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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 25 of 52 Research Studies DisplayedMellor JM, McInerney M, Garrow RC
The impact of Medicaid expansion on spending and utilization by older low-income Medicare beneficiaries.
This study examined indirect spillover effects of Affordable Care Act (ACA) Medicaid expansions to working-age adults on health care coverage, spending, and utilization by older low-income Medicare beneficiaries. The authors used data from the 2010-2018 Health and Retirement Study survey linked to annual Medicare beneficiary summary files. They estimated individual-level difference-in-differences models of total spending for inpatient, institutional outpatient, physician/professional provider services; inpatient stays, outpatient visits, physician visits; and Medicaid and Part A and B Medicare coverage. They also compared changes in outcomes before and after Medicaid expansion in expansion versus nonexpansion states. The sample included low-income respondents aged 69 and older with linked Medicare data, enrolled in full-year traditional Medicare, and living in the community. ACA Medicaid expansion was associated with a 9.8 percentage point increase in Medicaid coverage, a 4.4 percentage point increase in having any institutional outpatient spending, and a positive but statistically insignificant 2.4 percentage point change in Part B enrollment.
AHRQ-funded; HS025422.
Citation: Mellor JM, McInerney M, Garrow RC .
The impact of Medicaid expansion on spending and utilization by older low-income Medicare beneficiaries.
Health Serv Res 2023 Oct; 58(5):1024-34. doi: 10.1111/1475-6773.14155..
Keywords: Medicaid, Medicare, Low-Income, Healthcare Utilization, Healthcare Costs, Health Insurance
Kalata S, Howard R, Diaz A
Association of skilled nursing facility ownership by health care networks with utilization and spending.
The objective of this cross-sectional study was to determine the association of vertical integration of skilled nursing facilities (SNFs) within hospital networks with SNF utilization, readmissions, and spending. Claims data from Medicare beneficiaries aged 66 to 99 who had undergone elective hip replacement in nonfederal acute care hospitals during the study period was analyzed. Results showed that vertical SNF integration was associated with a higher rate of SNF utilization and a lower 30-day readmission rate; in spite of higher utilization, 30-day episode payments were slightly lower. Adjusted readmission rates were especially low for patients who were not sent to an SNF but were significantly higher for patients with a length of stay of less than 5 days. The authors concluded these findings support the value of integrating SNFs into hospital networks, but there is room for improvement in postoperative care early in the SNF patients’ stay.
AHRQ-funded; HS028606.
Citation: Kalata S, Howard R, Diaz A .
Association of skilled nursing facility ownership by health care networks with utilization and spending.
JAMA Netw Open 2023 Feb; 6(2):e230140. doi: 10.1001/jamanetworkopen.2023.0140..
Keywords: Nursing Homes, Healthcare Utilization, Healthcare Costs, Medicare
Chang E, Ali R, Seibert J
Interventions to improve outcomes for high-need, high-cost patients: a systematic review and meta-analysis.
The authors of this article reviewed evidence on the effectiveness of complex interventions designed to change the healthcare of high-need, high-cost patients. They found limited evidence of intervention effectiveness in relation to cost and use, but note that additional evidence is needed to strengthen their confidence in these findings. Few studies reported clinical/functional or social risk factor outcomes or sufficient details for determining why individual interventions work. They conclude that future evaluations could provide additional insights in assessing the impact of complex interventions.
AHRQ-funded; 290201500011I.
Citation: Chang E, Ali R, Seibert J .
Interventions to improve outcomes for high-need, high-cost patients: a systematic review and meta-analysis.
J Gen Intern Med 2023 Jan; 38(1):185-94. doi: 10.1007/s11606-022-07809-6..
Keywords: Healthcare Costs, Healthcare Delivery, Chronic Conditions, Healthcare Utilization
Williams PH, Gilmartin HM, Leonard C
The influence of the Rural Transitions Nurse Program for veterans on healthcare utilization costs.
