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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
10651 to 10675 of 12139 Research Studies DisplayedPadula 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
Sjoding MW, Prescott HC, Wunsch H
Hospitals with the highest intensive care utilization provide lower quality pneumonia care to the elderly.
The researchers investigate the relationship between a hospital’s ICU admission rate for elderly patients with pneumonia and the quality of care it provided to patients with pneumonia. They found that quality of care was lower among hospitals with the highest rates of ICU admission for elderly patients with pneumonia; such hospitals were less likely to deliver pneumonia processes of care and had worse outcomes for patients with pneumonia.
AHRQ-funded; HS020672.
Citation: Sjoding MW, Prescott HC, Wunsch H .
Hospitals with the highest intensive care utilization provide lower quality pneumonia care to the elderly.
Crit Care Med 2015 Jun;43(6):1178-86. doi: 10.1097/ccm.0000000000000925..
Keywords: Intensive Care Unit (ICU), Elderly, Inpatient Care, Quality of Care, Outcomes
Ripley DC, Kwong PL, Vogel WB
How does geographic access affect in-hospital mortality for veterans with acute ischemic stroke?
This study examined the relationship between estimated travel time to admitting hospital and mortality for veterans with acute ischemic stroke. It found that even after adjusting for the confounding effects of patient, treatment, and facility characteristics, travel time from home to admitting VAMC was significantly associated with inhospital mortality.
AHRQ-funded; HS018540.
Citation: Ripley DC, Kwong PL, Vogel WB .
How does geographic access affect in-hospital mortality for veterans with acute ischemic stroke?
Med Care 2015 Jun;53(6):501-9. doi: 10.1097/mlr.0000000000000366..
Keywords: Stroke, Mortality, Access to Care
Smith RJ, Kilaru AS, Perrone J
How, why, and for whom do emergency medicine providers use prescription drug monitoring programs?
The authors examined how emergency physicians use Prescription Drug Monitoring Programs (PDMPs), for which patients, and for what reasons. They found that providers use the information in PDMPs to alter clinical decisions and guide opioid prescribing patterns. Physicians used the databases additionally for improving their ability to facilitate discussions on addiction and for providing patient education. The authors recommended minimizing administrative barriers to PDMP access and suggested that alternative PDMP uses be further studied to determine their appropriateness and potentially expand their role in clinical practice.
AHRQ-funded; HS021956.
Citation: Smith RJ, Kilaru AS, Perrone J .
How, why, and for whom do emergency medicine providers use prescription drug monitoring programs?
Pain Med 2015 Jun;16(6):1122-31. doi: 10.1111/pme.12700.
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Keywords: Decision Making, Emergency Medical Services (EMS), Medication, Practice Patterns, Substance Abuse
Vaz LE, Kleinman KP, Kawai AT
Impact of Medicare's hospital-acquired condition policy on infections in safety net and non-safety net hospitals.
The researchers sought to determine whether the 2008 Centers for Medicare and Medicaid Services Hospital-Acquired Conditions policy had a differential impact on targeted healthcare-associated infection rates in safety net compared with non–safety net hospitals. They found that this policy did not have an impact, either positive or negative, on already declining rates of central line–associated bloodstream infection in safety net or non–safety net hospitals.
AHRQ-funded; HS018414.
Citation: Vaz LE, Kleinman KP, Kawai AT .
Impact of Medicare's hospital-acquired condition policy on infections in safety net and non-safety net hospitals.
Infect Control Hosp Epidemiol 2015 Jun;36(6):649-55. doi: 10.1017/ice.2015.38..
Keywords: Patient Safety, Medicare, Healthcare-Associated Infections (HAIs), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs)
Ballard TN, Grenda TR, Cohn AM
Innovative scheduling solutions for graduate medical education.
Operations research can be applied to solving numerous logistical problems, including residency scheduling dilemmas. The authors pointed out that training programs will need to employ more advanced approaches to solving scheduling dilemmas, and operations research offers innovative approaches to enable graduate medical education programs to efficiently address this constantly changing field.
