National Healthcare Quality and Disparities Report
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- Access to Care (1)
- Arthritis (2)
- Behavioral Health (2)
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- Caregiving (1)
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- Dementia (1)
- Depression (2)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
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- Elderly (1)
- Electronic Health Records (EHRs) (1)
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- Injuries and Wounds (1)
- Medical Devices (1)
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- Medication (1)
- Mortality (1)
- Outcomes (4)
- Pain (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (1)
- (-) Racial and Ethnic Minorities (20)
- Respiratory Conditions (1)
- Risk (1)
- (-) Sex Factors (20)
- Sleep Problems (1)
- Social Determinants of Health (1)
- Stroke (3)
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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 20 of 20 Research Studies DisplayedMcQuillan J, Andersen JA, Berdahl TA
AHRQ Author: Berdahl TA
Associations of rheumatoid arthritis and depressive symptoms over time: are there differences by education, race/ethnicity, and gender?
The objective of this study was to examine associations between changes in Rheumatoid Arthritis symptoms and depressive symptoms and to test if these associations differed by education, or gender, or race/ethnicity. Data was taken from the National Rheumatoid Arthritis Study, 1988-98. The results indicated that people with Rheumatoid Arthritis experienced increases in depressive symptoms as well as pain, functional disability, and household work disability over the study period. There was no difference noted in the rate of change in depressive symptoms by education, gender, nor race/ethnicity, but the association of functional disability with depressive symptoms was stronger for men than women. The researchers concluded that it is important to monitor and treat both mental and physical health symptoms, and that future research should focus on the collection of data that reflects the educational, gender, and racial/ethnic diversity of people with Rheumatoid Arthritis.
AHRQ-authored.
Citation: McQuillan J, Andersen JA, Berdahl TA .
Associations of rheumatoid arthritis and depressive symptoms over time: are there differences by education, race/ethnicity, and gender?
Arthritis Care Res 2022 Dec;74(12):2050-58. doi: 10.1002/acr.24730..
Keywords: Arthritis, Depression, Behavioral Health, Racial and Ethnic Minorities, Sex Factors, Chronic Conditions
Marcaccio CL, Patel PB, de Guerre L
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
The purpose of this study was to identify variations in 5-year outcomes and imaging surveillance after elective endovascular aortic aneurysm repair (EVAR) by sex, race, and ethnicity and to examine possible mechanisms contributing to these variations. The primary outcome was 5-year aneurysm rupture. Secondary outcomes were 5-year reintervention and mortality, and having no aortic imaging follow-up from 6 to 24 months after EVAR. The study found that among 16,040 patients, 73% were White males, 18% were White females, 2.6% were Black males, 1.1% were Black females, 0.9% were Asian males, 0.2% were Asian females, 1.7% were Hispanic males, and 0.4% were Hispanic females. At 5 years, Black females had the highest rupture rates at 6.4% and white males had the lowest at 2.3%. Compared with White males, rupture rates were higher in White females, Black females, and Asian females. Among other groups, Black males had higher reintervention and both Black and Hispanic males had higher rates of no imaging follow-up. In adjusted analyses, White, Black, and Asian females remained at significantly higher risk for 5-year rupture. The researchers concluded that Black females had higher 5-year aneurysm rupture, reintervention, and mortality rates after elective EVAR as compared with White male patients, whereas White females had higher rupture, mortality and loss-to-imaging-follow-up compared to White male patients. Black males had higher reintervention and no imaging follow-up, and Asian females had higher rupture rates.
AHRQ-funded; HS027285.
Citation: Marcaccio CL, Patel PB, de Guerre L .
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
J Vasc Surg 2022 Nov;76(5):1205-15.e4. doi: 10.1016/j.jvs.2022.03.886..
Keywords: Disparities, Racial and Ethnic Minorities, Sex Factors, Outcomes, Imaging, Heart Disease and Health, Cardiovascular Conditions
Marcaccio CL, O'Donnell TFX, Dansey KD
Disparities in reporting and representation by sex, race, and ethnicity in endovascular aortic device trials.
