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
12201 to 12225 of 12227 Research Studies DisplayedAbdus S, Selden TM
AHRQ Author: Abdus S, Selden TM
Adherence with recommended well-child visits has grown, but large gaps persist among various socioeconomic groups.
Using MEPS data, the authors examined trends in well-child visit adherence and whether differences across population subgroups narrowed or widened over time. They found that the ratio of actual to recommended visits rose, with large differences in adherence at the start of the study period across income, race or ethnicity, parent education, region, insurance coverage, and having a usual source of care. None of these differences had narrowed significantly by the end of the study period, and differences widened across parent education, between those with and without insurance coverage, by usual source of care, and between the Northeast and the Midwest and West regions.
AHRQ-authored.
Citation: Abdus S, Selden TM .
Adherence with recommended well-child visits has grown, but large gaps persist among various socioeconomic groups.
Health Aff 2013 Mar;32(3):508-15. doi: 10.1377/hlthaff.2012.0691.
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Keywords: Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Prevention, Social Determinants of Health
Kleinman LC, Dougherty D
AHRQ Author: Dougherty D
Assessing quality improvement in health care: theory for practice.
The authors reviewed the role of theory as a means to enhance the practice of quality improvement (QI) research and to propose a novel conceptual model focused on the operations of health care. They concluded that such a theory can promote opportunities for moving the field forward and organizing the planning and interpretation of comparable studies.
AHRQ-authored.
Citation: Kleinman LC, Dougherty D .
Assessing quality improvement in health care: theory for practice.
Pediatrics 2013 Mar;131 Suppl 1:S110-9. doi: 10.1542/peds.2012-1427n.
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Keywords: Quality Improvement, Healthcare Delivery, Organizational Change, Quality of Care, Health Services Research (HSR)
Clancy CM, Moy E
AHRQ Author: Clancy CM, Moy E
Commentary: measuring what matters most.
The authors discuss a Milbank Quarterly best practices article by Frank and Haw and how it relates to AHRQ's National Healthcare Disparities Report, concluding that helping policymakers glean the information they most need from an overload of data noise will improve the chances that critical disparities can be recognized, targeted, and eliminated.
AHRQ-authored.
Citation: Clancy CM, Moy E .
Commentary: measuring what matters most.
Milbank Q 2013 Mar;91(1):201-4. doi: 10.1111/milq.12008.
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Keywords: Disparities, Quality of Care, Health Status, Policy, Social Determinants of Health
Rubinson L, Mutter R, Viboud C
AHRQ Author: Mutter R
Impact of the fall 2009 influenza A(H1N1)pdm09 pandemic on US hospitals.
The authors investigated the impact of the 2009 influenza A(H1N1)pdm09 pandemic on US hospitals. They found that the fall 2009 pandemic period substantially impacted US hospitals, mostly through increased emergency department visits. Furhter, for a small proportion of hospitals that experienced a high surge in inpatient admissions, increased mortality from selected clinical conditions was associated with both prepandemic outcomes and surge, highlighting the linkage between daily hospital operations and disaster preparedness.
AHRQ-authored.
Citation: Rubinson L, Mutter R, Viboud C .
Impact of the fall 2009 influenza A(H1N1)pdm09 pandemic on US hospitals.
Med Care 2013 Mar;51(3):259-65. doi: 10.1097/MLR.0b013e31827da8ea.
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Keywords: Emergency Department, Emergency Preparedness, Healthcare Cost and Utilization Project (HCUP), Hospitals, Influenza
Baron KG, Lattie E, Ho J
Interest and use of mental health and specialty behavioral medicine counseling in US primary care patients.
This study investigating interest in mental health and specialty behavioral medicine counseling and predictors of utilization over 1 year among primary care patients found high interest but low utilization. Interest in receiving services at the baseline initial survey was the strongest predictor of utilization.
AHRQ-funded; HS00078
Citation: Baron KG, Lattie E, Ho J .
Interest and use of mental health and specialty behavioral medicine counseling in US primary care patients.