This study’s objective was to examine changes from pre- to post-hospitalization in total, inpatient, and outpatient 30-day healthcare utilization costs for Veterans Affairs Healthcare System Rural Transitions Nurse Program (TNP) enrollees compared to controls. Although findings showed no difference in change in total costs between veterans enrolled in TNP and controls, TNP was associated with a smaller increase in direct inpatient medical costs and a larger increase in direct outpatient medical costs, suggesting a shifting of costs from the inpatient to outpatient setting.
AHRQ-funded; HS024569.
Citation: Williams PH, Gilmartin HM, Leonard C .
The influence of the Rural Transitions Nurse Program for veterans on healthcare utilization costs.
J Gen Intern Med 2022 Nov;37(14):3529-34. doi: 10.1007/s11606-022-07401-y..
Keywords: Rural Health, Nursing, Transitions of Care, Healthcare Utilization, Healthcare Costs
Encinosa W, Lane K, Cornelio N
AHRQ Author: Encinosa W
How state surprise billing protections increased ED visits, 2007-2018: potential implications for the No Surprises Act.
This article discusses the 2022 No Surprises Act whose goal was to prevent patients from receiving unexpected emergency department (ED) out-of-network physician bills and restrict out-of-network co-payments to in-network co-payment levels. Similar state bans were examined to determine whether the large reduction in out-of-pocket payments under bans will have an unintended consequence of an increase in ED visits and spending. The authors examined 16 million nonelderly, fully funded, privately insured health maintenance organization (HMO) enrollees between 2007 and 2018 from 15 states with balance billing bans for HMO ED visits and 16 states without bans as the control group. They found that the bans reduced spending per visit by 14% but spurred a demand response with an increase of 3 percentage points in ED visits which wiped away the cost savings. The authors predict that the federal ban will result in $5.1 billion in savings but 3.5 million more ED visits at $4.2 billion in extra spending per year, largely negating expected savings.
AHRQ-authored; AHRQ-funded; HS027698.
Citation: Encinosa W, Lane K, Cornelio N .
How state surprise billing protections increased ED visits, 2007-2018: potential implications for the No Surprises Act.
Am J Manag Care 2022 Sep;28(9):e333-e38. doi: 10.37765/ajmc.2022.89226..
Keywords: Healthcare Costs, Emergency Department, Policy, Healthcare Utilization
Levine DM, Chalasani R, Linder JA
Association of the Patient Protection and Affordable Care Act with ambulatory quality, patient experience, utilization, and cost, 2014-2016.
The national impact of the Patient Protection and Affordable Care Act (ACA) continues to be debated. The purpose of this cross-sectional study was to determine the relationship between the ACA and ambulatory quality, patient experience, utilization, and cost by comparing outcomes before (2011-2013) and after (2014-2016) ACA implementation. The study focused on United States adults between 18 and 64 years of age with income less than and greater than or equal to 400% of the federal poverty level (FPL), who had responded to the annual Medical Expenditure Panel Survey. Researchers conducted analysis of data from a sample of 123,171 individuals between January 2021 and March 2022. The study found that after the implementation of ACA, adults with income levels less than 400% of the FPL received increased high value care such as diagnostic and preventive testing when compared with adults with income 400% or higher of the FPL, and there were no differences in the other quality measures. Individuals with income less than 400% of the FPL had greater improvements in access, experience, and communication measures compared with those who had income greater than or equal to 400% of the FPL. Receipt of primary care services increased for individuals with lower income compared to individuals with higher income and for those with lower income compared to those with higher income, total out-of-pocket expenditures decreased. There were no other differences in utilization or cost between those groups. The researchers concluded that in this study, the ACA was not associated with changes in utilization, quality, or cost, but was related to decreased out-of-pocket expenditures and improved patient access, communication, and experience.
AHRQ-funded; 233201500020I; HS026506; HS028127.
Citation: Levine DM, Chalasani R, Linder JA .
Association of the Patient Protection and Affordable Care Act with ambulatory quality, patient experience, utilization, and cost, 2014-2016.
