, they found that nearly all providers described challenges engaging with and educating patients about oral cancer therapies. Despite their initial hypothesis, the researchers also found that safetynet patients encountered few barriers accessing oral therapies when compared to patients receiving care in the tertiary referral center.
AHRQ-funded; HS022418.
Citation: Murphy CC, Lee SJC, Gerber DE .
Patient and provider perspectives on delivery of oral cancer therapies.
Patient Educ Couns 2019 Nov;102(11):2102-09. doi: 10.1016/j.pec.2019.06.019..
Keywords: Cancer, Healthcare Delivery, Access to Care, Patient-Centered Outcomes Research, Care Management
Knerr S, Bowles EJA, Leppig KA
Trends in BRCA test utilization in an integrated health system, 2005-2015.
The authors reported 10-year trends in BRCA testing in an integrated health-care system with long-standing access to genetic services. They found that many eligible women did not receive BRCA testing despite having insurance coverage and access to specialty genetic services, thus underscoring challenges to primary and secondary hereditary cancer prevention.
AHRQ-funded; HS022982.
Citation: Knerr S, Bowles EJA, Leppig KA .
Trends in BRCA test utilization in an integrated health system, 2005-2015.
J Natl Cancer Inst 2019 Aug;111(8):795-802. doi: 10.1093/jnci/djz008..
Keywords: Cancer: Breast Cancer, Cancer: Ovarian Cancer, Cancer, Genetics, Screening, Prevention, Healthcare Utilization, Healthcare Delivery, Women
Huguet N, Angier H, Rdesinski R
Cervical and colorectal cancer screening prevalence before and after Affordable Care Act Medicaid expansion.
This study assessed changes in the prevalence of cervical and colorectal cancer screening from before and after the Affordable Care Act in Medicaid expansion and non-expansion states among patients seen in community health centers. Results showed that, despite increased prevalences of cervical and colorectal cancer screening in both expansion and non-expansion states across all race/ethnicity groups, rates remained suboptimal for this population of socioeconomically disadvantaged patients.
AHRQ-funded; HS024270.
Citation: Huguet N, Angier H, Rdesinski R .
Cervical and colorectal cancer screening prevalence before and after Affordable Care Act Medicaid expansion.
Prev Med 2019 Jul;124:91-97. doi: 10.1016/j.ypmed.2019.05.003..
Keywords: Cancer, Cancer: Cervical Cancer, Cancer: Colorectal Cancer, Healthcare Delivery, Healthcare Utilization, Medicaid, Policy, Prevention, Screening
Johnston FM, Neiman JH, Parmley LE
Stakeholder perspectives on the use of community health workers to improve palliative care use by African Americans with cancer.
This study focused on the issue of lack of palliative care for African-Americans with cancer. Stakeholder interviews and focus groups were conducted with cancer patients, caregivers, health care administrators, oncologists, and community health workers (CHWs). Participants felt that CHWs could play a central role in bridging patients with their providers, information and resources. They also felt that CHWs should either come from the community, or be familiar with the history, culture, and norms of the communities from which they operate.
AHRQ-funded; HS024736.
Citation: Johnston FM, Neiman JH, Parmley LE .
Stakeholder perspectives on the use of community health workers to improve palliative care use by African Americans with cancer.
J Palliat Med 2019 Mar;22(3):302-06. doi: 10.1089/jpm.2018.0366..
Keywords: Access to Care, Cancer, Healthcare Delivery, Healthcare Utilization, Cultural Competence, Disparities, Palliative Care, Racial and Ethnic Minorities
Skinner D, Franz B, Howard J
The politics of primary care expansion: lessons from cancer survivorship and substance abuse.
The purpose of this study was to understand the perspectives of primary care innovators treating patient populations not traditionally considered to be within the purview of primary care. The authors indicated that their study findings suggested that the politics surrounding entrenched professional identities contributed to barriers faced by conference participants in their efforts to provide innovative care for these nontraditional populations. Specifically, obstacles surfaced in relation to sharing patients across disciplinary boundaries, which resulted in issues of possessiveness, a questioning of provider qualifications, and a lack of interprofessional trust.
AHRQ-funded; HS021287.
Citation: Skinner D, Franz B, Howard J .
The politics of primary care expansion: lessons from cancer survivorship and substance abuse.
J Healthc Manag 2018 Sep-Oct;63(5):323-36. doi: 10.1097/jhm-d-16-00030..
Keywords: Primary Care, Primary Care: Models of Care, Patient-Centered Healthcare, Cancer, Substance Abuse, Policy, Healthcare Delivery, Organizational Change, Quality of Care
Kamal AH
Redesigning oncology care delivery: Early wins, lessons learned, and a roadmap.
