National Healthcare Quality and Disparities Report
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- Access to Care (9)
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- Racial and Ethnic Minorities (28)
- Rehabilitation (1)
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- Respiratory Conditions (2)
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- (-) Social Determinants of Health (76)
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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 25 of 76 Research Studies DisplayedBeck A, Davidson AJ, Xu S
A multilevel analysis of individual, health system, and neighborhood factors associated with depression within a large metropolitan area.
This study geocoded depression diagnosis and demographic data from electronic health records to obtain both individual and neighborhood factors related to depression. The researchers found higher depression rates associated with greater age, female gender, white race, medical comorbidities, and with lower rates of home owner occupancy, residential stability, and higher educational attainment, but not with economic disadvantage. Among the cohort, higher depression rates were associated with higher crime rates and a lower percent of foreign born residents and single mother households.
AHRQ-funded; HS022143.
Citation: Beck A, Davidson AJ, Xu S .
A multilevel analysis of individual, health system, and neighborhood factors associated with depression within a large metropolitan area.
J Urban Health 2017 Dec;94(6):780-90. doi: 10.1007/s11524-017-0190-x..
Keywords: Depression, Electronic Health Records (EHRs), Social Determinants of Health, Urban Health
Raven MC, Guzman D, Chen AH
Out-of-network emergency department use among managed Medicaid beneficiaries.
The researchers examined factors associated with out-of-network ED use among Medicaid beneficiaries. They concluded that there are a number of factors related to out-of-network ED use, including the proximity and density of out-of-network EDs, race and ethnicity, a prior history of out-of-network ED use, and individuals' connection to primary care.
AHRQ-funded; HS021700.
Citation: Raven MC, Guzman D, Chen AH .
Out-of-network emergency department use among managed Medicaid beneficiaries.
Health Serv Res 2017 Dec;52(6):2156-74. doi: 10.1111/1475-6773.12604.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Medicaid, Primary Care, Social Determinants of Health
Attanasio LB, Hardeman RR, Kozhimannil KB
Prenatal attitudes toward vaginal delivery and actual delivery mode: variation by race/ethnicity and socioeconomic status.
This study examined whether women's prenatal attitudes toward vaginal delivery differed by race/ethnicity or socioeconomic status, and whether attitudes were differently related to delivery mode depending on race/ethnicity or socioeconomic status. The study concluded that there are racial/ethnic differences in chances of cesarean delivery, and these differences are not explained by birth attitudes. Findings also suggested that white and high-socioeconomic status women may be more able to realize their preferences in childbirth.
AHRQ-funded; HS024215.
Citation: Attanasio LB, Hardeman RR, Kozhimannil KB .
Prenatal attitudes toward vaginal delivery and actual delivery mode: variation by race/ethnicity and socioeconomic status.
Birth 2017 Dec;44(4):306-14. doi: 10.1111/birt.12305..
Keywords: Health Services Research (HSR), Labor and Delivery, Pregnancy, Racial and Ethnic Minorities, Social Determinants of Health
Parker TC, Mohammed A, Leong T
Rotavirus vaccination rate disparities seen among infants with acute gastroenteritis in Georgia.
The purpose of this study was to determine possible disparities and socio-economic differences in RV vaccination rates. The study conclude that racial disparities and socio-economic differences are not determinants in rotavirus vaccination rates; however, age and ethnicity have an effect on RV vaccine status.
AHRQ-funded; HS024338.
Citation: Parker TC, Mohammed A, Leong T .
Rotavirus vaccination rate disparities seen among infants with acute gastroenteritis in Georgia.
Ethn Health 2017 Dec;22(6):585-95. doi: 10.1080/13557858.2016.1244744..
Keywords: Disparities, Health Status, Newborns/Infants, Social Determinants of Health, Vaccination
Oates GR, Hamby BW, Stepanikova I
Social determinants of adherence to pulmonary rehabilitation for chronic obstructive pulmonary disease.
Adherence to pulmonary rehabilitation (PR) is low. Previous studies have focused on clinical predictors of PR completion. This study aimed to identify social determinants of adherence to PR. The findings showed that, relative to high adherence, low adherence is associated with limited functional capacity and current smoking, while moderate adherence is associated with socioeconomic disadvantage. The distinction highlights different pathways to suboptimal adherence and calls for tailored intervention approaches.
