National Healthcare Quality and Disparities Report
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- Screening (457)
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- Sex Factors (67)
- Sexual Health (126)
- Shared Decision Making (583)
- Sickle Cell Disease (49)
- Simulation (48)
- Skin Conditions (121)
- Sleep Problems (70)
- Social Determinants of Health (355)
- Social Media (46)
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- Stress (71)
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- Uninsured (80)
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- Vitamins and Supplements (10)
- Vulnerable Populations (229)
- Web-Based (84)
- Women (545)
- Workflow (66)
- Workforce (89)
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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
7326 to 7350 of 12139 Research Studies DisplayedLi X, Xu H, Shen C
Automated linkage of patient records from disparate sources.
This study discusses an automated method of record linkage that the researchers created to classify record pairs to matches or non-matches. They compared their method to the Fellegi-Sunter model and their results were considered as efficient.
AHRQ-funded; HS018553.
Citation: Li X, Xu H, Shen C .
Automated linkage of patient records from disparate sources.
Stat Methods Med Res 2018 Jan;27(1):172-84. doi: 10.1177/0962280215626180..
Keywords: Patient Safety
Tran Smith B, Seaton K, Andrews C
Benefit requirements for substance use disorder treatment in state health insurance exchanges.
This study assessed the extent to which state insurance departments regulate the types of substance use disorder (SUD) treatment that services and medications plans must provide, and also their use of utilization controls. Data were obtained from state insurance departments via an internet-based survey, as part of the National Drug Abuse Treatment System Survey. The results indicate that states vary widely in regulations on qualified health plans’ (QHPs) administration of SUD treatment benefits; some required plans to cover all the SUD treatment services and medications assessed in this study, while others did not require plans to cover any at all. Nearly all states allowed the plans to employ utilization controls, but reported little guidance on their usage. The authors conclude that by not requiring coverage for the entire SUD continuum of care, some states hinder client access to the appropriate types of care needed for recovery.
AHRQ-funded; HS000084.
Citation: Tran Smith B, Seaton K, Andrews C .
Benefit requirements for substance use disorder treatment in state health insurance exchanges.
Am J Drug Alcohol Abuse 2018;44(4):426-30. doi: 10.1080/00952990.2017.111934..
Keywords: Access to Care, Health Insurance, Medication, Policy, Substance Abuse
Kemper AR, Krist AH, Tseng CW
AHRQ Author: Mabry-Hernandez IR, Wolff TA
Challenges in developing U.S. Preventive Services Task Force child health recommendations.
In March 2016, the USPSTF convened an expert panel to discuss its portfolio of child and adolescent recommendations and identify unique methodologic issues when evaluating evidence regarding children and adolescents. The panel identified key domains of challenges, including measuring patient-centered health outcomes; identifying intermediate outcomes predictive of important health outcomes and evaluating the long time horizon needed to assess the balance of benefits and harms.
AHRQ-authored.
Citation: Kemper AR, Krist AH, Tseng CW .
Challenges in developing U.S. Preventive Services Task Force child health recommendations.
Am J Prev Med 2018 Jan;54(1s1):S63-s69. doi: 10.1016/j.amepre.2017.08.023.
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Keywords: Children/Adolescents, Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research, U.S. Preventive Services Task Force (USPSTF)
Koroukian SM, Basu J, Schiltz NK
AHRQ Author: Basu J
Changes in case-mix and health outcomes of Medicare fee-for-service beneficiaries and managed care enrollees during the years 1992-2011.
This study examined changes in differentials between managed care enrollees (MCEs) and fee-for-service beneficiaries (FFSBs) both in case-mix and health outcomes over time. It found that the case-mix differential between MCEs and FFSBs persisted over time. Both MCEs and FFSBs were as likely to die within 2 years from the Health and Retirement Study interview.
AHRQ-authored; AHRQ-funded; HS023113.
Citation: Koroukian SM, Basu J, Schiltz NK .
Changes in case-mix and health outcomes of Medicare fee-for-service beneficiaries and managed care enrollees during the years 1992-2011.
Med Care 2018 Jan;56(1):39-46. doi: 10.1097/mlr.0000000000000847.
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Keywords: Elderly, Payment, Medicare, Health Insurance, Outcomes
Soni A, Sabik LM, Simon K
Changes in insurance coverage among cancer patients under the Affordable Care Act.
Uninsurance among patients with newly diagnosed cancer fell by one-third in the ACA’s first year. Coverage gains were significant across numerous common cancers, multiple demographic groups, and early-stage and late-stage disease. Large gains among Hispanic individuals were consistent with findings of other ACA studies and may indicate narrowing disparities.
