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
7851 to 7875 of 12139 Research Studies DisplayedAdams JL, Paddock SM
Misclassification risk of tier-based physician quality performance systems.
The authors estimated misclassification rates for two-category high-quality physician identification systems. They found that current methods for profiling physicians on quality may produce misleading results, and that misclassification is a policy-relevant measure of the potential impact of tiering on providers, payers, and patients. They concluded that quantifying misclassification rates should inform the construction of high-performance networks and quality improvement initiatives.
AHRQ-funded; HS021860.
Citation: Adams JL, Paddock SM .
Misclassification risk of tier-based physician quality performance systems.
Health Serv Res 2017 Aug;52(4):1277-96. doi: 10.1111/1475-6773.12561.
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Keywords: Provider Performance, Quality of Care, Payment
Metersky ML, Eldridge N, Wang Y
AHRQ Author: Eldridge N
National trends in the frequency of bladder catheterization and physician-diagnosed catheter-associated urinary tract infections: results from the Medicare Patient Safety Monitoring System.
The researchers assessed bladder catheterization frequency (percentage of patients catheterized) and risk-adjusted catheter-associated urinary tract infection (CAUTI frequency (percentage of catheterized patients developing CAUTI) from 2009-2014. They found statistically significant declines in observed bladder catheterization frequency and adjusted CAUTI frequency in some patient populations between 2009 and 2014.
AHRQ-authored; AHRQ-funded; 290201200003C; HS019767; HS024385; HS018334.
Citation: Metersky ML, Eldridge N, Wang Y .
National trends in the frequency of bladder catheterization and physician-diagnosed catheter-associated urinary tract infections: results from the Medicare Patient Safety Monitoring System.
Am J Infect Control 2017 Aug;45(8):901-04. doi: 10.1016/j.ajic.2017.03.008.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Urinary Tract Infection (UTI), Patient Safety, Adverse Events, Medicare
Brown SM, Duggal A, Hou PC
Nonlinear imputation of PaO2/FIO2 from SpO2/FIO2 among mechanically ventilated patients in the ICU: a prospective, observational study.
The objective of the study was to validate the superiority of nonlinear imputation of PaO2/FIO2 (a clinical indicator of hypoxaemia) among mechanically ventilated patients and understand what factors influence the accuracy of imputation. It concluded that in mechanically ventilated patients, nonlinear imputation of PaO2/FIO2 from SpO2/FIO2 seems accurate, especially for moderate-severe hypoxemia. Linear and log-linear imputations cannot be recommended.
AHRQ-funded; HS021456.
Citation: Brown SM, Duggal A, Hou PC .
Nonlinear imputation of PaO2/FIO2 from SpO2/FIO2 among mechanically ventilated patients in the ICU: a prospective, observational study.
Crit Care Med 2017 Aug;45(8):1317-24. doi: 10.1097/ccm.0000000000002514.
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Keywords: Diagnostic Safety and Quality, Respiratory Conditions, Intensive Care Unit (ICU), Emergency Medical Services (EMS)
Keller SC, Gurses AP, Werner N
Older adults and management of medical devices in the home: five requirements for appropriate use.
This study concerns a qualitative evaluation of barriers and facilitators of appropriate use, and outcomes of inappropriate use, among older adults at the transition from hospital to home with skilled home health care (SHHC). Five requirements for the appropriate use of home medical devices were identified. A systems approach integrating the hospital with the SHHC agency is needed to make the use of home medical devices safer.
AHRQ-funded; HS022916.
Citation: Keller SC, Gurses AP, Werner N .
Older adults and management of medical devices in the home: five requirements for appropriate use.
Popul Health Manag 2017 Aug;20(4):278-86. doi: 10.1089/pop.2016.0070.
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Keywords: Elderly, Caregiving, Home Healthcare, Medical Devices, Patient Safety
Thomas HN, Hamm M, Hess R
Patient-centered outcomes and treatment preferences regarding sexual problems: a qualitative study among midlife women.
This study sought a better understanding of the sexual function outcomes that were most important to sexually active women 45 to 60 years old and the types of treatments they would prefer from individual interviews and focus groups. It found that many midlife women in the sample expressed a preference for behavioral approaches over pharmaceutical approaches for the treatment of sexual dysfunction.
AHRQ-funded; HS022989.
Citation: Thomas HN, Hamm M, Hess R .
Patient-centered outcomes and treatment preferences regarding sexual problems: a qualitative study among midlife women.
