National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Antibiotics (2)
- Antimicrobial Stewardship (2)
- Arthritis (1)
- Behavioral Health (2)
- Blood Clots (1)
- Cancer (3)
- Cancer: Lung Cancer (1)
- Cancer: Ovarian Cancer (1)
- Cardiovascular Conditions (1)
- Caregiving (1)
- Care Management (1)
- Children/Adolescents (2)
- Chronic Conditions (1)
- Comparative Effectiveness (1)
- Depression (1)
- Diabetes (3)
- Digestive Disease and Health (1)
- Disparities (2)
- Education (1)
- Elderly (2)
- Eye Disease and Health (1)
- (-) Healthcare Costs (28)
- Healthcare Utilization (1)
- Health Insurance (3)
- Heart Disease and Health (1)
- Hepatitis (1)
- Home Healthcare (1)
- Human Immunodeficiency Virus (HIV) (1)
- Medical Expenditure Panel Survey (MEPS) (2)
- Medicare (4)
- (-) Medication (28)
- Neurological Disorders (1)
- Opioids (1)
- Osteoporosis (1)
- Outcomes (1)
- Palliative Care (1)
- Patient-Centered Outcomes Research (1)
- Patient Adherence/Compliance (2)
- Patient Safety (1)
- Policy (2)
- Practice Patterns (2)
- Prevention (1)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (1)
- Screening (1)
- Shared Decision Making (2)
- Substance Abuse (1)
- Surgery (1)
- Treatments (2)
- Vaccination (1)
- Women (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 28 Research Studies DisplayedLeeds IL, DiBrito SR, Canner JK
Cost-benefit limitations of extended, outpatient venous thromboembolism prophylaxis following surgery for Crohn's disease.
This goal of this study was to assess the cost-effectiveness of extended prophylaxis in patients with Crohn's disease after abdominal surgery. A decision tree model was used to assess cost-effectiveness and cost-per-case averted with extended-duration venous thromboembolism prophylaxis following abdominal surgery. Results showed that extended prophylaxis in patients with Crohn's disease postoperatively is not cost-effective when the cumulative incidence of posthospital thrombosis remains less than 4.9%. These findings are driven by the low absolute risk of thrombosis in this population and the considerable cost of universal treatment.
AHRQ-funded; HS024547.
Citation: Leeds IL, DiBrito SR, Canner JK .
Cost-benefit limitations of extended, outpatient venous thromboembolism prophylaxis following surgery for Crohn's disease.
Dis Colon Rectum 2019 Nov;62(11):1371-80. doi: 10.1097/dcr.0000000000001461..
Keywords: Prevention, Digestive Disease and Health, Surgery, Healthcare Costs, Adverse Events, Patient Safety, Blood Clots, Shared Decision Making, Medication
McClellan C, Fingar KR, Ali MM
AHRQ Author: McClellan C
Price elasticity of demand for buprenorphine/naloxone prescriptions.
In this study, using the IBM MarketScan(R) Commercial Claims and Encounters Database for individuals with employer-sponsored private health insurance coverage, the researchers examined the relationship between cost sharing and the number of buprenorphine/naloxone prescription fills using enrollee-level longitudinal fixed effects models.
AHRQ-authored.
Citation: McClellan C, Fingar KR, Ali MM .
Price elasticity of demand for buprenorphine/naloxone prescriptions.
J Subst Abuse Treat 2019 Nov;106:4-11. doi: 10.1016/j.jsat.2019.08.001..
Keywords: Medication, Healthcare Costs, Health Insurance
Shaker M, Greenhawt M
Cost-effectiveness of stock epinephrine autoinjectors on commercial aircraft.
This study examined the cost-effectiveness of commercial airlines stocking epinephrine autoinjectors on every plane versus the standard emergency kit epinephrine ampules. The study assumed the autoinjectors reduced fatality risk by 10%. They used a Markov movule with microsimulation over an 80-year time horizon and concluded that it was cost-effective with a low annual cost per passenger-at-risk of 8 cents.