JAMA Netw Open 2022 Jun 1;5(6):e2218167. doi: 10.1001/jamanetworkopen.2022.18167..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Healthcare Utilization, Ambulatory Care and Surgery, Health Insurance, Access to Care
Elser H, Lin W, Catalano RA
Does the implementation of reference pricing result in reduced utilization? Evidence from inpatient and outpatient procedures.
This study examined whether there an unintentional reduction in utilization of elective surgeries when reference pricing (RP) is implemented to incentivize patients to use low-price settings. The authors looked at claims from a large employee who adopted RP for selected elective surgeries, including inpatient joint replacement surgery and outpatient cataract surgery, colonoscopy, and arthroscopic surgery. They found no evidence of short-term decreases (within 3 months of RP implementation), however there were very modest declines of 20% fewer arthroscopic knee surgeries 6 months after RP implementation and 17.2% fewer colonoscopies. There were no declines in the other procedures mentioned above.
AHRQ-funded; HS022098.
Citation: Elser H, Lin W, Catalano RA .
Does the implementation of reference pricing result in reduced utilization? Evidence from inpatient and outpatient procedures.
Med Care Res Rev 2022 Feb;79(1):58-68. doi: 10.1177/1077558720971117..
Keywords: Healthcare Utilization, Healthcare Costs
Bayer ND, Hall M, LI Y
Trends in health care use and spending for young children with neurologic impairment.
This retrospective study examined trends in health care use and spending for young children with neurologic impairment (NI) during their first 5 years of life. This study of 13,947 children with NI used data in the multistate IBM Medicaid MarketScan Database from 2009 to 2017. Inpatient service use decreased from 66.8% during the first year down to 5.8% during the fifth year. Emergency department (ED) use decreased more gradually from 67.8% during the first year to 44.4% during the fifth year. Per-member-per-year spending decreased from $83,352 during the first year down to $1944 in the fifth year.
AHRQ-funded; HS025138.
Citation: Bayer ND, Hall M, LI Y .
Trends in health care use and spending for young children with neurologic impairment.
Pediatrics 2022 Jan;149(1). doi: 10.1542/peds.2021-050905.
AHRQ-funded; HS025138..
AHRQ-funded; HS025138..
Keywords: Children/Adolescents, Healthcare Costs, Healthcare Utilization, Neurological Disorders
Brown TT, Hurley VB, Rodriguez HP
Association of patient engagement strategies with utilisation and spending for musculoskeletal problems in the USA: a cross-sectional analysis of Medicare patients and physician practices.
This cross-sectional study assessed the association of physician practice-level adoption of patient engagement strategies (PES), such as shared decision-making and motivational interviewing, with utilization and spending. The cohort included primary and secondary patients in 2190 practices who receiving treatment for hip (39,336), knee (48,362), and lower-back (67,940) issues who were Medicare beneficiaries that were matched to the 2017-2018 National Survey of Healthcare Organizations and Systems. Outcome measures were total knee replacement (TKR), total hip replacement (THR), 1-2 level posterior lumbar fusion (LF), total annual spending, and components of total annual spending. Spending was significantly lower in some categories for practices with relatively higher PES adoption, but did not differ for other practices. The odds of receiving THR were higher in independent practices for patients attributed to practices with moderate PES compared to patients in practices with low PES.
AHRQ-funded; HS024075.
Citation: Brown TT, Hurley VB, Rodriguez HP .
Association of patient engagement strategies with utilisation and spending for musculoskeletal problems in the USA: a cross-sectional analysis of Medicare patients and physician practices.
BMJ Open 2021 Nov 26;11(11):e053121. doi: 10.1136/bmjopen-2021-053121..
Keywords: Patient and Family Engagement, Healthcare Utilization, Healthcare Costs, Arthritis, Orthopedics
Chhabra KR, Fan Z, Chao GF
The role of commercial health insurance characteristics in bariatric surgery utilization.
