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 (5)
- Adverse Drug Events (ADE) (1)
- Asthma (2)
- Behavioral Health (2)
- Cancer (1)
- Cancer: Breast Cancer (1)
- Care Management (1)
- Children's Health Insurance Program (CHIP) (4)
- Children/Adolescents (12)
- Chronic Conditions (3)
- Community-Based Practice (3)
- Comparative Effectiveness (4)
- Data (1)
- Dental and Oral Health (4)
- Depression (1)
- Diabetes (1)
- Disparities (2)
- Domestic Violence (1)
- Electronic Health Records (EHRs) (1)
- Emergency Department (3)
- Emergency Medical Services (EMS) (1)
- Eye Disease and Health (1)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Costs (4)
- Healthcare Delivery (1)
- Healthcare Utilization (7)
- Health Insurance (11)
- Health Services Research (HSR) (2)
- Health Status (1)
- Heart Disease and Health (1)
- Hospitalization (1)
- Hospital Readmissions (1)
- Human Immunodeficiency Virus (HIV) (3)
- Lifestyle Changes (1)
- Low-Income (3)
- (-) Medicaid (39)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medicare (6)
- Medication (7)
- Nursing Homes (2)
- Opioids (1)
- Outcomes (2)
- Pain (1)
- Patient-Centered Healthcare (3)
- Patient Adherence/Compliance (2)
- Payment (1)
- Policy (5)
- Pregnancy (1)
- Prevention (1)
- Primary Care (3)
- Provider: Health Personnel (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (2)
- Research Methodologies (3)
- Respiratory Conditions (1)
- Shared Decision Making (1)
- Social Determinants of Health (1)
- Transitions of Care (1)
- Uninsured (4)
- Vulnerable Populations (1)
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 25 of 39 Research Studies DisplayedKuo DZ, Hall M, Agrawal R
Comparison of health care spending and utilization among children with Medicaid insurance.
This study's objectives were to assess health care and spending among children with Medicaid insurance by their resource use. It found that as resource use increases in children with Medicaid, spending rises unevenly across health services: Spending on primary care rises modestly compared with other health services.
AHRQ-funded; HS023092.
Citation: Kuo DZ, Hall M, Agrawal R .
Comparison of health care spending and utilization among children with Medicaid insurance.
Pediatrics 2015 Dec;136(6):1521-9. doi: 10.1542/peds.2015-0871.
.
.
Keywords: Medicaid, Healthcare Utilization, Children/Adolescents, Healthcare Costs, Health Services Research (HSR)
Decker SL, Lipton BJ
AHRQ Author: Decker SL
Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health.
This article examines the effect of Medicaid adult dental coverage on use of dental care and dental health outcomes using state-level variation in dental coverage during 2000-2012. Its findings imply that dental coverage is associated with an increase in the likelihood of a recent dental visit, with the size of the effect increasing with Medicaid payment rates to dentists, and a reduction in the likelihood of untreated dental caries.
AHRQ-authored.
Citation: Decker SL, Lipton BJ .
Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health.
J Health Econ 2015 Dec;44:212-25. doi: 10.1016/j.jhealeco.2015.08.009.
.
.
Keywords: Access to Care, Dental and Oral Health, Health Insurance, Healthcare Utilization, Medicaid, Outcomes
Hellinger FJ
AHRQ Author: Hellinger FJ
In four ACA expansion states, the percentage of uninsured hospitalizations for people with HIV declined, 2012-14.
This study examines the influence of the Affordable Care Act's optional state Medicaid expansion on insurance coverage and health outcomes for hospitalized patients with HIV. It found that the percentage of hospitalizations of uninsured people with HIV in the four expansion states fell from 13.7 percent to 5.5 percent in the study period, while the percentage in the two nonexpanding states increased from 14.5 percent to 15.7 percent.
AHRQ-authored.
Citation: Hellinger FJ .
In four ACA expansion states, the percentage of uninsured hospitalizations for people with HIV declined, 2012-14.
Health Aff 2015 Dec;34(12):2061-8. doi: 10.1377/hlthaff.2015.0718..
Keywords: Policy, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Human Immunodeficiency Virus (HIV), Medicaid, Uninsured
Lipton BJ, Decker SL
AHRQ Author: Decker SL
The effect of health insurance coverage on medical care utilization and health outcomes: evidence from Medicaid adult vision benefits.
The reserarchers examined the effect of vision insurance on eye care utilization and vision health outcomes by taking advantage of quasi-experimental variation in Medicaid coverage of adult vision care. They found that Medicaid beneficiaries with vision coverage are 4.4 percentage points more likely to have seen an eye doctor in the past year,and 5.3 percentage points less likely to report needing but not purchasing eyeglasses or contacts due to cost.
