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
11076 to 11100 of 12139 Research Studies DisplayedSpittel ML, Riley WT, Kaplan RM
AHRQ Author: Kaplan RM
Educational attainment and life expectancy: a perspective from the NIH Office of Behavioral and Social Sciences Research.
This article is the introduction to a special issue of papers on the subject of educational attainment and life expectancy. The significance of this collection of research papers is that the findings offer new insights into the complex processes underlying the widely known, but poorly understood, association between higher educational attainment and better health status together with greater life expectancy.
AHRQ-authored.
Citation: Spittel ML, Riley WT, Kaplan RM .
Educational attainment and life expectancy: a perspective from the NIH Office of Behavioral and Social Sciences Research.
Soc Sci Med. 2015 Feb;127:203-5. doi: 10.1016/j.socscimed.2014.11.017..
Keywords: Disparities, Healthcare Costs, Health Status, Social Determinants of Health
Chang E, Chan KS, Han HR
Effect of acculturation on variations in having a usual source of care among Asian Americans and non-Hispanic whites in California.
This study examined variations in having a usual source of care among non-Hispanic White and Asian American adults in California. It found that, after adding in acculturation factors, there was no statistically significant racial disparity between the two groups. However, higher education was not associated with better access among Asian Americans.
AHRQ-funded; HS021684
Citation: Chang E, Chan KS, Han HR .
Effect of acculturation on variations in having a usual source of care among Asian Americans and non-Hispanic whites in California.
Am J Public Health 2015 Feb;105(2):398-407. doi: 10.2105/AJPH.2014.301950..
Keywords: Primary Care, Disparities, Racial and Ethnic Minorities
Chang E, Chan KS, Han HR
Effect of acculturation on variations in having a usual source of care among Asian Americans and non-Hispanic whites in California.
This study explored factors influencing the disparity between Asian American and non-Hispanic whites in having a usual source of care (USC). The researchers found that the disparity in having a USC to be statistically nonsignificant after adding acculturation factors such as English proficiency and length of residence. Increasing levels of education and insurance were not associated with better access among Asian Americans.
AHRQ-funded; HS021684
Citation: Chang E, Chan KS, Han HR .
Effect of acculturation on variations in having a usual source of care among Asian Americans and non-Hispanic whites in California.
Am J Pub Health. 2015 Feb;105(2):398-407. doi: 10.2105/ajph.2014.301950..
Keywords: Disparities, Social Determinants of Health, Racial and Ethnic Minorities, Access to Care
Kindermann DR, Mutter RL, Houchens RL
Emergency department transfers and transfer relationships in United States hospitals.
The study objective was to describe transfers out of hospital-based emergency departments (EDs) in a total of 97,021 ED transfer encounters. Among the 50 highest transfer rate disease categories, in U.S. EDs, patients are often transported great distances, more commonly to large teaching hospitals with greater resources.
AHRQ-funded; 290201300002C
Citation: Kindermann DR, Mutter RL, Houchens RL .
Emergency department transfers and transfer relationships in United States hospitals.
Acad Emerg Med. 2015 Feb;22(2):157-65. doi: 10.1111/acem.12586..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Transitions of Care, Hospitals
Brody H, Croisant SA, Crowder JW
Ethical issues in patient-centered outcomes research and comparative effectiveness research: a pilot study of community dialogue.
Community bioethics dialogues were held on the topic of patient-centered outcomes research (PCOR) and comparative effectiveness research (CER). Participants were 65 and older and represented either a lower income, African American group or a higher income White group. The groups showed both independence in judgment from the investigators and diversity of opinion between the two groups.
AHRQ-funded; HS022134.
Citation: Brody H, Croisant SA, Crowder JW .
Ethical issues in patient-centered outcomes research and comparative effectiveness research: a pilot study of community dialogue.
J Empir Res Hum Res Ethics 2015 Feb;10(1):22-30. doi: 10.1177/1556264614568426..
Keywords: Communication, Comparative Effectiveness, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Social Determinants of Health
Singer SJ, Reyes Nieva H, Brede N
Evaluating ambulatory practice safety: the PROMISES project administrators and practice staff surveys.
