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
1 to 25 of 44 Research Studies DisplayedHong I, Goodwin JS, Reistetter TA, I, Goodwin JS, Reistetter TA
Comparison of functional status improvements among patients with stroke receiving postacute care in inpatient rehabilitation vs skilled nursing facilities.
This cohort study compared functional status improvements of poststroke patients who either went to an inpatient rehabilitation facility (IRF) or a skilled nursing facility (SNF). The study used data from Medicare claims for stroke from January 2013 through November 2014. A total of 99,185 patients were studied. Patients admitted to SNFs tended to be older, female, and had a longer hospital length of stay than those admitted to IRFs. Stroke patients admitted to IRFs had larger improvements for mobility score points and for self-care on admission compared with those admitted to SNFs. There was found to be no statistical difference in the odds of 30- to 365-day mortality.
AHRQ-funded; HS024711; HS022134.
Citation: Hong I, Goodwin JS, Reistetter TA, I, Goodwin JS, Reistetter TA .
Comparison of functional status improvements among patients with stroke receiving postacute care in inpatient rehabilitation vs skilled nursing facilities.
JAMA Netw Open 2019 Dec 2;2(12):e1916646. doi: 10.1001/jamanetworkopen.2019.16646..
Keywords: Stroke, Cardiovascular Conditions, Rehabilitation, Health Status, Hospitalization, Nursing Homes
Barber CEH, Zell J, Yazdany J
2019 American College of Rheumatology recommended patient-reported functional status assessment measures in rheumatoid arthritis.
This study’s objective was to develop American College of Rheumatology (ACR) Functional Status Assessment Measures (FSAMs) for patient reporting in most clinic settings. The authors convened a workgroup to conduct a systematic literature review through March 2017. They focused on the following FSAMs: the Health Assessment Questionnaire (HAQ) and derived measures from the Patient-Reported Outcomes Measurement Information System (PROMIS) tool. Out of 11,835 articles identified in the search, 56 were included in the review. A modified Delphi process identified 7 measures which fulfilled the minimum standard for regular use, and 3 measures were recommended: the PROMIS 10-item short form, the HAQ-II, and the Multidimensional HAQ.
AHRQ-funded; HS025638.
Citation: Barber CEH, Zell J, Yazdany J .
2019 American College of Rheumatology recommended patient-reported functional status assessment measures in rheumatoid arthritis.
Arthritis Care Res 2019 Dec;71(12):1531-39. doi: 10.1002/acr.24040..
Keywords: Arthritis, Health Status, Guidelines, Evidence-Based Practice
Roy B, Riley C, Herrin J
Associations between community well-being and hospitalisation rates: results from a cross-sectional study within six US states.
The objective of this study was to evaluate the association between community well-being, a positively framed, multidimensional assessment of the health and quality of life of a geographic community, and hospitalisation rates. The investigators found that community well-being was inversely associated with local hospitalisation rates. They suggest that in addition to health and quality-of-life benefits, higher community well-being may also result in fewer unnecessary hospitalisations.
AHRQ-funded; HS023000.
Citation: Roy B, Riley C, Herrin J .
Associations between community well-being and hospitalisation rates: results from a cross-sectional study within six US states.
BMJ Open 2019 Nov 27;9(11):e030017. doi: 10.1136/bmjopen-2019-030017..
Keywords: Hospitalization, Health Status, Quality of Life, Healthcare Utilization, Social Determinants of Health
Calthorpe LM, Pantell MS
Differences in the prevalence of childhood adversity by geography in the 2017-18 National Survey of Children's Health.
This study examined differences in childhood exposures to adverse childhood experiences (ACEs) by geography and determined whether geography moderates the relationship between ACE exposure and health outcomes including overall health, asthma, ADHD, and special health care needs. Cross-sectional data from 2017-2017 National Survey of Children’s Health (NSCH) was analyzed. Rural residency was associated with 1.29 times increased odds of exposure to 4+ ACEs compared to suburban residency. Urban residency status was observed to increase the association between ACEs and asthma.