AHRQ-funded; HS000053.
Citation: Ballard TN, Grenda TR, Cohn AM .
Innovative scheduling solutions for graduate medical education.
J Grad Med Educ 2015 Jun;7(2):169-70. doi: 10.4300/jgme-d-14-00581.1.
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Keywords: Education: Continuing Medical Education, Training
Spector WD, Limcangco R, Mutter RL
AHRQ Author: Spector WD, Mutter RL, Owens P
Inpatient admissions from the ED for adults with injuries: the role of clinical and nonclinical factors.
The study objective was to explore the association of clinical and nonclinical factors with the decision to admit ED patients with injury. It found that injury location, type, and mechanism and comorbidities had large effects on hospitalization rates as expected. We found higher inpatient admission rates by level of trauma center designation and hospital size, but findings differed by age and type of injury.
AHRQ-authored.
Citation: Spector WD, Limcangco R, Mutter RL .
Inpatient admissions from the ED for adults with injuries: the role of clinical and nonclinical factors.
Am J Emerg Med 2015 Jun;33(6):764-9. doi: 10.1016/j.ajem.2015.02.045..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Emergency Department
Gupta K, Mueller SK
Interhospital transfers: the need for standards.
Patient transfers from one hospital to another are common and occur for a multitude of reasons with varied outcomes. The authors discuss interhospital transfers and difficulties encountered by the providers who care for these patients. They recommend further research to identify more clearly which patients are most likely to benefit from transfer and why.
AHRQ-funded; HS023331.
Citation: Gupta K, Mueller SK .
Interhospital transfers: the need for standards.
J Hosp Med 2015 Jun;10(6):415-7. doi: 10.1002/jhm.2320.
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Keywords: Case Study, Decision Making, Elderly, Patient Safety, Transitions of Care
Frasier LL, Leverson G, Gosain A
Laparoscopic versus open Ladd's procedure for intestinal malrotation in adults.
This study was designed to investigate outcomes for adults undergoing laparoscopic surgery vs. open Ladd’s repair for malrotation. It found no significant differences in complication rates, need for re-operation, or symptom resolution. There was a statistically significant decrease in length of stay following laparoscopy compared to open surgery.
AHRQ-funded; HS022403.
Citation: Frasier LL, Leverson G, Gosain A .
Laparoscopic versus open Ladd's procedure for intestinal malrotation in adults.
Surg Endosc 2015 Jun;29(6):1598-604. doi: 10.1007/s00464-014-3849-3..
Keywords: Surgery, Outcomes, Patient-Centered Outcomes Research, Adverse Events, Comparative Effectiveness
Overby CL, Devine EB, Abernethy N
Making pharmacogenomic-based prescribing alerts more effective: a scenario-based pilot study with physicians.
This pilot study explored the communication effectiveness and clinical impact of using a prototype clinical decision support (CDS) system embedded in an electronic health record (EHR) to deliver pharmacogenomic (PGx) information to physicians. The proportion of physicians that saw a relative advantage to using PGx-CDS was 83 percent at the start and 94 percent at the conclusion of our study.
AHRQ-funded; HS014739.
Citation: Overby CL, Devine EB, Abernethy N .
Making pharmacogenomic-based prescribing alerts more effective: a scenario-based pilot study with physicians.
J Biomed Inform 2015 Jun;55:249-59. doi: 10.1016/j.jbi.2015.04.011..
Keywords: Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Patient Safety
Cavazos-Rehg PA, Krauss MJ, Spitznagel EL
Maternal age and risk of labor and delivery complications.
