National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
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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
26 to 44 of 44 Research Studies DisplayedDeMeester RH, Xu LJ, Nocon RS
Solving disparities through payment and delivery system reform: a program to achieve health equity.
In 2013 the Finding Answers: Solving Disparities through Payment and Delivery System Reform program of the Robert Wood Johnson Foundation sought to understand how alternative payment models might intentionally incorporate a disparities-reduction component to promote health equity. A qualitative analysis of forty proposals to the program revealed that applicants generally did not link payment reform tightly to disparities reduction.
AHRQ-funded; HS000084.
Citation: DeMeester RH, Xu LJ, Nocon RS .
Solving disparities through payment and delivery system reform: a program to achieve health equity.
Health Aff 2017 Jun;36(6):1133-39. doi: 10.1377/hlthaff.2016.0979.
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Keywords: Disparities, Healthcare Delivery, Payment, Policy
Kamal AH, Bull J, Wolf SP
Unmet needs of African Americans and whites at the time of palliative care consultation.
Researchers aimed to compare characteristics and palliative care needs of African Americans (AAs) and whites during initial palliative care consultation. Nearly two-thirds in both racial groups reported 3 or more symptoms of any severity; one-third reported 3 or more moderate or severe symptoms. A larger proportion of Africans than whites reported pain of any severity.
AHRQ-funded; HS023681; HS022763.
Citation: Kamal AH, Bull J, Wolf SP .
Unmet needs of African Americans and whites at the time of palliative care consultation.
Am J Hosp Palliat Care 2017 Jun;34(5):461-65. doi: 10.1177/1049909116632508.
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Keywords: Disparities, Quality of Care, Palliative Care, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Chang SH, Yu YC, Carlsson NP
Racial disparity in life expectancies and life years lost associated with multiple obesity-related chronic conditions.
This study investigated racial disparity in life expectancies (LEs) and life years lost associated with multiple obesity-related chronic conditions. It found that black individuals had higher risks of developing diabetes, hypertension, and stroke. This disparity in LE between white and black participants was largest in men age 40 to 49 with at least stroke: black men lived 3.12 years shorter than white men.
AHRQ-funded; HS022330.
Citation: Chang SH, Yu YC, Carlsson NP .
Racial disparity in life expectancies and life years lost associated with multiple obesity-related chronic conditions.
Obesity 2017 May;25(5):950-57. doi: 10.1002/oby.21822.
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Keywords: Chronic Conditions, Disparities, Health Status, Medical Expenditure Panel Survey (MEPS), Obesity, Racial and Ethnic Minorities
Jackson BE, Oates GR, Singh KP
Disparities in chronic medical conditions in the Mid-South.
This study examined differences in socio-demographic characteristics and health behaviors relevant to chronic medical conditions (CMCs) in the Mid-South region (Alabama, Mississippi, Louisiana, Kentucky, Tennessee, and Arkansas), and identified subpopulations with increased burden of chronic disease. It concluded that in the Mid-South, race and gender disparities in the top five chronic conditions are more prominent among higher-income rather than lower-income individuals.
AHRQ-funded; HS023009.
Citation: Jackson BE, Oates GR, Singh KP .
Disparities in chronic medical conditions in the Mid-South.
Ethn Health 2017 Apr;22(2):196-208. doi: 10.1080/13557858.2016.1232805.
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Keywords: Chronic Conditions, Disparities, Health Status, Racial and Ethnic Minorities, Social Determinants of Health
Tung EL, Baig AA, Huang ES
Racial and ethnic disparities in diabetes screening between asian americans and other adults: BRFSS 2012-2014.
The researchers assessed racial and ethnic disparities in diabetes screening between Asian Americans and other adults. They found that Asian Americans were the least likely racial and ethnic group to receive recommended diabetes screening. Overall, Asian Americans had 34 percent lower adjusted odds of receiving recommended diabetes screening compared to non-Hispanic whites.
AHRQ-funded; HS000078.
