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
7376 to 7400 of 12139 Research Studies DisplayedEzer N, Kale M, Sigel K
Outcomes after video-assisted thoracoscopic lobectomy versus open lobectomy for early-stage lung cancer in older adults.
This study evaluated whether the improved perioperative outcomes associated with video-assisted thoracoscopic surgery (VATS) lobectomy are explained by surgeon characteristics, including case volume and specialty training. It concluded that VATS lobectomy for non-small cell lung cancer (NSCLC) is associated with better postoperative outcomes, but similar long-term survival, compared with open lobectomy among older adults, even after controlling for surgeon experience.
AHRQ-funded; HS019670.
Citation: Ezer N, Kale M, Sigel K .
Outcomes after video-assisted thoracoscopic lobectomy versus open lobectomy for early-stage lung cancer in older adults.
Ann Am Thorac Soc 2018 Jan;15(1):76-82. doi: 10.1513/AnnalsATS.201612-980OC.
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Keywords: Comparative Effectiveness, Elderly, Cancer: Lung Cancer, Surgery
Black KZ, Johnson LS, Samuel-Hodge CD
Perceived barriers and preferred components for physical activity interventions in African-American survivors of breast or endometrial cancer with type 2 diabetes: the S.U.C.C.E.S.S. framework.
The study’s objectives were to explore the perspectives of African American survivors with type 2 diabetes on perceived barriers to physical activity (PA) and preferences for a PA intervention and develop a framework for a PA program after cancer treatment. Nine themes were identified that focused on post-treatment physical symptoms. The S.U.C.C.E.S.S. framework summarizes the survivors' preferences for effective lifestyle interventions such as supporting efforts to maintain PA.
AHRQ-funded; HS023418.
Citation: Black KZ, Johnson LS, Samuel-Hodge CD .
Perceived barriers and preferred components for physical activity interventions in African-American survivors of breast or endometrial cancer with type 2 diabetes: the S.U.C.C.E.S.S. framework.
Support Care Cancer 2018 Jan;26(1):231-40. doi: 10.1007/s00520-017-3839-9.
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Keywords: Cancer, Cancer: Breast Cancer, Diabetes, Lifestyle Changes, Racial and Ethnic Minorities
Burton RA, Peters RA, Devers KJ
Perspectives on implementing quality improvement collaboratives effectively: qualitative findings from the CHIPRA quality demonstration grant program.
The most frequently pursued intervention in the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) quality demonstration (2010-2015) was quality improvement collaboratives. This study was conducted to identify which aspects of these collaboratives were viewed by organizers and participants as working well and which were not. It found that aspects of collaboratives that interviewees valued were aimed at attracting participation, maintaining engagement, or facilitating learning.
AHRQ-funded; 2902009000191.
Citation: Burton RA, Peters RA, Devers KJ .
Perspectives on implementing quality improvement collaboratives effectively: qualitative findings from the CHIPRA quality demonstration grant program.
Jt Comm J Qual Patient Saf 2018 Jan;44(1):12-22. doi: 10.1016/j.jcjq.2017.08.004.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Quality of Care, Quality Improvement
Sun D, Sarda G, Skube SJ
Phenotyping and visualizing infusion-related reactions for breast cancer patients.
Researchers developed and evaluated a phenotyping algorithm to detect Infusion-related reactions (IRRs) for breast cancer patients. They also designed a visualization prototype to render IRR patients' medications, lab tests and vital signs over time. By comparing with the 42 randomly selected doses that are manually labeled by a domain expert, the sensitivity, positive predictive value, specificity, and negative predictive value of the algorithms are 69 percent, 60 percent, 79 percent, and 85 percent, respectively.
AHRQ-funded; HS022085.
Citation: Sun D, Sarda G, Skube SJ .
Phenotyping and visualizing infusion-related reactions for breast cancer patients.
Stud Health Technol Inform 2017;245:599-603.
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Keywords: Adverse Drug Events (ADE), Cancer: Breast Cancer, Medication, Medication: Safety, Patient Safety
Psoinos CM, Collins CE, Ayturk MD
Post-hospitalization treatment regimen and readmission for C. difficile colitis in Medicare beneficiaries.
C. difficile (CDI) has surpassed methicillin-resistant staph aureus as the most common nosocomial infection with recurrence reaching 30% and the elderly being disproportionately affected. The authors hypothesized that post-discharge antibiotic therapy for continued CDI treatment reduces readmissions. The study concluded that patients discharged with single-drug therapy for CDI had lower readmission rates compared to patients discharged on no ongoing CDI treatment suggesting that short-term monotherapy may be beneficial in inducing eradication and preventing relapse.