This study reports findings from the baseline practice staff and administrator surveys designed as part of the PROMISES Project to assess safety and malpractice risks in the ambulatory setting. It found that administrators frequently reported important safety systems and processes were absent. Suboptimal or incomplete implementation of referral and test result management systems were related to staff perceptions of their quality.
AHRQ-funded; HS019508.
Citation: Singer SJ, Reyes Nieva H, Brede N .
Evaluating ambulatory practice safety: the PROMISES project administrators and practice staff surveys.
Med Care 2015 Feb;53(2):141-52. doi: 10.1097/mlr.0000000000000269..
Keywords: Ambulatory Care and Surgery, Patient Safety, Medical Liability, Provider
Klevens J, Barnett SB, Florence C
Exploring policies for the reduction of child physical abuse and neglect.
This article identifies 37 state policies that might have impacts on the social determinants of child maltreatment and utilizes the available data to explore effects of 11 policies. There were two policies that were significantly associated with decreased child maltreatment rates: lack of waitlists to access subsidized child care and policies that facilitate continuity of child health care.
AHRQ-funded; HS013853.
Citation: Klevens J, Barnett SB, Florence C .
Exploring policies for the reduction of child physical abuse and neglect.
Child Abuse Negl 2015 Feb;40:1-11. doi: 10.1016/j.chiabu.2014.07.013.
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Keywords: Domestic Violence, Children/Adolescents, Policy, Risk
Dotson JL, Crandall WV, Zhang P
Feasibility and validity of the pediatric ulcerative colitis activity index in routine clinical practice.
The specific objectives of this study were to evaluate the feasibility of using the Pediatric Ulcerative Colitis Activity Index (PUCAI) in routine clinical practice settings and the cross-sectional and longitudinal associations between PUCAI and physician global assessment. Based on a population drawn from a large, diverse collection of pediatric gastroenterology practices, the study concluded that the PUCAI is feasible to use in routine clinical settings.
AHRQ-funded; HS020024.
Citation: Dotson JL, Crandall WV, Zhang P .
Feasibility and validity of the pediatric ulcerative colitis activity index in routine clinical practice.
J Pediatr Gastroenterol Nutr 2015 Feb;60(2):200-4. doi: 10.1097/mpg.0000000000000568.
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Keywords: Children/Adolescents, Registries, Children/Adolescents, Comparative Effectiveness
Steinman BA, Allen SM, Chen J
Functional limitations as potential mediators of the effects of self-reported vision status on fall risk of older adults.
The purpose of this study was to examine mediating effects of two indices of physical functioning (mobility and large-muscle functioning) on self-reported vision status, as it relates to falls in older adults. Limited evidence was found for a mediating effect among women; however, large-muscle groups were implicated as partially mediating risk factors for falls among men with fair self-reported vision status.
AHRQ-funded; HS000011.
Citation: Steinman BA, Allen SM, Chen J .
Functional limitations as potential mediators of the effects of self-reported vision status on fall risk of older adults.
J Aging Health 2015 Feb;27(1):158-76. doi: 10.1177/0898264314543473..
Keywords: Elderly, Falls, Eye Disease and Health, Risk
Callaghan BC, Kerber KA, Burke JF
Headaches and neuroimaging—reply.
The authors of this letter, replying to two letters commenting on their earlier article on headaches and neuroimaging, find that they all share the view that neuroimaging is overused in headache presentations. They also discuss the potential downsides of interventions to reduce use, the impact of medical malpractice on overuse of tests, and the lack of consensus in defining low-value tests.
AHRQ-funded; HS017690
Citation: Callaghan BC, Kerber KA, Burke JF .
Headaches and neuroimaging—reply.
JAMA Intern Med. 2015 Feb;175(2):313-4. doi: 10.1001/jamainternmed.2014.7014..
Keywords: Neurological Disorders, Healthcare Costs, Chronic Conditions, Guidelines
Goyette P, Boucher G, Mallon D
High-density mapping of the MHC identifies a shared role for HLA-DRB1*01:03 in inflammatory bowel diseases and heterozygous advantage in ulcerative colitis.
