National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (3)
- Behavioral Health (1)
- Blood Pressure (1)
- Cancer (3)
- Cancer: Breast Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cancer: Prostate Cancer (1)
- Cardiovascular Conditions (1)
- Chronic Conditions (4)
- COVID-19 (1)
- Critical Care (1)
- Dementia (1)
- Depression (1)
- Diabetes (4)
- Digestive Disease and Health (2)
- Disparities (9)
- (-) Elderly (23)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (2)
- Health Insurance (2)
- Health Literacy (2)
- Health Status (1)
- Heart Disease and Health (1)
- Home Healthcare (3)
- Hospital Discharge (1)
- Hospitalization (1)
- Hospital Readmissions (1)
- Human Immunodeficiency Virus (HIV) (1)
- Long-Term Care (4)
- Low-Income (1)
- Medicare (3)
- Medication (1)
- Medication: Safety (1)
- Mortality (5)
- Nursing Homes (4)
- Patient Experience (1)
- Prevention (1)
- (-) Racial and Ethnic Minorities (23)
- Risk (1)
- Screening (1)
- Social Determinants of Health (2)
- Stroke (2)
- Surgery (1)
- Telehealth (2)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 23 of 23 Research Studies DisplayedFashaw-Walters SA, McCreedy E, Bynum JPW
Disproportionate increases in schizophrenia diagnoses among Black nursing home residents with ADRD.
Investigators examined how race and Alzheimer's and related dementia (ADRD) status influenced the rate of schizophrenia diagnoses among nursing home (NH) residents following the CMS National Partnership to Improve Dementia Care. Using 2011-2015 Minimum Data Set 3.0 assessments, they found that, following the partnership, black NH residents with ADRD were more likely to have a schizophrenia diagnosis documented on their minimum data set assessments, and schizophrenia rates increased for black NH residents with ADRD only.
AHRQ-funded; HS000011.
Citation: Fashaw-Walters SA, McCreedy E, Bynum JPW .
Disproportionate increases in schizophrenia diagnoses among Black nursing home residents with ADRD.
J Am Geriatr Soc 2021 Dec;69(12):3623-30. doi: 10.1111/jgs.17464..
Keywords: Elderly, Dementia, Nursing Homes, Racial and Ethnic Minorities, Long-Term Care
Werner RM, Templeton Z, Apathy N
Trends in post-acute care in US nursing homes: 2001-2017.
The purpose of this retrospective cohort study was to describe recent trends in post-acute care provision within nursing homes, focusing specifically on nursing homes' degree of specialization in post-acute care. The investigators concluded that over the last 2 decades, post-acute care has become increasingly concentrated in a subset of nursing homes, which tend to be for-profit, part of a chain, and less likely to serve racial and ethnic minorities and persons on Medicaid.
AHRQ-funded; HS026116.
Citation: Werner RM, Templeton Z, Apathy N .
Trends in post-acute care in US nursing homes: 2001-2017.
J Am Med Dir Assoc 2021 Dec;22(12):2491-95.e2. doi: 10.1016/j.jamda.2021.06.015..
Keywords: Elderly, Nursing Homes, Racial and Ethnic Minorities
Herb J, Staley BS, Roberson M
Use and disparities in parathyroidectomy for symptomatic primary hyperparathyroidism in the Medicare population.
The investigators’ objective was to determine national usage and disparities in parathyroidectomy for symptomatic primary hyperparathyroidism among insured older adults. Data was obtained using Medicare claims. They found that parathyroidectomy was underused and recommended that quality improvement efforts, rooted in equitable care, be undertaken to increase access to parathyroidectomy for this disease.
AHRQ-funded; HS000032.
Citation: Herb J, Staley BS, Roberson M .
Use and disparities in parathyroidectomy for symptomatic primary hyperparathyroidism in the Medicare population.
Surgery 2021 Nov;170(5):1376-82. doi: 10.1016/j.surg.2021.05.026..
Keywords: Elderly, Disparities, Medicare, Surgery, Racial and Ethnic Minorities
Smith JM, Lin H, Thomas-Hawkins C
Timing of home health care initiation and 30-day rehospitalizations among Medicare beneficiaries with diabetes by race and ethnicity.
Older adults with diabetes are at elevated risk of complications following hospitalization. Home health care services mitigate the risk of adverse events and facilitate a safe transition home. In the United States, when home health care services are prescribed, federal guidelines require they begin within two days of hospital discharge. This study examined the association between timing of home health care initiation and 30-day rehospitalization outcomes in a cohort of 786,734 Medicare beneficiaries following a diabetes-related index hospitalization admission during 2015.
AHRQ-funded; HS022406.