The purpose of this study was to examine the demographics of patients enrolled in critical U.S. endovascular aortic device trials to explore the representation of vulnerable populations, including women and racial and ethnic minorities. The primary outcomes included the percentage of trials reporting participant sex, race, and ethnicity and the percentage of participants across sex, racial, and ethnic groups. The study found that the Food and Drug Administration (FDA) provided 29 approvals from 29 trials of 24 devices with a total of 4046 patients: 52% (15) were EVAR devices, 41% (12) were TEVAR devices, and 3.4% (1) was a FEVAR device, with 1 dissection stent (3.4%). Fifty-two percent of the trials reported the three most common racial groups (White, Black, Asian), and 48% reported Hispanic ethnicity. The TEVAR trials were the most likely to report all three racial groups and Hispanic ethnicity (92% and 75%, respectively), while the EVAR trials had the lowest reporting rates (13% and 20%, respectively). The median female enrollment was 21%, with the EVAR trials having the lowest female enrollment compared with 41% in the TEVAR trials, 21% in the FEVAR trial, and 34% in the dissection stent trial. The study concluded that in critical aortic device trials that led to FDA approval, female patients were underrepresented, especially for EVAR, and racial and ethnic minority groups were under-represented and underreported.
AHRQ-funded; HS027285.
Citation: Marcaccio CL, O'Donnell TFX, Dansey KD .
Disparities in reporting and representation by sex, race, and ethnicity in endovascular aortic device trials.
J Vasc Surg 2022 Nov;76(5):1244-52.e2. doi: 10.1016/j.jvs.2022.05.003..
Keywords: Disparities, Racial and Ethnic Minorities, Heart Disease and Health, Cardiovascular Conditions, Medical Devices, Sex Factors
McCoy RG, Van Houten HK, Dunlay SM
Race and sex differences in the initiation of diabetes drugs by privately insured US adults.
The authors examined the differences in the use of three glucose-lowering medications as a function of both sex and race. They found that, compared to white men, GLP-1RA were 43% more likely to be started by White women, 12% more likely to be started by non-White men, and 21% less likely to be started by non-White women. SGLT2i were at least 10% less likely to be started by all groups compared to White men, and DPP4i were used more often by non-White than White patients of both sexes.
AHRQ-funded; HS024075.
Citation: McCoy RG, Van Houten HK, Dunlay SM .
Race and sex differences in the initiation of diabetes drugs by privately insured US adults.
Race and sex differences in the initiation of diabetes drugs by privately insured US adults..
Keywords: Diabetes, Chronic Conditions, Medication, Sex Factors, Racial and Ethnic Minorities
Jarman MP, Pollack Porter K, Curriero FC
Factors mediating demographic determinants of injury mortality.
The authors investigated the role of injury characteristics and access to trauma care as mediators of the relationships between race, ethnicity, sex, and injury mortality. They found that distance, injury characteristics, and insurance mediate the effects of demographic characteristics on injury mortality and appear to contribute to disparities in injury mortality.
AHRQ-funded; HS000029.
Citation: Jarman MP, Pollack Porter K, Curriero FC .
Factors mediating demographic determinants of injury mortality.
Ann Epidemiol 2019 Jun;34:58-64.e2. doi: 10.1016/j.annepidem.2019.03.013..
Keywords: Access to Care, Disparities, Injuries and Wounds, Mortality, Racial and Ethnic Minorities, Sex Factors, Social Determinants of Health, Trauma
Angraal S, Khera R, Wang Y
Sex and race differences in the utilization and outcomes of coronary artery bypass grafting among Medicare beneficiaries, 1999-2014.
The authors sought to evaluate how the use of coronary artery bypass grafting (CABG) and its outcomes have evolved in different sex and racial subgroups. Using Medicare data, they found that women and black patients had persistently higher CABG mortality than men and white patients, respectively, despite greater declines over the time period. The authors conclude that these findings indicate progress, but further progress is needed.
AHRQ-funded; HS023000.
Citation: Angraal S, Khera R, Wang Y .
Sex and race differences in the utilization and outcomes of coronary artery bypass grafting among Medicare beneficiaries, 1999-2014.
J Am Heart Assoc 2018 Jul 12;7(14). doi: 10.1161/jaha.118.009014..
