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 (1)
- Adverse Events (1)
- Asthma (1)
- Behavioral Health (1)
- Brain Injury (1)
- Case Study (1)
- Children/Adolescents (3)
- Chronic Conditions (3)
- Community Partnerships (1)
- Disparities (1)
- Elderly (1)
- Emergency Department (2)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Delivery (2)
- Healthcare Utilization (1)
- Hospital Discharge (1)
- Hospitals (1)
- Low-Income (1)
- Medicare (1)
- Mortality (1)
- Nursing Homes (1)
- Outcomes (1)
- Primary Care (2)
- Provider (1)
- Provider: Clinician (1)
- Provider: Physician (1)
- Racial and Ethnic Minorities (1)
- Rehabilitation (1)
- Respiratory Conditions (1)
- Rural Health (4)
- Screening (1)
- Sickle Cell Disease (1)
- Social Determinants of Health (3)
- Trauma (1)
- (-) Urban Health (9)
- Vulnerable Populations (2)
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 9 of 9 Research Studies DisplayedFraze TK, Lewis VA, Wood A
Configuration and delivery of primary care in rural and urban settings.
This study examined configuration and delivery of rural primary care of Medicare beneficiaries compared to more urban settings. The study included over 27 million participants with qualifying visits who were assigned to practices. The authors characterized practices’ structures, capabilities, and payment reform participation and measured beneficiary utilization by rurality. Rural practices were smaller, more primary care dominant and system owned with more beneficiaries per practice. Rural area beneficiaries were more likely to be from high-poverty areas and disabled. There was less engagement in quality-focused payment programs than in metropolitan practices. There was less preventive care, such as fewer beneficiaries with diabetes receiving an eye exam, fewer mammograms, and higher overall and condition-specific readmissions. While most isolated beneficiaries traveled to more urban practices for outpatient care, those receiving care in rural practices had similar outpatient and inpatient utilization to urban counterparts except for readmissions and quality metrics that rely on services outside of primary care.
AHRQ-funded; HS024075.
Citation: Fraze TK, Lewis VA, Wood A .
Configuration and delivery of primary care in rural and urban settings.
J Gen Intern Med 2022 Sep;37(12):3045-53. doi: 10.1007/s11606-022-07472-x..
Keywords: Primary Care, Healthcare Delivery, Rural Health, Urban Health, Medicare
Kim B, Mulready-Ward C, Thorpe LE
Housing environments and asthma outcomes within population-based samples of adults and children in NYC.
This study assessed the relationship between housing type (i.e., home ownership, public housing, rental assistance, rent-controlled housing, and other rental housing) and asthma outcomes among New York City (NYC) adults and children (ages 1-13). The authors used the 2019 NYC Community Health Survey (CHS) and 2019 NYC KIDS survey to analyze associations between housing type and ever having been diagnosed with asthma (“ever asthma”) and experiencing an asthma attack within the past year. They also examined whether associations were modified by smoking status (among adults), smoking within the house (among children), and overweight/obesity. Among adults, living in public housing, compared to home ownership, was associated with higher odds of ever asthma and past-year asthma attack. Rental assistance housing living was also significantly associated with ever asthma. Public or rental assistance housing associations and ever asthma were marginally significant among children but were more pronounced among ever smokers than among never smokers.
AHRQ-funded; HS026120.
Citation: Kim B, Mulready-Ward C, Thorpe LE .
Housing environments and asthma outcomes within population-based samples of adults and children in NYC.
Prev Med 2022 Aug;161:107147. doi: 10.1016/j.ypmed.2022.107147..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Social Determinants of Health, Vulnerable Populations, Urban Health, Chronic Conditions
Heller CG, Rehm CD, Parsons AH
The association between social needs and chronic conditions in a large, urban primary care population.
This study sought to understand the association between social needs and chronic health conditions using a screening tool and clinical data from Electronic Health Records. From April 2018 to December 2019, 33,550 adult patients completed a 10-item social needs screening tool during primary visits in Bronx and Westchester Counties, NY. A positive, cumulative association between social needs and each of the eight outcomes asked about was found. The relationship was strongest for elevated PHQ-2 (depression screening), alcohol/drug use disorder, and smoking. Those with 3 or greater social needs were 3.9 times more likely to have an elevated PHQ-2 than those without needs. Healthcare transportation challenges was associated with each condition and was the most strongly associated need with half of conditions in the fully-adjusted models. Examples included those with an alcohol/drug use disorder (84% more likely), and smokers (41% more likely).
AHRQ-funded; HS026396.
Citation: Heller CG, Rehm CD, Parsons AH .
The association between social needs and chronic conditions in a large, urban primary care population.
Prev Med 2021 Dec;153:106752. doi: 10.1016/j.ypmed.2021.106752..
Keywords: Chronic Conditions, Urban Health, Primary Care, Low-Income, Social Determinants of Health, Screening
Greenwood-Ericksen M, Kamdar N, Lin P
Association of rural and critical access hospital status with patient outcomes after emergency department visits among Medicare beneficiaries.
This study compared 30-day mortality rates after emergency department (ED) visits to rural or critical access hospitals (CAHs) compared to urban hospitals for Medicare beneficiaries. A 20% sample of Medicare beneficiaries was used from January 2011 to October 31, 2015. The primary outcome measured was 30-day mortality. Secondary outcome examined was ED visits with and without rehospitalization. Mortality rates were comparable with both groups, although patients in rural EDs experienced more transfers and less hospitalization.
AHRQ-funded; HS024160.
Citation: Greenwood-Ericksen M, Kamdar N, Lin P .
Association of rural and critical access hospital status with patient outcomes after emergency department visits among Medicare beneficiaries.
JAMA Netw Open 2021 Nov;4(11):e2134980. doi: 10.1001/jamanetworkopen.2021.34980..