This editorial, discusses oncology care delivery and comments on an article by Colligan, et al., published, in 2017, in Medical Care, entitled “Two innovative cancer care programs have potential to reduce utilization and spending.”
AHRQ-funded; HS023681.
Citation: Kamal AH .
Redesigning oncology care delivery: Early wins, lessons learned, and a roadmap.
Med Care 2017 Oct;55(10):871-72. doi: 10.1097/mlr.00000000000.
Keywords: Cancer, Healthcare Delivery, Patient-Centered Outcomes Research
Singal AG, Tiro J, Li X
Hepatocellular carcinoma surveillance among patients with cirrhosis in a population-based integrated health care delivery system.
This study characterized guideline-concordant hepatocellular carcinoma (HCC) surveillance rates and patient-level factors associated with surveillance among a population-based cohort of patients with cirrhosis. It concluded that, although one third of patients undergo inconsistent HCC surveillance, less than 2 percent of patients receive guideline-concordant biannual HCC surveillance.
AHRQ-funded; HS022418.
Citation: Singal AG, Tiro J, Li X .
Hepatocellular carcinoma surveillance among patients with cirrhosis in a population-based integrated health care delivery system.
J Clin Gastroenterol 2017 Aug;51(7):650-55. doi: 10.1097/mcg.0000000000000708.
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Keywords: Cancer, Guidelines, Healthcare Delivery, Patient-Centered Outcomes Research, Practice Patterns
Rocque GB, Pisu M, Jackson BE
Resource use and Medicare costs during lay navigation for geriatric patients with cancer.
This study examined the influence of lay navigation on health care spending and resource use among geriatric patients with cancer within The University of Alabama at Birmingham Health System Cancer Community Network. It found that, compared with a matched comparison group, the mean total costs declined by $781.29 more per quarter per navigated patient, for an estimated $19 million decline per year across the network.
AHRQ-funded; HS023009.
Citation: Rocque GB, Pisu M, Jackson BE .
Resource use and Medicare costs during lay navigation for geriatric patients with cancer.
JAMA Oncol 2017 Jun;3(6):817-25. doi: 10.1001/jamaoncol.2016.6307.
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Keywords: Elderly, Cancer, Healthcare Costs, Medicare, Patient and Family Engagement, Patient-Centered Healthcare, Healthcare Delivery
O'Malley D, Hudson SV, Nekhlyudov L
Learning the landscape: implementation challenges of primary care innovators around cancer survivorship care.
This study describes the experiences of early implementers of primary care-focused cancer survivorship delivery models. Implementation challenges included (1) lack of key stakeholder buy-in; (2) practice resources allocated to competing (non-survivorship) change efforts; and (3) competition with higher priority initiatives incentivized by payers.
AHRQ-funded; HS021287.
Citation: O'Malley D, Hudson SV, Nekhlyudov L .
Learning the landscape: implementation challenges of primary care innovators around cancer survivorship care.
J Cancer Surviv 2017 Feb;11(1):13-23. doi: 10.1007/s11764-016-0555-2.
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Keywords: Primary Care, Cancer, Healthcare Delivery, Primary Care: Models of Care, Mortality
Rocque GB, Williams CP, Jackson BE
Choosing Wisely: opportunities for improving value in cancer care delivery?
The researchers conducted a retrospective analysis of Medicare claims data to examine concordance with Choosing Wisely recommendations across 12 cancer centers in the southeastern United States. Significant variability was noted across centers for all recommendations. The researchers concluded that if concordance were to increase to 95 percent for all measures, an estimated $19 million difference in total cost of care per quarter would be saved.
AHRQ-funded; HS023009.
Citation: Rocque GB, Williams CP, Jackson BE .
Choosing Wisely: opportunities for improving value in cancer care delivery?
J Oncol Pract 2017 Jan;13(1):e11-e21. doi: 10.1200/jop.2016.015396.
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Keywords: Cancer, Guidelines, Healthcare Delivery, Medicare
Gerber DE, Reimer T, Williams EL
Resolving rivalries and realigning goals: challenges of clinical and research multiteam systems.
This article describes the care processes for a 64-year-old man with newly diagnosed advanced non-small-cell lung cancer who was enrolled in a first-line clinical trial of a new immunotherapy regimen. Research team and clinical team members have limited knowledge of the roles and work of individuals outside their team. Recommendations to increase trust and collaboration are provided.
AHRQ-funded; HS022418.
Citation: Gerber DE, Reimer T, Williams EL .
Resolving rivalries and realigning goals: challenges of clinical and research multiteam systems.
J Oncol Pract 2016 Nov;12(11):1020-28. doi: 10.1200/jop.2016.013060.
