National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (8)
- Ambulatory Care and Surgery (1)
- Autism (1)
- Behavioral Health (5)
- Cancer (1)
- Caregiving (1)
- Children/Adolescents (7)
- Chronic Conditions (2)
- Clinician-Patient Communication (3)
- Communication (1)
- Community-Based Practice (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- COVID-19 (2)
- Cultural Competence (1)
- Data (2)
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- Healthcare Utilization (1)
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- Health Literacy (1)
- Health Status (2)
- Infectious Diseases (1)
- Labor and Delivery (1)
- Low-Income (1)
- Medicaid (4)
- (-) Medical Expenditure Panel Survey (MEPS) (37)
- Medication (5)
- Obesity (3)
- Opioids (2)
- Pain (1)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (1)
- Patient Adherence/Compliance (1)
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- Payment (1)
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- Primary Care: Models of Care (1)
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- Racial and Ethnic Minorities (9)
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- Risk (2)
- Shared Decision Making (1)
- Social Determinants of Health (2)
- Uninsured (4)
- Young Adults (1)
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 37 Research Studies DisplayedZuvekas SH, Kashihara D
AHRQ Author: Zuvekas SH
The impacts of the COVID-19 pandemic on the Medical Expenditure Panel Survey.
The COVID-19 pandemic caused substantial disruptions in the field operations of all 3 major components of the Medical Expenditure Panel Survey (MEPS). In this study, the investigators described how the MEPS program successfully responded to these challenges by reengineering field operations, including survey modes, to complete data collection and maintain data release schedules.
AHRQ-authored.
Citation: Zuvekas SH, Kashihara D .
The impacts of the COVID-19 pandemic on the Medical Expenditure Panel Survey.
Am J Public Health 2021 Dec;111(12):2157-66. doi: 10.2105/ajph.2021.306534..
Keywords: Medical Expenditure Panel Survey (MEPS), COVID-19, Healthcare Costs, Data
Abdus S
AHRQ Author: Abdus S
Trends in differences across subgroups of adults in preventive services utilization.
This study examines whether preventive services utilization changed over time, across subgroups of adults defined by race/ethnicity, insurance coverage, poverty status, Census region, and urbanicity. Using MEPS data and examining general checkups, blood cholesterol screening, mammograms, and colorectal cancer screening, findings showed modest increases in utilization between 2008/2009 and 2015/2016 for blood cholesterol and colorectal cancer screenings. Large gaps in utilization across income groups and between those with and without coverage persisted. Disparities across racial/ethnic groups in general checkups persisted over time as well.
AHRQ-authored.
Citation: Abdus S .
Trends in differences across subgroups of adults in preventive services utilization.
Med Care 2021 Dec;59(12):1059-66. doi: 10.1097/mlr.0000000000001634..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Utilization, Prevention
Abdus S
AHRQ Author: Abdus S
Financial burdens of out-of-pocket prescription drug expenditures under high-deductible health plans.
This study examines financial burdens of out-of-pocket prescription drug expenditures across different levels of deductibles, focusing on low-income adults with multiple, prevalent chronic conditions. The results of this study suggest that for low-income adults with multiple chronic conditions who are enrolled in employer-sponsored high-deductible plans, out-of-pocket prescription drug costs may still result in significant financial hardships. The key takeaway point of this paper for general internists is that for patients with chronic conditions, out-of-pocket costs of prescription drugs could be excessively burdensome if they are enrolled in high-deductible plans.
AHRQ-authored.
Citation: Abdus S .
Financial burdens of out-of-pocket prescription drug expenditures under high-deductible health plans.
J Gen Intern Med 2021 Sep;36(9):2903-05. doi: 10.1007/s11606-020-06226-x..
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Healthcare Costs, Medication
Zuvekas SH, Grosse SD, Lavelle TA
AHRQ Author: Zuvekas SH
Healthcare costs of pediatric autism spectrum disorder in the United States, 2003-2015.
