National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (3)
- Children's Health Insurance Program (CHIP) (1)
- Children/Adolescents (2)
- Community-Based Practice (1)
- Disparities (1)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (2)
- Healthcare Utilization (2)
- Health Insurance (7)
- Human Immunodeficiency Virus (HIV) (1)
- Low-Income (4)
- Medicaid (2)
- Medicare (1)
- Medication (1)
- Policy (1)
- Prevention (1)
- Racial and Ethnic Minorities (1)
- (-) Uninsured (11)
- Vulnerable Populations (3)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 11 of 11 Research Studies DisplayedChu J, Roby DH, Boudreaux MH
Effects of the Children's Health Insurance Reauthorization Act on immigrant children's healthcare access.
The purpose of this study was to estimate the effects of the Children's Health Insurance Reauthorization Act (CHIPRA) on insurance coverage, access, utilization, and health outcomes among immigrant children. The researchers utilized the restricted use 2000-2016 National Health Interview Survey (NHIS)with a sample which included immigrant children between the ages of 0 and 18 born outside the United States, with family income below 300% of the Federal Poverty Level (FPL). The study found that CHIPRA was related with a decrease in uninsured rates and an increase in public insurance enrollment for immigrant children. The effects of CHIPRA became small and statistically not significant 3 years after adoption. The researchers found no significant changes in health care access and utilization, and health outcomes, overall and across subgroups due to CHIPRA. The researchers concluded that the eligibility expansion of CHIPRA was related with increases in public insurance coverage for low-income children. However, no effect of CHIPRA on access to care and health was found.
AHRQ-funded; HS028532.
Citation: Chu J, Roby DH, Boudreaux MH .
Effects of the Children's Health Insurance Reauthorization Act on immigrant children's healthcare access.
Health Serv Res 2022 Dec;57(suppl 2):315-25. doi: 10.1111/1475-6773.14061..
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Access to Care, Vulnerable Populations, Uninsured
Behr CL, Hull P, Hsu J
Geographic access to federally qualified health centers before and after the Affordable Care Act.
Funding for Federally Qualified Health Centers (FQHCs) increased with the advent of the Affordable Care Act (ACA). The purpose of this study was to define FQHC service areas based on patient use and examine the characteristics of areas that gained FQHC access post-ACA. The researchers first defined FQHC service areas using total patient counts by ZIP code from the Uniform Data System (UDS) and then compared that approach with other methods. The authors then compared the characteristics of ZIP codes from Medically Underserved Areas/ Populations (MUA/Ps) that gained access to FQHCs between 2011-2015, with MUA/P ZIP codes that did not gain access to FQHCs during that same time period. The study found that FQHC service areas based on the UDS data included a larger percentage of FQHC patients and a higher use of FQHCs among low-income residents, on average, than Primary Care Service Areas or counties. The researchers also discovered that MUA/Ps that gained access to an FQHC between 2011 and 2015 included more poor, publicly insured, uninsured, and foreign born residents than underserved areas that did not gain access. The study concluded that measures of actual patient use are a useful method of assessing FQHC service areas and access.
AHRQ-funded; HS025378.
Citation: Behr CL, Hull P, Hsu J .
Geographic access to federally qualified health centers before and after the Affordable Care Act.
BMC Health Serv Res 2022 Mar 23;22(1):385. doi: 10.1186/s12913-022-07685-0..
Keywords: Access to Care, Uninsured, Vulnerable Populations
Porteny T, Ponce N, Sommers BD
Immigrants and the Affordable Care Act: changes in coverage and access to care by documentation status.
This study used data from the California Health Interview Survey (2003-2016) to compare changes in health coverage and access to care among immigrants in California before and after the Affordable Care Act (ACA). The authors found that the ACA has led to major gains in coverage for lawful permanent residents in California, but unauthorized immigrants experienced only modest increases in coverage. This result widened the disparity in uninsured rates for unauthorized immigrants relative to citizens considerably since 2014.
AHRQ-funded; HS000055.
Citation: Porteny T, Ponce N, Sommers BD .
Immigrants and the Affordable Care Act: changes in coverage and access to care by documentation status.
J Immigr Minor Health 2022 Feb;24(1):86-94. doi: 10.1007/s10903-020-01124-0..
Keywords: Access to Care, Health Insurance, Uninsured, Vulnerable Populations
Chang L, Rees CA, Michelson KA
Association of socioeconomic characteristics with where children receive emergency care.
This study’s objective was to characterize national associations of neighborhood income and insurance type for children with the characteristics of emergency departments (EDs) from which they receive care. The authors conducted a cross-sectional study of ED visits by children from 2014 to 2017 using the Nationwide Emergency Department Sample. Emergency department characteristics were characterized by pediatric volume category. There was a total of 107.6 million ED visits from 2014 to 2017. Children outside of the wealthiest neighborhood income quartile had lower proportions of visits to high-volume pediatric EDs and greater proportions of visits to low-volume pediatric EDs than children in the wealthiest quartile. Publicly insured children were modestly more likely to visit higher-volume pediatric EDs than privately insurance and uninsured children. This association appears to be principally driven by urban-rural differences in access to pediatric emergency care.
AHRQ-funded; HS026503.
Citation: Chang L, Rees CA, Michelson KA .
Association of socioeconomic characteristics with where children receive emergency care.
Pediatr Emerg Care 2022 Jan;38(1):e264-e67. doi: 10.1097/pec.0000000000002244..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Health Insurance, Uninsured, Low-Income
Vargas Bustamante A, Chen J
The great recession and health spending among uninsured U.S. immigrants: implications for the Affordable Care Act implementation.
