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AHRQ Research Studies Date
Topics
- Behavioral Health (1)
- Children/Adolescents (3)
- COVID-19 (1)
- Disparities (4)
- Emergency Department (2)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (1)
- Healthcare Cost and Utilization Project (HCUP) (2)
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- Healthcare Utilization (4)
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- Health Services Research (HSR) (1)
- Health Status (2)
- Hospitalization (3)
- Human Immunodeficiency Virus (HIV) (1)
- Injuries and Wounds (2)
- Labor and Delivery (1)
- Low-Income (1)
- Maternal Care (1)
- Medical Expenditure Panel Survey (MEPS) (4)
- Medicare (1)
- Mortality (1)
- Newborns/Infants (1)
- Orthopedics (1)
- Outcomes (2)
- Patient-Centered Outcomes Research (1)
- Policy (1)
- Pregnancy (1)
- Prevention (3)
- Quality of Care (1)
- Racial and Ethnic Minorities (1)
- Risk (1)
- (-) Social Determinants of Health (18)
- Surgery (1)
- Uninsured (1)
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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
1 to 18 of 18 Research Studies DisplayedNeerland C, Slaughter-Acey J, Behrens K
An evidence map for social and structural determinants for maternal morbidity and mortality: a systematic review.
The study aimed to identify social and structural determinants of maternal morbidity and mortality during prenatal and postpartum periods in the U.S. Out of 8,378 references screened, 118 studies were included, covering domains like identity, socioeconomic factors, violence, and trauma. Findings revealed mixed patterns between risk factors and outcomes, with notable attention to depression and mental health. Advancing the field long-term should involve developing comprehensive datasets to thoroughly investigate intersections with biological and medical risk factors.
AHRQ-funded; 75Q80120D00008.
Citation: Neerland C, Slaughter-Acey J, Behrens K .
An evidence map for social and structural determinants for maternal morbidity and mortality: a systematic review.
Obstet Gynecol 2024 Mar; 143(3):383-92. doi: 10.1097/aog.0000000000005489.
Keywords: Social Determinants of Health, Maternal Care, Mortality, Evidence-Based Practice, Risk, Women, Outcomes
Hogg-Graham R, Benitez JA, Lacy ME
Association between community social vulnerability and preventable hospitalizations.
The purpose of this study was to explore the relationship between variations in social vulnerability and preventable hospitalization rates. The researchers analyzed county-level preventable hospitalization rates for 33 states linked with data from the 2020 Social Vulnerability Index (SVI). The study found that preventable hospitalizations were 40% greater in the most vulnerable counties compared with the least vulnerable. Adjusted regression results confirm the strong relationship between social vulnerability and preventable hospitalizations.
AHRQ-funded; HS025494.
Citation: Hogg-Graham R, Benitez JA, Lacy ME .
Association between community social vulnerability and preventable hospitalizations.
Med Care Res Rev 2024 Feb; 81(1):31-38. doi: 10.1177/10775587231197248..
Keywords: Hospitalization, Social Determinants of Health
Carroll AR, Hall M, Noelke C
Association of neighborhood opportunity and pediatric hospitalization rates in the United States.
This study examined associations between a validated, multidimensional measure of social determinants of health and population-based hospitalization rates among children <18 years across 18 states from the 2017 Healthcare Cost and Utilization Project State Inpatient Databases and the US Census. Exposure was ZIP code-level Child Opportunity Index (COI), a composite measure of neighborhood resources and conditions that matter for children's health. The cohort included 614,823 hospitalizations among a population of 29,244,065 children, which measures at 21.02 hospitalizations per 1000. Adjusted hospitalization rates decreased significantly and in a stepwise fashion as COI increased, from 26.56 per 1000 in very low COI areas to 14.76 per 1000 in very high COI areas (incidence rate ratio 1.8). Decreasing neighborhood opportunity was associated with increasing hospitalization rates among children in the study.
AHRQ-funded; HS026122.
Citation: Carroll AR, Hall M, Noelke C .
Association of neighborhood opportunity and pediatric hospitalization rates in the United States.
J Hosp Med 2024 Feb; 19(2):120-25. doi: 10.1002/jhm.13252..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Hospitalization, Social Determinants of Health
Fleming MD, Safaeinili N, Knox M
Organizational and community resilience for COVID-19 and beyond: leveraging a system for health and social services integration.
This case study paper examined how a preexisting initiative to align health care, public health, and social services influenced COVID-19 pandemic response. In-depth interviews were conducted with administrators and frontline staff in health care, public health, and social services in Contra Costa County, California from October 2020 to May 2021. The authors interviewed 31 informants including 14 managers in public health, health care, or social services and 17 social needs case managers who coordinated services across these sectors on behalf of patients. They identified four distinct components of the county's system alignment capabilities that supported COVID-19 response, including (1) an organizational culture of adaptability fostered through earlier system alignment efforts, which included the ability and willingness to rapidly implement new organizational processes, (2) trusting relationships among organizations based on prior, positive experiences of cross-sector collaboration, (3) capacity to monitor population health of historically marginalized community members, including information infrastructures, data analytics, and population monitoring and outreach, and (4) frontline staff with flexible skills to support health and social care who had built relationships with the highest risk community members.