Published healthcare cost estimates for children with autism spectrum disorder (ASD) vary widely. One possible contributor is different methods of case ascertainment. In this study, autism spectrum disorder (ASD) case status was determined using two sources of parent reports among 45,944 children ages 3-17 years in the Medical Expenditure Panel Survey (MEPS) linked to the National Health Interview Survey (NHIS) Sample Child Core questionnaire. In this paper, the investigators describe their process and conclusions.
AHRQ-authored.
Citation: Zuvekas SH, Grosse SD, Lavelle TA .
Healthcare costs of pediatric autism spectrum disorder in the United States, 2003-2015.
J Autism Dev Disord 2021 Aug;51(8):2950-58. doi: 10.1007/s10803-020-04704-z..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Autism, Healthcare Costs, Behavioral Health
Borsky AE, Zuvekas SH, Kent EE
AHRQ Author: Borsky AE, Zuvekas SH
Understanding the characteristics of US cancer survivors with informal caregivers.
This AHRQ-authored paper’s purpose is to provide a national representative description of the sociodemographic characteristics of cancer survivors who have or had an informal caregiver. Cross-sectional data from the MEPS Experiences With Cancer Survivorship Supplement survey in 2011, 2016, and 2017 was used. The study population consisted of 720 US adult survivors of cancer other than nonmelanoma skin cancer who were treated for cancer less than 3 years before the survey and were living in the community. A total of 55.2% of cancer survivors reported having an informal caregiving during or after their cancer treatment. Males were more likely to have a spouse as their caregiver and females were more likely to have a child. Cancer survivors who were female, were married, were of a non-White race/ethnicity, or were in poor health were more likely to have an informal caregiver.
AHRQ-authored.
Citation: Borsky AE, Zuvekas SH, Kent EE .
Understanding the characteristics of US cancer survivors with informal caregivers.
Cancer 2021 Aug 1;127(15):2752-61. doi: 10.1002/cncr.33535..
Keywords: Medical Expenditure Panel Survey (MEPS), Cancer, Caregiving
Berdahl TA, Moriya AS
AHRQ Author: Berdahl TA, Moriya AS
Insurance coverage for non-standard workers: experiences of temporary workers, freelancers, and part-time workers in the USA, 2010-2017.
This AHRQ-authored paper estimates insurance disparities across non-standard employment categories and determines how coverage disparities shifted following health reform in 2014. Data on working-age adults was analyzed from the 2010-2012 and 2015-2017 MEPS. Uninsurance decreased after health reform for all groups of nonstandard workers with a 10-14% point decline. Uninsurance remained high for all freelance workers at 30.8%, full-time temporary workers (25.1%) and part-time workers (17.9%) compared to full-time workers (11.9%). Lower uninsurance in a Medicaid expansion state was found for all categories of workers.
AHRQ-authored.
Citation: Berdahl TA, Moriya AS .
Insurance coverage for non-standard workers: experiences of temporary workers, freelancers, and part-time workers in the USA, 2010-2017.
J Gen Intern Med 2021 Jul;36(7):1997-2003. doi: 10.1007/s11606-021-06700-0..
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Policy, Uninsured, Medicaid, Low-Income
Bernard DM, Encinosa W, Cohen J
AHRQ Author: Bernard DM Encinosa W Cohen J Fang Z
Patient factors that affect opioid use among adults with and without chronic pain.
Investigators sought to determine patient characteristics associated with opioid use among adults with and without chronic pain treatment. Using MEPS data, they found that health-related attitudes affect both adults with and without chronic pain treatment similarly. Adults with self-reliant health attitudes were less likely to start and more likely to discontinue opioid use. Exercise was associated with higher probability of choosing no analgesic treatments over using opioids and also with higher probability of discontinuing opioid use in the year following opioid initiation for those electing to use them.
AHRQ-authored.
Citation: Bernard DM, Encinosa W, Cohen J .
Patient factors that affect opioid use among adults with and without chronic pain.
Res Social Adm Pharm 2021 Jun;17(6):1059-65. doi: 10.1016/j.sapharm.2020.07.036..
Keywords: Medical Expenditure Panel Survey (MEPS), Opioids, Medication, Pain, Chronic Conditions
Kirby JB, Bernard D, Liang L
AHRQ Author: Kirby JB, Bernard D, Liang L
The prevalence of food insecurity is highest among Americans for whom diet is most critical to health.