The researchers examined associations between maternal age and prevalence of maternal morbidity during complications of labor and delivery. Using HCUP data, they found that complications with the highest odds among women 11-18 years of age included preterm delivery, chorioamnionitis, endometritis, and mild preeclampsia. Pregnant women 15-19 years old had greater odds for severe preeclampsia, eclampsia, postpartum hemorrhage, poor fetal growth, and fetal distress. Pregnant women 35 and older had greater odds for preterm delivery, hypertension, superimposed preeclampsia, severe preeclampsia, and decreased risk for chorioamnionitis. Women over 40 had increased odds for mild preeclampsia, fetal distress, and poor fetal growth.
AHRQ-funded; HS019455.
Citation: Cavazos-Rehg PA, Krauss MJ, Spitznagel EL .
Maternal age and risk of labor and delivery complications.
Matern Child Health J 2015 Jun;19(6):1202-11. doi: 10.1007/s10995-014-1624-7.
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Keywords: Adverse Events, Healthcare Cost and Utilization Project (HCUP), Labor and Delivery, Pregnancy, Risk
DeCamp M, Sugarman J, Berkowitz SA
Meaningfully engaging patients in ACO decision making.
In this article, the authors describe how ACOs can achieve meaningful system-level patient engagement. They specify a three-step engagement framework: identifying beneficiary representatives, cultivating relationships, and evaluating engagement. They conclude that their proposed three-step framework can help accountable care organizations (ACOs) conceptualize a plan for meaningfully engaging patients in ACO governance.
AHRQ-funded; HS023684.
Citation: DeCamp M, Sugarman J, Berkowitz SA .
Meaningfully engaging patients in ACO decision making.
Am J Accountable Care 2015 Jun;3(2):30-33.
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Keywords: Patient and Family Engagement, Decision Making, Health Insurance, Healthcare Delivery
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
Shih T, Ryan AM, Gonzalez AA
Medicare's hospital readmissions reduction program in surgery may disproportionately affect minority-serving hospitals.
The authors aimed to project readmission penalties for hospitals performing cardiac surgery and examine how these penalties will affect minority-serving hospitals. They found that minority-serving hospitals would disproportionately bear the burden of readmission penalties if expanded to include cardiac surgery.
AHRQ-funded; HS018546.
Citation: Shih T, Ryan AM, Gonzalez AA .
Medicare's hospital readmissions reduction program in surgery may disproportionately affect minority-serving hospitals.
Ann Surg 2015 Jun;261(6):1027-31. doi: 10.1097/sla.0000000000000778.
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Keywords: Hospitals, Medicare, Racial and Ethnic Minorities, Hospital Readmissions, Surgery
Marcum ZA, Hardy SE
Medication management skills in older skilled nursing facility residents transitioning home.
The objective of this pilot study was to describe potential medication management deficiencies of older SNF residents transitioning home. It found that medication management deficiencies were found to be common in a high-risk group of elderly adults making this important transition.
AHRQ-funded; HS020831.
Citation: Marcum ZA, Hardy SE .
Medication management skills in older skilled nursing facility residents transitioning home.
J Am Geriatr Soc 2015 Jun;63(6):1266-8. doi: 10.1111/jgs.13469..
Keywords: Patient Safety, Nursing Homes, Elderly, Medication, Transitions of Care
Sorkin DH, Billimek J, August KJ
AHRQ Author: Ngo-Metzger Q
Mental health symptoms and patient-reported diabetes symptom burden: implications for medication regimen changes.
The aim of this paper was to examine the relative contribution of glycaemic control (HbA1C) and depressive symptoms on diabetes-related symptom burden (hypoglycaemia and hyperglycaemia) in order to guide medication modification. The authors found that mental health symptoms are associated with higher levels of patient-reported diabetes-related symptoms, but the association between diabetes-related symptoms and subsequent regimen modifications is diminished in patients with greater depressive symptoms.
AHRQ-authored.
Citation: Sorkin DH, Billimek J, August KJ .
Mental health symptoms and patient-reported diabetes symptom burden: implications for medication regimen changes.
