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- (-) Access to Care (21)
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- (-) Racial and Ethnic Minorities (21)
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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 21 of 21 Research Studies DisplayedSteenland MW, Wilson IB, Matteson KA
Association of Medicaid expansion in Arkansas with postpartum coverage, outpatient care, and racial disparities.
This study’s objective was to measure the association of Medicaid expansion in Arkansas with postpartum coverage, outpatient care, and racial disparities. A total of 60,990 childbirths were reviewed from January 1, 2014 on with a total of 72.3% paid for by Medicaid and 27.7% paid for by a commercial payer. The mean age of the birthing person was 27; with 67% White, 22% Black, and 7% Hispanic. Medicaid expansion in Arkansas was associated with a 27.8 percentage point increase in continuous insurance coverage and an increase in outpatient visits of 0.9 during the first 6 months postpartum, representing relative increases of 54.9% and 75.0%, respectively. Racial disparities in postpartum coverage decreased from 6.3 percentage points before expansion to -2.0 after. However, disparities in outpatient care after expansion persisted between Black and White individuals.
AHRQ-funded; HS027464.
Citation: Steenland MW, Wilson IB, Matteson KA .
Association of Medicaid expansion in Arkansas with postpartum coverage, outpatient care, and racial disparities.
JAMA Health Forum 2021 Dec;2(12):e214167. doi: 10.1001/jamahealthforum.2021.4167..
Keywords: Medicaid, Maternal Care, Pregnancy, Racial and Ethnic Minorities, Disparities, Policy, Women, Access to Care
Purnell TS, Simpson DC, Callender CO
Dismantling structural racism as a root cause of racial disparities in COVID-19 and transplantation.
As the United States faces unparalleled challenges due to COVID-19, racial disparities in health and healthcare have once again taken center stage. If effective interventions to address racial disparities in transplantation, including those magnified by COVID-19, are to be designed and implemented at the national level, it is first critical to understand the complex mechanisms by which structural, institutional, interpersonal, and internalized racism influence the presence of racial disparities in healthcare and transplantation. IN this article the authors discuss their viewpoint.
AHRQ-funded; HS024600.
Citation: Purnell TS, Simpson DC, Callender CO .
Dismantling structural racism as a root cause of racial disparities in COVID-19 and transplantation.
Am J Transplant 2021 Jul;21(7):2327-32. doi: 10.1111/ajt.16543..
Keywords: COVID-19, Racial and Ethnic Minorities, Disparities, Transplantation, Surgery, Access to Care
Smith JM, Jarrín OF, Lin H
Racial disparities in post-acute home health care referral and utilization among older adults with diabetes.
The purpose of this study was to examine the association between race/ethnicity and hospital discharge to home health care and subsequent utilization of home health care among a cohort of adults (age 50 and older) who experienced a diabetes-related hospitalization. The investigators found that among those discharged to home health care, all non-white racial/ethnic minority patients were less likely to receive services within 14-days.
AHRQ-funded; HS022406.
Citation: Smith JM, Jarrín OF, Lin H .
Racial disparities in post-acute home health care referral and utilization among older adults with diabetes.
Int J Environ Res Public Health 2021 Mar 19;18(6):3196. doi: 10.3390/ijerph18063196..
Keywords: Elderly, Home Healthcare, Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Disparities, Access to Care, Healthcare Utilization
Han B, Chen PG, Yu H
Access to after-hours primary care: a key determinant of children's medical home status.
Researchers sought to identify individual survey items or domains that best predict medical home (MH) status for children and use them to develop brief markers of MH status. Using MEPS data, they found that accessibility, especially the ability to access health care after regular office hours, appeared to be the major predictor of having a MH among children. They recommended that the ongoing efforts to promote the MH model target improving accessibility of health care after regular hours for children overall and especially for Latino children.
AHRQ-funded; HS023336.
Citation: Han B, Chen PG, Yu H .
Access to after-hours primary care: a key determinant of children's medical home status.
BMC Health Serv Res 2021 Feb 27;21(1):185. doi: 10.1186/s12913-021-06192-y..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare, Access to Care, Healthcare Delivery, Disparities, Racial and Ethnic Minorities
Lee CI, Zhu W, Onega T
Comparative access to and use of digital breast tomosynthesis screening by women's race/ethnicity and socioeconomic status.