AHRQ-authored.
Citation: Lipton BJ, Decker SL .
The effect of health insurance coverage on medical care utilization and health outcomes: evidence from Medicaid adult vision benefits.
J Health Econ 2015 Dec;44:320-32. doi: 10.1016/j.jhealeco.2015.10.006.
.
.
Keywords: Medicaid, Eye Disease and Health, Healthcare Utilization, Health Services Research (HSR), Outcomes
Kohler RE, Goyal RK, Lich KH
Association between medical home enrollment and health care utilization and costs among breast cancer patients in a state Medicaid program.
The objective of this study was to examine health care utilization and expenditures as a function of patient-centered medical home (PCMH) enrollment among breast cancer patients in North Carolina’s Medicaid program. It found that PCMH enrollment was significantly associated with greater outpatient service use, but there was no difference in the probability of inpatient hospitalizations or ED visits.
AHRQ-funded; HS019468.
Citation: Kohler RE, Goyal RK, Lich KH .
Association between medical home enrollment and health care utilization and costs among breast cancer patients in a state Medicaid program.
Cancer 2015 Nov 15;121(22):3975-81. doi: 10.1002/cncr.29596..
Keywords: Cancer, Cancer: Breast Cancer, Healthcare Utilization, Medicaid, Patient-Centered Healthcare
Ajmera M, Sambamoorthi U, Metzger A
Multimorbidity and COPD Medication receipt among Medicaid beneficiaries with newly diagnosed COPD.
The aim of this study was to examine the association between multimorbidity and chronic obstructive pulmonary disease ( COPD) medication receipt among Medicaid beneficiaries with newly diagnosed COPD. It found that in this group 81.9 percen had at least one co-occurring chronic condition. After controlling for subject characteristics, adults with multimorbidity were less likely to receive COPD medications compared with those without any inflammation-related multimorbidity.
AHRQ-funded; HS022444.
Citation: Ajmera M, Sambamoorthi U, Metzger A .
Multimorbidity and COPD Medication receipt among Medicaid beneficiaries with newly diagnosed COPD.
Respir Care 2015 Nov;60(11):1592-602. doi: 10.4187/respcare.03788.
.
.
Keywords: Chronic Conditions, Respiratory Conditions, Medication, Medicaid
Garcia Mosqueira A, Hua LM, Sommers BD
Racial differences in awareness of the Affordable Care Act and application assistance among low-income adults in three Southern states.
The researchers explored potential factors related to racial/ethnic differences in ACA enrollment - awareness of the law and receipt of application assistance such as navigator services. Their results highlight the importance of ACA outreach efforts to increase awareness among low-income and less educated populations to close existing disparities in coverage.
AHRQ-funded; HS021291.
Citation: Garcia Mosqueira A, Hua LM, Sommers BD .
Racial differences in awareness of the Affordable Care Act and application assistance among low-income adults in three Southern states.
Inquiry 2015 Oct 8;52. doi: 10.1177/0046958015609607.
.
.
Keywords: Disparities, Health Insurance, Low-Income, Medicaid, Racial and Ethnic Minorities
Jung HY, Trivedi AN, Grabowski DC
Integrated Medicare and Medicaid managed care and rehospitalization of dual eligibles.
The objective of this study was to conduct an early evaluation of an innovative program that coordinates benefits for elderly dual eligibles. The authors found no statistically significant effect of senior care options on rehospitalization. They concluded that coordinating the financing and delivery of services through an integrated managed program may not sufficiently address the problems of inefficiency and fragmentation in care for hospitalized dual eligible enrollees.
AHRQ-funded; HS020756.
Citation: Jung HY, Trivedi AN, Grabowski DC .
Integrated Medicare and Medicaid managed care and rehospitalization of dual eligibles.
Am J Manag Care 2015 Oct;21(10):711-7.
.
.
Keywords: Healthcare Delivery, Care Management, Medicaid, Medicare, Hospital Readmissions
Portela M, Sommers BD
On the outskirts of national health reform: a comparative assessment of health insurance and access to care in Puerto Rico and the United States.
This article presents an overview of Puerto Rico’s health care system and a comparative analysis of coverage and access to care in Puerto Rico and the mainland United States. It found that uninsured rates were significantly lower in Puerto Rico;. Medicaid was far more common in Puerto Rico. Puerto Rican residents were more likely than those in the mainland United States to have a usual source of care and to have had a checkup within the past year.
AHRQ-funded; HS021291.
Citation: Portela M, Sommers BD .
