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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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11101 to 11125 of 11152 Research Studies DisplayedHenke RM, Maeda JL, Marder WD
Medicare and commercial inpatient resource use: impact of hospital competition.
The authors examined the influence of hospital competition on small-area inpatient resource use by payer. Using HCUP data, they found that policies or incentives that promote or encourage competition in less competitive markets may reduce variation in resource use for both Medicare and private payers.
AHRQ-authored; AHRQ-funded; 290200600009C.
Citation: Henke RM, Maeda JL, Marder WD .
Medicare and commercial inpatient resource use: impact of hospital competition.
Am J Manag Care 2013 Jun;19(6):e238-48.
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Keywords: Healthcare Utilization, Healthcare Cost and Utilization Project (HCUP), Hospitals, Medicare
Davidoff AJ, Weiss SR, Baer MR
Patterns of erythropoiesis-stimulating agent use among Medicare beneficiaries with myelodysplastic syndromes and consistency with clinical guidelines.
The researchers used SEER registries data to assess population-based patterns of erythropoiesis-stimulating agents (ESA) use relative to treatment guidelines. They found widespread use of ESA in Medicare beneficiaries with myelodysplastic syndromes.
AHRQ-authored.
Citation: Davidoff AJ, Weiss SR, Baer MR .
Patterns of erythropoiesis-stimulating agent use among Medicare beneficiaries with myelodysplastic syndromes and consistency with clinical guidelines.
Leuk Res 2013 Jun;37(6):675-80. doi: 10.1016/j.leukres.2013.02.021.
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Keywords: Guidelines, Healthcare Utilization, Medicare, Practice Patterns, Registries
Clancy C
AHRQ: CUSP – scaling up a safety framework.
In this article, the author describes the Comprehensive Unit-based Safety Program, or CUSP, toolkit and its role in addressing healthcare-associated infections (HAIs) and other patient safety factors. The author outlines the components of the core CUSP toolkit which help clinicians: learn about CUSP, assemble the team, engage senior executives, understand the science of safety, identify defects through “sensemaking”, implement teamwork and communications and apply CUSP.
AHRQ-authored.
Citation: Clancy C .
AHRQ: CUSP – scaling up a safety framework.
Patient Safety & Quality Healthcare 2013 May/Jun..
Keywords: Comprehensive Unit-based Safety Program (CUSP), Quality of Care, Healthcare-Associated Infections (HAIs), Patient Safety, Teams
Berdahl TA, Friedman BS, McCormick MC
Annual report on health care for children and youth in the United States: trends in racial/ethnic, income, and insurance disparities over time, 2002-2009.
Using MEPS and HCUP data, the authors examined trends in children's health access, utilization, and expenditures over time by race/ethnicity, income, and insurance status/expected payer. They found that disparities by race/ethnicity and income persist in access to and use of care, with Hispanic children experiencing progress in a number of measures, while black children did not.
AHRQ-authored.
Citation: Berdahl TA, Friedman BS, McCormick MC .
Annual report on health care for children and youth in the United States: trends in racial/ethnic, income, and insurance disparities over time, 2002-2009.
Acad Pediatr 2013 May-Jun;13(3):191-203. doi: 10.1016/j.acap.2013.02.003.
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Keywords: Children/Adolescents, Disparities, Healthcare Cost and Utilization Project (HCUP), Medical Expenditure Panel Survey (MEPS), Social Determinants of Health
Mohanan M
Causal effects of health shocks on consumption and debt: Quasi-experimental evidence from bus accident injuries.
Mohanan presented new evidence of causal effects on consumption and debt, finding that households faced with shock-related expenditures are able to smooth consumption on food, housing, and festivals, with small reductions in educational spending.
AHRQ-funded; HS000055.
Citation: Mohanan M .
Causal effects of health shocks on consumption and debt: Quasi-experimental evidence from bus accident injuries.
Rev Econ Stat 2013 May;95(2):673-81. doi: 10.1162/REST_a_00262.
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Keywords: Healthcare Costs, Injuries and Wounds, Social Determinants of Health
Mohanan M
Causal effects of health shocks on consumption and debt: Quasi-experimental evidence from bus accident injuries.
