National Healthcare Quality and Disparities Report
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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 7 of 7 Research Studies DisplayedOdlum M, Moise N, Kronish IM
Trends in poor health indicators among Black and Hispanic middle-aged and older adults in the United States, 1999-2018.
This study used records extracted from the Behavioral Risk Factor Surveillance System to determine which health indicators have improved or became worse among Black and Hispanic middle-aged (45 and older) adults compared to Whites from 1999 to 2018. This data is required by the Minority Health and Health Disparities Research and Education Act of 2000. A sample included of 4,856,326 participants, of them 60.9% women, mean age 60.4. During the last 20 years, Black adults showed an overall decrease showing improvement in uninsured status and physical inactivity while showing an overall increase in hypertension, diabetes, asthma, and stroke, and also the same increases and decreases in the Black-White gap. Hispanic adults showed improvement in physical inactivity and perceived poor health, while they showed overall deterioration in hypertension and diabetes. The Hispanic-White gap improved in coronary heart disease, stroke, kidney disease, asthma, arthritis, depression and physical inactivity while it increased for diabetes, hypertension, and uninsured status.
AHRQ-funded; HS025198.
Citation: Odlum M, Moise N, Kronish IM .
Trends in poor health indicators among Black and Hispanic middle-aged and older adults in the United States, 1999-2018.
JAMA Netw Open 2020 Nov 2;3(11):e2025134. doi: 10.1001/jamanetworkopen.2020.25134..
Keywords: Elderly, Racial and Ethnic Minorities, Disparities, Health Status, Health Insurance, Diabetes, Blood Pressure, Chronic Conditions
Shah SC, McKinley M, Gupta S
Population-based analysis of differences in gastric cancer incidence among races and ethnicities in individuals age 50 years and older.
There are racial and ethnic differences in the incidence of gastric adenocarcinoma worldwide and in the US. Based on a decision analysis, screening for noncardia gastric adenocarcinoma might be cost-effective for non-White individuals 50 years or older. In this study, the investigators aimed to estimate the differences in gastric adenocarcinoma incidence in specific anatomic sites among races and ethnicities in individuals 50 years or older.
AHRQ-funded; HS026395.
Citation: Shah SC, McKinley M, Gupta S .
Population-based analysis of differences in gastric cancer incidence among races and ethnicities in individuals age 50 years and older.
Gastroenterology 2020 Nov;159(5):1705-14.e2. doi: 10.1053/j.gastro.2020.07.049..
Keywords: Elderly, Cancer, Digestive Disease and Health, Racial and Ethnic Minorities, Disparities
Roberts ET, Mehrotra A
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
In this study, the investigators examined disparities in digital access (ie, access at home to technology that enables video telemedicine visits) among Medicare beneficiaries by socioeconomic and demographic characteristics. The investigators concluded that the proportion of beneficiaries who lacked digital access was higher among those with low socioeconomic status, those 85 years or older, and in communities of color.
AHRQ-funded; HS026727.
Citation: Roberts ET, Mehrotra A .
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
JAMA Intern Med 2020 Oct;180(10):1386-89. doi: 10.1001/jamainternmed.2020.2666..
Keywords: Elderly, Medicare, Telehealth, Health Information Technology (HIT), Disparities, Access to Care, Social Determinants of Health, Low-Income, Racial and Ethnic Minorities
Li J, Qi M, Werner RM
Assessment of receipt of the first home health care visit after hospital discharge among older adults.
Investigators examined how often patients referred to home health care at hospital discharge receive it and whether there is evidence of disparities. Their study used Medicare data regarding the postacute home health care setting; participants were Medicare fee-for-service and Medicare Advantage beneficiaries discharged from the hospital with a referral to home health care. They found that only 54% of patients discharged received home health care services within 14 days of discharge. Of the remaining 46% discharged, 37.7% never received any home health care, while 8.3% were institutionalized or died within 14 days without a preceding home health care visit. Patients who were Black or Hispanic received home health at lower rates than did patients who were White. They concluded that disparities in the use of home health care remain an issue in the US.
