National Healthcare Quality and Disparities Report
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Topics
- (-) Access to Care (16)
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- Primary Care: Models of Care (1)
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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 16 of 16 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
Sanchez JI, Shankaran V, Unger JM
Inequitable access to surveillance colonoscopy among Medicare beneficiaries with surgically resected colorectal cancer.
After colorectal cancer (CRC) surgery, surveillance with colonoscopy is an important step for the early detection of local recurrence. Unfortunately, surveillance colonoscopy is underused, especially among racial/ethnic minorities. This study assessed the association between patient and neighborhood factors and receipt of surveillance colonoscopy. The investigators concluded that receipt of initial surveillance colonoscopy remained low, and that there were acute disparities between Black and NHW patients.
AHRQ-funded; HS013853.
Citation: Sanchez JI, Shankaran V, Unger JM .
Inequitable access to surveillance colonoscopy among Medicare beneficiaries with surgically resected colorectal cancer.
Cancer 2021 Feb;127(3):412-21. doi: 10.1002/cncr.33262..
Keywords: Colonoscopy, Cancer: Colorectal Cancer, Cancer, Access to Care, Screening, Prevention, Disparities, Medicare
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
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
Ray KN, Chari AV, Engberg J
Disparities in time spent seeking medical care in the United States.
The researchers assessed how time associated with medical visits varied across socioeconomic variables and visit characteristics. They determined that patients spent on average 123 minutes obtaining medical care, including 86 minutes of clinic time and 38 minutes travel time. Clinic time was significantly longer for racial/ethnic minorities, individuals with less education, and unemployed individuals.
AHRQ-funded; HS022989.
Citation: Ray KN, Chari AV, Engberg J .
Disparities in time spent seeking medical care in the United States.
JAMA Intern Med 2015 Dec;175(12):1983-6. doi: 10.1001/jamainternmed.2015.4468..
Keywords: Disparities, Racial and Ethnic Minorities, Social Determinants of Health, Access to Care, Quality of Care
Abdus S, Mistry KB, Selden TM
AHRQ Author: Mistry KB, Selden TM
Racial and ethnic disparities in services and the Patient Protection and Affordable Care Act.
The researchers examined pre-reform patterns in insurance coverage, access to care, and preventive services use by race/ethnicity in adults targeted by the coverage expansions of the Patient Protection and Affordable Care Act (ACA). They found that minorities were disproportionately represented among those targeted by the coverage provisions of the ACA.
AHRQ-authored.
Citation: Abdus S, Mistry KB, Selden TM .
Racial and ethnic disparities in services and the Patient Protection and Affordable Care Act.
Am J Public Health 2015 Nov;105(Suppl 5):S668-75. doi: 10.2105/ajph.2015.302892..
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Disparities, Racial and Ethnic Minorities, Access to Care
Traino HM, Nonterah CW, Cyrus JW
Disparities in the completion of steps to kidney transplantation: protocol for a systematic review.
This review will catalogue disparities in the steps to transplantation as well as the barriers and facilitators to completion of each step identified in the extant literature. The results of the review will be used to generate recommendations for future research to improve equity in access to kidney transplantation.
AHRQ-funded; HS018113.
Citation: Traino HM, Nonterah CW, Cyrus JW .
Disparities in the completion of steps to kidney transplantation: protocol for a systematic review.
BMJ Open 2015 Sep 08;5(9):e008677. doi: 10.1136/bmjopen-2015-008677.
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Keywords: Disparities, Transplantation, Kidney Disease and Health, Access to Care, Guidelines
Sofolahan-Oladeinde Y, Mullins CD, Baquet CR
Using community-based participatory research in patient-centered outcomes research to address health disparities in under-represented communities.
The authors proposed ways by which patient-centered outcomes research can effectively use community-based participatory research principles to engage patients in general, and specifically patients from underserved communities, in the hope that this will help to reduce and eventually eliminate health disparities.
AHRQ-funded; HS022135.
Citation: Sofolahan-Oladeinde Y, Mullins CD, Baquet CR .