Mohanan presented new evidence of causal effects on consumption and debt, finding that households faced with shock-related expenditures are able to smooth consumption on food, housing, and festivals, with small reductions in educational spending.
AHRQ-funded; HS000055.
Citation: Mohanan M .
Causal effects of health shocks on consumption and debt: Quasi-experimental evidence from bus accident injuries.
Rev Econ Stat 2013 May;95(2):673-81. doi: 10.1162/REST_a_00262..
Keywords: Healthcare Costs, Injuries and Wounds, Social Determinants of Health
Clancy CM, Chesley F, Dougherty D
Health care for children and youth in the United States: 13 years of evidence.
In this article, the authors discuss the 10th in a series of annual reports summarizing various dimensions of health care for children and youth in the United States. They cover the evolution of the reports and reflect on changes in and improvements to children's health services research.
AHRQ-authored.
Citation: Clancy CM, Chesley F, Dougherty D .
Health care for children and youth in the United States: 13 years of evidence.
Acad Pediatr 2013 May-Jun;13(3):181-3. doi: 10.1016/j.acap.2013.03.012.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Healthcare Cost and Utilization Project (HCUP), Medical Expenditure Panel Survey (MEPS)
McNellis RJ, Genevro JL, Meyers DS
Lessons learned from the study of primary care transformation.
This article discusses the patient-centered medical home (PCMH) model. The authors conclude that the transformation of primary care is essential to achieving the triple aim of better outcomes, better value, and better experience of care, and that the PCMH may be the most viable solution in the current health care environment.
AHRQ-authored.
Citation: McNellis RJ, Genevro JL, Meyers DS .
Lessons learned from the study of primary care transformation.
Ann Fam Med 2013 May-Jun;11 Suppl 1:S1-5. doi: 10.1370/afm.1548.
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Keywords: Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Healthcare Delivery, Organizational Change, Quality Improvement, Quality of Care
Pesis-Katz I, Phelps CE, Temkin-Greener H
Making difficult decisions: the role of quality of care in choosing a nursing home.
The authors investigated how quality of care affects nursing home choice. They examined choices in California, Ohio, New York, and Texas, in 2001. They found that, in all states, consumers were more likely to choose nursing homes of high hotel services quality but not clinical care quality; choice was also significantly associated with shorter distance from prior residence, not-for-profit status, and larger facility size.
AHRQ-authored.
Citation: Pesis-Katz I, Phelps CE, Temkin-Greener H .
Making difficult decisions: the role of quality of care in choosing a nursing home.
Am J Public Health 2013 May;103(5):e31-7. doi: 10.2105/ajph.2013.301243.
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Keywords: Decision Making, Quality of Care, Nursing Homes, Provider Performance, Quality of Life
Cohen SB, Cohen JW
The capacity of the Medical Expenditure Panel Survey to inform the Affordable Care Act.
The authors provided a summary of the capacity of the Medical Expenditure Panel Survey to inform program planning, implementation, and evaluations of program performance for several components of the Affordable Care Act.
AHRQ-authored.
Citation: Cohen SB, Cohen JW .
The capacity of the Medical Expenditure Panel Survey to inform the Affordable Care Act.
Inquiry 2013 May;50(2):124-34. doi: 10.1177/0046958013513678.
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Keywords: Data, Healthcare Costs, Health Insurance, Policy, Medical Expenditure Panel Survey (MEPS)
Percac-Lima S, Benner CS, Lui R
The impact of a culturally tailored patient navigator program on cervical cancer prevention in Latina women.
The authors evaluated the impact of patient navigation on cervical cancer prevention in Latinas. They found that patient navigation can prevent cervical cancer in Latina women by increasing colposcopy clinic attendance, shortening time to colposcopy, and decreasing severity of cervical abnormalities over time.
AHRQ-funded; HS019161.
Citation: Percac-Lima S, Benner CS, Lui R .
The impact of a culturally tailored patient navigator program on cervical cancer prevention in Latina women.
J Womens Health 2013 May;22(5):426-31. doi: 10.1089/jwh.2012.3900.