On the outskirts of national health reform: a comparative assessment of health insurance and access to care in Puerto Rico and the United States.
Milbank Q 2015 Sep;93(3):584-608. doi: 10.1111/1468-0009.12138..
Keywords: Health Insurance, Access to Care, Policy, Medicaid, Uninsured
Fischer MA, Allen-Coleman C, Farrell SF
Stakeholder assessment of comparative effectiveness research needs for Medicaid populations.
Because children, pregnant women and people with mental illness have generally been underrepresented in research discussions, comparative effectiveness rsearch (CER) questions for these groups may be understudied. To address this problem, AHRQ commissioned a team to work with Medicaid Medical Directors and other stakeholders to identify relevant CER questions. Through an iterative process of topic identification and refinement, they developed relevant, feasible and actionable questions based on issues affecting Medicaid programs nationwide.
AHRQ-funded; 290200500161.
Citation: Fischer MA, Allen-Coleman C, Farrell SF .
Stakeholder assessment of comparative effectiveness research needs for Medicaid populations.
J Comp Eff Res 2015 Sep;4(5):465-71. doi: 10.2217/cer.15.26.
.
.
Keywords: Comparative Effectiveness, Medicaid, Research Methodologies, Shared Decision Making, Vulnerable Populations
Davidoff AJ, Hill SC, Bernard D
AHRQ Author: Hill SC, Bernard D
The Affordable Care Act and expanded insurance eligibility among nonelderly adult cancer survivors.
The researchers examined potential improvements in access to insurance for cancer survivors through adult Medicaid expansions and premium tax credits in the new insurance marketplaces under the Affordable Care Act (ACA). They found that under the ACA, many of the uninsured and a larger proportion of survivors facing financial hardship will be eligible for Medicaid or premium tax credits in the Marketplaces.
AHRQ-authored.
Citation: Davidoff AJ, Hill SC, Bernard D .
The Affordable Care Act and expanded insurance eligibility among nonelderly adult cancer survivors.
J Natl Cancer Inst 2015 Sep;107(9):djv181. doi: 10.1093/jnci/djv181..
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Medicaid
Palmsten K, Hernandez-Diaz S, Chambers CD
The most commonly dispensed prescription medications among pregnant women enrolled in the U.S. Medicaid program.
The researchers characterize the 20 most common prescription medications and the 10 most common prescription medications classified in the former U.S. Food and Drug Administration categories D or X dispensed to pregnant women enrolled in the U.S. Medicaid program. They found that medications used to treat infections were the most commonly dispensed prescription medications.
AHRQ-funded; HS018533.
Citation: Palmsten K, Hernandez-Diaz S, Chambers CD .
The most commonly dispensed prescription medications among pregnant women enrolled in the U.S. Medicaid program.
Obstet Gynecol 2015 Sep;126(3):465-73. doi: 10.1097/aog.0000000000000982..
Keywords: Medicaid, Pregnancy, Medication
Fingar KR, Smith MW, Davies S
AHRQ Author: Stocks C
Medicaid dental coverage alone may not lower rates of dental emergency department visits.
This study examined county-level rates of ED visits for nontraumatic dental conditions in twenty-nine States in 2010 in relation to dental provider density and Medicaid coverage of nonemergency dental services. It found that county-level Medicaid-funded dental ED visit rates were lower in states where Medicaid covered nonemergency dental services than in other states, although this difference was not significant after other factors were adjusted for.
AHRQ-authored; AHRQ-funded; 290201200003I; HS021700.
Citation: Fingar KR, Smith MW, Davies S .
Medicaid dental coverage alone may not lower rates of dental emergency department visits.
Health Aff 2015 Aug;34(8):1349-57. doi: 10.1377/hlthaff.2015.0223..
Keywords: Dental and Oral Health, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Comparative Effectiveness, Medicaid
DeVoe JE, Crawford C, Angier H
The association between Medicaid coverage for children and parents persists: 2002-2010.
The researchers assessed the likelihood of children’s having public health insurance coverage and their parents’ maintenance, gain, or loss of public coverage. The study found that, despite differing eligibility requirements, strong associations persisted between coverage continuity for parents and children in Oregon’s public health insurance program.
AHRQ-funded; HS018569
Citation: DeVoe JE, Crawford C, Angier H .
The association between Medicaid coverage for children and parents persists: 2002-2010.
Matern Child Health J. 2015 Aug;19(8):1766-74. doi: 10.1007/s10995-015-1690-5..
Keywords: Medicaid, Children/Adolescents, Health Insurance
DeVoe JE, Marino M, Gold R
Community health center use after Oregon's randomized medicaid experiment.
