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
1 to 25 of 62 Research Studies DisplayedGanguli I, Mackwood MB, Yang CW
Racial differences in low value care among older adult Medicare patients in US health systems: retrospective cohort study.
The objective of this retrospective cohort study was to characterize racial differences in receipt of low-value care among older Medicare beneficiaries overall and within U.S. health systems. Medicare fee-for-service administrative data was used for Black and White Medicare patients who were at least 65 as of 2016. Findings showed that, of the 40 low value services examined, Black patients had a higher adjusted receipt of 9 services and lower receipt of 20 services than White patients. Differences were generally small and largely due to differential care within health systems, but the authors concluded that their findings suggested potential factors that researchers, policymakers, and health system leaders might investigate to improve health care quality and equity.
AHRQ-funded; HS024930.
Citation: Ganguli I, Mackwood MB, Yang CW .
Racial differences in low value care among older adult Medicare patients in US health systems: retrospective cohort study.
BMJ 2023 Oct 25; 383:e074908. doi: 10.1136/bmj-2023-074908..
Keywords: Elderly, Racial and Ethnic Minorities, Medicare, Health Systems
Hua Y, Temkin-Greener H, Cai S
Primary care telemedicine use among assisted living residents with dementia during COVID-19: race and dual enrollment status.
The purpose of this study was to explore primary care telemedicine use among Medicare beneficiaries with Alzheimer’s disease and related dementias (ADRD) who resided in Assisted Living Facilities (Als) during the early stage of the COVID-19 pandemic, with a focus on possible racial and socioeconomic differences. The study found that at the start of the pandemic in quarter 2 of 2020, Black residents were less likely to have telemedicine visits than their White counterparts. In the following two quarters, Black residents were more likely to receive primary care via telemedicine than White residents; a similar difference was observed between Hispanic and White residents, but with smaller effect sizes. Compared with nondual residents, dual residents were more likely to receive primary care via telemedicine in Q3. In addition, residents in AL communities with a higher proportion of dual residents, compared with those in low-dual ALs, were less likely to receive primary care via telemedicine throughout the study period. However, the difference in telemedicine use between higher vs lower dual ALs narrowed over time.
AHRQ-funded; HS026893.
Citation: Hua Y, Temkin-Greener H, Cai S .
Primary care telemedicine use among assisted living residents with dementia during COVID-19: race and dual enrollment status.
J Am Med Dir Assoc 2023 Aug; 24(8):1157-58.e3. doi: 10.1016/j.jamda.2023.05.005..
Keywords: COVID-19, Primary Care, Telehealth, Health Information Technology (HIT), Nursing Homes, Long-Term Care, Dementia, Neurological Disorders, Racial and Ethnic Minorities, Elderly
Enzinger AC, Ghosh K, Keating NL
Racial and ethnic disparities in opioid access and urine drug screening among older patients with poor-prognosis cancer near the end of life.
This research characterized racial and ethnic disparities and trends in opioid access and urine drug screening (UDS) among older patients dying of cancer, and to explore potential mechanisms. Among 18,549 non-Hispanic White (White), Black, and Hispanic Medicare decedents older than 65 years with poor-prognosis cancers, the authors examined 2007-2019 trends in opioid prescription fills and potency (morphine milligram equivalents [MMEs] per day [MMEDs]) near the end of life (EOL), defined as 30 days before death or hospice enrollment. They found that between 2007 and 2019, White, Black, and Hispanic decedents experienced steady declines in EOL opioid access and rapid expansion of UDS. Compared with White patients, Black and Hispanic patients were less likely to receive any opioid (Black, -4.3 percentage points; Hispanic, -3.6 percentage points) and long-acting opioids (Black, -3.1 percentage points; Hispanic, -2.2 percentage points). They also received lower daily doses (Black, -10.5 MMED; Hispanic, -9.1 MMED) and lower total doses (Black, -210 MMEs; Hispanic, -179 MMEs). Black patients were also more likely to undergo UDS (0.5 percentage points).
AHRQ-funded; HS024072.
Citation: Enzinger AC, Ghosh K, Keating NL .
Racial and ethnic disparities in opioid access and urine drug screening among older patients with poor-prognosis cancer near the end of life.
