National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (9)
- Ambulatory Care and Surgery (1)
- Behavioral Health (3)
- Blood Pressure (1)
- Cardiovascular Conditions (1)
- Children/Adolescents (4)
- Chronic Conditions (2)
- Community-Based Practice (1)
- Dental and Oral Health (2)
- Diabetes (2)
- Disparities (3)
- Healthcare Costs (5)
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- (-) Healthcare Utilization (23)
- Health Insurance (7)
- Health Services Research (HSR) (1)
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- Heart Disease and Health (1)
- Maternal Care (1)
- Medicaid (3)
- (-) Medical Expenditure Panel Survey (MEPS) (23)
- Medicare (1)
- Medication (3)
- Obesity (2)
- Policy (3)
- Pregnancy (1)
- Prevention (4)
- Primary Care (1)
- Racial and Ethnic Minorities (1)
- Rural Health (1)
- Social Determinants of Health (2)
- Uninsured (1)
- Women (1)
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 23 of 23 Research Studies DisplayedAbdus S, Selden TM
AHRQ Author: Abdus S, Selden TM
Well-child visit adherence.
This article presents updated evidence on well-child visit adherence, using MEPS data to conduct a cross-sectional study. The results indicate that average adherence increased between 2006-07 and 2016-17, but the authors note that large gaps remain in such areas as race and ethnicity, poverty level, insurance coverage, and geographic region.
AHRQ-authored.
Citation: Abdus S, Selden TM .
Well-child visit adherence.
JAMA Pediatr 2022 Nov;176(11):1143-45. doi: 10.1001/jamapediatrics.2022.2954..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Healthcare Utilization, Access to Care
Levine DM, Chalasani R, Linder JA
Association of the Patient Protection and Affordable Care Act with ambulatory quality, patient experience, utilization, and cost, 2014-2016.
The national impact of the Patient Protection and Affordable Care Act (ACA) continues to be debated. The purpose of this cross-sectional study was to determine the relationship between the ACA and ambulatory quality, patient experience, utilization, and cost by comparing outcomes before (2011-2013) and after (2014-2016) ACA implementation. The study focused on United States adults between 18 and 64 years of age with income less than and greater than or equal to 400% of the federal poverty level (FPL), who had responded to the annual Medical Expenditure Panel Survey. Researchers conducted analysis of data from a sample of 123,171 individuals between January 2021 and March 2022. The study found that after the implementation of ACA, adults with income levels less than 400% of the FPL received increased high value care such as diagnostic and preventive testing when compared with adults with income 400% or higher of the FPL, and there were no differences in the other quality measures. Individuals with income less than 400% of the FPL had greater improvements in access, experience, and communication measures compared with those who had income greater than or equal to 400% of the FPL. Receipt of primary care services increased for individuals with lower income compared to individuals with higher income and for those with lower income compared to those with higher income, total out-of-pocket expenditures decreased. There were no other differences in utilization or cost between those groups. The researchers concluded that in this study, the ACA was not associated with changes in utilization, quality, or cost, but was related to decreased out-of-pocket expenditures and improved patient access, communication, and experience.
AHRQ-funded; 233201500020I; HS026506; HS028127.
Citation: Levine DM, Chalasani R, Linder JA .
Association of the Patient Protection and Affordable Care Act with ambulatory quality, patient experience, utilization, and cost, 2014-2016.
JAMA Netw Open 2022 Jun 1;5(6):e2218167. doi: 10.1001/jamanetworkopen.2022.18167..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Healthcare Utilization, Ambulatory Care and Surgery, Health Insurance, Access to Care
Kumar V, Encinosa W
AHRQ Author: Kumar V, Encinosa W
Explaining the obesity paradox in healthcare utilization among people with type 2 diabetes.
The authors sought to examine changes in the relationship between BMI and number of visits in diabetic vs nondiabetic populations, controlling for confounding risk factors. Using MEPS data, they found that the obesity paradox does not exist at the utilization level and is due to the presence of statistical biases such as confounding and reverse causation.
AHRQ-authored.
Citation: Kumar V, Encinosa W .
Explaining the obesity paradox in healthcare utilization among people with type 2 diabetes.
Diabetol Int 2022 Jan;13(1):232-43. doi: 10.1007/s13340-021-00530-5..
Keywords: Medical Expenditure Panel Survey (MEPS), Obesity, Diabetes, Chronic Conditions, Healthcare Utilization
Abdus S
AHRQ Author: Abdus S
Trends in differences across subgroups of adults in preventive services utilization.