AHRQ-funded; HS023009.
Citation: Oates GR, Hamby BW, Stepanikova I .
Social determinants of adherence to pulmonary rehabilitation for chronic obstructive pulmonary disease.
Copd 2017 Dec;14(6):610-17. doi: 10.1080/15412555.2017.1379070..
Keywords: Respiratory Conditions, Racial and Ethnic Minorities, Patient Adherence/Compliance, Social Determinants of Health
Tung EL, Cagney KA, Peek ME
Spatial context and health inequity: reconfiguring race, place, and poverty.
The authors build on the Chicago School of Sociology's contributions in urban research and one of its contemporary elaborations, often described as the "neighborhood effects approach," to propose a three-axis model of health inequity. This model, in alignment with Chicago School theory, postulates a dynamic and adaptive relationship between spatial context and health inequity. Compositional axes of race and poverty form the foundation of the model.
AHRQ-funded; HS023007.
Citation: Tung EL, Cagney KA, Peek ME .
Spatial context and health inequity: reconfiguring race, place, and poverty.
J Urban Health 2017 Dec;94(6):757-63. doi: 10.1007/s11524-017-0210-x.
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Keywords: Disparities, Low-Income, Racial and Ethnic Minorities, Social Determinants of Health, Urban Health
Taira DA, Shen C, King M
Access to medications for Medicare enrollees related to race/ethnicity: results from the 2013 Medicare Current Beneficiary Survey.
Prescription medications are taken by millions of Americans to manage chronic conditions and treat acute conditions. These medications, however, are not equally accessible to all. The purpose of this study was to examine medication access by race/ethnicity among Medicare beneficiaries. The authors found that possible interventions for non-Hispanic blacks might include assisting them in finding the best drug plan to meeting their needs, connecting them to medication assistance programs, and discussing convenience of pharmacy with patients.
AHRQ-funded; HS023185.
Citation: Taira DA, Shen C, King M .
Access to medications for Medicare enrollees related to race/ethnicity: results from the 2013 Medicare Current Beneficiary Survey.
Res Social Adm Pharm 2017 Nov;13(6):1208-13. doi: 10.1016/j.sapharm.2016.10.021..
Keywords: Access to Care, Medicare, Medication, Racial and Ethnic Minorities, Social Determinants of Health
Lines LM, Rosen AB, Ash AS
Enhancing administrative data to predict emergency department utilization: the role of neighborhood sociodemographics.
Much of emergency department (ED) use is avoidable, and high-quality primary care can reduce it, but performance measures related to ED use may be inadequately risk-adjusted. To explore associations between ED use and neighborhood poverty, a secondary analysis of Massachusetts managed care network data, 2009-2011, was conducted.
AHRQ-funded; HS022194.
Citation: Lines LM, Rosen AB, Ash AS .
Enhancing administrative data to predict emergency department utilization: the role of neighborhood sociodemographics.
J Health Care Poor Underserved 2017;28(4):1487-508. doi: 10.1353/hpu.2017.0129..
Keywords: Emergency Department, Low-Income, Social Determinants of Health, Healthcare Utilization
Heerman WJ, Jackson N, Roumie CL
Recruitment methods for survey research: findings from the Mid-South Clinical Data Research Network.
The objective of this study was to report survey response rates and demographic characteristics of eight recruitment approaches to determine acceptability and effectiveness of large-scale patient recruitment among various populations. The study concluded that technology-enabled recruitment approaches such as registries and emails are effective for recruiting but may yield less racial/ethnic diversity compared to traditional, more time-intensive approaches.
AHRQ-funded; HS022990.
Citation: Heerman WJ, Jackson N, Roumie CL .
Recruitment methods for survey research: findings from the Mid-South Clinical Data Research Network.
Contemp Clin Trials 2017 Nov;62:50-55. doi: 10.1016/j.cct.2017.08.006..
Keywords: Patient-Centered Outcomes Research, Research Methodologies, Racial and Ethnic Minorities, Social Determinants of Health
Bachmann JM, Huang S, Gupta DK
Association of neighborhood socioeconomic context with participation in cardiac rehabilitation.