J Clin Oncol 2023 May 10; 41(14):2511-22. doi: 10.1200/jco.22.01413..
Keywords: Elderly, Opioids, Medication, Cancer, Racial and Ethnic Minorities, Disparities, Access to Care
Sanghavi P, Chen Z
Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings.
The purpose of this study was to evaluate the relationship between nursing home characteristics and reporting of 2 of 3 specific clinical outcomes reported by the Nursing Home Care Compare (NHCC) website: major injury falls and pressure ulcers. The researchers of this quality improvement study utilized hospitalization data for all Medicare fee-for-service beneficiaries between January 1, 2011, and December 31, 2017. Hospital admission claims for major injury falls and pressure ulcers were linked with facility-reported evaluations at the nursing home resident level. For each linked hospital claim, it was determined whether the nursing home had reported the event and rates of reporting were computed. To evaluate whether nursing homes reported similarly on both measures, the researchers estimated the relationship between reporting of major injury falls and pressure ulcers within a nursing home, and explored racial and ethnic disparities that could otherwise explain the associations. The study sample included 13,179 nursing homes where 131,000 residents experienced major injury fall or pressure ulcer hospitalizations. Of the 98,669 major injury fall hospitalizations, 60.0% were reported, and of the 39,894 stage 3 or 4 pressure ulcer hospitalizations, 67.7% were reported. Underreporting for both conditions was pervasive, with 69.9% and 71.7% of nursing homes having reporting rates less than 80% for major injury fall and pressure ulcer hospitalizations, respectively. Lower reporting rates had few correlations with facility characteristics other than racial and ethnic composition. Facilities with high vs low fall reporting rates had significantly more White residents (86.9% vs 73.3%), and facilities with high vs low pressure ulcer reporting rates had significantly fewer White residents (69.7% vs 74.9%).
AHRQ-funded; HS026957.
Citation: Sanghavi P, Chen Z .
Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings.
JAMA Netw Open 2023 May; 6(5):e2314822. doi: 10.1001/jamanetworkopen.2023.14822..
Keywords: Quality Measures, Quality of Care, Elderly, Disparities, Racial and Ethnic Minorities, Nursing Homes, Pressure Ulcers, Healthcare-Associated Infections (HAIs), Quality Indicators (QIs), Long-Term Care
Zuo SW, Ackenbom MF, Harris J
Racial differences in urinary catheter use among female nursing home residents.
This study assessed racial differences in prevalence of indwelling urinary catheterization and intermittent catheterization among female nursing home (NH) residents in the US. This cross-sectional analysis used the 2019 Minimum Data Set 3.0 and looked at a cohort of 597,966 women predominantly White race with a median age of 80 years. Eight percent of female residents had indwelling catheters, and 0.5% used intermittent catheterization. Black residents had a 7% lower odds of having an indwelling catheter, and a 38% lower odds of utilizing intermittent catheterization compared to White residents when controlling for common factors associated with catheter use.
AHRQ-funded; HS026943.
Citation: Zuo SW, Ackenbom MF, Harris J .
Racial differences in urinary catheter use among female nursing home residents.
Urology 2023 Feb; 172:105-10. doi: 10.1016/j.urology.2022.11.026..
Keywords: Elderly, Racial and Ethnic Minorities, Nursing Homes, Women
Temkin-Greener H, Mao Y, McGarry B
Health care use and outcomes in assisted living communities: race, ethnicity, and dual eligibility.
The purpose of this study was to examine the type and quality of care received in residential long-term care setting by racial/ ethnic minorities or residents eligible for dual Medicare and Medicaid. With 2018 Medicare data, the researchers identified 255,564 fee-for-service Medicare beneficiaries over the age of 55 who were living in 24,108 assisted living facilities across the United States and evaluated the relationship between race/ethnicity and dual status with emergency room use, inpatient hospital admission, 30-day readmission, and placement in a nursing home. The study found variations within and across assisted living facilities for racial/ethnic minority and dual residents, suggesting that outcome disparities are the most significant by dual eligibility status instead of only race/ ethnicity. The researchers concluded that these results can be used to inform and guide future research, as well as healthcare providers and policy makers.
AHRQ-funded; HS026893.
Citation: Temkin-Greener H, Mao Y, McGarry B .
