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
401 to 419 of 419 Research Studies DisplayedKesselheim AS, Tan YT, Darrow JJ
Existing FDA pathways have potential to ensure early access to, and appropriate use of, specialty drugs.
The researchers reviewed the different strategies that the FDA can use to approve and influence the post-approval prescribing of specialty drugs, including expediting the drugs' availability to patients through expanded access programs and expedited approval pathways, limiting the scope of the drugs' indications, and encouraging the development of companion diagnostic tests to indicate which patients should receive the drugs.
AHRQ-funded; HS018465.
Citation: Kesselheim AS, Tan YT, Darrow JJ .
Existing FDA pathways have potential to ensure early access to, and appropriate use of, specialty drugs.
Health Aff 2014 Oct;33(10):1770-8. doi: 10.1377/hlthaff.2014.0529.
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Keywords: Access to Care, Medication, Policy
Adeoye O, Albright KC, Carr BG
Geographic access to acute stroke care in the United States.
In this article the authors describe access of the US population to all facilities that actually provide intravenous recombinant tissue-type plasminogen activator (r-tPA) or endovascular therapy for acute ischemic stroke. The investigators concluded that more than half of the US population has geographic access to hospitals that actually deliver acute stroke care but treatment rates remain low.
AHRQ-funded; HS013852.
Citation: Adeoye O, Albright KC, Carr BG .
Geographic access to acute stroke care in the United States.
Stroke 2014 Oct;45(10):3019-24. doi: 10.1161/strokeaha.114.006293.
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Keywords: Access to Care, Stroke
Basu J
AHRQ Author: Basu J
Has access to care changed in minority communities? A study of preventable hospitalizations over time in selected States.
Basu assessed the changes in access to care in minority communities by examining the association between preventable hospitalization rates and racial/ethnic composition of the community during 1995-2005. Using HCUP data, the results indicated increases in barriers faced by minority adults in accessing primary care over time, with no similar evidence for the elderly subgroup.
AHRQ-authored.
Citation: Basu J .
Has access to care changed in minority communities? A study of preventable hospitalizations over time in selected States.
J Ambul Care Manage 2014 Oct-Dec;37(4):314-30. doi: 10.1097/jac.0000000000000024.
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Keywords: Access to Care, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Primary Care, Racial and Ethnic Minorities
Zhang Y, Thamer M, Kshirsagar O
Dialysis chains and placement on the waiting list for a cadaveric kidney transplant.
The purpose of this paper is to investigate the effect of dialysis facility chain status on renal transplantation therapy. The researchers concluded that dialysis chain affiliation expands previously observed ownership-related differences in placement on the waiting list, and for-profit ownership of dialysis chain facilities appears to be a significant impediment to access to renal transplants.
AHRQ-funded; HS020243.
Citation: Zhang Y, Thamer M, Kshirsagar O .
Dialysis chains and placement on the waiting list for a cadaveric kidney transplant.
Transplantation 2014 Sep 15;98(5):543-51. doi: 10.1097/tp.0000000000000106.
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Keywords: Kidney Disease and Health, Transplantation, Access to Care
Sharma R, Lebrun-Harris LA, Ngo-Metzger Q
AHRQ Author: Ngo-Metzger Q
Costs and clinical quality among Medicare beneficiaries: associations with health center penetration of low-income residents.
The authors determined the association between access to primary care by the underserved and Medicare spending and clinical quality across hospital referral regions (HRRs). They found that, compared with elderly fee-for-service beneficiaries residing in areas with low-penetration of health center patients among low-income residents, those residing in high-penetration areas may accrue Medicare cost savings.
AHRQ-authored.
Citation: Sharma R, Lebrun-Harris LA, Ngo-Metzger Q .
Costs and clinical quality among Medicare beneficiaries: associations with health center penetration of low-income residents.
Medicare Medicaid Res Rev 2014 Sep 8;4(3). doi: 10.5600/mmrr.004.03.a05.