The goal of this study was to understand relationships among insurance plan type, out-of-pocket cost sharing, and the utilization of bariatric surgery among commercially insured patients. Over 73,000 commercially insured members of the IBM MarketScan commercial claims database who underwent bariatric surgery from 2014-17 were retroactively reviewed. Findings showed that insurance plan types with higher cost sharing have lower utilization of bariatric surgery.
AHRQ-funded; HS025778; HS000053.
Citation: Chhabra KR, Fan Z, Chao GF .
The role of commercial health insurance characteristics in bariatric surgery utilization.
Ann Surg 2021 Jun;273(6):1150-56. doi: 10.1097/sla.0000000000003569..
Keywords: Health Insurance, Obesity, Obesity: Weight Management, Surgery, Healthcare Costs, Healthcare Utilization
Rapoport AB, Fine DR, Manne-Goehler JM
High inpatient health care utilization and charges associated with injection drug use-related infections: a cohort study, 2012-2015.
This study described the characteristics of patients hospitalized with injection drug use-related infection over a multiyear period in a region highly impacted by the opioid epidemic. Findings revealed a longer average length of stay with subsequent higher cost, a higher percentage of 30-day readmissions, disproportionate public payer mix representation, and higher rates of discharge to alternate facilities for ongoing care as compared with the total inpatient cohort.
AHRQ-funded; HS026215.
Citation: Rapoport AB, Fine DR, Manne-Goehler JM .
High inpatient health care utilization and charges associated with injection drug use-related infections: a cohort study, 2012-2015.
Open Forum Infect Dis 2021 Mar;8(3):ofab009. doi: 10.1093/ofid/ofab009..
Keywords: Opioids, Substance Abuse, Hospitalization, Healthcare Costs, Healthcare Utilization
Myong C, Hull P, Price M
The impact of funding for federally qualified health centers on utilization and emergency department visits in Massachusetts.
This retrospective study examined the impact of funding for federally qualified health centers (FQHCs) on utilization and emergency department (ED) visits in Massachusetts. The authors theorized that greater funding for FQHCs could increase the local availability of clinic-based care and reduce more costly resource use, such as ED visits. Data from the Massachusetts All Payer Claims Database (APCD) 2010-2013 was used that included enrollees in 559 Massachusetts ZIP codes (2010 numbers 6,173,563). They calculated shift-share predictions of changes in FQHC funding at the ZIP code-level for FQHCs that received Community Health Center funds in any year. They found that a standard deviation increase in prior year FQHC funding (31%) was associated with a 2.3% increase in enrollees with FQHC visits and a 1.3% decrease in enrollees at EDs. However, there were no significant changes in emergent ED visit rates.
AHRQ-funded; HS025378.
Citation: Myong C, Hull P, Price M .
The impact of funding for federally qualified health centers on utilization and emergency department visits in Massachusetts.
PLoS One 2020 Dec 3;15(12):e0243279. doi: 10.1371/journal.pone.0243279..
Keywords: Community-Based Practice, Healthcare Utilization, Emergency Department, Healthcare Costs, Access to Care, Vulnerable Populations, Policy
Fung V, Price M, Nierenberg AA
Assessment of behavioral health services use among low-income Medicare beneficiaries after reductions in coinsurance fees.
This study looked at outcomes from reducing behavioral health care Medicare coinsurance from 50% to 20% from 2009 to 2013. The sample of patients looked at included some diagnosed with SMI (serious mental illness) including schizophrenia, bipolar, or major depressive disorder). Data analysis was performed on 793,275 beneficiaries with SMI in 2008 and compared them with costs in 2013. The mean adjusted out-of-pocket costs for outpatient behavioral care decreased from $132 annually to $64, but the number of visits only increased slightly. No association was found between cost-sharing reductions and changes in behavioral health care visits.
AHRQ-funded; HS024725.
Citation: Fung V, Price M, Nierenberg AA .