Health care use and outcomes in assisted living communities: race, ethnicity, and dual eligibility.
Med Care Res Rev 2022 Aug;79(4):500-10. doi: 10.1177/10775587211050189..
Keywords: Elderly, Racial and Ethnic Minorities, Long-Term Care, Medicare
Givan A, Downer B, Chou LN
Cognitive impairment and low physical function among older Mexican Americans: findings from a 20-year follow-up(☆).
This longitudinal study’s aim was to examine the association between cognitive impairment and low physical function over a 20-year follow-up period among Mexican Americans aged 65 and older. The final sample included 1545 community-dwelling Mexican Americans from the Hispanic Established Population for the Epidemiological Study of the Elderly, who scored moderate-high on Short Physical Performance Battery (SPPB) and were non-disabled at baseline (1993/94). The Mini Mental State Examination scale defines cognitive impairment as less than 21 points. General Estimating Equation was used to estimate the odds of having low physical function (defined with the SPPB at <7 points) over time as a function of cognitive impairment, adjusting for socio-demographics, self-reported medical conditions, body mass index, and depressive symptoms. Participants with cognitive impairment had increased odds of lower physical function over time compared to those without cognitive impairment.
AHRQ-funded; HS026133.
Citation: Givan A, Downer B, Chou LN .
Cognitive impairment and low physical function among older Mexican Americans: findings from a 20-year follow-up(☆).
Ann Epidemiol 2022 Jun;70:9-15. doi: 10.1016/j.annepidem.2022.03.006..
Keywords: Elderly, Racial and Ethnic Minorities, Neurological Disorders
Temkin-Greener H, Guo W, Hua Y
End-of-life care in assisted living communities: race and ethnicity, dual enrollment status, and state regulations.
The purpose of this study was to evaluate the relationships between death at home and home hospice care with race, ethnicity, community characteristics, strictness of state-level regulations for assisted living facilities, dual Medicare-Medicaid enrollment, and other individual characteristics. The researchers found that almost 60% of the 100,783 fee-for-service Medicare beneficiaries residing in 16,560 assisted living communities who died in 2018-2019, died at home. Of those individuals, 84% were with home hospice care. Dual Medicare-Medicaid enrollment was a more important predictor of death at home than race or ethnicity; yet race was a stronger predictor than dual enrollment for hospice care at death. In states with lower regulatory strictness for assisted living communities, residents were less likely to die at home. The study concludes that these results imply an important role for state regulation of assisted living facilities and can help guide efforts to ensure equitable access to the individual’s preference for end-of-life-care.
Citation: Temkin-Greener H, Guo W, Hua Y .
End-of-life care in assisted living communities: race and ethnicity, dual enrollment status, and state regulations.
Health Aff 2022 May;41(5):654-62. doi: 10.1377/hlthaff.2021.01677..
Keywords: Elderly, Palliative Care, Long-Term Care, Racial and Ethnic Minorities
Kurasz AM, Smith GE, Curiel RE
Patient values in healthcare decision making among diverse older adults.
This study investigated the types of values that culturally diverse older adults incorporate in medical decision making. Focus groups were held with 49 individuals, 49% with mild cognitive impairment, and 51% Hispanic. Participants described barriers and facilitators that interfere with or promote value solicitation and incorporation. A wide range of values relating to individual factors, familial/cultural beliefs and expectations, balancing risks and benefits, receiving decisional support, and considering values other than their own were expressed. Participants also emphasized that values are individual-specific, influenced by aging, and change throughout life.
AHRQ-funded; HS024159.
Citation: Kurasz AM, Smith GE, Curiel RE .
Patient values in healthcare decision making among diverse older adults.
Patient Educ Couns 2022 May;105(5):1115-22. doi: 10.1016/j.pec.2021.08.031..
Keywords: Elderly, Shared Decision Making, Racial and Ethnic Minorities
Fashaw-Walters SA, McCreedy E, Bynum JPW
Disproportionate increases in schizophrenia diagnoses among Black nursing home residents with ADRD.
