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
Topics
- Access to Care (8)
- Cancer (4)
- Cancer: Cervical Cancer (2)
- Cancer: Colorectal Cancer (4)
- Children/Adolescents (3)
- Community-Based Practice (1)
- Dental and Oral Health (2)
- Diabetes (1)
- Disparities (1)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Healthcare Costs (2)
- Healthcare Delivery (1)
- Healthcare Utilization (4)
- Health Insurance (6)
- Health Services Research (HSR) (1)
- Maternal Care (2)
- (-) Medicaid (14)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medicare (1)
- Patient-Centered Healthcare (1)
- Patient Adherence/Compliance (1)
- Policy (5)
- Pregnancy (1)
- (-) Prevention (14)
- Primary Care (2)
- Screening (4)
- Sexual Health (1)
- Uninsured (1)
- Women (3)
- Young Adults (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 14 of 14 Research Studies DisplayedHolland JE, Varni SE, Pulcini CD
Assessing the relationship between well-care visit and emergency department utilization among adolescents and young adults.
This study investigated the association between adolescent and young adult (AYA) well-care visits and emergency department (ED) utilization. Vermont’s all-payer claims data for 2018 was used to evaluate visits for 49,089 AYAs (aged 12-21 years) with a health-care claim. Nearly half (49%) of AYAs who engaged with the health-care system did not have a well-care visit in 2018. Those AYAs had 24% greater odds of going to the ED at least once in 2018, controlling for age, sex, insurance type, and medical complexity. Late adolescents and young adults (aged 18-21) who did not attend a well-care visit had 47% greater odds of ED visits, middle adolescents (15-17 years) had 9% greater odds, and early adolescents (12-14 years) had 16% greater odds.
AHRQ-funded; HS024575.
Citation: Holland JE, Varni SE, Pulcini CD .
Assessing the relationship between well-care visit and emergency department utilization among adolescents and young adults.
J Adolesc Health 2022 Jan;70(1):64-69. doi: 10.1016/j.jadohealth.2021.08.011..
Keywords: Children/Adolescents, Young Adults, Emergency Department, Healthcare Utilization, Medicaid, Prevention
Hill SC, Abdus S
AHRQ Author: Hill SC Abdus S
The effects of Medicaid on access to care and adherence to recommended preventive services.
Using MEPS data, the authors sought to quantify the impact of Medicaid enrollment on access to care and adherence to recommended preventive services. They found that Medicaid enrollment decreased the probability of having unmet needs for medical care and of experiencing delays getting prescription drugs. Medicaid enrollment increased the probability of having a usual source of care, of having a routine checkup, and of having a flu shot in past year.
AHRQ-authored.
Citation: Hill SC, Abdus S .
The effects of Medicaid on access to care and adherence to recommended preventive services.
Health Serv Res 2021 Feb;56(1):84-94. doi: 10.1111/1475-6773.13603..
Keywords: Medical Expenditure Panel Survey (MEPS), Medicaid, Access to Care, Prevention, Patient Adherence/Compliance
Hatch B, Hoopes M, Darney BG
Impacts of the Affordable Care Act on receipt of women's preventive services in Community Health Centers in Medicaid expansion and nonexpansion states.
Researchers assessed whether ACA implementation and Medicaid expansion were followed by greater receipt of recommended preventive services among women and girls in a large network of community health centers. Data was collected from electronic health records in 14 states. The researchers found that among female patients at community health centers, receipt of recommended preventive care improved after ACA implementation in both Medicaid expansion and non-expansion states, although the overall rates remained low. They recommended continued support to overcome barriers to preventive care in this population.
AHRQ-funded; HS025155.
Citation: Hatch B, Hoopes M, Darney BG .
Impacts of the Affordable Care Act on receipt of women's preventive services in Community Health Centers in Medicaid expansion and nonexpansion states.
Womens Health Issues 2021 Jan-Feb;31(1):9-16. doi: 10.1016/j.whi.2020.08.011..
Keywords: Cancer, Medicaid, Health Insurance, Uninsured, Access to Care, Policy, Cancer: Cervical Cancer, Prevention, Women, Healthcare Utilization
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
Huguet N, Angier H, Rdesinski R
Cervical and colorectal cancer screening prevalence before and after Affordable Care Act Medicaid expansion.