Int J Behav Med. 2013 Mar;20(1):69-76. doi: 10.1007/s12529-011-9211-4..
Keywords: Behavioral Health, Healthcare Utilization, Primary Care
Mark TL, Lawrence W, Coffey RM
AHRQ Author: Lawrence W, Steiner C
The value of linking hospital discharge and mortality data for comparative effectiveness research.
The purpose of this paper was to demonstrate the value of linking state community hospital discharge data to vital statistics death files for research by conducting a comparative effectiveness analysis. The analysis revealed that in the matched cohort, in-hospital and 30-day postdischarge mortality rates were significantly lower following endovascular aneurysm repair than open aneurysm repair, but differences in the 1- and 5-year rates were not statistically significant.
AHRQ-authored.
Citation: Mark TL, Lawrence W, Coffey RM .
The value of linking hospital discharge and mortality data for comparative effectiveness research.
J Comp Eff Res 2013 Mar;2(2):175-84. doi: 10.2217/cer.13.4.
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Keywords: Comparative Effectiveness, Data, Healthcare Cost and Utilization Project (HCUP), Mortality, Surgery
Koh HK, Brach C, Harris LM
AHRQ Author: Brach C
A proposed 'health literate care model' would constitute a systems approach to improving patients' engagement in care.
The researchers proposed a Health Literate Care Model that would weave health literacy strategies into the widely adopted Care Model (formerly known as the Chronic Care Model). Their new model calls for approaching all patients with the assumption that they are at risk of not understanding their health conditions or how to deal with them, and then confirming and ensuring patients' understanding. They suggested that health literacy would then become an organizational value infused into all aspects of planning and operations. They also proposed a measurement framework to track the impact of the new Health Literate Care Model on patient outcomes and quality of care.
AHRQ-authored.
Citation: Koh HK, Brach C, Harris LM .
A proposed 'health literate care model' would constitute a systems approach to improving patients' engagement in care.
Health Aff 2013 Feb;32(2):357-67. doi: 10.1377/hlthaff.2012.1205.
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Keywords: Healthcare Delivery, Shared Decision Making, Education: Patient and Caregiver, Health Literacy, Primary Care: Models of Care, Patient and Family Engagement
Lobach DF, Kawamoto K, Anstrom KJ
A randomized trial of population-based clinical decision support to manage health and resource use for Medicaid beneficiaries.
This study tested the impact of 3 clinical decision support modalities (emails to care managers, printed reports to clinic administrators, and letters to patients) on the use and cost of medical services for Medicaid patients. It found that some modalities can significantly reduce emergency department use and medical costs, while other interventions may have had detrimental consequences.
AHRQ-funded; HS015057
Citation: Lobach DF, Kawamoto K, Anstrom KJ .
A randomized trial of population-based clinical decision support to manage health and resource use for Medicaid beneficiaries.
J Med Syst. 2013 Feb;37(1):9922. doi: 10.1007/s10916-012-9922-3..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Medicaid, Emergency Medical Services (EMS), Quality of Care
O'Leary KJ, Devisetty VK, Patel AR
Comparison of traditional trigger tool to data warehouse based screening for identifying hospital adverse events.
This study compared a traditional trigger tool with an enterprise data warehouse (EDW) based screening method to detect hospital adverse events (AEs). The authors found relatively poor agreement between traditional trigger tool and EDW based screening with only approximately a third of all AEs detected by both methods. They recommended a combination of complementary methods as the optimal approach to detecting AEs among hospitalized patients.
AHRQ-funded; HS019630.
Citation: O'Leary KJ, Devisetty VK, Patel AR .
Comparison of traditional trigger tool to data warehouse based screening for identifying hospital adverse events.
BMJ Qual Saf 2013 Feb;22(2):130-8. doi: 10.1136/bmjqs-2012-001102.
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Keywords: Adverse Events, Hospitals, Medical Errors, Patient Safety, Quality Indicators (QIs)
Sharkey S, Hudak S, Horn SD
AHRQ Author: Spector W
Exploratory study of nursing home factors associated with successful implementation of clinical decision support tools for pressure ulcer prevention.
