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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 15 of 15 Research Studies DisplayedDennett JM, Baicker K
Medicaid, health, and the moderating role of neighborhood characteristics.
The purpose of this study was to evaluate whether the characteristics of different neighborhoods have an impact on the interaction between local environment and the effect of health insurance on health. The researchers utilized existing data from the Oregon Health Insurance Experiment and combined it with new, expanded data on neighborhood characteristics to assess whether those characteristics impacted the relationship between getting health insurance and health outcomes. The study found that the multiple domains of neighborhood characteristics did not affect the correlation between insurance and health outcomes, and concluded that Medicaid expansions do not differ greatly in effectiveness across neighborhoods.
AHRQ-funded; HS000055.
Citation: Dennett JM, Baicker K .
Medicaid, health, and the moderating role of neighborhood characteristics.
J Urban Health 2022 Feb;99(1):116-33. doi: 10.1007/s11524-021-00579-2..
Keywords: Medicaid, Social Determinants of Health, Health Insurance
Hammad Mrig E
Integrating fundamental cause theory and Bourdieu to explain pathways between socioeconomic status and health: the case of health insurance denials for genetic testing.
This paper proposes that Pierre Bourdieu's theories of capital and symbolic power can be integrated with fundamental cause theory to address limitations in the latter theory, making it more useful in health disparities research. This work deepens appreciation for the durable relationship between socioeconomic status and health. Study results reveal the multiple and complex mechanisms that play a role in access to healthcare services, which has significant implications for how we think about the role of health policy in addressing health disparities.
AHRQ-funded; HS017589.
Citation: Hammad Mrig E .
Integrating fundamental cause theory and Bourdieu to explain pathways between socioeconomic status and health: the case of health insurance denials for genetic testing.
Sociol Health Illn 2021 Jan;43(1):133-48. doi: 10.1111/1467-9566.13195..
Keywords: Social Determinants of Health, Disparities, Health Insurance, Access to Care, Genetics, Policy
Grafova IB, Monheit AC, Kumar R
How do changes in income, employment and health insurance affect family mental health spending?
This study used eight two-year panels from the MEPS data for 2004 to 2012 to examine the effect of economic shocks on mental health spending by families with children. Researchers wanted to determine whether the greatest impact on mental health spending comes from income, employment, or health insurance shocks. They used two-part expenditure models to estimate that employment losses are positively related to an increase in total family mental health expenditures. But no link was found between economic shocks and mental health spending on fathers.
AHRQ-funded; HS024053.
Citation: Grafova IB, Monheit AC, Kumar R .
How do changes in income, employment and health insurance affect family mental health spending?
Rev Econ Househ 2020 Mar;18(1:239-63. doi: 10.1007/s11150-018-9436-y.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Behavioral Health, Social Determinants of Health, Health Insurance
Byhoff E, Taylor LA
Massachusetts community-based organization perspectives on Medicaid redesign.
The purpose of the study was to investigate how community-based organizations perceive Medicaid policy changes to address the social determinants of health. Forty-six key informant interviews were conducted, representing 44 community-based organizations across Massachusetts. Findings showed that changes to Medicaid policy can catalyze interest in partnership between healthcare organizations and community-based organizations. Recommendations included having policymakers and healthcare leadership ensure that community-based organizations are part of strategy development and social service program implementation.
AHRQ-funded; HS026664.
Citation: Byhoff E, Taylor LA .
Massachusetts community-based organization perspectives on Medicaid redesign.
Am J Prev Med 2019 Dec;57(6 Suppl 1):S74-s81. doi: 10.1016/j.amepre.2019.07.017..
Keywords: Medicaid, Social Determinants of Health, Policy, Health Insurance
Mehra R, Shebi FM, Cunningham SD
Area-level deprivation and preterm birth: results from a national, commercially-insured population.
This research studied the association between area-level deprivation and preterm birth. A retrospective cohort study was conducted using data obtained from the Health Care Cost Institute that uses national, commercial health claims data from 2011. The highest quartile of area-level deprivation experienced the highest number of preterm birth (24.9%) as opposed to the lowest quarter (9.6%). This was true even among commercially-insured women.