Citation: Tung EL, Baig AA, Huang ES .
Racial and ethnic disparities in diabetes screening between asian americans and other adults: BRFSS 2012-2014.
J Gen Intern Med 2017 Apr;32(4):423-29. doi: 10.1007/s11606-016-3913-x.
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Keywords: Racial and Ethnic Minorities, Diabetes, Screening, Disparities, Prevention
Sohn H
Racial and ethnic disparities in health insurance coverage: dynamics of gaining and losing coverage over the life-course.
This article describes age- and group-specific dynamics of insurance gain and loss that contribute to inequalities found in traditional cross-sectional studies. The authors assert that a formal decomposition on increment-decrement life-tables of insurance gain and loss shows that coverage disparities are predominately driven by minority groups' greater propensity to lose the insurance that they already have. They note that uninsured African Americans were faster to gain insurance than non-Hispanic whites but their high rates of insurance loss more than negated this advantage.
AHRQ-funded; HS000046.
Citation: Sohn H .
Racial and ethnic disparities in health insurance coverage: dynamics of gaining and losing coverage over the life-course.
Popul Res Policy Rev 2017 Apr;36(2):181-201. doi: 10.1007/s11113-016-9416-y.
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Keywords: Disparities, Health Insurance, Racial and Ethnic Minorities, Uninsured
Naidech AM, Toledo P, Prabhakaran S
Disparities in the use of seizure medications after intracerebral hemorrhage.
The researchers investigated potential disparities in the use of prophylactic seizure medications in patients with intracerebral hemorrhage. They concluded that although multicenter electronic health record data showed apparent racial/ethnic disparities in the use of prophylactic seizure medications, a more complete single-center cohort found the apparent disparity to be confounded by the clinical factors of hypertension and hematoma location.
AHRQ-funded; HS023437; HS000078.
Citation: Naidech AM, Toledo P, Prabhakaran S .
Disparities in the use of seizure medications after intracerebral hemorrhage.
Stroke 2017 Mar;48(3):802-04. doi: 10.1161/strokeaha.116.015779.
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Keywords: Disparities, Medication, Prevention, Adverse Drug Events (ADE), Risk
Popescu I, Heslin KC, Coffey RM
AHRQ Author: Heslin KC, Washington RE
Differences in use of high-quality and low-quality hospitals among working-age individuals by insurance type.
This study found that compared with patients who have private insurance, those with Medicaid or no insurance were more likely to be minorities and to reside in areas with low-socioeconomic status. The probability of admission to high-quality hospitals was similar for patients with Medicaid (23.3 percent) and private insurance (23.0 percent) but was significantly lower for patients without insurance (19.8 percent) compared with the other 2 insurance groups.
AHRQ-authored.
Citation: Popescu I, Heslin KC, Coffey RM .
Differences in use of high-quality and low-quality hospitals among working-age individuals by insurance type.
Med Care 2017 Feb;55(2):148-54. doi: 10.1097/mlr.0000000000000633.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Health Insurance, Disparities, Quality of Care, Hospitals
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
Morales-Aleman MM, Opoku J, Murray A
Disparities in retention in HIV care among HIV-infected young men who have sex with men in the District of Columbia, 2013.
Among young men who have sex with men (YMSM), aged 13-24 years, Blacks/African Americans and Hispanics/Latinos are disproportionately affected by HIV. This study analyzed surveillance data from the District of Columbia to examine care retention among YMSM living with HIV infection. They found that retention in HIV care was suboptimal for YMSM and indicated that increased retention efforts are warranted to improve outcomes and reduce age and racial/ethnic disparities.
AHRQ-funded; HS013852.
Citation: Morales-Aleman MM, Opoku J, Murray A .
Disparities in retention in HIV care among HIV-infected young men who have sex with men in the District of Columbia, 2013.
LGBT Health 2017 Feb;4(1):34-41. doi: 10.1089/lgbt.2016.0126..