The researchers determined those factors that are associated with nursing homes' success in implementing the On-Time quality improvement (QI) for pressure ulcer prevention program and integrating health information technology (HIT) tools into practice at the unit level. They found that after at least 9 months of implementation effort, 36% of the nursing homes achieved level III of the On-Time QI-HIT program. They concluded that the learning from On-Time QI offers several lessons associated with facility factors that contribute to high level of implementation of a QI-HIT program in a nursing home.
AHRQ-authored; AHRQ-funded; 29020050020.
Citation: Sharkey S, Hudak S, Horn SD .
Exploratory study of nursing home factors associated with successful implementation of clinical decision support tools for pressure ulcer prevention.
Adv Skin Wound Care 2013 Feb;26(2):83-92; quiz p.93-4. doi: 10.1097/01.ASW.0000426718.59326.bb.
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Keywords: Health Information Technology (HIT), Nursing Homes, Pressure Ulcers, Prevention, Quality Improvement
Fleurence R, Selby JV, Odom-Walker K
AHRQ Author: Slutsky JR
How the Patient-Centered Outcomes Research Institute is engaging patients and others in shaping its research agenda.
This article describes PCORI's approach to generating topics for research and how it is being used in selection of research that PCORI will fund. It further describes challenges facing this approach, including a lack of common language and training on the part of patients and resistance on the part of researchers to questions that are not researcher generated.
AHRQ-authored.
Citation: Fleurence R, Selby JV, Odom-Walker K .
How the Patient-Centered Outcomes Research Institute is engaging patients and others in shaping its research agenda.
Health Aff 2013 Feb;32(2):393-400. doi: 10.1377/hlthaff.2012.1176.
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Keywords: Health Services Research (HSR), Patient and Family Engagement, Patient-Centered Outcomes Research, Research Methodologies
Koh HK, Baur C, Brach C
AHRQ Author: Brach C
Toward a systems approach to health literacy research.
The authors discuss a call for research exploring how health care organizations can effectively address health literacy and patient-centered care. Topics include AHRQ's Health Literacy Universal Precautions Toolkit, Accountable Care Organizations, and Patient Centered Medical Homes.
AHRQ-authored.
Citation: Koh HK, Baur C, Brach C .
Toward a systems approach to health literacy research.
J Health Commun 2013;18(1):1-5. doi: 10.1080/10810730.2013.759029.
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Keywords: Healthcare Delivery, Health Literacy, Health Services Research (HSR), Patient-Centered Healthcare, Tools & Toolkits
Boland MR, Miotto R, Weng C
A method for probing disease relatedness using common clinical eligibility criteria.
The researchers explored the feasibility of using disease-specific common eligibility features (CEFs) for representing diseases and understanding their relatedness. They constructed disease-specific CEF networks to assess the degree of overlap among three types of diseases. Using these automatically derived networks, they were able to highlight connections among schizophrenia, epilepsy and depression. This finding and similar observations confirm the value of using clinical trial eligibility criteria for identifying disease relatedness.
AHRQ-funded; HS019853.
Citation: Boland MR, Miotto R, Weng C .
A method for probing disease relatedness using common clinical eligibility criteria.
Stud Health Technol Inform 2013;192:481-5..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Registries
Dixon BE, Rosenman M, Xia Y
A vision for the systematic monitoring and improvement of the quality of electronic health data.
In order to more systematically define, characterize and improve electronic health data quality, the authors propose a novel framework for health data stewardship. Their framework is adapted from prior data quality research outside of health, but it has been reshaped to apply a systems approach to data quality with an emphasis on health outcomes.
AHRQ-funded; HS020909.
Citation: Dixon BE, Rosenman M, Xia Y .
A vision for the systematic monitoring and improvement of the quality of electronic health data.
