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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 DisplayedMartwick J, Kaufmann J, Bailey S
Impact of healthcare location concordance on receipt of preventive care among children whose parents have a substance use and/or mental health diagnosis.
This study examined the association of children with parents with >1 substance use and/or other mental health (SU/MH) diagnoses and parent-child clinic concordance with rates of well-child checks (WCCs) and childhood vaccinations. This retrospective cohort study used electronic health record data from the OCHIN network of community health organizations (CHOs) from 2010 to 2018. This included 280 CHOs across 17 states and 41,413 parents with >1 SU/MH diagnosis linked to 65,417 children ages 0 to 17 years, each with >1 visit to an OCHIN clinic during the study period. The authors found that among children utilizing the same clinic as their parent versus children using a different clinic (reference group), there were greater WCC rates in the first 15 months of life; no difference in WCC rates in ages 3 to 17; higher odds for vaccine completion before age 2; and lower odds for vaccine completion before age 18.
AHRQ-funded; HS025962.
Citation: Martwick J, Kaufmann J, Bailey S .
Impact of healthcare location concordance on receipt of preventive care among children whose parents have a substance use and/or mental health diagnosis.
J Prim Care Community Health 2024 Jan-Dec; 15. doi: 10.1177/21501319241229925.
Keywords: Children/Adolescents, Prevention, Substance Abuse, Behavioral Health, Vaccination, Healthcare Utilization
Angier H, Kaufmann J, Heintzman J
Association of parent preventive care with their child's recommended well-child visits.
The purpose of this retrospective, cohort study was to explore whether there is a relationship between parent preventive care and their children's well-child visits. The researchers utilized electronic health record data to identify children and link them to parents both seen in an OCHIN network of 363 clinics from 17 states, then randomly selected a child between the ages of 3 and 17 with more than 1 ambulatory medical visit between the years 2015 and 2018. The study included a sample of 75,398 linked mother only pairs, 12,438 father only pairs, and 4,156 2-parent pairs. Children in the mother only sample had a 6% greater rate of yearly well-child visits when their mother received preventive care compared to no preventive care, children in the father only sample had a 7% greater rate of yearly well-child visits when their father received preventive care versus no preventive care, and children in the two parent sample had an 11% greater rate of yearly well-child visits when both parents received preventive care compared to neither receiving preventive care. The researchers concluded that well-child visit rates may improve when care is provided for the entire family.
AHRQ-funded; HS025962.
Citation: Angier H, Kaufmann J, Heintzman J .
Association of parent preventive care with their child's recommended well-child visits.
Acad Pediatr 2022 Nov-Dec;22(8):1422-28. doi: 10.1016/j.acap.2022.03.019..
Keywords: Children/Adolescents, Prevention, Family Health and History, Healthcare Utilization
Holland JE, Varni SE, Pulcini CD
Assessing the relationship between well-care visit and emergency department utilization among adolescents and young adults.
This study investigated the association between adolescent and young adult (AYA) well-care visits and emergency department (ED) utilization. Vermont’s all-payer claims data for 2018 was used to evaluate visits for 49,089 AYAs (aged 12-21 years) with a health-care claim. Nearly half (49%) of AYAs who engaged with the health-care system did not have a well-care visit in 2018. Those AYAs had 24% greater odds of going to the ED at least once in 2018, controlling for age, sex, insurance type, and medical complexity. Late adolescents and young adults (aged 18-21) who did not attend a well-care visit had 47% greater odds of ED visits, middle adolescents (15-17 years) had 9% greater odds, and early adolescents (12-14 years) had 16% greater odds.
AHRQ-funded; HS024575.
Citation: Holland JE, Varni SE, Pulcini CD .
Assessing the relationship between well-care visit and emergency department utilization among adolescents and young adults.
J Adolesc Health 2022 Jan;70(1):64-69. doi: 10.1016/j.jadohealth.2021.08.011..
Keywords: Children/Adolescents, Young Adults, Emergency Department, Healthcare Utilization, Medicaid, Prevention
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
Baskin AS, Wang T, Bredbeck BC
Trends in contralateral prophylactic mastectomy utilization for small unilateral breast cancer.
