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 (8)
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Behavioral Health (2)
- Blood Pressure (1)
- Cancer (4)
- Cancer: Breast Cancer (1)
- Cardiovascular Conditions (1)
- Care Management (1)
- Centers for Education and Research on Therapeutics (CERTs) (1)
- Children's Health Insurance Program (CHIP) (4)
- Children/Adolescents (8)
- Chronic Conditions (4)
- Colonoscopy (1)
- Data (3)
- Dental and Oral Health (3)
- Diabetes (2)
- Disparities (4)
- Elderly (3)
- Electronic Health Records (EHRs) (3)
- Emergency Department (4)
- Emergency Medical Services (EMS) (2)
- Evidence-Based Practice (1)
- Eye Disease and Health (1)
- Healthcare Cost and Utilization Project (HCUP) (5)
- Healthcare Costs (23)
- Healthcare Delivery (4)
- Healthcare Utilization (6)
- Health Information Technology (HIT) (1)
- (-) Health Insurance (80)
- Health Services Research (HSR) (3)
- Health Status (2)
- Heart Disease and Health (1)
- Hospitalization (1)
- Hospital Readmissions (1)
- Hospitals (1)
- Human Immunodeficiency Virus (HIV) (1)
- Injuries and Wounds (1)
- Intensive Care Unit (ICU) (1)
- Kidney Disease and Health (1)
- Labor and Delivery (2)
- Lifestyle Changes (1)
- Long-Term Care (1)
- Low-Income (12)
- Medicaid (19)
- Medical Expenditure Panel Survey (MEPS) (11)
- Medicare (9)
- Medication (5)
- Mortality (1)
- Newborns/Infants (1)
- Nursing Homes (1)
- Obesity (1)
- Outcomes (2)
- Patient-Centered Healthcare (1)
- Patient Adherence/Compliance (2)
- Patient and Family Engagement (1)
- Payment (4)
- Policy (15)
- Practice-Based Research Network (PBRN) (1)
- Pregnancy (2)
- Prevention (4)
- Primary Care (5)
- Provider: Health Personnel (1)
- Racial and Ethnic Minorities (4)
- Screening (1)
- Sex Factors (1)
- Shared Decision Making (1)
- Sickle Cell Disease (1)
- Sleep Problems (1)
- Social Determinants of Health (3)
- Substance Abuse (1)
- Surgery (5)
- Tobacco Use (1)
- Trauma (1)
- Treatments (2)
- Uninsured (8)
- Women (1)
- Young Adults (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
26 to 50 of 80 Research Studies DisplayedAkosa Antwi Y, Moriya AS, Simon K
AHRQ Author: Moriya AS
Changes in emergency department use among young adults after the Patient Protection and Affordable Care Act's dependent coverage provision.
This study examined the effects of the Affordable Care Act’s expansion of family insurance coverage to include dependents up to the age of 26 on the use of the emergency department by 19 to 25 year young adults. It found a modest but statistically significant decrease in ED use related to weekday visits, nonurgent conditions and conditions treatable in other settings.
AHRQ Author
Citation: Akosa Antwi Y, Moriya AS, Simon K .
Changes in emergency department use among young adults after the Patient Protection and Affordable Care Act's dependent coverage provision.
Ann Emerg Med. 2015 Jun;65(6):664-672.e2. doi: 10.1016/j.annemergmed.2015.01.010..
Keywords: Healthcare Costs, Emergency Department, Health Insurance
Akosa Antwi Y, Moriya AS, Simon K
AHRQ Author: Moriya AS
Changes in emergency department use among young adults after the Patient Protection and Affordable Care Act's dependent coverage provision.
The researchers evaluated the effect of the Patient Protection and Affordable Care Act insurance expansion on ED use among young adults. They found a modest decrease in ED use of young adults aged 19 to 25 years compared with those aged 27 to 29 years, particularly for less urgent conditions.
AHRQ-authored.
Citation: Akosa Antwi Y, Moriya AS, Simon K .
Changes in emergency department use among young adults after the Patient Protection and Affordable Care Act's dependent coverage provision.
Ann Emerg Med 2015 Jun;65(6):664-72.e2. doi: 10.1016/j.annemergmed.2015.01.010..