Keywords: Disparities, Human Immunodeficiency Virus (HIV), Patient-Centered Healthcare, Young Adults
Mays VM, Jones AL, Delany-Brumsey A
Perceived discrimination in health care and mental health/substance abuse treatment among blacks, Latinos, and whites.
The researchers investigated whether perceived discrimination in mental health/substance abuse visits contributes to participants' ratings of treatment helpfulness and stopped treatment. They found that fifteen percent of California adults reported discrimination during a health care visit and 4% specifically during mental health/substance abuse visits. Latinos, the uninsured, and those with past year mental disorders were twice as likely as others to report health care discrimination.
AHRQ-funded; HS021721.
Citation: Mays VM, Jones AL, Delany-Brumsey A .
Perceived discrimination in health care and mental health/substance abuse treatment among blacks, Latinos, and whites.
Med Care 2017 Feb;55(2):173-81. doi: 10.1097/mlr.0000000000000638.
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Keywords: Racial and Ethnic Minorities, Substance Abuse, Behavioral Health, Disparities
Witt WP, Coffey RM, Lopez-Gonzalez L
AHRQ Author: Andrews RM, Washington RE
Understanding racial and ethnic disparities in postsurgical complications occurring in U.S. hospitals.
This study of 5,474,067 inpatient surgical discharges examined the role of patient, hospital, and community characteristics on racial and ethnic disparities in in-hospital postsurgical complications. It concluded that race does not appear to be an important determinant of in-hospital postsurgical complications, but insurance and community characteristics have an effect.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Witt WP, Coffey RM, Lopez-Gonzalez L .
Understanding racial and ethnic disparities in postsurgical complications occurring in U.S. hospitals.
Health Serv Res 2017 Feb;52(1):220-43. doi: 10.1111/1475-6773.12475.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Disparities, Surgery, Adverse Events
Lewis VA, Fraze T, Fisher ES
ACOs serving high proportions of racial and ethnic minorities lag in quality performance.
Researchers analyzed racial and ethnic disparities in health care outcomes among accountable care organizations (ACOs). Their findings suggest that ACOs with a high share of minority patients may struggle with quality performance under ACO contracts, especially during their early years of participation-maintaining or potentially exacerbating current inequities.
AHRQ-funded; HS024075.
Citation: Lewis VA, Fraze T, Fisher ES .
ACOs serving high proportions of racial and ethnic minorities lag in quality performance.
Health Aff 2017 Jan;36(1):57-66. doi: 10.1377/hlthaff.2016.0626.
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Keywords: Disparities, Racial and Ethnic Minorities, Provider Performance, Quality Indicators (QIs), Quality of Care
Gounder PP, Holman RC, Seeman SM
AHRQ Author: Steiner CA
Infectious disease hospitalizations among American Indian/Alaska native and non-American Indian/Alaska native persons in Alaska, 2010-2011.
The researchers used a merged state database to determine infectious disease (ID) hospitalization rates among American Indian/Alaska native (AI/AN) and non-American Indian/Alaska native persons in Alaska. They concluded that a substantial disparity in ID hospitalization rates exists between AI/AN and non-AI/AN persons, and the most common reason for ID hospitalization among AI/AN persons was lower respiratory tract infection.
AHRQ-authored.
Citation: Gounder PP, Holman RC, Seeman SM .
Infectious disease hospitalizations among American Indian/Alaska native and non-American Indian/Alaska native persons in Alaska, 2010-2011.
Public Health Rep 2017 Jan/Feb;132(1):65-75. doi: 10.1177/0033354916679807.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Hospitalization, Disparities, Racial and Ethnic Minorities
Stepanikova I, Oates GR
Perceived discrimination and privilege in health care: the role of socioeconomic status and race.
This study examined how perceived racial privilege and perceived racial discrimination in health care varied with race and socioeconomic status (SES). It found that in whites, higher income and education contributed to increased perceptions of privileged treatment and decreased perceptions of discrimination. The pattern was reversed in blacks, who reported more discrimination and less privilege at higher income and education levels.