AHRQ-funded; HS021291.
Citation: Soni A, Sabik LM, Simon K .
Changes in insurance coverage among cancer patients under the Affordable Care Act.
JAMA Oncol 2018 Jan;4(1):122-24. doi: 10.1001/jamaoncol.2017.3176.
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Keywords: Cancer, Health Insurance, Policy, Uninsured
Chang AC, Lincoln J, Lantaff WM
Characterization of actions taken during the delivery of medication therapy management: a time-and-motion approach.
The purpose of this study was to characterize actions performed by pharmacists and support staff during provision of medication therapy management (MTM) and to compare actions performed according to practice characteristics. The investigators found that MTM activities were longer at Later Maturity Level practices, and these practices were more likely to use paid pharmacy interns and to receive physician referrals for MTM.
AHRQ-funded; HS022119.
Citation: Chang AC, Lincoln J, Lantaff WM .
Characterization of actions taken during the delivery of medication therapy management: a time-and-motion approach.
J Am Pharm Assoc 2018 Jan - Feb;58(1):61-66.e7. doi: 10.1016/j.japh.2017.09.059.
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Keywords: Medication, Practice Patterns, Provider: Pharmacist
Gorski Findling MT, Werth PM, Musicus AA
Comparing five front-of-pack nutrition labels' influence on consumers' perceptions and purchase intentions.
In 2011, a National Academy of Medicine report recommended that packaged food in the U.S. display a uniform front-of-package nutrition label, using a system such as a 0-3 star ranking. This study compares five front-of-pack nutrition labels' influence on consumers' perceptions and purchase intentions. The authors indicated that results did not point to a clearly superior label design, but suggested that a 3-star label might not be best for educating consumers.
AHRQ-funded; HS000055.
Citation: Gorski Findling MT, Werth PM, Musicus AA .
Comparing five front-of-pack nutrition labels' influence on consumers' perceptions and purchase intentions.
Prev Med 2018 Jan;106:114-21. doi: 10.1016/j.ypmed.2017.10.022..
Keywords: Education, Nutrition, Obesity
Hochman MJ, Yu Y, Wolf SP
Comparing the palliative care needs of patients with hematologic and solid malignancies.
The objective of the study is to compare unmet symptom needs in a cohort of hematologic and solid tumor patients referred to specialty palliative care services. The study concluded that hematologic and solid tumor patients have significant symptom burden at time of referral to palliative care services. Blood cancer patients may have unique concerns warranting targeted attention, including substantial drowsiness and tiredness. The findings suggest a need to optimize palliative care usage in the hematologic cancer population.
AHRQ-funded; HS023681; HS022763.
Citation: Hochman MJ, Yu Y, Wolf SP .
Comparing the palliative care needs of patients with hematologic and solid malignancies.
J Pain Symptom Manage 2018 Jan;55(1):82-88.e1. doi: 10.1016/j.jpainsymman.2017.08.030..
Keywords: Cancer, Palliative Care, Patient-Centered Outcomes Research
Hsuan C, Horwitz JR, Ponce NA
Complying with the Emergency Medical Treatment and Labor Act (EMTALA): challenges and solutions.
EMTALA, which requires Medicare-participating hospitals to provide emergency care to patients regardless of their ability to pay, plays an important role in protecting the uninsured. Yet many hospitals do not comply. This study examines the reasons for noncompliance and proposes solutions. Respondents identified 5 main causes of noncompliance as well as suggesting methods to improve compliance.
AHRQ-funded; HS024247.
Citation: Hsuan C, Horwitz JR, Ponce NA .
Complying with the Emergency Medical Treatment and Labor Act (EMTALA): challenges and solutions.
J Healthc Risk Manag 2018 Jan;37(3):31-41. doi: 10.1002/jhrm.21288.
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Keywords: Emergency Medical Services (EMS), Payment, Hospitals, Medicare, Uninsured
Ngo-Metzger Q, Moyer V, Grossman D
AHRQ Author: Ngo-Metzger Q, Chowdhury J, Kato E
Conflicts of interest in clinical guidelines: update of U.S. Preventive Services Task Force policies and procedures.
The conflicts of interest policy is described, as is the formal process by which best practices were incorporated to update the policy. The USPSTF conflicts of interest policy includes disclosures for immediate family members, a clear non-financial conflicts of interest definition, long look-back period and application of the policy to prospective members. The conflicts of interest policy is publicly available as part of the USPSTF Procedure Manual.
AHRQ-authored.
Citation: Ngo-Metzger Q, Moyer V, Grossman D .