This study investigated the association of neighborhood socioeconomic context with Cardiac Rehabilitation (CR) participation in the Southern Community Cohort Study- a prospective cohort study of 84 569 adults in the southeastern United States from 2002 to 2009, 52 117 of whom have Medicare or Medicaid claims. The study found that lower neighborhood socioeconomic context was associated with decreased CR participation independent of individual socioeconomic status. These data invite research on interventions to increase CR access in deprived communities.
AHRQ-funded; HS022990.
Citation: Bachmann JM, Huang S, Gupta DK .
Association of neighborhood socioeconomic context with participation in cardiac rehabilitation.
J Am Heart Assoc 2017 Oct 11;6(10). doi: 10.1161/jaha.117.006260..
Keywords: Cardiovascular Conditions, Healthcare Utilization, Patient-Centered Outcomes Research, Rehabilitation, Social Determinants of Health
Xavier Moore J, Donnelly JP, Griffin R
Community characteristics and regional variations in sepsis.
This study aimed to determine the influence of community characteristics upon regional variations in sepsis incidence and case fatality. The study concluded that regional variations in sepsis incidence may be partly explained by community poverty. Other community characteristics do not explain regional variations in sepsis incidence or case fatality.
AHRQ-funded; HS013852.
Citation: Xavier Moore J, Donnelly JP, Griffin R .
Community characteristics and regional variations in sepsis.
Int J Epidemiol 2017 Oct 1;46(5):1607-17. doi: 10.1093/ije/dyx099..
Keywords: Disparities, Low-Income, Mortality, Sepsis, Social Determinants of Health
Leeds IL, Alimi Y, Hobson DR
Racial and socioeconomic differences manifest in process measure adherence for enhanced recovery after surgery pathway.
This study aims to demonstrate the association between recovery pathway implementation, process measures, and short-term surgical outcomes by population subgroup. It concluded that differences in outcomes by race and socioeconomic status did not arise following implementation of an enhanced recovery pathway. Differences in process measures by population subgroups highlight differences in care that require further investigation.
AHRQ-funded; HS024736; HS024547.
Citation: Leeds IL, Alimi Y, Hobson DR .
Racial and socioeconomic differences manifest in process measure adherence for enhanced recovery after surgery pathway.
Dis Colon Rectum 2017 Oct;60(10):1092-101. doi: 10.1097/dcr.0000000000000879.
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Keywords: Racial and Ethnic Minorities, Social Determinants of Health, Surgery, Outcomes, Adverse Events
Davidov DM, Davis SM, Zhu M
AHRQ Author: Stocks C
Intimate partner violence-related hospitalizations in Appalachia and the non-Appalachian United States.
The objective of this study was to estimate the rate of intimate partner violence -related hospitalizations in Appalachia and the non-Appalachian United States for 2007-2011 and compare hospitalizations in each region by clinical and sociodemographic factors.. After adjusting for age and rurality, Appalachian counties had a 22 percent higher hospitalization rate than non-Appalachian counties.
AHRQ-authored.
Citation: Davidov DM, Davis SM, Zhu M .
Intimate partner violence-related hospitalizations in Appalachia and the non-Appalachian United States.
PLoS One 2017 Sep 8;12(9):e0184222. doi: 10.1371/journal.pone.0184222.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Domestic Violence, Hospitalization, Social Determinants of Health, Rural Health
Attanasio L, Kozhimannil KB
Health care engagement and follow-up after perceived discrimination in maternity care.
The authors sought to determine if perceived discrimination during the birth hospitalization is associated with postpartum follow-up care. Using data from the Listening to Mothers III survey, they found that women who experienced perceived discrimination (race/ethnicity, insurance type, difference of opinion with provider about care) had more than twice the odds of postpartum visit nonattendance, after adjusting for socioeconomic and medical characteristics.
AHRQ-funded; HS024215.
Citation: Attanasio L, Kozhimannil KB .
Health care engagement and follow-up after perceived discrimination in maternity care.
Med Care 2017 Sep;55(9):830-33. doi: 10.1097/mlr.0000000000000773.
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Keywords: Access to Care, Maternal Care, Patient Experience, Racial and Ethnic Minorities, Social Determinants of Health
Goto T, Faridi MK, Gibo K
Trends in 30-day readmission rates after COPD hospitalization, 2006-2012.