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Keywords: Access to Care, Community-Based Practice, Quality of Care, Low-Income, Medicare
Wheeler SB, Kuo TM, Goyal RK
Regional variation in colorectal cancer testing and geographic availability of care in a publicly insured population.
The researchers examined colorectal cancer (CRC) testing across regions of North Carolina by using population-based Medicare and Medicaid claims data from disabled individuals who turned 50 years of age during 2003-2008. They found that fewer than 50% of eligible individuals had evidence of CRC testing; men, African-Americans, Medicaid beneficiaries, and those living furthest away from endoscopy facilities had significantly lower odds of CRC testing, with significant regional variation.
AHRQ-funded; HS019468.
Citation: Wheeler SB, Kuo TM, Goyal RK .
Regional variation in colorectal cancer testing and geographic availability of care in a publicly insured population.
Health Place 2014 Sep;29:114-23. doi: 10.1016/j.healthplace.2014.07.001.
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Keywords: Access to Care, Cancer: Colorectal Cancer, Disparities, Screening, Social Determinants of Health
Aliu O, Auger KA, Sun GH
The effect of pre-Affordable Care Act (ACA) Medicaid eligibility expansion in New York State on access to specialty surgical care.
Using the natural experiment of Medicaid expansion in New York (NY) State in October 2001, the study investigators examined whether Medicaid expansion increased access to common musculoskeletal procedures for Medicaid beneficiaries. They concluded that Medicaid expansion in NY State significantly improved access to common musculoskeletal procedures for Medicaid beneficiaries.
AHRQ-funded; HS020672.
Citation: Aliu O, Auger KA, Sun GH .
The effect of pre-Affordable Care Act (ACA) Medicaid eligibility expansion in New York State on access to specialty surgical care.
Med Care 2014 Sep;52(9):790-5. doi: 10.1097/mlr.0000000000000175..
Keywords: Access to Care, Policy, Medicaid, Surgery
Saloner B, Le Cook B
An ACA provision increased treatment for young adults with possible mental illnesses relative to comparison group.
The researchers examined the impact of the ACA dependent coverage provision on people ages 18-25 with possible mental health or substance use disorders. They found that after implementation of the ACA provision, among people ages 18-25 with possible mental health disorders, mental health treatment increased by 5.3 percentage points relative to a comparison group of similar people ages 26-35. For those using mental health treatment, uninsured visits declined by 12.4 percentage points, and visits paid by private insurance increased by 12.9 percentage points.
AHRQ-funded; HS021486.
Citation: Saloner B, Le Cook B .
An ACA provision increased treatment for young adults with possible mental illnesses relative to comparison group.
Health Aff 2014 Aug;33(8):1425-34. doi: 10.1377/hlthaff.2014.0214.
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Keywords: Access to Care, Health Insurance, Behavioral Health, Substance Abuse, Young Adults
Kenik J, Jean-Jacques M, Feinglass J
Explaining racial and ethnic disparities in cholesterol screening.
This study examining the impact of low socioeconomic status, access to care, and language on racial and ethnic disparities in cholesterol screening found that these factors explained most of those disparities. After adjusting for these factors, disparities between whites and Blacks and Hispanics but not Asians and Pacific Islanders were eliminated.
AHRQ-funded; HS021141
Citation: Kenik J, Jean-Jacques M, Feinglass J .
Explaining racial and ethnic disparities in cholesterol screening.
Prev Med. 2014 Aug;65:65-9. doi: 10.1016/j.ypmed.2014.04.026..
Keywords: Social Determinants of Health, Disparities, Racial and Ethnic Minorities, Screening, Access to Care
Fung V, Graetz I, Galbraith A
Financial barriers to care among low-income children with asthma: health care reform implications.
This study examined the associations between cost-sharing, income, and care seeking and financial stress among children with asthma. It found that cost-related barriers to care among children with asthma were concentrated among low-income families with higher cost-sharing levels.
AHRQ-funded; HS019669
Citation: Fung V, Graetz I, Galbraith A .