AHRQ-funded; HS024599.
Citation: Shaker M, Greenhawt M .
Cost-effectiveness of stock epinephrine autoinjectors on commercial aircraft.
J Allergy Clin Immunol Pract 2019 Sep - Oct;7(7):2270-76. doi: 10.1016/j.jaip.2019.04.029..
Keywords: Healthcare Costs, Medication
Shaker M, Greenhawt M
Providing cost-effective care for food allergy.
This article discusses the cost-effectiveness of food allergy management strategies for children. Screening at-risk infants for peanut allergy in particular carries a risk of overdiagnosis and is not cost-effective. An evidence review of the literature using PubMed showed that cost-effective care could be optimized in minimizing delay in oral food challenges for at-risk patients and for school-age children to epinephrine pens available at reasonable cost.
AHRQ-funded; HS024599.
Citation: Shaker M, Greenhawt M .
Providing cost-effective care for food allergy.
Ann Allergy Asthma Immunol 2019 Sep;123(3):240-48.e1. doi: 10.1016/j.anai.2019.05.015..
Keywords: Healthcare Costs, Medication, Children/Adolescents
Selden TM, Abdus S, Miller GE
AHRQ Author: Selden TM, Abdus S, Miller GE
Decomposing changes in the growth of U.S. prescription drug use and expenditures, 1999-2016.
Data from the Medical Expenditure Panel Survey (MEPS) was examined to analyze factors associated with changes in prescription drug use and expenditures in the US from 1999 to 2016. There were large increases in prescription drug use during that period, with per capita utilization increasing by nearly half and per capita expenditures more than doubled. Treatment of long-term conditions was a large driver in the increases in medication use.
AHRQ-authored.
Citation: Selden TM, Abdus S, Miller GE .
Decomposing changes in the growth of U.S. prescription drug use and expenditures, 1999-2016.
Health Serv Res 2019 Aug;54(4):752-63. doi: 10.1111/1475-6773.13164..
Keywords: Healthcare Costs, Healthcare Utilization, Medical Expenditure Panel Survey (MEPS), Medication
Hung A, Slejko JF, Lugo A
Validating a budget impact model using payer insight and claims data: a framework and case study.
The goal of this study was to assess the face validity, internal verification, and predictive validity of a previously published model that assessed the budgetary impact of antidiabetic formulary changes. The authors found that the budget impact model overpredicted utilization in the year after the formulary changes, and that discoveries through the validation process improved the accuracy and transparency of the model.
AHRQ-funded; HS024857.
Citation: Hung A, Slejko JF, Lugo A .
Validating a budget impact model using payer insight and claims data: a framework and case study.
J Manag Care Spec Pharm 2019 Aug;25(8):913-21. doi: 10.18553/jmcp.2019.25.8.913..
Keywords: Healthcare Costs, Medication
Gong CL, Zangwill KM, Hay JW
Behavioral economics interventions to improve outpatient antibiotic prescribing for acute respiratory infections: a cost-effectiveness analysis.
Researchers sought to determine the cost-effectiveness of three behavioral economic interventions designed to reduce inappropriate antibiotic prescriptions for acute respiratory infections (ARIs). Provider education on guidelines for the appropriate ARI treatment is compared with suggested alternatives, which use computerized clinical decision support to suggest non-antibiotic treatment choices; accountable justification, which mandates free-text justification into the patient's electronic health record when antibiotics are prescribed; and peer comparison. The authors concluded that behavioral economics interventions can be cost-effective strategies for reducing inappropriate antibiotic prescriptions by reducing healthcare resource utilization.
AHRQ-funded; HS019913.
Citation: Gong CL, Zangwill KM, Hay JW .
Behavioral economics interventions to improve outpatient antibiotic prescribing for acute respiratory infections: a cost-effectiveness analysis.
J Gen Intern Med 2019 Jun;34(6):846-54. doi: 10.1007/s11606-018-4467-x..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Practice Patterns, Healthcare Costs, Respiratory Conditions
Callaghan BC, Reynolds E, Banerjee M
Out-of-pocket costs are on the rise for commonly prescribed neurologic medications.