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Keywords: Cancer: Cervical Cancer, Cultural Competence, Prevention, Racial / Ethnic Minorities, Screening
Bardenheier BH, Elixhauser A, Imperatore G
Variation in prevalence of gestational diabetes mellitus among hospital discharges for obstetric delivery across 23 states in the United States.
The authors examined variability in diagnosed gestational diabetes mellitus (GDM) prevalence at delivery by race/ethnicity and state. Their results suggest that GDM rates differ by state, with this variation attributable to differences in obesity at the population level, age, race/ethnicity, hospital, and insurance.
AHRQ-authored.
Citation: Bardenheier BH, Elixhauser A, Imperatore G .
Variation in prevalence of gestational diabetes mellitus among hospital discharges for obstetric delivery across 23 states in the United States.
Diabetes Care 2013 May;36(5):1209-14. doi: 10.2337/dc12-0901.
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Keywords: Diabetes, Healthcare Cost and Utilization Project (HCUP), Hospital Discharge, Labor and Delivery, Pregnancy
Wilcox L, Patel R, Back A
Patient-clinician communication: the roadmap for HCI.
The authors discussed their view of a workshop, envisioning opening up a dialogue among researchers and clinicians who wish to discuss directions for future research and focusing on exploring how technologies available today, as well as projected for the future, can support the communication needs of clinicians and patients.
AHRQ-funded; HS021393.
Citation: Wilcox L, Patel R, Back A .
Patient-clinician communication: the roadmap for HCI.
Ext Abstr Hum Factors Computing Syst 2013 Apr 27;2013:3291-94. doi: 10.1145/2468356.2479669.
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Keywords: Communication, Health Information Technology (HIT), Patient-Centered Outcomes Research, Clinician-Patient Communication
Machlin SR, Soni A
Health care expenditures for adults with multiple treated chronic conditions: estimates from the Medical Expenditure Panel Survey, 2009.
The authors illustrated the usefulness of MEPS data for examining variations in medical expenditures for people with multiple chronic conditions (MCC). They found that the proportion of adults treated for MCC increased with age, with white non-Hispanic adults most likely and Hispanic and Asian adults least likely to be treated for MCC. Regardless of age or sex, hypertension and hyperlipidemia was the most common dyad among adults treated for MCC, and diabetes in conjunction with these 2 conditions was a common triad. They concluded that MEPS has the capacity to produce national estimates of health care expenditures associated with MCC.
AHRQ-authored.
Citation: Machlin SR, Soni A .
Health care expenditures for adults with multiple treated chronic conditions: estimates from the Medical Expenditure Panel Survey, 2009.
Prev Chronic Dis 2013 Apr 25;10:E63. doi: 10.5888/pcd10.120172.
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Keywords: Cancer: Colorectal Cancer, Chronic Conditions, Healthcare Costs, Medical Expenditure Panel Survey (MEPS)
Steiner CA, Friedman B
Hospital utilization, costs, and mortality for adults with multiple chronic conditions, Nationwide Inpatient Sample, 2009.
The investigators provided a national estimate across all payers of the distribution and cost of selected chronic conditions for hospitalized adults in 2009, stratified by demographic characteristics. They found that there were approximately 28 million adult discharges from US hospitals other than those related to pregnancy and maternity; 39% had 2 to 3 multiple chronic conditions (MCC), and 33% had 4 or more. They concluded that their descriptive analysis of multipayer inpatient data provides a robust national view of the substantial use and costs among adults hospitalized with MCC.
AHRQ-authored.
Citation: Steiner CA, Friedman B .
Hospital utilization, costs, and mortality for adults with multiple chronic conditions, Nationwide Inpatient Sample, 2009.
Prev Chronic Dis 2013 Apr 25;10:E62. doi: 10.5888/pcd10.120292.
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Keywords: Chronic Conditions, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Mortality
Shah MN, Morris D, Jones CM
A qualitative evaluation of a telemedicine-enhanced emergency care program for older adults.