This study assessed changes in the prevalence of cervical and colorectal cancer screening from before and after the Affordable Care Act in Medicaid expansion and non-expansion states among patients seen in community health centers. Results showed that, despite increased prevalences of cervical and colorectal cancer screening in both expansion and non-expansion states across all race/ethnicity groups, rates remained suboptimal for this population of socioeconomically disadvantaged patients.
AHRQ-funded; HS024270.
Citation: Huguet N, Angier H, Rdesinski R .
Cervical and colorectal cancer screening prevalence before and after Affordable Care Act Medicaid expansion.
Prev Med 2019 Jul;124:91-97. doi: 10.1016/j.ypmed.2019.05.003..
Keywords: Cancer, Cancer: Cervical Cancer, Cancer: Colorectal Cancer, Healthcare Delivery, Healthcare Utilization, Medicaid, Policy, Prevention, Screening
Cottrell E, Darney BG, Marino M
Study protocol: a mixed-methods study of women's healthcare in the safety net after Affordable Care Act implementation - EVERYWOMAN.
In this paper, the authors describe a 5-year, mixed-methods study comparing women's contraceptive, preventive, prenatal and postpartum care before and after ACA implementation and between Medicaid expansion and non-expansion states. They conclude that the findings will be relevant to policy and practice, informing efforts that enhance the provision of timely, evidence-based reproductive care, to improve health outcomes, and to reduce disparities among women. Patient, provider and practice-level interviews will serve to contextualize their findings and to develop subsequent studies and interventions to support women's healthcare provision in community health center settings.
AHRQ-funded; HS025155.
Citation: Cottrell E, Darney BG, Marino M .
Study protocol: a mixed-methods study of women's healthcare in the safety net after Affordable Care Act implementation - EVERYWOMAN.
Health Res Policy Syst 2019 Jun 11;17(1):58. doi: 10.1186/s12961-019-0445-y..
Keywords: Women, Access to Care, Medicaid, Policy, Prevention, Maternal Care, Sexual Health
O'Leary MC, Lich KH, Gu Y
Colorectal cancer screening in newly insured Medicaid members: a review of concurrent federal and state policies.
The goal of this study was to determine the impact of national and state policies enacted to increase access to Medicaid and to promote colorectal cancer (CRC) screening on newly enrolled, age-eligible Oregon Medicaid beneficiaries. 2010 - 2015 Oregon Medicaid claims data was used to conduct a cohort analysis of enrollees who turned 50 and became age-eligible for CRC screening. Individuals newly enrolled in Medicaid in 2013 or 2014 were more likely to initiate CRC screening than those enrolled by 2010, associated with the timing of policies such as Medicaid expansion and federal matching for preventive services. A primary care visit during the calendar year, one or more chronic conditions, and Hispanic ethnicity were also associated with CRC screening initiation.
AHRQ-funded; HS022981.
Citation: O'Leary MC, Lich KH, Gu Y .
Colorectal cancer screening in newly insured Medicaid members: a review of concurrent federal and state policies.
BMC Health Serv Res 2019 May 9;19(1):298. doi: 10.1186/s12913-019-4113-2..
Keywords: Access to Care, Cancer, Cancer: Colorectal Cancer, Medicaid, Policy, Prevention, Screening
Mehra R, Cunningham SD, Lewis JB
Recommendations for the pilot expansion of Medicaid coverage for doulas in New York state.
AHRQ-funded; HS017589.
Citation: Mehra R, Cunningham SD, Lewis JB .
Recommendations for the pilot expansion of Medicaid coverage for doulas in New York state.
Am J Public Health 2019 Feb;109(2):217-19. doi: 10.2105/ajph.2018.304797..
Keywords: Medicaid, Pregnancy, Maternal Care, Health Insurance, Healthcare Costs, Prevention, Women, Disparities
Davis MM, Shafer P, Renfro S
Does a transition to accountable care in Medicaid shift the modality of colorectal cancer testing?
This study investigated whether Medicaid expansion due to the Affordable Care Act (ACA) increased the number of patients who tested for colorectal cancer (CRC). Results in Oregon showed that there was an increased in statewide fecal testing mainly in Coordinated Care Organizations (CCOs).
AHRQ-funded; HS022981.
Citation: Davis MM, Shafer P, Renfro S .
Does a transition to accountable care in Medicaid shift the modality of colorectal cancer testing?