To better understand the effect of new Medicaid coverage on community health center (CHC)use over time, the researchers studied Oregon’s 2008 randomized Medicaid expansion (the “Oregon Experiment”). Their results suggest that use of many different types of CHC services will increase as patients gain Medicaid through Affordable Care Act expansions.
AHRQ-funded; HS021522.
Citation: DeVoe JE, Marino M, Gold R .
Community health center use after Oregon's randomized medicaid experiment.
Ann Fam Med 2015 Jul;13(4):312-20. doi: 10.1370/afm.1812..
Keywords: Community-Based Practice, Healthcare Utilization, Medicaid, Primary Care
Dumas SA, Polk D
Pediatric dental clinic location and utilization in a high-resource setting.
This study examined dental utilization by Medicaid-insured children living in a high-resource area and characterized distance and travel-related variables to accessing care. It concluded that closer proximity may contribute to the higher utilization of services observed compared with national rates.
AHRQ-funded; HS019486.
Citation: Dumas SA, Polk D .
Pediatric dental clinic location and utilization in a high-resource setting.
J Public Health Dent 2015 Summer;75(3):183-90. doi: 10.1111/jphd.12086.
.
.
Keywords: Children/Adolescents, Healthcare Utilization, Dental and Oral Health, Access to Care, Medicaid
Sommers BD, Maylone B, Nguyen KH
The impact of state policies on ACA applications and enrollment among low-income adults in Arkansas, Kentucky, and Texas.
The researchers surveyed nearly 3,000 low-income adults in late 2014 to compare experiences in three states with markedly different policies: Kentucky, Arkansas, and Texas. They found that application rates, successful enrollment, and positive experiences with the ACA were highest in Kentucky, followed by Arkansas, with Texas performing worst. Limited awareness remains a critical barrier: Fewer than half of adults had heard some or a lot about the coverage expansions.
AHRQ-funded; HS021291.
Citation: Sommers BD, Maylone B, Nguyen KH .
The impact of state policies on ACA applications and enrollment among low-income adults in Arkansas, Kentucky, and Texas.
Health Aff 2015 Jun;34(6):1010-8. doi: 10.1377/hlthaff.2015.0215..
Keywords: Policy, Low-Income, Medicaid, Health Insurance
Brouwer ES, Napravnik S, Eron JJ, Jr.
Validation of Medicaid claims-based diagnosis of myocardial infarction using an HIV clinical cohort.
The investigators aimed to validate claims-based myocardial infarction (MI) algorithms in a Medicaid population using an HIV clinical cohort as the gold standard. Studying 1063 individuals over 2.5 years, 17 had an MI. Specificity ranged from 0.979 to 0.993 with the highest specificity obtained using the ICD-9 code 410.xx in the primary or secondary position and a length of stay greater than 3 days. Sensitivity of MI ascertainment varied from 0.588 to 0.824 depending on algorithm. They recommended that the type of algorithm used be prioritized based on study question and maximization of specific validation parameters that will minimize bias while also considering precision.
AHRQ-funded; HS018731.
Citation: Brouwer ES, Napravnik S, Eron JJ, Jr. .
Validation of Medicaid claims-based diagnosis of myocardial infarction using an HIV clinical cohort.
Med Care 2015 Jun;53(6):e41-8. doi: 10.1097/MLR.0b013e318287d6fd.
.
.
Keywords: Comparative Effectiveness, Human Immunodeficiency Virus (HIV), Medicaid, Heart Disease and Health, Research Methodologies
Christensen AL, Zickafoose JS, Natzke B
Associations between practice-reported medical homeness and health care utilization among publicly insured children.
This study assessed the relationship between having a patient-centered medical home and use of health services by children enrolled in Medicaid in three States. The researchers found that medical homeness was not associated with the likelihood of receiving well-child care. Association of medical homeness with non-urgent, preventable, or avoidable emergency department visits varied.
AHRQ-funded; 290200900019I
Citation: Christensen AL, Zickafoose JS, Natzke B .
Associations between practice-reported medical homeness and health care utilization among publicly insured children.
Acad Pediatr. 2015 May-Jun;15(3):267-74. doi: 10.1016/j.acap.2014.12.001..
Keywords: Children/Adolescents, Medicaid, Patient-Centered Healthcare, Children's Health Insurance Program (CHIP), Healthcare Utilization
Raghavan R, Brown DS, Allaire BT
Challenges in using Medicaid claims to ascertain child maltreatment.
Using data from the first National Survey of Child and Adolescent Well-Being and Medicaid claims, this study assessed the validity of Medicaid codes in identifying maltreatment. Medicaid claims identify maltreatment in only 15 percent of all children identified by the child’s investigating child welfare worker as having been maltreated.
