National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
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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 13 of 13 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
Pylypchuk Y, Kirby JB
AHRQ Author: Kirby JB
The role of marriage in explaining racial and ethnic disparities in access to health care for men in the US.
The researchers investigated the association between marriage and access to health care among men, and estimate the extent to which racial and ethnic differences in both the returns to marriage and marital rates explain differences in access and preventive service use. They found that marriage accounts for up to 24 percent of racial and ethnic differences in access and preventive use.
AHRQ-authored.
Citation: Pylypchuk Y, Kirby JB .
The role of marriage in explaining racial and ethnic disparities in access to health care for men in the US.
Review of Economics of the Household 2017 Sep;15(3):807-32..
Keywords: Medical Expenditure Panel Survey (MEPS), Disparities, Racial and Ethnic Minorities, Access to Care
Angier H, Hoopes M, Marino M
Uninsured primary care visit disparities under the Affordable Care Act.
The researchers aimed to assess changes in insurance coverage at community health center (CHC) visits after the Patient Protection and Affordable Care Act (ACA) Medicaid expansion by race and ethnicity. After the ACA was implemented, uninsured visit rates decreased for all racial and ethnic groups. Hispanic patients experienced the greatest increases in Medicaid-insured visit rates after ACA implementation in expansion states.
AHRQ-funded; HS024270.
Citation: Angier H, Hoopes M, Marino M .
Uninsured primary care visit disparities under the Affordable Care Act.
Ann Fam Med 2017 Sep;15(5):434-42. doi: 10.1370/afm.2125.
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Keywords: Uninsured, Primary Care, Disparities, Healthcare Utilization, Access to Care
Kim G, Dautovich N, Ford KL
Geographic variation in mental health care disparities among racially/ethnically diverse adults with psychiatric disorders.
The main purpose of this study is to examine geographic variation in unmet need for mental health care among racially/ethnically diverse adults with psychiatric disorders in the US. It found that Latinos in the South, Blacks and Latinos in the Midwest, and Latinos and Asians in the West had higher unmet need than non-Hispanic Whites, whereas no significant racial/ethnic effects were found in the Northeast.
AHRQ-funded; HS021486.
Citation: Kim G, Dautovich N, Ford KL .
Geographic variation in mental health care disparities among racially/ethnically diverse adults with psychiatric disorders.
Soc Psychiatry Psychiatr Epidemiol 2017 Aug;52(8):939-48. doi: 10.1007/s00127-017-1401-1.
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Keywords: Access to Care, Disparities, Behavioral Health, Racial and Ethnic Minorities
Carr BG, Bowman AJ, Wolff CS
Disparities in access to trauma care in the United States: a population-based analysis.
This study examined the association between geographic, demographic, and socioeconomic factors and trauma center access, with subgroup analyses of urban-rural disparities. It concluded that, while the majority of the United States has access to trauma care within an hour, almost 30 million US residents do not. Significant disparities in access were evident for vulnerable populations defined by insurance status, income, and rurality.
AHRQ-funded; HS017960.
Citation: Carr BG, Bowman AJ, Wolff CS .
Disparities in access to trauma care in the United States: a population-based analysis.
Injury 2017 Feb;48(2):332-38. doi: 10.1016/j.injury.2017.01.008.
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Keywords: Access to Care, Disparities, Health Services Research (HSR), Social Determinants of Health, Trauma
Cook BL, Trinh NH, Li Z
Trends in racial-ethnic disparities in access to mental health care, 2004-2012.
This study compared trends in racial-ethnic disparities in mental health care access among whites, blacks, Hispanics, and Asians by using the Institute of Medicine definition of disparities as all differences except those due to clinical appropriateness, clinical need, and patient preferences. The investigators found that significant disparities were found in 2004-2005 and in 2011-2012 for all three racial-ethnic minority groups compared with whites in all three measures of access.
AHRQ-funded; HS021486.
Citation: Cook BL, Trinh NH, Li Z .
Trends in racial-ethnic disparities in access to mental health care, 2004-2012.
Psychiatr Serv 2017 Jan;68(1):9-16. doi: 10.1176/appi.ps.201500453..
Keywords: Access to Care, Disparities, Behavioral Health, Racial and Ethnic Minorities
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