National Healthcare Quality and Disparities Report
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- Access to Care (12)
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- (-) Disparities (74)
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- Quality Indicators (QIs) (3)
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- Racial and Ethnic Minorities (46)
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- Sex Factors (4)
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- Social Determinants of Health (12)
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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 25 of 74 Research Studies DisplayedRay KN, Chari AV, Engberg J
Disparities in time spent seeking medical care in the United States.
The researchers assessed how time associated with medical visits varied across socioeconomic variables and visit characteristics. They determined that patients spent on average 123 minutes obtaining medical care, including 86 minutes of clinic time and 38 minutes travel time. Clinic time was significantly longer for racial/ethnic minorities, individuals with less education, and unemployed individuals.
AHRQ-funded; HS022989.
Citation: Ray KN, Chari AV, Engberg J .
Disparities in time spent seeking medical care in the United States.
JAMA Intern Med 2015 Dec;175(12):1983-6. doi: 10.1001/jamainternmed.2015.4468..
Keywords: Disparities, Racial and Ethnic Minorities, Social Determinants of Health, Access to Care, Quality of Care
Nadpara P, Madhavan SS, Tworek C
Guideline-concordant timely lung cancer care and prognosis among elderly patients in the United States: a population-based study.
This study evaluated the variations in guideline-concordant timely lung cancer care and prognosis among elderly in the US. It found that the time to diagnosis and treatment varied significantly among the elderly. However, 77.5 percent received guideline-concordant timely lung cancer care. The likelihood of receiving timely care significantly decreased with early stage diagnosis, increasing age, non-white race, higher comorbidity score, and lower income.
AHRQ-funded; HS018622.
Citation: Nadpara P, Madhavan SS, Tworek C .
Guideline-concordant timely lung cancer care and prognosis among elderly patients in the United States: a population-based study.
Cancer Epidemiol 2015 Dec;39(6):1136-44. doi: 10.1016/j.canep.2015.06.005.
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Keywords: Cancer: Lung Cancer, Elderly, Guidelines, Disparities, Diagnostic Safety and Quality
Du XL, Parikh RC, Lairson DR
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
The authors examined racial/ethnic and geographical disparities in cancer care and costs during the last 6 months of life for lung cancer decedents after the FDA's approval of bevacizumab. They found that there were substantial racial/ethnic and geographic disparities in the types of cancer care and costs in the last 6 months of life among lung cancer decedents, regardless of the length of survival times and hospice care status.
AHRQ-funded; HS018956.
Citation: Du XL, Parikh RC, Lairson DR .
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
Lung Cancer 2015 Dec;90(3):442-50. doi: 10.1016/j.lungcan.2015.09.017.
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Keywords: Cancer, Cancer: Lung Cancer, Disparities, Healthcare Costs, Medication, Palliative Care, Patient-Centered Outcomes Research, Practice Patterns, Racial and Ethnic Minorities
Mukamel DB, Ladd H, Li Y
AHRQ Author: Ngo-Metzger Q
Have racial disparities in ambulatory care sensitive admissions abated over time?
The researchers evaluated whether disparities in quality of ambulatory care have abated during the decade of 2000 by asking whether there were there differences in ambulatory care sensitive hospital admissions rates by race? In 2003 the overall Prevention Quality Indicators (PQI) admission rates were higher for African Americans (around 16.5/1000) than for whites (around 15/1000). By 2009, the overall and the chronic PQI admission rates declined significantly for whites but not for African Americans.
AHRQ-authored.
Citation: Mukamel DB, Ladd H, Li Y .
Have racial disparities in ambulatory care sensitive admissions abated over time?
Med Care 2015 Nov;53(11):931-9. doi: 10.1097/mlr.0000000000000426..
Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Quality Indicators (QIs), Racial and Ethnic Minorities, Quality of Care
Abdus S, Mistry KB, Selden TM
AHRQ Author: Mistry KB, Selden TM
Racial and ethnic disparities in services and the Patient Protection and Affordable Care Act.
The researchers examined pre-reform patterns in insurance coverage, access to care, and preventive services use by race/ethnicity in adults targeted by the coverage expansions of the Patient Protection and Affordable Care Act (ACA). They found that minorities were disproportionately represented among those targeted by the coverage provisions of the ACA.
AHRQ-authored.
