National Healthcare Quality and Disparities Report
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 3 of 3 Research Studies DisplayedDaw JR, Yekta S, Jacobson-Davies FE
Consistency and adequacy of public and commercial health insurance for US children, 2016 to 2021.
This study used the 2016 to 2021 National Survey of Children’s Health to compare overall rates, COVID-19 public health emergency-related changes, and child and family characteristics associated with inconsistent and inadequate coverage for publicly and commercially insured children. The authors were looking at inconsistent insurance, defined by failure to meet 3 criteria: (1) benefits usually/always sufficient to meet child's needs; (2) coverage usually/always allows child to access needed health care practitioners; and (3) no or usually/always reasonable annual out-of-pocket payments for child's health care. Of this nationally representative sample of 203,691 insured children, 34.5% were publicly insured (mean age 8.4 [4.1] years; 47.4% female) and 65.5% were commercially insured (mean age, 8.7 [5.6]; 49.1% female). Most publicly insured children were either non-Hispanic Black (20.9%) or Hispanic (36.4%); living with 2 married parents (38.4%) or a single parent (33.1%); and had a household income less than 200% of the federal poverty level (79%); and most commercially insured children were non-Hispanic White (62.8%), living with 2 married parents (79.0%); and had a household income of 400% of the federal poverty level or higher (49.1%). Compared with commercially insured children, publicly insured children had higher rates of inconsistent coverage (4.2% vs 1.4%; difference, 2.7 percentage points [pp]) and lower rates of inadequate coverage (12.2% vs 33.0%; difference). Compared with the period from 2016 to 2019, inconsistent insurance decreased by 42% for publicly insured children and inadequate insurance decreased by 6% for commercially insured children during the COVID-19 public health emergency (PHE) (2020-2021).
AHRQ-funded; HS029159.
Citation: Daw JR, Yekta S, Jacobson-Davies FE .
Consistency and adequacy of public and commercial health insurance for US children, 2016 to 2021.
JAMA Health Forum 2023 Nov; 4(11):e234179. doi: 10.1001/jamahealthforum.2023.4179..
Keywords: Children/Adolescents, Health Insurance, COVID-19
Vasan A, Kenyon CC, Fiks AG
Continuous eligibility and coverage policies expanded children's Medicaid enrollment.
Researchers examined children's participation in Medicaid during 2019-21. Their findings found that states that had adopted continuous Medicaid coverage for children during the COVID-19 pandemic experienced a 4.62 percent relative increase in children's Medicaid participation when compared with states with existing continuous eligibility policies.
AHRQ-funded; HS028555.
Citation: Vasan A, Kenyon CC, Fiks AG .
Continuous eligibility and coverage policies expanded children's Medicaid enrollment.
Health Aff 2023 Jun; 42(6):753-58. doi: 10.1377/hlthaff.2022.01465..
Keywords: Children/Adolescents, Medicaid, Policy, Health Insurance, Access to Care
Carlton EF, Becker NV, Moniz MH
Out-of-pocket spending for non-birth-related hospitalizations of privately insured US children, 2017 to 2019.
This study’s goal was to estimate out-of-pocket spending for non-birth pediatric hospitalizations of privately insured children from 2017 to 2019. This study used data from the IBM MarketScan Commercial Database. Among 183,780 hospitalizations, half were for female children, with a median age of 12 (4-16) years. Most (79.0%) hospitalizations were for children with a chronic condition and 24.1% were covered by a high-deductible health plan. Mean (SD) and median (IQR) out-of-pocket spending per hospitalization was $1313 and $656 respectively. Out-of-pocket spending exceeded $3000 for 14.0% of hospitalizations. Factors associated with higher out-of-pocket spending included hospitalization in quarter 1 compared with quarter 4 (average marginal effect [AME], $637) and lack of chronic conditions compared with having a complex chronic condition (AME, $732). Hospitalizations covered by the least generous plans (deductible of $3000 or more and coinsurance of 20% or more) found mean out-of-pocket spending was $1974, while the most generous plans (deductible less than $1000 and coinsurance of 1-19%), mean out-of-pocket spending was found to be $826.
AHRQ-funded; HS025465; HS028817.
Citation: Carlton EF, Becker NV, Moniz MH .
Out-of-pocket spending for non-birth-related hospitalizations of privately insured US children, 2017 to 2019.
JAMA Pediatr 2023 May; 177(5):516-25. doi: 10.1001/jamapediatrics.2023.0130..
Keywords: Children/Adolescents, Healthcare Costs, Hospitalization, Health Insurance