Stud Health Technol Inform 2013;192:884-8..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care
Mehrabi S, Schmidt CM, Waters JA
An efficient pancreatic cyst identification methodology using natural language processing.
Accurate identification, surveillance and treatment of pancreatic cysts represents an opportunity to prevent pancreatic cancer. Much information about pancreatic cysts can be found in free text format in various narrative medical reports. To capture this information, the researchers modified their cyst identification technique using the Unstructured Information Management Architecture (UIMA) pipeline.
AHRQ-funded; HS019818.
Citation: Mehrabi S, Schmidt CM, Waters JA .
An efficient pancreatic cyst identification methodology using natural language processing.
Stud Health Technol Inform 2013;192:822-6..
Keywords: Cancer, Electronic Health Records (EHRs), Data, Health Information Technology (HIT), Prevention
Zhang M, Del Fiol G, Grout RW
Automatic identification of comparative effectiveness research from Medline citations to support clinicians' treatment information needs.
The goal of this study was to design and assess an algorithm for automatically identifying comparative effectiveness studies on the treatment of a given condition and extracting the interventions investigated in these studies. A total of 86% of the interventions extracted perfectly or partially matched the gold standard. The researchers concluded that, overall, the algorithm achieved reasonable performance.
AHRQ-funded; HS018352.
Citation: Zhang M, Del Fiol G, Grout RW .
Automatic identification of comparative effectiveness research from Medline citations to support clinicians' treatment information needs.
Stud Health Technol Inform 2013;192:846-50..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Clinical Decision Support (CDS)
Santa JS
Communicating information about "what not to do" to consumers.
The author reports on ways in which Consumer Reports magazine has communicated information about health services to its readers. Over a 5-year period, the author shows that the magazine as it learned more about how to communicate “what not to do” to consumers, was ultimately able to enhance the effectiveness of this difficult message.
AHRQ-funded; 290200810015C
Citation: Santa JS .
Communicating information about "what not to do" to consumers.
BMC Med Inform Decis Making 2013;13 Suppl 3:S2. doi: 10.1186/1472-6947-13-s3-s2..
Keywords: Communication, Education: Patient and Caregiver
Taylor EF, Machta RM, Meyers DS
AHRQ Author: Meyers DS, Genevro J
Enhancing the primary care team to provide redesigned care: the roles of practice facilitators and care managers.
This article discusses how practice facilitators and care managers can play important but distinct roles in redesigning and improving care delivery in order to deliver coordinated, accessible, comprehensive, and patient-centered care.
AHRQ-authored.
Citation: Taylor EF, Machta RM, Meyers DS .
Enhancing the primary care team to provide redesigned care: the roles of practice facilitators and care managers.
Ann Fam Med 2013 Jan-Feb;11(1):80-3. doi: 10.1370/afm.1462.
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Keywords: Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Healthcare Delivery, Organizational Change, Quality Improvement, Quality of Care
Bruckner TA, Rehkopf DH, Catalano RA
Income gains and very low-weight birth among low-income black mothers in California.
The researchers examined pregnant women in California in the 1990s who likely received a lump sum federal tax refund as a result of the Earned Income Tax Credit (EITC) in order to determine the effect, if any, on their infant’s birthweight. Contrary to expectation, the odds of a very low birthweight (VLBW) infant increase above expected values two months immediately following the tax disbursement.
AHRQ-funded; HS0008609.
Citation: Bruckner TA, Rehkopf DH, Catalano RA .
Income gains and very low-weight birth among low-income black mothers in California.
Biodemography Soc Biol 2013;59(2):141-56. doi: 10.1080/19485565.2013.833802..
Keywords: Newborns/Infants, Low-Income, Social Determinants of Health, Labor and Delivery
Siminoff LA
Incorporating patient and family preferences into evidence-based medicine.
The authors contend that the goal of patient-centered evidence based medicine (EBM) can be achieved through the incorporation of patient-derived data. Their article discusses the data needed to expand the EBM paradigm, including the role of patients’ families and their contributions to diagnosis seeking and treatment-related decisionmaking.
