National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- (-) Children's Health Insurance Program (CHIP) (18)
- (-) Children/Adolescents (18)
- Disparities (1)
- Electronic Health Records (EHRs) (1)
- Healthcare Costs (2)
- Healthcare Utilization (1)
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- Health Services Research (HSR) (3)
- Low-Income (2)
- Medicaid (8)
- Medical Expenditure Panel Survey (MEPS) (1)
- Patient-Centered Healthcare (1)
- Policy (1)
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- Quality Indicators (QIs) (1)
- Quality Measures (6)
- Quality of Care (8)
- Racial and Ethnic Minorities (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 18 of 18 Research Studies DisplayedAllen CD
Who loses public health insurance when states pass restrictive omnibus immigration-related laws? The moderating role of county Latino density.
Using comparative interrupted time series methods and a nationally-representative sample of US citizen, Latino children with noncitizen parents from the National Health Interview Survey (2005-2014, n=18,118), this study found that living in counties with higher co-ethnic density placed children at greater risk of losing Medicaid and Children's Health Insurance Program coverage when their states passed restrictive state omnibus immigrant laws.
AHRQ-funded; HS024248.
Citation: Allen CD .
Who loses public health insurance when states pass restrictive omnibus immigration-related laws? The moderating role of county Latino density.
Health Place 2018 Nov;54:20-28. doi: 10.1016/j.healthplace.2018.08.023..
Keywords: Access to Care, Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Medicaid, Racial and Ethnic Minorities
Silber JH, Zeigler AE, Reiter JG
Using appendicitis to improve estimates of childhood Medicaid participation rates.
This study introduces appendectomy-based participation (ABP) to estimate statewide Medicaid/Children's Health Insurance Program participation rates using claims by taking advantage of a natural experiment around statewide appendicitis admissions to improve the accuracy of participation rate estimates. The study concluded that using the ABP rate derived from Medicaid Analytic eXtract (MAX) administrative claims is a valid method to estimate statewide public insurance participation rates in children.
AHRQ-funded; HS023258; HS021112.
Citation: Silber JH, Zeigler AE, Reiter JG .
Using appendicitis to improve estimates of childhood Medicaid participation rates.
Acad Pediatr 2018 Jul;18(5):593-600. doi: 10.1016/j.acap.2018.03.008..
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Medicaid
Ireys HT, Brach C, Anglin G
AHRQ Author: Brach C
After the demonstration: what states sustained after the end of federal grants to improve children's health care quality.
As part of the CHIPRA Quality Demonstration Grant Program’s multifaceted evaluation, this study examined the extent to which states sustained key program activities after the demonstration ended. It concluded that as a result of the federal government's investment in this grant program, many demonstration states are in a strong position to extend and spread specific strategies for improving the quality of care for children in Medicaid and CHIP.
AHRQ-authored; AHRQ-funded; 29020090002191.
Citation: Ireys HT, Brach C, Anglin G .
After the demonstration: what states sustained after the end of federal grants to improve children's health care quality.
Matern Child Health J 2018 Feb;22(2):195-203. doi: 10.1007/s10995-017-2391-z.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Quality of Care, Health Insurance, Medicaid
Burton RA, Peters RA, Devers KJ
Perspectives on implementing quality improvement collaboratives effectively: qualitative findings from the CHIPRA quality demonstration grant program.
The most frequently pursued intervention in the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) quality demonstration (2010-2015) was quality improvement collaboratives. This study was conducted to identify which aspects of these collaboratives were viewed by organizers and participants as working well and which were not. It found that aspects of collaboratives that interviewees valued were aimed at attracting participation, maintaining engagement, or facilitating learning.
AHRQ-funded; 2902009000191.
Citation: Burton RA, Peters RA, Devers KJ .
Perspectives on implementing quality improvement collaboratives effectively: qualitative findings from the CHIPRA quality demonstration grant program.
Jt Comm J Qual Patient Saf 2018 Jan;44(1):12-22. doi: 10.1016/j.jcjq.2017.08.004.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Quality of Care, Quality Improvement
Christensen AL, Zickafoose JS, Natzke B
Associations between practice-reported medical homeness and health care utilization among publicly insured children.