Citation: Abdus S, Mistry KB, Selden TM .
Racial and ethnic disparities in services and the Patient Protection and Affordable Care Act.
Am J Public Health 2015 Nov;105(Suppl 5):S668-75. doi: 10.2105/ajph.2015.302892..
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Disparities, Racial and Ethnic Minorities, Access to Care
Ross RE, Garfield LD, Brown DS
The Affordable Care Act and implications for health care services for American Indian and Alaska Native individuals.
This paper summarizes the Affordable Care Act provisions that directly and/or indirectly affect the service delivery of health care provided by tribes and the Indian Health Service.
AHRQ-funded; HS020269.
Citation: Ross RE, Garfield LD, Brown DS .
The Affordable Care Act and implications for health care services for American Indian and Alaska Native individuals.
J Health Care Poor Underserved 2015 Nov;26(4):1081-8. doi: 10.1353/hpu.2015.0129.
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Keywords: Disparities, Policy, Health Status, Health Services Research (HSR), Racial and Ethnic Minorities
Shaw JJ, Santry HP
Who gets early tracheostomy? Evidence of unequal treatment at 185 academic medical centers.
The researchers identified clinical and demographic disparities the reasons for variation in time from intubation to tracheostomy. They found that although early tracheostomy was associated with increased survival, there were still significant disparities in time to tracheostomy according to sex, race, and type of insurance.
AHRQ-funded; HS022694.
Citation: Shaw JJ, Santry HP .
Who gets early tracheostomy? Evidence of unequal treatment at 185 academic medical centers.
Chest 2015 Nov;148(5):1242-50. doi: 10.1378/chest.15-0576..
Keywords: Disparities, Quality of Care, Critical Care
Aparicio HJ, Carr BG, Kasner SE
Racial disparities in intravenous recombinant tissue plasminogen activator use persist at primary stroke centers.
The researechers found that racial disparities in intravenous recombinant tissue plasminogen activator (rt-PA) use were not reduced by presentation to primary stroke centers (PSCs). Black patients were less likely to receive thrombolytic treatment than white patients at both non-PSCs and PSCs. Hispanic patients were less likely to be seen at PSCs relative to white patients and were less likely to receive intravenous rt-PA in the fully adjusted model.
AHRQ-funded; HS018362; HS017960; HS013852.
Citation: Aparicio HJ, Carr BG, Kasner SE .
Racial disparities in intravenous recombinant tissue plasminogen activator use persist at primary stroke centers.
J Am Heart Assoc 2015 Oct 14;4(10):e001877. doi: 10.1161/jaha.115.001877.
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Keywords: Healthcare Delivery, Disparities, Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Stroke
Garcia Mosqueira A, Hua LM, Sommers BD
Racial differences in awareness of the Affordable Care Act and application assistance among low-income adults in three Southern states.
The researchers explored potential factors related to racial/ethnic differences in ACA enrollment - awareness of the law and receipt of application assistance such as navigator services. Their results highlight the importance of ACA outreach efforts to increase awareness among low-income and less educated populations to close existing disparities in coverage.
AHRQ-funded; HS021291.
Citation: Garcia Mosqueira A, Hua LM, Sommers BD .
Racial differences in awareness of the Affordable Care Act and application assistance among low-income adults in three Southern states.
Inquiry 2015 Oct 8;52. doi: 10.1177/0046958015609607.
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Keywords: Disparities, Health Insurance, Low-Income, Medicaid, Racial and Ethnic Minorities
Higashi RT, Craddock Lee SJ, Leonard T
Multiple comorbidities and interest in research participation among clients of a nonprofit food distribution site.
The researchers sought to better understand the health needs of a nonclinical population to inform future research and interventions. Their analysis of focus group findings led them to conclude that Crossroads Community Services clients represent a high-need, under-reached population willing to engage in health-related research that affords them opportunity to connect with peers in group settings and obtain information to improve management of daily life challenges.
AHRQ-funded; HS022418.
Citation: Higashi RT, Craddock Lee SJ, Leonard T .
Multiple comorbidities and interest in research participation among clients of a nonprofit food distribution site.
Clin Transl Sci 2015 Oct;8(5):584-90. doi: 10.1111/cts.12325.
