National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Chronic Conditions (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- COVID-19 (1)
- Diabetes (1)
- Disparities (6)
- Elderly (2)
- Healthcare Costs (1)
- Health Insurance (2)
- Home Healthcare (1)
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- Hospital Readmissions (2)
- Hospitals (1)
- Human Immunodeficiency Virus (HIV) (1)
- Low-Income (1)
- (-) Medicare (9)
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- Quality Improvement (1)
- Quality Measures (1)
- Quality of Care (2)
- (-) Racial and Ethnic Minorities (9)
- Surgery (2)
- Uninsured (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 9 of 9 Research Studies DisplayedSong Zhang, Zhang X, Patterson LJ
Racial and ethnic disparities in hospitalization outcomes among Medicare beneficiaries during the COVID-19 pandemic.
This study assessed assess racial and ethnic differences in hospitalization outcomes during the COVID-19 pandemic among Medicare beneficiaries. Medicare claims from the Social Security Administration was used to determine in-hospital mortality and mortality inclusive of discharges to hospice and discharges to postacute care. Over 31 million Medicare recipients in the database were analyzed with over 14 million hospitalizations from January 2019 to February 2021. There was a decline in non-COVID-19 and an emergence of COVID-19 hospitalizations among beneficiaries of different racial and ethnic minority groups through February 2021. In-hospital mortality was not significantly different among Black patients relative to White patients but was 3.5 percentage points higher among Hispanic patients and other racial and ethnic minority groups. There were disparities in discharges to hospice and postacute care as well.
AHRQ-funded; HS024072.
Citation: Song Zhang, Zhang X, Patterson LJ .
Racial and ethnic disparities in hospitalization outcomes among Medicare beneficiaries during the COVID-19 pandemic.
JAMA Health Forum 2021 Dec 23;2(12):e214223. doi: 10.1001/jamahealthforum.2021.4223..
Keywords: COVID-19, Racial and Ethnic Minorities, Disparities, Medicare, Hospitalization, Outcomes, Mortality
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
Grafova IB, Jarrín OF
Beyond Black and White: mapping misclassification of Medicare beneficiaries race and ethnicity.
This study examined state-level variation in racial/ethnic misclassification of race and ethnicity in the Centers for Medicare and Medicaid Services administrative database using the enrollment database (EDB) beneficiary race code and the Research Triangle Institute (RTI) race code. The cohort included 4,231,370 Medicare beneficiaries who utilized home health care services in 2015. The authors found substantial variation between states in misclassification of self-identified Hispanic, Asian American/Pacific Islander, and American Indian/Alaska Native beneficiaries.
AHRQ-funded; HS022406.
Citation: Grafova IB, Jarrín OF .
Beyond Black and White: mapping misclassification of Medicare beneficiaries race and ethnicity.
Med Care Res Rev 2021 Oct;78(5):616-26. doi: 10.1177/1077558720935733..
Keywords: Medicare, Racial and Ethnic Minorities, Disparities
Markovitz AA, Ayanian JZ, Warrier A
Medicare Advantage plan double bonuses drive racial disparity in payments, yield no quality or enrollment improvements.
Using national data for 2008-18, investigators found that double bonuses were not associated with either improvements in plan quality or increased Medicare Advantage enrollment. Additionally, double bonuses increased payments to plans to care for Black beneficiaries by $60 per year, compared with $91 for White beneficiaries. These findings suggest that double bonuses not only fail to improve quality and enrollment but also foster a racially inequitable distribution of Medicare funds that disfavors Black beneficiaries. This study supports eliminating double bonuses, thereby saving Medicare an estimated $1.8 billion per year.
AHRQ-funded; HS000053.
Citation: Markovitz AA, Ayanian JZ, Warrier A .
Medicare Advantage plan double bonuses drive racial disparity in payments, yield no quality or enrollment improvements.
Health Aff 2021 Sep;40(9):1411-19. doi: 10.1377/hlthaff.2021.00349..
