National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Access to Care (2)
- Behavioral Health (1)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Disparities (5)
- Genetics (1)
- Health Insurance (4)
- Health Status (1)
- Hospital Readmissions (1)
- Medicaid (3)
- Medicare (2)
- Nursing Homes (1)
- Nutrition (1)
- Payment (2)
- (-) Policy (14)
- Quality of Care (1)
- Racial and Ethnic Minorities (2)
- Risk (1)
- Screening (1)
- (-) Social Determinants of Health (14)
- Substance Abuse (1)
- Vulnerable Populations (4)
- Young Adults (1)
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 14 of 14 Research Studies DisplayedRogstad TL, Gupta S, Connolly J
Social risk adjustment In the hospital readmissions reduction program: a systematic review and implications for policy.
Investigators reviewed fourteen studies of social risk adjustment in Medicare's Hospital Readmissions Reduction Program (HRRP). They concluded that their findings support the use of social risk adjustment to improve provider payment equity and highlight opportunities to enhance social risk adjustment in value-based payment programs.
AHRQ-funded; HS026727.
Citation: Rogstad TL, Gupta S, Connolly J .
Social risk adjustment In the hospital readmissions reduction program: a systematic review and implications for policy.
Health Aff 2022 Sep;41(9):1307-15. doi: 10.1377/hlthaff.2022.00614..
Keywords: Social Determinants of Health, Hospital Readmissions, Risk, Policy
Leifheit KM, Schwartz GL, Pollack CE
Building health equity through housing policies: critical reflections and future directions for research.
This article provides a series of recommendations to help build health equity through housing policies. The authors recommend more justice- and action-oriented research to help address current levels of housing insecurity that are the result of clear and inequitable policy choices, leading to the entrenchment of health inequities-particularly, across race and class.
AHRQ-funded; HS000046.
Citation: Leifheit KM, Schwartz GL, Pollack CE .
Building health equity through housing policies: critical reflections and future directions for research.
J Epidemiol Community Health 2022 Aug;76(8):759-63. doi: 10.1136/jech-2021-216439.
Keywords: Social Determinants of Health, Vulnerable Populations, Policy
Blanco C, Kato EU, Aklin WM
AHRQ Author: Kato EU, Tong ST, Bierman A, Meyers D
Research to move policy - using evidence to advance health equity for substance use disorders.
This paper discusses ways that evidence-based research can advance health equity for substance use disorder (SUD) treatment. Racial and ethnic disparities in treatment access and outcomes have widened, despite substantial efforts to address the epidemic of overdose-related deaths in the US. Overdose rates are rising faster in Black, Latinx, and American Indian and Alaska Native populations than in White populations. Possible opportunities to address these disparities include addressing social determinants of health, implementing prevention measures, and supporting data science. The steps to ensure that research reduces disparities are to: 1) include members of underrepresented groups in the development of preventive interventions and treatments, 2) adequately recruit members of historically represented groups and ensure that studies are large enough to measure differences in outcomes according to race and ethnic group, 3) establish equitable partnerships with people who currently have or have had SUDS and their families and engage these groups in evidence production, 4) diversify the scientific workforce, and 4) have investigators measure the effects of policies and interventions on equity.
AHRQ-authored.
Citation: Blanco C, Kato EU, Aklin WM .
Research to move policy - using evidence to advance health equity for substance use disorders.
N Engl J Med 2022 Jun 16;386(24):2253-55. doi: 10.1056/NEJMp2202740..
Keywords: Substance Abuse, Behavioral Health, Policy, Racial and Ethnic Minorities, Disparities, Social Determinants of Health
Malhotra NA, Nevar A, Yearby R
Medicaid's EPSDT benefit: an opportunity to improve pediatric screening for social determinants of health.
This paper discusses the Early and Periodic Screening, Diagnostic, and Treatment (EPDST) benefit which is a key component of Medicaid policy intended to define an essential set of services provided to patients age 21 and younger. This qualitative review examines the extent to which EPSDT might be used to implement structured screening to identify environmental and social factors affecting children’s health. Semistructured interviews conducted in 2017 were triangulated with a review of the recent literature to describe how states currently consider the EPSDT benefit with respect to social determinants of health (SDOH) screening. Findings suggest that with sufficient stakeholder advocacy given the evidence supporting social determinants of health as “medically necessary”, EPSDT benefits could be considered as a funding source to incentivize the incorporation of SDOH screening into the basic package of well-child care.
AHRQ-funded; 233201600221A.
Citation: Malhotra NA, Nevar A, Yearby R .
Medicaid's EPSDT benefit: an opportunity to improve pediatric screening for social determinants of health.
