National Healthcare Quality and Disparities Report
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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
51 to 75 of 96 Research Studies DisplayedGallego CJ, Shirts BH, Bennette CS
Next-generation sequencing panels for the diagnosis of colorectal cancer and polyposis syndromes: a cost-effectiveness analysis.
The researchers evaluated the cost effectiveness of next-generation sequencing (NGS) panels for the diagnosis of colorectal cancer and polyposis (CRCP) syndromes in patients referred to cancer genetics clinics. They concluded that the use of an NGS panel that includes genes associated with highly penetrant CRCP syndromes in addition to Lynch syndrome genes as a first-line test is likely to provide meaningful clinical benefits in a cost-effective manner.
AHRQ-funded; HS021686.
Citation: Gallego CJ, Shirts BH, Bennette CS .
Next-generation sequencing panels for the diagnosis of colorectal cancer and polyposis syndromes: a cost-effectiveness analysis.
J Clin Oncol 2015 Jun 20;33(18):2084-91. doi: 10.1200/jco.2014.59.3665..
Keywords: Cancer, Cancer: Colorectal Cancer, Shared Decision Making, Diagnostic Safety and Quality, Genetics, Healthcare Costs, Screening
Shih T, Chen LM, Nallamothu BK
Will bundled payments change health care? Examining the evidence thus far in cardiovascular care.
The authors explore bundled payment initiatives and their potential advantages and disadvantages, focusing their review on previous and current bundled payment programs for cardiovascular conditions. They conclude by discussing what implications these programs might have as healthcare reform takes further shape in the coming years.
AHRQ-funded; HS020671.
Citation: Shih T, Chen LM, Nallamothu BK .
Will bundled payments change health care? Examining the evidence thus far in cardiovascular care.
Circulation 2015 Jun 16;131(24):2151-8. doi: 10.1161/circulationaha.114.010393..
Keywords: Healthcare Costs, Evidence-Based Practice, Cardiovascular Conditions, Policy
Duseja R, Bardach NS, Lin GA
Revisit rates and associated costs after an emergency department encounter: a multistate analysis.
This study describes revisit rates, variation in revisit rates by diagnosis and state, and associated costs. It found that revisits after an index ED encounter are more frequent than previously reported, in part because many occur outside the index institution. Among ED patients in Florida, more resources are spent on revisits than on index ED visits.
AHRQ-funded; HS020667.
Citation: Duseja R, Bardach NS, Lin GA .
Revisit rates and associated costs after an emergency department encounter: a multistate analysis.
Ann Intern Med 2015 Jun 2;162(11):750-6. doi: 10.7326/m14-1616..
Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Emergency Department, Hospitalization, Hospital Readmissions
Akosa Antwi Y, Moriya AS, Simon K
AHRQ Author: Moriya AS
Changes in emergency department use among young adults after the Patient Protection and Affordable Care Act's dependent coverage provision.
This study examined the effects of the Affordable Care Act’s expansion of family insurance coverage to include dependents up to the age of 26 on the use of the emergency department by 19 to 25 year young adults. It found a modest but statistically significant decrease in ED use related to weekday visits, nonurgent conditions and conditions treatable in other settings.
AHRQ Author
Citation: Akosa Antwi Y, Moriya AS, Simon K .
Changes in emergency department use among young adults after the Patient Protection and Affordable Care Act's dependent coverage provision.
Ann Emerg Med. 2015 Jun;65(6):664-672.e2. doi: 10.1016/j.annemergmed.2015.01.010..
Keywords: Healthcare Costs, Emergency Department, Health Insurance
Yazdany J, Dudley RA, Chen R
Coverage for high-cost specialty drugs for rheumatoid arthritis in Medicare Part D.
The aim of this study was to conduct the first systematic, national investigation of how Part D plans cover biologic disease-modifying anti-rheumatic drugs (DMARDs) and to determine patients’ financial burden under current cost-sharing structures. It found that all Medicare Part D drug plans cover at least 1 biologic DMARD, access is highly controlled through prior authorization requirements, and beneficiaries face significant cost sharing.
AHRQ-funded; HS017723; HS016772.
Citation: Yazdany J, Dudley RA, Chen R .
Coverage for high-cost specialty drugs for rheumatoid arthritis in Medicare Part D.