AHRQ-funded; HS026383.
Citation: Calthorpe LM, Pantell MS .
Differences in the prevalence of childhood adversity by geography in the 2017-18 National Survey of Children's Health.
Child Abuse Negl 2021 Jan;111:104804. doi: 10.1016/j.chiabu.2020.104804..
Keywords: Children/Adolescents, Social Determinants of Health, Health Status
Zullo AR, Adams JW, Gantenberg JR
Examining neighborhood poverty-based disparities in HIV/STI prevalence: an analysis of Add Health data.
The purpose of the study was to estimate the effect of exposure to neighborhood poverty in adolescence on HIV/STI prevalence in early adulthood. The investigators found that strong evidence for neighborhood poverty-based differences in HIV/STI prevalence was not observed. They suggest that researchers should continue to investigate the effect of neighborhood-level socioeconomic position measures and, if warranted, identify etiologically relevant exposure periods.
AHRQ-funded; HS022998.
Citation: Zullo AR, Adams JW, Gantenberg JR .
Examining neighborhood poverty-based disparities in HIV/STI prevalence: an analysis of Add Health data.
Ann Epidemiol 2019 Nov;39:8-14.e4. doi: 10.1016/j.annepidem.2019.09.010..
Keywords: Children/Adolescents, Low-Income, Vulnerable Populations, Disparities, Social Determinants of Health, Human Immunodeficiency Virus (HIV), Infectious Diseases, Young Adults, Health Status
Huguet N, Angier H, Hoopes MJ
Prevalence of pre-existing conditions among community health center patients before and after the Affordable Care Act.
Investigators assessed the prevalence of pre-existing conditions for community health center (CHC) patients who gained insurance coverage post-Affordable Care Act (ACA). They found that their study emphasized the high prevalence of pre-existing conditions among CHC patients and the large increase in the proportion of patients with at least one of these diagnoses post-ACA. They conclude that, given how common these conditions are, repealing pre-existing condition protections could be extremely harmful to millions of patients and would likely exacerbate health care and health disparities.
AHRQ-funded; HS024270.
Citation: Huguet N, Angier H, Hoopes MJ .
Prevalence of pre-existing conditions among community health center patients before and after the Affordable Care Act.
J Am Board Fam Med 2019 Nov-Dec;32(6):883-89. doi: 10.3122/jabfm.2019.06.190087..
Keywords: Health Status, Chronic Conditions, Health Insurance, Policy
McKellar MS, Kuchibhatla MN, Oursler KAK
Racial differences in change in physical functioning in older male veterans with HIV.
Little is known about longitudinal change in physical functioning of older African American/Black and White HIV-infected persons. In this study, the investigators examined up to 10 years of data on African American and White men with HIV infection and comparable HIV-negative men age 50-91 years from the Veterans Aging Cohort Study Survey sample.
AHRQ-funded; HS021112; HS023464; HS023258.
Citation: McKellar MS, Kuchibhatla MN, Oursler KAK .
Racial differences in change in physical functioning in older male veterans with HIV.
AIDS Res Hum Retroviruses 2019 Nov/Dec;35(11-12):1034-43. doi: 10.1089/aid.2018.0296..
Keywords: Human Immunodeficiency Virus (HIV), Health Status, Racial and Ethnic Minorities, Elderly, Men's Health
Campbell AD, Baker EH
Do income inequalities in higher weight status depend on social integration?
In this study, the investigators use data from the 2003-2008 National Health and Nutrition Examination Survey (NHANES) to examine whether the association between higher weight status and social integration varies by income. The investigators concluded that the association between income and higher weight status operates differently for women and men and is dependent, in part, on their level of social integration.
AHRQ-funded; HS013852.
Citation: Campbell AD, Baker EH .
Do income inequalities in higher weight status depend on social integration?
Soc Sci Res 2019 Sep;83:102301. doi: 10.1016/j.ssresearch.2019.04.014..
