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- (-) Access to Care (23)
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- Primary Care (2)
- Public Health (1)
- Racial and Ethnic Minorities (2)
- Research Methodologies (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 23 of 23 Research Studies DisplayedKirby JB, Yabroff KR
AHRQ Author: Kirby JB
Rural-urban differences in access to primary care: beyond the usual source of care provider.
This study used 2014-2016 MEPS data to analyze differences between rural and urban areas to primary care access beyond the usual source of care provider. While rural residents were more likely to have a usual source of care, they were less likely to have a provider with office hours on nights and weekends.
AHRQ-authored.
Citation: Kirby JB, Yabroff KR .
Rural-urban differences in access to primary care: beyond the usual source of care provider.
Am J Prev Med 2020 Jan;58(1):89-96. doi: 10.1016/j.amepre.2019.08.026..
Keywords: Medical Expenditure Panel Survey (MEPS), Access to Care, Primary Care, Rural Health, Urban Health, Health Services Research (HSR)
Broder-Fingert S, Kuhn J, Sheldrick RC
Using the Multiphase Optimization Strategy (MOST) framework to test intervention delivery strategies: a study protocol.
Researchers describe a study protocol for a large randomized controlled trial using the Multiphase Optimization Strategy (MOST), a novel framework developed to optimize interventions. They apply this framework to delivery of Family Navigation (FN), an evidence-based care management strategy designed to reduce disparities and improve access to behavioral health services, and test four components related to its implementation. In this paper, they describe how the MOST framework can be used to improve intervention delivery. These methods will be useful for future studies testing intervention delivery strategies and their impact on implementation.
AHRQ-funded; HS022242.
Citation: Broder-Fingert S, Kuhn J, Sheldrick RC .
Using the Multiphase Optimization Strategy (MOST) framework to test intervention delivery strategies: a study protocol.
Trials 2019 Dec 16;20(1):728. doi: 10.1186/s13063-019-3853-y..
Keywords: Research Methodologies, Health Services Research (HSR), Healthcare Delivery, Behavioral Health, Evidence-Based Practice, Access to Care
Hsuan C, Hsia RY, Horwitz JR
Ambulance diversions following public hospital emergency department closures.
The purpose of this study was to examine whether hospitals are more likely to temporarily close their emergency departments to ambulances, through ambulance diversions, if neighboring diverting hospitals are public vs private. Results showed that sample hospitals respond differently to diversions by neighboring public (vs private) hospitals. The authors conclude that these findings suggest that these hospitals might be strategically declaring ambulance diversions to avoid treating low-paying patients served by public hospitals.
AHRQ-funded; HS024247.
Citation: Hsuan C, Hsia RY, Horwitz JR .
Ambulance diversions following public hospital emergency department closures.
Health Serv Res 2019 Aug;54(4):870-79. doi: 10.1111/1475-6773.13147..
Keywords: Access to Care, Emergency Department, Emergency Medical Services (EMS), Health Services Research (HSR), Hospitals
Burgette JM, Preisser JS, Rozier RG
Access to preventive services after the integration of oral health care into early childhood education and medical care.
The authors compared children enrolled in North Carolina Early Head Start (EHS) programs with similar children enrolled in Medicaid but not EHS on the use of POHS. They analyzed 4 dependent variables (oral assessment by medical health care provider, oral assessment by oral health care provider, fluoride application by medical health care provider, fluoride application by oral health care provider) by using multivariate logistic regression that controlled for covariates.
AHRQ-funded; HS000032.
Citation: Burgette JM, Preisser JS, Rozier RG .
Access to preventive services after the integration of oral health care into early childhood education and medical care.
J Am Dent Assoc 2018 Dec;149(12):1024-31.e2. doi: 10.1016/j.adaj.2018.07.019..
Keywords: Access to Care, Children/Adolescents, Dental and Oral Health, Health Services Research (HSR), Medicaid, Patient-Centered Healthcare, Prevention
Brennan-Cook J, Bonnabeau E, Aponte R
Barriers to care for persons with sickle cell disease: the case manager's opportunity to improve patient outcomes.
The purpose of this paper was to review the barriers to care for patients with sickle cell disease (SCD). Chronic pain and the perception of addiction, implicit bias, frequent hospitalizations and emergency department visits, clinician and patient knowledge deficits, and SCD stigma all impede the ability to provide evidence-based care for patients with SCD. The authors assert that case managers can coordinate and advocate for appropriate care that improves patient outcomes.
AHRQ-funded; HS024501.
Citation: Brennan-Cook J, Bonnabeau E, Aponte R .
Barriers to care for persons with sickle cell disease: the case manager's opportunity to improve patient outcomes.
Prof Case Manag 2018 Jul/Aug;23(4):213-19. doi: 10.1097/ncm.0000000000000260..