Investigators examined how race and Alzheimer's and related dementia (ADRD) status influenced the rate of schizophrenia diagnoses among nursing home (NH) residents following the CMS National Partnership to Improve Dementia Care. Using 2011-2015 Minimum Data Set 3.0 assessments, they found that, following the partnership, black NH residents with ADRD were more likely to have a schizophrenia diagnosis documented on their minimum data set assessments, and schizophrenia rates increased for black NH residents with ADRD only.
AHRQ-funded; HS000011.
Citation: Fashaw-Walters SA, McCreedy E, Bynum JPW .
Disproportionate increases in schizophrenia diagnoses among Black nursing home residents with ADRD.
J Am Geriatr Soc 2021 Dec;69(12):3623-30. doi: 10.1111/jgs.17464..
Keywords: Elderly, Dementia, Nursing Homes, Racial and Ethnic Minorities, Long-Term Care
Werner RM, Templeton Z, Apathy N
Trends in post-acute care in US nursing homes: 2001-2017.
The purpose of this retrospective cohort study was to describe recent trends in post-acute care provision within nursing homes, focusing specifically on nursing homes' degree of specialization in post-acute care. The investigators concluded that over the last 2 decades, post-acute care has become increasingly concentrated in a subset of nursing homes, which tend to be for-profit, part of a chain, and less likely to serve racial and ethnic minorities and persons on Medicaid.
AHRQ-funded; HS026116.
Citation: Werner RM, Templeton Z, Apathy N .
Trends in post-acute care in US nursing homes: 2001-2017.
J Am Med Dir Assoc 2021 Dec;22(12):2491-95.e2. doi: 10.1016/j.jamda.2021.06.015..
Keywords: Elderly, Nursing Homes, Racial and Ethnic Minorities
Herb J, Staley BS, Roberson M
Use and disparities in parathyroidectomy for symptomatic primary hyperparathyroidism in the Medicare population.
The investigators’ objective was to determine national usage and disparities in parathyroidectomy for symptomatic primary hyperparathyroidism among insured older adults. Data was obtained using Medicare claims. They found that parathyroidectomy was underused and recommended that quality improvement efforts, rooted in equitable care, be undertaken to increase access to parathyroidectomy for this disease.
AHRQ-funded; HS000032.
Citation: Herb J, Staley BS, Roberson M .
Use and disparities in parathyroidectomy for symptomatic primary hyperparathyroidism in the Medicare population.
Surgery 2021 Nov;170(5):1376-82. doi: 10.1016/j.surg.2021.05.026..
Keywords: Elderly, Disparities, Medicare, Surgery, Racial and Ethnic Minorities
Smith JM, Lin H, Thomas-Hawkins C
Timing of home health care initiation and 30-day rehospitalizations among Medicare beneficiaries with diabetes by race and ethnicity.
Older adults with diabetes are at elevated risk of complications following hospitalization. Home health care services mitigate the risk of adverse events and facilitate a safe transition home. In the United States, when home health care services are prescribed, federal guidelines require they begin within two days of hospital discharge. This study examined the association between timing of home health care initiation and 30-day rehospitalization outcomes in a cohort of 786,734 Medicare beneficiaries following a diabetes-related index hospitalization admission during 2015.
AHRQ-funded; HS022406.
Citation: Smith JM, Lin H, Thomas-Hawkins C .
Timing of home health care initiation and 30-day rehospitalizations among Medicare beneficiaries with diabetes by race and ethnicity.
Int J Environ Res Public Health 2021 May 25;18(11). doi: 10.3390/ijerph18115623..
Keywords: Elderly, Home Healthcare, Hospital Readmissions, Medicare, Diabetes, Chronic Conditions, Racial and Ethnic Minorities
Smith JM, Jarrín OF, Lin H
Racial disparities in post-acute home health care referral and utilization among older adults with diabetes.
The purpose of this study was to examine the association between race/ethnicity and hospital discharge to home health care and subsequent utilization of home health care among a cohort of adults (age 50 and older) who experienced a diabetes-related hospitalization. The investigators found that among those discharged to home health care, all non-white racial/ethnic minority patients were less likely to receive services within 14-days.
AHRQ-funded; HS022406.
Citation: Smith JM, Jarrín OF, Lin H .
Racial disparities in post-acute home health care referral and utilization among older adults with diabetes.
Int J Environ Res Public Health 2021 Mar 19;18(6):3196. doi: 10.3390/ijerph18063196..