AHRQ-funded; HS017589; HS022242.
Citation: Mehra R, Shebi FM, Cunningham SD .
Area-level deprivation and preterm birth: results from a national, commercially-insured population.
BMC Public Health 2019 Feb 27;19(1):236. doi: 10.1186/s12889-019-6533-7..
Keywords: Health Insurance, Newborns/Infants, Pregnancy, Social Determinants of Health, Women
Xie Z, St Clair P, Goldman DP
Racial and ethnic disparities in medication adherence among privately insured patients in the United States.
The purpose of this study was to examine the association between socioeconomic status (SES) and racial and ethnic disparities in medication adherence for three widely prescribed therapeutic classes. The investigators concluded that racial/ethnic disparities in adherence were mitigated, but persisted after controlling for detailed socioeconomic measures. They suggest that interventions should focus more on improving medication adherence of existing users, particularly in treating asymptomatic conditions.
AHRQ-funded; HS013447.
Citation: Xie Z, St Clair P, Goldman DP .
Racial and ethnic disparities in medication adherence among privately insured patients in the United States.
PLoS One 2019 Feb 14;14(2):e0212117. doi: 10.1371/journal.pone.0212117..
Keywords: Racial and Ethnic Minorities, Disparities, Patient Adherence/Compliance, Medication, Social Determinants of Health, Health Insurance
Wisk LE, Sharma N
Inequalities in young adult health insurance coverage post-federal health reform.
The article investigates disparities in the insurance coverage of young adults before and after the implementation of the Affordable Care Act (ACA). Data from the 2000-2016 National Health Interview Survey was used to compare the effects of the ACA on three groups, aged 13 to 18, 19 to 25, and 26 to 30, with the 19 to 25 group considered as “young adults” for the purposed of this study. Respondents reported their types of health insurance coverage during the last 12 months, their reasons for being uninsured, and sociodemographic information. The article concludes that the ACA significantly impacted insurance coverage for young adults, but disparities remain.
AHRQ-funded; HS022986.
Citation: Wisk LE, Sharma N .
Inequalities in young adult health insurance coverage post-federal health reform.
J Gen Intern Med 2019 Jan;34(1):65-74. doi: 10.1007/s11606-018-4723-0..
Keywords: Disparities, Health Insurance, Policy, Social Determinants of Health, Young Adults
Abdus S, Selden TM, Keenan P
AHRQ Author: Abdus S, Selden TM, Keenan P
The financial burdens of high-deductible plans.
The increased prevalence of high-deductible health plans raises concerns regarding high financial burdens from health care, particularly for low-income adults.
AHRQ-authored.
Citation: Abdus S, Selden TM, Keenan P .
The financial burdens of high-deductible plans.
Health Aff 2016 Dec;35(12):2297-301. doi: 10.1377/hlthaff.2016.0842.
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Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Healthcare Costs, Social Determinants of Health
Fraze T, Lewis VA, Rodriguez HP
Housing, transportation, and food: how ACOs seek to improve population health by addressing nonmedical needs of patients.
The authors examined how accountable care organizations (ACOs) addressed the nonmedical needs of their patients. They found that ACOs most commonly addressed the need for transportation, housing, and food insecurity, which they identified through the primary care visit or care transformation programs. They concluded that their findings offer insights into how health care organizations such as ACOs integrate themselves with nonmedical organizations.
AHRQ-funded; HS024792.
Citation: Fraze T, Lewis VA, Rodriguez HP .
Housing, transportation, and food: how ACOs seek to improve population health by addressing nonmedical needs of patients.
Health Aff 2016 Nov;35(11):2109-15. doi: 10.1377/hlthaff.2016.0727.
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Keywords: Social Determinants of Health, Patient-Centered Healthcare, Health Insurance, Healthcare Delivery, Primary Care, Public Health
Moriya AS, Selden TM, Simon KI
AHRQ Author: Moriya AS, Selden TM
Little change seen in part-time employment as a result of the Affordable Care Act.