Financial barriers to care among low-income children with asthma: health care reform implications.
JAMA Pediatr. 2014 Jul;168(7):649-56. doi: 10.1001/jamapediatrics.2014.79..
Keywords: Children/Adolescents, Asthma, Low-Income, Access to Care, Healthcare Costs
Moy E, Freeman W
AHRQ Author: Moy E, Freeman W
Federal investments to eliminate racial/ethnic health-care disparities.
The authors presented a model that describes the relationships among social disadvantage, health-care disparities, and health disparities. They proposed that increasing the diversity of the public health and health-care workforces is an efficient strategy for reducing disparities because it impacts both access to care and patient-provider communication.
AHRQ-authored.
Citation: Moy E, Freeman W .
Federal investments to eliminate racial/ethnic health-care disparities.
Public Health Rep 2014 Jan-Feb;129 Suppl 2:62-70. doi: 10.1177/00333549141291s212.
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Keywords: Access to Care, Disparities, Racial and Ethnic Minorities, Social Determinants of Health, Vulnerable Populations
Wexler RK
Invited letter: the evolving model of health care in the United States: system change is not enough.
In this letter, the author argues that the spread of new health care delivery models such as the Patient-Centered Medical Home and Accountable Care Organizations are necessary to improve population health but do not fully address the need for a fundamental change in how patients think about and access care. He calls for raising patient awareness of how the health care delivery system works and draws attention to practitioners’ concerns about patient satisfaction as a definitive marker of quality.
AHRQ-funded; HS020693
Citation: Wexler RK .
Invited letter: the evolving model of health care in the United States: system change is not enough.
Adv Health Care Manag. 2014;16:173-6..
Keywords: Access to Care, Healthcare Delivery, Patient-Centered Healthcare, Patient Experience, Primary Care, Primary Care: Models of Care
Hsuan C, Rodriguez HP
The adoption and discontinuation of clinical services by local health departments.
The researchers identified factors associated with local health department (LHD) adoption and discontinuation of clinical services. They found that most LHDs are discontinuing clinical services over time. Those that cover a wide range of core public health functions are less likely to discontinue services when residents lack care access.
AHRQ-funded; AHRQ Predoctoral Traineeship.
Citation: Hsuan C, Rodriguez HP .
The adoption and discontinuation of clinical services by local health departments.
Am J Public Health 2014 Jan;104(1):124-33. doi: 10.2105/ajph.2013.301426..
Keywords: Public Health, Access to Care, Health Services Research (HSR)
Basu J, Mobley LR, Thumula V
AHRQ Author: Basu J
The small area predictors of ambulatory care sensitive hospitalizations: a comparison of changes over time.
The investigators examined the predictors of ambulatory care sensitive conditions (ACSCs) admissions in small geographic areas in two cross-sections spanning an 11-year time interval (1995-2005). They found that ACSC admission rates were inversely related to the availability of local primary care physicians, and managed care was associated with declines in ACSC admissions for the elderly. Additionally, minorities, aged elderly, and percent under federal poverty level were found to be associated with higher ACSC rates. They concluded that improvements in socioeconomic conditions and geographic access may have helped improve the quality of primary care received by the elderly over the last decade, particularly among some minority groups.
AHRQ-authored.
Citation: Basu J, Mobley LR, Thumula V .
The small area predictors of ambulatory care sensitive hospitalizations: a comparison of changes over time.
Soc Work Public Health 2014;29(2):176-88. doi: 10.1080/19371918.2013.776316.
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Keywords: Access to Care, Hospitalization, Ambulatory Care and Surgery, Primary Care
Myers SR, Salhi RA, Lerner EB
A pilot study describing access to emergency care in two states using a model emergency care categorization system.
To improve regionalization of care and patient decisions when seeking emergency care, the researchers surveyed emergency departments (EDs) in 2 States. They found that 25 percent provided advanced care, 10.5 percent comprehensive care, and 1.6 percent pediatric critical care. Overall, 75.1 percent of the population could reach advanced or comprehensive ED within 60 minutes by ground transportation.