Keywords: Emergency Department, Emergency Medical Services (EMS), Health Insurance
DeCamp M, Sugarman J, Berkowitz SA
Meaningfully engaging patients in ACO decision making.
In this article, the authors describe how ACOs can achieve meaningful system-level patient engagement. They specify a three-step engagement framework: identifying beneficiary representatives, cultivating relationships, and evaluating engagement. They conclude that their proposed three-step framework can help accountable care organizations (ACOs) conceptualize a plan for meaningfully engaging patients in ACO governance.
AHRQ-funded; HS023684.
Citation: DeCamp M, Sugarman J, Berkowitz SA .
Meaningfully engaging patients in ACO decision making.
Am J Accountable Care 2015 Jun;3(2):30-33.
.
.
Keywords: Patient and Family Engagement, Shared Decision Making, Health Insurance, Healthcare Delivery
Hirth RA, Gibson TB, Levy HG
New evidence on the persistence of health spending.
Using the MarketScan claims database, the researchers characterized the persistence of health care spending in the privately insured, under-65 population. They found that over a 6-year period,69.8 percent of enrollees never had annual spending in the top 10 percent of the distribution and the bottom 50 percent of spenders accounted for less than 10 percent of spending.
AHRQ-funded; HS017706.
Citation: Hirth RA, Gibson TB, Levy HG .
New evidence on the persistence of health spending.
Med Care Res Rev 2015 Jun;72(3):277-97. doi: 10.1177/1077558715572387..
Keywords: Healthcare Costs, Health Insurance, Data
Sommers BD, Maylone B, Nguyen KH
The impact of state policies on ACA applications and enrollment among low-income adults in Arkansas, Kentucky, and Texas.
The researchers surveyed nearly 3,000 low-income adults in late 2014 to compare experiences in three states with markedly different policies: Kentucky, Arkansas, and Texas. They found that application rates, successful enrollment, and positive experiences with the ACA were highest in Kentucky, followed by Arkansas, with Texas performing worst. Limited awareness remains a critical barrier: Fewer than half of adults had heard some or a lot about the coverage expansions.
AHRQ-funded; HS021291.
Citation: Sommers BD, Maylone B, Nguyen KH .
The impact of state policies on ACA applications and enrollment among low-income adults in Arkansas, Kentucky, and Texas.
Health Aff 2015 Jun;34(6):1010-8. doi: 10.1377/hlthaff.2015.0215..
Keywords: Policy, Low-Income, Medicaid, Health Insurance
Annis AM, Holtrop JS, Tao M
Comparison of provider and plan-based targeting strategies for disease management.
The researchers described and contrasted the targeting methods and engagement outcomes for health plan-delivered disease management with those of a provider-delivered care management program. They concluded that both provide advantages and that an optimal model may be to combine the strengths of each approach to maximize benefits in care management.
AHRQ-funded; HS020108.
Citation: Annis AM, Holtrop JS, Tao M .
Comparison of provider and plan-based targeting strategies for disease management.
Am J Manag Care 2015 May;21(5):344-51.
.
.
Keywords: Care Management, Primary Care, Health Insurance, Healthcare Delivery
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.
.
.
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Policy, Medicaid
DeVoe JE, Tillotson CJ, Angier H
Predictors of children's health insurance coverage discontinuity in 1998 versus 2009: parental coverage continuity plays a major role.
This study examines the strength of association between known and potential predictors of children’s health insurance continuity in both 1998 and 2009. It found that, compared to children with at least one parent continuously covered, children whose parents did not have continuous coverage had a significantly higher relative risk of a coverage gap.
AHRQ-funded; HS018569.
Citation: DeVoe JE, Tillotson CJ, Angier H .
Predictors of children's health insurance coverage discontinuity in 1998 versus 2009: parental coverage continuity plays a major role.
Matern Child Health J 2015 Apr;19(4):889-96. doi: 10.1007/s10995-014-1590-0.
.
.
Keywords: Medical Expenditure Panel Survey (MEPS), Children's Health Insurance Program (CHIP), Uninsured, Health Insurance
Geynisman DM, Hu JC, Liu L
Treatment patterns and costs for metastatic renal cell carcinoma patients with private insurance in the United States.
