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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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11101 to 11125 of 11623 Research Studies DisplayedEllimoottil C, Miller S, Ayanian JZ
Effect of insurance expansion on utilization of inpatient surgery.
The researchers examined the differential effect of the Massachusetts insurance expansion on the use of discretionary vs. nondiscretionary surgical procedures. They found that discretionary surgery increased 9.3 percent while nondiscretionary surgery decreased by 4.5 percent. The greatest increase in discretionary surgery was observed for nonwhite participants.
AHRQ-funded; HS018346.
Citation: Ellimoottil C, Miller S, Ayanian JZ .
Effect of insurance expansion on utilization of inpatient surgery.
JAMA Surg. 2014 Aug;149(8):829-36. doi: 10.1001/jamasurg.2014.857..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Health Insurance, Healthcare Utilization
Henrikson NB, Anderson ML, Hubbard RA
Employee knowledge of value-based insurance design benefits.
The authors assessed knowledge of features of a value-based insurance design (VBD). They concluded that incomplete knowledge of benefits is prevalent in an employee population soon after VBD rollout.
AHRQ-funded; HS018913.
Citation: Henrikson NB, Anderson ML, Hubbard RA .
Employee knowledge of value-based insurance design benefits.
Am J Prev Med 2014 Aug;47(2):115-22. doi: 10.1016/j.amepre.2014.03.005.
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Keywords: Evidence-Based Practice, Healthcare Delivery, Health Insurance
Kenik J, Jean-Jacques M, Feinglass J
Explaining racial and ethnic disparities in cholesterol screening.
This study examining the impact of low socioeconomic status, access to care, and language on racial and ethnic disparities in cholesterol screening found that these factors explained most of those disparities. After adjusting for these factors, disparities between whites and Blacks and Hispanics but not Asians and Pacific Islanders were eliminated.
AHRQ-funded; HS021141
Citation: Kenik J, Jean-Jacques M, Feinglass J .
Explaining racial and ethnic disparities in cholesterol screening.
Prev Med. 2014 Aug;65:65-9. doi: 10.1016/j.ypmed.2014.04.026..
Keywords: Social Determinants of Health, Disparities, Racial and Ethnic Minorities, Screening, Access to Care
Berner ES, Ray MN, Panjamapirom A
Exploration of an automated approach for receiving patient feedback after outpatient acute care visits.
The authors' objective was to provide post-visit feedback to physicians on patient outcomes following acute care visits. They found that many patients who do not improve as expected do not take action to further address unresolved problems. They suggested that systematic follow-up/feedback mechanisms can potentially identify and connect such patients to needed care.
AHRQ-funded; HS017060.
Citation: Berner ES, Ray MN, Panjamapirom A .
Exploration of an automated approach for receiving patient feedback after outpatient acute care visits.
J Gen Intern Med 2014 Aug;29(8):1105-12. doi: 10.1007/s11606-014-2783-3.
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Keywords: Critical Care, Emergency Medical Services (EMS), Health Information Technology (HIT), Ambulatory Care and Surgery, Cancer
Hartung DM, McCarty D, Fu R
Extended-release naltrexone for alcohol and opioid dependence: a meta-analysis of healthcare utilization studies.
The authors evaluated cost and utilization outcomes between extended-release naltrexone (XR-NTX) and other pharmacotherapies for treatment of alcohol and opioid dependence. They found that alcohol dependent XR-NTX patients had longer medication refill persistence versus acamprosate and oral naltrexone, with healthcare utilization and costs being generally lower or as low for XR-NTX-treated patients relative to other alcohol dependence agents. Opioid dependent XR-NTX patients had lower inpatient substance abuse-related utilization versus other agents and $8170 lower total cost versus methadone.
AHRQ-funded; HS019456.
Citation: Hartung DM, McCarty D, Fu R .
Extended-release naltrexone for alcohol and opioid dependence: a meta-analysis of healthcare utilization studies.
J Subst Abuse Treat 2014 Aug;47(2):113-21. doi: 10.1016/j.jsat.2014.03.007.
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Keywords: Alcohol Use, Comparative Effectiveness, Medication, Opioids, Substance Abuse
Gomez SL, Lichtensztajn DY, Parikh P
Hospital practices in the collection of patient race, ethnicity, and language data: a statewide survey, California, 2011.