The purpose of this study was to determine out-of-pocket costs for neurologic medications in 5 common neurologic diseases. The investigators concluded that out-of-pocket costs for neurologic medications have increased considerably over the last 12 years, particularly for those in high-deductible health plans. Out-of-pocket costs vary widely both across and within conditions. They assert that to minimize patient financial burden, neurologists require access to precise cost information when making treatment decisions.
AHRQ-funded; HS022258.
Citation: Callaghan BC, Reynolds E, Banerjee M .
Out-of-pocket costs are on the rise for commonly prescribed neurologic medications.
Neurology 2019 May 28;92(22):e2604-e13. doi: 10.1212/wnl.0000000000007564.
.
.
Keywords: Health Insurance, Healthcare Costs, Medication, Neurological Disorders
Krah NM, Bardsley T, Nelson R
Economic burden of home antimicrobial therapy: OPAT versus oral therapy.
There is increasing evidence that outpatient parenteral antimicrobial therapy (OPAT) is overused for children and that outcomes with oral therapy are equivalent. The objective of this study was to compare economic burden between OPAT and oral therapy, accounting for direct and indirect costs and caregiver quality of life (QoL). The investigators concluded that the overall burden of OPAT was substantially higher than that of oral therapy, including higher direct and indirect costs and greater impact on caregiver QoL.
AHRQ-funded; HS023320.
Citation: Krah NM, Bardsley T, Nelson R .
Economic burden of home antimicrobial therapy: OPAT versus oral therapy.
Hosp Pediatr 2019 Apr;9(4):234-40. doi: 10.1542/hpeds.201-0193.
.
.
Keywords: Healthcare Costs, Children/Adolescents, Caregiving, Home Healthcare, Antimicrobial Stewardship, Antibiotics, Medication
Hung A, Mullins CD, Slejko JF
Using a budget impact model framework to evaluate antidiabetic formulary changes and utilization management tools.
This study projected cost savings to the TRICARE program from changes to the antidiabetic formulary and utilization management (UM) policies. Budgetary impacts for 3 years as projected using a Microsoft Excel spreadsheet. This model projected a savings of up to $43 million in the third year from revisions to the payer’s formulary.
AHRQ-funded; HS024857.
Citation: Hung A, Mullins CD, Slejko JF .
Using a budget impact model framework to evaluate antidiabetic formulary changes and utilization management tools.
J Manag Care Spec Pharm 2019 Mar;25(3):342-49. doi: 10.18553/jmcp.2019.25.3.342..
Keywords: Care Management, Elderly, Healthcare Costs, Medication, Policy
Shaker MS, Greenhawt MJ
Analysis of value-based costs of undesignated school stock epinephrine policies for peanut anaphylaxis.
Children experiencing anaphylaxis at school may lack access to a personal epinephrine device, prompting recent legislation permitting undesignated (eg, non-student specific) stock epinephrine autoinjector units at school. However, epinephrine device costs vary, and the cost-effectiveness of undesignated school stock epinephrine is uncharacterized to date. The objective of this study was to define value-based strategies for undesignated school stock epinephrine programs.
AHRQ-funded; HS024599.
Citation: Shaker MS, Greenhawt MJ .
Analysis of value-based costs of undesignated school stock epinephrine policies for peanut anaphylaxis.
JAMA Pediatr 2019 Feb;173(2):169-75. doi: 10.1001/jamapediatrics.2018.4275..
Keywords: Healthcare Costs, Education, Policy, Medication
Smith GH, Shore S, Allen LA
Discussing out-of-pocket costs with patients: shared decision making for sacubitril-valsartan in heart failure.
This study examined how prescription costs can greatly impact decision-making in patients with serious medical conditions. Forty-nine patients with heart failure with reduced ejection fracture were recruited and interviewed about a drug sacrubitril-valsartan. The drug is considered effective but can be costly. Most patients (45/49) said they would take the medicine if the out-of-pocket cost was only $5 per month more than their current medication. But if the costs increased to $100 more per month then only 43% would switch to sacrubritil-valsartan. Only 20% of participants said their physician had discussed medication costs in the past year.