This study examines whether preventive services utilization changed over time, across subgroups of adults defined by race/ethnicity, insurance coverage, poverty status, Census region, and urbanicity. Using MEPS data and examining general checkups, blood cholesterol screening, mammograms, and colorectal cancer screening, findings showed modest increases in utilization between 2008/2009 and 2015/2016 for blood cholesterol and colorectal cancer screenings. Large gaps in utilization across income groups and between those with and without coverage persisted. Disparities across racial/ethnic groups in general checkups persisted over time as well.
AHRQ-authored.
Citation: Abdus S .
Trends in differences across subgroups of adults in preventive services utilization.
Med Care 2021 Dec;59(12):1059-66. doi: 10.1097/mlr.0000000000001634..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Utilization, Prevention
Zuvekas SH, McClellan CB, Ali MM
AHRQ Author: Zuvekas SH, McClellan CB
Medicaid expansion and health insurance coverage and treatment utilization among individuals with a mental health condition.
AHRQ-authored.
Citation: Zuvekas SH, McClellan CB, Ali MM .
Medicaid expansion and health insurance coverage and treatment utilization among individuals with a mental health condition.
J Ment Health Policy Econ 2020 Sep 1;23(3):151-82..
Keywords: Medical Expenditure Panel Survey (MEPS), Behavioral Health, Medicaid, Health Insurance, Access to Care, Healthcare Utilization, Policy, Uninsured
Cook BL, Flores M, Zuvekas SH
AHRQ Author: Zuvekas SH
The impact Of Medicare's mental health cost-sharing parity on use of mental health care services.
This study examined the impact of Medicare’s mental health cost-sharing parity on use of mental health care services, which was phased in from 2010 to 2014. The authors assessed whether the reduction in mental health cost sharing was associated with changes in specialty and primary care outpatient mental health visits and psychotropic medication fills. They compared people with Medicare and private insurance before and after implementation. Medicare beneficiaries’ use of psychotropic medication increased after implementation but there was not a detectable change in visits.
AHRQ-authored.
Citation: Cook BL, Flores M, Zuvekas SH .
The impact Of Medicare's mental health cost-sharing parity on use of mental health care services.
Health Aff 2020 May;39(5):819-27. doi: 10.1377/hlthaff.2019.01008..
Keywords: Medical Expenditure Panel Survey (MEPS), Medicare, Behavioral Health, Healthcare Costs, Policy, Health Insurance, Healthcare Utilization, Access to Care
Berdahl T, Biener A, McCormick MC
AHRQ Author: Berdahl T
Annual report on children's healthcare: healthcare access and utilization by obesity status in the United States.
This study examined access to care and utilization patterns across a set of healthcare measures by obesity status and sociodemographic characteristics among children. Data from the Medical Expenditure Panel Survey (MEPS) from 2010-2015 was used to determine obesity status, number of well-child visits, access to a usual source of care, number of preventive dental visits and prescription medication fills in the past year. It was found that uninsured adolescents with obesity were less like to have a usual source of care provider than children without obesity. Among younger children, those living in the Northeast were more than twice as likely to have had a well-child visit than those living in the West. Preventive dental care was less likely to have occurred for children with obesity than non-obese children. More prescription refills were completed for obese adolescents than for younger children.
AHRQ-authored.
Citation: Berdahl T, Biener A, McCormick MC .
Annual report on children's healthcare: healthcare access and utilization by obesity status in the United States.
Acad Pediatr 2020 Mar;20(2):175-87. doi: 10.1016/j.acap.2019.11.020..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Access to Care, Healthcare Utilization, Obesity
Abdus S
AHRQ Author: Abdus S
The role of plan choice in health care utilization of high-deductible plan enrollees.
This study examined the role of plan choice in health care utilization of high-deductible plan enrollees. 2011-2016 MEPS Household Component data on nonelderly adults enrolled in employer-sponsored insurance was used. Four types of health plans were examined: high-deductible, consumer-directed, low-deductible, and no-deductible. Among adults with a choice of plans, high-deductible enrollees had lower levels of utilization compared with no-deductible enrollees for all types of services. This might be explained by favorable selection and that the enrollees are probably younger and healthier with the high-deductible plans being lower in cost than other plan types. Among adults without any choice of plans, the differences were not statistically significant.
AHRQ-authored.
Citation: Abdus S .
The role of plan choice in health care utilization of high-deductible plan enrollees.
Health Serv Res 2020 Feb;55(1):119-27. doi: 10.1111/1475-6773.13223..
