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 (8)
- Behavioral Health (2)
- Breast Feeding (1)
- Cancer (1)
- Cancer: Cervical Cancer (2)
- Cardiovascular Conditions (1)
- Care Management (1)
- Community-Based Practice (1)
- Community Partnerships (1)
- Critical Care (1)
- Disparities (2)
- Electronic Health Records (EHRs) (2)
- Emergency Department (2)
- Evidence-Based Practice (1)
- Healthcare Delivery (3)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (5)
- Home Healthcare (1)
- Hospitals (2)
- Implementation (2)
- Medicaid (2)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medication (3)
- Newborns/Infants (1)
- Opioids (3)
- Outcomes (1)
- Prevention (1)
- Primary Care (3)
- Provider (2)
- Provider: Nurse (1)
- Provider: Physician (1)
- Provider Performance (1)
- Quality of Care (1)
- (-) Rural Health (14)
- Simulation (1)
- Substance Abuse (3)
- Teams (1)
- Telehealth (3)
- Urban Health (2)
- Workforce (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 14 of 14 Research Studies DisplayedCE Kranz, AM DeYoreo, M
AHRQ Author: O'Hanlon
Access, quality, and financial performance of rural hospitals following health system affiliation.
This study examined the effect of a rural hospital affiliating itself with a health system. The comparison study used data from 2008 to 2017. A propensity score-weighted set of twelve measures were used on structure, utilization, financial performance, and quality. The rural hospitals that affiliated themselves with a health system experienced a significant reduction in on-site diagnostic imaging technologies, the availability of obstetric and primary care services, and outpatient nonemergency visits as well as a significant increase in operating margins. While these affiliations may help to keep a rural hospital open, it may also reduce access to services in these rural areas.
AHRQ-funded; HS024067.
Citation: CE Kranz, AM DeYoreo, M .
Access, quality, and financial performance of rural hospitals following health system affiliation.
Health Aff 2019 Dec;38(12):2095-104. doi: 10.1377/hlthaff.2019.00918..
Keywords: Provider Performance, Quality of Care, Hospitals, Rural Health
Salvador J, Bhatt S, Fowler R
Engagement with Project ECHO to increase medication-assisted treatment in rural primary care.
The purpose of this study was to understand the barriers and facilitators that affect engagement with Project ECHO (Extension for Community Healthcare Outcomes) to implement medication-assisted treatment (MAT) in primary care settings. This brief report identified key systematic challenges that may directly limit primary care providers' engagement in telementoring models such as Project ECHO.
AHRQ-funded; HS025345.
Citation: Salvador J, Bhatt S, Fowler R .
Engagement with Project ECHO to increase medication-assisted treatment in rural primary care.
Psychiatr Serv 2019 Dec;70(12):1157-60. doi: 10.1176/appi.ps.201900142..
Keywords: Opioids, Medication, Substance Abuse, Primary Care, Rural Health, Telehealth, Health Information Technology (HIT)
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
Germack HD, Kandrack R, Martsolf GR
When rural hospitals close, the physician workforce goes.
Researchers examined the relationship between rural hospital closures and the supply of physicians across different specialties in the years leading up to and after a closure. They observed significant annual reductions in the supply of general surgeons in the years leading up to a closure. They also found that rural hospital closures were associated with immediate and persistent decreases in the supply of surgical specialists and long-term decreases in the supply of physicians across multiple specialties. Because this decrease could lead to reduced access to care for rural residents, they recommended that future policy efforts focus on supporting and maintaining health care delivery models that do not depend on hospitals.
AHRQ-funded; HS000032.
Citation: Germack HD, Kandrack R, Martsolf GR .
When rural hospitals close, the physician workforce goes.
Health Aff 2019 Dec;38(12):2086-94. doi: 10.1377/hlthaff.2019.00916..
Keywords: Rural Health, Hospitals, Workforce, Provider: Physician, Provider
Vakkalanka JP, Harland KK, Wittrock A
Telemedicine is associated with rapid transfer and fewer involuntary holds among patients presenting with suicidal ideation in rural hospitals: a propensity matched cohort study.
The purpose of this retrospective propensity-matched cohort study was to evaluate the impact of telemedicine in clinical management and patient outcomes of patients presenting to rural critical access hospital emergency departments (EDs) with suicidal ideation or attempt. The authors suggest that the role of telemedicine in influencing access, quality and efficiency of care in underserved rural hospitals is critically important as these networks become more prevalent in rural healthcare environments.
AHRQ-funded; HS025753.
Citation: Vakkalanka JP, Harland KK, Wittrock A .
Telemedicine is associated with rapid transfer and fewer involuntary holds among patients presenting with suicidal ideation in rural hospitals: a propensity matched cohort study.
J Epidemiol Community Health 2019 Nov;73(11):1033-39. doi: 10.1136/jech-2019-212623..