Keywords: Health Status, Obesity, Obesity: Weight Management, Social Determinants of Health
Vistnes JP, Hill SC
AHRQ Author: Vistnes JP, Hill SC
The dynamics Of Medicaid enrollment, employment, and beneficiary health status.
In this article, the authors discuss the dynamics of Medicaid enrollment, employment and beneficiary status. Using national data, the investigators found that 13.9 percent of new, nonelderly adult Medicaid beneficiaries in 2015-16 had experienced a decline in health before enrollment, and a similar percentage had had jobs that ended before they enrolled.
AHRQ-authored.
Citation: Vistnes JP, Hill SC .
The dynamics Of Medicaid enrollment, employment, and beneficiary health status.
Health Aff 2019 Sep;38(9):1491-95. doi: 10.1377/hlthaff.2019.00066..
Keywords: Health Status, Medicaid, Medical Expenditure Panel Survey (MEPS), Policy
Rundle AG, Chen Y, Quinn JW
Development of a neighborhood walkability index for studying neighborhood physical activity contexts in communities across the U.S. over the past three decades.
To examine how urban form shapes physical activity and health over time, a measure of neighborhood walkability is needed that can be linked to cohort studies with participants living across the United States (U.S.) that have been followed over the past decades. In this study, the Built Environment and Health-Neighborhood Walkability Index (BEH-NWI), a measure of neighborhood walkability that can be calculated for communities across the United States between 1990 and 2015, was conceptualized, developed, and tested using data from the New York City Tri-State Area.
AHRQ-funded; HS026120.
Citation: Rundle AG, Chen Y, Quinn JW .
Development of a neighborhood walkability index for studying neighborhood physical activity contexts in communities across the U.S. over the past three decades.
J Urban Health 2019 Aug;96(4):583-90. doi: 10.1007/s11524-019-00370-4
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Keywords: Urban Health, Lifestyle Changes, Health Status, Social Determinants of Health
Papaleontiou M, Reyes-Gastelum D, Gay BL
Worry in thyroid cancer survivors with a favorable prognosis.
Researchers investigated cancer-related worry in thyroid cancer survivors with favorable prognosis. A diverse cohort of patients diagnosed with differentiated thyroid cancer, selected from the Surveillance, Epidemiology, and End Results (SEER) Program registries were surveyed for two to four years after diagnosis. The researchers recommended that physicians be aware that worry is a major issue for thyroid cancer survivors with favorable prognosis. Efforts should be undertaken to alleviate worry, especially among vulnerable groups, including female patients, younger patients, those with lower education, and racial/ethnic minorities.
AHRQ-funded; HS024512.
Citation: Papaleontiou M, Reyes-Gastelum D, Gay BL .
Worry in thyroid cancer survivors with a favorable prognosis.
Thyroid 2019 Aug;29(8):1080-88. doi: 10.1089/thy.2019.0163..
Keywords: Cancer, Anxiety, Stress, Health Status
Nguyen UDT, Perneger T, Franklin PD
Improvement in mental health following total hip arthroplasty: the role of pain and function.
This prospective study examined whether mental health improved in patients who had total hip arthroplasty (THA) due to improvement in pain and function 1 year post-surgery. Patients enrolled in a THA registry from 2010 to 2014 were included and the mental component score (MCS) was examined before and 1 year post-surgery. There was a significant improvement in mental health due to less pain and improved function.
AHRQ-funded; HS018910.
Citation: Nguyen UDT, Perneger T, Franklin PD .
Improvement in mental health following total hip arthroplasty: the role of pain and function.
BMC Musculoskelet Disord 2019 Jun 29;20(1):307. doi: 10.1186/s12891-019-2669-y..
Keywords: Health Status, Behavioral Health, Orthopedics, Outcomes, Pain, Patient-Centered Outcomes Research, Quality of Life, Surgery
Sonik RA, Parish SL, Mitra M
Association of health status with receipt of supplemental security income among individuals with severe disabilities and very low income and assets.