Fam Pract 2015 Jun;32(3):317-22. doi: 10.1093/fampra/cmv014.
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Keywords: Depression, Diabetes, Medication, Practice Patterns, Social Determinants of Health
Schmittdiel JA, Desai J, Schroeder EB
Methods for engaging stakeholders in comparative effectiveness research: a patient-centered approach to improving diabetes care.
This article presents ways to engage stakeholders in comparative effectiveness research, including patient community surveys, stakeholder meetings with substantial patient representation, and patient stakeholder deciding votes in selecting pilot research topics. Researchers and health care leaders should continue to develop best-practices and strategies for increasing patient involvement in comparative effectiveness and delivery science research.
AHRQ-funded; HS022963; HS019859.
Citation: Schmittdiel JA, Desai J, Schroeder EB .
Methods for engaging stakeholders in comparative effectiveness research: a patient-centered approach to improving diabetes care.
Healthc (Amst) 2015 Jun;3(2):80-8. doi: 10.1016/j.hjdsi.2015.02.005.
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Keywords: Comparative Effectiveness, Diabetes, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient and Family Engagement
Reiter-Palmon R, Kennel V, Allen JA
Naturalistic decision making in after-action review meetings: the implementation of and learning from post-fall huddles.
In this study, the authors added to our understanding of Naturalistic Decision Making (NDM) in healthcare and how After Action Reviews (AARs) can be utilized as a learning tool to reduce errors. They found that the use of self-guided post-fall huddles increased over the time of the project, the types of errors identified as contributing to the patient fall changed, and the proportion of falls with less adverse effects increased during the project time period. They concluded that , over time, self-guided AARs can be useful for some aspects of learning from errors.
AHRQ-funded; HS021429.
Citation: Reiter-Palmon R, Kennel V, Allen JA .
Naturalistic decision making in after-action review meetings: the implementation of and learning from post-fall huddles.
J Occup Organ Psychol 2015 Jun;88(2):322-40. doi: 10.1111/joop.12084.
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Keywords: Adverse Events, Falls, Decision Making, Medical Errors, Patient Safety
Hirth RA, Gibson TB, Levy HG
New evidence on the persistence of health spending.
Using the MarketScan claims database, the researchers characterized the persistence of health care spending in the privately insured, under-65 population. They found that over a 6-year period,69.8 percent of enrollees never had annual spending in the top 10 percent of the distribution and the bottom 50 percent of spenders accounted for less than 10 percent of spending.
AHRQ-funded; HS017706.
Citation: Hirth RA, Gibson TB, Levy HG .
New evidence on the persistence of health spending.
Med Care Res Rev 2015 Jun;72(3):277-97. doi: 10.1177/1077558715572387..
Keywords: Healthcare Costs, Health Insurance, Data
Dumas SA, Polk D
Pediatric dental clinic location and utilization in a high-resource setting.
This study examined dental utilization by Medicaid-insured children living in a high-resource area and characterized distance and travel-related variables to accessing care. It concluded that closer proximity may contribute to the higher utilization of services observed compared with national rates.
AHRQ-funded; HS019486.
Citation: Dumas SA, Polk D .
Pediatric dental clinic location and utilization in a high-resource setting.
J Public Health Dent 2015 Summer;75(3):183-90. doi: 10.1111/jphd.12086.
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Keywords: Children/Adolescents, Healthcare Utilization, Dental and Oral Health, Access to Care, Medicaid
Guillory J, Chang P, Henderson CR
Piloting a text message-based social support intervention for patients with chronic pain: establishing feasibility and preliminary efficacy.
This pilot study examined the effectiveness of a short message service (SMS) text message–based social support intervention through mobile technology for pain attenuation and improving positive affect in a sample of patients with chronic noncancer pain. Findings show that this novel social support intervention reduced perceptions of pain and pain interference and improved positive affect among patients randomized to the intervention condition.
AHRQ-funded; HS020648.