Arthritis Rheumatol 2015 Jun;67(6):1474-80. doi: 10.1002/art.39079..
Keywords: Medicare, Medication, Healthcare Costs, Arthritis
Keohane LM, Grebla RC, Mor V
Medicare Advantage members' expected out-of-pocket spending for inpatient and skilled nursing facility services.
In 2011, new federal regulations restricted inpatient and skilled nursing facility cost sharing and mandated limits on out-of-pocket spending in Medicare Advantage (MA) plans. The authors found that some MA beneficiaries may still have difficulty affording acute and postacute care despite greater regulation of cost sharing.
AHRQ-funded; HS000011.
Citation: Keohane LM, Grebla RC, Mor V .
Medicare Advantage members' expected out-of-pocket spending for inpatient and skilled nursing facility services.
Health Aff 2015 Jun;34(6):1019-27. doi: 10.1377/hlthaff.2014.1146.
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Keywords: Healthcare Costs, Hospitalization, Policy, Medicare, Nursing Homes
Hirth RA, Gibson TB, Levy HG
New evidence on the persistence of health spending.
Using the MarketScan claims database, the researchers characterized the persistence of health care spending in the privately insured, under-65 population. They found that over a 6-year period,69.8 percent of enrollees never had annual spending in the top 10 percent of the distribution and the bottom 50 percent of spenders accounted for less than 10 percent of spending.
AHRQ-funded; HS017706.
Citation: Hirth RA, Gibson TB, Levy HG .
New evidence on the persistence of health spending.
Med Care Res Rev 2015 Jun;72(3):277-97. doi: 10.1177/1077558715572387..
Keywords: Healthcare Costs, Health Insurance, Data
Vemana G, Vetter J, Chen L
Sources of variation in follow-up expenditure after radical cystectomy.
Follow-up care after radical cystectomy is poorly defined, with extensive variation in practice patterns. The researchers sought to determine sources of these variations in care as well as examine the economic effect of standardization of care on guideline-recommended care. The most variation in expenditure on follow-up care was at the patient level, largely based on node positivity, chemotherapy status, and final cancer stage.
AHRQ-funded; HS019455.
Citation: Vemana G, Vetter J, Chen L .
Sources of variation in follow-up expenditure after radical cystectomy.
Urol Oncol 2015 Jun;33(6):267.e31-7. doi: 10.1016/j.urolonc.2015.03.009..
Keywords: Cancer, Surgery, Healthcare Costs, Elderly
Field TS, Ogarek J, Garber L
Association of early post-discharge follow-up by a primary care physician and 30-day rehospitalization among older adults.
The researchers aimed to determine whether an office visit with a primary care physician within 7 days after discharge is associated with 30-day rehospitalization. Of 3,661 patients discharged to home during the study year, 1,808 received an office visit within 7 days and of these, 1,000 were with a primary care physician. No protective effect for office visits within 7 days was found.
AHRQ-funded; HS017203.
Citation: Field TS, Ogarek J, Garber L .
Association of early post-discharge follow-up by a primary care physician and 30-day rehospitalization among older adults.
J Gen Intern Med 2015 May;30(5):565-71. doi: 10.1007/s11606-014-3106-4..
Keywords: Hospital Readmissions, Primary Care, Hospital Discharge, Elderly, Healthcare Costs
Sentell TL, Ahn HJ, Miyamura J
Cost burden of potentially preventable hospitalizations for cardiovascular disease and diabetes for Asian Americans, Pacific Islanders, and Whites in Hawai'i.
The authors compared the cost burdens of potentially preventable hospitalizations for cardiovascular disease and diabetes for Asian Americans, Pacific Islanders, and Whites using Hawai'i statewide 2007-2012 inpatient data. They found that costs for preventable diabetes-related amputations were significantly higher for Native Hawaiians, Japanese, and other Pacific Islanders compared with Whites.
AHRQ-funded; HS019990.
Citation: Sentell TL, Ahn HJ, Miyamura J .
Cost burden of potentially preventable hospitalizations for cardiovascular disease and diabetes for Asian Americans, Pacific Islanders, and Whites in Hawai'i.
J Health Care Poor Underserved 2015 May;26(2 Suppl):63-82. doi: 10.1353/hpu.2015.0068.