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Keywords: Cancer, Cancer: Lung Cancer, Case Study, Healthcare Delivery, Patient-Centered Healthcare, Teams
Brand SR, Pickard L, Mack JW
What adult cancer care can learn from pediatrics.
However, pediatric cancer centers follow three core principles that enhance their patients’ overall care experience. This article discusses those principles, with the aim of helping adult cancer centers learn from what pediatric centers do well.
AHRQ-funded; HS000063.
Citation: Brand SR, Pickard L, Mack JW .
What adult cancer care can learn from pediatrics.
J Oncol Pract 2016 Sep;12(9):765-7. doi: 10.1200/jop.2016.015057..
Keywords: Cancer, Children/Adolescents, Health Services Research (HSR), Healthcare Delivery, Patient Experience, Children/Adolescents
Liu S, Mazur T, Li H
SU-F-T-275: A correlation study on 3D fluence-based QA and 2D dose measurement-based QA.
The aim of this paper was to demonstrate the feasibility and creditability of computing and verifying 3D fluencies to assure IMRT and VMAT treatment deliveries, by correlating the passing rates of the 3D fluence-based QA (P(alpha)) to the passing rates of 2D dose measurement based QA (P(Dm)). It concluded that the demonstrated correlations improve the creditability of using 3D fluence-based QA for assuring treatment deliveries for IMRT/VMAT plans.
AHRQ-funded; HS022888.
Citation: Liu S, Mazur T, Li H .
SU-F-T-275: A correlation study on 3D fluence-based QA and 2D dose measurement-based QA.
Med Phys 2016 Jun;43(6 Part 17):3525-26. doi: 10.1118/1.4956415.
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Keywords: Cancer, Healthcare Delivery, Treatments, Patient Safety, Health Information Technology (HIT)
Liu S, Wu Y, Chang X
TU-FG-201-03: Automatic pre-delivery verification using statistical analysis of consistencies in treatment plan parameters by the treatment site and modality.
A novel computer software system, namely APDV (Automatic Pre-Delivery Verification), was developed for verifying patient treatment plan parameters right prior to treatment deliveries in order to automatically detect and prevent catastrophic errors. This study implemented APDV as a stand-alone program to ensure required real time performance. It concluded that APDV could be useful in detecting and preventing catastrophic errors immediately before treatment deliveries.
AHRQ-funded; HS022888.
Citation: Liu S, Wu Y, Chang X .
TU-FG-201-03: Automatic pre-delivery verification using statistical analysis of consistencies in treatment plan parameters by the treatment site and modality.
Med Phys 2016 Jun;43(6 Part 35):3753. doi: 10.1118/1.4957526.
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Keywords: Cancer, Healthcare Delivery, Treatments, Patient Safety, Health Information Technology (HIT)
Kamal AH, Nipp RD, Bull JH
Quality of palliative care for patients with advanced cancer in a community consortium.
The authors formed the Carolinas Consortium for Palliative Care and collected a quality data registry to monitor their practice and to inform quality improvement efforts. They demonstrated that measures evaluating process assessment, as opposed to interventions, are better documented. They concluded that analyzing data on quality is feasible and valuable in community-based palliative care and that, overall, processes to collect data on quality using nontechnology methods may underestimate true adherence to quality measures.
AHRQ-funded; HS022763.
Citation: Kamal AH, Nipp RD, Bull JH .
Quality of palliative care for patients with advanced cancer in a community consortium.
J Pain Symptom Manage 2015 Feb;49(2):289-92. doi: 10.1016/j.jpainsymman.2014.05.024.
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Keywords: Cancer, Healthcare Delivery, Quality of Care, Palliative Care, Registries
Rabin BA, Ellis JL, Steiner JF
Health-care utilization by prognosis profile in a managed care setting: using the Surveillance, Epidemiology and End Results Cancer Survival Calculator SEER*CSC.
The authors described health service utilization patterns of subgroups of prostate cancer and colorectal cancer (CRC) patients with different relative probabilities of dying of their cancer or other conditions. They found that although a new diagnosis of cancer increased utilization of cancer-related services for an extended time period, the timing of cancer diagnosis did not appear to affect other types of utilization.
AHRQ-funded; HS019520.
Citation: Rabin BA, Ellis JL, Steiner JF .
Health-care utilization by prognosis profile in a managed care setting: using the Surveillance, Epidemiology and End Results Cancer Survival Calculator SEER*CSC.
J Natl Cancer Inst Monogr 2014 Nov;2014(49):275-81. doi: 10.1093/jncimonographs/lgu023.
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Keywords: Cancer: Prostate Cancer, Cancer: Colorectal Cancer, Cancer, Healthcare Utilization, Mortality, Healthcare Delivery