Keywords: Elderly, Home Healthcare, Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Disparities, Access to Care, Healthcare Utilization
Odlum M, Moise N, Kronish IM
Trends in poor health indicators among Black and Hispanic middle-aged and older adults in the United States, 1999-2018.
This study used records extracted from the Behavioral Risk Factor Surveillance System to determine which health indicators have improved or became worse among Black and Hispanic middle-aged (45 and older) adults compared to Whites from 1999 to 2018. This data is required by the Minority Health and Health Disparities Research and Education Act of 2000. A sample included of 4,856,326 participants, of them 60.9% women, mean age 60.4. During the last 20 years, Black adults showed an overall decrease showing improvement in uninsured status and physical inactivity while showing an overall increase in hypertension, diabetes, asthma, and stroke, and also the same increases and decreases in the Black-White gap. Hispanic adults showed improvement in physical inactivity and perceived poor health, while they showed overall deterioration in hypertension and diabetes. The Hispanic-White gap improved in coronary heart disease, stroke, kidney disease, asthma, arthritis, depression and physical inactivity while it increased for diabetes, hypertension, and uninsured status.
AHRQ-funded; HS025198.
Citation: Odlum M, Moise N, Kronish IM .
Trends in poor health indicators among Black and Hispanic middle-aged and older adults in the United States, 1999-2018.
JAMA Netw Open 2020 Nov 2;3(11):e2025134. doi: 10.1001/jamanetworkopen.2020.25134..
Keywords: Elderly, Racial and Ethnic Minorities, Disparities, Health Status, Health Insurance, Diabetes, Blood Pressure, Chronic Conditions
Shah SC, McKinley M, Gupta S
Population-based analysis of differences in gastric cancer incidence among races and ethnicities in individuals age 50 years and older.
There are racial and ethnic differences in the incidence of gastric adenocarcinoma worldwide and in the US. Based on a decision analysis, screening for noncardia gastric adenocarcinoma might be cost-effective for non-White individuals 50 years or older. In this study, the investigators aimed to estimate the differences in gastric adenocarcinoma incidence in specific anatomic sites among races and ethnicities in individuals 50 years or older.
AHRQ-funded; HS026395.
Citation: Shah SC, McKinley M, Gupta S .
Population-based analysis of differences in gastric cancer incidence among races and ethnicities in individuals age 50 years and older.
Gastroenterology 2020 Nov;159(5):1705-14.e2. doi: 10.1053/j.gastro.2020.07.049..
Keywords: Elderly, Cancer, Digestive Disease and Health, Racial and Ethnic Minorities, Disparities
Roberts ET, Mehrotra A
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
In this study, the investigators examined disparities in digital access (ie, access at home to technology that enables video telemedicine visits) among Medicare beneficiaries by socioeconomic and demographic characteristics. The investigators concluded that the proportion of beneficiaries who lacked digital access was higher among those with low socioeconomic status, those 85 years or older, and in communities of color.
AHRQ-funded; HS026727.
Citation: Roberts ET, Mehrotra A .
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
JAMA Intern Med 2020 Oct;180(10):1386-89. doi: 10.1001/jamainternmed.2020.2666..
Keywords: Elderly, Medicare, Telehealth, Health Information Technology (HIT), Disparities, Access to Care, Social Determinants of Health, Low-Income, Racial and Ethnic Minorities
Dos Santos Marques IC, Theiss LM, Baker SJ
Low health literacy exists in the inflammatory bowel disease (IBD) population and is disproportionately prevalent in older African Americans.
This study assessed the prevalence of low health literacy rates among adult patients with inflammatory bowel disease (IBD) in a diverse population and identified risk factors for low health literacy. IBD patients at a single institution from November 2017 to May 2018 were assessed for health literacy using the Newest Vital Sign (NWS). Secondary outcomes were length-of-stay (LOS) and 30-day readmissions after surgery. There were 175 patients surveyed who were 59% female, 23% African Americans, 91% with Crohn’s disease, and mean age was 46. Overall the low health literacy rate was 24%, with African Americans having a higher prevalence (47.5%) versus 17.0% for white IBD patients. Low health literacy was associated with older age and African American race. There were no significant differences between LOS and readmissions rates by health literacy levels.