AHRQ-funded; HS027648.
Citation: Fleming MD, Safaeinili N, Knox M .
Organizational and community resilience for COVID-19 and beyond: leveraging a system for health and social services integration.
Health Serv Res 2024 Feb; 59(suppl 1):e14250. doi: 10.1111/1475-6773.14250..
Keywords: COVID-19, Social Determinants of Health
Danielson EC, Li W, Suleiman L
Social risk and patient-reported outcomes after total knee replacement: implications for Medicare policy.
The objective of this study was to determine if county- or patient-level social risk factors are associated with patient-reported outcomes after total knee replacement when added to the comprehensive joint replacement risk-adjustment model. Patient and outcomes data from the Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement cohort were merged with the CDC Social Vulnerability Index. The findings indicated that patient-reported race, education, and income were associated with patient-reported pain or functional scores; pain improvement was negatively associated with Black race and positively associated with higher annual incomes. The authors concluded that these findings suggested that patient-level social factors warrant further investigation to promote health equity in patient-reported outcomes after total knee replacement.
Citation: Danielson EC, Li W, Suleiman L .
Social risk and patient-reported outcomes after total knee replacement: implications for Medicare policy.
Health Serv Res 2024 Feb; 59(1):e14215. doi: 10.1111/1475-6773.14215.
Keywords: Surgery, Orthopedics, Medicare, Outcomes, Patient-Centered Outcomes Research, Social Determinants of Health
Hwang SW, Chambers C, Chiu S
A comprehensive assessment of health care utilization among homeless adults under a system of universal health insurance.
The researchers comprehensively assessed health care utilization in a population-based sample of homeless adults and matched controls under a universal health insurance system. They found that homeless people had substantially higher rates of ED and hospital use than general population controls; these rates were largely driven by a subset of homeless persons with extremely high-intensity usage of health services.
AHRQ-funded; HS014129.
Citation: Hwang SW, Chambers C, Chiu S .
A comprehensive assessment of health care utilization among homeless adults under a system of universal health insurance.
Am J Public Health 2013 Dec;103 Suppl 2:S294-301. doi: 10.2105/ajph.2013.301369..
Keywords: Healthcare Utilization, Social Determinants of Health, Emergency Department, Emergency Medical Services (EMS)
Chambers C, Chiu S, Katic M
High utilizers of emergency health services in a population-based cohort of homeless adults.
This study identified predictors of frequent emergency department (ED) use among a population-based sample of homeless adults in Toronto, Ontario. It found that among homeless adults with universal health insurance, a small subgroup accounted for the majority of visits to emergency services. Frequent use was driven by multiple predisposing, enabling, and need factors.
AHRQ-funded; HS014129.
Citation: Chambers C, Chiu S, Katic M .
High utilizers of emergency health services in a population-based cohort of homeless adults.
Am J Public Health 2013 Dec;103 Suppl 2:S302-10. doi: 10.2105/ajph.2013.301397..
Keywords: Emergency Department, Social Determinants of Health, Health Insurance, Healthcare Utilization
John DA, de Castro AB, Duran B
Nativity and occupational class disparities in uninsurance and routine preventive care use among Asian Americans.
The researchers examined how nativity and occupational class among Asian Americans may explain disparities in uninsurance and use of routine preventive healthcare services such as routine physical checkup and dental/eye exams. They found that 35 to 40 percent of workers in blue-collar and service occupations reported no physical checkup or dental/eye exams in the past year.
AHRQ-funded; HS013853
Citation: John DA, de Castro AB, Duran B .
Nativity and occupational class disparities in uninsurance and routine preventive care use among Asian Americans.
J Immigr Minor Health. 2013 Dec;15(6):1011-22. doi: 10.1007/s10903-013-9851-3..
Keywords: Disparities, Uninsured, Racial and Ethnic Minorities, Social Determinants of Health, Prevention
Chambers C, Katic M, Chiu S
Predictors of medical or surgical and psychiatric hospitalizations among a population-based cohort of homeless adults.
This study identified factors associated with inpatient hospitalizations among a population-based cohort of homeless adults in Toronto, Ontario. Health care need was a strong predictor of medical or surgical and psychiatric hospitalizations. Some hospitalizations among homeless adults were potentially avoidable, whereas others represented an unavoidable use of health services.
AHRQ-funded; HS014129.
Citation: Chambers C, Katic M, Chiu S .
Predictors of medical or surgical and psychiatric hospitalizations among a population-based cohort of homeless adults.
Am J Public Health 2013 Dec;103 Suppl 2:S380-8. doi: 10.2105/ajph.2013.301646..
Keywords: Hospitalization, Social Determinants of Health, Behavioral Health, Health Status
Zhang S, Senteio C, Felizzola J
Racial/ethnic disparities in antiretroviral treatment among HIV-infected pregnant Medicaid enrollees, 2005-2007.