This study looked at access to digital breast tomography (DBT) versus regular mammography and whether women of minority race/ethnicity and lower socioeconomic status experienced lower DBT access during the early adoption period and persistently lower DBT use over time. This cross-sectional study included 92 geographically diverse imaging facilities across 5 US states, with over 2.3 million screening examinations performed among women aged 40 to 89 years from January 1, 2011, to December 31, 2017. Data were analyzed from June 2019, to August 2020. Women who used DBT increased for all women from 3.3% in 2011 to 82.6% in 2017. In 2012, Black, Hispanic, Asian American, and women with less than a high school education had lower DBT access compared to White women attending the same facility and also college graduates. Lower DBT access continued over time regardless of the number of years after facility-level DBT adoption.
AHRQ-funded; HS018366.
Citation: Lee CI, Zhu W, Onega T .
Comparative access to and use of digital breast tomosynthesis screening by women's race/ethnicity and socioeconomic status.
JAMA Netw Open 2021 Feb;4(2):e2037546. doi: 10.1001/jamanetworkopen.2020.37546..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Access to Care, Women, Social Determinants of Health, Racial and Ethnic Minorities, Screening
Mallick R, Xie R, Kirklin JK
Race and gender disparities in access to parathyroidectomy: a need to change processes for diagnosis and referral to surgeons.
This study examined whether race and gender disparities impact treatment for hyperparathyroidism with a parathyroidectomy. Data was reviewed on 2289 patients with hypercalcemia and abnormal parathyroid hormone levels who were seen at a tertiary referral center from 2011 to 2016. Cohort median age was 63, and 74% were women. Only 21% patients underwent a parathyroidectomy. Of the patients undergoing surgery, time from initial diagnosis to surgical treatment was longest for African-American men, who waited a median of 13.6 months compared to 2.9 months for Caucasian males. African-American women waited a median of 6.7 months versus 3.5 months for Caucasian women. Surgery rates after 1 year of index abnormal calcium was only 6% for black men versus 20% for white men, and 13% for black women versus 20% for white woman. Substantial delays were found for minorities, particularly for African-American men.
AHRQ-funded; HS023009.
Citation: Mallick R, Xie R, Kirklin JK .
Race and gender disparities in access to parathyroidectomy: a need to change processes for diagnosis and referral to surgeons.
Ann Surg Oncol 2021 Jan;28(1):476-83. doi: 10.1245/s10434-020-08707-z..
Keywords: Racial and Ethnic Minorities, Disparities, Access to Care
Vu JV, Gunaseelan V, Dimick JB
Mechanisms of age and race differences in receiving minimally invasive inguinal hernia repair.
Black patients and older adults are less likely to receive minimally invasive hernia repair. In this study, the investigators explored the association between race, age, and surgeon utilization of minimally invasive surgery (MIS) with the likelihood of receiving MIS inguinal hernia repair. The investigators concluded that race differences were explained by surgeon MIS utilization, implicating access to MIS-performing surgeon as a mediator. Conversely, age disparity was independent of MIS utilization, even after adjusting for comorbidities, indicating some degree of provider bias against performing MIS repair in older patients.
AHRQ-funded; HS025778.
Citation: Vu JV, Gunaseelan V, Dimick JB .
Mechanisms of age and race differences in receiving minimally invasive inguinal hernia repair.
Surg Endosc 2019 Dec;33(12):4032-37. doi: 10.1007/s00464-019-06695-0..
Keywords: Racial and Ethnic Minorities, Surgery, Elderly, Access to Care, Healthcare Utilization
Biener AI, Zuvekas SH
AHRQ Author: Zuvekas SH
Do racial and ethnic disparities in mental health treatment vary with underlying mental health?
AHRQ-authored.
Citation: Biener AI, Zuvekas SH .
Do racial and ethnic disparities in mental health treatment vary with underlying mental health?
Med Care Res Rev 2021 Aug;78(4):392-403. doi: 10.1177/1077558720903589..
Keywords: Medical Expenditure Panel Survey (MEPS), Behavioral Health, Disparities, Racial and Ethnic Minorities, Access to Care
Rice WS, Stringer KL, Sohail M
Accessing pre-exposure prophylaxis (PrEP): perceptions of current and potential prEP users in Birmingham, Alabama.