AHRQ-funded; HS023009.
Citation: Dos Santos Marques IC, Theiss LM, Baker SJ .
Low health literacy exists in the inflammatory bowel disease (IBD) population and is disproportionately prevalent in older African Americans.
Crohns Colitis 360 2020 Oct;2(4). doi: 10.1093/crocol/otaa076..
Keywords: Elderly, Health Literacy, Digestive Disease and Health, Racial and Ethnic Minorities, Chronic Conditions
Li J, Qi M, Werner RM
Assessment of receipt of the first home health care visit after hospital discharge among older adults.
Investigators examined how often patients referred to home health care at hospital discharge receive it and whether there is evidence of disparities. Their study used Medicare data regarding the postacute home health care setting; participants were Medicare fee-for-service and Medicare Advantage beneficiaries discharged from the hospital with a referral to home health care. They found that only 54% of patients discharged received home health care services within 14 days of discharge. Of the remaining 46% discharged, 37.7% never received any home health care, while 8.3% were institutionalized or died within 14 days without a preceding home health care visit. Patients who were Black or Hispanic received home health at lower rates than did patients who were White. They concluded that disparities in the use of home health care remain an issue in the US.
AHRQ-funded; HS024266; HS026836.
Citation: Li J, Qi M, Werner RM .
Assessment of receipt of the first home health care visit after hospital discharge among older adults.
JAMA Netw Open 2020 Sep;3(9):e2015470. doi: 10.1001/jamanetworkopen.2020.15470..
Keywords: Elderly, Hospital Discharge, Home Healthcare, Disparities, Access to Care, Racial and Ethnic Minorities
Li Y, Temkin-Greener H, Shan G
COVID-19 infections and deaths among Connecticut nursing home residents: facility correlates.
This study looked at the relationship between higher registered nurse (RN) staffing, quality ratings, the concentration of Medicaid residents or racial/ethnic minorities; and the number of COVID-19 confirmed cases and deaths at nursing homes. All Connecticut nursing homes (n = 215) were included in the study. As of April 16, 2020, the average number of confirmed cases was 8 per nursing home (zero in 107 facilities) and the number of confirmed deaths was 1.7 per nursing (zero in 131 facilities). In nursing homes with at least one death, every 20-minute increase in RN staffing significantly predicted 26% fewer COVID-19 deaths and was associated with 22% fewer confirmed cases. Facilities with a high concentration of Medicaid residents or racial/ethnic minority residents had 16% and 15% more confirmed cases.
AHRQ-funded; HS024923; HS026893.
Citation: Li Y, Temkin-Greener H, Shan G .
COVID-19 infections and deaths among Connecticut nursing home residents: facility correlates.
J Am Geriatr Soc 2020 Sep;68(9):1899-906. doi: 10.1111/jgs.16689..
Keywords: Elderly, COVID-19, Nursing Homes, Long-Term Care, Mortality, Racial and Ethnic Minorities
Fashaw S, Chisholm L, Mor V
Inappropriate antipsychotic use: the impact of nursing home socioeconomic and racial composition.
Researchers examined how nursing home characteristics, particularly the racial and socioeconomic composition of residents, are associated with the inappropriate use of antipsychotics, using national data from Long-Term Care: Facts on Care. They found an overall decline in the use of antipsychotics. Although findings indicated facilities with higher proportions of blacks had lower inappropriate antipsychotic use, facility-level socioeconomic disparities continued to persist among nursing homes. They recommended that policy interventions focusing on reimbursement be considered to promote reductions in antipsychotic use, specifically among Medicaid-reliant nursing homes.
ARHQ-funded; HS000011.
Citation: Fashaw S, Chisholm L, Mor V .
Inappropriate antipsychotic use: the impact of nursing home socioeconomic and racial composition.
J Am Geriatr Soc 2020 Mar;68(3):630-36. doi: 10.1111/jgs.16316..
Keywords: Nursing Homes, Long-Term Care, Elderly, Medication, Medication: Safety, Social Determinants of Health, Disparities, Racial and Ethnic Minorities
Davis SN, Wischhusen JW, Sutton SK
Demographic and psychosocial factors associated with limited health literacy in a community-based sample of older Black Americans.