The researchers used a large claims database to examine the evolution of treatment patterns and associated costs for 1527 metastatic renal cell carcinoma (mRCC) patients in the United States. They found that the treatment of mRCC has transitioned from cytokines and cytotoxic chemotherapy to almost exclusively targeted therapy. Cost of care for mRCC is rising each year, and out-of-pocket costs for patients are significant.
AHRQ-funded; HS018535; HS020263.
Citation: Geynisman DM, Hu JC, Liu L .
Treatment patterns and costs for metastatic renal cell carcinoma patients with private insurance in the United States.
Clin Genitourin Cancer 2015 Apr;13(2):e93-100. doi: 10.1016/j.clgc.2014.08.013..
Keywords: Cancer, Kidney Disease and Health, Health Insurance, Healthcare Costs
Robinson JC, Brown T, Whaley C
Reference-based benefit design changes consumers' choices and employers' payments for ambulatory surgery.
The researchers analyzed the impact of reference-based benefit (RBB) designs on cataract surgery patients choice of less-expensive ambulatory surgery centers over more expensive hospital outpatient departments. Examining two groups of patients, one in plans incorporating RBB and the other in non-RBB plans, they found that the shift to RBB led to an 8.6 percent increase in ambulatory surgery centers as well as a 19.7 percent decrease in payments per procedure.
AHRQ-funded; HS022098
Citation: Robinson JC, Brown T, Whaley C .
Reference-based benefit design changes consumers' choices and employers' payments for ambulatory surgery.
Health Aff. 2015 Mar;34(3):415-22. doi: 10.1377/hlthaff.2014.1198..
Keywords: Ambulatory Care and Surgery, Eye Disease and Health, Health Insurance, Healthcare Costs, Health Insurance
Manski RJ, Moeller JF, Chen H
AHRQ Author: Manski RJ
Dental use and expenditures for older uninsured Americans: the simulated impact of expanded coverage.
The purpose of this paper is to empirically determine if insurance alone would close the current gaps in dental use and expenditures between insured and uninsured older Americans. Comparing simulated dental use and expenditures rates of newly insured persons against the corresponding rates for those previously insured, the authors found that it would close previous gaps in use and expense.
AHRQ-authored.
Citation: Manski RJ, Moeller JF, Chen H .
Dental use and expenditures for older uninsured Americans: the simulated impact of expanded coverage.
Health Serv Res. 2015 Feb;50(1):117-35. doi: 10.1111/1475-6773.12205..
Keywords: Medical Expenditure Panel Survey (MEPS), Dental and Oral Health, Health Insurance, Elderly, Healthcare Costs
Koroukian SM
Dual-eligibility status: a marker of vulnerability and cancer-related disparities.
This editorial discusses a study by Warren et al that highlights important differences in receipt of chemotherapy across subgroups of the Medicare population according to type of supplemental insurance. It explores the important questions raised by the findings, especially the individual factors that may have contributed to the observed disparities.
AHRQ-funded; HS023113.
Citation: Koroukian SM .
Dual-eligibility status: a marker of vulnerability and cancer-related disparities.
J Clin Oncol 2015 Feb 1;33(4):297-8. doi: 10.1200/jco.2014.59.1933..
Keywords: Medicare, Cancer, Health Insurance, Treatments, Disparities
Hill SC
AHRQ Author: Hill SC
Medicaid expansion in opt-out states would produce consumer savings and less financial burden than exchange coverage.
This study simulated potential differences in out-of-pocket spending for uninsured adults gaining eligibility for Marketplace coverage (silver plan) because their states have not used the provisions of the Affordable Care Act to expand Medicaid. Compared with having a Marketplace silver plan, being able to take advantage to expanded Medicaid would reduce average out-of-pocket spending by more than 50 percent for these adults and their families.
AHRQ-authored.
Citation: Hill SC .
Medicaid expansion in opt-out states would produce consumer savings and less financial burden than exchange coverage.
Health Aff. 2015 Feb;34(2):340-9. doi: 10.1377/hlthaff.2014.1058..