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AHRQ-funded; HS022694
Citation: Psoinos CM, Collins CE, Ayturk MD .
Post-hospitalization treatment regimen and readmission for C. difficile colitis in Medicare beneficiaries.
World J Surg 2018 Jan;42(1):246-53. doi: 10.1007/s00268-017-4139-8..
Keywords: Antibiotics, Clostridium difficile Infections, Elderly, Hospital Discharge, Hospital Readmissions
Sanders BD, Davis MG, Holley SL
Pregnancy-associated stroke.
This article reviews assessment and treatment of pregnant and postpartum women experiencing stroke. There are 2 main types of stroke, ischemic and hemorrhagic that present similar symptoms but have very different pathophysiology and treatment. This article provides guidance for subsequent maternity and primary care for front-line perinatal care providers.
AHRQ-funded; HS024733.
Citation: Sanders BD, Davis MG, Holley SL .
Pregnancy-associated stroke.
J Midwifery Womens Health 2018 Jan;63(1):23-32. doi: 10.1111/jmwh.12720..
Keywords: Cardiovascular Conditions, Maternal Care, Pregnancy, Primary Care, Risk, Stroke, Women
Greenhawt M, DunnGalvin A
Preliminary psychometric analyses and clinical performance of a caregiver self-efficacy scale for food allergy self-management.
The researchers examined the preliminary reliability, validity, and clinical performance of a novel 8-item Food Allergy Self-Efficacy Questionnaire (FASEQ). They present preliminary evidence that the FASEQ is a valid tool to assess caregiver food allergy self-efficacy.
AHRQ-funded; HS024599.
Citation: Greenhawt M, DunnGalvin A .
Preliminary psychometric analyses and clinical performance of a caregiver self-efficacy scale for food allergy self-management.
Ann Allergy Asthma Immunol 2018 Jan;120(1):73-79. doi: 10.1016/j.anai.2017.09.060.
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Keywords: Caregiving, Nutrition, Patient Self-Management, Tools & Toolkits
Kim LY, Rose DE, Soban LM
Primary care tasks associated with provider burnout: findings from a Veterans Health Administration survey.
The purpose of this study was to investigate (1) the extent to which primary care providers (PCPs) share responsibility for 14 discrete primary care tasks with other team members, and (2) which, if any, of the primary care tasks performed by the PCPs (without reliance on team members) are associated with PCP burnout.
AHRQ-funded; HS000046.
Citation: Kim LY, Rose DE, Soban LM .
Primary care tasks associated with provider burnout: findings from a Veterans Health Administration survey.
J Gen Intern Med 2018 Jan;33(1):50-56. doi: 10.1007/s11606-017-4188-6..
Keywords: Healthcare Delivery, Health Services Research (HSR), Patient-Centered Healthcare, Primary Care, Provider, Workforce
Kuo YF, Adhikari D, Eke CG
Processes and outcomes of congestive heart failure care by different types of primary care models.
This study compared treatment of congestive heart failure (CHF) with primary care physicians (PCPs), nurse practitioners (NPs), or shared with PCPs and NPs. The rate of emergency room (ER) visits and hospitalizations along with Medicare spending was tracked although most patients (73%) were treated by PCPs. Patients under the shared care model had a higher rate of ER visits and hospitalizations than the PCP model.
AHRQ-funded; HS020642; HS022134.
Citation: Kuo YF, Adhikari D, Eke CG .
Processes and outcomes of congestive heart failure care by different types of primary care models.
J Card Fail 2018 Jan;24(1):9-18. doi: 10.1016/j.cardfail.2017.08.459..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Primary Care, Primary Care: Models of Care
Campione J, Famolaro T
Promising practices for improving hospital patient safety culture.
This study was conducted to gain knowledge about promising best practices used by hospitals to improve patient safety culture hospitalwide. Among six large hospitals that improved their hospitalwide culture score, the common best practices were the implementation of routine culture measurement with a wide dissemination of results, and multifaceted patient safety programs and education.
AHRQ-funded; 290201300003C.
Citation: Campione J, Famolaro T .
Promising practices for improving hospital patient safety culture.
Jt Comm J Qual Patient Saf 2018 Jan;44(1):23-32. doi: 10.1016/j.jcjq.2017.09.001.
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Keywords: Hospitals, Patient Safety, Quality of Care, Quality Improvement
Basu J, Hanchate A, Bierman A
AHRQ Author: Basu J, Bierman A
Racial/ethnic disparities in readmissions in US hospitals: the role of insurance coverage.