AHRQ-funded; HS026081.
Citation: Smith GH, Shore S, Allen LA .
Discussing out-of-pocket costs with patients: shared decision making for sacubitril-valsartan in heart failure.
J Am Heart Assoc 2019 Jan 8;8(1):e010635. doi: 10.1161/jaha.118.010635..
Keywords: Healthcare Costs, Shared Decision Making, Heart Disease and Health, Cardiovascular Conditions, Medication, Chronic Conditions
Eaton EF, Kulczycki A, Saag M
Immunization costs and programmatic barriers at an urban HIV clinic.
This study estimated costs of providing Gardasil, Prevnar, and Zostavax to eligible patients at a US Ryan White Part C academically affiliated HIV clinic in 2013. Its cost analysis of 3 vaccines showed great variation in insurance coverage, with potential losses of almost $100 000 for one HIV clinic if eligible patients received vaccinations in one calendar year.
AHRQ-funded; HS013852.
Citation: Eaton EF, Kulczycki A, Saag M .
Immunization costs and programmatic barriers at an urban HIV clinic.
Clin Infect Dis 2015 Dec;61(11):1726-31. doi: 10.1093/cid/civ637.
.
.
Keywords: Human Immunodeficiency Virus (HIV), Healthcare Costs, Medication, Vaccination
Du XL, Parikh RC, Lairson DR
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
The authors examined racial/ethnic and geographical disparities in cancer care and costs during the last 6 months of life for lung cancer decedents after the FDA's approval of bevacizumab. They found that there were substantial racial/ethnic and geographic disparities in the types of cancer care and costs in the last 6 months of life among lung cancer decedents, regardless of the length of survival times and hospice care status.
AHRQ-funded; HS018956.
Citation: Du XL, Parikh RC, Lairson DR .
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
Lung Cancer 2015 Dec;90(3):442-50. doi: 10.1016/j.lungcan.2015.09.017.
.
.
Keywords: Cancer, Cancer: Lung Cancer, Disparities, Healthcare Costs, Medication, Palliative Care, Patient-Centered Outcomes Research, Practice Patterns, Racial and Ethnic Minorities
Poonawalla IB, Parikh RC, Du XL
Cost effectiveness of chemotherapeutic agents and targeted biologics in ovarian cancer: a systematic review.
The authors evaluated the cost-effectiveness of various chemotherapeutic and targeted therapy alternatives for ovarian cancer. They found that standard platinum-taxane combination chemotherapy for first-line treatment was most cost-effective.
AHRQ-funded; HS018956.
Citation: Poonawalla IB, Parikh RC, Du XL .
Cost effectiveness of chemotherapeutic agents and targeted biologics in ovarian cancer: a systematic review.
Pharmacoeconomics 2015 Nov;33(11):1155-85. doi: 10.1007/s40273-015-0304-9.
.
.
Keywords: Treatments, Healthcare Costs, Medication, Cancer: Ovarian Cancer
Miller GE, Sarpong EM, Hill SC
AHRQ Author: Miller GE, Sarpong EM, Hill SC
Does increased adherence to medications change health care financial burdens for adults with diabetes?
The aim of the present study was to investigate increased out-of-pocket drug costs and financial burdens of achieving adherence to oral antidiabetic medications and medications for prevalent comorbidities. The researchers found that the mean simulated additional out-of-pocket drug costs of achieving adherence were $310 for uninsured adults treated for diabetes. These additional drug costs would increase the percentage of uninsured adults with financial burden.
AHRQ-authored.
Citation: Miller GE, Sarpong EM, Hill SC .
Does increased adherence to medications change health care financial burdens for adults with diabetes?
J Diabetes 2015 Nov;7(6):872-80. doi: 10.1111/1753-0407.12292..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Diabetes, Patient Adherence/Compliance, Medication
Hernandez I, Zhang Y
Comparing clinical and economic outcomes of biologic and conventional medications in postmenopausal women with osteoporosis.