This study investigated how widespread food insecurity is among people with diabetes among different insurance types and whether food assistance is adequately addressing the problem. The authors used new data on food insecurity from the AHRQ MEPS in 2016 and 2017. The sample was limited to adults ages 18-64 years. Results found the prevalence of food insecurity was much higher among adults with diabetes compared to those without diabetes (16% vs. 9%). People with diabetes who were taking insulin or who had eye or kidney complications had even rates of food insecurity at 19% and 22%, respectively. Food insecurity prevalence was much higher among Medicaid enrollees compared with those with other types of insurance. Nearly one-third of Medicaid enrollees with diabetes were food insecure, compared with 7% with private insurance. Medicaid enrollees with insulin-dependent diabetes had the highest food insecurity (44%), which is over 6 times higher than their counterparts with private insurance. They also found that a sizable fraction of people with diabetes who were food insecure were not receiving Supplemental Nutrition Assistance Program (SNAP) benefits. Over 80% of people with private insurance did not receive SNAP benefits, likely reflecting SNAP eligibility. However, even among Medicaid enrollees, 29% of people with diabetes were not receiving SNAP, and 68% of the uninsured were not receiving SNAP benefits. Even among SNAP recipients, over 40% of Medicaid enrollees with diabetes remained food insecure.
AHRQ-authored.
Citation: Kirby JB, Bernard D, Liang L .
The prevalence of food insecurity is highest among Americans for whom diet is most critical to health.
Diabetes Care 2021 Jun;44(6):e131-3132. doi: 10.2337/dc20-3116..
Keywords: Medical Expenditure Panel Survey (MEPS), Social Determinants of Health
Hill SC, Zuvekas SH
AHRQ Author: Hill SC, Zuvekas SH
Patient-centered medical homes and pediatric preventive counseling.
The authors sought to measure pediatric preventive counseling at patient-centered medical homes (PCMHs) compared with practices that reported undertaking some or no quality-related activities. Using MEPS data, they found that PCMHs were associated with substantially greater receipt of pediatric preventive counseling. They recommended that evaluations of PCMHs account for the quality-related activities of comparison practices.
AHRQ-authored.
Citation: Hill SC, Zuvekas SH .
Patient-centered medical homes and pediatric preventive counseling.
Acad Pediatr 2021 Apr 1;21(3):488-96. doi: 10.1016/j.acap.2020.07.001..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Patient-Centered Healthcare, Prevention
Kirby JB, Berdahl TA, Stone RA
AHRQ Author: Kirby JB, Berdahl TA
Perceptions of patient-provider communication across the six largest Asian subgroups in the USA.
Investigators sought to estimate racial/ethnic differences in perceptions of provider communication among the six largest Asian subgroups. Using MEPS data, they found that negative views of provider communication are not pervasive among all Asians but, rather, primarily reflect the perceptions of Chinese and, possibly, Vietnamese patients. They recommended that researchers, policymakers, health plan executives, and others who produce or use data on patients' experiences with health care avoid categorizing all Asians into a single group.
AHRQ-authored.
Citation: Kirby JB, Berdahl TA, Stone RA .
Perceptions of patient-provider communication across the six largest Asian subgroups in the USA.
J Gen Intern Med 2021 Apr;36(4):888-93. doi: 10.1007/s11606-020-06391-z..
Keywords: Medical Expenditure Panel Survey (MEPS), Consumer Assessment of Healthcare Providers and Systems (CAHPS), Clinician-Patient Communication, Communication, Patient Experience, Racial and Ethnic Minorities, Cultural Competence
Peltz A, Kan K, Garg A
Racial and ethnic differences in managed care enrollment among US children.
The authors used national survey data to compare rates of HMO enrollment, by race and ethnicity, for children with commercial and public coverage. They found that, when adjusted for sociodemographic characteristics, Hispanic children with public coverage, non-Hispanic Black children with commercial coverage, and Hispanic children with commercial coverage were more likely to be enrolled in HMOs than non-Hispanic White children. They recommended future study to examine the degree to which the observed national imbalance in HMO enrollment results from state-specific policies, family preferences, or coverage affordability.