Studies in inflammatory bowel diseases (IBD) have indicated that multiple independent associations exist at human leukocyte antigen (HLA) and non-HLA genes, but they have lacked the statistical power to define the architecture of association and causal alleles. To address this, the researchers performed high-density single nucleotide polymorphism (SNP) typing of the major histocompatibility complex in >32,000 individuals with IBD.
AHRQ-funded; HS021747.
Citation: Goyette P, Boucher G, Mallon D .
High-density mapping of the MHC identifies a shared role for HLA-DRB1*01:03 in inflammatory bowel diseases and heterozygous advantage in ulcerative colitis.
Nat Genet 2015 Feb;47(2):172-9. doi: 10.1038/ng.3176..
Keywords: Chronic Conditions, Genetics, Digestive Disease and Health
Smith MW, Stocks C, Santora PB
AHRQ Author: Stocks C
Hospital readmission rates and emergency department visits for mental health and substance abuse conditions.
The purpose of this study is to examine data on the readmission rates and ED visits of individuals diagnosed with mental health and substance abuse (MHSA) conditions to determine which individuals with specific MHSA conditions are more likely to return to the ED or be readmitted. It found that alcohol or drug dependence, dementias, psychotic disorders, autism, impulse control disorders, and personality disorders were most strongly associated with future inpatient admission or ED revisit.
AHRQ-authored; AHRQ-funded; 290200600009C.
Citation: Smith MW, Stocks C, Santora PB .
Hospital readmission rates and emergency department visits for mental health and substance abuse conditions.
Community Ment Health J 2015 Feb;51(2):190-7. doi: 10.1007/s10597-014-9784-x..
Keywords: Emergency Department, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Behavioral Health, Substance Abuse
Hwang CS, Chang HY, Alexander GC
Impact of abuse-deterrent OxyContin on prescription opioid utilization.
The researchers quantified the degree to which the August 2010 reformulation of abuse-deterrent OxyContin affected its use, as well as the use of alternative extended-release and immediate-release opioids. They found that the market debut of abuse-deterrent OxyContin was associated with declines in its use after accounting for the simultaneous contraction of the generic extended-release oxycodone market.
AHRQ-funded; HS018960.
Citation: Hwang CS, Chang HY, Alexander GC .
Impact of abuse-deterrent OxyContin on prescription opioid utilization.
Pharmacoepidemiol Drug Saf 2015 Feb;24(2):197-204. doi: 10.1002/pds.3723.
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Keywords: Medication, Opioids, Prevention, Substance Abuse
Schaefer PW, Souza L, Kamalian S
Limited reliability of computed tomographic perfusion acute infarct volume measurements compared with diffusion-weighted imaging in anterior circulation stroke.
The researchers tested whether thresholded computed tomographic cerebral blood flow (CT-CBF) and CT-cerebral blood volume (CT-CBV) maps are sufficiently accurate to substitute for diffusion-weighted imaging (DWI) for estimating the critically ischemic tissue volume. They found that the poor contrast:noise ratios of CT-CBV and CT-CBF compared with those of DWI result in large measurement error, make it problematic to substitute CTP for DWI in selecting individual acute stroke patients for treatment.
AHRQ-funded; HS011392.
Citation: Schaefer PW, Souza L, Kamalian S .
Limited reliability of computed tomographic perfusion acute infarct volume measurements compared with diffusion-weighted imaging in anterior circulation stroke.
Stroke 2015 Feb;46(2):419-24. doi: 10.1161/strokeaha.114.007117..
Keywords: Stroke, Imaging
Hill SC
AHRQ Author: Hill SC
Medicaid expansion in opt-out states would produce consumer savings and less financial burden than exchange coverage.
This study simulated potential differences in out-of-pocket spending for uninsured adults gaining eligibility for Marketplace coverage (silver plan) because their states have not used the provisions of the Affordable Care Act to expand Medicaid. Compared with having a Marketplace silver plan, being able to take advantage to expanded Medicaid would reduce average out-of-pocket spending by more than 50 percent for these adults and their families.
AHRQ-authored.
Citation: Hill SC .
Medicaid expansion in opt-out states would produce consumer savings and less financial burden than exchange coverage.