This study compared clinical and economic outcomes between teriparatide (monthly costs $1120) and bisphosphonates (monthly costs $14) among postmenopausal women with osteoporosis. It found that teriparatide users had higher risk of fracture and higher costs, compared with similar bisphosphonates users. The hazard ratios of fracture for teriparatide relative to bisphosphonates ranged from 1.37 to 2.12, depending on methods.
AHRQ-funded; HS018657.
Citation: Hernandez I, Zhang Y .
Comparing clinical and economic outcomes of biologic and conventional medications in postmenopausal women with osteoporosis.
J Eval Clin Pract 2015 Oct;21(5):840-7. doi: 10.1111/jep.12389.
.
.
Keywords: Medication, Women, Osteoporosis, Healthcare Costs
Shih YC, Smieliauskas F, Geynisman DM
Trends in the cost and use of targeted cancer therapies for the privately insured nonelderly: 2001 to 2011.
This study sought to define and identify drivers of trends in cost and use of targeted therapeutics among privately insured nonelderly patients with cancer receiving chemotherapy between 2001 and 2011. It found a large increase in the use of targeted intravenous anticancer medications and a gradual increase in targeted oral anticancer medications; targeted therapies accounted for 63 percent of all chemotherapy expenditures in 2011.
AHRQ-funded; HS018535; HS020263.
Citation: Shih YC, Smieliauskas F, Geynisman DM .
Trends in the cost and use of targeted cancer therapies for the privately insured nonelderly: 2001 to 2011.
J Clin Oncol 2015 Jul 1;33(19):2190-6. doi: 10.1200/jco.2014.58.2320..
Keywords: Healthcare Costs, Cancer, Health Insurance, Medication
Yazdany J, Dudley RA, Chen R
Coverage for high-cost specialty drugs for rheumatoid arthritis in Medicare Part D.
The aim of this study was to conduct the first systematic, national investigation of how Part D plans cover biologic disease-modifying anti-rheumatic drugs (DMARDs) and to determine patients’ financial burden under current cost-sharing structures. It found that all Medicare Part D drug plans cover at least 1 biologic DMARD, access is highly controlled through prior authorization requirements, and beneficiaries face significant cost sharing.
AHRQ-funded; HS017723; HS016772.
Citation: Yazdany J, Dudley RA, Chen R .
Coverage for high-cost specialty drugs for rheumatoid arthritis in Medicare Part D.
Arthritis Rheumatol 2015 Jun;67(6):1474-80. doi: 10.1002/art.39079..
Keywords: Medicare, Medication, Healthcare Costs, Arthritis
Conti RM, Padula WV, Larson RA
Changing the cost of care for chronic myeloid leukemia: the availability of generic imatinib in the USA and the EU.
This article discusses various issues associated with potential impact on health system spending levels for chronic myeloid leukemia after generic imatinib becomes available. Included is a review of their implications for the development of country-specific cost-effectiveness models to predict the implications for cost and quality of care from generic imatinib.
AHRQ-funded; HS023710.
Citation: Conti RM, Padula WV, Larson RA .
Changing the cost of care for chronic myeloid leukemia: the availability of generic imatinib in the USA and the EU.
Ann Hematol 2015 Apr;94 Suppl 2:S249-57. doi: 10.1007/s00277-015-2319-x..
Keywords: Cancer, Medication, Healthcare Costs
Predmore ZS, Mattke S, Horvitz-Lennon M
Improving antipsychotic adherence among patients with schizophrenia: savings for states.
The authors presented findings of an analysis conducted to quantify the potential net savings to state budgets from interventions to improve adherence to antipsychotic drugs among patients with schizophrenia. Their financial model estimated an annual cost of $21.4 billion (in 2013 dollars) to Medicaid programs and other state agencies for people with schizophrenia. They concluded that better adherence could yield annual net savings of $3.28 billion to states and recommended that states consider interventions shown to increase medication adherence in this patient group.
