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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 9 of 9 Research Studies DisplayedOke I, Lutz SM, Hunter DG
Use and costs of instrument-based vision screening for US children aged 12 to 36 months.
This research letter describes a cohort study that examined patterns and out-of-pocket costs of instrument-based vision screening among US children 12 to 36 months. The authors used 2018 MarketScan Commerical Claims and Encounters data as of January 1, 2018 and excluded those with fewer than 12 months of continuous insurance coverage, enrollment in capitated insurance plans, no preventive care encounters, or missing data on residents. The study included 246,077 children. Instrument-based vision screening was received by 19.5% (n = 48,101) of children during 2018. Median (IQR) practitioner payment for instrument-based vision screening claims was $13. Screening incurred out-of-pocket expenses for 7% of children; 30% of these children had expenses related to co-payment, 20.2% to coinsurance, and 50.7% to deductibles. Median (IQR) out-of-pocket expense was $11. Increased odds of vision screening were associated with older age, high-deductible plan enrollment, having more than 1 preventative visit, and receiving care within an area in the highest quartile of practitioner payment. This study was limited by use of commercial claims data, which excluded 45% of children with public or no coverage. Nationwide prevalence of vision screening therefore may differ for the general population.
AHRQ-funded; HS000063.
Citation: Oke I, Lutz SM, Hunter DG .
Use and costs of instrument-based vision screening for US children aged 12 to 36 months.
JAMA Pediatr 2023 Jul; 177(7):728-30. doi: 10.1001/jamapediatrics.2023.0808..
Keywords: Newborns/Infants, Eye Disease and Health, Screening, Prevention, Healthcare Costs
Fendrick AM, Dalton VK, Tilea A
Out-of-pocket costs for colposcopy among commercially insured women from 2006 to 2019.
The objective of this study was to describe out-of-pocket costs for colposcopy and related services among age-appropriate, commercially insured women from 2006 to 2019. Findings suggested that out-of-pocket costs for colposcopy were very common and significant and have increased over time. Reported out-of-pocket costs for cervical cancer screening-related care, such as office visits, were not included, thus the findings may underestimate patients’ total financial burden.
AHRQ-funded; HS025465.
Citation: Fendrick AM, Dalton VK, Tilea A .
Out-of-pocket costs for colposcopy among commercially insured women from 2006 to 2019.
Obstet Gynecol 2022 Jan;139(1):113-15. doi: 10.1097/aog.0000000000004582..
Keywords: Healthcare Costs, Colonoscopy, Screening, Cancer: Cervical Cancer, Cancer, Prevention, Women
Skaathun B, Pho MT, Pollack HA
Comparison of effectiveness and cost for different HIV screening strategies implemented at large urban medical centre in the United States.
This analysis compared the effectiveness and cost of three HIV testing strategies in a high HIV burden area in the U.S. in identifying new HIV infections. The investigators performed a cost analysis comparing three HIV testing strategies in Chicago: (1) routine screening (RS) in an inpatient and outpatient setting, (2) modified partner services (MPS) among networks of the recently HIV infected and diagnosed, and (3) a respondent drive sampling (RDS)-based social network (SN) approach targeting young African-American men who have sex with men.
AHRQ-funded; HS000084.
Citation: Skaathun B, Pho MT, Pollack HA .
Comparison of effectiveness and cost for different HIV screening strategies implemented at large urban medical centre in the United States.
J Int AIDS Soc 2020 Oct;23(10):e25554. doi: 10.1002/jia2.25554..
Keywords: Human Immunodeficiency Virus (HIV), Screening, Healthcare Costs, Prevention, Infectious Diseases
Hassmiller Lich K, O'Leary MC, Nambiar S
Estimating the impact of insurance expansion on colorectal cancer and related costs in North Carolina: a population-level simulation analysis.
Researchers used microsimulation to estimate the health and financial effects of insurance expansion and reduction scenarios in North Carolina (NC) for colorectal cancer screening (CRC). The full lifetime of a simulated population of residents age-eligible for CRC screening (aged 50-75) during a 5-year period were simulated. Findings indicate that the estimated cost savings--balancing increased CRC screening/testing costs against decreased cancer treatment costs--were approximately $30 M and $970 M for Medicaid expansion and Medicare-for-all scenarios, respectively, compared to status quo. The researchers concluded that insurance expansion will likely improve CRC screening both overall and in underserved populations while saving money, with the largest savings realized by Medicare.
AHRQ-funded; HS022981.
Citation: Hassmiller Lich K, O'Leary MC, Nambiar S .
Estimating the impact of insurance expansion on colorectal cancer and related costs in North Carolina: a population-level simulation analysis.
Prev Med 2019 Dec;129s:105847. doi: 10.1016/j.ypmed.2019.105847..