The authors reported on a sruvey of general acute care hospitals in California to elucidate practices regarding collection and auditing of patient race, ethnicity, and primary spoken language (REL). They found that the majority of hospitals used standardized forms for collection, and 75% audited patient information for completeness. They concluded that California hospitals are collecting information on patient REL as mandated, but variation in data collection exists, and hospitals may benefit from standardized data collection and auditing practices.
AHRQ-funded; HS019963.
Citation: Gomez SL, Lichtensztajn DY, Parikh P .
Hospital practices in the collection of patient race, ethnicity, and language data: a statewide survey, California, 2011.
J Health Care Poor Underserved 2014 Aug;25(3):1384-96. doi: 10.1353/hpu.2014.0126.
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Keywords: Data, Hospitals, Racial and Ethnic Minorities, Social Determinants of Health
Austrom MG, Lu YY, Perkins AJ
Impact of noncaregiving-related stressors on informal caregiver outcomes.
The researchers studied the most stressful events experienced by spouse caregivers of older adults with Alzheimer s disease during a 6-month period. They found that caregivers reported no stressors 21.5% of the time, 1-2 stressors 25% of the time, and 3 stressors 53% of the time with 318 stressors reported in total. They concluded that their results can be used to develop targeted intervention and support strategies for spouse caregivers experiencing non-caregiving related stressors as well as the traditional challenges with caregiving-related issues.
AHRQ-funded; HS010884.
Citation: Austrom MG, Lu YY, Perkins AJ .
Impact of noncaregiving-related stressors on informal caregiver outcomes.
Am J Alzheimers Dis Other Demen 2014 Aug;29(5):426-32. doi: 10.1177/1533317513518652.
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Keywords: Caregiving, Dementia, Elderly, Stress
Hollingsworth JM, Sakshaug JW, Zhang Y
In-office imaging capabilities among procedure-based specialty practices.
The authors sought to determine whether arrangements tailored to fit Stark law spur utilization. They found that the availability of in-office advanced imaging is associated with increased imaging use.
AHRQ-funded; HS020927; HS018726.
Citation: Hollingsworth JM, Sakshaug JW, Zhang Y .
In-office imaging capabilities among procedure-based specialty practices.
Surg Innov 2014 Aug;21(4):403-8. doi: 10.1177/1553350613505715.
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Keywords: Ambulatory Care and Surgery, Quality of Care, Imaging, Practice Patterns
Huybrechts KF, Gerhard T, Franklin JM
Instrumental variable applications using nursing home prescribing preferences in comparative effectiveness research.
The objective of this study was to explore the presence of unexplained between-nursing home (NH) variation in prescribing and to empirically evaluate the validity of instruments based on NH prescribing preference. High-prescribing and low-prescribing nursing homes differed by a factor of 2. There was no evidence that instrument status was associated with markers of nursing home quality of care.
AHRQ-funded; 290200500161; HS021112
Citation: Huybrechts KF, Gerhard T, Franklin JM .
Instrumental variable applications using nursing home prescribing preferences in comparative effectiveness research.
Pharmacoepidemiol Drug Saf 2014 Aug;23(8):830-8. doi: 10.1002/pds.3611..
Keywords: Nursing Homes, Comparative Effectiveness, Medication, Quality of Care
Antonescu I, Scott S, Tran TT
Measuring postoperative recovery: what are clinically meaningful differences?
This paper's objective was to generate minimal clinically important difference (MCID) estimates for three postoperative recovery metrics. On the data analyzed, MCIDs were consistently smaller for patients rating their health as "excellent" or "very good" compared with those for patients rating their health as "fair" or "poor." The authors provided MCIDs and ranges around each estimate and recommended that these values be considered when planning and interpreting abdominal surgery clinical trials where patient-reported outcomes are assessed.
AHRQ-funded; HS021857.
Citation: Antonescu I, Scott S, Tran TT .
Measuring postoperative recovery: what are clinically meaningful differences?
Surgery 2014 Aug;156(2):319-27. doi: 10.1016/j.surg.2014.03.005.
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Keywords: Outcomes, Surgery
Trudnak T, Kelley D, Zerzan J
Medicaid admissions and readmissions: understanding the prevalence, payment, and most common diagnoses.