AHRQ-funded; HS024266; HS026836.
Citation: Li J, Qi M, Werner RM .
Assessment of receipt of the first home health care visit after hospital discharge among older adults.
JAMA Netw Open 2020 Sep;3(9):e2015470. doi: 10.1001/jamanetworkopen.2020.15470..
Keywords: Elderly, Hospital Discharge, Home Healthcare, Disparities, Access to Care, Racial and Ethnic Minorities
Bolstad CJ, Moak R, Brown CJ
Neighborhood disadvantage is associated with depressive symptoms but not depression diagnosis in older adults.
This study tested how neighborhood disadvantage (ND) relates to depressive symptomology and diagnosis to assess for neighborhood disparities in mental health care cross-sectionally. Using data from the University of Alabama at Birmingham Study of Aging, the investigators found living in the high and mid-ND tertiles to be associated with depressive symptomology, yet ND had no significant relation to depression diagnosis. They concluded that older adults living in high and mid-disadvantaged neighborhoods may be more likely to experience depressive symptomology but not receive a diagnosis, indicating a possible disparity in mental health care.
AHRQ-funded; HS013852.
Citation: Bolstad CJ, Moak R, Brown CJ .
Neighborhood disadvantage is associated with depressive symptoms but not depression diagnosis in older adults.
Int J Environ Res Public Health 2020 Aug 8;17(16). doi: 10.3390/ijerph17165745..
Keywords: Elderly, Depression, Behavioral Health, Diagnostic Safety and Quality, Disparities, Social Determinants of Health
Longacre CF, Neprash HT, Shippee ND
Evaluating travel distance to radiation facilities among rural and urban breast cancer patients in the Medicare population.
This study characterizes the actual distance older breast cancer patients traveled to radiation treatment and the minimum distance necessary to reach radiation care, and examines whether any patient demographic or clinical factors are associated with greater travel distance. Findings showed that patients living in rural areas traveled on average nearly 3 times as far as those from urban areas, and their nearest facility was more than 4 times farther away. Older age, being single or widowed, and lower household income were significantly associated with shorter actual travel distance, while increasing rurality was significantly associated with greater actual and minimum travel distance to radiation treatment.
AHRQ-funded; HS026660.
Citation: Longacre CF, Neprash HT, Shippee ND .
Evaluating travel distance to radiation facilities among rural and urban breast cancer patients in the Medicare population.
J Rural Health 2020 Jun;36(3):334-46. doi: 10.1111/jrh.12413..
Keywords: Rural Health, Cancer: Breast Cancer, Cancer, Elderly, Women, Access to Care, Disparities
Fashaw S, Chisholm L, Mor V
Inappropriate antipsychotic use: the impact of nursing home socioeconomic and racial composition.
Researchers examined how nursing home characteristics, particularly the racial and socioeconomic composition of residents, are associated with the inappropriate use of antipsychotics, using national data from Long-Term Care: Facts on Care. They found an overall decline in the use of antipsychotics. Although findings indicated facilities with higher proportions of blacks had lower inappropriate antipsychotic use, facility-level socioeconomic disparities continued to persist among nursing homes. They recommended that policy interventions focusing on reimbursement be considered to promote reductions in antipsychotic use, specifically among Medicaid-reliant nursing homes.
ARHQ-funded; HS000011.
Citation: Fashaw S, Chisholm L, Mor V .
Inappropriate antipsychotic use: the impact of nursing home socioeconomic and racial composition.
J Am Geriatr Soc 2020 Mar;68(3):630-36. doi: 10.1111/jgs.16316..
Keywords: Nursing Homes, Long-Term Care, Elderly, Medication, Medication: Safety, Social Determinants of Health, Disparities, Racial and Ethnic Minorities