AHRQ-funded; 290200810015C
Citation: Siminoff LA .
Incorporating patient and family preferences into evidence-based medicine.
BMC Med Inform Decis Making. 2013;13 Suppl 3:S6. doi: 10.1186/1472-6947-13-s3-s6..
Keywords: Evidence-Based Practice, Shared Decision Making, Patient-Centered Outcomes Research
Vawdrey DK, Natarajan K, Kanter AS
Informatics lessons from using a novel immunization information system.
This paper describes the informatics challenges and lessons learned during nearly 15 years of collecting, using, and exchanging electronic immunization information. The authors report on their experience with developing and using the EzVac system for 1) clinical care, both in local and global settings, 2) public health reporting, 3) consumer engagement, and 4) clinical and informatics research.
AHRQ-funded; HS018158.
Citation: Vawdrey DK, Natarajan K, Kanter AS .
Informatics lessons from using a novel immunization information system.
Stud Health Technol Inform 2013;192:589-93..
Keywords: Health Information Technology (HIT), Registries, Public Reporting, Vaccination
Sockolow PS, Bowles KH, Rogers M
Interdisciplinary care team adoption of electronic point-of-care documentation systems: an unrealized opportunity.
To address the knowledge gap about barriers and facilitators to interdisciplinary care team adoption of computer-based point-of-care documentation systems, the researchers conducted three evaluations at each of two community health sites. They found that at each site there was a need for continuous feedback from front line users and on-going training to improve knowledge. Clinicians did not perceive any impact of the point-of-care documentation systems on patient outcomes.
AHRQ-funded; HS021008.
Citation: Sockolow PS, Bowles KH, Rogers M .
Interdisciplinary care team adoption of electronic point-of-care documentation systems: an unrealized opportunity.
Stud Health Technol Inform 2013;192:939..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Care Coordination, Practice Patterns
Sanders Thompson VL
Making decisions in a complex information environment: evidential preference and information we trust.
This article discusses the role of information sources and evidential preferences—including the influence of health professionals, general and ethnicity-specific media, Internet sources, personal experiences, and family and friends and their testimonials and anecdotal evidence in health decisions. It also contains recommendations for health communication practices, professional training, and future research directions.
AHRQ-funded; 290200810015C
Citation: Sanders Thompson VL .
Making decisions in a complex information environment: evidential preference and information we trust.
BMC Med Inform Decis Making 2013;13 Suppl 3:S7. doi: 10.1186/1472-6947-13-s3-s7..
Keywords: Communication, Education: Patient and Caregiver, Shared Decision Making
Kravitz RL, Bell RA
Media, messages, and medication: strategies to reconcile what patients hear, what they want, and what they need from medications.
This analysis takes the form of a critical, integrative synthesis of research from the fields of medicine, marketing, public health, and health communications. The authors conclude that the problem is not a lack of information: rather, it is knowing what information to trust.
AHRQ-funded; 290200810015C
Citation: Kravitz RL, Bell RA .
Media, messages, and medication: strategies to reconcile what patients hear, what they want, and what they need from medications.
BMC Med Inform Decis Making 2013;13 Suppl 3:S5. doi: 10.1186/1472-6947-13-s3-s5..
Keywords: Communication, Education: Patient and Caregiver, Health Promotion, Medication, Public Health
Clancy CM
AHRQ Author: Clancy CM
New hospital readmission policy links financial and quality incentives.
This article describes AHRQ-related projects to reduce hospital readmissions, including Porject RED (Re-Engineered Discharge), Project BOOST (Better Outcomes for Older adults through Safe Transitions), and Patient Safety Organizations (PSOs).
AHRQ-authored.
Citation: Clancy CM .
New hospital readmission policy links financial and quality incentives.
J Nurs Care Qual 2013 Jan-Mar;28(1):1-4. doi: 10.1097/NCQ.0b013e3182725d82.
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Keywords: Elderly, Hospital Discharge, Patient Safety, Hospital Readmissions, Transitions of Care