This study assessed the relationship between having a patient-centered medical home and use of health services by children enrolled in Medicaid in three States. The researchers found that medical homeness was not associated with the likelihood of receiving well-child care. Association of medical homeness with non-urgent, preventable, or avoidable emergency department visits varied.
AHRQ-funded; 290200900019I
Citation: Christensen AL, Zickafoose JS, Natzke B .
Associations between practice-reported medical homeness and health care utilization among publicly insured children.
Acad Pediatr. 2015 May-Jun;15(3):267-74. doi: 10.1016/j.acap.2014.12.001..
Keywords: Children/Adolescents, Medicaid, Patient-Centered Healthcare, Children's Health Insurance Program (CHIP), Healthcare Utilization
Hudson JL, Hill SC, Selden TM
AHRQ Author: Hudson JL, Hill SC, Selden TM
If rollbacks go forward, up to 14 million children could become ineligible for public or subsidized coverage by 2019.
This study investigated the potential health insurance options available to low-income children if federal CHIP funding ends in 2017 or if federal requirements change in 2019, allowing states to roll back Medicaid- and CHIP-eligibility thresholds to minimum levels. It found that the percentage of low-income children ineligible for public coverage or subsidized Marketplace coverage would increase from 22 percent in 2014 (12.5 million children) to 46 percent after 2019 (26.5 million children).
Citation: Hudson JL, Hill SC, Selden TM .
If rollbacks go forward, up to 14 million children could become ineligible for public or subsidized coverage by 2019.
Health Aff 2015 May;34(5):864-70. doi: 10.1377/hlthaff.2015.0004..
Keywords: Children's Health Insurance Program (CHIP), Children/Adolescents, Health Insurance, Low-Income
Pati S, Wong AT, Calixte RE
Medicaid and CHIP retention among children in 12 states.
The authors sought to determine reproducibility of public insurance retention rates for children using 3 different metrics at the state and county level. They found that all 3 metrics demonstrated reproducible estimates at the state level. Reproducibility of relative rankings for child health insurance retention of counties within states were sensitive to county child population size and the amount of variability in retention rates within the county and at the state level.
AHRQ-funded; HS020508.
Citation: Pati S, Wong AT, Calixte RE .
Medicaid and CHIP retention among children in 12 states.
Acad Pediatr 2015 May-Jun;15(3):249-57. doi: 10.1016/j.acap.2014.09.012.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Policy, Medicaid
Selden TM, Dubay L, Miller GE
AHRQ Author: Selden TM, Miller GE
Many families may face sharply higher costs if public health insurance for their children is rolled back.
If possible cuts to the Children’s Health Insurance Program (CHIP) and elimination of the Affordable Care Act’s “maintenance of effort” provisions regarding Medicaid and CHIP take place; this study shows that many families would face sharply higher costs of providing insurance coverage for their children.
AHRQ Author
Citation: Selden TM, Dubay L, Miller GE .
Many families may face sharply higher costs if public health insurance for their children is rolled back.
Health Aff. 2015 Apr;34(4):697-706. doi: 10.1377/hlthaff.2015.0003..
Keywords: Children's Health Insurance Program (CHIP), Healthcare Costs, Children/Adolescents
DeVoe JE, Marino M, Angier H
Effect of expanding Medicaid for parents on children's health insurance coverage: lessons from the Oregon Experiment.
This study estimated the effect on a child’s health insurance coverage status when (1) a parent randomly gains access to health insurance and (2) a parent obtains coverage. It found that children’s odds of having Medicaid or CHIP coverage increased when their parents were randomly selected to apply for Medicaid. Children whose parents were selected and subsequently obtained coverage benefited most.
AHRQ-funded; HS018569
Citation: DeVoe JE, Marino M, Angier H .
Effect of expanding Medicaid for parents on children's health insurance coverage: lessons from the Oregon Experiment.
JAMA Surg. 2015 Mar;150(3):223-8. doi: 10.1001/jamasurg.2014.2239..