AHRQ-funded; HS017960; HS018604
Citation: Myers SR, Salhi RA, Lerner EB .
A pilot study describing access to emergency care in two states using a model emergency care categorization system.
Acad Emerg Med. 2013 Sep;20(9):894-903. doi: 10.1111/acem.12208..
Keywords: Emergency Medical Services (EMS), Access to Care, Critical Care, Shared Decision Making
Robin Yabroff K, Short PF, Machlin S
AHRQ Author: Machlin S
Access to preventive health care for cancer survivors.
The researchers evaluated the association between cancer survivorship and access to primary and preventive health care. They concluded that, although access and preventive care use in cancer survivors is generally equivalent or greater compared to that of other individuals, disparities for uninsured and publicly insured cancer survivors aged 18-64 years suggest that improvements in survivor care are needed.
AHRQ-authored.
Citation: Robin Yabroff K, Short PF, Machlin S .
Access to preventive health care for cancer survivors.
Am J Prev Med 2013 Sep;45(3):304-12. doi: 10.1016/j.amepre.2013.04.021.
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Keywords: Access to Care, Cancer, Medical Expenditure Panel Survey (MEPS), Prevention, Primary Care
Abasaeed R, Kranz AM, Rozier RG
The impact of the Great Recession on untreated dental caries among kindergarten students in North Carolina.
This study to determine the impact of the Great Recession on untreated dental caries in kindergarten-aged children in North Carolina found there were a higher proportion of children with more than one untreated decayed primary tooth as well as fewer children receiving dental treatment after 2006. The study covering 7 school years from 2003 to 2010 and 1,215 schools used increased participation in the National School Lunch Program as an indicator of the Great Recession.
AHRQ-funded; HS000032
Citation: Abasaeed R, Kranz AM, Rozier RG .
The impact of the Great Recession on untreated dental caries among kindergarten students in North Carolina.
J Am Dent Assoc. 2013 Sep;144(9):1038-46..
Keywords: Children/Adolescents, Dental and Oral Health, Healthcare Costs, Access to Care, Low-Income
Chambers DA, Haim A, Mullican CA
AHRQ Author: Mullican CA
Health information technology and mental health services research: a path forward.
This article reports on the AHRQ- and NIMH-organized November 2010 workshop, “Health Information Technology and Mental Health: The Way Forward.” The primary workshop goal was to bring together experts in mental health services and interventions research, practitioners, consumers, and technologists to discuss emerging opportunities in uniting all aspects of health IT and mental health research. The workshop resulted in a four-paper series, envisioning a future mental health system in which health IT is fully integrated within mental health service systems, for patient, clinician, and system levels.
AHRQ-authored.
Citation: Chambers DA, Haim A, Mullican CA .
Health information technology and mental health services research: a path forward.
Gen Hosp Psychiatry 2013 Jul-Aug;35(4):329-31. doi: 10.1016/j.genhosppsych.2013.03.006.
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Keywords: Access to Care, Health Information Technology (HIT), Health Services Research (HSR), Health Information Technology (HIT), Behavioral Health
Lebrun-Harris LA, Baggett TP, Jenkins DM
AHRQ Author: Ngo-Metzger Q
Health status and health care experiences among homeless patients in federally supported health centers: findings from the 2009 patient survey.
This study examined health status and health care experiences of homeless patients in health centers and compared them to nonhomeless counterparts. It found that homeless patients had worse health status (chronic conditions, mental health problems, and substance abuse) compared with housed respondents. They were also twice as likely to have unmet medical needs in the past year.
AHRQ-authored
Citation: Lebrun-Harris LA, Baggett TP, Jenkins DM .
Health status and health care experiences among homeless patients in federally supported health centers: findings from the 2009 patient survey.
Health Serv Res. 2013 Jun;48(3):992-1017. doi: 10.1111/1475-6773.12009..
Keywords: Health Status, Community-Based Practice, Access to Care, Disparities