AHRQ-funded; HS026385.
Citation: Peltz A, Kan K, Garg A .
Racial and ethnic differences in managed care enrollment among US children.
JAMA Netw Open 2021 Apr;4(4):e214162. doi: 10.1001/jamanetworkopen.2021.4162..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Health Insurance, Racial and Ethnic Minorities
Moriya AS, Xu L
AHRQ Author: Moriya AS
The complex relationships among race/ethnicity, social determinants, and opioid utilization.
The objective of this study was to examine individual- and community-level factors associated with racial/ethnic differences in individuals' opioid prescription use. The investigators found that the average annual rate of any outpatient opioid prescription use was higher for non-Hispanic whites than for non-Hispanic blacks and Hispanics. The smaller difference between non-Hispanic blacks and whites was not explained by the differences in the risk factors, while almost all the difference between Hispanics and non-Hispanic whites could be explained by the differences in the means of the risk factors.
AHRQ-authored.
Citation: Moriya AS, Xu L .
The complex relationships among race/ethnicity, social determinants, and opioid utilization.
Health Serv Res 2021 Apr;56(2):310-22. doi: 10.1111/1475-6773.13619..
Keywords: Medical Expenditure Panel Survey (MEPS), Racial and Ethnic Minorities, Social Determinants of Health, Opioids, Medication, Disparities
Han B, Chen PG, Yu H
Access to after-hours primary care: a key determinant of children's medical home status.
Researchers sought to identify individual survey items or domains that best predict medical home (MH) status for children and use them to develop brief markers of MH status. Using MEPS data, they found that accessibility, especially the ability to access health care after regular office hours, appeared to be the major predictor of having a MH among children. They recommended that the ongoing efforts to promote the MH model target improving accessibility of health care after regular hours for children overall and especially for Latino children.
AHRQ-funded; HS023336.
Citation: Han B, Chen PG, Yu H .
Access to after-hours primary care: a key determinant of children's medical home status.
BMC Health Serv Res 2021 Feb 27;21(1):185. doi: 10.1186/s12913-021-06192-y..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare, Access to Care, Healthcare Delivery, Disparities, Racial and Ethnic Minorities
Hill SC, Abdus S
AHRQ Author: Hill SC Abdus S
The effects of Medicaid on access to care and adherence to recommended preventive services.
Using MEPS data, the authors sought to quantify the impact of Medicaid enrollment on access to care and adherence to recommended preventive services. They found that Medicaid enrollment decreased the probability of having unmet needs for medical care and of experiencing delays getting prescription drugs. Medicaid enrollment increased the probability of having a usual source of care, of having a routine checkup, and of having a flu shot in past year.
AHRQ-authored.
Citation: Hill SC, Abdus S .
The effects of Medicaid on access to care and adherence to recommended preventive services.
Health Serv Res 2021 Feb;56(1):84-94. doi: 10.1111/1475-6773.13603..
Keywords: Medical Expenditure Panel Survey (MEPS), Medicaid, Access to Care, Prevention, Patient Adherence/Compliance
Jacobs PD
AHRQ Author: Jacobs PD
The impact of Medicare on access to and affordability of health care.
Jacobs used MEPS data and the National Health Interview Survey to test for changes in access to care and affordability around age sixty-five and found that Medicare eligibility is associated with a reduction in reports of being unable to get necessary care as well as a reduction in not being able to get needed care because of the cost. The author concluded that incremental Medicare expansions could have positive access and affordability benefits for enrollees compared with the insurance options available to them before they turn sixty-five.
AHRQ-authored.
Citation: Jacobs PD .
The impact of Medicare on access to and affordability of health care.
Health Aff 2021 Feb;40(2):266-73. doi: 10.1377/hlthaff.2020.00940..
Keywords: Medical Expenditure Panel Survey (MEPS), Access to Care, Healthcare Costs, Health Insurance
Selden TM, Berdahl TA
AHRQ Author: Selden TM, Berdahl TA
Risk of severe COVID-19 among workers and their household members.