Conflicts of interest in clinical guidelines: update of U.S. Preventive Services Task Force policies and procedures.
Am J Prev Med 2018 Jan;54(1s1):S70-s80. doi: 10.1016/j.amepre.2017.06.034.
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Keywords: Evidence-Based Practice, Guidelines, Policy, U.S. Preventive Services Task Force (USPSTF)
Naber SK, Kuntz KM, Henrikson NB
AHRQ Author: Ganiats TG
Cost effectiveness of age-specific screening intervals for people with family histories of colorectal cancer.
Despite relative risk of colorectal cancer (CRC) decreasing with age among individuals with a family history of CRC, no screening recommendations specify less frequent screening. Researchers found that for individuals with a family history of CRC, it is cost effective to gradually increase the screening interval if several subsequent screening colonoscopies have negative results and no new cases of CRC are found in family members.
AHRQ-authored.
Citation: Naber SK, Kuntz KM, Henrikson NB .
Cost effectiveness of age-specific screening intervals for people with family histories of colorectal cancer.
Gastroenterology 2018 Jan;154(1):105-16.e20. doi: 10.1053/j.gastro.2017.09.021.
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Keywords: Cancer: Colorectal Cancer, Healthcare Costs, Family Health and History, Risk, Screening
Balentine CJ, Vanness DJ, Schneider DF
Cost-effectiveness of lobectomy versus genetic testing (Afirma(R)) for indeterminate thyroid nodules: considering the costs of surveillance.
This study evaluated whether diagnostic thyroidectomy for indeterminate thyroid nodules would be more cost-effective than genetic testing after including the costs of long-term surveillance. Its base case estimate suggests that diagnostic lobectomy dominates genetic testing as a strategy for ruling out malignancy of indeterminate thyroid nodules.
AHRQ-funded; HS023009.
Citation: Balentine CJ, Vanness DJ, Schneider DF .
Cost-effectiveness of lobectomy versus genetic testing (Afirma(R)) for indeterminate thyroid nodules: considering the costs of surveillance.
Surgery 2018 Jan;163(1):88-96. doi: 10.1016/j.surg.2017.10.004.
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Keywords: Cancer, Shared Decision Making, Diagnostic Safety and Quality, Genetics, Healthcare Costs, Screening, Surgery
Pellegrini CA, Conroy DE, Phillips SM
Daily and seasonal influences on dietary self-monitoring using a smartphone application.
Researchers examined within-person variation in dietary self-monitoring during a 6-month technology-supported weight loss trial as a function of time-varying factors including time in the study, day of the week, and month of the year. They found that participants recorded less as time in the study progressed. Fewer foods were reported on the weekends compared with weekdays. More foods were self-monitored in January compared with October; however, a seasonal effect was not observed.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Conroy DE, Phillips SM .
Daily and seasonal influences on dietary self-monitoring using a smartphone application.
J Nutr Educ Behav 2018 Jan;50(1):56-61.e1. doi: 10.1016/j.jneb.2016.12.004.
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Keywords: Health Information Technology (HIT), Nutrition, Patient Adherence/Compliance, Patient Self-Management, Obesity: Weight Management
Murphy DR, Meyer A AND, Vaghani V
Development and validation of trigger algorithms to identify delays in diagnostic evaluation of gastroenterological cancer.
This study’s authors developed, refined, and tested trigger algorithms that identify patients with delayed follow-up evaluation of findings suspicious of colorectal cancer (CRC) or hepatocellular cancer (HCC). Using data from the Veterans Affairs electronic health record database, the researchers developed an algorithm that greatly reduces the number of record reviews necessary to identify delays in follow-up evaluations for patients with suspected CRC or HCC.
AHRQ-funded; HS022901.
Citation: Murphy DR, Meyer A AND, Vaghani V .
Development and validation of trigger algorithms to identify delays in diagnostic evaluation of gastroenterological cancer.
Clin Gastroenterol Hepatol 2018 Jan;16(1):90-98. doi: 10.1016/j.cgh.2017.08.007..
Keywords: Cancer, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Services Research (HSR)
Murphy DR, Meyer A AND, Vaghani V
Development and validation of trigger algorithms to identify delays in diagnostic evaluation of gastroenterological cancer.
This study’s authors developed, refined, and tested trigger algorithms that identify patients with delayed follow-up evaluation of findings suspicious of colorectal cancer (CRC) or hepatocellular cancer (HCC). Using data from the Veterans Affairs electronic health record database, the researchers developed an algorithm that greatly reduces the number of record reviews necessary to identify delays in follow-up evaluations for patients with suspected CRC or HCC.