Assessment of behavioral health services use among low-income Medicare beneficiaries after reductions in coinsurance fees.
JAMA Netw Open 2020 Oct;3(10):e2019854. doi: 10.1001/jamanetworkopen.2020.19854..
Keywords: Medicare, Health Insurance, Depression, Behavioral Health, Low-Income, Healthcare Costs, Healthcare Utilization
Iyer AS, Goodrich CA, Dransfield MT
End-of-life spending and healthcare utilization among older adults with chronic obstructive pulmonary disease.
This study examined end-of-life spending and healthcare utilization among Medicare beneficiaries aged 65 years or older with chronic obstructive pulmonary disease (COPD) who died during the period 2013-2014. Data on 146,240 decedents with COPD was investigated from 306 hospital referral regions (HRRs). The overall spending during the last 2 years of life varied significantly nationwide. Inpatient care accounted for 40.2% of spending, with 82% of decedents admitted to the hospital for 13.7±3.1 days and 55%±11% admitted to an intensive care unit for 3-7 days. Skilled nursing facilities accounted for 11.6% of spending and were utilized by 31-45% of decedents for 14-23 days. Hospitals were utilized by 39-56% of decedents and accounted for 10.3% of spending.
AHRQ-funded; HS023009.
Citation: Iyer AS, Goodrich CA, Dransfield MT .
End-of-life spending and healthcare utilization among older adults with chronic obstructive pulmonary disease.
Am J Med 2020 Jul;133(7):817-24.e1. doi: 10.1016/j.amjmed.2019.11.024..
Keywords: Elderly, Healthcare Utilization, Respiratory Conditions, Chronic Conditions, Healthcare Costs, Palliative Care
Rosenbloom J, Lewkowitz A, Sondgeroth K
Antenatal corticosteroid administration in late-preterm gestations: a cost-effectiveness analysis.
The purpose of this study was to evaluate whether administration of antenatal late-preterm betamethasone was cost-effective in the immediate neonatal period. Cost-effectiveness analysis of late-preterm betamethasone administration with a time horizon of 7.5 days was conducted using a health-system perspective The investigators concluded that administration of betamethasone in the late-preterm period was likely not cost-effective in the short-term.
AHRQ-funded; HS022330.
Citation: Rosenbloom J, Lewkowitz A, Sondgeroth K .
Antenatal corticosteroid administration in late-preterm gestations: a cost-effectiveness analysis.
J Matern Fetal Neonatal Med 2020 Jun;33(12):2109-15. doi: 10.1080/14767058.2018.1540582..
Keywords: Healthcare Cost and Utilization Project (HCUP), Newborns/Infants, Pregnancy, Respiratory Conditions, Medication, Healthcare Costs, Healthcare Utilization
Bartsch SM, Ferguson MC, McKinnell JA
The potential health care costs and resource use associated with COVID-19 in the United States.
The authors developed a Monte Carlo simulation model representing the U.S. Population and what can happen to every person who gets infected with COVID-19. The goal was to estimate resource use and direct medical costs per infection at the national level at different infection rates. They found that a single symptomatic COVID-19 infection would cost a median of $3,045 in direct medical costs. If 80% of the population got infected it would cost $654.0 billion in direct costs during the course of the pandemic. If 20% were to become infected, direct costs are estimated at $163.4 billion.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Ferguson MC, McKinnell JA .
The potential health care costs and resource use associated with COVID-19 in the United States.
Health Aff 2020 Jun;39(6):927-35. doi: 10.1377/hlthaff.2020.00426..
Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, COVID-19, Healthcare Utilization
Cook BL, Flores M, Zuvekas SH
AHRQ Author: Zuvekas SH
The impact Of Medicare's mental health cost-sharing parity on use of mental health care services.
This study examined the impact of Medicare’s mental health cost-sharing parity on use of mental health care services, which was phased in from 2010 to 2014. The authors assessed whether the reduction in mental health cost sharing was associated with changes in specialty and primary care outpatient mental health visits and psychotropic medication fills. They compared people with Medicare and private insurance before and after implementation. Medicare beneficiaries’ use of psychotropic medication increased after implementation but there was not a detectable change in visits.