J Sex Med 2017 Aug;14(8):1011-17. doi: 10.1016/j.jsxm.2017.05.014..
Keywords: Sexual Health, Women, Patient-Centered Outcomes Research, Quality of Life
Clark B, Baron K, Tynan-McKiernan K
Perspectives of clinicians at skilled nursing facilities on 30-day hospital readmissions: a qualitative study.
The purpose of this paper was to understand the perspectives of clinicians working at skilled nursing facilities (SNFs) regarding factors contributing to readmissions. SNF clinicians identified a broad range of factors that contributed to readmissions. The investigators suggest that addressing these factors may mitigate patients' risk of readmission from SNFs to acute care hospitals.
AHRQ-funded; HS023554.
Citation: Clark B, Baron K, Tynan-McKiernan K .
Perspectives of clinicians at skilled nursing facilities on 30-day hospital readmissions: a qualitative study.
J Hosp Med 2017 Aug;12(8):632-38. doi: 10.12788/jhm.2785..
Keywords: Hospital Readmissions, Nursing Homes, Quality Improvement, Transitions of Care
Dykes PC, Duckworth M, Cunningham S
Pilot testing Fall TIPS (Tailoring Interventions for Patient Safety): a patient-centered fall prevention toolkit.
Patient falls during an acute hospitalization cause injury, reduced mobility, and increased costs. The laminated paper Fall TIPS Toolkit (Fall TIPS) provides clinical decision support at the bedside by linking each patient's fall risk assessment with evidence-based interventions. The investigators examined strategies to integrate this evidence into clinical practice. They concluded that engaging hospital and clinical leadership is critical in translating evidence-based care into clinical practice. They address and detail barriers to adoption of the protocol to provide guidance for spread to other institutions.
AHRQ-funded; HS025128.
Citation: Dykes PC, Duckworth M, Cunningham S .
Pilot testing Fall TIPS (Tailoring Interventions for Patient Safety): a patient-centered fall prevention toolkit.
Jt Comm J Qual Patient Saf 2017 Aug;43(8):403-13. doi: 10.1016/j.jcjq.2017.05.002..
Keywords: Clinical Decision Support (CDS), Decision Making, Evidence-Based Practice, Falls, Hospitals, Injuries and Wounds, Inpatient Care, Patient Safety, Prevention, Risk, Tools & Toolkits
Pellegrini CA, Ledford G, Hoffman SA
Preferences and motivation for weight loss among knee replacement patients: implications for a patient-centered weight loss intervention.
The purpose of this study was to identify knee replacement patient preferences for weight loss programs and qualitatively understand previous motives for weight loss attempts as well as strategies used to facilitate behavior changes. It provides a preliminary examination into the motives for weight loss, strategies utilized during past weight loss attempts, and preferences for future weight loss programs as described by knee replacement patients.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Ledford G, Hoffman SA .
Preferences and motivation for weight loss among knee replacement patients: implications for a patient-centered weight loss intervention.
BMC Musculoskelet Disord 2017 Aug 1;18(1):327. doi: 10.1186/s12891-017-1687-x.
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Keywords: Patient-Centered Healthcare, Surgery, Obesity, Obesity: Weight Management
Chenoweth JA, Johnson MA, Shook L
Prevalence of intracranial hemorrhage after blunt head trauma in patients on pre-injury dabigatran.
Dabigatran etexilate was the first direct-acting oral anticoagulant approved in the United States. The researchers aimed to determine the prevalence of intracranial hemorrhage for patients on dabigatran presenting to a Level I trauma center. The intracranial hemorrhage prevalence in their study was similar to previous reports for patients on warfarin.
AHRQ-funded; HS022236.
Citation: Chenoweth JA, Johnson MA, Shook L .
Prevalence of intracranial hemorrhage after blunt head trauma in patients on pre-injury dabigatran.
West J Emerg Med 2017 Aug;18(5):794-99. doi: 10.5811/westjem.2017.5.33092.
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Keywords: Blood Thinners, Brain Injury, Trauma, Risk, Medication
Leonard CE, Hennessy S, Han X
Pro- and antiarrhythmic actions of sulfonylureas: Mechanistic and clinical evidence.
In this review, the authors explore the influence of sulfonylureas on the risk of serious arrhythmias, with specific foci on ischemic preconditioning, cardiac excitability, and serious hypoglycemia as putative mechanisms. They argue that elucidating the relationship between individual sulfonylureas and serious arrhythmias is critical, especially as the diabetes epidemic intensifies and sudden cardiac arrest (SCA) incidence increases in persons with diabetes.
