National Healthcare Quality and Disparities Report
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- (-) Health Services Research (HSR) (52)
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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 52 Research Studies DisplayedTyler A, Jolles M
Methodological progress note: implementation science contributions to healthcare research and practice.
Existing research reflects that specific populations such as senior citizens, minorities, and rural Americans have proportionally less access to telehealth when compared to the average American. The purpose of this study was to explore specific strategies for overcoming barriers to telehealth access through an evaluation of data collected by a medical student-run telehealth education program. During the study period the researchers contacted 47 patients by telephone through the GET (Geriatric Education On Telehealth) Access Program. The study found 4 main themes during the discussions with patients, including: completion of registration steps, familiarity with accessing and using video conferencing software, attainment of proxy access for parents of a pediatric patient, and resolution of miscellaneous technical queries.
AHRQ-funded; HS026512.
Citation: Tyler A, Jolles M .
Methodological progress note: implementation science contributions to healthcare research and practice.
J Hosp Med 2023 Oct; 18(10):920-25. doi: 10.1002/jhm.13147..
Keywords: Implementation, Health Services Research (HSR), Evidence-Based Practice
Tugwell P, Welch V, Magwood O
AHRQ Author: Chang C
Protocol for the development of guidance for collaborator and partner engagement in health care evidence syntheses.
The objectives of this protocol were to: Identify, map, and synthesize findings related to engagement in evidence syntheses; Explore how engagement in evidence synthesis promotes health equity; Develop equity-oriented guidance on methods for conducting, evaluating, and reporting engagement. The authors intended to use their findings to develop draft guidance checklists and assess agreement with each item through an international survey. The guidance checklists will be co-produced and after being finalized at a consensus meeting, an international team will develop guidance for collaborators and partner engagement. The authors concluded that incorporating partnership values and expectations may result in better uptake, potentially reducing health inequities.
AHRQ-authored.
Citation: Tugwell P, Welch V, Magwood O .
Protocol for the development of guidance for collaborator and partner engagement in health care evidence syntheses.
Syst Rev 2023 Aug 2; 12(1):134. doi: 10.1186/s13643-023-02279-1..
Keywords: Evidence-Based Practice, Health Services Research (HSR), Healthcare Delivery
Markham JL, Richardson T, Stephens JR
Essential concepts for reducing bias in observational studies.
This study discussed ways to reduce bias in pediatric observational studies, which may be used instead of randomized controlled trials (RCTs) due to barriers within pediatric populations, including lower disease prevalence, high costs, inadequate funding, and additional regulatory requirements. Observational studies do not involve randomization and thus have more potential for bias when compared with RCTs because of imbalances that can exist between comparison groups. The authors describe techniques to minimize bias by controlling for important measurable covariates within observational studies and discuss the challenges and opportunities in addressing specific variables.
AHRQ-funded; HS028845.
Citation: Markham JL, Richardson T, Stephens JR .
Essential concepts for reducing bias in observational studies.
Hosp Pediatr 2023 Aug; 13(8):e234-e39. doi: 10.1542/hpeds.2023-007116..
Keywords: Research Methodologies, Health Services Research (HSR)
Strayer TE, Hollingsworth EK, Shah AS
Why do older adults decline participation in research? Results from two deprescribing clinical trials.
The objective of this study was to examine reasons why hospitalized older adults declined participation in two deprescribing clinical trials, Shed-MEDS (non-Veterans) and VA DROP (Veterans). The reasons given by participating patients were condensed into three themes: feeling overwhelmed by current health status; lack of interest or mistrust; hesitancy to participate. A greater proportion of Veterans expressed a lack of interest or, while more non-Veterans expressed feeling overwhelmed by their current health status. The authors concluded that understanding the reasons why older adults decline participation can inform future strategies to engage this multimorbid population.
AHRQ-funded; HS026122.
Citation: Strayer TE, Hollingsworth EK, Shah AS .