Citation: Smith JM, Lin H, Thomas-Hawkins C .
Timing of home health care initiation and 30-day rehospitalizations among Medicare beneficiaries with diabetes by race and ethnicity.
Int J Environ Res Public Health 2021 May 25;18(11). doi: 10.3390/ijerph18115623..
Keywords: Elderly, Home Healthcare, Hospital Readmissions, Medicare, Diabetes, Chronic Conditions, Racial and Ethnic Minorities
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
Odlum M, Moise N, Kronish IM
Trends in poor health indicators among Black and Hispanic middle-aged and older adults in the United States, 1999-2018.
This study used records extracted from the Behavioral Risk Factor Surveillance System to determine which health indicators have improved or became worse among Black and Hispanic middle-aged (45 and older) adults compared to Whites from 1999 to 2018. This data is required by the Minority Health and Health Disparities Research and Education Act of 2000. A sample included of 4,856,326 participants, of them 60.9% women, mean age 60.4. During the last 20 years, Black adults showed an overall decrease showing improvement in uninsured status and physical inactivity while showing an overall increase in hypertension, diabetes, asthma, and stroke, and also the same increases and decreases in the Black-White gap. Hispanic adults showed improvement in physical inactivity and perceived poor health, while they showed overall deterioration in hypertension and diabetes. The Hispanic-White gap improved in coronary heart disease, stroke, kidney disease, asthma, arthritis, depression and physical inactivity while it increased for diabetes, hypertension, and uninsured status.
AHRQ-funded; HS025198.
Citation: Odlum M, Moise N, Kronish IM .
Trends in poor health indicators among Black and Hispanic middle-aged and older adults in the United States, 1999-2018.
JAMA Netw Open 2020 Nov 2;3(11):e2025134. doi: 10.1001/jamanetworkopen.2020.25134..
Keywords: Elderly, Racial and Ethnic Minorities, Disparities, Health Status, Health Insurance, Diabetes, Blood Pressure, Chronic Conditions
Shah SC, McKinley M, Gupta S
Population-based analysis of differences in gastric cancer incidence among races and ethnicities in individuals age 50 years and older.
There are racial and ethnic differences in the incidence of gastric adenocarcinoma worldwide and in the US. Based on a decision analysis, screening for noncardia gastric adenocarcinoma might be cost-effective for non-White individuals 50 years or older. In this study, the investigators aimed to estimate the differences in gastric adenocarcinoma incidence in specific anatomic sites among races and ethnicities in individuals 50 years or older.
AHRQ-funded; HS026395.
Citation: Shah SC, McKinley M, Gupta S .
Population-based analysis of differences in gastric cancer incidence among races and ethnicities in individuals age 50 years and older.
Gastroenterology 2020 Nov;159(5):1705-14.e2. doi: 10.1053/j.gastro.2020.07.049..
Keywords: Elderly, Cancer, Digestive Disease and Health, Racial and Ethnic Minorities, Disparities
Roberts ET, Mehrotra A
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
In this study, the investigators examined disparities in digital access (ie, access at home to technology that enables video telemedicine visits) among Medicare beneficiaries by socioeconomic and demographic characteristics. The investigators concluded that the proportion of beneficiaries who lacked digital access was higher among those with low socioeconomic status, those 85 years or older, and in communities of color.
AHRQ-funded; HS026727.
Citation: Roberts ET, Mehrotra A .
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
JAMA Intern Med 2020 Oct;180(10):1386-89. doi: 10.1001/jamainternmed.2020.2666..
Keywords: Elderly, Medicare, Telehealth, Health Information Technology (HIT), Disparities, Access to Care, Social Determinants of Health, Low-Income, Racial and Ethnic Minorities
Dos Santos Marques IC, Theiss LM, Baker SJ
Low health literacy exists in the inflammatory bowel disease (IBD) population and is disproportionately prevalent in older African Americans.
This study assessed the prevalence of low health literacy rates among adult patients with inflammatory bowel disease (IBD) in a diverse population and identified risk factors for low health literacy. IBD patients at a single institution from November 2017 to May 2018 were assessed for health literacy using the Newest Vital Sign (NWS). Secondary outcomes were length-of-stay (LOS) and 30-day readmissions after surgery. There were 175 patients surveyed who were 59% female, 23% African Americans, 91% with Crohn’s disease, and mean age was 46. Overall the low health literacy rate was 24%, with African Americans having a higher prevalence (47.5%) versus 17.0% for white IBD patients. Low health literacy was associated with older age and African American race. There were no significant differences between LOS and readmissions rates by health literacy levels.
AHRQ-funded; HS023009.