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Healthcare Utilization
Kirby JB, Zuvekas SH, Borsky AE
AHRQ Author: Kirby JB, Zuvekas SH, Borsky AE, Ngo-Metzger Q.
Rural residents with mental health needs have fewer care visits than urban counterparts.
This analysis compared the number of adults with mental health needs living in rural areas compared to those in urban areas. A nationally representative sample of adults showed that there were fewer ambulatory mental health visits for rural residents, even with those already on prescription medications for mental health conditions.
AHRQ-authored.
Citation: Kirby JB, Zuvekas SH, Borsky AE .
Rural residents with mental health needs have fewer care visits than urban counterparts.
Health Aff 2019 Dec;38(12):2057-60. doi: 10.1377/hlthaff.2019.00369..
Keywords: Medical Expenditure Panel Survey (MEPS), Behavioral Health, Rural Health, Access to Care, Healthcare Utilization
Ngo-Metzger Q, Zuvekas S, Shafer P
AHRQ Author: Ngo-Metzger Q, Zuvekas S, Shafer P, Tracer H, Borsky AE, Bierman AS
Ngo-Metzger Q, Zuvekas S, Shafer P, Tracer H, Borsky AE, Bierman AS. Statin use in the U.S. for secondary prevention of cardiovascular disease remains suboptimal.
Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of mortality in the United States. The purpose of this study was to examine the rates of statin use for secondary prevention of ASCVD events in the United States over the last decade and determine whether disparities in the treatment of ASCVD still persist among women and racial/ethnic minorities.
AHRQ-authored.
Citation: Ngo-Metzger Q, Zuvekas S, Shafer P .
Ngo-Metzger Q, Zuvekas S, Shafer P, Tracer H, Borsky AE, Bierman AS. Statin use in the U.S. for secondary prevention of cardiovascular disease remains suboptimal.
J Am Board Fam Med 2019 Nov-Dec;32(6):807-17. doi: 10.3122/jabfm.2019.06.180313..
Keywords: Medical Expenditure Panel Survey (MEPS), Cardiovascular Conditions, Medication, Healthcare Utilization, Prevention, Heart Disease and Health, Disparities
Fabiyi CA, Reid LD, Mistry KB
AHRQ Author: Fabiyi CA, Mistry KB
Postpartum health care use after gestational diabetes and hypertensive disorders of pregnancy.
The objective of this study was to examine postpartum health care utilization after a pregnancy complicated by gestational diabetes (GD) and hypertensive disorders of pregnancy (HDP) using nationally representative data. The investigators found that women with GD/HDP did not differ from women with neither complication on postpartum utilization outcomes. Less educated women with GD/HDP were more likely to miss an office visit within 1 year postpartum than less educated women with neither complication. Certain subgroups of women were more likely to forego timely and appropriate postpartum care.
AHRQ-authored.
Citation: Fabiyi CA, Reid LD, Mistry KB .
Postpartum health care use after gestational diabetes and hypertensive disorders of pregnancy.
J Womens Health 2019 Aug;28(8):1116-23. doi: 10.1089/jwh.2018.7198..
Keywords: Medical Expenditure Panel Survey (MEPS), Maternal Care, Pregnancy, Diabetes, Blood Pressure, Women, Healthcare Utilization
Selden TM, Abdus S, Miller GE
AHRQ Author: Selden TM, Abdus S, Miller GE
Decomposing changes in the growth of U.S. prescription drug use and expenditures, 1999-2016.
Data from the Medical Expenditure Panel Survey (MEPS) was examined to analyze factors associated with changes in prescription drug use and expenditures in the US from 1999 to 2016. There were large increases in prescription drug use during that period, with per capita utilization increasing by nearly half and per capita expenditures more than doubled. Treatment of long-term conditions was a large driver in the increases in medication use.
AHRQ-authored.
Citation: Selden TM, Abdus S, Miller GE .
Decomposing changes in the growth of U.S. prescription drug use and expenditures, 1999-2016.
Health Serv Res 2019 Aug;54(4):752-63. doi: 10.1111/1475-6773.13164..
Keywords: Healthcare Costs, Healthcare Utilization, Medical Expenditure Panel Survey (MEPS), Medication
Biener AI, Decker SL, Rohde F
AHRQ Author: Deck SL, Rohde F
Source of increased health care spending in the United States.
This infographic depicts MEPS information for five medical conditions that account for nearly 1/3 of all medical expenditures in 2015. Factors include the difference in spending associated with these conditions; the number of people treated for them; per capita costs; and related ambulatory visits and prescription drug costs as a proportion of health expenditures.
AHRQ-authored.