Why do older adults decline participation in research? Results from two deprescribing clinical trials.
Trials 2023 Jul 18; 24(1):456. doi: 10.1186/s13063-023-07506-7..
Keywords: Elderly, Research Methodologies, Health Services Research (HSR)
Rees CA, Stewart AM, Portillo EN
Reporting of important social determinants of health in pediatric clinical trials.
The purpose of this study was to assess the rates and trends in the reporting of sexual orientation, gender identity, preferred language, and socioeconomic factors in published pediatric clinical trials. The researchers conducted a cross-sectional study of pediatric clinical trials in the United States published from January 1, 2011 through December 31, 2020 in 5 general pediatric and 5 general medical journals with the highest impact factor in their respective fields. Outcomes included reporting of sexual orientation, gender identity, socioeconomic factors, and preferred language. The study found that in 612 trials, 29.6% reported preferred language. Among these, 64.6% exclusively enrolled participants whose preferred language was English. From 2011 to 2020, there was a relative increase in the reporting of preferred language. Socioeconomic factors were reported in 47.9% of trials. There was no significant change in the reporting of socioeconomic factors of published trial results among adolescent participants reported any measure of sexual orientation, and 1.1% reported gender identity. The researchers concluded that despite sexual orientation, gender identity, preferred language, and socioeconomic factors being increasingly recognized as social determinants of health these variables were infrequently included in pediatric clinical trial results reporting.
AHRQ-funded; HS026503.
Citation: Rees CA, Stewart AM, Portillo EN .
Reporting of important social determinants of health in pediatric clinical trials.
Am J Prev Med 2023 Jun; 64(6):918-26. doi: 10.1016/j.amepre.2022.12.004..
Keywords: Children/Adolescents, Social Determinants of Health, Health Services Research (HSR)
Huo T, Glueck DH, Shenkman EA
Stratified split sampling of electronic health records
Data extracted from electronic health records may require very different approaches for model building and analysis than data from clinical research. Because electronic health record data is designed for clinical use, researchers need to engage in the iterative process of defining and provide clear definitions of outcome and predictor variables and assessing associations. This process can increase Type I error rates and decrease the chance of replicability. Failure to consider subgroups may mask heterogeneous relationships between predictor and outcome by subgroups, thus decreasing the generalizability of the findings. To improve the likelihood of both replicability and generalizability, the researchers recommended utilizing a stratified split sample approach for studies using electronic health records. The researchers illustrate the approach through an electronic health record study of the relationships between socio-demographic factors and uptake of hepatic cancer screening, and potential heterogeneity of association in subgroups defined by gender, self-identified race and ethnicity, census-tract level poverty and insurance type.
AHRQ-funded; HS028283.
Citation: Huo T, Glueck DH, Shenkman EA .
Stratified split sampling of electronic health records
BMC Med Res Methodol 2023 May 25; 23(1):128. doi: 10.1186/s12874-023-01938-0..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies, Health Services Research (HSR)
Jaramillo ET, Willging CE, Saldana L
Barriers and facilitators to implementing evidence-based interventions in the context of a randomized clinical trial in the United States: a qualitative study.
This study examined factors that facilitate or impede success in the implementation of evidence-based interventions in a clinical trial. This study utilized the clinical trial SafeCare®, a child maltreatment intervention. Qualitative data were obtained between May and October 2017 as part of a larger mixed-methods study involving a cluster randomized trial comparing SafeCare to usual services for caregivers within nine child welfare agencies across four states. Individual interviews were conducted with a purposive sample of 21 child welfare administrators and 24 supervisors, and 19 focus groups were conducted with 84 providers. Facilitators and barriers were determined with facilitators including: 1) Benefits afforded through RCT participation; (2) Shared vision and sustained buy-in across system and organizational levels; and (3) Ongoing leadership support for SafeCare and the RCT. The three barriers identified that hindered SafeCare were: (1) Insufficient preparation to incorporate SafeCare into services; (2) Perceived lack of fit, leading to mixed support for SafeCare and the RCT; and (3) Requirements of RCT participation at the provider level.