Citation: Dos Santos Marques IC, Theiss LM, Baker SJ .
Low health literacy exists in the inflammatory bowel disease (IBD) population and is disproportionately prevalent in older African Americans.
Crohns Colitis 360 2020 Oct;2(4). doi: 10.1093/crocol/otaa076..
Keywords: Elderly, Health Literacy, Digestive Disease and Health, Racial and Ethnic Minorities, Chronic Conditions
Li J, Qi M, Werner RM
Assessment of receipt of the first home health care visit after hospital discharge among older adults.
Investigators examined how often patients referred to home health care at hospital discharge receive it and whether there is evidence of disparities. Their study used Medicare data regarding the postacute home health care setting; participants were Medicare fee-for-service and Medicare Advantage beneficiaries discharged from the hospital with a referral to home health care. They found that only 54% of patients discharged received home health care services within 14 days of discharge. Of the remaining 46% discharged, 37.7% never received any home health care, while 8.3% were institutionalized or died within 14 days without a preceding home health care visit. Patients who were Black or Hispanic received home health at lower rates than did patients who were White. They concluded that disparities in the use of home health care remain an issue in the US.
AHRQ-funded; HS024266; HS026836.
Citation: Li J, Qi M, Werner RM .
Assessment of receipt of the first home health care visit after hospital discharge among older adults.
JAMA Netw Open 2020 Sep;3(9):e2015470. doi: 10.1001/jamanetworkopen.2020.15470..
Keywords: Elderly, Hospital Discharge, Home Healthcare, Disparities, Access to Care, Racial and Ethnic Minorities
Li Y, Temkin-Greener H, Shan G
COVID-19 infections and deaths among Connecticut nursing home residents: facility correlates.
This study looked at the relationship between higher registered nurse (RN) staffing, quality ratings, the concentration of Medicaid residents or racial/ethnic minorities; and the number of COVID-19 confirmed cases and deaths at nursing homes. All Connecticut nursing homes (n = 215) were included in the study. As of April 16, 2020, the average number of confirmed cases was 8 per nursing home (zero in 107 facilities) and the number of confirmed deaths was 1.7 per nursing (zero in 131 facilities). In nursing homes with at least one death, every 20-minute increase in RN staffing significantly predicted 26% fewer COVID-19 deaths and was associated with 22% fewer confirmed cases. Facilities with a high concentration of Medicaid residents or racial/ethnic minority residents had 16% and 15% more confirmed cases.
AHRQ-funded; HS024923; HS026893.
Citation: Li Y, Temkin-Greener H, Shan G .
COVID-19 infections and deaths among Connecticut nursing home residents: facility correlates.
J Am Geriatr Soc 2020 Sep;68(9):1899-906. doi: 10.1111/jgs.16689..
Keywords: Elderly, COVID-19, Nursing Homes, Long-Term Care, Mortality, Racial and Ethnic Minorities
Fashaw S, Chisholm L, Mor V
Inappropriate antipsychotic use: the impact of nursing home socioeconomic and racial composition.
Researchers examined how nursing home characteristics, particularly the racial and socioeconomic composition of residents, are associated with the inappropriate use of antipsychotics, using national data from Long-Term Care: Facts on Care. They found an overall decline in the use of antipsychotics. Although findings indicated facilities with higher proportions of blacks had lower inappropriate antipsychotic use, facility-level socioeconomic disparities continued to persist among nursing homes. They recommended that policy interventions focusing on reimbursement be considered to promote reductions in antipsychotic use, specifically among Medicaid-reliant nursing homes.
ARHQ-funded; HS000011.
Citation: Fashaw S, Chisholm L, Mor V .
Inappropriate antipsychotic use: the impact of nursing home socioeconomic and racial composition.
J Am Geriatr Soc 2020 Mar;68(3):630-36. doi: 10.1111/jgs.16316..
Keywords: Nursing Homes, Long-Term Care, Elderly, Medication, Medication: Safety, Social Determinants of Health, Disparities, Racial and Ethnic Minorities
Davis SN, Wischhusen JW, Sutton SK
Demographic and psychosocial factors associated with limited health literacy in a community-based sample of older Black Americans.
This study examined the frequency of limited health literacy and demographic and psychosocial factors associated with limited health literacy in a sample of older black Americans. The participants enrolled in a community-based intervention to promote colorectal cancer screening and completed baseline surveys that assessed their health literacy using the Rapid Estimate of Adult Literacy in Medicine, Revised (REALM-R) test, CRC awareness, cancer fatalism, Preventive Health Model (PHM) constructs, and demographics. Findings showed that limited health literacy was associated with multiple complex factors. Recommendations include interventions to incorporate patient health literacy and low-literacy materials that can be delivered through multiple channels.