AHRQ-funded; HS022901.
Citation: Murphy DR, Meyer A AND, Vaghani V .
Development and validation of trigger algorithms to identify delays in diagnostic evaluation of gastroenterological cancer.
Clin Gastroenterol Hepatol 2018 Jan;16(1):90-98. doi: 10.1016/j.cgh.2017.08.007..
Keywords: Cancer, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Services Research (HSR)
Phillippi JC, Hartmann KE
Differentiating research, quality improvement, and case studies to ethically incorporate pregnant women.
This article discusses the need to involve pregnant women in research, quality improvement, and case studies and how to involve them in an ethical way with high standards to protect participants. This review includes vignettes to distinguish between the different types of studies and emphasizes that perinatal care providers will need to seek institutional review board approval for all research to be conducted.
AHRQ-funded; HS024733.
Citation: Phillippi JC, Hartmann KE .
Differentiating research, quality improvement, and case studies to ethically incorporate pregnant women.
J Midwifery Womens Health 2018 Jan;63(1):104-14. doi: 10.1111/jmwh.12673..
Keywords: Health Services Research (HSR), Healthcare Delivery, Maternal Care, Pregnancy, Quality of Care, Quality Improvement, Research Methodologies, Women
Govindan S, Wallace B, Iwashyna TJ
Do experts understand performance measures? A mixed-methods study of infection preventionists.
This study assessed expert interpretation of CLABSI quality data using a cross-sectional survey of members of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN). The investigators found that significant variability in the interpretation of CLABSI data exists among experts. They assert that this finding is likely related to data complexity, particularly with respect to risk-adjusted data. They suggest that improvements appear necessary in data sharing and public policy efforts to account for this complexity.
AHRQ-funded; HS022835.
Citation: Govindan S, Wallace B, Iwashyna TJ .
Do experts understand performance measures? A mixed-methods study of infection preventionists.
Infect Control Hosp Epidemiol 2018 Jan;39(1):71-76. doi: 10.1017/ice.2017.243..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Provider, Provider Performance, Quality of Care, Quality Measures
Chilukuri N, Cheng TL, Psoter KJ
AHRQ Author: Mistry KB
Effectiveness of a pediatric primary care intervention to increase maternal folate use: results from a cluster randomized controlled trial.
This study assessed the impact of provision of folate vitamins and a preconception health intervention on folate use among a group of mostly African-American and low-income mothers bringing infants to pediatric primary care. It found that among all participants, daily vitamin intake increased from baseline to 6-month follow-up (33.8 percent vs 42.6 percent).
AHRQ-authored.
Citation: Chilukuri N, Cheng TL, Psoter KJ .
Effectiveness of a pediatric primary care intervention to increase maternal folate use: results from a cluster randomized controlled trial.
J Pediatr 2018 Jan;192:247-52.e1. doi: 10.1016/j.jpeds.2017.09.020.
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Keywords: Primary Care, Maternal Care, Women
Kannampallil TG, Denton CA, Shapiro JS
Efficiency of emergency physicians: insights from an observational study using EHR log files.
The authors investigated the nature of electronic health records use and their effect on an emergency department's throughput and efficiency. They found that longer time spent on reviewing information on the electronic health record is potentially associated with decreased emergency department throughput efficiency. The authors also note that balancing between these competing goals is a challenge for physicians, and implications for patient safety are discussed.
AHRQ-funded; HS022670.
Citation: Kannampallil TG, Denton CA, Shapiro JS .
Efficiency of emergency physicians: insights from an observational study using EHR log files.
Appl Clin Inform 2018 Jan;9(1):99-104. doi: 10.1055/s-0037-1621705..
Keywords: Electronic Health Records (EHRs), Emergency Department, Healthcare Delivery, Health Information Technology (HIT), Provider, Provider: Physician
Rumball-Smith J, Shekelle P, Damberg CL
Electronic health record "super-users" and "under-users" in ambulatory care practices.
This study explored variation in the extent of use of electronic health record (EHR)-based health information technology (IT) functionalities across US ambulatory care practices. It found that seventy-three percent of practices were not using EHR technologies to their full capability, and nearly 40 percent were classified as under-users. Under-user practices were more likely to be of smaller size, situated in the West, and located outside a metropolitan area.
AHRQ-funded; HS024067.
Citation: Rumball-Smith J, Shekelle P, Damberg CL .
Electronic health record "super-users" and "under-users" in ambulatory care practices.
Am J Manag Care 2018 Jan;24(1):26-31.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Ambulatory Care and Surgery
Kim HS, McCarthy DM, Hoppe JA
Emergency department provider perspectives on benzodiazepine-opioid coprescribing: a qualitative study.