Limited studies to date assess barriers to and facilitators of pre-exposure prophylaxis (PrEP) uptake and utilization using a patient-centered access to care framework, among diverse socio-demographic groups, or in the U.S. Deep South, an area with disproportionate HIV burden. In this study, the investigators examine perceptions of PrEP access in qualitative interviews with 44 current and potential PrEP users in Birmingham, Alabama.
AHRQ-funded; HS013852.
Citation: Rice WS, Stringer KL, Sohail M .
Accessing pre-exposure prophylaxis (PrEP): perceptions of current and potential prEP users in Birmingham, Alabama.
AIDS Behav 2019 Nov;23(11):2966-79. doi: 10.1007/s10461-019-02591-9..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Healthcare Utilization, Patient-Centered Healthcare, Racial and Ethnic Minorities, Health Literacy, Education: Patient and Caregiver, Access to Care, Health Promotion
Nguyen KH, Trivedi AN
Asian American access to care in the Affordable Care Act era: findings from a population-based survey in California.
This study compared coverage and access to care between non-Hispanic White and Asian American adults after the ACA in California. The data was disaggregated into the five most populous ethnic subgroups (Chinese, Korean, Filipino, Vietnamese, and Japanese). The outcomes measured were 1) being uninsured, 2) having a usual source of care, 3) delaying necessary medical care, and 4) delaying necessary prescription medications. The sample included 19,201 non-Hispanic White and 3077 Asian American adults aged 18 to 64 in California. Koreans were significantly less likely to report a usual source of care relative to non-Hispanic whites while Chinese and Vietnamese adults were significantly less likely to delay necessary care.
AHRQ-funded; HS000011.
Citation: Nguyen KH, Trivedi AN .
Asian American access to care in the Affordable Care Act era: findings from a population-based survey in California.
J Gen Intern Med 2019 Nov;34(11):2660-68. doi: 10.1007/s11606-019-05328-5..
Keywords: Racial and Ethnic Minorities, Access to Care, Disparities, Health Insurance, Uninsured, Policy
Jarman MP, Pollack Porter K, Curriero FC
Factors mediating demographic determinants of injury mortality.
The authors investigated the role of injury characteristics and access to trauma care as mediators of the relationships between race, ethnicity, sex, and injury mortality. They found that distance, injury characteristics, and insurance mediate the effects of demographic characteristics on injury mortality and appear to contribute to disparities in injury mortality.
AHRQ-funded; HS000029.
Citation: Jarman MP, Pollack Porter K, Curriero FC .
Factors mediating demographic determinants of injury mortality.
Ann Epidemiol 2019 Jun;34:58-64.e2. doi: 10.1016/j.annepidem.2019.03.013..
Keywords: Access to Care, Disparities, Injuries and Wounds, Mortality, Racial and Ethnic Minorities, Sex Factors, Social Determinants of Health, Trauma
Sun CJ, Anderson KM, Bangsberg D
Access to HIV pre-exposure prophylaxis in practice settings: a qualitative study of sexual and gender minority adults' perspectives.
Sexual and gender minority (SGM) populations remain at disproportionate risk of HIV infection. Despite the effectiveness of pre-exposure prophylaxis (PrEP) in preventing HIV, PrEP uptake has been slow. The objective of this study was to identify barriers and facilitators of PrEP access by examining SGM patients' experiences with accessing health care systems and engaging with providers about PrEP in a variety of practice settings.
AHRQ-funded; HS022981.
Citation: Sun CJ, Anderson KM, Bangsberg D .
Access to HIV pre-exposure prophylaxis in practice settings: a qualitative study of sexual and gender minority adults' perspectives.
J Gen Intern Med 2019 Apr;34(4):535-43. doi: 10.1007/s11606-019-04850-w..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Infectious Diseases, Sexual Health, Racial and Ethnic Minorities, Access to Care
Angier H, Ezekiel-Herera D, Marino M
Racial/ethnic disparities in health insurance and differences in visit type for a population of patients with diabetes after Medicaid Expansion.
Racial/ethnic disparities in health insurance and differences in visit type for a population of patients with diabetes after Medicaid Expansion.
AHRQ-funded; HS024270.
Citation: Angier H, Ezekiel-Herera D, Marino M .
Racial/ethnic disparities in health insurance and differences in visit type for a population of patients with diabetes after Medicaid Expansion.