This study describes trends in contralateral prophylactic mastectomy (CPM) utilization for small unilateral breast cancer instead of breast-conserving surgery (BCS) which is recommended. The authors used the National Cancer Database to identify women with unilateral, T1 breast cancer. Of the total cohort of 765,487, 69% underwent BCS and 31% chose mastectomy. Of 176,673 women aged 70 years or older, 75% underwent BCS and 25% chose mastectomy. CPM rates have increased in both cohorts since 2006. Patient factors such as younger age, white rate, private insurance, tumor factors, and facility factors were associated with increased CPM rates compared with unilateral mastectomy.
Citation: Baskin AS, Wang T, Bredbeck BC .
Trends in contralateral prophylactic mastectomy utilization for small unilateral breast cancer.
J Surg Res 2021 Jun;262:71-84. doi: 10.1016/j.jss.2020.12.057..
Keywords: Cancer: Breast Cancer, Cancer, Women, Surgery, Prevention, Healthcare Utilization
Ukhanova M, Marino M, Angier H
The impact of capitated payment on preventive care utilization in community health clinics.
Only half of the United States population regularly receives recommended preventive care services. Alternative payment models (e.g., a per-member-per-month capitated payment model) may encourage the delivery of preventive services when compared to a fee-for-service visit based model; however, evaluation is lacking in the United States. This study assessed the impact of implementing Oregon's Alternative Payment Methodology (APM) on orders for preventive services within community health centers (CHCs).
AHRQ-funded; HS022651.
Citation: Ukhanova M, Marino M, Angier H .
The impact of capitated payment on preventive care utilization in community health clinics.
Prev Med 2021 Apr;145:106405. doi: 10.1016/j.ypmed.2020.106405..
Keywords: Payment, Community-Based Practice, Prevention, Healthcare Utilization
Hatch B, Hoopes M, Darney BG
Impacts of the Affordable Care Act on receipt of women's preventive services in Community Health Centers in Medicaid expansion and nonexpansion states.
Researchers assessed whether ACA implementation and Medicaid expansion were followed by greater receipt of recommended preventive services among women and girls in a large network of community health centers. Data was collected from electronic health records in 14 states. The researchers found that among female patients at community health centers, receipt of recommended preventive care improved after ACA implementation in both Medicaid expansion and non-expansion states, although the overall rates remained low. They recommended continued support to overcome barriers to preventive care in this population.
AHRQ-funded; HS025155.
Citation: Hatch B, Hoopes M, Darney BG .
Impacts of the Affordable Care Act on receipt of women's preventive services in Community Health Centers in Medicaid expansion and nonexpansion states.
Womens Health Issues 2021 Jan-Feb;31(1):9-16. doi: 10.1016/j.whi.2020.08.011..
Keywords: Cancer, Medicaid, Health Insurance, Uninsured, Access to Care, Policy, Cancer: Cervical Cancer, Prevention, Women, Healthcare Utilization
Gregory EF, Upadhya KK, Cheng TL
AHRQ Author: Mistry KB
Enabling factors associated with receipt of interconception health care.
This study examined factors associated with receipt of preventive health care between pregnancies (interconception) using data from a study at four health centers in the Baltimore metropolitan area. The Anderson’s Model of Health Services Use model was used to identify data on factors up to 15 months postpartum. Factors included health history, self-rated health, demographics, predisposing factors, and enabling factors. The cohort included 376 women who were predominantly non-Hispanic Black (84%), and low income. Two enabling factors were associated with receipt of care: having a personal doctor or nurse and having non-Medicaid insurance.
AHRQ-authored
Citation: Gregory EF, Upadhya KK, Cheng TL .
Enabling factors associated with receipt of interconception health care.
Matern Child Health J 2020 Mar;24(3):275-82. doi: 10.1007/s10995-019-02850-0..
Keywords: Maternal Care, Prevention, Pregnancy, Healthcare Utilization, Women, Access to Care
Rice WS, Stringer KL, Sohail M
Accessing pre-exposure prophylaxis (PrEP): perceptions of current and potential prEP users in Birmingham, Alabama.
Limited studies to date assess barriers to and facilitators of pre-exposure prophylaxis (PrEP) uptake and utilization using a patient-centered access to care framework, among diverse socio-demographic groups, or in the U.S. Deep South, an area with disproportionate HIV burden. In this study, the investigators examine perceptions of PrEP access in qualitative interviews with 44 current and potential PrEP users in Birmingham, Alabama.
AHRQ-funded; HS013852.
Citation: Rice WS, Stringer KL, Sohail M .
Accessing pre-exposure prophylaxis (PrEP): perceptions of current and potential prEP users in Birmingham, Alabama.