Citation: Biener AI, Decker SL, Rohde F .
Source of increased health care spending in the United States.
JAMA 2019 Mar 26;321(12):1147. doi: 10.1001/jama.2019.0679..
Keywords: Chronic Conditions, Healthcare Costs, Healthcare Utilization, Medical Expenditure Panel Survey (MEPS)
Biener AI, Zuvekas SH
AHRQ Author: Zuvekas SH
Do racial and ethnic disparities in health care use vary with health?
Researchers used Medical Expenditure Panel Survey (MEPS) data from 2010-2014 to evaluate health care use between black-white and Hispanic-white adults. They found that there was the widest disparity in health care use in adults in excellent health between Hispanics and whites but the opposite was true for blacks and whites. Differences are attributed to health insurance coverage and access to health care overall.
AHRQ-authored.
Citation: Biener AI, Zuvekas SH .
Do racial and ethnic disparities in health care use vary with health?
Health Serv Res 2019 Feb;54(1):64-74. doi: 10.1111/1475-6773.13087..
Keywords: Access to Care, Disparities, Healthcare Utilization, Health Insurance, Health Status, Medical Expenditure Panel Survey (MEPS), Racial and Ethnic Minorities
Abdus S, Decker SL
AHRQ Author: Abdus S, Decker SL
Association between Medicaid adult nonemergency dental benefits and dental services use and expenditures.
AHRQ researchers compared nonemergency dental services use in states with and without Medicaid adult nonemergency dental benefits. Dental use increased in states with the Medicaid dental benefit. Out-of-pocket expenses decreased approximately 19 percent in covered states.
AHRQ-authored.
Citation: Abdus S, Decker SL .
Association between Medicaid adult nonemergency dental benefits and dental services use and expenditures.
J Am Dent Assoc 2019 Jan;150(1):24-33. doi: 10.1016/j.adaj.2018.08.010..
Keywords: Dental and Oral Health, Healthcare Costs, Healthcare Utilization, Medicaid, Medical Expenditure Panel Survey (MEPS)
Biener AI, Zuvekas SH, Hill SC
AHRQ Author: Biener AI, Zuvekas SH, Hill SC
Impact of recent Medicaid expansions on office-based primary care and specialty care among the newly eligible.
The objective of this study was to quantify the effect of Medicaid expansions on office-based care among the newly eligible. The investigators concluded that State Medicaid expansions in 2014 were associated with greater likelihoods of visits with a variety of office-based providers. The estimated effects were larger among newly eligible compared with previous estimates on broader populations of low-income adults.
AHRQ-authored.
Citation: Biener AI, Zuvekas SH, Hill SC .
Impact of recent Medicaid expansions on office-based primary care and specialty care among the newly eligible.
Health Serv Res 2018 Aug;53(4):2426-45. doi: 10.1111/1475-6773.12793.
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Keywords: Access to Care, Healthcare Utilization, Medicaid, Medical Expenditure Panel Survey (MEPS), Primary Care
Kafali N, Progovac A, Hou SS
Long-run trends in antidepressant use among youths after the FDA black box warning.
This study analyzed long-run trends in antidepressant use among children before and after the black box warning for those with and without severe psychological impairment. It concluded that in the long run (2008-2011), however, there was no statistically significant difference. This return to the rates before the black box warning raises concern that the impact of the warning may have dissipated over time.
AHRQ-funded; HS021486.
Citation: Kafali N, Progovac A, Hou SS .
Long-run trends in antidepressant use among youths after the FDA black box warning.
Psychiatr Serv 2018 Apr;69(4):389-95. doi: 10.1176/appi.ps.201700089.
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Keywords: Medication, Children/Adolescents, Healthcare Utilization, Medical Expenditure Panel Survey (MEPS), Policy
Blosnich JR, Hammer J, Yu L
Health care use, health behaviors, and medical conditions among individuals in same-sex and opposite-sex partnerships: a cross-sectional observational analysis of the Medical Expenditures Panel Survey (MEPS), 2003-2011.
Thsi study's objective was to examine associations between sexual minority status and medical conditions. The researchers used MEPS data to determine measures of health risk, health services utilization, and the presence of 15 medical conditions. They found that individuals in same-sex partnerships had 67% increased odds of past-year emergency department utilization and 51% greater odds of three or more physician visits in the last year compared with opposite-sex partnered individuals.
AHRQ-funded; HS022989.
Citation: Blosnich JR, Hammer J, Yu L .