J Health Care Poor Underserved 2019;30(1):116-30. doi: 10.1353/hpu.2019.0011.
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Keywords: Access to Care, Diabetes, Disparities, Health Insurance, Medicaid, Racial and Ethnic Minorities
Tung EL, Hampton DA, Kolak M
Race/ethnicity and geographic access to urban trauma care.
The goal of this study was to examine racial/ethnic differences in geographic access to trauma care in Chicago, Los Angeles, and New York City using census tract data from the 2015 American Community Survey. The role of residential segregation and neighborhood poverty was also considered. Small-area analyses were conducted to assess trauma desert status; ‘trauma desert’ was defined as a travel distance greater than 8 km to the nearest adult level I or level II trauma center. The results for each city’s census tracts and racial/ethnic categories were compared.
AHRQ-funded; HS023007.
Citation: Tung EL, Hampton DA, Kolak M .
Race/ethnicity and geographic access to urban trauma care.
JAMA Netw Open 2019 Mar;2(3):e190138. doi: 10.1001/jamanetworkopen.2019.0138..
Keywords: Racial and Ethnic Minorities, Urban Health, Access to Care, Trauma, Disparities
Johnston FM, Neiman JH, Parmley LE
Stakeholder perspectives on the use of community health workers to improve palliative care use by African Americans with cancer.
This study focused on the issue of lack of palliative care for African-Americans with cancer. Stakeholder interviews and focus groups were conducted with cancer patients, caregivers, health care administrators, oncologists, and community health workers (CHWs). Participants felt that CHWs could play a central role in bridging patients with their providers, information and resources. They also felt that CHWs should either come from the community, or be familiar with the history, culture, and norms of the communities from which they operate.
AHRQ-funded; HS024736.
Citation: Johnston FM, Neiman JH, Parmley LE .
Stakeholder perspectives on the use of community health workers to improve palliative care use by African Americans with cancer.
J Palliat Med 2019 Mar;22(3):302-06. doi: 10.1089/jpm.2018.0366..
Keywords: Access to Care, Cancer, Healthcare Delivery, Healthcare Utilization, Cultural Competence, Disparities, Palliative Care, Racial and Ethnic Minorities
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
Lipton BJ, Decker SL, Sommers BD
AHRQ Author: Lipton BJ, Decker SL
The Affordable Care Act appears to have narrowed racial and ethnic disparities in insurance coverage and access to care among young adults.
This study analyzed insurance coverage gains of young adults aged 19 to 25 due to the Affordable Care Act’s 2010 coverage provision and also 2014 Medicaid and Marketplace expansions. There were gains in coverage of 11% for Hispanics, 10.1% for Blacks and 4.6% for Whites.
AHRQ-authored; AHRQ-funded; HS021291.
Citation: Lipton BJ, Decker SL, Sommers BD .
The Affordable Care Act appears to have narrowed racial and ethnic disparities in insurance coverage and access to care among young adults.
Med Care Res Rev 2019 Feb;76(1):1077558717706575. Epub ahead of print. doi: 10.1177/1077558717706575..
Keywords: Access to Care, Disparities, Health Insurance, Racial and Ethnic Minorities, Young Adults
Qato DM, Daviglus ML, Wilder J
'Pharmacy deserts' are prevalent in Chicago's predominantly minority communities, raising medication access concerns.
The authors examined whether trends in the availability of pharmacies varied across communities in Chicago with different racial or ethnic compositions and whether "pharmacy deserts," or low-access neighborhoods, were more common in segregated black and Hispanic communities than elsewhere. They found that in 2012 there were disproportionately more pharmacy deserts in segregated black communities, as well as in low-income communities and federally designated Medically Underserved Areas. These findings suggest that public policies aimed at improving access to prescription medications may need to address factors beyond insurance coverage and medication affordability.
AHRQ-funded; HS021093.
Citation: Qato DM, Daviglus ML, Wilder J .
'Pharmacy deserts' are prevalent in Chicago's predominantly minority communities, raising medication access concerns.
Health Aff 2014 Nov;33(11):1958-65. doi: 10.1377/hlthaff.2013.1397.
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Keywords: Access to Care, Medication, Provider: Pharmacist, Racial and Ethnic Minorities, Urban Health
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
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
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