Health Aff. 2015 Feb;34(2):340-9. doi: 10.1377/hlthaff.2014.1058..
Keywords: Healthcare Costs, Health Insurance, Policy, Low-Income, Medicaid, Uninsured
Ko EM, Sturmer T, Hong JL
Metformin and the risk of endometrial cancer: a population-based cohort study.
The researchers sought to estimate the risk of incident endometrial cancer in women who were new users of metformin compared to new users of sulfonylureas. They did not find a difference in cancer incidence in new initiators of metformin compared with sulfonylureas in the population under study.
AHRQ-funded; HS017950.
Citation: Ko EM, Sturmer T, Hong JL .
Metformin and the risk of endometrial cancer: a population-based cohort study.
Gynecol Oncol 2015 Feb;136(2):341-7. doi: 10.1016/j.ygyno.2014.12.001..
Keywords: Comparative Effectiveness, Cancer, Medication, Risk
Moy E, Barrett M, Coffey R
AHRQ Author: Moy E
Missed diagnoses of acute myocardial infarction in the emergency department: variation by patient and facility characteristics.
The purpose of this study is to estimate the frequency of missed heart attacks or their precursors (e.g., unstable angina) in the emergency department (ED) by examining use of EDs in the week prior to hospitalization for heart attack. This study of 111,973 patients found an overall rate of 0.9 percent for missed diagnoses of heart attacks.
AHRQ-authored; AHRQ-funded; 290201300002C
Citation: Moy E, Barrett M, Coffey R .
Missed diagnoses of acute myocardial infarction in the emergency department: variation by patient and facility characteristics.
Diagn. 2015 Feb;2(1):29-40..
Keywords: Diagnostic Safety and Quality, Heart Disease and Health, Emergency Department, Emergency Medical Services (EMS), Healthcare Cost and Utilization Project (HCUP)
Turrentine FE, Denlinger CE, Simpson VB
Morbidity, mortality, cost, and survival estimates of gastrointestinal anastomotic leaks.
The aims of this study were to examine the incidence of anastomotic leaks, a potentially deadly postoperative occurrence following gastrointestinal surgery, to identify risk factors predictive of leaks, and to explore the impact of anastomotic leaks on hospital cost and patient survival. The study demonstrates that anastomotic leaks remain a major source of increased morbidity, mortality, and hospital resource use for gastrointestinal surgery.
AHRQ-funded; HS011913.
Citation: Turrentine FE, Denlinger CE, Simpson VB .
Morbidity, mortality, cost, and survival estimates of gastrointestinal anastomotic leaks.
J Am Coll Surg 2015 Feb;220(2):195-206. doi: 10.1016/j.jamcollsurg.2014.11.002..
Keywords: Patient Safety, Surgery, Mortality, Healthcare Costs, Adverse Events
Salihu HM, Mogos MF, Salinas-Miranda AA
National trends in maternal use of opioid drugs among pregnancy-related hospitalizations in the United States, 1998 to 2009.
AHRQ-funded; HS019997.
Citation: Salihu HM, Mogos MF, Salinas-Miranda AA .
National trends in maternal use of opioid drugs among pregnancy-related hospitalizations in the United States, 1998 to 2009.
Am J Perinatol 2015 Feb;32(3):289-98. doi: 10.1055/s-0034-1384642..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Medication, Opioids, Pregnancy
Hilligoss B, Vogus TJ
Navigating care transitions: a process model of how doctors overcome organizational barriers and create awareness.
Using interviews and observations of doctors, the researchers examined transitions from an emergency department to inpatient units through a 2-year study of an academic medical center. They describe and document 3 challenges to between-unit transitions of care and identify the adaptive workarounds that doctors employ to resolve these challenges, thus addressing a significant gap in the literature on high-reliability healthcare organizations.
AHRQ-funded; HS018758
Citation: Hilligoss B, Vogus TJ .
Navigating care transitions: a process model of how doctors overcome organizational barriers and create awareness.
Med Care Res Rev. 2015 Feb;72(1):25-48. doi: 10.1177/1077558714563170..