AHRQ-funded; HS026120.
Citation: Davis SN, Wischhusen JW, Sutton SK .
Demographic and psychosocial factors associated with limited health literacy in a community-based sample of older Black Americans.
Patient Educ Couns 2020 Feb;103(2):385-91. doi: 10.1016/j.pec.2019.08.026..
Keywords: Health Literacy, Racial and Ethnic Minorities, Elderly, Screening, Cancer: Colorectal Cancer, Cancer, Prevention
Ning J, Peng S, Ueno N
Has racial difference in cause-specific death improved in older patients with late-stage breast cancer?
The researchers evaluated factors associated with overall, breast cancer-specific and other-cause mortalities using contemporary population data. They concluded that breast cancer-specific mortality among older women modestly improved from 2002 to 2009 across all races, but not other-cause mortality. Racial disparity in mortality persisted, but did not widen in this period.
AHRQ-funded; HS002026.
Citation: Ning J, Peng S, Ueno N .
Has racial difference in cause-specific death improved in older patients with late-stage breast cancer?
Ann Oncol 2015 Oct;26(10):2161-8. doi: 10.1093/annonc/mdv330.
.
.
Keywords: Cancer, Cancer: Breast Cancer, Elderly, Mortality, Racial and Ethnic Minorities
Kim MT, Lee JY, Ko J
Sources of response bias in older ethnic minorities: a case of Korean American elderly.
The study was undertaken to investigate potential sources of response bias in empirical research involving older ethnic minorities and to identify prudent strategies to reduce those biases, using Korean American elderly as an example. The results demonstrate sources and impacts of measurement biases in studies of older ethnic minorities. The identified response biases highlight the need for re-evaluation of current measurement practices.
AHRQ-funded; HS013160.
Citation: Kim MT, Lee JY, Ko J .
Sources of response bias in older ethnic minorities: a case of Korean American elderly.
J Cross Cult Gerontol 2015 Sep;30(3):269-83. doi: 10.1007/s10823-015-9266-9..
Keywords: Elderly, Racial and Ethnic Minorities
Guo MW, Ahn HJ, Juarez DT
Length of stay and deaths in diabetes-related preventable hospitalizations among Asian American, Pacific Islander, and white older adults on Medicare, Hawai'i, December 2006-December 2010.
The objective of this study was to compare in-hospital deaths and length of stays for diabetes-related preventable hospitalizations (D-RPHs) in Hawai‘i for Asian American, Pacific Islander, and white Medicare recipients aged 65 years or older. It found that Native Hawaiians were more likely to die during a D-RPH and were hospitalized at a younger age for a D-RPH than other studied racial/ethnic groups.
AHRQ-funded; HS019990.
Citation: Guo MW, Ahn HJ, Juarez DT .
Length of stay and deaths in diabetes-related preventable hospitalizations among Asian American, Pacific Islander, and white older adults on Medicare, Hawai'i, December 2006-December 2010.
Prev Chronic Dis 2015 Aug 6;12:E124. doi: 10.5888/pcd12.150092..
Keywords: Mortality, Hospitalization, Diabetes, Racial and Ethnic Minorities, Elderly
Chhatre S, Malkowicz SB, Schwartz JS
Understanding the racial and ethnic differences in cost and mortality among advanced stage prostate cancer patients (STROBE).
The aims of the study were to understand the racial/ethnic differences in cost of care and mortality in Medicare elderly with advanced stage prostate cancer. It found that relationship between race/ethnicity, cost of care, and mortality is intricate. For non-Hispanic black men, disparity in mortality can be attributed to treatment differences.
AHRQ-funded; HS024106.
Citation: Chhatre S, Malkowicz SB, Schwartz JS .
Understanding the racial and ethnic differences in cost and mortality among advanced stage prostate cancer patients (STROBE).
Med Health 2015 Aug;94(32):e1353. doi: 10.1097/md.0000000000001353..
Keywords: Cancer: Prostate Cancer, Mortality, Racial and Ethnic Minorities, Elderly, Disparities
Kabra R, Cram P, Girotra S
Effect of race on outcomes (stroke and death) in patients >65 years with atrial fibrillation.
The researchers sought to determine whether there are any racial differences in the outcomes of death and stroke in patients with newly diagnosed AF in patients >65 years. They found that the risks of death and stroke are higher in blacks and Hispanics compared with whites. The increased risk was eliminated or significantly reduced after adjusting for preexisting co-morbidities.
AHRQ-funded; HS021992.
Citation: Kabra R, Cram P, Girotra S .