Keywords: Hospitals, Rural Health, Urban Health, Emergency Department, Mortality, Outcomes
Hoffmann JA, Hall M, Lorenz D
Emergency department visits for suicidal ideation and self-harm in rural and urban youths.
The authors sought to compare emergency department (ED) visit rates for suicidal ideation and/or self-harm among youth by urban-rural location of residence. Data was taken from the Nationwide Emergency Department Sample. They found that, compared with youths living in urban areas, youths living in rural areas had higher ED visit rates for self-harm, including self-inflicted firearm injuries. The researchers recommended preventive approaches for self-harm based in community and ED settings in order to help address these differences.
AHRQ-funded; HS026385.
Citation: Hoffmann JA, Hall M, Lorenz D .
Emergency department visits for suicidal ideation and self-harm in rural and urban youths.
J Pediatr 2021 Nov;238:282-89.e1. doi: 10.1016/j.jpeds.2021.07.013..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Behavioral Health, Rural Health, Urban Health, Healthcare Utilization
Anderson MC, Evans E, Zonfrillo MR
Rural/urban differences in discharge from rehabilitation in older adults with traumatic brain injury.
This study compared differences in outcomes for older adults with traumatic brain injury (TBI) in rural and urban settings by 1) comparing the rates of successful community discharge; and 2) reasons for not achieving successful discharge. This retrospective national cohort study looked at skilled nursing facility (SNF) patients aged 66 and older using Medicare inpatient claims with Minimum Data Set assessments. A total of 11,771 SNFs were identified with a total population of 61,021 Medicare beneficiaries discharged to a SNF following hospitalization for TBI between 2011 and 2015. Patients in rural settings had lower rates of successful discharge compared with patients in urban settings (52.1% vs 58.5%). Reasons for unsuccessful discharge differed between rural and urban settings with rural patients less likely to discharged from SNF within 100 days although they were less likely to be rehospitalized within 30 days of SNF discharge.
AHRQ-funded; HS000011.
Citation: Anderson MC, Evans E, Zonfrillo MR .
Rural/urban differences in discharge from rehabilitation in older adults with traumatic brain injury.
J Am Geriatr Soc 2021 Jun;69(6):1601-08. doi: 10.1111/jgs.17065..
Keywords: Elderly, Brain Injury, Trauma, Rural Health, Urban Health, Rehabilitation, Nursing Homes
Costello WG, Zhang L, Schnipper J
Post-discharge adverse events among African American and Caucasian patients of an urban community hospital.
This study compared post-discharge adverse events (AEs) among African American and Caucasian patients at an urban community hospital. This prospective cohort study was conducted from December 2011 to October 2012. The cohort included 589 English-speaking patients who were discharged home and could be contacted after discharge for evaluation. Two nurses performed 30-day post-discharge telephone interviews, and two physicians reviewed health records to determine AEs using a previous methodology. African Americans had a slightly higher incidence of post-discharge AEs than Caucasian patients (30.6 vs. 29.9%) but it was not statistically significant.
AHRQ-funded; HS018694.
Citation: Costello WG, Zhang L, Schnipper J .
Post-discharge adverse events among African American and Caucasian patients of an urban community hospital.
J Racial Ethn Health Disparities 2021 Apr;8(2):439-47. doi: 10.1007/s40615-020-00800-z..
Keywords: Adverse Events, Racial and Ethnic Minorities, Urban Health, Disparities, Hospital Discharge
Olmos-Ochoa TT, Miake-Lye IM, Glenn BA
Sustaining successful clinical-community partnerships in medically underserved urban areas: a qualitative case study.
This qualitative case study examines the Faith Community Health Partnership, which is a collaboration between faith-community nurses and community organizations sustained over 25 years. Factors supporting partnership sustainability were identified through semi-structured interviews with 18 FHCP partners. Factors include maintaining partners’ commitment over time; strategic resource-sharing; facilitating engagement; and preserving partnership flexibility.
AHRQ-funded; HS000046.
Citation: Olmos-Ochoa TT, Miake-Lye IM, Glenn BA .
Sustaining successful clinical-community partnerships in medically underserved urban areas: a qualitative case study.
J Community Health Nurs 2021 Jan-Mar;38(1):1-12. doi: 10.1080/07370016.2021.1869423.
.
.
Keywords: Community Partnerships, Vulnerable Populations, Urban Health, Case Study, Access to Care, Healthcare Delivery
Loo S, Brochier A, Wexler MG
Addressing unmet basic needs for children with sickle cell disease in the United States: clinic and staff perspectives.
The purpose of this study was to assess pediatric hematology clinic staff's perspectives regarding barriers and facilitators in addressing unmet basic needs for children with sickle cell disease. Six focus groups were held at urban pediatric hematology clinics in the Northeastern region of the U.S. Four themes emerged: families of children with SCD have numerous unmet basic needs; clinic staff felt they had a role to play in addressing these needs; staff felt their ability to address these needs depended upon caregivers' capacity to act on staff recommendations; clinic staff's ability to address these needs was limited by organizational and systemic factors beyond their control. These findings have important implications for how best to address adverse social determinants of health for this vulnerable pediatric population so that urban-based pediatric hematology clinics can more equitably support families.
AHRQ-funded; HS022242.
Citation: Loo S, Brochier A, Wexler MG .
Addressing unmet basic needs for children with sickle cell disease in the United States: clinic and staff perspectives.
BMC Health Serv Res 2021 Jan 12;21(1):55. doi: 10.1186/s12913-020-06055-y..
Keywords: Children/Adolescents, Sickle Cell Disease, Chronic Conditions, Social Determinants of Health, Provider: Clinician, Provider: Physician, Provider, Urban Health