Keywords: Access to Care, Healthcare Delivery, Health Services Research (HSR), Patient-Centered Outcomes Research, Sickle Cell Disease
Jeffery MM, Wolfson J, Meier SK
Health care service use among elderly seasonal migrators.
Little research is available to guide providers and payers on the service use of seasonal migrators. The authors use claims data on fee-for-service (FFS) Medicare beneficiaries' locations throughout the year to (1) identify seasonal migrators and (2) describe the care they receive in each seasonal home, focusing on primary care and emergency department (ED) visits and the relationships between the two.
AHRQ-funded.
Citation: Jeffery MM, Wolfson J, Meier SK .
Health care service use among elderly seasonal migrators.
Popul Health Manag 2018 Oct;21(5):415-21. doi: 10.1089/pop.2017.0155..
Keywords: Access to Care, Elderly, Healthcare Utilization, Health Services Research (HSR)
Sohn H
Medicaid's lasting impressions: population health and insurance at birth.
This article examines lasting mortality improvements associated with availability of Medicaid at time and place of birth. Being born after Medicaid was associated with between 2.03 and 3.64 fewer deaths per 100,000 person-years in childhood and between 1.35 and 3.86 fewer deaths per 100,000 person-years in the thirties. The association between Medicaid at birth and mortality was the strongest in the oldest age group (36-40) in this study.
AHRQ-funded; HS000046.
Citation: Sohn H .
Medicaid's lasting impressions: population health and insurance at birth.
Soc Sci Med 2017 Mar;177:205-12. doi: 10.1016/j.socscimed.2017.01.043.
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Keywords: Access to Care, Health Insurance, Health Services Research (HSR), Medicaid, Mortality
Carr BG, Bowman AJ, Wolff CS
Disparities in access to trauma care in the United States: a population-based analysis.
This study examined the association between geographic, demographic, and socioeconomic factors and trauma center access, with subgroup analyses of urban-rural disparities. It concluded that, while the majority of the United States has access to trauma care within an hour, almost 30 million US residents do not. Significant disparities in access were evident for vulnerable populations defined by insurance status, income, and rurality.
AHRQ-funded; HS017960.
Citation: Carr BG, Bowman AJ, Wolff CS .
Disparities in access to trauma care in the United States: a population-based analysis.
Injury 2017 Feb;48(2):332-38. doi: 10.1016/j.injury.2017.01.008.
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Keywords: Access to Care, Disparities, Health Services Research (HSR), Social Determinants of Health, Trauma
Caldwell JT, Ford CL, Wallace SP
Racial and ethnic residential segregation and access to health care in rural areas.
This study examined the relationship between racial/ethnic residential segregation and access to health care in rural areas. In rural areas, segregation contributed to worse access to a usual source of health care but higher reports of health care needs being met among African Americans and Hispanics.
AHRQ-funded; HS000078; HS022811.
Citation: Caldwell JT, Ford CL, Wallace SP .
Racial and ethnic residential segregation and access to health care in rural areas.
Health Place 2017 Jan;43:104-12. doi: 10.1016/j.healthplace.2016.11.015.
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Keywords: Access to Care, Health Services Research (HSR), Racial and Ethnic Minorities, Rural Health, Social Determinants of Health
Ray KN, Mehrotra A
Trends in access to primary care for children in the United States, 2002-2013.
Using MEPS data, the authors described how access to primary care has changed over the last decade for children. They found no change in the proportion of children with a usual source of care (USC). Other measures improved, but out-of-pocket costs increased among privately insured children. Results suggested that after-hours accommodation within the USC is worsening, despite the promotion of patient-centered medical home initiatives. All measures of acceptability improved, consistent with a growing focus on family-centeredness of care.
AHRQ-funded; HS022989.
Citation: Ray KN, Mehrotra A .
Trends in access to primary care for children in the United States, 2002-2013.
JAMA Pediatr 2016 Oct;170(10):1023-25. doi: 10.1001/jamapediatrics.2016.0985.
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Keywords: Access to Care, Children/Adolescents, Health Services Research (HSR), Medical Expenditure Panel Survey (MEPS), Primary Care
Haidari LA, Brown ST, Constenla D
The economic value of increasing geospatial access to tetanus toxoid immunization in Mozambique.
The researchers assessed how well tetanus toxoid (TT) immunization locations meet population demand in Mozambique. They found that TT immunization locations are not geographically accessible by a significant proportion of pregnant women, resulting in substantial healthcare and productivity costs that could potentially be averted by adding or reconfiguring TT immunization locations.
AHRQ-funded; HS023317.
Citation: Haidari LA, Brown ST, Constenla D .
The economic value of increasing geospatial access to tetanus toxoid immunization in Mozambique.