AHRQ-authored.
Citation: Cook BL, Flores M, Zuvekas SH .
The impact Of Medicare's mental health cost-sharing parity on use of mental health care services.
Health Aff 2020 May;39(5):819-27. doi: 10.1377/hlthaff.2019.01008..
Keywords: Medical Expenditure Panel Survey (MEPS), Medicare, Behavioral Health, Healthcare Costs, Policy, Health Insurance, Healthcare Utilization, Access to Care
Subramanian MP, Liu J, Chapman WC
Utilization trends, outcomes, and cost in minimally invasive lobectomy.
The objective of this study was to compare outcomes and hospitalization costs among patients undergoing open, video-assisted thoracoscopic surgery (VATS) and RATS lobectomy. The investigators concluded that minimally invasive approaches were associated to improved clinical outcomes compared with open lobectomy. However, only robotic-assisted lobectomy has had rapid growth in utilization. Despite additional cost, RATS lobectomy appeared to provide a viable minimally invasive alternative for general thoracic procedures.
AHRQ-funded; HS019455.
Citation: Subramanian MP, Liu J, Chapman WC .
Utilization trends, outcomes, and cost in minimally invasive lobectomy.
Ann Thorac Surg 2019 Dec;108(6):1648-55. doi: 10.1016/j.athoracsur.2019.06.049..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Healthcare Costs, Healthcare Utilization, Outcomes
Ganguli I, Lupo C, Mainor AJ
Prevalence and cost of care cascades after low-value preoperative electrocardiogram for cataract surgery in fee-for-service Medicare beneficiaries.
This study examined the use and outcomes of preoperative electrocardiogram (EKG) for cataract surgery recipients on Medicare. The outcomes measured were cascade events if the EKG results were problematic. The study compared 110,183 cataract surgery recipients with 97,775 non-surgery participants (63.1% female). For the recipient group, 12,408 (11.3%) received a preoperative EKG (65.6% of them were female). Of those, 1978 (15.9%) had at least 1 potential cascade event. Additional tests, treatments, and cardiology visits added an additional estimated $35 million in addition to the $3.2 million spent on preoperative EKGs. Preoperative EKG recipients who were older, had more chronic conditions, lived in more cardiologist-dense areas, or had their EKG performed by a cardiac specialist rather than a primary care physician were more likely to experience a cascade event.
AHRQ-funded; HS023812.
Citation: Ganguli I, Lupo C, Mainor AJ .
Prevalence and cost of care cascades after low-value preoperative electrocardiogram for cataract surgery in fee-for-service Medicare beneficiaries.
JAMA Intern Med 2019 Sep;179(9):1157-308. doi: 10.1001/jamainternmed.2019.1739..
Keywords: Healthcare Costs, Medicare, Healthcare Utilization, Surgery, Elderly
Pickens G, Karaca Z, Gibson TB
AHRQ Author: Karaca Z, Wong HS
Changes in hospital service demand, cost, and patient illness severity following health reform.
This study examined the effects of expanded Medicaid coverage and the health insurance exchange on the number of hospital inpatient and emergency department (ED) utilization rates, cost, and patient illness severity. There was a significant drop in uninsured inpatient discharges and ED visits in states where Medicaid was expanded. For all by young females, uninsured inpatient discharge rates fell by 39% or greater. In nonexpansion states, the rates remained unchanged or increased slightly. Changes in all-payer and private insurance rates were not as dramatic, as was inpatient costs per discharge and all-payer inpatient costs.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Pickens G, Karaca Z, Gibson TB .
Changes in hospital service demand, cost, and patient illness severity following health reform.
Health Serv Res 2019 Aug;54(4):739-51. doi: 10.1111/1475-6773.13165..