AIDS Behav 2019 Nov;23(11):2966-79. doi: 10.1007/s10461-019-02591-9..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Healthcare Utilization, Patient-Centered Healthcare, Racial and Ethnic Minorities, Health Literacy, Education: Patient and Caregiver, Access to Care, Health Promotion
Ngo-Metzger Q, Zuvekas S, Shafer P
AHRQ Author: Ngo-Metzger Q, Zuvekas S, Shafer P, Tracer H, Borsky AE, Bierman AS
Ngo-Metzger Q, Zuvekas S, Shafer P, Tracer H, Borsky AE, Bierman AS. Statin use in the U.S. for secondary prevention of cardiovascular disease remains suboptimal.
Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of mortality in the United States. The purpose of this study was to examine the rates of statin use for secondary prevention of ASCVD events in the United States over the last decade and determine whether disparities in the treatment of ASCVD still persist among women and racial/ethnic minorities.
AHRQ-authored.
Citation: Ngo-Metzger Q, Zuvekas S, Shafer P .
Ngo-Metzger Q, Zuvekas S, Shafer P, Tracer H, Borsky AE, Bierman AS. Statin use in the U.S. for secondary prevention of cardiovascular disease remains suboptimal.
J Am Board Fam Med 2019 Nov-Dec;32(6):807-17. doi: 10.3122/jabfm.2019.06.180313..
Keywords: Medical Expenditure Panel Survey (MEPS), Cardiovascular Conditions, Medication, Healthcare Utilization, Prevention, Heart Disease and Health, Disparities
Knerr S, Bowles EJA, Leppig KA
Trends in BRCA test utilization in an integrated health system, 2005-2015.
The authors reported 10-year trends in BRCA testing in an integrated health-care system with long-standing access to genetic services. They found that many eligible women did not receive BRCA testing despite having insurance coverage and access to specialty genetic services, thus underscoring challenges to primary and secondary hereditary cancer prevention.
AHRQ-funded; HS022982.
Citation: Knerr S, Bowles EJA, Leppig KA .
Trends in BRCA test utilization in an integrated health system, 2005-2015.
J Natl Cancer Inst 2019 Aug;111(8):795-802. doi: 10.1093/jnci/djz008..
Keywords: Cancer: Breast Cancer, Cancer: Ovarian Cancer, Cancer, Genetics, Screening, Prevention, Healthcare Utilization, Healthcare Delivery, Women
Song LD, Newhouse JP, Garcia-De-Albeniz X
Changes in screening colonoscopy following Medicare reimbursement and cost-sharing changes.
This study examined changes in screening colonoscopy rates after Medicare reimbursement and cost-sharing changed when the Affordable Care Act (ACA) was implemented. A 20% random sample of fee-for-service (FFS) Medicare claims from 2002-2012 was used in this study. Screening colonoscopy rates did increase after 2001 when cost-sharing was eliminated but the amount varied depending on the algorithm used to classify the indication.
AHRQ-funded; HS023128.
Citation: Song LD, Newhouse JP, Garcia-De-Albeniz X .
Changes in screening colonoscopy following Medicare reimbursement and cost-sharing changes.
Health Serv Res 2019 Aug;54(4):839-50. doi: 10.1111/1475-6773.13150..
Keywords: Colonoscopy, Healthcare Costs, Healthcare Utilization, Medicare, Payment, Prevention, Screening
Huguet N, Angier H, Rdesinski R
Cervical and colorectal cancer screening prevalence before and after Affordable Care Act Medicaid expansion.
This study assessed changes in the prevalence of cervical and colorectal cancer screening from before and after the Affordable Care Act in Medicaid expansion and non-expansion states among patients seen in community health centers. Results showed that, despite increased prevalences of cervical and colorectal cancer screening in both expansion and non-expansion states across all race/ethnicity groups, rates remained suboptimal for this population of socioeconomically disadvantaged patients.
AHRQ-funded; HS024270.
Citation: Huguet N, Angier H, Rdesinski R .
Cervical and colorectal cancer screening prevalence before and after Affordable Care Act Medicaid expansion.
Prev Med 2019 Jul;124:91-97. doi: 10.1016/j.ypmed.2019.05.003..
Keywords: Cancer, Cancer: Cervical Cancer, Cancer: Colorectal Cancer, Healthcare Delivery, Healthcare Utilization, Medicaid, Policy, Prevention, Screening
Davis MM, Shafer P, Renfro S
Does a transition to accountable care in Medicaid shift the modality of colorectal cancer testing?