The purpose of this study was to describe racial/ethnic disparities in ARV treatment of low-income Medicaid-eligible HIV-infected women, with a focus on minority populations in southern states. It found that Hispanic or Latino women are a specific subgroup at risk for inadequate ARV therapy in pregnancy. The researchers point out a specific policy issue with regard to the systematic exclusion of many immigrants from Medicaid-covered care during the prenatal period.
AHRQ-funded; HS019470.
Citation: Zhang S, Senteio C, Felizzola J .
Racial/ethnic disparities in antiretroviral treatment among HIV-infected pregnant Medicaid enrollees, 2005-2007.
Am J Public Health 2013 Dec;103(12):e46-53. doi: 10.2105/ajph.2013.301328..
Keywords: Disparities, Human Immunodeficiency Virus (HIV), Pregnancy, Social Determinants of Health
Abdus S, Selden TM
AHRQ Author: Abdus S, Selden TM
Preventive services for adults: how have differences across subgroups changed over the past decade?
This study uses MEPS data to track changes over time in the distribution of preventive services use across groups defined by poverty status, race/ethnicity, insurance coverage, Census region, and urbanicity. The analysis found that differences across subgroups tended to persist over time, with some of the largest gaps between adults with and without coverage. Regional differences persisted or widened over the study period.
AHRQ-authored.
Citation: Abdus S, Selden TM .
Preventive services for adults: how have differences across subgroups changed over the past decade?
Med Care 2013 Nov;51(11):999-1007. doi: 10.1097/MLR.0b013e3182a97bc0.
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Keywords: Healthcare Utilization, Health Insurance, Medical Expenditure Panel Survey (MEPS), Prevention, Social Determinants of Health
Berdahl TA, Friedman BS, McCormick MC
AHRQ Author: Berdahl TA, Friedman BS
Annual report on health care for children and youth in the United States: trends in racial/ethnic, income, and insurance disparities over time, 2002-2009.
Using MEPS and HCUP data, the authors examined trends in children's health access, utilization, and expenditures over time by race/ethnicity, income, and insurance status/expected payer. They found that disparities by race/ethnicity and income persist in access to and use of care, with Hispanic children experiencing progress in a number of measures, while black children did not.
AHRQ-authored.
Citation: Berdahl TA, Friedman BS, McCormick MC .
Annual report on health care for children and youth in the United States: trends in racial/ethnic, income, and insurance disparities over time, 2002-2009.
Acad Pediatr 2013 May-Jun;13(3):191-203. doi: 10.1016/j.acap.2013.02.003.
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Keywords: Children/Adolescents, Disparities, Healthcare Cost and Utilization Project (HCUP), Medical Expenditure Panel Survey (MEPS), Social Determinants of Health
Mohanan M
Causal effects of health shocks on consumption and debt: Quasi-experimental evidence from bus accident injuries.
Mohanan presented new evidence of causal effects on consumption and debt, finding that households faced with shock-related expenditures are able to smooth consumption on food, housing, and festivals, with small reductions in educational spending.
AHRQ-funded; HS000055.
Citation: Mohanan M .
Causal effects of health shocks on consumption and debt: Quasi-experimental evidence from bus accident injuries.
Rev Econ Stat 2013 May;95(2):673-81. doi: 10.1162/REST_a_00262.
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Keywords: Healthcare Costs, Injuries and Wounds, Social Determinants of Health
Mohanan M
Causal effects of health shocks on consumption and debt: Quasi-experimental evidence from bus accident injuries.
Mohanan presented new evidence of causal effects on consumption and debt, finding that households faced with shock-related expenditures are able to smooth consumption on food, housing, and festivals, with small reductions in educational spending.
AHRQ-funded; HS000055.
Citation: Mohanan M .
Causal effects of health shocks on consumption and debt: Quasi-experimental evidence from bus accident injuries.
Rev Econ Stat 2013 May;95(2):673-81. doi: 10.1162/REST_a_00262..
Keywords: Healthcare Costs, Injuries and Wounds, Social Determinants of Health
Pylypchuk Y, Sarpong EM
AHRQ Author: Sarpong EM
Comparison of health care utilization: United States versus Canada.
The purpose of this paper was to compare health care utilization between Canadian and U.S. residents. Findings showed that the poor and less educated were more likely to utilize health care in Canada than in the United States, while health care use for residents with high incomes and higher levels of education were not markedly different between the two countries and often higher for U.S residents. Also, foreign-born residents were more likely to use health care in Canada than in the United States.
AHRQ-authored.
Citation: Pylypchuk Y, Sarpong EM .
Comparison of health care utilization: United States versus Canada.
Health Serv Res 2013 Apr;48(2 Pt 1):560-81. doi: 10.1111/j.1475-6773.2012.01466.x.
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Keywords: Health Services Research (HSR), Healthcare Utilization, Medical Expenditure Panel Survey (MEPS), Social Determinants of Health
Abdus 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
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
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