AHRQ-funded; HS023370.
Citation: Jaramillo ET, Willging CE, Saldana L .
Barriers and facilitators to implementing evidence-based interventions in the context of a randomized clinical trial in the United States: a qualitative study.
BMC Health Serv Res 2023 Jan 26; 23(1):88. doi: 10.1186/s12913-023-09079-2..
Keywords: Evidence-Based Practice, Health Services Research (HSR)
Sabbatini AK, Merck LH, Froemming AT
Optimizing patient-centered communication and multidisciplinary care coordination in emergency diagnostic imaging: a research agenda.
This article summarizes findings reached during the patient-centered outcomes session of the 2015 Academic Emergency Medicine consensus conference "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The primary objective was to develop a research agenda focused on 1) defining component parts of the emergency diagnostic imaging care coordination process, 2) identifying gaps in communication that affect emergency diagnostic imaging, and 3) defining optimal methods of communication.
AHRQ-funded; HS022982.
Citation: Sabbatini AK, Merck LH, Froemming AT .
Optimizing patient-centered communication and multidisciplinary care coordination in emergency diagnostic imaging: a research agenda.
Acad Emerg Med 2015 Dec;22(12):1427-34. doi: 10.1111/acem.12826.
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Keywords: Communication, Emergency Department, Health Services Research (HSR), Imaging, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Rundell SD, Goode AP, Friedly JL
Role of health services research in producing high-value rehabilitation care.
The overall purpose of this article is to present a framework to help clinicians, researchers, educators, and policy makers better understand the role of health services research in developing and evaluating evidence on value in rehabilitation. The authors believe that rehabilitation professionals have a great opportunity to increase their engagement in describing, evaluating, delivering, and disseminating high-value care, but there are several barriers they need to consider to be most successful.
AHRQ-Funded HS022982.
Citation: Rundell SD, Goode AP, Friedly JL .
Role of health services research in producing high-value rehabilitation care.
Phys Ther 2015 Dec;95(12):1703-11. doi: 10.2522/ptj.20150033..
Keywords: Health Services Research (HSR), Rehabilitation, Patient-Centered Outcomes Research, Comparative Effectiveness
Calo WA, Cubillos L, Breen J
Experiences of Latinos with limited English proficiency with patient registration systems and their interactions with clinic front office staff: an exploratory study to inform community-based translational research in North Carolina.
This study explored Latino patients with limited English proficiency (LEP) experiences with, and expectations for, interactions with patient registration systems and front office staff. It found that Latino patients in North Carolina experienced health services barriers unique to their LEP background. Participants identified ways in which the lack of cultural and linguistic competence of front office staff negatively affect their experiences seeking health services.
AHRQ-funded; HS000032.
Citation: Calo WA, Cubillos L, Breen J .
Experiences of Latinos with limited English proficiency with patient registration systems and their interactions with clinic front office staff: an exploratory study to inform community-based translational research in North Carolina.
BMC Health Serv Res 2015 Dec 23;15:570. doi: 10.1186/s12913-015-1235-z.
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Keywords: Access to Care, Communication, Health Services Research (HSR), Clinician-Patient Communication, Racial and Ethnic Minorities
Finnerty NM, Rodriguez RM, Carpenter CR
Clinical decision rules for diagnostic imaging in the emergency department: a research agenda.
The objective of this working group and article was to generate a consensus-based research agenda for the development and implementation of clinical decision rules (CDRs) for diagnostic imaging in the emergency department. A research agenda was developed, prioritizing a number of questions, including: what are the optimal methods to justify the derivation and validation of diagnostic imaging CDRs?
AHRQ-funded; HS023498.
Citation: Finnerty NM, Rodriguez RM, Carpenter CR .
Clinical decision rules for diagnostic imaging in the emergency department: a research agenda.