This study investigated trends in 30-day readmission rates after chronic obstructive pulmonary disease (COPD)-related hospitalization. Overall, the 30-day readmission rate for COPD-related hospitalization decreased modestly from 20.0 percent in 2006 to 19.2 percent in 2012. Similar to the overall population, the readmission rate over the 7-year period remained persistently high in most of AHRQ-defined priority populations.
AHRQ-funded; HS023305.
Citation: Goto T, Faridi MK, Gibo K .
Trends in 30-day readmission rates after COPD hospitalization, 2006-2012.
Respir Med 2017 Sep;130:92-97. doi: 10.1016/j.rmed.2017.07.058.
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Keywords: Respiratory Conditions, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Social Determinants of Health, Vulnerable Populations
Davis MM, Renfro S, Pham R
Geographic and population-level disparities in colorectal cancer testing: a multilevel analysis of Medicaid and commercial claims data.
This study used Medicaid and commercial claims data to examine individual and geographic factors associated with colorectal cancer testing rates in Oregon. CRC testing in newly age-eligible Medicaid and commercial members remains markedly low. Disparities exist by gender, geographic residence, insurance coverage, and access to primary care.
AHRQ-funded; HS022981.
Citation: Davis MM, Renfro S, Pham R .
Geographic and population-level disparities in colorectal cancer testing: a multilevel analysis of Medicaid and commercial claims data.
Prev Med 2017 Aug;101:44-52. doi: 10.1016/j.ypmed.2017.05.001.
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Disparities, Medicaid, Social Determinants of Health
McClintock HF, Bogner HR
Incorporating patients' social determinants of health into hypertension and depression care: a pilot randomized controlled trial.
The objective of this study was to carry out a randomized controlled pilot trial to test the effectiveness of an integrated intervention for hypertension and depression incorporating patients' social determinants of health (enhanced intervention) versus an integrated intervention alone (basic intervention). The pilot trial results indicate integrated care management that addresses the social determinants of health for patients with hypertension and depression may be effective.
AHRQ-funded; HS023445.
Citation: McClintock HF, Bogner HR .
Incorporating patients' social determinants of health into hypertension and depression care: a pilot randomized controlled trial.
Community Ment Health J 2017 Aug;53(6):703-10. doi: 10.1007/s10597-017-0131-x.
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Keywords: Depression, Behavioral Health, Blood Pressure, Social Determinants of Health, Patient-Centered Healthcare, Healthcare Delivery
Derose KP, Payan DD, Fulcar MA
Factors contributing to food insecurity among women living with HIV in the Dominican Republic: a qualitative study.
The researchers examined factors contributing to food insecurity among women living with HIV (WLHIV) in the Dominican Republic (DR). Respondents identified economic instability as the primary driver of food insecurity, precipitated by enacted stigma in the labor and social domains. Women described experiences of HIV-related labor discrimination in formal and informal sectors.
AHRQ-funded; HS000046.
Citation: Derose KP, Payan DD, Fulcar MA .
Factors contributing to food insecurity among women living with HIV in the Dominican Republic: a qualitative study.
PLoS One 2017 Jul 25;12(7):e0181568. doi: 10.1371/journal.pone.0181568.
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Keywords: Human Immunodeficiency Virus (HIV), Nutrition, Patient Safety, Social Stigma, Social Determinants of Health
Hewner S, Casucci S, Sullivan S
Integrating social determinants of health into primary care clinical and informational workflow during care transitions.
Care continuity during transitions between the hospital and home requires reliable communication between providers and settings and an understanding of social determinants that influence recovery. This paper describes the coordinating transitions intervention which uses real time alerts, delivered directly to the primary care practice for complex chronically ill patients discharged from an acute care setting, to facilitate nurse care coordinator led telephone outreach.
AHRQ-funded; HS022575.
Citation: Hewner S, Casucci S, Sullivan S .
Integrating social determinants of health into primary care clinical and informational workflow during care transitions.
eGEMS 2017 Jul 4;5(2):2. doi: 10.13063/2327-9214.1282..
Keywords: Care Coordination, Chronic Conditions, Patient-Centered Healthcare, Social Determinants of Health, Transitions of Care
Gao YN, Nocon RS, Sharma R
What factors are associated with Medicaid patients' use of health centers?.