AHRQ-funded; HS023009.
Citation: Stepanikova I, Oates GR .
Perceived discrimination and privilege in health care: the role of socioeconomic status and race.
Am J Prev Med 2017 Jan;52(1s1):S86-s94. doi: 10.1016/j.amepre.2016.09.024.
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Keywords: Disparities, Health Status, Racial and Ethnic Minorities, Social Determinants of Health
Simon AE, Boss EF, Zelaya CE
Racial and ethnic differences in receipt of pressure equalization tubes among US children, 2014.
More than 20 years ago, differences according to race/ethnicity in the national prevalence of having had pressure equalization tubes (PETs) placed were documented. This study found that, as of 2014, nearly 9 percent of US children have had PETs placed. Non-Hispanic white children still have a greater prevalence of PET placement compared with non-Hispanic black and Hispanic children.
AHRQ-funded; HS022932.
Citation: Simon AE, Boss EF, Zelaya CE .
Racial and ethnic differences in receipt of pressure equalization tubes among US children, 2014.
Acad Pediatr 2017 Jan - Feb;17(1):88-94. doi: 10.1016/j.acap.2016.07.004.
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Keywords: Children/Adolescents, Disparities, Ear Infections, Racial and Ethnic Minorities, Surgery
Magnusson DM, Mistry KB
AHRQ Author: Mistry KB
Racial and ethnic disparities in unmet need for pediatric therapy services: the role of family-centered care.
The researchers examined whether individual elements of family-centered care (FCC) mediate racial/ethnic disparities in parent-reported unmet therapy need. Eighteen percent of children with special health care needs 0 to 5 years old with reported therapy need experienced unmet need. Black and Hispanic children were more likely than white children to have parent-reported unmet therapy need.
AHRQ-authored.
Citation: Magnusson DM, Mistry KB .
Racial and ethnic disparities in unmet need for pediatric therapy services: the role of family-centered care.
Acad Pediatr 2017 Jan - Feb;17(1):27-33. doi: 10.1016/j.acap.2016.06.010.
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Keywords: Children/Adolescents, Disparities, Racial and Ethnic Minorities, Patient and Family Engagement, Racial and Ethnic Minorities
Stepanikova I, Bateman LB, Oates GR
Systemic inflammation in midlife: race, socioeconomic status, and perceived discrimination.
This study investigates social determinants of systemic inflammation, focusing on race, SES, and perceived discrimination. Data on 884 white and 170 black participants were obtained from the Survey of Midlife in the U.S., a cross-sectional observational study combining survey measures, anthropometry, and biomarker assay. It suggests that inflammation-reducing interventions should focus on blacks and individuals facing socioeconomic disadvantages, especially low education.
AHRQ-funded; HS023009.
Citation: Stepanikova I, Bateman LB, Oates GR .
Systemic inflammation in midlife: race, socioeconomic status, and perceived discrimination.
Am J Prev Med 2017 Jan;52(1s1):S63-s76. doi: 10.1016/j.amepre.2016.09.026.
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Keywords: Disparities, Health Status, Racial and Ethnic Minorities, Social Determinants of Health
Cook BL, Trinh NH, Li Z
Trends in racial-ethnic disparities in access to mental health care, 2004-2012.
This study compared trends in racial-ethnic disparities in mental health care access among whites, blacks, Hispanics, and Asians by using the Institute of Medicine definition of disparities as all differences except those due to clinical appropriateness, clinical need, and patient preferences. The investigators found that significant disparities were found in 2004-2005 and in 2011-2012 for all three racial-ethnic minority groups compared with whites in all three measures of access.
AHRQ-funded; HS021486.
Citation: Cook BL, Trinh NH, Li Z .
Trends in racial-ethnic disparities in access to mental health care, 2004-2012.
Psychiatr Serv 2017 Jan;68(1):9-16. doi: 10.1176/appi.ps.201500453..
Keywords: Access to Care, Disparities, Behavioral Health, Racial and Ethnic Minorities