This study investigated whether Medicaid expansion due to the Affordable Care Act (ACA) increased the number of patients who tested for colorectal cancer (CRC). Results in Oregon showed that there was an increased in statewide fecal testing mainly in Coordinated Care Organizations (CCOs).
AHRQ-funded; HS022981.
Citation: Davis MM, Shafer P, Renfro S .
Does a transition to accountable care in Medicaid shift the modality of colorectal cancer testing?
BMC Health Serv Res 2019 Jan 21;19(1):54. doi: 10.1186/s12913-018-3864-5..
Keywords: Cancer: Colorectal Cancer, Healthcare Utilization, Medicaid, Prevention, Screening
Rivera-Hernandez M, Rahman M, Galarraga O
Preventive healthcare-seeking behavior among poor older adults in Mexico: the impact of Seguro Popular, 2000-2012.
This study examined the effect of the Seguro Popular (SP) program in Mexico on preventive care utilization among low-income and uninsured elder beneficiaries. Results of three rounds of the Mexican National Health and Nutrition Survey from 2000, 2006, and 2012 was used. The findings show there was no significant effect on the use of preventive services, including screening for diabetes, hypertension, breast cancer and cervical cancer for adults aged 50 to 75 years.
AHRQ-funded; HS000011.
Citation: Rivera-Hernandez M, Rahman M, Galarraga O .
Preventive healthcare-seeking behavior among poor older adults in Mexico: the impact of Seguro Popular, 2000-2012.
Salud Publica Mex 2019 Jan-Feb;61(1):46-53. doi: 10.21149/9185..
Keywords: Elderly, Low-Income, Prevention, Healthcare Utilization, Access to Care, Uninsured
Chung S, Romanelli RJ, Stults CD
Preventive visit among older adults with Medicare's introduction of annual wellness visit: closing gaps in underutilization.
The study of Medicare beneficiaries aged 65 to 85 from a mixed-payer multispecialty outpatient healthcare organization in northern California between 2007 and 2016, evaluated changes in preventive visit utilization with Medicare's introduction of Annual Wellness Visits (AWVs) in 2011. It further assessed how coverage expansion differentially affected older adults who were previously underutilizing the service.
AHRQ-funded; HS019815.
Citation: Chung S, Romanelli RJ, Stults CD .
Preventive visit among older adults with Medicare's introduction of annual wellness visit: closing gaps in underutilization.
Prev Med 2018 Oct;115:110-18. doi: 10.1016/j.ypmed.2018.08.018..
Keywords: Elderly, Healthcare Utilization, Medicare, Prevention
Aalsma MC, Gilbert AL, Xiao S
Parent and adolescent views on barriers to adolescent preventive health care utilization.
The objective of the study was to determine adolescent and parent views of barriers to annual adolescent preventive care. Barriers for parents and adolescents include the belief that an appointment is only needed when a child is sick and family cannot afford cost. Barriers for parents include having their child see a specialist.
AHRQ-funded; HS022681.
Citation: Aalsma MC, Gilbert AL, Xiao S .
Parent and adolescent views on barriers to adolescent preventive health care utilization.
J Pediatr 2016 Feb;169:140-5. doi: 10.1016/j.jpeds.2015.10.090.
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Keywords: Children/Adolescents, Access to Care, Prevention, Primary Care, Healthcare Utilization
Strom MA, Silverberg JI
Utilization of preventive health care in adults and children with eczema.
This study examined associations of eczema with vaccination, disease screening, health maintenance, and healthcare utilization. Childhood eczema was associated with higher rates of vaccination for influenza; well child checkups; and interaction with most types of healthcare providers . Adult eczema was associated with higher odds of vaccination for various diseases. It was also associated with increased measurement of blood glucose; cholesterol; blood pressure and HIV infection.
AHRQ-funded; HS023011.
Citation: Strom MA, Silverberg JI .
Utilization of preventive health care in adults and children with eczema.
Am J Prev Med 2016 Feb;50(2):e33-44. doi: 10.1016/j.amepre.2015.07.029.
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Keywords: Vaccination, Prevention, Screening, Healthcare Utilization, Patient-Centered Outcomes Research
Sheridan SL, Sutkowi-Hemstreet A, Barclay C
A comparative effectiveness trial of alternate formats for presenting benefits and harms information for low-value screening services: a randomized clinical trial.