Keywords: Medicaid, Health Insurance, Children's Health Insurance Program (CHIP), Children/Adolescents
Miller D, Noonan K, Fiks AG
Increasing pediatrician participation in EHR incentive programs.
The authors addressed potential causes of the variability of pediatrician registration in the meaningful use (MU) program and suggested specific solutions to support effective pediatric electronic health record implementation across all states. They concluded that implementing their proposed solutions would support pediatricians’ use of electronic health records, with an ultimate goal of improving child health.
AHRQ-funded; HS022689.
Citation: Miller D, Noonan K, Fiks AG .
Increasing pediatrician participation in EHR incentive programs.
Pediatrics 2015 Jan;135(1):e1-4. doi: 10.1542/peds.2014-2438.
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Keywords: Children's Health Insurance Program (CHIP), Electronic Health Records (EHRs), Provider: Health Personnel, Medicaid, Children/Adolescents
Mistry KB, Chesley F, Llanos K
AHRQ Author: Mistry KB, Chesley F, Dougherty D.
Advancing children's health care and outcomes through the pediatric quality measures program.
This article focuses on the Pediatric Quality Measures Program and provides an overview of the program's goals and related activities, lessons learned, and future opportunities.
AHRQ-authored.
Citation: Mistry KB, Chesley F, Llanos K .
Advancing children's health care and outcomes through the pediatric quality measures program.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S19-26. doi: 10.1016/j.acap.2014.06.025.
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Keywords: Children's Health Insurance Program (CHIP), Quality of Care, Health Services Research (HSR), Children/Adolescents, Quality Measures
Kuhlthau KA, Mistry KB, Forrest CB
AHRQ Author: Mistry KB, Dougherty D
Advancing the science of measurement in pediatric quality of care.
This overview describes the articles in this supplement as falling into 3 broad themes: the value of pediatric quality measures to stakeholders; the scope of the CHIPRA Pediatric Quality Measures Program measurement initiative; and challenges in developing and testing pediatric quality measures. It concludes that the articles illustrate the considerations necessary for creating good measure sets and provide strategies for overcoming challenges encountered in the measurement development process.
AHRQ-authored; AHRQ-funded; HS020408.
Citation: Kuhlthau KA, Mistry KB, Forrest CB .
Advancing the science of measurement in pediatric quality of care.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S1-3. doi: 10.1016/j.acap.2014.06.016..
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Children/Adolescents, Quality Measures, Quality Measures
Dougherty D, Mistry KB, Llanos K
AHRQ Author: Dougherty D, Mistry KB, Chesley F
An AHRQ and CMS perspective on the pediatric quality measures program.
This article describes the Pediatric Quality Measures Program (PQMP). The PQMP has worked to close gaps in children’s health care quality by increasing the portfolio of new measures and methods as envisioned by the CHIPRA legislation. It is the adoption and use of these measures that can lead to improvements in the quality of care and elimination of disparities in health care for children over time.
AHRQ-authored.
Citation: Dougherty D, Mistry KB, Llanos K .
An AHRQ and CMS perspective on the pediatric quality measures program.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S17-8. doi: 10.1016/j.acap.2014.06.017.
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Keywords: Children's Health Insurance Program (CHIP), Quality of Care, Health Services Research (HSR), Children/Adolescents, Quality Measures
Byron SC, Gardner W, Kleinman LC
Developing measures for pediatric quality: methods and experiences of the CHIPRA pediatric quality measures program grantees.
The authors described the processes used by the Pediatric Quality Measures Program (PQMP) grantees to develop measures to assess the health care of children and adolescents in Medicaid and the Children's Health Insurance Program. They found that PQMP grantees faced common challenges, including the limited evidence base, data systems difficult or unsuited for measures reporting, and conflicting stakeholder priorities. Grantees were able to explore innovative methods to overcome measurement challenges, resulting in new quality measures for pediatric care.
AHRQ-funded; HS020513; HS020498; HS020516; HS020506; HS020518; HS020508; HS020503.
Citation: Byron SC, Gardner W, Kleinman LC .