Health care use, health behaviors, and medical conditions among individuals in same-sex and opposite-sex partnerships: a cross-sectional observational analysis of the Medical Expenditures Panel Survey (MEPS), 2003-2011.
Med Care 2016 Jun;54(6):547-54. doi: 10.1097/mlr.0000000000000529.
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Keywords: Healthcare Delivery, Disparities, Healthcare Utilization, Medical Expenditure Panel Survey (MEPS)
Hudson JL, Abdus S
AHRQ Author: Hudson JL
Coverage and care consequences for families in which children have mixed eligibility for public insurance.
The researchers used data from the Medical Expenditure Panel Survey (MEPS) Household Component for 2001–12 to examine insurance coverage, access to care, and health care use for eligible children in families with mixed eligible siblings compared to those in families where all siblings were eligible for one program. They found that mixed eligibility has a significant dampening effect for eligible children.
AHRQ-authored
Citation: Hudson JL, Abdus S .
Coverage and care consequences for families in which children have mixed eligibility for public insurance.
Health Aff 2015 Aug;34(8):1340-8. doi: 10.1377/hlthaff.2015.0128..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Health Insurance, Access to Care, Healthcare Utilization
Laiteerapong N, Kirby J, Gao Y
AHRQ Author: Kirby J, Ngo-Metzger Q
Health care utilization and receipt of preventive care for patients seen at federally funded health centers compared to other sites of primary care.
The investigators compared utilization and preventive care receipt among patients of federal Section 330 health centers (HCs) versus patients of other settings. They found that HC patients had fewer office visits and hospitalizations, were more likely to receive breast cancer screening, had fewer outpatient and emergency room visits, and were more likely to receive dietary advice compared to non-HC patients.
AHRQ-authored.
Citation: Laiteerapong N, Kirby J, Gao Y .
Health care utilization and receipt of preventive care for patients seen at federally funded health centers compared to other sites of primary care.
Health Serv Res 2014 Oct;49(5):1498-518. doi: 10.1111/1475-6773.12178.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Utilization, Prevention, Community-Based Practice, Healthcare Delivery
Manski RJ, Cohen LA, Brown E
AHRQ Author: Brown E, Carper KV
Dental service mix among older adults aged 65 and over, United States, 1999 and 2009.
To establish a baseline and provide data for oral health workforce models, this report describes the types of dental procedures received by US adults 65 years and older in 2009 and looks at trends since 1999. It found that between 1999 and 2009, the proportion of preventive services significantly increased, whereas the proportion of restorative and endodontic services significantly decreased.
Citation: Manski RJ, Cohen LA, Brown E .
Dental service mix among older adults aged 65 and over, United States, 1999 and 2009.
J Public Health Dent 2014 Sum;74(3):219-26. doi: 10.1111/jphd.12049..
Keywords: Medical Expenditure Panel Survey (MEPS), Dental and Oral Health, Healthcare Utilization
Abdus S, Selden TM
AHRQ Author: Abdus S, Selden TM
Preventive services for adults: how have differences across subgroups changed over the past decade?
This study uses MEPS data to track changes over time in the distribution of preventive services use across groups defined by poverty status, race/ethnicity, insurance coverage, Census region, and urbanicity. The analysis found that differences across subgroups tended to persist over time, with some of the largest gaps between adults with and without coverage. Regional differences persisted or widened over the study period.
AHRQ-authored.
Citation: Abdus S, Selden TM .
Preventive services for adults: how have differences across subgroups changed over the past decade?
Med Care 2013 Nov;51(11):999-1007. doi: 10.1097/MLR.0b013e3182a97bc0.
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Keywords: Healthcare Utilization, Health Insurance, Medical Expenditure Panel Survey (MEPS), Prevention, Social Determinants of Health
Pylypchuk Y, Sarpong EM
AHRQ Author: Sarpong EM
Comparison of health care utilization: United States versus Canada.
The purpose of this paper was to compare health care utilization between Canadian and U.S. residents. Findings showed that the poor and less educated were more likely to utilize health care in Canada than in the United States, while health care use for residents with high incomes and higher levels of education were not markedly different between the two countries and often higher for U.S residents. Also, foreign-born residents were more likely to use health care in Canada than in the United States.
AHRQ-authored.
Citation: Pylypchuk Y, Sarpong EM .
Comparison of health care utilization: United States versus Canada.
Health Serv Res 2013 Apr;48(2 Pt 1):560-81. doi: 10.1111/j.1475-6773.2012.01466.x.
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Keywords: Health Services Research (HSR), Healthcare Utilization, Medical Expenditure Panel Survey (MEPS), Social Determinants of Health