Supplemental Security Income (SSI) is a cash-transfer program for individuals with severe disabilities and very low incomes and assets. The investigators analyzed data from the first 12 waves of the 2008 panel of the Survey of Income and Program Participation. They found that there was a sharp decline in health status among eventual SSI recipients in the year before program entry and a modest improvement and stabilization in health status after entry. The investigators also discuss the limitations and implications of their study.
AHRQ-funded; HS026317.
Citation: Sonik RA, Parish SL, Mitra M .
Association of health status with receipt of supplemental security income among individuals with severe disabilities and very low income and assets.
JAMA Intern Med 2019 Jun;179(6):842-43. doi: 10.1001/jamainternmed.2018.8609..
Keywords: Health Status, Vulnerable Populations, Nutrition, Disabilities, Social Determinants of Health
Ahmad FS, Kallen MA, Schifferdecker KE
Development and initial validation of the PROMIS(R)-Plus-HF profile measure.
This paper describes the efforts to develop and validate the PROMIS®-Plus-HF (Patient-Reported Outcomes Measurement Information System®-Plus-Heart Failure) profile measure. The authors conducted 8 focus groups with 61 patients with HF and phone interviews with 10 HF clinicians. They tested the measure with a 600-patient sample. Validity was analyzed and confirmed using Pearson r and Spearman rho correlations with Kansas City Cardiomyopathy Questionnaire subscores. The measure consists of 86 items across 18 domains.
AHRQ-funded; HS026385.
Citation: Ahmad FS, Kallen MA, Schifferdecker KE .
Development and initial validation of the PROMIS(R)-Plus-HF profile measure.
Circ Heart Fail 2019 Jun;12(6):e005751. doi: 10.1161/circheartfailure.118.005751.
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Keywords: Patient-Centered Outcomes Research, Heart Disease and Health, Cardiovascular Conditions, Shared Decision Making, Quality of Life, Health Status
Angraal S, Gupta A, Khera R
Association of access to exercise opportunities and cardiovascular mortality.
The purpose of this study is to examine the patterns of cardiovascular disease (CVD) mortality in varying degrees of access within the U.S. at the county level. The results indicate that access to exercise opportunities has a significant association with adjusted CVD mortality--higher access correlates with lower CVD mortality. Counties that have lower access to exercise facilities show a higher prevalence of obesity and diabetes in comparison with counties that have higher access. States with fewer people living in close proximity to a park have higher percentage of people who do not engage in any leisure physical activity. These results suggest means by which opportunities to increase access may be developed.
AHRQ-funded; HS023000.
Citation: Angraal S, Gupta A, Khera R .
Association of access to exercise opportunities and cardiovascular mortality.
Am Heart J 2019 Jun;212:152-56. doi: 10.1016/j.ahj.2019.02.010..
Keywords: Cardiovascular Conditions, Health Status, Mortality, Social Determinants of Health
Forrest CB, Zorc JJ, Moon J
Evaluation of the PROMIS pediatric global health scale (PGH-7) in children with asthma.
The purpose of this study was to evaluate the reliability and validity of the PROMIS Pediatric Global Health scale, a 7-item measure of perceived physical, mental, and social health, in children with asthma. The investigators concluded that the PGH-7 is a reliable and valid patient-reported outcome for assessing general health among children with asthma. It is a useful complement to other asthma-specific outcome measures.
AHRQ-funded; HS020508.
Citation: Forrest CB, Zorc JJ, Moon J .
Evaluation of the PROMIS pediatric global health scale (PGH-7) in children with asthma.
J Asthma 2019 May;56(5):534-42. doi: 10.1080/02770903.2018.1471701..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Health Status
Baik D, Reading M, Jia H
Measuring health status and symptom burden using a web-based mHealth application in patients with heart failure.