The purpose of this study was to document the experiences of patients, their caregivers, healthcare personnel, and staff members with a program that provides telemedicine-enhanced emergency care to older adults residing in senior living communities (SLCs) and to delineate perceived barriers and facilitators. The authors concluded that telemedicine-enhanced emergency care is an acceptable method of providing emergency care to older adults in SLCs.
AHRQ-funded; HS018047.
Citation: Shah MN, Morris D, Jones CM .
A qualitative evaluation of a telemedicine-enhanced emergency care program for older adults.
J Am Geriatr Soc 2013 Apr;61(4):571-6. doi: 10.1111/jgs.12157..
Keywords: Elderly, Telehealth, Health Information Technology (HIT), Emergency Department, Healthcare Delivery, Long-Term Care
Pylypchuk Y, Sarpong EM
Comparison of health care utilization: United States versus Canada.
The purpose of this paper was to compare health care utilization between Canadian and U.S. residents. Findings showed that the poor and less educated were more likely to utilize health care in Canada than in the United States, while health care use for residents with high incomes and higher levels of education were not markedly different between the two countries and often higher for U.S residents. Also, foreign-born residents were more likely to use health care in Canada than in the United States.
AHRQ-authored.
Citation: Pylypchuk Y, Sarpong EM .
Comparison of health care utilization: United States versus Canada.
Health Serv Res 2013 Apr;48(2 Pt 1):560-81. doi: 10.1111/j.1475-6773.2012.01466.x.
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Keywords: Health Services Research (HSR), Healthcare Utilization, Medical Expenditure Panel Survey (MEPS), Social Determinants of Health
Merkow RP, Kmiecik TE, Bentrem DJ
Effect of including cancer-specific variables on models examining short-term outcomes.
The objectives of this paper were 1) to examine differences between existing American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) variables and cancer registry variables, and 2) to determine whether the addition of cancer-specific variables improves modeling of short-term outcomes. The researchers found that, although advanced disease stage and neoadjuvant therapy variables were predictors of short-term outcomes, their inclusion did not improve the models.
AHRQ-funded; HS021857.
Citation: Merkow RP, Kmiecik TE, Bentrem DJ .
Effect of including cancer-specific variables on models examining short-term outcomes.
Cancer 2013 Apr 1;119(7):1412-9. doi: 10.1002/cncr.27891.
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Keywords: Cancer: Colorectal Cancer, Outcomes, Quality Improvement, Registries
Sokas R, Braun B, Chenven L
Frontline hospital workers and the worker safety/patient safety nexus.
This article reported on panels and small-group discussions from a day-long workshop held in Washington, D.C., on October 25, 2012, to explore whether and how hospital-based frontline health care workers (HCWs) affect patient safety and how they experience safety in their work settings. Conference sponsors included AHRQ, and workshop sessions focused on the intersection of worker safety and patient safety and on specific steps that health care institutions have used to implement a culture of safety in the workplace.
AHRQ-authored.
Citation: Sokas R, Braun B, Chenven L .
Frontline hospital workers and the worker safety/patient safety nexus.
Jt Comm J Qual Patient Saf 2013 Apr;39(4):185-92.
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Keywords: Provider, Organizational Change, Patient Safety, Hospitals
Hempel S, Newberry S, Wang Z
Hospital fall prevention: a systematic review of implementation, components, adherence, and effectiveness.
The authors sought to document systematically the implementation, components, comparators, adherence, and effectiveness of published fall prevention approaches in U.S. acute care hospitals. They found that most interventions included multiple components, and the pooled postintervention incidence rate ratio (IRR) was 0.77. They found no systematic association between implementation intensity, intervention complexity, comparator information, or adherence levels and IRR. They concluded that promising approaches exist, but better reporting of outcomes, implementation, adherence, intervention components, and comparison group information is necessary to establish evidence on how hospitals can successfully prevent falls.
AHRQ-authored; AHRQ-funded; 290201000017I.
Citation: Hempel S, Newberry S, Wang Z .
Hospital fall prevention: a systematic review of implementation, components, adherence, and effectiveness.
J Am Geriatr Soc 2013 Apr;61(4):483-94. doi: 10.1111/jgs.12169.
