National Healthcare Quality and Disparities Report
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- Access to Care (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 7 of 7 Research Studies DisplayedWatnick S, Blake PG, Mehrotra R
System-level strategies to improve home dialysis: policy levers and quality initiatives.
This article discusses trends in home dialysis use, reviews the evolving understanding of what constitutes high quality care for the home dialysis population (as well as how this can be measured), and discusses policy and advocacy efforts that continue to shape the care of US patients, and compares with experiences in other countries. The authors conclude by discussing future directions for quality and advocacy efforts.
AHRQ-funded; HS028684.
Citation: Watnick S, Blake PG, Mehrotra R .
System-level strategies to improve home dialysis: policy levers and quality initiatives.
Clin J Am Soc Nephrol 2023 Dec; 18(12):1616-25. doi: 10.2215/cjn.0000000000000299..
Keywords: Home Healthcare, Kidney Disease and Health, Policy, Quality Improvement, Quality of Care
Chang SH, Wang M, Liu X
Racial/ethnic disparities in access and outcomes of simultaneous liver-kidney transplant among liver transplant candidates with renal dysfunction in the United States.
Since the Model for End-stage Liver Disease (MELD) allocation system was implemented, the proportion of simultaneous liver-kidney transplantation (SLKT) has increased significantly. The investigators study whether racial/ethnic disparities exist in access to SLKT and post-SLKT survival. The investigators concluded that in the MELD era, racial/ethnic differences exist in access and survival of SLKT for patients with renal dysfunction at listing for LT.
AHRQ-funded; HS022330.
Citation: Chang SH, Wang M, Liu X .
Racial/ethnic disparities in access and outcomes of simultaneous liver-kidney transplant among liver transplant candidates with renal dysfunction in the United States.
Transplantation 2019 Aug;103(8):1663-74. doi: 10.1097/tp.0000000000002574..
Keywords: Access to Care, Disparities, Kidney Disease and Health, Outcomes, Policy, Transplantation
Ashlagi I, Bingaman A, Burq M
Effect of match-run frequencies on the number of transplants and waiting times in kidney exchange.
Many U.S. kidney paired donation (KPD) registries have gradually shifted to high-frequency match-runs, raising the question of whether this harms the number of transplants. The authors conducted simulations and found that longer intervals between match-runs do not increase the total number of transplants, and that prioritizing highly sensitized patients is more effective than waiting longer between match-runs for transplanting these patients. Further, increasing arrival rates of new pairs improves both the fraction of transplanted pairs and waiting times.
AHRQ-funded; HS020610.
Citation: Ashlagi I, Bingaman A, Burq M .
Effect of match-run frequencies on the number of transplants and waiting times in kidney exchange.
Am J Transplant 2018 May;18(5):1177-86. doi: 10.1111/ajt.14566..
Keywords: Transplantation, Kidney Disease and Health, Health Services Research (HSR), Policy, Registries
Rees MA, Dunn TB, Kuhr CS
Kidney exchange to overcome financial barriers to kidney transplantation.
Organ shortage is the major limitation to kidney transplantation in the developed world. This proposal leverages the cost savings achieved through earlier transplantation over dialysis to fund the cost of kidney exchange between developed-world patient-donor pairs with immunological barriers and developing-world patient-donor pairs with financial barriers.
AHRQ-funded; HS020610.
Citation: Rees MA, Dunn TB, Kuhr CS .
Kidney exchange to overcome financial barriers to kidney transplantation.
Am J Transplant 2017 Mar;17(3):782-90. doi: 10.1111/ajt.14106.
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Keywords: Transplantation, Healthcare Costs, Policy, Kidney Disease and Health, Kidney Disease and Health
Erickson KF, Winkelmayer WC, Chertow GM
Hemodialysis hospitalizations and readmissions: the effects of payment reform.
The researchers used a retrospective cohort interrupted time-series study design to examine whether the 2004 nephrologist reimbursement reform led to reduced hospitalizations and rehospitalizations. They found no significant change in all-cause hospitalization or rehospitalization and slight reductions in fluid overload hospitalization and rehospitalization following reimbursement reform.
AHRQ-funded; HS019178.
Citation: Erickson KF, Winkelmayer WC, Chertow GM .
Hemodialysis hospitalizations and readmissions: the effects of payment reform.
Am J Kidney Dis 2017 Feb;69(2):237-46. doi: 10.1053/j.ajkd.2016.08.033.
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Keywords: Hospital Readmissions, Hospitalization, Kidney Disease and Health, Payment, Policy
Melcher ML, Roberts JP, Leichtman AB
Utilization of deceased donor kidneys to initiate living donor chains.
The authors proposed that some deceased donor kidneys be allocated to initiate nonsimultaneous extended altruistic donor chains of living donor kidney transplants. They hypothesized that a pilot program would show a positive impact on patients of all ethnicities and blood types.
AHRQ-funded; HS020610.
Citation: Melcher ML, Roberts JP, Leichtman AB .
Utilization of deceased donor kidneys to initiate living donor chains.
Am J Transplant 2016 May;16(5):1367-70. doi: 10.1111/ajt.13740.
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Keywords: Healthcare Delivery, Kidney Disease and Health, Policy, Transplantation
Davis AE, Mehrotra S, Kilambi V
The effect of the Statewide Sharing variance on geographic disparity in kidney transplantation in the United States.
This study examined the effect of Statewide Sharing on geographic allocation disparity over time between donor service areas (DSAs) within Tennessee and Florida and compared them with geographic disparity between the DSAs within a state for all states with more than one DSA (California, New York, North Carolina, Ohio, Pennsylvania, Texas, and Wisconsin). Findings suggested that changes which are untested run the risk of unintended consequences, and Statewide Sharing should be further studied and considered.
AHRQ-funded; HS021078.
Citation: Davis AE, Mehrotra S, Kilambi V .
The effect of the Statewide Sharing variance on geographic disparity in kidney transplantation in the United States.
Clin J Am Soc Nephrol 2014 Aug 7;9(8):1449-60. doi: 10.2215/cjn.05350513.
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Keywords: Chronic Conditions, Disparities, Kidney Disease and Health, Policy, Transplantation