The authors characterized acute care hospital admissions and thirty-day readmissions in the Medicaid population through a retrospective analysis in nineteen states. They found that Medicaid readmissions were both prevalent and costly, and that they represented 12.5 percent of Medicaid payments for all hospitalizations, with the most prevalent diagnostic categories being mental and behavioral disorders and diagnoses related to pregnancy, childbirth, and their complications.
AHRQ-authored; AHRQ-funded; 29020090015C.
Citation: Trudnak T, Kelley D, Zerzan J .
Medicaid admissions and readmissions: understanding the prevalence, payment, and most common diagnoses.
Health Aff 2014 Aug;33(8):1337-44. doi: 10.1377/hlthaff.2013.0632.
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Keywords: Healthcare Costs, Hospitalization, Medicaid, Hospital Readmissions
Pohl JM, Tanner C, Hamilton A
Medication safety after implementation of a commercial electronic health record system in five safety-net practices: a mixed methods approach.
This study, conducted in five safety-net practices, examined the impact of implementing a commercial electronic health records system on medication safety. The authors found 130 "true" drug-drug interaction (DDI) pairs, representing 149,087 visits and 62 providers, with the largest DDI categories being related to antihypertensive medications, which are often prescribed together. They found no significant differences between physicians and nurse practitioners on the rate of DDI pairs.
AHRQ-funded; HS017191.
Citation: Pohl JM, Tanner C, Hamilton A .
Medication safety after implementation of a commercial electronic health record system in five safety-net practices: a mixed methods approach.
J Am Assoc Nurse Pract 2014 Aug;26(8):438-44. doi: 10.1002/2327-6924.12089.
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Keywords: Medication: Safety, Medication, Electronic Health Records (EHRs), Health Information Technology (HIT), Adverse Drug Events (ADE), Adverse Events, Medical Errors, Patient Safety
Alexander GL, Pasupathy KS, Steege LM
Multi-disciplinary communication networks for skin risk assessment in nursing homes with high IT sophistication.
The researchers describe a mixed methods approach to communications strategies for skin risk used by health care providers in nursing homes with high IT sophistication. Using rigorous observation and social networking tools as well as focus groups, they sought to understand where and when skin risk communications took place between nurses and nurse assistants in nursing homes with greater IT adoption.
AHRQ-funded; HS016862
Citation: Alexander GL, Pasupathy KS, Steege LM .
Multi-disciplinary communication networks for skin risk assessment in nursing homes with high IT sophistication.
Int J Med Inform. 2014 Aug;83(8):581-91. doi: 10.1016/j.ijmedinf.2014.05.001..
Keywords: Communication, Health Information Technology (HIT), Nursing Homes
Majid A, McAninch J, Morgan DJ
Predictors of early treatment discontinuation in a cohort of patients treated with boceprevir-based therapy for hepatitis C infection.
This study aimed to assess early treatment discontinuation rates and identify underlying risk factors for discontinuation in a real-world boceprevir-based treatment cohort. Nearly half of patients started on boceprevir-based hepatitis C triple therapy stopped treatment by 24 weeks, with more discontinuing because of treatment intolerance than virologic failure. Early discontinuation was significantly more common in patients with comorbidities.
AHRQ-funded; HS018111.
Citation: Majid A, McAninch J, Morgan DJ .
Predictors of early treatment discontinuation in a cohort of patients treated with boceprevir-based therapy for hepatitis C infection.
J Viral Hepat 2014 Aug;21(8):585-9. doi: 10.1111/jvh.12201.
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Keywords: Hepatitis, Adverse Events, Medication, Risk
Smith SR
Preface to the AHRQ supplement.
AHRQ, through its Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) Research Network, sponsored this supplement to present various strategies in the design, analysis, and conduct of health outcomes studies relevant to rare diseases. The purpose of this supplement is to disseminate illustrative examples of research methods that can be applied to understand health outcomes and potentially to stimulate new patient-centered outcomes studies for rare diseases.
AHRQ-authored.
Citation: Smith SR .
Preface to the AHRQ supplement.