Vaccine 2016 Jul 29;34(35):4161-65. doi: 10.1016/j.vaccine.2016.06.065.
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Keywords: Access to Care, Healthcare Costs, Health Services Research (HSR), Pregnancy, Vaccination
Mueller LE, Haidari LA, Wateska AR
The impact of implementing a demand forecasting system into a low-income country's supply chain.
The authors evaluated the potential impact and value of applications of data from demand forecasting systems implemented in a lower-income country's vaccine supply chain with different levels of population change to urban areas. They used their HERMES software to study Niger's entire vaccine supply chain and found that demand forecasting systems have the potential to greatly improve vaccine demand fulfilment, and decrease logistics cost/dose, when implemented with storage and transportation increases.
AHRQ-funded; HS023317.
Citation: Mueller LE, Haidari LA, Wateska AR .
The impact of implementing a demand forecasting system into a low-income country's supply chain.
Vaccine 2016 Jul 12;34(32):3663-9. doi: 10.1016/j.vaccine.2016.05.027.
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Keywords: Access to Care, Health Services Research (HSR), Low-Income, Medication, Vaccination
Bernard D, Selden T, Yeh S
AHRQ Author: Bernard D, Selden T
Financial burdens and barriers to care among nonelderly adults: the role of functional limitations and chronic conditions.
The researchers examined the financial burdens and barriers to care among nonelderly adults, focusing on the role of functional limitations and chronic conditions. Functional limitations and chronic conditions were associated with increased prevalence of burdens and financial barriers in all insurance categories, with the exception that an association between functional limitations and the prevalence of burdens was not observed for public coverage.
AHRQ-authored.
Citation: Bernard D, Selden T, Yeh S .
Financial burdens and barriers to care among nonelderly adults: the role of functional limitations and chronic conditions.
Disabil Health J 2016 Apr;9(2):256-64. doi: 10.1016/j.dhjo.2015.09.003.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Chronic Conditions, Access to Care, Health Services Research (HSR)
Zullig LL, Whitson HE, Hastings SN
A systematic review of conceptual frameworks of medical complexity and new model development.
The authors sought to develop a conceptual model of complexity addressing gaps identified in a review of published conceptual models. Their Cycle of Complexity model illustrated relationships between acute shocks and medical events, healthcare access and utilization, workload and capacity, and patient preferences in the context of interpersonal, organizational, and community factors.
AHRQ-funded; HS023085; HS023099.
Citation: Zullig LL, Whitson HE, Hastings SN .
A systematic review of conceptual frameworks of medical complexity and new model development.
J Gen Intern Med 2016 Mar;31(3):329-37. doi: 10.1007/s11606-015-3512-2.
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Keywords: Access to Care, Chronic Conditions, Health Services Research (HSR)
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
Geissler KH, Becker C, Stearns SC
Exploring the association of homicides in northern Mexico and healthcare access for US residents.
The reesearchers analyzed whether recent increases in homicides in Mexico are associated with reduced healthcare access for US border residents. They found that, despite a decrease in border crossings, increased violence in Mexico did not appear to negatively affect healthcare access for US border residents.
AHRQ-funded; HS021074.
Citation: Geissler KH, Becker C, Stearns SC .
Exploring the association of homicides in northern Mexico and healthcare access for US residents.
J Immigr Minor Health 2015 Aug;17(4):1214-24. doi: 10.1007/s10903-014-0053-4.
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Keywords: Access to Care, Health Services Research (HSR), Social Determinants of Health
Davis AE, Mehrotra S, Friedewald JJ
Improving geographic equity in kidney transplantation using alternative kidney sharing and optimization modeling.
The authors analyzed current kidney allocation and developed an alternative kidney sharing strategy using a multiperiod linear optimization model, KSHARE, which aims to improve geographic equity in kidney transplantation while also respecting transplant system constraints and priorities. They used Organ Procurement and Transplant Network data to determine that enhancing the practice of sharing kidneys by the KSHARE model may increase geographic equity in kidney transplantation.
AHRQ-funded; HS021078.
Citation: Davis AE, Mehrotra S, Friedewald JJ .
Improving geographic equity in kidney transplantation using alternative kidney sharing and optimization modeling.
Med Decis Making 2015 Aug;35(6):797-807. doi: 10.1177/0272989x14557696.
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Keywords: Access to Care, Disparities, Health Services Research (HSR), Social Determinants of Health, Transplantation
Toro-Diaz H, Mayorga ME, Barritt AS
Predicting liver transplant capacity using discrete event simulation.
The researchers constructed a discrete event simulation model informed by current donor characteristics to predict future liver transplant trends through the year 2030. They found that by altering assumptions about the future donor pool, their model can be used to develop policy interventions to prevent a further decline in this lifesaving therapy.