The researchers examined the effect of different benefits and harms presentations on patients' intentions to accept low-value or potentially low-value screening services (prostate cancer screening in men ages 50-69 years; osteoporosis screening in low-risk women ages 50-64 years) They concluded that single, brief, written decision support interventions, such as the ones in this study, are unlikely to be sufficient to change intentions for screening.
AHRQ-funded; HS021133.
Citation: Sheridan SL, Sutkowi-Hemstreet A, Barclay C .
A comparative effectiveness trial of alternate formats for presenting benefits and harms information for low-value screening services: a randomized clinical trial.
JAMA Intern Med 2016 Jan;176(1):31-41. doi: 10.1001/jamainternmed.2015.7339.
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Keywords: Screening, Shared Decision Making, Health Services Research (HSR), Prevention, Healthcare Utilization
Smith JJ, Berman MD, Hiratsuka VY
The effect of regular primary care utilization on long-term glycemic and blood pressure control in adults with diabetes.
The researchers sought to assess the effect of primary care utilization on glycemic control and blood pressure control for a cohort of customer-owners with diabetes mellitus (DM) who received care from Southcentral Foundation, a tribal provider. They found that regular primary care utilization over 16 years was associated with higher rates of blood pressure control and glycemic control for adults with DM.
AHRQ-funded; HS019154.
Citation: Smith JJ, Berman MD, Hiratsuka VY .
The effect of regular primary care utilization on long-term glycemic and blood pressure control in adults with diabetes.
J Am Board Fam Med 2015 Jan-Feb;28(1):28-37. doi: 10.3122/jabfm.2015.01.130329..
Keywords: Primary Care, Diabetes, Healthcare Utilization, Blood Pressure, Prevention
Laiteerapong N, Kirby J, Gao Y
AHRQ Author: Kirby J, Ngo-Metzger Q
Health care utilization and receipt of preventive care for patients seen at federally funded health centers compared to other sites of primary care.
The investigators compared utilization and preventive care receipt among patients of federal Section 330 health centers (HCs) versus patients of other settings. They found that HC patients had fewer office visits and hospitalizations, were more likely to receive breast cancer screening, had fewer outpatient and emergency room visits, and were more likely to receive dietary advice compared to non-HC patients.
AHRQ-authored.
Citation: Laiteerapong N, Kirby J, Gao Y .
Health care utilization and receipt of preventive care for patients seen at federally funded health centers compared to other sites of primary care.
Health Serv Res 2014 Oct;49(5):1498-518. doi: 10.1111/1475-6773.12178.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Utilization, Prevention, Community-Based Practice, Healthcare Delivery
Heintzman J, Marino M, Hoopes M
Using electronic health record data to evaluate preventive service utilization among uninsured safety net patients.
This study used EHR data to compare the preventive service utilization of uninsured patients receiving care at Oregon community health centers (CHCs) in 2008 through 2011 with that of continuously insured patients at the same CHCs in the same period. The results showed that CHCs provided many preventive services to uninsured patients, but that uninsured patients were less likely than continuously insured patients to receive 5 of 11 preventive services. The authors concluded that lack of insurance is a barrier to preventive service utilization, even in patients who can access care at a CHC.
AHRQ-funded; HS021522.
Citation: Heintzman J, Marino M, Hoopes M .
Using electronic health record data to evaluate preventive service utilization among uninsured safety net patients.
Prev Med 2014 Oct;67:306-10. doi: 10.1016/j.ypmed.2014.08.006.
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Keywords: Community-Based Practice, Electronic Health Records (EHRs), Healthcare Utilization, Prevention, Uninsured
Abdus S, Selden TM
AHRQ Author: Abdus S, Selden TM
Preventive services for adults: how have differences across subgroups changed over the past decade?
This study uses MEPS data to track changes over time in the distribution of preventive services use across groups defined by poverty status, race/ethnicity, insurance coverage, Census region, and urbanicity. The analysis found that differences across subgroups tended to persist over time, with some of the largest gaps between adults with and without coverage. Regional differences persisted or widened over the study period.
AHRQ-authored.
Citation: Abdus S, Selden TM .
Preventive services for adults: how have differences across subgroups changed over the past decade?
Med Care 2013 Nov;51(11):999-1007. doi: 10.1097/MLR.0b013e3182a97bc0.
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Keywords: Healthcare Utilization, Health Insurance, Medical Expenditure Panel Survey (MEPS), Prevention, Social Determinants of Health