This study of the association between the timing of the Great Recession (GR) and health spending among uninsured U.S. immigrants found that the probability of any spending diminished for recent immigrants compared to citizens during the GR. For those with any spending, recent immigrants reported 27 percent higher spending during the GR.
AHRQ-funded; HS022634
Citation: Vargas Bustamante A, Chen J .
The great recession and health spending among uninsured U.S. immigrants: implications for the Affordable Care Act implementation.
Health Serv Res. 2014 Dec;49(6):1900-24. doi: 10.1111/1475-6773.12193..
Keywords: Healthcare Costs, Uninsured, Disparities
Epstein AM, Sommers BD, Kuznetsov Y
Low-income residents in three states view Medicaid as equal to or better than private coverage, support expansion.
The authors explored what low-income Americans think about Medicaid. They found that nearly 80 percent of their telephone survey sample favored Medicaid expansion, and approximately two-thirds of uninsured respondents said that they planned to apply for either Medicaid or subsidized private coverage in 2014. Most viewed having Medicaid as better than being uninsured and at least as good as private insurance in overall quality and affordability.
AHRQ-funded; HS021291.
Citation: Epstein AM, Sommers BD, Kuznetsov Y .
Low-income residents in three states view Medicaid as equal to or better than private coverage, support expansion.
Health Aff 2014 Nov;33(11):2041-7. doi: 10.1377/hlthaff.2014.0747.
.
.
Keywords: Health Insurance, Policy, Low-Income, Medicaid, Uninsured
Heintzman J, Marino M, Hoopes M
Using electronic health record data to evaluate preventive service utilization among uninsured safety net patients.
This study used EHR data to compare the preventive service utilization of uninsured patients receiving care at Oregon community health centers (CHCs) in 2008 through 2011 with that of continuously insured patients at the same CHCs in the same period. The results showed that CHCs provided many preventive services to uninsured patients, but that uninsured patients were less likely than continuously insured patients to receive 5 of 11 preventive services. The authors concluded that lack of insurance is a barrier to preventive service utilization, even in patients who can access care at a CHC.
AHRQ-funded; HS021522.
Citation: Heintzman J, Marino M, Hoopes M .
Using electronic health record data to evaluate preventive service utilization among uninsured safety net patients.
Prev Med 2014 Oct;67:306-10. doi: 10.1016/j.ypmed.2014.08.006.
.
.
Keywords: Community-Based Practice, Electronic Health Records (EHRs), Healthcare Utilization, Prevention, Uninsured
Yehia BR, Fleishman JA, Agwu AL
AHRQ Author: Fleishman JA
Health insurance coverage for persons in HIV care, 2006-2012.
The authors examined trends in health insurance coverage at 11 US HIV clinics between 2006 and 2012. They found that Medicaid coverage was more prevalent among women than men; blacks and Hispanics than whites; and individuals with injection drug use risk compared with other transmission risk factors, with Hispanics and younger age groups more likely to be uninsured than other racial/ethnic and older age groups, respectively.
AHRQ-authored; AHRQ-funded; 290201100007C.
Citation: Yehia BR, Fleishman JA, Agwu AL .
Health insurance coverage for persons in HIV care, 2006-2012.
J Acquir Immune Defic Syndr 2014 Sep 1;67(1):102-6. doi: 10.1097/qai.0000000000000251.
.
.
Keywords: Health Insurance, Human Immunodeficiency Virus (HIV), Medicare, Racial and Ethnic Minorities, Uninsured
Crisp GD, Roberts AW, Esserman DA
The University of North Carolina's Health Care Pharmacy Assistance Program.
This study examined a program providing financial assistance to uninsured residents of North Carolina who need prescription medications. It found that from 2009 to 2011, the program served 7,180 patients in 81 counties. These patients received a mean of 23 prescriptions at an average cost of $754 per recipient per year.
AHRQ-funded; HS000032
Citation: Crisp GD, Roberts AW, Esserman DA .
The University of North Carolina's Health Care Pharmacy Assistance Program.
N C Med J. 2014 Sep-Oct;75(5):303-9..
Keywords: Healthcare Costs, Uninsured, Medication, Healthcare Utilization
Politi MC, Kaphingst KA, Kreuter M
Knowledge of health insurance terminology and details among the uninsured.
This study examined currently uninsured individuals’ understanding of terminology and details in health care plans in a series of interviews of a small mostly low-income and African American population. It found that the cost of the premium and having fixed costs through co-payments rather than coinsurance were very important so that individuals could budget as best as possible.
AHRQ-funded; HS020309.
Citation: Politi MC, Kaphingst KA, Kreuter M .
Knowledge of health insurance terminology and details among the uninsured.
Med Care Res Rev 2014 Feb;71(1):85-98. doi: 10.1177/1077558713505327..
Keywords: Uninsured, Low-Income, Health Insurance
Sommers BD, Kenney GM, Epstein AM
New evidence on the Affordable Care Act: coverage impacts of early Medicaid expansions.
Since 2010 California, Connecticut, Minnesota, and Washington, D.C., have taken advantage of the Affordable Care Act’s option to expand coverage earlier to a portion of low-income childless adults. The researchers present new data on these expansions focusing on several questions including the extent to which childless adults’ new enrollment in Medicaid result from extending coverage to uninsured people as opposed to replacing private coverage.
AHRQ-funded; HS021291.
Citation: Sommers BD, Kenney GM, Epstein AM .
New evidence on the Affordable Care Act: coverage impacts of early Medicaid expansions.
Health Aff 2014 Jan;33(1):78-87. doi: 10.1377/hlthaff.2013.1087..
Keywords: Low-Income, Uninsured, Medicaid, Health Insurance