AHRQ-funded; HS020269.
Citation: Raghavan R, Brown DS, Allaire BT .
Challenges in using Medicaid claims to ascertain child maltreatment.
Challenges in using Medicaid claims to ascertain child maltreatment..
Keywords: Domestic Violence, Children/Adolescents, Medicaid
Pati S, Wong AT, Calixte RE
Medicaid and CHIP retention among children in 12 states.
The authors sought to determine reproducibility of public insurance retention rates for children using 3 different metrics at the state and county level. They found that all 3 metrics demonstrated reproducible estimates at the state level. Reproducibility of relative rankings for child health insurance retention of counties within states were sensitive to county child population size and the amount of variability in retention rates within the county and at the state level.
AHRQ-funded; HS020508.
Citation: Pati S, Wong AT, Calixte RE .
Medicaid and CHIP retention among children in 12 states.
Acad Pediatr 2015 May-Jun;15(3):249-57. doi: 10.1016/j.acap.2014.09.012.
.
.
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Policy, Medicaid
Konetzka RT, Grabowski DC, Perraillon MC
Nursing home 5-star rating system exacerbates disparities in quality, by payer source.
The researchers examined how the Centers for Medicare and Medicare Services’ five-star rating system for nursing homes has affected residents who are dually enrolled in Medicare and Medicaid (“dual eligibles”). They found that by 2010 the increased likelihood of choosing the highest-rated homes was substantially smaller for dual eligibles than for non–dual eligibles.
AHRQ-funded; HS021877.
Citation: Konetzka RT, Grabowski DC, Perraillon MC .
Nursing home 5-star rating system exacerbates disparities in quality, by payer source.
Health Aff 2015 May;34(5):819-27. doi: 10.1377/hlthaff.2014.1084..
Keywords: Nursing Homes, Medicare, Medicaid, Quality of Care
Ringwalt C, Roberts AW, Gugelmann H
Racial disparities across provider specialties in opioid prescriptions dispensed to Medicaid beneficiaries with chronic noncancer pain.
The purpose of this study was to examine differences across providers’ specialties in prescriptions filled by white and black Medicaid beneficiaries with chronic noncancer pain (CNCP). It found that race-based differences in beneficiaries’ dispensed opioid prescriptions were more prominent among patients of specialists in obstetrics and gynecology and internal medicine, as well as general practitioners/family medicine physicians.
AHRQ-funded; HS000032.
Citation: Ringwalt C, Roberts AW, Gugelmann H .
Racial disparities across provider specialties in opioid prescriptions dispensed to Medicaid beneficiaries with chronic noncancer pain.
Pain Med 2015 Apr;16(4):633-40. doi: 10.1111/pme.12555..
Keywords: Chronic Conditions, Disparities, Medicaid, Medication, Opioids, Pain, Racial and Ethnic Minorities
Brouwer ES, Moga DC, Eron JJ
Evaluating the incident user design in the HIV population: incident use versus naive?
Through linkage to a comprehensive HIV clinical cohort, the researchers aimed to quantify and describe the truly naïve patients in an incident use population identified in Medicaid administrative claims. In their sample, they found that 34 percent of the Medicaid incident users were naïve based on medical record abstraction of antiretroviral use.
AHRQ-funded; HS018731.
Citation: Brouwer ES, Moga DC, Eron JJ .
Evaluating the incident user design in the HIV population: incident use versus naive?
Pharmacoepidemiol Drug Saf 2015 Mar;24(3):297-300. doi: 10.1002/pds.3705..
Keywords: Human Immunodeficiency Virus (HIV), Research Methodologies, Comparative Effectiveness, Data, Medicaid
Wright KD, Pepper GA, Caserta M
Factors that influence physical function and emotional well-being among Medicare-Medicaid enrollees.
The researchers examined the associations between race, gender, age, neighborhood poverty, education, and health behaviors (i.e., smoking, exercise, and physical activity) with physical function and emotional well-being in Medicare-Medicaid enrollees. They determined that race, neighborhood poverty, education, and income did not influence physical function or emotional well-being; however, physical activity was associated both with an increased self-report of physical function and emotional well-being.
AHRQ-funded; HS014539.
Citation: Wright KD, Pepper GA, Caserta M .
Factors that influence physical function and emotional well-being among Medicare-Medicaid enrollees.
Geriatr Nurs 2015 Mar-Apr;36(2 Suppl):S16-20. doi: 10.1016/j.gerinurse.2015.02.022..
Keywords: Social Determinants of Health, Medicare, Medicaid, Lifestyle Changes, Health Status