Keywords: Healthcare Costs, Health Insurance, Policy, Low-Income, Medicaid, Uninsured
Boss EF, Benke JR, Tunkel DE
Public insurance and timing of polysomnography and surgical care for children with sleep-disordered breathing.
The purpose of this study was (1) to evaluate receipt and timing of polysomnography (PSG) in relation to ultimate surgical therapy with adenotonsillectomy for children undergoing evaluation for sleep-disordered breathing and (2) to evaluate differences based on socioeconomic status. It found that referral for PSG resulted in significant loss to follow-up for all children and delayed definitive surgical treatment for children with public insurance.
AHRQ-funded; HS022932.
Citation: Boss EF, Benke JR, Tunkel DE .
Public insurance and timing of polysomnography and surgical care for children with sleep-disordered breathing.
JAMA Otolaryngol Head Neck Surg 2015 Feb;141(2):106-11. doi: 10.1001/jamaoto.2014.3085..
Keywords: Children/Adolescents, Sleep Problems, Social Determinants of Health, Access to Care, Health Insurance, Surgery
Bailey SR, O'Malley JP, Gold R
Receipt of diabetes preventive services differs by insurance status at visit.
This study examined the association between having Medicaid health insurance and receiving diabetes preventive care during an office visit. They found that the lack of insurance was associated with a lower probability of receiving recommended diabetes preventive services that are due during a clinic visit.
AHRQ-funded; HS021522
Citation: Bailey SR, O'Malley JP, Gold R .
Receipt of diabetes preventive services differs by insurance status at visit.
Am J Prev Med 2015 Feb;48(2):229-33. doi: 10.1016/j.amepre.2014.08.035..
Keywords: Medicaid, Diabetes, Prevention, Primary Care, Health Insurance
Kastenberg ZJ, Hurley MP, Weiser TG
Adding insult to injury: discontinuous insurance following spine trauma.
The researchers evaluated patterns of discontinuation of initial insurance coverage for patients who undergo surgery for traumatic spine injury with and without spinal cord injury and compare these patterns with those for matched control subjects. They found a twofold increased risk of insurance discontinuation for patients with traumatic spine injury without spinal cord injury and a nearly threefold increased risk for patients with spinal cord injury.
AHRQ-Funded; HS000028.
Citation: Kastenberg ZJ, Hurley MP, Weiser TG .
Adding insult to injury: discontinuous insurance following spine trauma.
J Bone Joint Surg Am 2015 Jan 21;97(2):141-6. doi: 10.2106/jbjs.n.00148..
Keywords: Injuries and Wounds, Health Insurance, Trauma
DeCamp M, Lehmann LS
Guiding choice--ethically influencing referrals in ACOs.
The authors believe that accountable care organizations can influence referrals in an ethical manner that simultaneously enhances choice and improves patient outcomes if they consider three basic issues: transparency, appropriate metrics, and the right incentives. In this paper, they discuss these three issues and how they might be accomplished ethically.
AHRQ-funded; HS023684.
Citation: DeCamp M, Lehmann LS .
Guiding choice--ethically influencing referrals in ACOs.
N Engl J Med 2015 Jan 15;372(3):205-7. doi: 10.1056/NEJMp1412083.
.
.
Keywords: Health Insurance, Policy
Dale AM, Ryan D, Welch L
Comparison of musculoskeletal disorder health claims between construction floor layers and a general working population.
This study described the distributions and compared rates of personal (not Worker’s Compensation) health insurance claims for musculoskeletal disorders, but also compared rates seen between union floor layers and workers in general industry. It found that construction floor layers showed rates of personal health claims for chronic MSDs that were nearly double the rates for a general population of workers.
AHRQ-funded; HS019455.
Citation: Dale AM, Ryan D, Welch L .
Comparison of musculoskeletal disorder health claims between construction floor layers and a general working population.
Occup Environ Med 2015 Jan;72(1):15-20. doi: 10.1136/oemed-2014-102313..
Keywords: Chronic Conditions, Health Insurance
Scott JW, Sommers BD, Tsai TC
Dependent coverage provision led to uneven insurance gains and unchanged mortality rates in young adult trauma patients.