This cross-sectional study was conducted at an urban academic medical center to measure health status and symptom burdens of heart failure patients using a mHealth application called mi.Symptoms. Patients were diverse, with a mean age of 58.7, and were 37% women, 36% Black, and 36% Hispanic/Latino. Almost half were classified as New York Heart Association class III, and 44% reported not having enough income to make ends meet. Health status was measured with the Kansas City cardiomyopathy questionnaire clinical summary score. Predictors of better health status included higher physical function and ability to participate in social functions and activities. Predictors of poorer health status was New York Heart Association class IV status and dyspnea.
AHRQ-funded; HS021816.
Citation: Baik D, Reading M, Jia H .
Measuring health status and symptom burden using a web-based mHealth application in patients with heart failure.
Eur J Cardiovasc Nurs 2019 Apr;18(4):325-31. doi: 10.1177/1474515119825704..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Health Status, Telehealth, Health Information Technology (HIT)
Ngo-Metzger Q Sharif, MZ Biegler, K Mollica, et al.
A health profile and overview of healthcare experiences of Cambodian American refugees and immigrants residing in Southern California.
This study compared the health status and healthcare experiences of Cambodian American refugees and immigrants, using data were collected via questionnaires and medical records from two community clinics in Southern California. Minimal differences in self-reported health behaviors occurred between the two groups. Refugees reported lower levels of health-related quality of life overall and self-rated health, but similar or more positive healthcare experiences than the immigrants. Refugees had higher rates of diabetes and cardiovascular disease risk, in adjusted analyses. The authors conclude that there is a need for more health promotion efforts to improve health outcomes and perceived wellbeing of Cambodian American refugees and immigrants.
AHRQ-authored.
Citation: Ngo-Metzger Q Sharif, MZ Biegler, K Mollica, et al..
A health profile and overview of healthcare experiences of Cambodian American refugees and immigrants residing in Southern California.
J Immigr Minor Health 2019 Apr;21(2):346-55. doi: 10.1007/s10903-018-0736-3..
Keywords: Disparities, Health Status, Patient Experience, Quality of Life, Racial and Ethnic Minorities, Vulnerable Populations
Biener AI, Zuvekas SH
AHRQ Author: Zuvekas SH
Do racial and ethnic disparities in health care use vary with health?
Researchers used Medical Expenditure Panel Survey (MEPS) data from 2010-2014 to evaluate health care use between black-white and Hispanic-white adults. They found that there was the widest disparity in health care use in adults in excellent health between Hispanics and whites but the opposite was true for blacks and whites. Differences are attributed to health insurance coverage and access to health care overall.
AHRQ-authored.
Citation: Biener AI, Zuvekas SH .
Do racial and ethnic disparities in health care use vary with health?
Health Serv Res 2019 Feb;54(1):64-74. doi: 10.1111/1475-6773.13087..
Keywords: Access to Care, Disparities, Healthcare Utilization, Health Insurance, Health Status, Medical Expenditure Panel Survey (MEPS), Racial and Ethnic Minorities
Hanmer J, Yu L, Li J
The diagnosis of asymptomatic disease is associated with fewer healthy days: a cross sectional analysis from the national health and nutrition examination survey.
This study measured the effect of asymptomatic disease on health-related quality of life (HRQoL). The health conditions focused on were glucose intolerance, hyperlipidaemia and hypertension. A secondary analysis was done of data from the 2011-2012 National Health and Nutrition Examination Survey (NHANES). Patients who knew about their diagnosis but did not receive treatment reported lower QoL scores than those who did not know about their disease. Conversely, those without the condition reported about the same scores as those who did not know about their disease.
AHRQ-funded; HS022989.
Citation: Hanmer J, Yu L, Li J .
The diagnosis of asymptomatic disease is associated with fewer healthy days: a cross sectional analysis from the national health and nutrition examination survey.
Br J Health Psychol 2019 Feb;24(1):88-101. doi: 10.1111/bjhp.12341..
Keywords: Diagnostic Safety and Quality, Health Status, Quality of Life
McDonald ML, Huang A, Proudfoot JA
Association of obesity, BMI, and Hispanic ethnicity on ambulatory status in children with spinal dysraphism followed near the California-Mexico border.