Using prepandemic MEPS data, the investigators examined the prevalence of Centers for Disease Control and Prevention (CDC) risk factors for severe coronavirus disease 2019 (COVID-19). They then estimated how many adults at increased risk of severe COVID-19 held essential jobs and could not work at home (WAH) or who lived in households with such workers.
AHRQ-authored.
Citation: Selden TM, Berdahl TA .
Risk of severe COVID-19 among workers and their household members.
JAMA Intern Med 2021 Jan;181(1):120-22. doi: 10.1001/jamainternmed.2020.6249..
Keywords: Medical Expenditure Panel Survey (MEPS), COVID-19, Risk, Public Health, Infectious Diseases
Biener AI, Selden TM
AHRQ Author: Biener AI, Selden TM
Public and private payments for physician office visits.
Using data for 2014-15 from the Medical Expenditure Panel Survey to estimate standardized payments for nonelderly adults' physician office visits by type of insurance, researchers found that adults with public insurance, especially Medicaid, had substantially lower provider payments, out-of-pocket spending, and third-party payments than their peers with employer-sponsored or Marketplace insurance.
AHRQ-authored.
Citation: Biener AI, Selden TM .
Public and private payments for physician office visits.
Health Aff 2017 Dec;36(12):2160-64. doi: 10.1377/hlthaff.2017.0749.
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Keywords: Healthcare Costs, Payment, Health Insurance, Ambulatory Care and Surgery, Medical Expenditure Panel Survey (MEPS)
Kirby JB, Sharma R
AHRQ Author: Kirby JB
The availability of community health center services and access to medical care.
This study examined the associations between the availability of Community Health Centers (CHCs) services in communities and two key measures of ambulatory care access - having a usual source of care and having any office-based medical visits over a one year period. It found that the availability of CHC services was positively associated with both measures of access among those with no insurance coverage.
AHRQ-authored.
Citation: Kirby JB, Sharma R .
The availability of community health center services and access to medical care.
Healthc 2017 Dec;5(4):174-82. doi: 10.1016/j.hjdsi.2016.12.006.
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Keywords: Access to Care, Community-Based Practice, Medicaid, Medical Expenditure Panel Survey (MEPS), Uninsured
Yabroff KR, Kirby J, Zodet M
AHRQ Author: Kirby J, Zodet M
Association of insurance gains and losses with access to prescription drugs.
The researchers used longitudinal data to assess the effects of insurance gains and losses on prescription drug access. Their findings that unmet need for prescription drugs declined among initially uninsured adults who gained coverage and doubled among initially insured adults who lost coverage provide longitudinal evidence that having and maintaining health insurance is a key protection against unmet need for prescription drugs in a nationally representative sample.
AHRQ-authored.
Citation: Yabroff KR, Kirby J, Zodet M .
Association of insurance gains and losses with access to prescription drugs.
JAMA Intern Med 2017 Oct;177(10):1531-32. doi: 10.1001/jamainternmed.2017.4011.
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Keywords: Access to Care, Health Insurance, Medication, Medical Expenditure Panel Survey (MEPS), Uninsured
Liang L, Brach C
AHRQ Author: Liang L, Brach C
Health literacy universal precautions are still a distant dream: analysis of U.S. data on health literate practices.
This study sought to examine whether there has been an increase in the delivery of health literate care and whether recommendations for health literacy universal precautions are being followed. It found that the proportion of adults in the U.S. who reported receiving health literate care increased from 2011 to 2014, but fell far short of health literacy universal precautions recommendations of delivering health literate care to everyone.
AHRQ-authored.
Citation: Liang L, Brach C .
Health literacy universal precautions are still a distant dream: analysis of U.S. data on health literate practices.
Health Lit Res Pract 2017 Oct;1(4):e216-e30. doi: 10.3928/24748307-20170929-01.
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Keywords: Healthcare Delivery, Health Literacy, Medical Expenditure Panel Survey (MEPS), Clinician-Patient Communication
Gonzales G, Golberstein E, Hill SC
AHRQ Author: Hill, SC; Zuvekas, SH
Psychological distress and enrollment in Medicaid.