This study examined the frequency of limited health literacy and demographic and psychosocial factors associated with limited health literacy in a sample of older black Americans. The participants enrolled in a community-based intervention to promote colorectal cancer screening and completed baseline surveys that assessed their health literacy using the Rapid Estimate of Adult Literacy in Medicine, Revised (REALM-R) test, CRC awareness, cancer fatalism, Preventive Health Model (PHM) constructs, and demographics. Findings showed that limited health literacy was associated with multiple complex factors. Recommendations include interventions to incorporate patient health literacy and low-literacy materials that can be delivered through multiple channels.
AHRQ-funded; HS026120.
Citation: Davis SN, Wischhusen JW, Sutton SK .
Demographic and psychosocial factors associated with limited health literacy in a community-based sample of older Black Americans.
Patient Educ Couns 2020 Feb;103(2):385-91. doi: 10.1016/j.pec.2019.08.026..
Keywords: Health Literacy, Racial and Ethnic Minorities, Elderly, Screening, Cancer: Colorectal Cancer, Cancer, Prevention
Vu JV, Gunaseelan V, Dimick JB
Mechanisms of age and race differences in receiving minimally invasive inguinal hernia repair.
Black patients and older adults are less likely to receive minimally invasive hernia repair. In this study, the investigators explored the association between race, age, and surgeon utilization of minimally invasive surgery (MIS) with the likelihood of receiving MIS inguinal hernia repair. The investigators concluded that race differences were explained by surgeon MIS utilization, implicating access to MIS-performing surgeon as a mediator. Conversely, age disparity was independent of MIS utilization, even after adjusting for comorbidities, indicating some degree of provider bias against performing MIS repair in older patients.
AHRQ-funded; HS025778.
Citation: Vu JV, Gunaseelan V, Dimick JB .
Mechanisms of age and race differences in receiving minimally invasive inguinal hernia repair.
Surg Endosc 2019 Dec;33(12):4032-37. doi: 10.1007/s00464-019-06695-0..
Keywords: Racial and Ethnic Minorities, Surgery, Elderly, Access to Care, Healthcare Utilization
Goins RT, Jones J, Schure M
Type 2 diabetes management among older American Indians: beliefs, attitudes, and practices.
This study’s purpose was to examine beliefs, attitudes, and practices of older Native Americans regarding type 2 diabetes mellitus (T2DM) management. This disease is one the leading causes of morbidity and mortality among Native Americans, and they are twice as likely to have T2DM, and over three times the mortality rate from T2DM as Whites. Semi-structured in-depth qualitative interviews were conducted with 28 participants with a mean age of 73 years, with 57% female. Participants’ mean confidence score of their T2DM management was 8.0 on a scale of 1 to 10 and their mean Hb1Ac was 7.3.%. Overall 5 themes were discussed: sociocultural factors, causes and consequences, cognitive and affective assessment, diet and exercise, and medical management.
AHRQ-funded; HS000078.
Citation: Goins RT, Jones J, Schure M .
Type 2 diabetes management among older American Indians: beliefs, attitudes, and practices.
Ethn Health 2020 Nov;25(8):1055-71. doi: 10.1080/13557858.2018.1493092..
Keywords: Diabetes, Chronic Conditions, Elderly, Racial and Ethnic Minorities, Patient Self-Management, Care Management
McKellar MS, Kuchibhatla MN, Oursler KAK
Racial differences in change in physical functioning in older male veterans with HIV.
Little is known about longitudinal change in physical functioning of older African American/Black and White HIV-infected persons. In this study, the investigators examined up to 10 years of data on African American and White men with HIV infection and comparable HIV-negative men age 50-91 years from the Veterans Aging Cohort Study Survey sample.
AHRQ-funded; HS021112; HS023464; HS023258.
Citation: McKellar MS, Kuchibhatla MN, Oursler KAK .
Racial differences in change in physical functioning in older male veterans with HIV.
AIDS Res Hum Retroviruses 2019 Nov/Dec;35(11-12):1034-43. doi: 10.1089/aid.2018.0296..
Keywords: Human Immunodeficiency Virus (HIV), Health Status, Racial and Ethnic Minorities, Elderly, Men's Health