Acad Emerg Med 2015 Dec;22(12):1406-16. doi: 10.1111/acem.12828.
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Keywords: Shared Decision Making, Emergency Department, Health Services Research (HSR), Imaging
Kanzaria HK, McCabe AM, Meisel ZM
Advancing patient-centered outcomes in emergency diagnostic imaging: a research agenda.
This article provides background on patient-centered outcomes research (PCOR) in emergency diagnostic imaging. and the conclusions of the 2015 Academic Emergency Medicine consensus conference PCOR work group regarding "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The goal was to determine a prioritized research agenda to establish which outcomes related to emergency diagnostic imaging are most important to patients, caregivers, and other key stakeholders.
AHRQ-funded; HS023498.
Citation: Kanzaria HK, McCabe AM, Meisel ZM .
Advancing patient-centered outcomes in emergency diagnostic imaging: a research agenda.
Acad Emerg Med 2015 Dec;22(12):1435-46. doi: 10.1111/acem.12832.
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Keywords: Emergency Department, Health Services Research (HSR), Imaging, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Kuehl DR, Berdahl CT, Jackson TD
Advancing the use of administrative data for emergency department diagnostic imaging research.
This article summarizes the discussions of the breakout session on the use of administrative data for emergency imaging research at the May 2015 Academic Emergency Medicine consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The authors describe the areas where administrative data have been applied to research evaluating the use of diagnostic imaging in the ED, the common sources for these data, and the strengths and limitations of administrative data.
AHRQ-funded; HS023498.
Citation: Kuehl DR, Berdahl CT, Jackson TD .
Advancing the use of administrative data for emergency department diagnostic imaging research.
Acad Emerg Med 2015 Dec;22(12):1417-26. doi: 10.1111/acem.12827.
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Keywords: Data, Emergency Department, Health Services Research (HSR), Imaging
Kronick R, Casalino LP, Bindman AB
AHRQ Author: Kronick R
Apple pickers or federal judges: strong versus weak incentives in physician payment.
The authors provide an introduction for five papers commissioned by AHRQ focusing on incentives for physicians that are featured in this special issue of Health Services Research. These papers concentrate on suggesting a conceptual framework for the use of financial incentives in health care, key implications of the evidence to date on pay for performance and public reporting in health care and several related topics.
AHRQ-authored.
Citation: Kronick R, Casalino LP, Bindman AB .
Apple pickers or federal judges: strong versus weak incentives in physician payment.
Health Serv Res 2015 Dec;50 Suppl 2:2049-56. doi: 10.1111/1475-6773.12424.
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Keywords: Payment, Provider Performance, Policy, Health Services Research (HSR), Quality of Care, Healthcare Costs, Quality Improvement
Kuo DZ, Hall M, Agrawal R
Comparison of health care spending and utilization among children with Medicaid insurance.
This study's objectives were to assess health care and spending among children with Medicaid insurance by their resource use. It found that as resource use increases in children with Medicaid, spending rises unevenly across health services: Spending on primary care rises modestly compared with other health services.
AHRQ-funded; HS023092.
Citation: Kuo DZ, Hall M, Agrawal R .
Comparison of health care spending and utilization among children with Medicaid insurance.
Pediatrics 2015 Dec;136(6):1521-9. doi: 10.1542/peds.2015-0871.
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Keywords: Medicaid, Healthcare Utilization, Children/Adolescents, Healthcare Costs, Health Services Research (HSR)
Marin JR, Mills AM
Developing a research agenda to optimize diagnostic imaging in the emergency department: an executive summary of the 2015 Academic Emergency Medicine Consensus Conference.
The 2015 Academic Emergency Medicine consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization" was held on May 12, 2015, with the goal of developing a high-priority research agenda on which to base future research. The authors describe the specific aims of the conference and the methods used to achieve consensus.
AHRQ-funded; HS023498.
Citation: Marin JR, Mills AM .