Keywords: Transitions of Care, Emergency Department, Hospitalization, Care Coordination
Sanghavi P, Jena AB, Newhouse JP
Outcomes after out-of-hospital cardiac arrest treated by basic vs advanced life support.
Patients with out-of-hospital cardiac arrest who received basic life support had a higher survival rate and had better neurological functioning at hospital discharge and at 90 days after discharge than those patients who received advanced life support.
AHRQ-funded; HS022798
Citation: Sanghavi P, Jena AB, Newhouse JP .
Outcomes after out-of-hospital cardiac arrest treated by basic vs advanced life support.
JAMA Intern Med. 2015 Feb;175(2):196-204. doi: 10.1001/jamainternmed.2014.5420..
Keywords: Emergency Medical Services (EMS), Cardiovascular Conditions, Critical Care
Silver MI, Rositch AF, Burke AE
Patient concerns about human papillomavirus testing and 5-year intervals in routine cervical cancer screening.
The purpose of this study was to explore attitudes toward new cervical cancer screening options and understand factors associated with those beliefs among women in routine gynecologic care. It found that the majority still believed women should be screened every year. Despite this, two-thirds stated that they would be willing to extend screening to every 3 years if their doctor recommended it.
AHRQ-funded; HS022199.
Citation: Silver MI, Rositch AF, Burke AE .
Patient concerns about human papillomavirus testing and 5-year intervals in routine cervical cancer screening.
Obstet Gynecol 2015 Feb;125(2):317-29. doi: 10.1097/aog.0000000000000638..
Keywords: Screening, Guidelines, Cancer, Women
Wong A, Kraus PS, Lau BD
Patient preferences regarding pharmacologic venous thromboembolism prophylaxis.
The purpose of this study was to assess patient preferences regarding pharmacological venous thromboembolism prophylaxis. It found that a majority preferred an oral route of administration for prophylaxis. Also, patients preferring subcutaneous injections were less likely to refuse doses of ordered pharmacologic prophylaxis.
AHRQ-funded; HS017952.
Citation: Wong A, Kraus PS, Lau BD .
Patient preferences regarding pharmacologic venous thromboembolism prophylaxis.
J Hosp Med 2015 Feb;10(2):108-11. doi: 10.1002/jhm.2282..
Keywords: Comparative Effectiveness, Blood Clots, Medication, Prevention
Armstrong AW, Johnson MA, Lin S
Patient-centered, direct-access online care for management of atopic dermatitis: a randomized clinical trial.
The researchers compared the effectiveness of a direct-access, online model with that of an in-person model for follow-up management of pediatric and adult patients with atopic dermatitis. They found that patients whose disease was managed through the direct-access online model achieved equivalent improvements in atopic dermatitis disease severity compared with those whose disease was managed through the usual, in-person visits.
AHRQ-funded; HS018341.
Citation: Armstrong AW, Johnson MA, Lin S .
Patient-centered, direct-access online care for management of atopic dermatitis: a randomized clinical trial.
JAMA Dermatol 2015 Feb;151(2):154-60. doi: 10.1001/jamadermatol.2014.2299..
Keywords: Healthcare Delivery, Comparative Effectiveness, Health Information Technology (HIT), Patient-Centered Healthcare, Patient-Centered Outcomes Research
Rundell SD, Sherman KJ, Heagerty PJ
Patient-reported outcomes associated with use of physical therapist services by older adults with a new visit for back pain.
The researchers conducted an observational comparative effectiveness research study to investigate the association between types or amounts of physical therapist services and outcomes, such as disability and pain intensity, among older adults. Higher amounts of active physical therapy were associated with decreased back and leg pain and increased odds of clinically meaningful improvements in back and leg pain relative to results obtained with no active physical therapy.
AHRQ-funded; HS019222.
Citation: Rundell SD, Sherman KJ, Heagerty PJ .
Patient-reported outcomes associated with use of physical therapist services by older adults with a new visit for back pain.
Phys Ther 2015 Feb;95(2):190-201. doi: 10.2522/ptj.20140132..
Keywords: Back Health and Pain, Patient-Centered Outcomes Research, Comparative Effectiveness, Treatments, Elderly