This study examined differences in rates of 30-day readmissions across patients by race/ethnicity and the extent to which these differences were moderated by insurance coverage. It found higher readmission risk for non-Hispanic blacks, compared with non-Hispanic whites, among those covered by Medicare and private insurance, but lower risk among uninsured and similar risk among Medicaid.
AHRQ-authored.
Citation: Basu J, Hanchate A, Bierman A .
Racial/ethnic disparities in readmissions in US hospitals: the role of insurance coverage.
Inquiry 2018 Jan-Dec;55:46958018774180. doi: 10.1177/0046958018774180.
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Keywords: Disparities, Health Insurance, Healthcare Cost and Utilization Project (HCUP), Hospitals, Hospital Readmissions
Evaristo E, Stocco FG, Shah NR
Ranolazine reduces repolarization heterogeneity in symptomatic patients with diabetes and non-flow-limiting coronary artery stenosis.
In symptomatic diabetic patients with non-flow-limiting coronary artery stenosis with diffuse atherosclerosis and/or microvascular dysfunction, the authors explored whether ranolazine reduces T-wave heterogeneity (TWH). They found that, in the studied population, ranolazine reduced TWH at rest but not during exercise; reduction in repolarization abnormalities appears to be independent of alterations in myocardial blood flow.
AHRQ-funded; HS022998.
Citation: Evaristo E, Stocco FG, Shah NR .
Ranolazine reduces repolarization heterogeneity in symptomatic patients with diabetes and non-flow-limiting coronary artery stenosis.
Ann Noninvasive Electrocardiol 2018 Jan;23(1). doi: 10.1111/anec.12480.
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Keywords: Cardiovascular Conditions, Diabetes, Medication, Patient-Centered Outcomes Research
Aguirre TM, Koehler AE, Joshi A
Recruitment and retention challenges and successes.
This study presents strategies used to successfully recruit and retain rural Hispanic women during a breastfeeding education intervention. The authors found that phone assessments facilitated participation as transportation was an issue. In addition, accommodating requests to deliver or mail study materials and providing incentives were important. Extra effort was needed to maintain contact when phone service was disrupted or participants moved. Keys to success were persistence, flexibility, and alleviating barriers to participation.
AHRQ-funded; HS021321.
Citation: Aguirre TM, Koehler AE, Joshi A .
Recruitment and retention challenges and successes.
Ethn Health 2018 Jan;23(1):111-19. doi: 10.1080/13557858.2016.1246427..
Keywords: Breast Feeding, Racial and Ethnic Minorities, Education: Patient and Caregiver, Women
Russo ET, Reid M, Taher R
Referral strategies to a tobacco quitline and racial and/or ethnic differences in participation.
This study evaluated the reach of two referral strategies to the Massachusetts tobacco-use quitline among African American and Hispanic smokers in Boston. The two strategies were a provider-referred strategy based in pediatric and dental clinics and a large-scale, targeted media campaign that promoted self-referral to the quitline. Demographic characteristics of the quitline participants during the study period were compared between the two strategies. Characteristics of self-referred smokers were also compared in the years before and after the media campaign, as were the characteristics of quitline participants with smokers in the 2010 Boston Behavioral Risk Factor Surveillance Survey. The results indicate that the media campaign was associated with higher quitline participation overall, but that the provider-referred strategy which was based in community health centers, yielded greater participation from African American and Hispanic smokers.
AHRQ-funded; HS024332; HS022986.
Citation: Russo ET, Reid M, Taher R .
Referral strategies to a tobacco quitline and racial and/or ethnic differences in participation.
Pediatrics 2018 Jan;141(Suppl 1):S30-s39. doi: 10.1542/peds.2017-1026G..
Keywords: Racial and Ethnic Minorities, Prevention, Tobacco Use, Tobacco Use: Smoking Cessation
Williams D, Jr., Holmes M
Rural health care costs: are they higher and why might they differ from urban health care costs?
Do health care costs differ between rural and urban populations, and if so, why might that be? Rural Americans are more vulnerable than their urban counterparts, which could lead one to suspect rural health care costs are higher. However, the answer may differ depending on how costs are measured and who is paying.
AHRQ-funded; HS000032.
Citation: Williams D, Jr., Holmes M .
Rural health care costs: are they higher and why might they differ from urban health care costs?
N C Med J 2018 Jan-Feb;79(1):51-55. doi: 10.18043/ncm.79.1.51.