Keywords: Telehealth, Rural Health, Access to Care, Behavioral Health, Health Information Technology (HIT), Healthcare Delivery, Care Management, Outcomes, Emergency Department
Sockolow PS, Bass EJ, Ynag Y
Availability and quality of information used by nurses while admitting patients to a rural home health care agency.
This study investigated the availability and quality of information used by nurses in a rural home health care agency during patient admission. Twelve in-home admissions were observed and the nurses were interviewed before and after the admissions process. Content and quality of documents available to the nurses was analyzed and needed documents were not uniformly present. They rarely received visit pattern or medication management information. These results show the need for a high quality electronic health record system.
AHRQ-funded; HS024537.
Citation: Sockolow PS, Bass EJ, Ynag Y .
Availability and quality of information used by nurses while admitting patients to a rural home health care agency.
Stud Health Technol Inform 2019 Aug 21;264:798-802. doi: 10.3233/shti190333..
Keywords: Rural Health, Home Healthcare, Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Nurse, Provider
Cochran G, Cole ES, Warwick J
Rural access to MAT in Pennsylvania (RAMP): a hybrid implementation study protocol for medication assisted treatment adoption among rural primary care providers.
This paper reports the design and protocol of an implementation study seeking to advance availability of medication-assisted treatment (MAT) for opioid use disorder (OUD) in rural Pennsylvania counties for patients insured by Medicaid in primary care settings. Results showed an urgent need in the US to expand access to high quality, evidence-based OUD treatment, particularly in rural areas where capacity is limited for service delivery, in order to improve patient health and protect lives. Further, results of this study will provide needed evidence in the field for appropriate methods for implementing MAT among a large number of rural primary care providers.
AHRQ-funded; HS025072.
Citation: Cochran G, Cole ES, Warwick J .
Rural access to MAT in Pennsylvania (RAMP): a hybrid implementation study protocol for medication assisted treatment adoption among rural primary care providers.
Addict Sci Clin Pract 2019 Aug 1;14(1):25. doi: 10.1186/s13722-019-0154-4..
Keywords: Opioids, Substance Abuse, Rural Health, Medication, Access to Care, Implementation, Primary Care, Healthcare Delivery, Medicaid
Cole ES, DiDomenico E, Cochran G
The role of primary care in improving access to medication-assisted treatment for rural Medicaid enrollees with opioid use disorder.
The authors examined the degree to which rural residents with opioid use disorder (OUD) are engaged with primary care providers (PCPs); they also described the role of rural PCPs in medication-assisted treatment (MAT) delivery, and estimated the association between enrollee distance to MAT prescribers and MAT utilization. They concluded that PCP utilization among rural Medicaid enrollees diagnosed with OUD is high, presenting a potential intervention point to treat OUD, particularly if the enrollee's PCP is located nearer than their MAT prescriber.
AHRQ-funded; HS025072.
Citation: Cole ES, DiDomenico E, Cochran G .
The role of primary care in improving access to medication-assisted treatment for rural Medicaid enrollees with opioid use disorder.
J Gen Intern Med 2019 Jun;34(6):936-43. doi: 10.1007/s11606-019-04943-6..
Keywords: Opioids, Substance Abuse, Rural Health, Medication, Access to Care, Implementation, Primary Care, Healthcare Delivery, Medicaid
Spees LP, Brewster WR, Varia MA
Examining urban and rural differences in how distance to care influences the initiation and completion of treatment among insured cervical cancer patients.
Although rural cancer patients encounter substantial barriers to care, they more often report receiving timely care than urban patients. In this study, the investigators examined whether geographic distance, a contributor to urban-rural health disparities, differentially influenced treatment initiation and completion among insured urban and rural cervical cancer patients. The investigators found that geographic distance differentially influenced the initiation and completion of treatment among urban and rural cervical cancer patients.
AHRQ-funded; HS000032.
Citation: Spees LP, Brewster WR, Varia MA .
Examining urban and rural differences in how distance to care influences the initiation and completion of treatment among insured cervical cancer patients.
Cancer Epidemiol Biomarkers Prev 2019 May;28(5):882-89. doi: 10.1158/1055-9965.Epi-18-0945..
Keywords: Rural Health, Urban Health, Disparities, Access to Care, Cancer: Cervical Cancer, Cancer
Bond WF, Barker LT, Cooley KL
A simple low-cost method to integrate telehealth interprofessional team members during in situ simulation.
This article describes the integration of remote telehealth electronic intensive care unit (eICU) personnel into in situ simulations with rural emergency department (ED) care teams and the technical challenges of creating shared awareness of the patient's condition and the care team's progress among the care team, the eICU, and those running the simulation. The purpose of the simulations was to introduce telehealth technology and new processes of engaging the eICU via telehealth during sepsis care in rural EDs; development of the scenarios included experts in sepsis, telehealth, and emergency medicine. A shared in situ simulation clinical actions observational checklist was created using an off-the-shelf survey software program. The checklist was completed during the simulations by an onsite observer, and shared with the eICU team via teleconferencing software to and cue eICU nurse engagement. Staff from the two EDs were engaged and an eICU nurse participated in debriefing via the telehealth video system.