AHRQ-funded; HS023898.
Citation: Leonard CE, Hennessy S, Han X .
Pro- and antiarrhythmic actions of sulfonylureas: Mechanistic and clinical evidence.
Trends Endocrinol Metab 2017 Aug;28(8):561-86. doi: 10.1016/j.tem.2017.04.003.
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Keywords: Adverse Drug Events (ADE), Cardiovascular Conditions, Diabetes, Medication, Mortality
Misra-Hebert AD, Hu B, Klein EA
Prostate cancer screening practices in a large, integrated health system: 2007-2014.
The researchers assessed prostate cancer screening practices in primary care since the initial United States Preventive Services Task Force (USPSTF) recommendation against prostate-specific antigen (PSA) testing for older men. Prostate cancer screening declined from 2007 to 2014 even in higher-risk groups and follow-up screening rates were not related to previous PSA level.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Hu B, Klein EA .
Prostate cancer screening practices in a large, integrated health system: 2007-2014.
BJU Int 2017 Aug;120(2):257-64. doi: 10.1111/bju.13793.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Prostate Cancer, Screening, Primary Care, Practice Patterns
Novak P, Williams-Parry KF, Chen J
AHRQ Author: Novak P
Racial and ethnic disparities among the remaining uninsured young adults with behavioral health disorders after the ACA expansion of dependent coverage.
The objective of this study is to explore the population characteristics of the remaining uninsured individuals with and without behavioral health disorders (BHDs) and to examine whether the factors that contribute to racial and ethnic disparities in the likelihood of being uninsured were different after ACA. The major factor associated with the ethnic disparity among those with BHDs was the immigrant status of Latinos, and the major factor associated with racial disparity was geographic location.
AHRQ-authored; AHRQ-funded; HS022135.
Citation: Novak P, Williams-Parry KF, Chen J .
Racial and ethnic disparities among the remaining uninsured young adults with behavioral health disorders after the ACA expansion of dependent coverage.
J Racial Ethn Health Disparities 2017 Aug;4(4):607-14. doi: 10.1007/s40615-016-0264-6.
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Keywords: Behavioral Health, Disparities, Policy, Medical Expenditure Panel Survey (MEPS), Uninsured
Farias AJ, Du XL
Racial differences in adjuvant endocrine therapy use and discontinuation in association with mortality among Medicare breast cancer patients by receptor status.
The purpose of this study was to determine whether racial/ethnic differences in use and discontinuation of adjuvant endocrine therapy (AET) differed by hormone receptor status and whether discontinuation was associated with mortality. There are racial/ethnic differences in AET use and discontinuation. Discontinuing treatment was associated with higher risk of all-cause and cancer-specific mortality regardless of hormone receptor status.
AHRQ-funded; HS018956.
Citation: Farias AJ, Du XL .
Racial differences in adjuvant endocrine therapy use and discontinuation in association with mortality among Medicare breast cancer patients by receptor status.
Cancer Epidemiol Biomarkers Prev 2017 Aug;26(8):1266-75. doi: 10.1158/1055-9965.epi-17-0280.
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Keywords: Cancer: Breast Cancer, Disparities, Elderly, Mortality, Racial and Ethnic Minorities
Tyson MD, Alvarez J, Koyama T
Racial variation in patient-reported outcomes following treatment for localized prostate cancer: results from the CEASAR study.
This study tested the hypothesis that treatment-related changes in urinary, bowel, sexual, and hormonal function vary by race/ethnicity. It concluded that the effect of treatment for prostate cancer on patient-reported function did not vary dramatically by race/ethnicity. Compared to white men, African-American men experienced a somewhat more pronounced decline in urinary continence after radical prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: Tyson MD, Alvarez J, Koyama T .
Racial variation in patient-reported outcomes following treatment for localized prostate cancer: results from the CEASAR study.
Eur Urol 2017 Aug;72(2):307-14. doi: 10.1016/j.eururo.2016.10.036.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer: Prostate Cancer, Racial and Ethnic Minorities, Surgery
Murtaugh CM, Deb P, Zhu C
Reducing readmissions among heart failure patients discharged to home health care: effectiveness of early and intensive nursing services and early physician follow-up.
This study compared the effectiveness of two "treatments"-early, intensive home health nursing and physician follow-up within a week-versus less intense and later postacute care in reducing readmissions among heart failure patients discharged to home health care. Neither treatment by itself had a statistically significant effect on hospital readmission. In combination, however, they reduced the probability of readmission by roughly 8 percentage points.