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Keywords: Healthcare Costs, Rural Health, Urban Health
Calabrese SK, Earnshaw VA, Magnus M
Sexual stereotypes ascribed to black men who have sex with men: an intersectional analysis.
This online, survey-based study used an inductive, intersectional approach to characterize the sexual stereotypes ascribed to Black men who have sex with men (MSM) by the U.S. general public, their distinctiveness from those ascribed to Black men and MSM in general, and their relative prototypicality as compared to dominant subgroups.
AHRQ-funded; HS022986.
Citation: Calabrese SK, Earnshaw VA, Magnus M .
Sexual stereotypes ascribed to black men who have sex with men: an intersectional analysis.
Arch Sex Behav 2018 Jan;47(1):143-56. doi: 10.1007/s10508-016-0911-3..
Keywords: Racial and Ethnic Minorities, Social Stigma
Aggarwal R, Brown KM, de Groen PC
AHRQ Author: Henriksen K
Simulation research in gastrointestinal and urologic care-challenges and opportunities: summary of a National Institute of Diabetes and Digestive and Kidney Diseases and National Institute of Biomedical Imaging and Bioengineering workshop.
The purpose of the workshop was to examine the extent to which simulation approaches have been used by skilled proceduralists (not trainees) caring for patients with gastrointestinal and urologic diseases. The current status of research findings in the use and effectiveness of simulation applications was reviewed, and numerous knowledge gaps and research needs were identified by the faculty and the attendees.
AHRQ-authored.
Citation: Aggarwal R, Brown KM, de Groen PC .
Simulation research in gastrointestinal and urologic care-challenges and opportunities: summary of a National Institute of Diabetes and Digestive and Kidney Diseases and National Institute of Biomedical Imaging and Bioengineering workshop.
Ann Surg 2018 Jan;267(1):26-34. doi: 10.1097/sla.0000000000002228.
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Keywords: Digestive Disease and Health, Education: Continuing Medical Education, Evidence-Based Practice, Research Methodologies
Sylvia LG, Chang WC, Kamali M
Sleep disturbance may impact treatment outcome in bipolar disorder: a preliminary investigation in the context of a large comparative effectiveness trial.
The purpose of this paper is to explore the potential impact of poor sleep at baseline on outcomes in a randomized effectiveness trial of quetiapine and lithium. Sixty-three percent of patients had baseline sleep disturbance. Individuals with sleep disturbance had worse bipolar illness severity, greater severity of depression, mania, anxiety, irritability, and psychosis, were less likely to have sustained response, and had more necessary clinical adjustments.
AHRQ-funded; HS019371.
Citation: Sylvia LG, Chang WC, Kamali M .
Sleep disturbance may impact treatment outcome in bipolar disorder: a preliminary investigation in the context of a large comparative effectiveness trial.
J Affect Disord 2018 Jan 1;225:563-68. doi: 10.1016/j.jad.2017.08.056.
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Keywords: Medication, Comparative Effectiveness, Behavioral Health, Patient-Centered Outcomes Research, Sleep Problems
Smieliauskas F, Sharma H, Hurley C
State insurance mandates and off-label use of chemotherapy.
In this study, the investigators hypothesized that state health insurance mandates for private insurers to provide coverage for off-label use of cancer drugs cause higher rates of off-label use. They used Truven MarketScan data from 1999 to 2007 on utilization of 35 infused chemotherapy drugs in private health plans in the United States to study trends in off-label use of drugs, distinguishing between appropriate and inappropriate off-label use according to drug compendia, and estimated difference-in-difference regressions of the effect of state laws on off-label use.
AHRQ-funded; HS018535.
Citation: Smieliauskas F, Sharma H, Hurley C .
State insurance mandates and off-label use of chemotherapy.
Health Econ 2018 Jan;27(1):e55-e70. doi: 10.1002/hec.3537.
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Keywords: Access to Care, Cancer, Treatments, Health Insurance, Medication
DeWaters AL, Chansard M, Anzueto A
The association between major depressive disorder and outcomes in older veterans hospitalized with pneumonia.
The aim of this study was to examine the association between depression and outcomes, including mortality and intensive care unit admission, in veterans hospitalized with pneumonia. It found that patients with untreated depression had a significantly higher 30-day and 90-day mortality, as well as significantly higher intensive care unit admission rates, compared to patients with treated depression.
AHRQ-funded; HS022418.
Citation: DeWaters AL, Chansard M, Anzueto A .
The association between major depressive disorder and outcomes in older veterans hospitalized with pneumonia.