Developing a research agenda to optimize diagnostic imaging in the emergency department: an executive summary of the 2015 Academic Emergency Medicine Consensus Conference.
Pediatr Emerg Care 2015 Dec;31(12):876-82. doi: 10.1097/pec.0000000000000636.
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Keywords: Imaging, Emergency Department, Health Services Research (HSR), Research Methodologies
Marin JR, Mills AM
Developing a research agenda to optimize diagnostic imaging in the emergency department: an executive summary of the 2015 Academic Emergency Medicine Consensus Conference.
The 2015 Academic Emergency Medicine consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization" was held on May 12, 2015, with the goal of developing a high-priority research agenda on which to base future research. The authors describe the specific aims of the conference and the methods used to achieve consensus.
AHRQ-funded; HS023498.
Citation: Marin JR, Mills AM .
Developing a research agenda to optimize diagnostic imaging in the emergency department: an executive summary of the 2015 Academic Emergency Medicine Consensus Conference.
Acad Emerg Med 2015 Dec;22(12):1363-71. doi: 10.1111/acem.12818.
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Keywords: Imaging, Emergency Department, Health Services Research (HSR), Research Methodologies
Hempel S, Shekelle PG, Liu JL
Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications.
This study developed and psychometrically tested a critical appraisal instrument, the QI Minimum Quality Criteria Set (QI-MQCS) for assessing QI-specific features of quality improvement (QI) publications. The critical appraisal instrument is accompanied by a user manual detailing What to consider, Where to look, and How to rate.
AHRQ-funded; HS018139.
Citation: Hempel S, Shekelle PG, Liu JL .
Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications.
BMJ Qual Saf 2015 Dec;24(12):796-804. doi: 10.1136/bmjqs-2014-003151.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Quality Improvement
Cherney AR, Marin JR, Brown J
AHRQ Author: Henriksen K
Funding research in emergency diagnostic imaging: summary of a panel discussion at the 2015 Academic Emergency Medicine Consensus Conference.
As part of the 2015 Academic Emergency Medicine consensus conference "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization," a panel of representatives from several Federal agencies and organizations including AHRQ was assembled to discuss future opportunities for funding research in this particular area of interest. Representatives from these agencies and organizations discussed their missions and priorities and how they distribute funding.
AHRQ-authored.
Citation: Cherney AR, Marin JR, Brown J .
Funding research in emergency diagnostic imaging: summary of a panel discussion at the 2015 Academic Emergency Medicine Consensus Conference.
Acad Emerg Med 2015 Dec;22(12):1400-5. doi: 10.1111/acem.12825.
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Keywords: Imaging, Emergency Department, Health Services Research (HSR), Healthcare Utilization
Layton TJ, Ryan AM
Higher incentive payments in Medicare Advantage's pay-for-performance program did not improve quality but did increase plan offerings.
The researchers evaluated the effects of the size of financial bonuses on quality of care and the number of plan offerings in the Medicare Advantage Quality Bonus Payment Demonstration. They concluded that at great expense to Medicare, double bonuses in the Medicare Advantage Quality Bonus Payment Demonstration were not associated with improved quality but were associated with more plan offerings.
AHRQ-funded; HS018546.
Citation: Layton TJ, Ryan AM .
Higher incentive payments in Medicare Advantage's pay-for-performance program did not improve quality but did increase plan offerings.
Health Serv Res 2015 Dec;50(6):1810-28. doi: 10.1111/1475-6773.12409..
Keywords: Medicare, Payment, Provider Performance, Health Services Research (HSR), Quality Improvement, Quality of Care
Probst MA, Dayan PS, Raja AS
Knowledge translation and barriers to imaging optimization in the emergency department: a research agenda.
This article outlines a research agenda to promote the dissemination and implementation (also known as knowledge translation) of evidence-based interventions for emergency department (ED) imaging, i.e., clinical pathways, clinical decision instruments, and clinical practice guidelines. A multidisciplinary group of stakeholders held online and telephone discussions over a 6-month period culminating at the 2015 Academic Emergency Medicine consensus conference. They were able to identify four overarching research questions.