Med Care Res Rev 2021 Apr;78(2):87-102. doi: 10.1177/1077558719874211..
Keywords: Children/Adolescents, Medicaid, Social Determinants of Health, Screening, Disparities, Policy
Hammad Mrig E
Integrating fundamental cause theory and Bourdieu to explain pathways between socioeconomic status and health: the case of health insurance denials for genetic testing.
This paper proposes that Pierre Bourdieu's theories of capital and symbolic power can be integrated with fundamental cause theory to address limitations in the latter theory, making it more useful in health disparities research. This work deepens appreciation for the durable relationship between socioeconomic status and health. Study results reveal the multiple and complex mechanisms that play a role in access to healthcare services, which has significant implications for how we think about the role of health policy in addressing health disparities.
AHRQ-funded; HS017589.
Citation: Hammad Mrig E .
Integrating fundamental cause theory and Bourdieu to explain pathways between socioeconomic status and health: the case of health insurance denials for genetic testing.
Sociol Health Illn 2021 Jan;43(1):133-48. doi: 10.1111/1467-9566.13195..
Keywords: Social Determinants of Health, Disparities, Health Insurance, Access to Care, Genetics, Policy
Ornelas IJ, Yamanis TJ, Ruiz RA
The health of undocumented Latinx immigrants: what we know and future directions.
This review article summarizes the limited but growing literature on the health of undocumented Latinx immigrations and how exposure to trauma, immigration enforcement, changes to social networks, and discrimination negatively affect their mental and physical health. The authors discuss how policies and social ties can promote their health. They focus on areas of concern and recommend how future research should be conducted.
AHRQ-funded; HS013853.
Citation: Ornelas IJ, Yamanis TJ, Ruiz RA .
The health of undocumented Latinx immigrants: what we know and future directions.
Annu Rev Public Health 2020 Apr 2;41:289-308. doi: 10.1146/annurev-publhealth-040119-094211..
Keywords: Racial and Ethnic Minorities, Vulnerable Populations, Social Determinants of Health, Policy
Byhoff E, Taylor LA
Massachusetts community-based organization perspectives on Medicaid redesign.
The purpose of the study was to investigate how community-based organizations perceive Medicaid policy changes to address the social determinants of health. Forty-six key informant interviews were conducted, representing 44 community-based organizations across Massachusetts. Findings showed that changes to Medicaid policy can catalyze interest in partnership between healthcare organizations and community-based organizations. Recommendations included having policymakers and healthcare leadership ensure that community-based organizations are part of strategy development and social service program implementation.
AHRQ-funded; HS026664.
Citation: Byhoff E, Taylor LA .
Massachusetts community-based organization perspectives on Medicaid redesign.
Am J Prev Med 2019 Dec;57(6 Suppl 1):S74-s81. doi: 10.1016/j.amepre.2019.07.017..
Keywords: Medicaid, Social Determinants of Health, Policy, Health Insurance
Huffstetler AN, Phillips RL
Payment structures that support social care integration with clinical care: social deprivation indices and novel payment models.
This perspective article focuses on four models employed both internationally and domestically to outline the implementation, successes, limitations, and research needed to support national application of social determinants of health (SDH) models. The association between high social risk and poor medical outcomes has been established globally; however, healthcare payment policies designed to respond to this relationship generally lack evidence of affecting outcomes. In countries with a legacy of adjusting healthcare payments for social risk, more robust evaluation of associated effects could be helpful. Payers, states, or health systems making similar resource commitments should build in robust longitudinal evaluations of outcomes to inform the evolution of their payment policies.
AHRQ-funded; HS026664.
Citation: Huffstetler AN, Phillips RL .
Payment structures that support social care integration with clinical care: social deprivation indices and novel payment models.
Am J Prev Med 2019 Dec;57(6s1):S82-s88. doi: 10.1016/j.amepre.2019.07.011..
Keywords: Payment, Social Determinants of Health, Policy
Chatterjee P, Qi M, Coe NB
Association between high discharge rates of vulnerable patients and skilled nursing facility copayments.
The authors sought to determine whether patterns of skilled nursing facility (SNF) discharge are associated with the change in Medicare payment responsibility on day 20. They found that Medicare beneficiaries were more often discharged from SNFs on benefit day 20 than on benefit days 19 or 21. Those discharged on day 20 were more likely to be racial/ethnic minorities and to live in areas of lower socioeconomic status compared with those discharged before or after day 20. Their findings suggested an association between disproportionately high SNF discharge rates of vulnerable patients and existing Medicare payment policies. The authors recommended that payment policies be designed with consideration of the potential for such unintended consequences, and that any potential consequences be mitigated by balancing existing payment structures with incentives to provide optimal patient care.