Keywords: Cardiovascular Conditions, Elderly, Evidence-Based Practice, Heart Disease and Health, Healthcare Utilization, Medicare, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Sex Factors
Gilmore-Bykovskyi A, Johnson R, Walljasper L
Underreporting of gender and race/ethnicity differences in NIH-funded dementia caregiver support interventions.
The objective of this study was to determine the inclusion and reporting rates among NIH-funded dementia caregiver support interventions. Findings suggested limited NIH guideline compliance that may reflect a lack of awareness regarding potential gender disparities in caregiving roles. In order to ensure NIH guideline compliance, shared investments from researchers, editors, and reviewers to make certain that group differences are systematically identified and reported are recommended.
AHRQ-funded; HS022548.
Citation: Gilmore-Bykovskyi A, Johnson R, Walljasper L .
Underreporting of gender and race/ethnicity differences in NIH-funded dementia caregiver support interventions.
Am J Alzheimers Dis Other Demen 2018 May;33(3):145-52. doi: 10.1177/1533317517749465..
Keywords: Caregiving, Sex Factors, Racial and Ethnic Minorities, Guidelines, Dementia, Disparities
Lau KSL, Rosenman MB, Wiehe SE
Race/ethnicity, and behavioral health status: first arrest and outcomes in a large sample of juvenile offenders.
The objective of this study was to assess the simultaneous effects of gender, race/ethnicity, and pre-arrest behavioral health (BH) service-use on age at first arrest, and first arrest outcomes. It found that black youth were arrested at younger ages than white or Hispanic youth. Youth with psychiatric problems were arrested at younger ages than youth with substance-use, dual-diagnoses, or no BH problems.
AHRQ-funded; HS024296; HS023318.
Citation: Lau KSL, Rosenman MB, Wiehe SE .
Race/ethnicity, and behavioral health status: first arrest and outcomes in a large sample of juvenile offenders.
J Behav Health Serv Res 2018 Apr;45(2):237-51. doi: 10.1007/s11414-017-9578-3.
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Keywords: Behavioral Health, Outcomes, Racial and Ethnic Minorities, Sex Factors
Acker WW, Plasek JM, Blumenthal KG
Prevalence of food allergies and intolerances documented in electronic health records.
The researchers sought to determine the prevalence of food allergy and intolerance documented in the EHR allergy module. Among 2.7 million patients, they identified 97,482 patients (3.6 percent) with 1 or more food allergies or intolerances. The prevalence of food allergy and intolerance was higher in females (4.2 percent vs 2.9 percent) and Asians (4.3 percent vs 3.6 percent).
AHRQ-funded; HS022728.
Citation: Acker WW, Plasek JM, Blumenthal KG .
Prevalence of food allergies and intolerances documented in electronic health records.
J Allergy Clin Immunol 2017 Dec;140(6):1587-91.e1. doi: 10.1016/j.jaci.2017.04.006.
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Keywords: Electronic Health Records (EHRs), Patient Safety, Racial and Ethnic Minorities, Sex Factors
Goto T, Faridi MK, Gibo K
Sex and racial/ethnic differences in the reason for 30-day readmission after COPD hospitalization.
This retrospective cohort study used 2006-2012 data from the State Inpatient Database of eight geographically-diverse US states (Arkansas, California, Florida, Iowa, Nebraska, New York, Utah, and Washington) to examine 30-day readmissions in patients hospitalized for chronic obstructive pulmonary disease (COPD). In their analysis of all-payer population-based data, the authors found sex and racial/ethnic differences in the reason for 30-day readmission in patients hospitalized for COPD.
AHRQ-funded; HS023305.
Citation: Goto T, Faridi MK, Gibo K .
Sex and racial/ethnic differences in the reason for 30-day readmission after COPD hospitalization.
Respir Med 2017 Oct;131:6-10. doi: 10.1016/j.rmed.2017.07.056..
Keywords: Respiratory Conditions, Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Hospital Readmissions, Sex Factors
Boehme AK, Carr BG, Kasner SE
Sex differences in rt-PA utilization at hospitals treating stroke: the National Inpatient Sample.
The researchers sought to explore sex and race differences in the utilization of recombinant tissue plasminogen activator (rt-PA) at primary stroke centers (PSCs) compared to non-PSCs across the US. They found that women are less likely to receive rt-PA than men at both PSCs and non-PSCs. Absolute treatment rates are lowest in black women.