This study examined attitudes of emergency department residents, attending physicians, and pharmacists from three hospitals on coprescribing benzodiazepines and opioids. There is mounting evidence that this increases overdose risk. Focus groups were conducted using semistructured interviews which were audio-recorded and transcribed. Participants were reluctant to admit coprescribing and said when they did that specific discharge instructions were provided. The decision was also influenced by a provider’s belief in the efficacy of combination therapy as well as self-imposed pressure to escalate care or avoid hospital admission. They did not like the idea of using computerized alerts, but were support of pharmacist-assisted interventions.
AHRQ-funded; HS023011; HS000078.
Citation: Kim HS, McCarthy DM, Hoppe JA .
Emergency department provider perspectives on benzodiazepine-opioid coprescribing: a qualitative study.
Acad Emerg Med 2018 Jan;25(1):15-24. doi: 10.1111/acem.13273..
Keywords: Emergency Department, Guidelines, Medication, Opioids, Practice Patterns, Provider: Clinician, Provider: Pharmacist, Provider: Physician
Hung MC, Ekwueme DU, White A
Estimating health benefits and cost-savings for achieving the Healthy People 2020 objective of reducing invasive colorectal cancer.
This study aims to quantify the aggregate potential life-years (LYs) saved and healthcare cost-savings if the Healthy People 2020 objective were met to reduce invasive colorectal cancer (CRC) incidence by 15 percent. It concluded that achieving the HP2020 objective of reducing invasive CRC incidence by that amount by year 2020 would potentially save nearly 150,000 life-years and $624 million on healthcare costs.
AHRQ-funded; HS022330.
Citation: Hung MC, Ekwueme DU, White A .
Estimating health benefits and cost-savings for achieving the Healthy People 2020 objective of reducing invasive colorectal cancer.
Prev Med 2018 Jan;106:38-44. doi: 10.1016/j.ypmed.2017.09.022.
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Keywords: Medical Expenditure Panel Survey (MEPS), Comparative Effectiveness, Patient Safety
Bove AM, Smith KJ, Bise CG
Exercise, manual therapy, and booster sessions in knee osteoarthritis: cost-effectiveness analysis from a multicenter randomized controlled trial.
The study objective was to compare the cost-effectiveness of 4 different combinations of exercise, manual therapy, and booster sessions for individuals with knee osteoarthritis (OA). The authors found that spacing exercise-based physical therapy sessions over 12 months using periodic booster sessions was less costly and more effective over 2 years than strategies not containing booster sessions for individuals with knee OA.
AHRQ-funded; HS019642.
Citation: Bove AM, Smith KJ, Bise CG .
Exercise, manual therapy, and booster sessions in knee osteoarthritis: cost-effectiveness analysis from a multicenter randomized controlled trial.
Phys Ther 2018 Jan;98(1):16-27. doi: 10.1093/ptj/pzx104..
Keywords: Arthritis, Comparative Effectiveness, Healthcare Costs, Outcomes
Ali SB, Romero J, Morrison K
Focus section health it usability: applying a task-technology fit model to adapt an electronic patient portal for patient work.
Although electronic patient portals are offered by most health care organizations, poor usability and poor fit to patient needs may pose barriers to adoption. In this study, the investigators collaborated with an academic hospital to conduct iterative user evaluation of a newly deployed portal designed to deliver inpatient data upon hospital discharge.
AHRQ-funded; HS021531.
Citation: Ali SB, Romero J, Morrison K .
Focus section health it usability: applying a task-technology fit model to adapt an electronic patient portal for patient work.
Appl Clin Inform 2018 Jan;9(1):174-84. doi: 10.1055/s-0038-1632396..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Information Technology (HIT), Web-Based
Ashok M, Hung D, Rojas-Smith L
AHRQ Author: Harrison M
Framework for research on implementation of process redesigns.
Complex system interventions benefit from close attention to factors affecting implementation and resultant outcomes. This article describes a framework for examining these factors in process redesign (PR) and for assessing PR outcomes. The authors concluded that their PR framework helped guide the qualitative study and aided researchers in informing their leadership about critical issues affecting PR implementation.
AHRQ-authored; AHRQ-funded; 290200710056I; 2902010000221.
Citation: Ashok M, Hung D, Rojas-Smith L .
Framework for research on implementation of process redesigns.
Qual Manag Health Care 2018 Jan/Mar;27(1):17-23. doi: 10.1097/qmh.0000000000000158.
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Keywords: Implementation, Primary Care: Models of Care, Primary Care, System Design