AHRQ-funded; HS019468.
Citation: Toro-Diaz H, Mayorga ME, Barritt AS .
Predicting liver transplant capacity using discrete event simulation.
Med Decis Making 2015 Aug;35(6):784-96. doi: 10.1177/0272989x14559055.
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Keywords: Access to Care, Health Services Research (HSR), Policy, Transplantation
Malecki K, Wisk LE, Walsh M
Oral health equity and unmet dental care needs in a population-based sample: findings from the Survey of the Health of Wisconsin.
The authors explored individual-, psychosocial-, and community-level predictors of oral health status in the Survey of the Health of Wisconsin Oral Health Screening project. Their results suggested that costs were a primary predictor of access to care and poor oral health status, underscoring the role that primary care, in conjunction with dental health care providers, could play in promoting oral health care, particularly in reducing barriers and promoting preventive health behaviors.
AHRQ-funded; HS000063.
Citation: Malecki K, Wisk LE, Walsh M .
Oral health equity and unmet dental care needs in a population-based sample: findings from the Survey of the Health of Wisconsin.
Am J Public Health 2015 Jul;105 Suppl 3:S466-74. doi: 10.2105/ajph.2014.302338.
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Keywords: Access to Care, Dental and Oral Health, Disparities, Healthcare Costs, Health Services Research (HSR)
Mullen MT, Branas CC, Kasner SE
Optimization modeling to maximize population access to comprehensive stroke centers.
This report demonstrates how mathematical optimization modeling can inform the strategic development of the US network of stroke centers by simulating the conversion of primary stroke centers into comprehensive stroke centers (CSCs). Optimal system simulation can be used to develop efficient care systems that maximize accessibility. Under optimal conditions, a large proportion of the US population will be unable to access a CSC within 60 minutes.
AHRQ-funded; HS013852; HS017960; HS010914.
Citation: Mullen MT, Branas CC, Kasner SE .
Optimization modeling to maximize population access to comprehensive stroke centers.
Neurology 2015 Mar 24;84(12):1196-205. doi: 10.1212/wnl.0000000000001390..
Keywords: Stroke, Access to Care, Health Services Research (HSR)
Gold R, Bailey SR, O'Malley JP
Estimating demand for care after a Medicaid expansion: lessons from Oregon.
In order to estimate how the Affordable Care Act's Medicaid expansions will affect demand for services, the authors measured ambulatory care utilization among adult patients who gained insurance during Oregon's 2008 Medicaid expansion. They found that, in comparisons of the pre- and postcoverage periods, the mean annual encounters among persons who gained insurance increased 22% to 35%, but declined in the comparison groups.
AHRQ-funded; HS021522.
Citation: Gold R, Bailey SR, O'Malley JP .
Estimating demand for care after a Medicaid expansion: lessons from Oregon.
J Ambul Care Manage 2014 Oct-Dec;37(4):282-92. doi: 10.1097/jac.0000000000000023.
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Keywords: Access to Care, Healthcare Utilization, Policy, Health Services Research (HSR), Medicaid
Hsuan C, Rodriguez HP
The adoption and discontinuation of clinical services by local health departments.
The researchers identified factors associated with local health department (LHD) adoption and discontinuation of clinical services. They found that most LHDs are discontinuing clinical services over time. Those that cover a wide range of core public health functions are less likely to discontinue services when residents lack care access.
AHRQ-funded; AHRQ Predoctoral Traineeship.
Citation: Hsuan C, Rodriguez HP .
The adoption and discontinuation of clinical services by local health departments.
Am J Public Health 2014 Jan;104(1):124-33. doi: 10.2105/ajph.2013.301426..
Keywords: Public Health, Access to Care, Health Services Research (HSR)
Chambers DA, Haim A, Mullican CA
AHRQ Author: Mullican CA
Health information technology and mental health services research: a path forward.
This article reports on the AHRQ- and NIMH-organized November 2010 workshop, “Health Information Technology and Mental Health: The Way Forward.” The primary workshop goal was to bring together experts in mental health services and interventions research, practitioners, consumers, and technologists to discuss emerging opportunities in uniting all aspects of health IT and mental health research. The workshop resulted in a four-paper series, envisioning a future mental health system in which health IT is fully integrated within mental health service systems, for patient, clinician, and system levels.
AHRQ-authored.
Citation: Chambers DA, Haim A, Mullican CA .
Health information technology and mental health services research: a path forward.
Gen Hosp Psychiatry 2013 Jul-Aug;35(4):329-31. doi: 10.1016/j.genhosppsych.2013.03.006.
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Keywords: Access to Care, Health Information Technology (HIT), Health Services Research (HSR), Health Information Technology (HIT), Behavioral Health