Adults with poor mental health may want and need insurance to obtain care, but symptoms may impede enrollment into public health insurance. The enrollment response to Medicaid expansions prior to the Affordable Care Act was stronger for adults symptomatic of psychological distress compared with adults without distress and compared to adults with chronic physical health problems.
AHRQ-authored.
Citation: Gonzales G, Golberstein E, Hill SC .
Psychological distress and enrollment in Medicaid.
J Behav Health Serv Res 2017 Oct;44(4):523-35. doi: 10.1007/s11414-016-9532-9.
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Keywords: Access to Care, Policy, Medicaid, Medical Expenditure Panel Survey (MEPS), Behavioral Health
Chen J, Vargas-Bustamante A, Novak P
Reducing young adults' health care spending through the ACA expansion of dependent coverage.
The researchers estimated health care expenditure trends among young adults ages 19-25 before and after the 2010 implementation of the Affordable Care Act (ACA) provision that extended eligibility for dependent private health insurance coverage. They found that increased health insurance enrollment as a consequence of the ACA provision for dependent coverage has successfully reduced spending and catastrophic expenditures, providing financial protections for young adults.
AHRQ-funded; HS022135.
Citation: Chen J, Vargas-Bustamante A, Novak P .
Reducing young adults' health care spending through the ACA expansion of dependent coverage.
Health Serv Res 2017 Oct;52(5):1835-57. doi: 10.1111/1475-6773.12555.
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Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Healthcare Costs, Policy, Young Adults
Vistnes JP, Rohde F, Miller GE
AHRQ Author: Vistnes JP, Rohde F, Miller GE, Cooper PF
Substantial churn in health insurance offerings by small employers, 2014-15.
New data for 2014-15 from the Medical Expenditure Panel Survey-Insurance Component longitudinal survey show substantial churn in insurance offers by small employers (those with fifty or fewer workers), with 14.6 percent of employers that offered insurance in 2014 having dropped it in 2015 and 5.5 percent of those that did not offer it adding coverage.
AHRQ-authored.
Citation: Vistnes JP, Rohde F, Miller GE .
Substantial churn in health insurance offerings by small employers, 2014-15.
Health Aff 2017 Sep;36(9):1632-36. doi: 10.1377/hlthaff.2017.0431.
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Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Health Insurance
Pylypchuk Y, Kirby JB
AHRQ Author: Kirby JB
The role of marriage in explaining racial and ethnic disparities in access to health care for men in the US.
The researchers investigated the association between marriage and access to health care among men, and estimate the extent to which racial and ethnic differences in both the returns to marriage and marital rates explain differences in access and preventive service use. They found that marriage accounts for up to 24 percent of racial and ethnic differences in access and preventive use.
AHRQ-authored.
Citation: Pylypchuk Y, Kirby JB .
The role of marriage in explaining racial and ethnic disparities in access to health care for men in the US.
Review of Economics of the Household 2017 Sep;15(3):807-32..
Keywords: Medical Expenditure Panel Survey (MEPS), Disparities, Racial and Ethnic Minorities, Access to Care
Cook BL, Zuvekas SH, Chen J
AHRQ Author: Zuvekas SH
Assessing the individual, neighborhood, and policy predictors of disparities in mental health care.
This study assessed individual- and area-level predictors of racial/ethnic disparities in mental health care episodes for adults with psychiatric illness. It found that racial/ethnic disparities arise because minorities are more likely to live in neighborhoods where treatment initiation is low, rather than because of a differential influence of neighborhood disadvantage on treatment initiation for minorities compared with whites.
AHRQ-authored; AHRQ-funded; HS021486.
Citation: Cook BL, Zuvekas SH, Chen J .
Assessing the individual, neighborhood, and policy predictors of disparities in mental health care.
Med Care Res Rev 2017 Aug;74(4):404-30. doi: 10.1177/1077558716646898.
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Keywords: Disparities, Medical Expenditure Panel Survey (MEPS), Behavioral Health, Policy, Racial and Ethnic Minorities