There has been speculation that the Affordable Care Act's coverage provisions and employer mandate have led to an increase in part-time employment. Using the Current Population Survey for the period 2005-15, the researchers examined data on weekly hours worked by firm size, reason for working part time, age, education, and health insurance. They found only limited evidence to support this speculation.
AHRQ-authored.
Citation: Moriya AS, Selden TM, Simon KI .
Little change seen in part-time employment as a result of the Affordable Care Act.
Health Aff 2016 Jan;35(1):119-23. doi: 10.1377/hlthaff.2015.0949.
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Keywords: Health Insurance, Policy, Social Determinants of Health
Boss EF, Benke JR, Tunkel DE
Public insurance and timing of polysomnography and surgical care for children with sleep-disordered breathing.
The purpose of this study was (1) to evaluate receipt and timing of polysomnography (PSG) in relation to ultimate surgical therapy with adenotonsillectomy for children undergoing evaluation for sleep-disordered breathing and (2) to evaluate differences based on socioeconomic status. It found that referral for PSG resulted in significant loss to follow-up for all children and delayed definitive surgical treatment for children with public insurance.
AHRQ-funded; HS022932.
Citation: Boss EF, Benke JR, Tunkel DE .
Public insurance and timing of polysomnography and surgical care for children with sleep-disordered breathing.
JAMA Otolaryngol Head Neck Surg 2015 Feb;141(2):106-11. doi: 10.1001/jamaoto.2014.3085..
Keywords: Children/Adolescents, Sleep Problems, Social Determinants of Health, Access to Care, Health Insurance, Surgery
Nichols GA, Schroeder EB, Karter AJ
Trends in diabetes incidence among 7 million insured adults, 2006-2011: the SUPREME-DM project.
This study of diabetes trends found that among 7 million insured adults there was no significant increase between 2006 and 2010. The small increase that occurred from 2010 to 2011 coincided with a shift from fasting plasma glucose testing to use of the HbA1c assay. The increase in diabetes incidence rates was significant only among racial and ethnic minority groups and among very obese persons.
AHRQ-funded; HS019859
Citation: Nichols GA, Schroeder EB, Karter AJ .
Trends in diabetes incidence among 7 million insured adults, 2006-2011: the SUPREME-DM project.
Am J Epidemiol. 2015 Jan;181(1):32-9. doi: 10.1093/aje/kwu255..
Keywords: Diabetes, Health Insurance, Social Determinants of Health, Obesity
Richards MR, Marti J
Heterogeneity in the smoking response to health shocks by out-of-pocket spending risk.
Using longitudinal data from 11 European countries, the researchers investigated the impact of a new cardiovascular (CV) health shock on smoking decisions among older adults and examine whether personal exposure to medical spending risk influences the smoking response. They found that CV shocks impact the propensity to smoke, with relatively more impact among individuals with high financial risk exposure to medical spending.
AHRQ-funded; HS017589.
Citation: Richards MR, Marti J .
Heterogeneity in the smoking response to health shocks by out-of-pocket spending risk.
Health Econ Policy Law 2014 Oct;9(4):343-57. doi: 10.1017/s1744133114000152..
Keywords: Cardiovascular Conditions, Tobacco Use, Lifestyle Changes, Health Insurance, Social Determinants of Health
Chambers C, Chiu S, Katic M
High utilizers of emergency health services in a population-based cohort of homeless adults.
This study identified predictors of frequent emergency department (ED) use among a population-based sample of homeless adults in Toronto, Ontario. It found that among homeless adults with universal health insurance, a small subgroup accounted for the majority of visits to emergency services. Frequent use was driven by multiple predisposing, enabling, and need factors.
AHRQ-funded; HS014129.
Citation: Chambers C, Chiu S, Katic M .
High utilizers of emergency health services in a population-based cohort of homeless adults.
Am J Public Health 2013 Dec;103 Suppl 2:S302-10. doi: 10.2105/ajph.2013.301397..
Keywords: Emergency Department, Social Determinants of Health, Health Insurance, Healthcare Utilization
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