AHRQ-funded; HS023498.
Citation: Probst MA, Dayan PS, Raja AS .
Knowledge translation and barriers to imaging optimization in the emergency department: a research agenda.
Acad Emerg Med 2015 Dec;22(12):1455-64. doi: 10.1111/acem.12830.
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Keywords: Emergency Department, Evidence-Based Practice, Health Services Research (HSR), Guidelines, Imaging, Implementation
Neprash HT, Wallace J, Chernew ME
Measuring prices in health care markets using commercial claims data.
The objective of this study was to compare methods of price measurement in health care markets. It concluded that market-level price measures reflecting broad sets of services are likely to rank markets similarly. Price indices relying on individual sentinel services may be more appropriate for examining specialty- or service-specific drivers of prices.
AHRQ-funded; HS000055.
Citation: Neprash HT, Wallace J, Chernew ME .
Measuring prices in health care markets using commercial claims data.
Health Serv Res 2015 Dec;50(6):2037-47. doi: 10.1111/1475-6773.12304..
Keywords: Data, Healthcare Costs, Health Insurance, Health Services Research (HSR)
Luft HS
Policy-oriented research on improved physician incentives for higher value health care.
Policy makers (both public and private) are seeking ways to improve the value delivered within our health care system. To inform such policy changes, this paper identifies areas in which little is known about the effects of specific incentives (FFS, salary, etc.) on the two components of value: resource use and quality. Specific suggestions are offered focusing on fundamental "building block" studies.
AHRQ-funded.
Citation: Luft HS .
Policy-oriented research on improved physician incentives for higher value health care.
Health Serv Res 2015 Dec;50 Suppl 2:2187-215. doi: 10.1111/1475-6773.12423.
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Keywords: Policy, Health Insurance, Payment, Health Services Research (HSR)
Lewiss RE, Chan W, Sheng AY
Research priorities in the utilization and interpretation of diagnostic imaging: Education, assessment, and competency.
A group of radiologists, physicists, and emergency physicians convened at the 2015 Academic Emergency Medicine consensus conference to discuss and prioritize a research agenda related to education, assessment, and competency in ordering and interpreting diagnostic imaging. In this article, the authors review the supporting reliability and validity evidence and make specific recommendations for future research on the education, competency, and assessment of learning diagnostic imaging.
AHRQ-funded; HS023498.
Citation: Lewiss RE, Chan W, Sheng AY .
Research priorities in the utilization and interpretation of diagnostic imaging: Education, assessment, and competency.
Acad Emerg Med 2015 Dec;22(12):1447-54. doi: 10.1111/acem.12833.
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Keywords: Imaging, Education: Continuing Medical Education, Emergency Department, Emergency Medical Services (EMS), Healthcare Utilization, Health Services Research (HSR)
Lipton BJ, Decker SL
AHRQ Author: Decker SL
The effect of health insurance coverage on medical care utilization and health outcomes: evidence from Medicaid adult vision benefits.
The reserarchers examined the effect of vision insurance on eye care utilization and vision health outcomes by taking advantage of quasi-experimental variation in Medicaid coverage of adult vision care. They found that Medicaid beneficiaries with vision coverage are 4.4 percentage points more likely to have seen an eye doctor in the past year,and 5.3 percentage points less likely to report needing but not purchasing eyeglasses or contacts due to cost.
AHRQ-authored.
Citation: Lipton BJ, Decker SL .
The effect of health insurance coverage on medical care utilization and health outcomes: evidence from Medicaid adult vision benefits.
J Health Econ 2015 Dec;44:320-32. doi: 10.1016/j.jhealeco.2015.10.006.
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Keywords: Medicaid, Eye Disease and Health, Healthcare Utilization, Health Services Research (HSR), Outcomes