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Keywords: Cardiovascular Conditions, Diabetes, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities
Troyer JL, Jones AE, Shapiro NI
Cost-effectiveness of quantitative pretest probability intended to reduce unnecessary medical radiation exposure in emergency department patients with chest pain and dyspnea.
The purpose of this study was to consider the long-term (beyond 30-day) costs and beyond 90-day outcomes of the pretest probability intervention. It found that a single use of a quantitative pretest probability instrument with associated clinical advice resulted in lifetime medical cost savings of approximately $500, with a small increase in quality-of-life years, for a 40-year-old patient.
AHRQ-funded; HS018519.
Citation: Troyer JL, Jones AE, Shapiro NI .
Cost-effectiveness of quantitative pretest probability intended to reduce unnecessary medical radiation exposure in emergency department patients with chest pain and dyspnea.
Acad Emerg Med 2015 May;22(5):525-35. doi: 10.1111/acem.12648..
Keywords: Emergency Department, Emergency Medical Services (EMS), Healthcare Costs, Healthcare Costs
Pallas SW, Khuat TH, Le QD
The changing donor landscape of health sector aid to Vietnam: a qualitative case study.
The study objective was to identify how donors and government agencies in Vietnam responded to donor proliferation in health sector aid between 1995 and 2012. The study concludes that central government and donor agencies in Vietnam responded to donor proliferation in health sector aid by endorsing aid effectiveness policies but implementing these policies inconsistently in practice.
AHRQ-funded; HS017589.
Citation: Pallas SW, Khuat TH, Le QD .
The changing donor landscape of health sector aid to Vietnam: a qualitative case study.
Soc Sci Med 2015 May;132:165-72. doi: 10.1016/j.socscimed.2015.03.027..
Keywords: Policy, Health Services Research (HSR), Healthcare Costs
Pisu M, Kenzik KM, Oster RA
Economic hardship of minority and non-minority cancer survivors 1 year after diagnosis: another long-term effect of cancer?
The authors investigated economic hardships experienced by racial/ethnic minority cancer survivors compared to whites. They found that economic hardship was evident in almost 1 in 2 cancer survivors 1 year after diagnosis, especially African Americans. They recommended that future research evaluate and address risk factors and their impact on survival and survivorship outcomes.
AHRQ-funded; HS013852.
Citation: Pisu M, Kenzik KM, Oster RA .
Economic hardship of minority and non-minority cancer survivors 1 year after diagnosis: another long-term effect of cancer?
Cancer 2015 Apr 15;121(8):1257-64. doi: 10.1002/cncr.29206.
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Keywords: Cancer, Disparities, Healthcare Costs, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Conti RM, Padula WV, Larson RA
Changing the cost of care for chronic myeloid leukemia: the availability of generic imatinib in the USA and the EU.
This article discusses various issues associated with potential impact on health system spending levels for chronic myeloid leukemia after generic imatinib becomes available. Included is a review of their implications for the development of country-specific cost-effectiveness models to predict the implications for cost and quality of care from generic imatinib.
AHRQ-funded; HS023710.
Citation: Conti RM, Padula WV, Larson RA .
Changing the cost of care for chronic myeloid leukemia: the availability of generic imatinib in the USA and the EU.
Ann Hematol 2015 Apr;94 Suppl 2:S249-57. doi: 10.1007/s00277-015-2319-x..
Keywords: Cancer, Medication, Healthcare Costs
Predmore ZS, Mattke S, Horvitz-Lennon M
Improving antipsychotic adherence among patients with schizophrenia: savings for states.
The authors presented findings of an analysis conducted to quantify the potential net savings to state budgets from interventions to improve adherence to antipsychotic drugs among patients with schizophrenia. Their financial model estimated an annual cost of $21.4 billion (in 2013 dollars) to Medicaid programs and other state agencies for people with schizophrenia. They concluded that better adherence could yield annual net savings of $3.28 billion to states and recommended that states consider interventions shown to increase medication adherence in this patient group.
AHRQ-funded; HS000029.
Citation: Predmore ZS, Mattke S, Horvitz-Lennon M .
Improving antipsychotic adherence among patients with schizophrenia: savings for states.
Psychiatr Serv 2015 Apr;66(4):343-5. doi: 10.1176/appi.ps.201400506.