J Gen Intern Med 2014 Aug;29 Suppl 3:S712-3. doi: 10.1007/s11606-014-2922-x.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Outcomes, Patient-Centered Outcomes Research, Research Methodologies
Gillette C, Blalock SJ, Rao JK
Provider-caregiver-child discussions about risks associated with asthma control medications: content and prevalence.
The objectives of the study were to: (1) describe the extent to which primary care pediatric providers discuss risks associated with asthma control medications with families and (2) examine the relationship between child, caregiver, provider, and clinic visit characteristics and discussions about risks associated with asthma control medications. It found that providers discussed asthma control medication risks during 23% of visits.
AHRQ-funded; HS020534.
Citation: Gillette C, Blalock SJ, Rao JK .
Provider-caregiver-child discussions about risks associated with asthma control medications: content and prevalence.
Pediatr Pulmonol 2014 Aug;49(8):727-33. doi: 10.1002/ppul.22892..
Keywords: Medication, Asthma, Children/Adolescents, Clinician-Patient Communication, Primary Care
Schiltz NK, Finkelstein Rosenthal B, Crowley MA
Rehospitalization during the first year of life by insurance status.
The authors assessed the association of insurance status on infant rehospitalization in a population-based setting. They found that Medicaid coverage and being uninsured were strong predictors of rehospitalizations, with Medicaid bearing a disproportionate share of the economic burden. Normal birth weight infants had the lowest risk. They further found that jaundice and acute bronchiolitis were the leading causes of rehospitalization within 30 days and 1 year, respectively.
AHRQ-funded; HS000059.
Citation: Schiltz NK, Finkelstein Rosenthal B, Crowley MA .
Rehospitalization during the first year of life by insurance status.
Clin Pediatr 2014 Aug;53(9):845-53. doi: 10.1177/0009922814536924.
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Keywords: Health Insurance, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Newborns/Infants, Medicaid, Newborns/Infants
Lebrun-Harris LA, Tomoyasu N, Ngo-Metzger Q
Substance use, risk of dependence, counseling and treatment among adult health center patients.
The authors examined the prevalence of substance use and risk of dependence among health center patients, and identified factors associated with desire for counseling/treatment and discussions about substance use with a clinician. They found that 84% of patients who desired substance use counseling or treatment reported receiving it, and those patients most likely to desire substance use counseling or treatment were male, unmarried, insured, current smokers, and indicated mental health problems.
AHRQ-authored.
Citation: Lebrun-Harris LA, Tomoyasu N, Ngo-Metzger Q .
Substance use, risk of dependence, counseling and treatment among adult health center patients.
J Health Care Poor Underserved 2014 Aug;25(3):1217-30. doi: 10.1353/hpu.2014.0130.
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Keywords: Behavioral Health, Community-Based Practice, Substance Abuse, Vulnerable Populations
Sarpong EM
The impact of obesity on medication use and expenditures among nonelderly adults with asthma.
The author examined the impact of obesity on medication use and expenditures among nonelderly adults with asthma using the Medical Expenditure Panel Survey. He found that obese classes II/III individuals were more likely to have current asthma, seek treatment for asthma, use more medications, and have higher medication and health care expenditures compared with normal weight individuals. His results suggested that reduction in body weight may help reduce health resource use and expenditures for nonelderly adults with asthma.
AHRQ-authored.
Citation: Sarpong EM .
The impact of obesity on medication use and expenditures among nonelderly adults with asthma.
J Health Care Poor Underserved 2014 Aug;25(3):1245-61. doi: 10.1353/hpu.2014.0142.
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Keywords: Asthma, Healthcare Costs, Medical Expenditure Panel Survey (MEPS), Medication, Obesity
Huang LC, Conley D, Lipsitz S
The Surgical Safety Checklist and teamwork coaching tools: a study of inter-rater reliability.
The authors assessed the inter-rater reliability (IRR) of two novel observation tools for measuring surgical safety checklist performance and teamwork. They found that both the Checklist Coaching Tool and the Surgical Teamwork Tool demonstrated substantial IRR and required limited training to use, indicating that both instruments may be used to observe checklist performance and teamwork in the operating room. They recommended that further refinement and calibration of observer expectations, particularly in rating teamwork, could improve the utility of the tools.
AHRQ-funded; HS019631.
Citation: Huang LC, Conley D, Lipsitz S .