Using community-based participatory research in patient-centered outcomes research to address health disparities in under-represented communities.
J Comp Eff Res 2015 Sep;4(5):515-23. doi: 10.2217/cer.15.31.
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Keywords: Access to Care, Disparities, Evidence-Based Practice, Patient-Centered Outcomes Research, Vulnerable Populations
Davis AE, Mehrotra S, Friedewald JJ
Improving geographic equity in kidney transplantation using alternative kidney sharing and optimization modeling.
The authors analyzed current kidney allocation and developed an alternative kidney sharing strategy using a multiperiod linear optimization model, KSHARE, which aims to improve geographic equity in kidney transplantation while also respecting transplant system constraints and priorities. They used Organ Procurement and Transplant Network data to determine that enhancing the practice of sharing kidneys by the KSHARE model may increase geographic equity in kidney transplantation.
AHRQ-funded; HS021078.
Citation: Davis AE, Mehrotra S, Friedewald JJ .
Improving geographic equity in kidney transplantation using alternative kidney sharing and optimization modeling.
Med Decis Making 2015 Aug;35(6):797-807. doi: 10.1177/0272989x14557696.
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Keywords: Access to Care, Disparities, Health Services Research (HSR), Social Determinants of Health, Transplantation
Malecki K, Wisk LE, Walsh M
Oral health equity and unmet dental care needs in a population-based sample: findings from the Survey of the Health of Wisconsin.
The authors explored individual-, psychosocial-, and community-level predictors of oral health status in the Survey of the Health of Wisconsin Oral Health Screening project. Their results suggested that costs were a primary predictor of access to care and poor oral health status, underscoring the role that primary care, in conjunction with dental health care providers, could play in promoting oral health care, particularly in reducing barriers and promoting preventive health behaviors.
AHRQ-funded; HS000063.
Citation: Malecki K, Wisk LE, Walsh M .
Oral health equity and unmet dental care needs in a population-based sample: findings from the Survey of the Health of Wisconsin.
Am J Public Health 2015 Jul;105 Suppl 3:S466-74. doi: 10.2105/ajph.2014.302338.
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Keywords: Access to Care, Dental and Oral Health, Disparities, Healthcare Costs, Health Services Research (HSR)
Chang E, Chan KS, Han HR
Effect of acculturation on variations in having a usual source of care among Asian Americans and non-Hispanic whites in California.
This study explored factors influencing the disparity between Asian American and non-Hispanic whites in having a usual source of care (USC). The researchers found that the disparity in having a USC to be statistically nonsignificant after adding acculturation factors such as English proficiency and length of residence. Increasing levels of education and insurance were not associated with better access among Asian Americans.
AHRQ-funded; HS021684
Citation: Chang E, Chan KS, Han HR .
Effect of acculturation on variations in having a usual source of care among Asian Americans and non-Hispanic whites in California.
Am J Pub Health. 2015 Feb;105(2):398-407. doi: 10.2105/ajph.2014.301950..
Keywords: Disparities, Social Determinants of Health, Racial and Ethnic Minorities, Access to Care
Dy CY, Marx RG, Ghomrawi HM
The potential influence of regionalization strategies on delivery of care for elective total joint arthroplasty.
Regionalization of total joint arthroplasty (TJA) to high volume hospitals (HVHs) may affect access to care and complication risk. Using administrative data, the authors found that the complication risk was higher if patients went to a local low volume hospital. Black and Medicaid patients were more likely to utilize the local low volume hospital than a local HVH. Utilizing a local HVH is associated with lower complication risks, but patients from vulnerable groups were less likely to utilize these patterns.
AHRQ-funded; HS016075.
Citation: Dy CY, Marx RG, Ghomrawi HM .
The potential influence of regionalization strategies on delivery of care for elective total joint arthroplasty.
J Arthroplasty 2015 Jan;30(1):1-6. doi: 10.1016/j.arth.2014.08.017.
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Keywords: Access to Care, Disparities, Healthcare Delivery, Orthopedics, Surgery
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