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Keywords: Healthcare Costs, Medication, Behavioral Health, Patient Adherence/Compliance
Selden TM, Dubay L, Miller GE
AHRQ Author: Selden TM, Miller GE
Many families may face sharply higher costs if public health insurance for their children is rolled back.
If possible cuts to the Children’s Health Insurance Program (CHIP) and elimination of the Affordable Care Act’s “maintenance of effort” provisions regarding Medicaid and CHIP take place; this study shows that many families would face sharply higher costs of providing insurance coverage for their children.
AHRQ Author
Citation: Selden TM, Dubay L, Miller GE .
Many families may face sharply higher costs if public health insurance for their children is rolled back.
Health Aff. 2015 Apr;34(4):697-706. doi: 10.1377/hlthaff.2015.0003..
Keywords: Children's Health Insurance Program (CHIP), Healthcare Costs, Children/Adolescents
Hellinger FJ
AHRQ Author: Hellinger FJ
Measuring the cost effectiveness of HIV prevention interventions in the US: pitfalls and problems.
The author comments on a review of cost-effectiveness studies of four types of HIV prevention interventions in the US. He agrees with the primary conclusion of the review that more cost-effectiveness research is needed to fill the knowledge gaps of interventions related to prevention for HIV-positives, condom distribution, and policy initiatives, in order to help guide the most efficient use of resources.
AHRQ-authored.
Citation: Hellinger FJ .
Measuring the cost effectiveness of HIV prevention interventions in the US: pitfalls and problems.
Appl Health Econ Health Policy 2015 Apr;13(2):129-33. doi: 10.1007/s40258-015-0158-5..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Healthcare Costs
Cook BL, Liu Z, Lessios AS
The costs and benefits of reducing racial-ethnic disparities in mental health care.
The investigators examined whether reducing racial-ethnic disparities in mental health care offsets costs of care. They found that, for blacks and Latinos, the potential savings from eliminating disparities in inpatient general medical expenditures are substantial, as much as $1 billion nationwide, suggesting that financial and equity considerations can be aligned when planning disparity reduction programs.
AHRQ-funded; HS021486.
Citation: Cook BL, Liu Z, Lessios AS .
The costs and benefits of reducing racial-ethnic disparities in mental health care.
Psychiatr Serv 2015 Apr;66(4):389-96. doi: 10.1176/appi.ps.201400070.
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Keywords: Disparities, Healthcare Costs, Racial and Ethnic Minorities, Medical Expenditure Panel Survey (MEPS), Behavioral Health
Schackman BR, Fleishman JA, Su AE
AHRQ Author: Fleishman JA
The lifetime medical cost savings from preventing HIV in the United States.
The researchers sought to estimate the medical cost saved by averting 1 HIV infection in the United States. They found that the estimated discounted lifetime cost for persons who become HIV infected at age 35 is $326,500 (60% for antiretroviral medications, 15% for other medications, 25% nondrug costs.
AHRQ-authored; AHRQ-funded; 290201100007C.
Citation: Schackman BR, Fleishman JA, Su AE .
The lifetime medical cost savings from preventing HIV in the United States.
Med Care 2015 Apr;53(4):293-301. doi: 10.1097/mlr.0000000000000308..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Human Immunodeficiency Virus (HIV), Prevention
Geynisman DM, Hu JC, Liu L
Treatment patterns and costs for metastatic renal cell carcinoma patients with private insurance in the United States.
The researchers used a large claims database to examine the evolution of treatment patterns and associated costs for 1527 metastatic renal cell carcinoma (mRCC) patients in the United States. They found that the treatment of mRCC has transitioned from cytokines and cytotoxic chemotherapy to almost exclusively targeted therapy. Cost of care for mRCC is rising each year, and out-of-pocket costs for patients are significant.
AHRQ-funded; HS018535; HS020263.
Citation: Geynisman DM, Hu JC, Liu L .
Treatment patterns and costs for metastatic renal cell carcinoma patients with private insurance in the United States.
Clin Genitourin Cancer 2015 Apr;13(2):e93-100. doi: 10.1016/j.clgc.2014.08.013..
Keywords: Cancer, Kidney Disease and Health, Health Insurance, Healthcare Costs
Adams AS, Soumerai SB, Zhang F
Effects of eliminating drug caps on racial differences in antidepressant use among dual enrollees with diabetes and depression.