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Keywords: Adverse Events, Falls, Hospitals, Patient Safety, Prevention
Braithwaite S, Friedman B, Mutter R
Microsimulation of financial impact of demand surge on hospitals: the H1N1 influenza pandemic of fall 2009.
Microsimulation was used to assess the financial impact on hospitals of a surge in influenza admissions in advance of the H1N1 pandemic in the fall of 2009 with the goal of estimating net income and losses of a response of filling unused hospital bed capacity proportionately and postponing elective admissions. They concluded that aggregate and distributional results did not suggest that a policy of promising additional financial compensation to hospitals in anticipation of the surge in flu cases was necessary.
AHRQ-authored.
Citation: Braithwaite S, Friedman B, Mutter R .
Microsimulation of financial impact of demand surge on hospitals: the H1N1 influenza pandemic of fall 2009.
Health Serv Res 2013 Apr;48(2 Pt 2):735-52. doi: 10.1111/1475-6773.12041.
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Keywords: Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Influenza
Robertson J, Farris KB, Schultz SK
Older adults' views about "Managing Your Medications" booklet.
The objective of the study was to evaluate the Managing Your Medications (MYM) booklet to improve medication management. Older adults reported it was comprehensible and 17 percent reported behavioral intentions to change their current actions regarding medications. Overall, 12.7 percent of respondents agreed that MYM changed their opinion of the topic. The most popular means to dis¬seminate were doctors’ offices and senior citizens’ centers.
AHRQ-funded; HS016094.
Citation: Robertson J, Farris KB, Schultz SK .
Older adults' views about "Managing Your Medications" booklet.
J Appl Gerontol 2013 Apr;32(3):370-82. doi: 10.1177/0733464811421910..
Keywords: Elderly, Education: Patient and Caregiver, Health Literacy, Medication
Lee SY, Weiner BJ, Harrison MI
Organizational transformation: a systematic review of empirical research in health care and other industries.
The investigators reported findings from a systematic review of empirical research on transformational change in the health care and non-health care literature, with a focus on the antecedents, processes, and outcomes of transformational change. They found that available research documents the multiplicity of factors affecting change and the complexity of their interactions, but less information is available about the processes of transformational change than about its antecedents and consequences. They discussed research and practice implications.
AHRQ-authored.
Citation: Lee SY, Weiner BJ, Harrison MI .
Organizational transformation: a systematic review of empirical research in health care and other industries.
Med Care Res Rev 2013 Apr;70(2):115-42. doi: 10.1177/1077558712458539.
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Keywords: Healthcare Delivery, Health Services Research (HSR), Organizational Change
Miller GE, Selden TM
Tax subsidies for employer-sponsored health insurance: updated microsimulation estimates and sensitivity to alternative incidence assumptions.
Using MEPS data, the authors estimated 2012 tax expenditures for employer-sponsored insurance (ESI) in the United States and explored the sensitivity of estimates to assumptions regarding the incidence of employer premium contributions. They concluded that the aggregate value of the ESI tax subsidy and its distribution across firms can be reliably estimated using simplified incidence assumptions.
AHRQ-authored.
Citation: Miller GE, Selden TM .
Tax subsidies for employer-sponsored health insurance: updated microsimulation estimates and sensitivity to alternative incidence assumptions.
Health Serv Res 2013 Apr;48(2 Pt 2):866-83. doi: 10.1111/1475-6773.12037.
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Keywords: Healthcare Costs, Health Insurance, Medical Expenditure Panel Survey (MEPS)
Pines JM, Mutter RL, Zocchi MS
Variation in emergency department admission rates across the United States.
The authors investigated factors related to variation in hospital-level emergency department (ED) admission rates. Using HCUP data, they found that higher proportions of Medicare and uninsured patients, more inpatient beds, lower ED volumes, for-profit ownership, trauma center status, and higher hospital occupancy rates were associated with higher ED admission rates.
AHRQ-authored.
Citation: Pines JM, Mutter RL, Zocchi MS .
Variation in emergency department admission rates across the United States.
Med Care Res Rev 2013 Apr;70(2):218-31. doi: 10.1177/1077558712470565.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Health Insurance, Healthcare Cost and Utilization Project (HCUP), Hospitalization