AHRQ-funded; HS024027.
Citation: Bond WF, Barker LT, Cooley KL .
A simple low-cost method to integrate telehealth interprofessional team members during in situ simulation.
Simul Healthc 2019 Apr;14(2):129-36. doi: 10.1097/sih.0000000000000357..
Keywords: Critical Care, Electronic Health Records (EHRs), Emergency Department, Health Information Technology (HIT), Rural Health, Simulation, Teams, Telehealth
Reid R, Rising E, Kaufman A
The influence of a place-based foundation and a public university in growing a rural health workforce.
This article describes a partnership between a private, place-based foundation and the University of New Mexico's Office for Community Health. The university’s resources and the JF Maddox Foundation’s entrepreneurial nature, discretionary grant-making, and local convening capabilities combined to an innovative approach for addressing an acute shortage in the local health care delivery workforce in an isolated, rural setting in New Mexico. Results included a significant increase in recruitment of key health care professionals, a more cohesive medical community, a school-based clinic, and support for other community challenges such as the prevention of teen pregnancy.
AHRQ-funded; HS023904.
Citation: Reid R, Rising E, Kaufman A .
The influence of a place-based foundation and a public university in growing a rural health workforce.
J Community Health 2019 Apr;44(2):292-96. doi: 10.1007/s10900-018-0585-y..
Keywords: Access to Care, Community-Based Practice, Community Partnerships, Rural Health, Workforce
Gore MO, Krantz MJ, Albright K
A controlled trial of mobile short message service among participants in a rural cardiovascular disease prevention program.
Researchers with the Colorado Healthy Heart Solutions (CHHS) program conducted a pilot trial to see determine if the use of mobile phone SMS (text messages) improves cardiovascular disease (CVD) risk profiles for the medically underserved population it serves. Results showed that for most outcomes there was no statistical significance between the intervention and control groups for all but self-reported fat intake.
AHRQ-funded.
Citation: Gore MO, Krantz MJ, Albright K .
A controlled trial of mobile short message service among participants in a rural cardiovascular disease prevention program.
Prev Med Rep 2019 Mar;13:126-31. doi: 10.1016/j.pmedr.2018.11.021..
Keywords: Cardiovascular Conditions, Health Information Technology (HIT), Prevention, Rural Health
Ray KN, Demirci JR, Uscher-Pines L
Geographic access to international board-certified lactation consultants in Pennsylvania.
The goals of this study were to assess geographic access to international board-certified lactation consultants in Pennsylvania, to compare access in rural vs. urban counties, and to compare access by county-level breastfeeding initiation rates. Researchers used geographic information systems methodology and a cross-sectional observational design to calculate the proportion of all young children, children in urban and rural counties, children in counties with low, medium, and high breastfeeding initiation rates who lived within specific distances of board-certified lactation consultants in Pennsylvania. Comparisons were made to answer the research goals. While the results indicate that most Pennsylvania children live in proximity to a board-certified lactation consultant, a lower percentage of children in rural counties and in counties with lower breastfeeding rates do.
AHRQ-funded; HS022989.
Citation: Ray KN, Demirci JR, Uscher-Pines L .
Geographic access to international board-certified lactation consultants in Pennsylvania.
J Hum Lact 2019 Feb;35(1):90-99. doi: 10.1177/0890334418768458..
Keywords: Access to Care, Breast Feeding, Newborns/Infants, Rural Health
Spees LP, Wheeler SB, Varia M
Evaluating the urban-rural paradox: the complicated relationship between distance and the receipt of guideline-concordant care among cervical cancer patients.
A recent study suggests that the distance to reach care may affect urban and rural cancer patients differentially; the authors of this article examined whether or not this urban-rural paradox exists among cervical cancer patients. Patients diagnosed with cervical cancer from 2004 to 2013 were identified via a statewide cancer registry linked to multi-payer insurance claims. 62% of the cervical cancer patients received guideline-concordant care. The association between distance and receipt of care differed by type of treatment. The authors conclude that there is evidence supporting the urban-rural paradox.
AHRQ-funded; HS000032.
Citation: Spees LP, Wheeler SB, Varia M .
Evaluating the urban-rural paradox: the complicated relationship between distance and the receipt of guideline-concordant care among cervical cancer patients.
Gynecol Oncol 2019 Jan;152(1):112-18. doi: 10.1016/j.ygyno.2018.11.010.
.
.
Keywords: Access to Care, Cancer: Cervical Cancer, Disparities, Evidence-Based Practice, Rural Health, Urban Health