Developing measures for pediatric quality: methods and experiences of the CHIPRA pediatric quality measures program grantees.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S27-32. doi: 10.1016/j.acap.2014.06.013.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Quality of Care, Children/Adolescents, Quality Measures
Dougherty D, Mistry KB, Lindly O
AHRQ Author: Dougherty D, Mistry KB, Desoto M, Chesley F
Systematic evidence-based quality measurement life-cycle approach to measure retirement in CHIPRA.
The authors assessed selected child core set (CCS) measures for potential retirement. The Subcommittee of the National Advisory Council on Healthcare Research and Quality recommended 3 measures for retirement: access to primary care; testing for strep before recommending antibiotics for pharyngitis; and annual HbA1c testing of children with diabetes. CMS recommended that state Medicaid and CHIP programs retire 2 of the recommended measures from the CCS, but retained the access to primary care measure.
AHRQ-authored.
Citation: Dougherty D, Mistry KB, Lindly O .
Systematic evidence-based quality measurement life-cycle approach to measure retirement in CHIPRA.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S97-s103. doi: 10.1016/j.acap.2014.06.015.
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Keywords: Children's Health Insurance Program (CHIP), Quality of Care, Health Services Research (HSR), Children/Adolescents, Quality Measures
Gidengil C, Mangione-Smith R, Bailey LC
Using Medicaid and CHIP claims data to support pediatric quality measurement: lessons from 3 centers of excellence in measure development.
The investigators sought to explore the claims data-related issues relevant to quality measure development for Medicaid and the Children's Health Insurance Program (CHIP), illustrating the challenges encountered and solutions developed around 3 distinct performance measure topics: care coordination for children with complex needs, quality of care for high-prevalence conditions, and hospital readmissions. Their three Centers of Excellence in pediatric quality measurement used innovative methods to develop algorithms that use Medicaid claims data to identify children with complex needs; to overcome some shortcomings of existing data for measuring quality of care for common conditions such as otitis media; and to identify readmissions after hospitalizations for lower respiratory infections.
AHRQ-funded; HS020513; HS020506; HS020508.
Citation: Gidengil C, Mangione-Smith R, Bailey LC .
Using Medicaid and CHIP claims data to support pediatric quality measurement: lessons from 3 centers of excellence in measure development.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S76-81. doi: 10.1016/j.acap.2014.06.014.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Medicaid, Quality Indicators (QIs), Quality Measures, Quality of Care
Abdus S, Hudson J, Hill SC
AHRQ Author: Abdus S, Hudson J, Hill SC, Selden TM
Children's health insurance program premiums adversely affect enrollment, especially among lower-income children.
Using MEPS data, the authors showed that the relationship between premiums and coverage varies considerably by income level and by parental access to employer-sponsored insurance. They found that the increase in uninsurance is largest among children whose parents lack offers of employer coverage.
AHRQ-authored.
Citation: Abdus S, Hudson J, Hill SC .
Children's health insurance program premiums adversely affect enrollment, especially among lower-income children.
Health Aff 2014 Aug;33(8):1353-60. doi: 10.1377/hlthaff.2014.0182.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Healthcare Costs, Medical Expenditure Panel Survey (MEPS), Low-Income
Dougherty D, Chen X, Gray DT
AHRQ Author: Dougherty D, Gray DT
Child and adolescent health care quality and disparities: are we making progress?
The authors sought to examine trends over time in health care quality and disparities by race, Hispanic ethnicity, income, insurance, gender, rurality, and special health care needs. Using data from the 2011 National Healthcare Quality Report and Naitonal Healthcare Disparities Reprot, they found that there was some progress in health care quality and reducing disparities in children's health care quality from 2000 to 2009, but opportunities for targeting improvement strategies remain.
AHRQ-authored.
Citation: Dougherty D, Chen X, Gray DT .
Child and adolescent health care quality and disparities: are we making progress?
Acad Pediatr 2014 Mar-Apr;14(2):137-48. doi: 10.1016/j.acap.2013.11.008.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Disparities, Quality of Care