Citation: Guillory J, Chang P, Henderson CR .
Piloting a text message-based social support intervention for patients with chronic pain: establishing feasibility and preliminary efficacy.
Clin J Pain 2015 Jun;31(6):548-56. doi: 10.1097/ajp.0000000000000193..
Keywords: Comparative Effectiveness, Chronic Conditions, Health Information Technology (HIT), Social Media
Goldberg DS, Forde KA, Carbonari DM
Population-representative incidence of drug-induced acute liver failure based on an analysis of an integrated health care system.
The researchers conducted an assessment of the incidence and outcomes of acute drug-induced liver failure within a large, integrated healthcare system that approximates a population-representative cohort. They found the incident of acute drug-induced liver failure to be 1.61 per million person years with the overwhelming majority being due to over-the-counter medications or products.
AHRQ-funded; HS018372.
Citation: Goldberg DS, Forde KA, Carbonari DM .
Population-representative incidence of drug-induced acute liver failure based on an analysis of an integrated health care system.
Gastroenterology 2015 Jun;148(7):1353-61.e3. doi: 10.1053/j.gastro.2015.02.050..
Keywords: Medication, Chronic Conditions, Patient Safety
Witt WP, Mandell KC, Wisk LE
Predictors of alcohol and tobacco use prior to and during pregnancy in the US: the role of maternal stressors.
The purpose of the study was to understand the association between stressful life events prior to conception (PSLEs) and women’s alcohol and tobacco use prior to and during pregnancy, and the continuation of such use through pregnancy. It finds that PSLEs are associated with increased tobacco use prior to and during pregnancy, as well as an increased amount of alcohol use during pregnancy among U.S. women.
AHRQ-funded; HS000063; HS000083.
Citation: Witt WP, Mandell KC, Wisk LE .
Predictors of alcohol and tobacco use prior to and during pregnancy in the US: the role of maternal stressors.
Arch Womens Ment Health 2015 Jun;18(3):523-37. doi: 10.1007/s00737-014-047-9.
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Keywords: Pregnancy, Lifestyle Changes, Alcohol Use, Tobacco Use, Maternal Care
Wisk LE, Finkelstein JA, Sawicki GS
Predictors of timing of transfer from pediatric- to adult-focused primary care.
The researchers examined the timing of transfer to adult-focused primary care providers (PCPs), the time between last pediatric-focused and first adult-focused PCP visits, and the predictors of transfer timing. They found that most youths are transferring care later than recommended and with gaps of more than a year. They further noted that while youths with chronic conditions have shorter gaps, they may need even shorter transfer intervals to ensure continuous access to care.
AHRQ-funded; HS000063; HS020513.
Citation: Wisk LE, Finkelstein JA, Sawicki GS .
Predictors of timing of transfer from pediatric- to adult-focused primary care.
JAMA Pediatr 2015 Jun;169(6):e150951. doi: 10.1001/jamapediatrics.2015.0951.
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Keywords: Children/Adolescents, Chronic Conditions, Primary Care, Transitions of Care, Young Adults
Parmar AD, Sheffield KM, Adhikari D
PREOP-Gallstones: a prognostic nomogram for the management of symptomatic cholelithiasis in older patients.
The objective of this study was to develop and validate a risk prediction model that would identify older patients who are at highest risk for recurrent episodes. It concluded that surgeons can use a prognostic nomogram to accurately provide patients with their 2-year risk of developing gallstone-related complications, allowing patients and physicians to make informed decisions in the context of their symptom severity and its impact on their quality of life.
AHRQ-funded; HS022134
Citation: Parmar AD, Sheffield KM, Adhikari D .
PREOP-Gallstones: a prognostic nomogram for the management of symptomatic cholelithiasis in older patients.
Ann Surg. 2015 Jun;261(6):1184-90. doi: 10.1097/sla.0000000000000868..
Keywords: Comparative Effectiveness, Risk, Elderly, Decision Making