Am J Med Sci 2018 Jan;355(1):21-26. doi: 10.1016/j.amjms.2017.08.015.
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Keywords: Depression, Hospitalization, Patient-Centered Outcomes Research, Pneumonia
Lee AK, Warren B, Lee CJ
The association of severe hypoglycemia with incident cardiovascular events and mortality in adults with type 2 diabetes.
There is suggestive evidence linking hypoglycemia with cardiovascular disease, but few data have been collected in a community-based setting. This study found that hypoglycemia was not associated with stroke, heart failure, atrial fibrillation, or noncardiovascular and noncancer death. Results were robust within subgroups defined by age, sex, race, diabetes duration, and baseline cardiovascular risk.
AHRQ-funded; HS018542.
Citation: Lee AK, Warren B, Lee CJ .
The association of severe hypoglycemia with incident cardiovascular events and mortality in adults with type 2 diabetes.
Diabetes Care 2018 Jan;41(1):104-11. doi: 10.2337/dc17-1669.
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Keywords: Adverse Events, Cardiovascular Conditions, Diabetes, Mortality
Domenick Sridharan N, Fish L, Yu L
The associations of hemodialysis access type and access satisfaction with health-related quality of life.
This study sought to understand the impact of hemodialysis (HD) access type on health-related quality of life (HRQOL). The study concluded that HD patients experience greatest satisfaction with fistula, and access satisfaction is significantly associated with better HRQOL. Controlling for access satisfaction, there is no significant independent association of access type on HRQOL.
AHRQ-funded; HS019486.
Citation: Domenick Sridharan N, Fish L, Yu L .
The associations of hemodialysis access type and access satisfaction with health-related quality of life.
J Vasc Surg 2018 Jan;67(1):229-35. doi: 10.1016/j.jvs.2017.05.131..
Keywords: Kidney Disease and Health, Kidney Disease and Health, Patient Experience, Quality of Life, Surgery, Patient-Centered Outcomes Research
Cutler E, Karaca Z, Henke R
AHRQ Author: Karaca Z, Wong HS
The effects of Medicare accountable organizations on inpatient mortality rates.
This study examined whether Medicare Accountable Care Organizations (ACOs) have improved hospital quality of care, specifically focusing on preventable inpatient mortality. The investigators concluded that, on average, Medicare ACO hospitals are not associated with improved mortality rates for the studied inpatient quality indicator conditions. They suggest that stakeholders may potentially consider providing ACOs with incentives or designing new programs for ACOs to target inpatient mortality reductions.
AHRQ-authored.
Citation: Cutler E, Karaca Z, Henke R .
The effects of Medicare accountable organizations on inpatient mortality rates.
Inquiry 2018 Jan-Dec;55:46958018800092. doi: 10.1177/0046958018800092..
Keywords: Quality of Care, Healthcare Cost and Utilization Project (HCUP), Hospitals, Medicare, Mortality
Biener A, Cawley J, Meyerhoefer C
AHRQ Author: Biener A
The impact of obesity on medical care costs and labor market outcomes in the US.
The economic consequences of obesity are not well understood. Researchers analyzed data for 2001-2015 and estimated the percentage of healthcare costs that were associated with adult obesity. They found that a substantial and rising percentage of healthcare costs are associated with obesity. This is true for the US, for individual states, for each category of expenditure, and for each type of payer.
AHRQ-authored.
Citation: Biener A, Cawley J, Meyerhoefer C .
The impact of obesity on medical care costs and labor market outcomes in the US.
Clin Chem 2018 Jan;64(1):108-17. doi: 10.1373/clinchem.2017.272450.
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Keywords: Healthcare Costs, Medical Expenditure Panel Survey (MEPS), Obesity, Workforce
Ricciardi R
AHRQ Author: Ricciardi R
The next frontier for nurses: improving quality and safety in primary care.
Nurses’ role in advancing quality and protecting the safety of patients in primary care settings is becoming more important. As primary care moves to team-based practice models to meet the needs of Accountable Care Organizations and the Quality Payment Program, RNs are well positioned to take on leading roles and new responsibilities. The author discusses the challenges and opportunities faced by the nursing profession and AHRQ’s role in assisting this process.
AHRQ-authored.
Citation: Ricciardi R .
The next frontier for nurses: improving quality and safety in primary care.
J Nurs Care Qual 2018 Jan/Mar;33(1):1-4. doi: 10.1097/ncq.0000000000000304.
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Keywords: Quality of Care, Nursing, Patient Safety, Primary Care