Effect of race on outcomes (stroke and death) in patients >65 years with atrial fibrillation.
Am J Cardiol 2015 Jul 15;116(2):230-5. doi: 10.1016/j.amjcard.2015.04.012..
Keywords: Elderly, Heart Disease and Health, Cardiovascular Conditions, Racial and Ethnic Minorities, Stroke, Mortality, Risk
Lyerly MJ, Albright KC, Boehme AK
Patient selection for drip and ship thrombolysis in acute ischemic stroke.
The authors sought to determine whether the population of their offsite stroke patients receiving thrombolysis differed from patients treated directly at their stroke center. Their results showed that a smaller proportion of blacks and older adults arrived at their center from other facilities, possibly reflecting differences in how patients are selected for thrombolysis and transferred to a higher level of care.
AHRQ-funded; HS013852.
Citation: Lyerly MJ, Albright KC, Boehme AK .
Patient selection for drip and ship thrombolysis in acute ischemic stroke.
South Med J 2015 Jul;108(7):393-8. doi: 10.14423/smj.0000000000000306.
.
.
Keywords: Critical Care, Elderly, Stroke, Racial and Ethnic Minorities
McGarry BE, Temkin-Greener H, Li Y
Role of race and ethnicity in private long-term care insurance ownership.
The authors sought to determine if racial/ethnic disparities exist in the ownership of private long-term care insurance (LTCI) among current Medicare beneficiaries. They found that 12.3% of Blacks and 5.8% of Hispanics, compared with 20.2% of Whites, reported having LTCI coverage and that Hispanics were 48% less likely to have LTCI compared with Whites. Hispanic women were 81% less likely to be insured compared with White women.
AHRQ-funded; HS000044.
Citation: McGarry BE, Temkin-Greener H, Li Y .
Role of race and ethnicity in private long-term care insurance ownership.
Gerontologist 2014 Dec;54(6):1001-12. doi: 10.1093/geront/gnt102.
.
.
Keywords: Disparities, Elderly, Health Insurance, Long-Term Care, Racial and Ethnic Minorities
Abara WE, Smith L, Zhang S
The influence of race and comorbidity on the timely initiation of antiretroviral therapy among older persons living with HIV/AIDS.
In this article, the investigators examined whether the timely initiation of antiretroviral therapy (ART) differed by race and comorbidity among older (>/= 50 years) people living with HIV/AIDS (PLWHA). The investigators concluded that comorbidities affected timely ART initiation in older PLWHA. They asserted that older PLWHA may benefit from integrating and coordinating HIV care with care for other comorbidities and the development of ART treatment guidelines specific to this population.
AHRQ-funded; HS019470.
Citation: Abara WE, Smith L, Zhang S .
The influence of race and comorbidity on the timely initiation of antiretroviral therapy among older persons living with HIV/AIDS.
Am J Public Health 2014 Nov;104(11):e135-41. doi: 10.2105/ajph.2014.302227..
Keywords: Elderly, Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities
Jang Y, Chiriboga DA, Molinari V
Telecounseling for the linguistically isolated: a pilot study with older Korean immigrants.
This study explored the feasibility and preliminary efficacy of a telecounseling program in the client’s native language. Participants who were native Korean language speakers living in Florida showed generally high levels of acceptance and adherence to the telecounseling program. The high retention of the participants may be due to multiple factors including brevity of the program and convenience of the location.
AHRQ-funded; HS020636
Citation: Jang Y, Chiriboga DA, Molinari V .
Telecounseling for the linguistically isolated: a pilot study with older Korean immigrants.
Gerontologist 2014 Apr;54(2):290-6. doi: 10.1093/geront/gns196..
Keywords: Depression, Elderly, Health Information Technology (HIT), Behavioral Health, Racial and Ethnic Minorities, Telehealth
Sorkin DH, Ngo-Metzger Q
AHRQ Author: Ngo-Metzger Q
The unique health status and health care experiences of older Asian Americans: research findings and treatment recommendations.
Asian Americans over 65 years of age are among the fastest growing minority groups in the United States. Although the health status of Asian Americans when considered as a group is remarkably good, certain Asian American groups suffer high rates of illness and disability from specific health causes. This article discusses the unique health status and health care experiences of older Asian Americans and includes research findings and treatment recommendations.
AHRQ-authored.
Citation: Sorkin DH, Ngo-Metzger Q .
The unique health status and health care experiences of older Asian Americans: research findings and treatment recommendations.
Clin Gerontol 2014 2014/11/06;37(1):18-32. doi: 10.1080/07317115.2013.847513..
Keywords: Elderly, Patient Experience, Racial and Ethnic Minorities