This study evaluated the relationship between body mass index (BMI), overweight status (OW), or obesity (OB) and ambulatory status in a predominantly Hispanic population of children with spinal dysraphism (SD). It found that,despite no difference in ambulatory status, increasing BMI and OW / OB are associated with Hispanic ethnicity and increasing age.
AHRQ-funded; HS022404.
Citation: McDonald ML, Huang A, Proudfoot JA .
Association of obesity, BMI, and Hispanic ethnicity on ambulatory status in children with spinal dysraphism followed near the California-Mexico border.
J Health Care Poor Underserved 2016;27(4):1956-69. doi: 10.1353/hpu.2016.0173.
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Keywords: Obesity, Racial and Ethnic Minorities, Racial and Ethnic Minorities, Children/Adolescents, Health Status
Kenzik KM, Kent EE, Martin MY
Chronic condition clusters and functional impairment in older cancer survivors: a population-based study.
The purpose of this study was to identify chronic condition clusters at pre- and post-cancer diagnosis, evaluate predictors of developing clusters post-cancer, and examine the impact on functional impairment among older cancer survivors. It found that distinct condition clusters of two or more chronic conditions are prevalent among older cancer survivors. Cluster prevalence increases from pre- to post-cancer diagnosis.
AHRQ-funded; HS023009; HS013852.
Citation: Kenzik KM, Kent EE, Martin MY .
Chronic condition clusters and functional impairment in older cancer survivors: a population-based study.
J Cancer Surviv 2016 Dec;10(6):1096-103. doi: 10.1007/s11764-016-0553-4.
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Keywords: Chronic Conditions, Cancer, Elderly, Research Methodologies, Health Status
Arora A, Spatz E, Herrin J
Population well-being measures help explain geographic disparities in life expectancy at the county level.
This study investigated whether population well-being - a comprehensive measure of physical, mental, and social health - helps explain geographic variation in life expectancy. At the county level, it found that for every 1-standard-deviation (4.2-point) increase in the well-being score, life expectancy was 1.9 years higher for females and 2.6 years higher for males.
AHRQ-funded; HS023000.
Citation: Arora A, Spatz E, Herrin J .
Population well-being measures help explain geographic disparities in life expectancy at the county level.
Health Aff 2016 Nov 01;35(11):2075-82. doi: 10.1377/hlthaff.2016.0715.
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Keywords: Disparities, Health Status, Low-Income, Social Determinants of Health
Goodwin JS, Sheffield K, Li S
Receipt of cancer screening is a predictor of life expectancy.
The researchers sought to determine the association between receipt of screening mammography or PSA and overall survival. They found that the subjects with prior cancer screening had actual median survivals higher than those who were not screened, with differences ranging from 1.7 to 2.1 years for women and 0.9 to 1.1 years for men.
AHRQ-funded; HS022134.
Citation: Goodwin JS, Sheffield K, Li S .
Receipt of cancer screening is a predictor of life expectancy.
J Gen Intern Med 2016 Nov;31(11):1308-14. doi: 10.1007/s11606-016-3787-y.
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Keywords: Cancer, Cancer: Breast Cancer, Cancer: Prostate Cancer, Screening, Women, Men's Health, Health Status
Hanmer J, Hess R, Sullivan S
Benchmarking health-related quality-of-life data from a clinical setting.
This paper's objective was to construct a nationally representative health-related quality of life (HRQoL) benchmark for use with a clinical sample. The results showed that HRQoL benchmarks can be created from current public datasets, and subgroups in national samples may provide more valid benchmarks for clinical populations.
AHRQ-funded; HS022989.
Citation: Hanmer J, Hess R, Sullivan S .
Benchmarking health-related quality-of-life data from a clinical setting.
Am J Manag Care 2016 Oct;22(10):669-75.
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Keywords: Health Status, Medical Expenditure Panel Survey (MEPS), Quality of Life