BMC Health Serv Res 2019 Jan 21;19(1):54. doi: 10.1186/s12913-018-3864-5..
Keywords: Cancer: Colorectal Cancer, Healthcare Utilization, Medicaid, Prevention, Screening
Burgette JM, Preisser JS, Rozier RG
Access to preventive services after the integration of oral health care into early childhood education and medical care.
The authors compared children enrolled in North Carolina Early Head Start (EHS) programs with similar children enrolled in Medicaid but not EHS on the use of POHS. They analyzed 4 dependent variables (oral assessment by medical health care provider, oral assessment by oral health care provider, fluoride application by medical health care provider, fluoride application by oral health care provider) by using multivariate logistic regression that controlled for covariates.
AHRQ-funded; HS000032.
Citation: Burgette JM, Preisser JS, Rozier RG .
Access to preventive services after the integration of oral health care into early childhood education and medical care.
J Am Dent Assoc 2018 Dec;149(12):1024-31.e2. doi: 10.1016/j.adaj.2018.07.019..
Keywords: Access to Care, Children/Adolescents, Dental and Oral Health, Health Services Research (HSR), Medicaid, Patient-Centered Healthcare, Prevention
Marino M, Bailey SR, Gold R
Receipt of preventive services after Oregon's randomized Medicaid experiment.
This study examined the three-year impact of Oregon's 2008 randomized Medicaid expansion (the "Oregon Experiment") on receipt of 12 preventive care services in community health centers using electronic health record data. They found that Medicaid coverage significantly increased the odds of receipt of most preventive services. They concluded that rates of preventive services receipt will likely increase as community health center patients gain insurance through Affordable Care Act expansions. They recommended continued effort to increase health insurance coverage in an effort to decrease health disparities in vulnerable populations.
AHRQ-funded; HS021522.
Citation: Marino M, Bailey SR, Gold R .
Receipt of preventive services after Oregon's randomized Medicaid experiment.
Am J Prev Med 2016 Feb;50(2):161-70. doi: 10.1016/j.amepre.2015.07.032.
.
.
Keywords: Access to Care, Community-Based Practice, Health Insurance, Medicaid, Prevention
Bailey SR, O'Malley JP, Gold R
Receipt of diabetes preventive services differs by insurance status at visit.
This study examined the association between having Medicaid health insurance and receiving diabetes preventive care during an office visit. They found that the lack of insurance was associated with a lower probability of receiving recommended diabetes preventive services that are due during a clinic visit.
AHRQ-funded; HS021522
Citation: Bailey SR, O'Malley JP, Gold R .
Receipt of diabetes preventive services differs by insurance status at visit.
Am J Prev Med 2015 Feb;48(2):229-33. doi: 10.1016/j.amepre.2014.08.035..
Keywords: Medicaid, Diabetes, Prevention, Primary Care, Health Insurance
Beil H, Rozier RG, Preisser JS
Effects of early dental office visits on dental caries experience.
This study determined the association between timing of a first dentist office visit before age 5 and dental disease in kindergarten. It found that children with early dental visits (before age 2) had higher rates of tooth decay than those who had later visits (between ages 3 and 5).
AHRQ-funded; HS018076.
Citation: Beil H, Rozier RG, Preisser JS .
Effects of early dental office visits on dental caries experience.
Am J Public Health. 2014 Oct;104(10):1979-85. doi: 10.2105/AJPH.2013.301325..
Keywords: Dental and Oral Health, Children/Adolescents, Access to Care, Medicaid, Prevention
Heintzman J, Bailey SR, Hoopes MJ
Agreement of Medicaid claims and electronic health records for assessing preventive care quality among adults.
The researchers sought to compare the agreement of electronic health records (EHR) data versus Medicaid claims data in documenting adult preventive care. For services performed in the primary care setting, EHR data compared favorably to Medicaid claims in documenting the percentage of patients with service receipt; services that were referred out were less frequently observed in the EHR.
AHRQ-funded; HS021522
Citation: Heintzman J, Bailey SR, Hoopes MJ .
Agreement of Medicaid claims and electronic health records for assessing preventive care quality among adults.
J Am Med Inform Assoc. 2014 Jul-Aug;21(4):720-4. doi: 10.1136/amiajnl-2013-002333..
Keywords: Electronic Health Records (EHRs), Health Insurance, Medicaid, Prevention, Primary Care