This study aimed to evaluate the impact of removing a significant financial barrier to prescription medications (drug caps) on existing black-white disparities in antidepressant treatment rates among patients with diabetes and comorbid depression. It found that policies that remove financial barriers to medications may increase depression treatment rates among patients with diabetes overall while exacerbating treatment disparities.
AHRQ-funded; HS018577; HS018072.
Citation: Adams AS, Soumerai SB, Zhang F .
Effects of eliminating drug caps on racial differences in antidepressant use among dual enrollees with diabetes and depression.
Clin Ther 2015 Mar;37(3):597-609. doi: 10.1016/j.clinthera.2014.12.011..
Keywords: Medication, Disparities, Depression, Diabetes, Healthcare Costs
Leung MY, Pollack LM, Colditz GA
Life years lost and lifetime health care expenditures associated with diabetes in the U.S., National Health Interview Survey, 1997-2000.
The authors analyzed the lifetime health care expenditures and life years lost associated with diabetes in the U.S. Their results showed that diabetes is associated with large decreases in life expectancy and large increases in lifetime health care expenditures, with the life years and expenditures depending on age-race-sex-BMI classification groups.
AHRQ-funded; HS022330.
Citation: Leung MY, Pollack LM, Colditz GA .
Life years lost and lifetime health care expenditures associated with diabetes in the U.S., National Health Interview Survey, 1997-2000.
Diabetes Care 2015 Mar;38(3):460-8. doi: 10.2337/dc14-1453.
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Keywords: Diabetes, Healthcare Costs, Medical Expenditure Panel Survey (MEPS), Mortality
Prentice JC, Conlin PR, Gellad WF
Long-term outcomes of analogue insulin compared with NPH for patients with type 2 diabetes mellitus.
The researchers compared the effects of neutral protamine Hagedorn (NPH) and long-acting insulin analogues on long-term outcomes. They found no consistent difference in long-term health outcomes when comparing use of long-acting insulin analogues and NPH insulin. The higher cost of analogue insulin without demonstrable clinical benefit raises questions of its cost effectiveness in the treatment of patients with diabetes.
AHRQ-funded; HS019708.
Citation: Prentice JC, Conlin PR, Gellad WF .
Long-term outcomes of analogue insulin compared with NPH for patients with type 2 diabetes mellitus.
Am J Manag Care 2015 Mar;21(3):e235-43..
Keywords: Comparative Effectiveness, Diabetes, Healthcare Costs, Medication, Outcomes
Davidoff AJ, Hendrick FB, Zeidan AM
AHRQ Author: Davidoff AJ
Patient cost sharing and receipt of erythropoiesis-stimulating agents through Medicare part D.
This study examined use of erythropoiesis-stimulating agents (ESAs) to manage anemia in patients with myelodysplastic syndromes (MDS). It found that few patients with MDS received ESAs through Part D. OOP payments required under Part D were substantially higher than under Part B. Cost sharing, as reflected by low-income subsidy receipt, likely affected decisions to prescribe ESAs outside of the physician office.
AHRQ-authored.
Citation: Davidoff AJ, Hendrick FB, Zeidan AM .
Patient cost sharing and receipt of erythropoiesis-stimulating agents through Medicare part D.
J Oncol Pract 2015 Mar;11(2):e190-8. doi: 10.1200/jop.2014.001527..
Keywords: Elderly, Healthcare Costs, Medicare, Medication
Rust G, Zhang S, McRoy L
Potential savings from increasing adherence to inhaled corticosteroid therapy in Medicaid-enrolled children.
This study simulated the cost impact of achieving various levels of increase in inhaled corticosteroid therapy (ICS-Rx) adherence levels among elementary school–aged children (5-12 years) initially receiving a new ICS-Rx for asthma. It found that increasing the proportion of children who maintain higher adherence to 40 percent would generate savings of $95 per child per year.
AHRQ-funded; HS022444.
Citation: Rust G, Zhang S, McRoy L .
Potential savings from increasing adherence to inhaled corticosteroid therapy in Medicaid-enrolled children.
Am J Manag Care 2015 Mar;21(3):173-80..
Keywords: Children/Adolescents, Asthma, Patient Adherence/Compliance, Healthcare Costs, Medicaid