Keywords: Access to Care, Health Insurance, Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Healthcare Utilization, Hospitals, Medicaid, Policy, Uninsured
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
Selden TM, Abdus S, Miller GE
AHRQ Author: Selden TM, Abdus S, Miller GE
Decomposing changes in the growth of U.S. prescription drug use and expenditures, 1999-2016.
Data from the Medical Expenditure Panel Survey (MEPS) was examined to analyze factors associated with changes in prescription drug use and expenditures in the US from 1999 to 2016. There were large increases in prescription drug use during that period, with per capita utilization increasing by nearly half and per capita expenditures more than doubled. Treatment of long-term conditions was a large driver in the increases in medication use.
AHRQ-authored.
Citation: Selden TM, Abdus S, Miller GE .
Decomposing changes in the growth of U.S. prescription drug use and expenditures, 1999-2016.
Health Serv Res 2019 Aug;54(4):752-63. doi: 10.1111/1475-6773.13164..
Keywords: Healthcare Costs, Healthcare Utilization, Medical Expenditure Panel Survey (MEPS), Medication
Colla CH, Lewis VA, Stachowski C
Changes in use of postacute care associated with accountable care organizations in hip fracture, stroke, and pneumonia hospitalized cohorts.
In this study, researchers examined changes in more and less discretionary condition-specific postacute care use associated with Medicare accountable care organization (ACO) implementation. They found that ACOs decreased spending on postacute care by decreasing use of discretionary services. In addition, ACO implementation was associated with reduced length of stay in skilled nursing facilities, while hip fracture patients used institutional postacute settings at higher rates. The authors also observed decreases in spending, readmission days, and mortality among pneumonia patients.
AHRQ-funded; HS024698.
Citation: Colla CH, Lewis VA, Stachowski C .
Changes in use of postacute care associated with accountable care organizations in hip fracture, stroke, and pneumonia hospitalized cohorts.
Med Care 2019 Jun;57(6):444-52. doi: 10.1097/mlr.0000000000001121..
Keywords: Injuries and Wounds, Healthcare Costs, Healthcare Utilization, Hospitalization, Medicare, Pneumonia, Stroke
Delling FN, Vittinghoff E, Dewland TA
Does cannabis legalisation change healthcare utilisation? A population-based study using the healthcare cost and utilisation project in Colorado, USA.
Researchers studied whether the legalization of cannabis in Colorado has affected healthcare utilization compared to two states where it is still illegal (New York and Oklahoma). ICD-9 was used to determine changes in healthcare utilization relative to various medical diagnoses. According to the National Academy of Science (NAS), legal cannabis use creates an increase in cannabis abuse hospitalizations and also linked to motor vehicle accidents, alcohol abuse, and overdose injury and that was true in CO. There was not a change in hospital stays and costs in CO compared to NY and OK.
AHRQ-funded.
Citation: Delling FN, Vittinghoff E, Dewland TA .
Does cannabis legalisation change healthcare utilisation? A population-based study using the healthcare cost and utilisation project in Colorado, USA.
BMJ Open 2019 May 15;9(5):e027432. doi: 10.1136/bmjopen-2018-027432..
Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Healthcare Utilization, Policy, Substance Abuse
Berry JG, Goodman DM, Coller RJ
Association of home respiratory equipment and supply use with health care resource utilization in children.
The purpose of this cohort study was to compare health care use and spending in children using vs not using respiratory medical equipment and supplies (RMES). The investigators found that the use of RMES was associated with high health care spending, especially with hospital and home health care. They suggest that population health initiatives in children may benefit from consideration of RMES in comprehensive risk assessment for health care spending.
AHRQ-funded; HS02513.
Citation: Berry JG, Goodman DM, Coller RJ .
Association of home respiratory equipment and supply use with health care resource utilization in children.
J Pediatr 2019 Apr;207:169-75.e2. doi: 10.1016/j.jpeds.2018.11.046..
Keywords: Children/Adolescents, Healthcare Costs, Healthcare Utilization, Home Healthcare, Respiratory Conditions