AHRQ-funded; HS020257.
Citation: Murtaugh CM, Deb P, Zhu C .
Reducing readmissions among heart failure patients discharged to home health care: effectiveness of early and intensive nursing services and early physician follow-up.
Health Serv Res 2017 Aug;52(4):1445-72. doi: 10.1111/1475-6773.12537.
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Keywords: Comparative Effectiveness, Heart Disease and Health, Home Healthcare, Hospital Readmissions, Patient-Centered Outcomes Research
Guo JW, Bennett H, Crouch BI
Reference website use patterns of poison control center specialists.
The purpose of this pilot study was to describe web reference use patterns of poison control center specialists using time tracking software. Investigators analyzed two weeks of web site use data from Utah poison control center (PCC) computers to describe patterns of reference web site use. The study demonstrated the utility of time tracking software for better understanding reference utilization in the PCC setting.
AHRQ-funded; HS021472.
Citation: Guo JW, Bennett H, Crouch BI .
Reference website use patterns of poison control center specialists.
2017 IEEE International Conference on Healthcare Informatics (ICHI) 2017 Aug:453. doi: 10.1109/ICHI.2017.40..
Keywords: Patient Safety, Imaging, Quality of Care
Shih YT, Xu Y, Liu L
Rising prices of targeted oral anticancer medications and associated financial burden on Medicare beneficiaries.
This study examined trends in targeted oral anticancer medication (TOAM) prices and patient out-of-pocket (OOP) payments in Medicare Part D and estimated the actual effects on patient OOP payments of partial filling of the coverage gap by 2012. It concluded that rising TOAM prices threaten the financial relief patients have begun to experience under closure of the coverage gap in Medicare Part D.
AHRQ-funded; HS020263.
Citation: Shih YT, Xu Y, Liu L .
Rising prices of targeted oral anticancer medications and associated financial burden on Medicare beneficiaries.
J Clin Oncol 2017 Aug 1;35(22):2482-89. doi: 10.1200/jco.2017.72.3742.
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Keywords: Cancer, Medication, Healthcare Costs, Medicare, Elderly
Smith AB, Basch E
Role of patient-reported outcomes in postsurgical monitoring in oncology.
This article describes the benefits of electronic patient-reported outcomes (ePROs) in postsurgical symptom monitoring for surgical oncology patients; ePROs can identify at-risk patients, provide closer monitoring, and provide a mechanism to identify and treat complications before they worsen. The article also summarizes the literature of ePRO use in surgical oncology.
AHRQ-funded; HS024134.
Citation: Smith AB, Basch E .
Role of patient-reported outcomes in postsurgical monitoring in oncology.
J Oncol Pract 2017 Aug;13(8):535-38. doi: 10.1200/jop.2017.023838..
Keywords: Cancer, Care Management, Health Information Technology (HIT), Electronic Health Records (EHRs), Surgery, Outcomes
Roxbury CR, Li L, Rhee D
Safety and perioperative adverse events in pediatric endoscopic sinus surgery: an ACS-NSQIP-P analysis.
This study describes safety outcomes of pediatric endoscopic sinus surgery (ESS) to identify risk factors for 30-day postoperative adverse events using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database. It concluded that urgent/emergent procedures carry the greatest risk of postoperative adverse events, and black children are significantly more likely to undergo higher acuity surgery than white children.
AHRQ-funded; HS022932.
Citation: Roxbury CR, Li L, Rhee D .
Safety and perioperative adverse events in pediatric endoscopic sinus surgery: an ACS-NSQIP-P analysis.
Int Forum Allergy Rhinol 2017 Aug;7(8):827-36. doi: 10.1002/alr.21954.
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Keywords: Adverse Events, Children/Adolescents, Quality Improvement, Risk, Surgery
Bailey SR, Heintzman JD, Marino M
Smoking-cessation assistance: before and after stage 1 meaningful use implementation.
This study examined whether smoking status assessment, cessation assistance, and odds of being a current smoker changed after Stage 1 Meaningful Use (MU) implementation. Its findings suggest that incentives for MU of electronic health records increase the odds of smoking assessment and cessation assistance, which could lead to decreased smoking rates among vulnerable populations.
AHRQ-funded; HS021522.
Citation: Bailey SR, Heintzman JD, Marino M .
Smoking-cessation assistance: before and after stage 1 meaningful use implementation.
Am J Prev Med 2017 Aug;53(2):192-200. doi: 10.1016/j.amepre.2017.02.006.