AHRQ-funded; HS000029.
Citation: Predmore ZS, Mattke S, Horvitz-Lennon M .
Improving antipsychotic adherence among patients with schizophrenia: savings for states.
Psychiatr Serv 2015 Apr;66(4):343-5. doi: 10.1176/appi.ps.201400506.
.
.
Keywords: Healthcare Costs, Medication, Behavioral Health, Patient Adherence/Compliance
Adams AS, Soumerai SB, Zhang F
Effects of eliminating drug caps on racial differences in antidepressant use among dual enrollees with diabetes and depression.
This study aimed to evaluate the impact of removing a significant financial barrier to prescription medications (drug caps) on existing black-white disparities in antidepressant treatment rates among patients with diabetes and comorbid depression. It found that policies that remove financial barriers to medications may increase depression treatment rates among patients with diabetes overall while exacerbating treatment disparities.
AHRQ-funded; HS018577; HS018072.
Citation: Adams AS, Soumerai SB, Zhang F .
Effects of eliminating drug caps on racial differences in antidepressant use among dual enrollees with diabetes and depression.
Clin Ther 2015 Mar;37(3):597-609. doi: 10.1016/j.clinthera.2014.12.011..
Keywords: Medication, Disparities, Depression, Diabetes, Healthcare Costs
Prentice JC, Conlin PR, Gellad WF
Long-term outcomes of analogue insulin compared with NPH for patients with type 2 diabetes mellitus.
The researchers compared the effects of neutral protamine Hagedorn (NPH) and long-acting insulin analogues on long-term outcomes. They found no consistent difference in long-term health outcomes when comparing use of long-acting insulin analogues and NPH insulin. The higher cost of analogue insulin without demonstrable clinical benefit raises questions of its cost effectiveness in the treatment of patients with diabetes.
AHRQ-funded; HS019708.
Citation: Prentice JC, Conlin PR, Gellad WF .
Long-term outcomes of analogue insulin compared with NPH for patients with type 2 diabetes mellitus.
Am J Manag Care 2015 Mar;21(3):e235-43..
Keywords: Comparative Effectiveness, Diabetes, Healthcare Costs, Medication, Outcomes
Davidoff AJ, Hendrick FB, Zeidan AM
AHRQ Author: Davidoff AJ
Patient cost sharing and receipt of erythropoiesis-stimulating agents through Medicare part D.
This study examined use of erythropoiesis-stimulating agents (ESAs) to manage anemia in patients with myelodysplastic syndromes (MDS). It found that few patients with MDS received ESAs through Part D. OOP payments required under Part D were substantially higher than under Part B. Cost sharing, as reflected by low-income subsidy receipt, likely affected decisions to prescribe ESAs outside of the physician office.
AHRQ-authored.
Citation: Davidoff AJ, Hendrick FB, Zeidan AM .
Patient cost sharing and receipt of erythropoiesis-stimulating agents through Medicare part D.
J Oncol Pract 2015 Mar;11(2):e190-8. doi: 10.1200/jop.2014.001527..
Keywords: Elderly, Healthcare Costs, Medicare, Medication
Zhang Y, Baik SH, Newhouse JP
Use of intelligent assignment to Medicare Part D plans for people with schizophrenia could produce substantial savings.
The investigators simulated Medicare Part D savings from replacing random assignment with an "intelligent assignment" algorithm that would assign beneficiaries to the least expensive plan in 2010 based on their drug usage in the previous year. They found that intelligent assignment could have saved about $150 million for Medicare and beneficiaries with schizophrenia combined in 2010.
AHRQ-funded; HS018657.
Citation: Zhang Y, Baik SH, Newhouse JP .
Use of intelligent assignment to Medicare Part D plans for people with schizophrenia could produce substantial savings.
Health Aff 2015 Mar;34(3):455-60. doi: 10.1377/hlthaff.2014.1227.
.
.
Keywords: Healthcare Costs, Medicare, Medication, Behavioral Health