AHRQ-funded; HS024266.
Citation: Chatterjee P, Qi M, Coe NB .
Association between high discharge rates of vulnerable patients and skilled nursing facility copayments.
JAMA Intern Med 2019 Sep;179(9):1296-98. doi: 10.1001/jamainternmed.2019.1209.
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Keywords: Vulnerable Populations, Nursing Homes, Medicare, Payment, Policy, Social Determinants of Health
Wisk LE, Sharma N
Inequalities in young adult health insurance coverage post-federal health reform.
The article investigates disparities in the insurance coverage of young adults before and after the implementation of the Affordable Care Act (ACA). Data from the 2000-2016 National Health Interview Survey was used to compare the effects of the ACA on three groups, aged 13 to 18, 19 to 25, and 26 to 30, with the 19 to 25 group considered as “young adults” for the purposed of this study. Respondents reported their types of health insurance coverage during the last 12 months, their reasons for being uninsured, and sociodemographic information. The article concludes that the ACA significantly impacted insurance coverage for young adults, but disparities remain.
AHRQ-funded; HS022986.
Citation: Wisk LE, Sharma N .
Inequalities in young adult health insurance coverage post-federal health reform.
J Gen Intern Med 2019 Jan;34(1):65-74. doi: 10.1007/s11606-018-4723-0..
Keywords: Disparities, Health Insurance, Policy, Social Determinants of Health, Young Adults
Keohane LM, Rahman M, Mor V
Reforming access: trends in Medicaid enrollment for new Medicare beneficiaries, 2008-2011.
This study evaluated whether aligning the Part D low-income subsidy and Medicaid program enrollment pathways in 2010 increased Medicaid participation among new Medicare beneficiaries. It found that the percentage of beneficiaries enrolling in limited Medicaid at the start of Medicare coverage increased in 2010 by 0.3 percentage points for individuals aging into Medicare and by 1.3 percentage points for those qualifying due to disability.
AHRQ-funded; HS000011.
Citation: Keohane LM, Rahman M, Mor V .
Reforming access: trends in Medicaid enrollment for new Medicare beneficiaries, 2008-2011.
Health Serv Res 2016 Apr;51(2):550-69. doi: 10.1111/1475-6773.12349.
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Keywords: Medicare, Medicaid, Policy, Access to Care, Social Determinants of Health
Moriya AS, Selden TM, Simon KI
AHRQ Author: Moriya AS, Selden TM
Little change seen in part-time employment as a result of the Affordable Care Act.
There has been speculation that the Affordable Care Act's coverage provisions and employer mandate have led to an increase in part-time employment. Using the Current Population Survey for the period 2005-15, the researchers examined data on weekly hours worked by firm size, reason for working part time, age, education, and health insurance. They found only limited evidence to support this speculation.
AHRQ-authored.
Citation: Moriya AS, Selden TM, Simon KI .
Little change seen in part-time employment as a result of the Affordable Care Act.
Health Aff 2016 Jan;35(1):119-23. doi: 10.1377/hlthaff.2015.0949.
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Keywords: Health Insurance, Policy, Social Determinants of Health
Whittle HJ, Palar K, Hufstedler LL
Food insecurity, chronic illness, and gentrification in the San Francisco Bay Area: an example of structural violence in United States public policy.
This study sought to explore the experiences and structural determinants of food insecurity among a group of low-income PLHIV in the San Francisco Bay Area. It found that the lived experience of food insecurity among participants included periods of insufficient quantity of food and resultant hunger, as well as long-term struggles with quality of food that led to concerns about the poor health effects of a cheap diet.
AHRQ-funded; HS000046.
Citation: Whittle HJ, Palar K, Hufstedler LL .
Food insecurity, chronic illness, and gentrification in the San Francisco Bay Area: an example of structural violence in United States public policy.
Soc Sci Med 2015 Oct;143:154-61. doi: 10.1016/j.socscimed.2015.08.027..
Keywords: Chronic Conditions, Policy, Social Determinants of Health, Nutrition, Vulnerable Populations
Clancy CM, Moy E
AHRQ Author: Clancy CM, Moy E
Commentary: measuring what matters most.
The authors discuss a Milbank Quarterly best practices article by Frank and Haw and how it relates to AHRQ's National Healthcare Disparities Report, concluding that helping policymakers glean the information they most need from an overload of data noise will improve the chances that critical disparities can be recognized, targeted, and eliminated.
AHRQ-authored.
Citation: Clancy CM, Moy E .
Commentary: measuring what matters most.
Milbank Q 2013 Mar;91(1):201-4. doi: 10.1111/milq.12008.
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Keywords: Disparities, Quality of Care, Health Status, Policy, Social Determinants of Health