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Keywords: Behavioral Health, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Primary Care, Tobacco Use
Boffa D, Fernandez FG, Kim S
Surgically managed clinical stage iiia-clinical n2 lung cancer in the Society of Thoracic Surgeons Database.
The objective of this study was to characterize the management of clinical stage IIIA-N2 positive (cIIIA-N2) lung cancer in The Society of Thoracic Surgeons General Thoracic Surgery Database. Surgeons achieved excellent short- and long-term results treating predominantly lobectomy-amenable cIIIA-N2 lung cancer. However, prevalent overstaging and abstention from induction therapy suggested "overcoding" of false positives on imaging or variable compliance with current guidelines for cIIIA-N2 lung cancer.
AHRQ-funded; HS022279.
Citation: Boffa D, Fernandez FG, Kim S .
Surgically managed clinical stage iiia-clinical n2 lung cancer in the Society of Thoracic Surgeons Database.
Ann Thorac Surg 2017 Aug;104(2):395-403. doi: 10.1016/j.athoracsur.2017.02.031.
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Keywords: Surgery, Cancer: Lung Cancer, Registries, Elderly, Outcomes
Roydhouse JK, Wilson IB
Systematic review of caregiver responses for patient health-related quality of life in adult cancer care.
The aim of this review is to help cancer researchers select a validated health-related quality of life tool if they anticipate using proxy-reported data. It concluded that the evidence base is strongest for the EORTC (disease-specific tools), COOP/WONCA (generic tools), and MQOL (end-of-life-specific tools).
AHRQ-funded; HS000011.
Citation: Roydhouse JK, Wilson IB .
Systematic review of caregiver responses for patient health-related quality of life in adult cancer care.
Qual Life Res 2017 Aug;26(8):1925-54. doi: 10.1007/s11136-017-1540-6.
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Keywords: Cancer, Caregiving, Patient-Centered Outcomes Research, Quality of Life
Wong MS, Showell NN, Bleich SN
The association between parent-reported provider communication quality and child obesity status: variation by parent obesity and child race/ethnicity.
This study examined the association between healthcare provider communication quality and child obesity status, and the role of parent obesity and child race/ethnicity regarding this association. It found that parents of obese children experienced better communication if parents were non-obese or children were non-Hispanic Black or Asian.
AHRQ-funded; HS000029.
Citation: Wong MS, Showell NN, Bleich SN .
The association between parent-reported provider communication quality and child obesity status: variation by parent obesity and child race/ethnicity.
Patient Educ Couns 2017 Aug;100(8):1588-97. doi: 10.1016/j.pec.2017.03.015.
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Keywords: Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Obesity, Clinician-Patient Communication, Racial and Ethnic Minorities
Quattrin Wilfley, DE
The promise and opportunities for screening and treating childhood obesity: USPSTF recommendation statement.
This editorial discusses the updated recommendation statement and evidence review released by the United States Preventive Services Task Force (USPSTF) on screening for obesity in children. The Task Force recommendations are called ‘a call to arms’ against a condition that has immediate as well as long-term consequences for the health of the children affected. The authors note that the evaluation techniques for screening for obesity carry very few risks. Family-based behavioral treatment and the effectiveness of behavioral interventions, as well as pharmacotherapies, are also discussed.
AHRQ-funded; HS022816.
Citation: Quattrin Wilfley, DE .
The promise and opportunities for screening and treating childhood obesity: USPSTF recommendation statement.
JAMA Pediatr 2017 Aug;171(8):733-35. doi: 10.1001/jamapediatrics.2017.1604..
Keywords: Children/Adolescents, Guidelines, Obesity, Prevention, Screening, U.S. Preventive Services Task Force (USPSTF)
Vouri SM, Olsen MA, Theodoro D
Treated-and-released urinary catheterization in the emergency department by sex.
The prevalence of conditions associated with urinary catheterization (UC) visits in men and women were identified. The rate of UC in treated-and-released ED visits was higher in men than women, and UC rate increased with age. The heterogeneity of conditions coded in UC visits in women compared with men may suggest more potentially avoidable UC in women in the treated-and-released ED population.
AHRQ-funded; HS019455.
Citation: Vouri SM, Olsen MA, Theodoro D .
Treated-and-released urinary catheterization in the emergency department by sex.
Am J Infect Control 2017 Aug;45(8):905-10. doi: 10.1016/j.ajic.2017.02.025.
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Keywords: Emergency Department, Healthcare Cost and Utilization Project (HCUP), Sex Factors