This study identified patient and neighborhood factors associated with health center (HC) use. Dually eligible patients and those with high chronic disease burden had lower odds of HC use. Temporary Assistance for Needy Families participants and Hispanic beneficiaries had higher odds. Local HC presence predicted higher HC use.
AHRQ-funded; HS000084.
Citation: Gao YN, Nocon RS, Sharma R .
What factors are associated with Medicaid patients' use of health centers?.
J Prim Care Community Health 2017 Jul;8(3):141-46. doi: 10.1177/2150131916687919.
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Keywords: Community-Based Practice, Healthcare Utilization, Medicaid, Primary Care, Social Determinants of Health
Weech-Maldonado R, Miller MJ, Lord JC
The relationships among socio-demographics, perceived health, and happiness.
This article explores explore the relationships among socio-demographics, perceived health, and happiness in a patient population of 221 adults recruited from 39 primary care practices in Alabama. Results suggest that policies aimed at increasing health literacy, promoting health, and reducing income disparities may be associated with greater happiness.
AHRQ-funded; HS021110.
Citation: Weech-Maldonado R, Miller MJ, Lord JC .
The relationships among socio-demographics, perceived health, and happiness.
Appl Res Qual Life 2017 Jun;12(2):289-302. doi: 10.1007/s11482-017-9517-8.
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Keywords: Primary Care, Social Determinants of Health
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
Fiechtner L, Cheng ER, Lopez G
Multilevel correlates of healthy BMI maintenance and return to a healthy BMI among children in Massachusetts.
This study examined predictors of healthy BMI maintenance (HBM) or return to a healthy BMI (RHB) among children. It found that racial/ethnic minorities had lower odds of HBM and RHB than non-Hispanic white children. Higher neighborhood median household income, proximity to a supermarket, and access to more open recreational space were associated with a higher odds of HBM.
AHRQ-funded; HS024332; HS022986.
Citation: Fiechtner L, Cheng ER, Lopez G .
Multilevel correlates of healthy BMI maintenance and return to a healthy BMI among children in Massachusetts.
Child Obes 2017 Apr;13(2):146-53. doi: 10.1089/chi.2016.0261.
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Keywords: Children/Adolescents, Health Promotion, Obesity, Social Determinants of Health
Farvardin S, Patel J, Khambaty M
Patient-reported barriers are associated with lower hepatocellular carcinoma surveillance rates in patients with cirrhosis.
This study characterized the association between hepatocellular carcinoma (HCC) surveillance receipt and patient knowledge, attitudes, and perceived barriers in a racially diverse and socioeconomically disadvantaged cohort of patients with cirrhosis. It found that patients with cirrhosis are knowledgeable and interested in HCC surveillance; however, patient-reported barriers are associated with lower surveillance rates in clinical practice and represent potential intervention targets to improve HCC surveillance effectiveness.
AHRQ-funded; HS022418.
Citation: Farvardin S, Patel J, Khambaty M .
Patient-reported barriers are associated with lower hepatocellular carcinoma surveillance rates in patients with cirrhosis.
Hepatology 2017 Mar;65(3):875-84. doi: 10.1002/hep.28770.
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Keywords: Cancer, Education: Patient and Caregiver, Social Determinants of Health, Diagnostic Safety and Quality
Koroukian SM, Schiltz NK, Warner DF
Social determinants, multimorbidity, and patterns of end-of-life care in older adults dying from cancer.
In this study, the researchers examined the association between end-of-life care and each of the social determinants of health and multimorbidity (MM), hypothesizing that higher MM is associated with less aggressive care. They found that, while 61.2 percent of the patients enrolled in hospice, 24.6 percent underwent cancer-directed treatment; 55.1 percent were admitted to the hospital and/or ED; and 21.7 percent died in the hospital.
AHRQ-funded; HS023113.
Citation: Koroukian SM, Schiltz NK, Warner DF .
Social determinants, multimorbidity, and patterns of end-of-life care in older adults dying from cancer.
J Geriatr Oncol 2017 Mar;8(2):117-24. doi: 10.1016/j.jgo.2016.10.001.
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Keywords: Cancer, Elderly, Palliative Care, Social Determinants of Health