The Affordable Care Act (ACA) allows young adults to remain covered under their parents’ plans until age 26. This study conducted a difference-in-differences analysis of coverage rates among trauma patients ages 19-25 (compared to patients ages 26 to 34) and examined trauma-relevant outcomes. It found a 3.4 percent decrease in uninsurance status among younger trauma patients following the ACA policy change.
AHRQ-funded; HS000055
Citation: Scott JW, Sommers BD, Tsai TC .
Dependent coverage provision led to uneven insurance gains and unchanged mortality rates in young adult trauma patients.
Health Aff. 2015 Jan;34(1):125-33. doi: 10.1377/hlthaff.2014.0880..
Keywords: Access to Care, Healthcare Costs, Health Insurance, Outcomes
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
Lee J, Ding R, Zeger SL
Impact of subsidized health insurance coverage on emergency department utilization by low-income adults in Massachusetts.
The authors aimed to estimate the change in emergency department (ED) utilization per individual among a cohort who qualified for subsidized health insurance following the Massachusetts health care reform. They concluded that expanding subsidized health insurance did not uniformly change ED utilization for all newly insured low-income adults in Massachusetts.
AHRQ-funded; HS017957.
Citation: Lee J, Ding R, Zeger SL .
Impact of subsidized health insurance coverage on emergency department utilization by low-income adults in Massachusetts.
Med Care 2015 Jan;53(1):38-44. doi: 10.1097/mlr.0000000000000279.
.
.
Keywords: Emergency Department, Healthcare Utilization, Health Insurance, Policy, Low-Income
Lepore MJ, Shield RR, Looze J
Medicare and Medicaid reimbursement rates for nursing homes motivate select culture change practices but not comprehensive culture change.
The researchers use mixed methods to examine the presence of culture change practices in the context of a nursing home’s (NH’s) payer sources. They concluded that qualitative data show how higher pay from Medicare versus Medicaid influences implementation of select culture change practices, and quantitative data show NHs with higher proportions of Medicare residents have significantly higher (measured) environmental culture change implementation.
AHRQ-funded; HS000011.
Citation: Lepore MJ, Shield RR, Looze J .
Medicare and Medicaid reimbursement rates for nursing homes motivate select culture change practices but not comprehensive culture change.
J Aging Soc Policy 2015;27(3):215-31. doi: 10.1080/08959420.2015.1022102..
Keywords: Nursing Homes, Medicare, Medicaid, Payment, Health Insurance
Chung S, Lesser LI, Lauderdale DS
Medicare annual preventive care visits: use increased among fee-for-service patients, but many do not participate.
The researchers find that, following the implementation of the Affordable Care Act which expanded Medicare coverage to fully cover annual preventive care visits, the annual use of preventive visits among Medicare fee-for-service patients rose from 1.7 percent to 27.5 percent. However, the increased rates are still 10-20 percentage points lower than those with private or Medicare HMO coverage.
AHRQ-funded; HS019815
Citation: Chung S, Lesser LI, Lauderdale DS .
Medicare annual preventive care visits: use increased among fee-for-service patients, but many do not participate.
Health Aff. 2015 Jan;34(1):11-20. doi: 10.1377/hlthaff.2014.0483..
Keywords: Medicare, Healthcare Costs, Prevention, Health Insurance
Nichols GA, Schroeder EB, Karter AJ
Trends in diabetes incidence among 7 million insured adults, 2006-2011: the SUPREME-DM project.
This study of diabetes trends found that among 7 million insured adults there was no significant increase between 2006 and 2010. The small increase that occurred from 2010 to 2011 coincided with a shift from fasting plasma glucose testing to use of the HbA1c assay. The increase in diabetes incidence rates was significant only among racial and ethnic minority groups and among very obese persons.
AHRQ-funded; HS019859
Citation: Nichols GA, Schroeder EB, Karter AJ .
Trends in diabetes incidence among 7 million insured adults, 2006-2011: the SUPREME-DM project.
Am J Epidemiol. 2015 Jan;181(1):32-9. doi: 10.1093/aje/kwu255..
Keywords: Diabetes, Health Insurance, Social Determinants of Health, Obesity