AHRQ-funded; HS17960; HS018362; HS013852.
Citation: Boehme AK, Carr BG, Kasner SE .
Sex differences in rt-PA utilization at hospitals treating stroke: the National Inpatient Sample.
Front Neurol 2017 Sep 27;8:500. Original Research. doi: 10.3389/fneur.2017.00500.
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Keywords: Healthcare Delivery, Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Sex Factors, Stroke
Bersamira CS, Lin YA, Park K
Drug use among Asian Americans: Differentiating use by acculturation status and gender.
This study examined past-year drug use among Asian Americans with respect to ethnic subgroup, acculturation, and gender differences. Survey data were collected during the National Latino and Asian American Survey, a national epidemiological household survey of behavioral health prevalence and service utilization rates. The investigators indicate that findings suggest the need to better understand the heterogeneous character of Asian American drug use when considering the provision of culturally competent and linguistically appropriate prevention and treatment services.
AHRQ-funded; HS000084.
Citation: Bersamira CS, Lin YA, Park K .
Drug use among Asian Americans: Differentiating use by acculturation status and gender.
J Subst Abuse Treat 2017 Aug;79:76-81. doi: 10.1016/j.jsat.2017.06.002..
Keywords: Racial and Ethnic Minorities, Sex Factors, Substance Abuse
Stepanikova I, Oates GR, Bateman LB
Does one size fit all? The role of body mass index and waist circumference in systemic inflammation in midlife by race and gender.
This study investigated the associations of body mass index (BMI) and waist circumference (WC) with markers of systemic inflammation in midlife by race and gender. Compared to White men, Black women have higher BMI and higher levels of all four inflammation markers; White women have lower BMI, lower WC, and lower E-selectin and fibrinogen but higher C-reactive protein, and Black men have higher fibrinogen.
AHRQ-funded; HS023009.
Citation: Stepanikova I, Oates GR, Bateman LB .
Does one size fit all? The role of body mass index and waist circumference in systemic inflammation in midlife by race and gender.
Ethn Health 2017 Apr;22(2):169-83. doi: 10.1080/13557858.2016.1235681.
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Keywords: Health Status, Racial and Ethnic Minorities, Risk, Sex Factors
Musey PI, Jr., Kline JA
Do gender and race make a difference in acute coronary syndrome pretest probabilities in the emergency department?
The objective was to test for significant differences in subjective and objective pretest probabilities for acute coronary syndrome (ACS) in chest pain patients. Despite consistently estimating the risk for ACS to be lower for both females and minorities concordantly with calculated objective pretest assessments, there does not appear to have been any significant decrease in subsequent evaluation of these perceived lower-risk groups when radiation exposure and costs are taken into account.
AHRQ-funded; HS018519.
Citation: Musey PI, Jr., Kline JA .
Do gender and race make a difference in acute coronary syndrome pretest probabilities in the emergency department?
Acad Emerg Med 2017 Feb;24(2):142-51. doi: 10.1111/acem.13131.
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Keywords: Sex Factors, Racial and Ethnic Minorities, Cardiovascular Conditions, Emergency Medical Services (EMS)
Womack VY, De Chavez PJ, Albrecht SS
A longitudinal relationship between depressive symptoms and development of metabolic syndrome: the Coronary Artery Risk Development in Young Adults study.
The researchers tested whether baseline and time-varying depressive symptoms were associated with metabolic syndrome incidence in black and white men and women from the Coronary Artery Risk Development in Young Adults study. They found that, over 15 years, the incidence rate of metabolic syndrome varied by race and sex, with the highest rate in black women followed by white men, black men, and white women. Depressive symptoms were associated with incident metabolic syndrome in white men and white women. However, they found no significant association between depression and metabolic syndrome among black men or black women.
AHRQ-funded; HS023009.
Citation: Womack VY, De Chavez PJ, Albrecht SS .
A longitudinal relationship between depressive symptoms and development of metabolic syndrome: the Coronary Artery Risk Development in Young Adults study.
Psychosom Med 2016 Sep;78(7):867-73. doi: 10.1097/psy.0000000000000347.
