National Healthcare Quality and Disparities Report
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 3 of 3 Research Studies DisplayedBell N, Lòpez-De Fede A, Cai B
Geographic proximity to primary care providers as a risk-assessment criterion for quality performance measures.
This retrospective cohort study examined geographic proximity to primary care providers as a risk-assessment criterion for quality performance measures for pediatric patients with either attention deficit/hyperactivity disorder (ADD, ages 6-12) or asthma (MMA, ages 5-18) defined using Healthcare Effectiveness Data and Information Set (HEDIS) performance measures. The authors investigated differences in avoidable and potentially avoidable ED visits by the beneficiary's primary care medical home (PCMH) attribution type and in relation to differences in proximity to their primary care providers versus hospitals. There was a 2.4 percentage point reduction in risk of avoidable emergency department (ED) visits among children in the ADD cohort who attended a PCMH versus those who did not which increased to 3.9 to 7.2 percentage points as relative proximity to primary care providers versus hospitals improved. Children in the ADD and MMA cohorts who were enrolled in a PCMH but did not attend one for primary care services exhibited a 5.4 and 3.0 percentage point increase in avoidable ED visits compared to children who were unenrolled and did not attend medical homes, but these differences were only observed when geographic proximity to hospitals was more convenient than primary care providers.
AHRQ-funded; HS026263.
Citation: Bell N, Lòpez-De Fede A, Cai B .
Geographic proximity to primary care providers as a risk-assessment criterion for quality performance measures.
PLoS One 2022 Sep 6;17(9):e0273805. doi: 10.1371/journal.pone.0273805..
Keywords: Children/Adolescents, Primary Care, Asthma, Medicaid, Emergency Department
Meiselbach MK, Drake C, Saloner B
Medicaid managed care: access to primary care providers who prescribe buprenorphine.
This study examined variation in access to in-network buprenorphine-prescribing primary care providers that can treat opioid use disorder among Medicaid managed care enrollees. Approximately 32.2% of Medicaid enrollees had fewer than one in-network network buprenorphine-prescribing primary care providers per 100,000 county residents. There was on average a greater number of in-network buprenorphine-prescribing primary care providers in states with higher compared with lower overdose death rates, but most enrollees lived in areas with a shortage of these providers. The authors found that a 25 percent higher network participation rate by prescribers compared with nonprescribers could improve the probability that enrollees see a prescriber by approximately 25 percent.
AHRQ-funded; HS000029.
Citation: Meiselbach MK, Drake C, Saloner B .
Medicaid managed care: access to primary care providers who prescribe buprenorphine.
Health Aff 2022 Jun;41(6):901-10. doi: 10.1377/hlthaff.2021.01719..
Keywords: Medicaid, Primary Care, Access to Care, Medication, Care Management, Opioids, Substance Abuse, Behavioral Health
Bronstein JM, Huang L, Shelley JP
Primary care visits and ambulatory care sensitive diabetes hospitalizations among adult Alabama Medicaid beneficiaries.
This retrospective cohort study described patterns of care use for Alabama Medicaid adult beneficiaries with diabetes and the association of primary care utilization and ambulatory care sensitive (ACS) diabetes hospitalizations. Alabama Medicaid claims data from January 2010 to April 2018 for 52, 549 covered adults aged 19-64 with diabetes was analyzed. Individuals were categorized by demographics, comorbidities, and health care use. Characteristics of the cohort with and without ACS hospitalization was reported. One third of the cohort had at least one ACS diabetes hospitalization over the observed periods. Hospital users tended to have multiple ACS hospitalizations as well as more comorbidities and pharmaceutical and other types of care use than those with no ACS hospitalizations. Having a primary care visit in one year was significantly associated with a reduced likelihood of ACS hospitalization in the following year.
AHRQ-funded; HS023009.
Citation: Bronstein JM, Huang L, Shelley JP .
Primary care visits and ambulatory care sensitive diabetes hospitalizations among adult Alabama Medicaid beneficiaries.
Prim Care Diabetes 2022 Feb;16(1):116-21. doi: 10.1016/j.pcd.2021.10.005..
Keywords: Diabetes, Hospitalization, Medicaid, Primary Care