Keywords: Medicare, Health Insurance, Payment, Quality Improvement, Quality of Care, Disparities, Racial and Ethnic Minorities
Meyers DJ, Rahman M, Mor V
Association of Medicare Advantage Star Ratings with racial, ethnic, and socioeconomic disparities in quality of care.
This cross-sectional study looked at racial/ethnic minority and socioeconomic disparities in ratings for Medicare Advantage (MA) plans, which disproportionately enroll these populations. A total of 1,578,564 enrollees were included in this analysis that used 22 measures of quality and satisfaction at the individual enrollee level, aggregated into simulated star ratings from 2-5 stratified by socioeconomic status (SES) and race/ethnicity. Low SES enrollees had simulated stratified star ratings 0.5 stars lower than individuals with high SES in the same contract. Black enrollees had simulated star ratings that were 0.3 stars lower and Hispanic enrollees had 0.1 lower simulated star ratings than White enrollees in the same contract. There was a larger difference in ratings with 4.5 to 5-star contracts with Black and Hispanic enrollees with Whites, and no statistical difference in 2.0 to 2.5 star-rated contracts. There was only low correlation between simulated ratings for enrollees of low SES and high SES.
AHRQ-funded; HS02705101.
Citation: Meyers DJ, Rahman M, Mor V .
Association of Medicare Advantage Star Ratings with racial, ethnic, and socioeconomic disparities in quality of care.
JAMA Health Forum 2021 Jun;2(6):e210793..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Medicare, Patient Experience, Disparities, Quality Measures, Provider Performance, Quality of Care, 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
Shih T, Ryan AM, Gonzalez AA
Medicare's hospital readmissions reduction program in surgery may disproportionately affect minority-serving hospitals.
The authors aimed to project readmission penalties for hospitals performing cardiac surgery and examine how these penalties will affect minority-serving hospitals. They found that minority-serving hospitals would disproportionately bear the burden of readmission penalties if expanded to include cardiac surgery.
AHRQ-funded; HS018546.
Citation: Shih T, Ryan AM, Gonzalez AA .
Medicare's hospital readmissions reduction program in surgery may disproportionately affect minority-serving hospitals.
Ann Surg 2015 Jun;261(6):1027-31. doi: 10.1097/sla.0000000000000778.
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Keywords: Hospitals, Medicare, Racial and Ethnic Minorities, Hospital Readmissions, Surgery
Yehia BR, Fleishman JA, Agwu AL
AHRQ Author: Fleishman JA
Health insurance coverage for persons in HIV care, 2006-2012.
The authors examined trends in health insurance coverage at 11 US HIV clinics between 2006 and 2012. They found that Medicaid coverage was more prevalent among women than men; blacks and Hispanics than whites; and individuals with injection drug use risk compared with other transmission risk factors, with Hispanics and younger age groups more likely to be uninsured than other racial/ethnic and older age groups, respectively.
AHRQ-authored; AHRQ-funded; 290201100007C.
Citation: Yehia BR, Fleishman JA, Agwu AL .
Health insurance coverage for persons in HIV care, 2006-2012.
J Acquir Immune Defic Syndr 2014 Sep 1;67(1):102-6. doi: 10.1097/qai.0000000000000251.
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Keywords: Health Insurance, Human Immunodeficiency Virus (HIV), Medicare, Racial and Ethnic Minorities, Uninsured
McGarry BE, Strawderman RL, Li Y
Lower Hispanic participation in Medicare Part D may reflect program barriers.
This study found that Hispanics were 35 percent less likely than non-Hispanic whites to have Medicare Part D coverage. This difference may be driven by ethnic disparities among those eligible for the low-income Part D subsidy but not automatically enrolled in it.
AHRQ-funded; HS00044
Citation: McGarry BE, Strawderman RL, Li Y .
Lower Hispanic participation in Medicare Part D may reflect program barriers.
Health Aff. 2014 May;33(5):856-62. doi: 10.1377/hlthaff.2013.0671..
Keywords: Medicare, Disparities, Racial and Ethnic Minorities, Low-Income, Healthcare Costs