The Surgical Safety Checklist and teamwork coaching tools: a study of inter-rater reliability.
BMJ Qual Saf 2014 Aug;23(8):639-50. doi: 10.1136/bmjqs-2013-002446.
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Keywords: Patient Safety, Surgery, Tools & Toolkits, Teams, Adverse Events, Medical Errors, Prevention
Drake FT, Mottey NE, Farrokhi ET
Time to appendectomy and risk of perforation in acute appendicitis.
This study sought to determine whether there is an association between time and perforation after acute appendicitis patients arrive at the hospital. Using data on 7,505 patients treated at 52 hospitals, they found that there was no association between perforation and in-hospital time prior to surgery among adults treated with appendectomy.
AHRQ-funded; SCOAP-CERTAIN
Citation: Drake FT, Mottey NE, Farrokhi ET .
Time to appendectomy and risk of perforation in acute appendicitis.
JAMA Surg. 2014 Aug;149(8):837-44. doi: 10.1001/jamasurg.2014.77..
Keywords: Surgery, Quality of Care, Patient Safety, Critical Care
Perry LM, Winthrop KL, Curtis JR
Vaccinations for rheumatoid arthritis.
The goal of this paper is to highlight the most recent literature on the key vaccines and the specific considerations for the rheumatologist and their rheumatoid arthritis (RA) patients, with a particular focus on influenza, pneumococcal, and herpes zoster vaccines. It is important for rheumatologists to understand which vaccines are live and what potential contraindications exist for giving vaccines to RA patients.
AHRQ-funded; HS018517
Citation: Perry LM, Winthrop KL, Curtis JR .
Vaccinations for rheumatoid arthritis.
Curr Rheumatol Rep. 2014 Aug;16(8):431. doi: 10.1007/s11926-014-0431-x..
Keywords: Arthritis, Vaccination, Prevention
Allgood KL, Rauscher GH, Whitman S
Validating self-reported mammography use in vulnerable communities: findings and recommendations.
The researchers examined the potential extent of overreporting of mammography use in low-income African-American and Latina women, and whether self-report inaccuracies might bias estimated associations between patient characteristics and mammography use. They found that although 73% of women self-reported a mammogram in the last 2 years, only 44% of self-reports were documented. Overreporting of mammography use was observed for all ethnic groups studied.
AHRQ-funded; HS018366.
Citation: Allgood KL, Rauscher GH, Whitman S .
Validating self-reported mammography use in vulnerable communities: findings and recommendations.
Cancer Epidemiol Biomarkers Prev 2014 Aug;23(8):1649-58. doi: 10.1158/1055-9965.epi-13-1253.
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Keywords: Healthcare Utilization, Vulnerable Populations, Racial and Ethnic Minorities, Women, Low-Income, Urban Health
Singh H, Sittig DF
Were my diagnosis and treatment correct? No news is not necessarily good news.
The authors discussed Berner et al., elsewhere in the same issue, which explored the use of an automated interactive voice response system to reach patients after acute care visits. They suggested that providers evaluate the rigor and outcomes of follow-up practices within their own clinical settings.
AHRQ-funded; HS022087.
Citation: Singh H, Sittig DF .
Were my diagnosis and treatment correct? No news is not necessarily good news.
J Gen Intern Med 2014 Aug;29(8):1087-9. doi: 10.1007/s11606-014-2890-1.
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Keywords: Emergency Medical Services (EMS), Health Information Technology (HIT), Ambulatory Care and Surgery
Holzer JK, Ellis L, Merritt MW
Why we need community engagement in medical research.
The aim of this article was to illustrate how community engagement can help to remedy shortfalls of community trust, participant enrollment, and uptake of research findings. After briefly describing these shortfalls, the authors considered 3 case examples that demonstrate the potential of community engagement to address each. They also discussed the ethical importance and implications of demonstrating respect for the community.
AHRQ-funded; HS017589.
Citation: Holzer JK, Ellis L, Merritt MW .
Why we need community engagement in medical research.
J Investig Med 2014 Aug;62(6):851-5. doi: 10.1097/jim.0000000000000097..
Keywords: Health Services Research (HSR), Patient-Centered Outcomes Research, Research Methodologies, Implementation