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Keywords: Cardiovascular Conditions, Depression, Racial and Ethnic Minorities, Sex Factors, Young Adults
Lee S, Teschemaker AR, Daniel M
Calcium and vitamin D use among older adults in U.S.: results from national survey.
The investigators conducted this study to describe a 10-year trend of calcium and vitamin D use from 2000 to 2009 and to evaluate age, gender, and racial disparities using national level health data. They found variability in the access to the medications, despite the observed increases associated with calcium and vitamin D supplements.
AHRQ-funded; HS011673.
Citation: Lee S, Teschemaker AR, Daniel M .
Calcium and vitamin D use among older adults in U.S.: results from national survey.
J Nutr Health Aging 2016 Mar;20(3):300-5. doi: 10.1007/s12603-015-0614-9.
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Keywords: Disparities, Racial and Ethnic Minorities, Sex Factors
Bhave PD, Lu X, Girotra S
Race- and sex-related differences in care for patients newly diagnosed with atrial fibrillation.
The researchers sought to determine whether significant race and sex differences exist in the treatment of newly diagnosed AF in Medicare beneficiaries. They found that there were statistically significant differences in the use of AF-related services by both race and sex, with white patients and male patients receiving the most care.
AHRQ-funded; HS021992.
Citation: Bhave PD, Lu X, Girotra S .
Race- and sex-related differences in care for patients newly diagnosed with atrial fibrillation.
Heart Rhythm 2015 Jul;12(7):1406-12. doi: 10.1016/j.hrthm.2015.03.031..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Racial and Ethnic Minorities, Sex Factors, Disparities
Petrov ME, Goodin BR, Cruz-Almeida Y
Disrupted sleep is associated with altered pain processing by sex and ethnicity in knee osteoarthritis.
This study examines the association between sleep disruption with increased pain sensitivity and enhanced pain facilitation in addition to reduced pain inhibition in persons with chronic pain such as knee OA. It found that disrupted sleep was associated with altered pain processing by sex and ethnicity/race.
AHRQ-funded; HS013852.
Citation: Petrov ME, Goodin BR, Cruz-Almeida Y .
Disrupted sleep is associated with altered pain processing by sex and ethnicity in knee osteoarthritis.
J Pain 2015 May;16(5):478-90. doi: 10.1016/j.jpain.2015.02.004..
Keywords: Pain, Sleep Problems, Arthritis, Racial and Ethnic Minorities, Sex Factors
Govindarajan P, Friedman BT, Delgadillo JQ
Race and sex disparities in prehospital recognition of acute stroke.
The investigators examined prehospital provider recognition of stroke by race and sex. They found that correct prehospital recognition of stroke was lower among Hispanic patients, Asians, and others, when compared with non-Hispanic whites, and also in women compared with men. They concluded that significant disparities exist in prehospital stroke recognition.
AHRQ-funded; HS017965.
Citation: Govindarajan P, Friedman BT, Delgadillo JQ .
Race and sex disparities in prehospital recognition of acute stroke.
Acad Emerg Med 2015 Mar;22(3):264-72. doi: 10.1111/acem.12595.
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Keywords: Diagnostic Safety and Quality, Disparities, Racial and Ethnic Minorities, Sex Factors, Stroke
Boehme AK, Siegler JE, Mullen MT
Racial and gender differences in stroke severity, outcomes, and treatment in patients with acute ischemic stroke.
This study sought to determine the association of race and gender on initial stroke severity, thrombolysis, and functional outcome after acute ischemic stroke (AIS). The investigators concluded that race and gender were not significantly associated with short-term outcome, although black women were significantly less likely to be treated with tissue plasminogen activator (tPA). Black women had more tPA exclusions than any other group. The primary reason for tPA exclusion in this study was not arriving within 3 hours of stroke symptom onset.
AHRQ-funded; HS013852.
Citation: Boehme AK, Siegler JE, Mullen MT .
Racial and gender differences in stroke severity, outcomes, and treatment in patients with acute ischemic stroke.
J Stroke Cerebrovasc Dis 2014 Apr;23(4):e255-61. doi: 10.1016/j.jstrokecerebrovasdis.2013.11.003..
Keywords: Racial and Ethnic Minorities, Outcomes, Sex Factors, Stroke