Keywords: Health Insurance, Cancer: Colorectal Cancer, Cancer, Healthcare Costs, Screening, Prevention, Medicaid, Medicare, Policy, Access to Care
Song LD, Newhouse JP, Garcia-De-Albeniz X
Changes in screening colonoscopy following Medicare reimbursement and cost-sharing changes.
This study examined changes in screening colonoscopy rates after Medicare reimbursement and cost-sharing changed when the Affordable Care Act (ACA) was implemented. A 20% random sample of fee-for-service (FFS) Medicare claims from 2002-2012 was used in this study. Screening colonoscopy rates did increase after 2001 when cost-sharing was eliminated but the amount varied depending on the algorithm used to classify the indication.
AHRQ-funded; HS023128.
Citation: Song LD, Newhouse JP, Garcia-De-Albeniz X .
Changes in screening colonoscopy following Medicare reimbursement and cost-sharing changes.
Health Serv Res 2019 Aug;54(4):839-50. doi: 10.1111/1475-6773.13150..
Keywords: Colonoscopy, Healthcare Costs, Healthcare Utilization, Medicare, Payment, Prevention, Screening
Tina Shih YC, Dong W, Xu Y
Assessing the cost-effectiveness of updated breast cancer screening guidelines for average-risk women.
The goal of this study was to evaluate the cost-effectiveness of recently updated US-based mammography screening guidelines. Researchers developed a microsimulation model to generate the natural history of invasive breast cancer and capture how screening and treatment modified the natural course of the disease, and used the model to assess the cost-effectiveness of screening strategies. Results indicated that the hybrid screening strategy that starts annual mammography at the age of 45 years and switches to biennial screening between the ages of 55 and 75 years was the most cost-effective.
AHRQ-funded; HS020263.
Citation: Tina Shih YC, Dong W, Xu Y .
Assessing the cost-effectiveness of updated breast cancer screening guidelines for average-risk women.
Value Health 2019 Feb;22(2):185-93. doi: 10.1016/j.jval.2018.07.880..
Keywords: Cancer: Breast Cancer, Cancer, Screening, Evidence-Based Practice, Prevention, Healthcare Costs
Kirby JB, Davidoff AJ, Basu J
AHRQ Author: Kirby JB, Basu J
The ACA's zero cost-sharing mandate and trends in out-of-pocket expenditures on well-child and screening mammography visits.
This study used a nationally representative sample of ambulatory care visits to estimate the impact of the zero cost-sharing mandate on out-of-pocket expenditures on well-child and screening mammography visits. It concluded that the Affordable Care Act's zero cost-sharing mandate for preventive care has had a large impact on out-of-pocket expenditures for well-child and mammography visits.
AHRQ-authored.
Citation: Kirby JB, Davidoff AJ, Basu J .
The ACA's zero cost-sharing mandate and trends in out-of-pocket expenditures on well-child and screening mammography visits.
Med Care 2016 Dec;54(12):1056-62. doi: 10.1097/mlr.0000000000000610.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Screening, Women, Policy, Prevention
Roth JA, Gulati R, Gore JL
Economic analysis of prostate-specific antigen screening and selective treatment strategies.
The researchers evaluated the potential cost-effectiveness of plausible prostate-specific antigen (PSA) screening strategies and assessed the value added by increased use of conservative management among low-risk, screen-detected cases. They found that, with contemporary treatment, only strategies with biopsy referral for PSA levels higher than 10.0 ng/mL or age-dependent thresholds were associated with increased quality-adjusted life-years (QALYs), and only quadrennial screening of patients aged 55 to 69 years was potentially cost-effective in terms of cost per QALY. They concluded that, for PSA screening to be cost-effective, it needs to be used conservatively and ideally in combination with a conservative management approach for low-risk disease.
AHRQ-funded; HS022982.
Citation: Roth JA, Gulati R, Gore JL .
Economic analysis of prostate-specific antigen screening and selective treatment strategies.
JAMA Oncol 2016 Jul;2(7):890-8. doi: 10.1001/jamaoncol.2015.6275.
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Keywords: Healthcare Costs, Prevention, Cancer: Prostate Cancer, Quality of Life, Screening
Levy DE, Munshi VN, Ashburner JM
Health IT-assisted population-based preventive cancer screening: a cost analysis.
The researchers analyzed costs from a randomized trial of 2 health IT strategies to improve cancer screening compared with usual care from the perspective of a primary care network. They found that over the course of the study year, the value of reduced physician time devoted to preventive cancer screening outweighed the costs of the interventions.
AHRQ-funded; HS020308; HS018161.
Citation: Levy DE, Munshi VN, Ashburner JM .
Health IT-assisted population-based preventive cancer screening: a cost analysis.
Am J Manag Care 2015 Dec;21(12):885-91..
Keywords: Health Information Technology (HIT), Cancer, Screening, Prevention, Healthcare Costs