National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
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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 6 of 6 Research Studies DisplayedPurnell TS, Luo X, Crews DC
Neighborhood poverty and sex differences in live donor kidney transplant outcomes in the United States.
Neighborhood poverty has been associated with worse outcomes after live donor kidney transplantation (LDKT), and prior work suggests that women with kidney disease may be more susceptible to the negative influence of poverty than men. As such, our goal was to examine whether poverty differentially affects women in influencing LDKT outcomes. The investigators concluded that given their findings that poverty was more strongly associated with graft loss in women, targeted efforts are needed to specifically address mechanisms driving these disparities in LDKT outcomes.
AHRQ-funded; HS024600.
Citation: Purnell TS, Luo X, Crews DC .
Neighborhood poverty and sex differences in live donor kidney transplant outcomes in the United States.
Transplantation 2019 Oct;103(10):2183-89. doi: 10.1097/tp.0000000000002654.
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Keywords: Transplantation, Kidney Disease and Health, Patient-Centered Outcomes Research, Disparities, Women, Sex Factors, Low-Income, Outcomes
Shahu A, Herrin J, Dhruva SS
Disparities in socioeconomic context and association with blood pressure control and cardiovascular outcomes in ALLHAT.
This study used data from the randomized clinical trial ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial) to study the effect of socioeconomics and blood pressure control and cardiovascular outcomes. The study sites were stratified by their county-level median household income into income quintiles. The lowest income sites (quintile 1) were most likely to be women, black or Hispanic, have less education, to live in the South and to have fewer cardiovascular risk factors. Despite standardized treatment protocols, quintile 1 participants were less likely to have blood pressure control, and all greater all-cause mortality, heart failure hospitalizations/mortality and end-stage renal disease than the highest income participants (quintile 5).
AHRQ-funded; HS023000.
Citation: Shahu A, Herrin J, Dhruva SS .
Disparities in socioeconomic context and association with blood pressure control and cardiovascular outcomes in ALLHAT.
J Am Heart Assoc 2019 Aug 6;8(15):e012277. doi: 10.1161/jaha.119.012277..
Keywords: Blood Pressure, Cardiovascular Conditions, Disparities, Patient-Centered Outcomes Research, Medication, Prevention, Outcomes
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
Gordon BE, Basak R, Carpenter WR
Factors influencing prostate cancer treatment decisions for African American and white men.
This prospective, population-based cohort study examined some possible reasons for mortality outcome differences for prostate cancer between African American (AA) and white patients. A cohort of 1170 men with nonmetastatic prostate cancer were enrolled from 2011 to 2013 before treatment in North Carolina. Participants were asked to rate their aggressiveness of their cancer, and also the importance of 10 factors their treatment decision-making process. Among low-risk patients, there was no difference in perception of their cancer as “not very aggressive”. Among high-risk patients, 54% of AA patients considered their cancer to be “not very aggressive” while only 24% of white patients did. For AA patients, cost, treatment time, and recovery time were considered very important more than white patients.
AHRQ-funded.
Citation: Gordon BE, Basak R, Carpenter WR .
Factors influencing prostate cancer treatment decisions for African American and white men.
Cancer 2019 May 15;125(10):1693-700. doi: 10.1002/cncr.31932..
Keywords: Shared Decision Making, Cancer, Cancer: Prostate Cancer, Disparities, Men's Health, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Marcolini EG, Albrecht JS, Sethuraman KN
Gender disparities in trauma care: how sex determines treatment, behavior, and outcome.
This study used US and European trauma database statistics, including the National Trauma Databank, to examine sex disparities in trauma care. Their findings indicate that sex differences in risk-taking behaviors that lead to traumatic injury have been associated with males, with female menstrual cycle timing, and with cortisol levels. Differences in access to services at trauma centers, including triage or transfer and level of medical attention are associated with sex as well race, rural or urban location, and insurance status. Outcomes, such as in-hospital mortality, multiple organ failure, pneumonia, and sepsis are associated with sex disparities in the general trauma patient; outcomes after general trauma and specifically traumatic brain injury show mixed results.
AHRQ-funded; HS024560.
Citation: Marcolini EG, Albrecht JS, Sethuraman KN .
Gender disparities in trauma care: how sex determines treatment, behavior, and outcome.
Anesthesiol Clin 2019 Mar;37(1):107-17. doi: 10.1016/j.anclin.2018.09.007..
Keywords: Access to Care, Disparities, Injuries and Wounds, Outcomes, Patient-Centered Outcomes Research, Risk, Sex Factors, Trauma
Lee T, Qian J, Thamer M
Gender disparities in vascular access surgical outcomes in elderly hemodialysis patients.
In this study, the investigators assessed clinically relevant arteriovenous fistulas (AVF) and arteriovenous grafts (AVG) surgical outcomes in elderly male and female patients initiating hemodialysis with a central venous catheter (CVC). The investigators concluded that while AVFs should be considered the preferred vascular access in most circumstances, clinical AVF surgical outcomes were uniformly worse in females. They suggest that clinicians should also consider AVGs as a viable alternative in elderly female patients initiating hemodialysis with a CVC to avoid extended CVC dependence.
AHRQ-funded; HS022931; HS021229.
Citation: Lee T, Qian J, Thamer M .
Gender disparities in vascular access surgical outcomes in elderly hemodialysis patients.
Am J Nephrol 2019;49(1):11-19. doi: 10.1159/000495261..
Keywords: Elderly, Sex Factors, Surgery, Kidney Disease and Health, Disparities, Outcomes, Patient-Centered Outcomes Research