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Keywords: Nutrition, Racial and Ethnic Minorities, Disparities, Low-Income, Vulnerable Populations
Attanasio L, Kozhimannil KB
Patient-reported communication quality and perceived discrimination in maternity care.
The researchers assessed racial/ethnic disparities in patient-reported communication problems and perceived discrimination in maternity care among women nationally and measured racial/ethnic variation in the correlates of these outcomes. They found that over 40 percent of women reported communication problems in prenatal care, and 24 percent perceived discrimination during their hospitalization for birth.
AHRQ-funded; HS000036.
Citation: Attanasio L, Kozhimannil KB .
Patient-reported communication quality and perceived discrimination in maternity care.
Med Care 2015 Oct;53(10):863-71. doi: 10.1097/mlr.0000000000000411..
Keywords: Communication, Disparities, Maternal Care, Clinician-Patient Communication, Racial and Ethnic Minorities
Thorpe RJ, Jr., Kennedy-Hendricks A, Griffith DM
Race, social and environmental conditions, and health behaviors in men.
The investigators examined the nature of disparities in health behaviors among African American and white men in the Exploring Health Disparities in Integrated Communities Study-Southwest Baltimore to data from the 2003 National Health Interview Survey. They found that race disparities in physical activity, drinking, and smoking were ameliorated where African American and white men were living under similar social, environmental, and socioeconomic status conditions, suggesting that social environment may be an important determinant of health behaviors among African American and white men.
AHRQ-funded; HS000029.
Citation: Thorpe RJ, Jr., Kennedy-Hendricks A, Griffith DM .
Race, social and environmental conditions, and health behaviors in men.
Fam Community Health 2015 Oct-Dec;38(4):297-306. doi: 10.1097/fch.0000000000000078.
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Keywords: Disparities, Health Status, Lifestyle Changes, Racial and Ethnic Minorities, Social Determinants of Health
Mortel M, Rauscher GH, Murphy AM
Racial and ethnic disparity in symptomatic breast cancer awareness despite a recent screen: the role of tumor biology and mammography facility characteristics.
In a racially and ethnically diverse sample of recently diagnosed urban patients with breast cancer, the researchers examined associations of patient, tumor biology, and mammography facility characteristics on the probability of symptomatic discovery of their breast cancer despite a recent prior screening mammogram. They concluded that facility resources and tumor aggressiveness explain much of the racial/ethnic disparity in symptomatic breast cancer among recently screened patients.
AHRQ-funded; HS018366.
Citation: Mortel M, Rauscher GH, Murphy AM .
Racial and ethnic disparity in symptomatic breast cancer awareness despite a recent screen: the role of tumor biology and mammography facility characteristics.
Cancer Epidemiol Biomarkers Prev 2015 Oct;24(10):1599-606. doi: 10.1158/1055-9965.epi-15-0305.
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Keywords: Cancer: Breast Cancer, Cancer, Disparities, Women, Racial and Ethnic Minorities, Screening, Prevention
Heo HH, Sentell TL, Li D
Disparities in potentially preventable hospitalizations for chronic conditions among Korean Americans, Hawaii, 2010-2012.
The researchers compared preventable hospitalizations for chronic conditions in aggregate and for congestive heart failure (CHF) for Korean Americans and whites in Hawaii. They found that older Korean American patients may have significant disparities in preventable hospitalizations, which suggests poor access to or poor quality of primary health care.
AHRQ-funded; HS019990.
Citation: Heo HH, Sentell TL, Li D .
Disparities in potentially preventable hospitalizations for chronic conditions among Korean Americans, Hawaii, 2010-2012.
Prev Chronic Dis 2015 Sep 17;12:E152. doi: 10.5888/pcd12.150057.
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Keywords: Disparities, Racial and Ethnic Minorities, Hospitalization, Prevention, Chronic Conditions
Traino HM, Nonterah CW, Cyrus JW
Disparities in the completion of steps to kidney transplantation: protocol for a systematic review.
This review will catalogue disparities in the steps to transplantation as well as the barriers and facilitators to completion of each step identified in the extant literature. The results of the review will be used to generate recommendations for future research to improve equity in access to kidney transplantation.
AHRQ-funded; HS018113.
Citation: Traino HM, Nonterah CW, Cyrus JW .
Disparities in the completion of steps to kidney transplantation: protocol for a systematic review.
BMJ Open 2015 Sep 08;5(9):e008677. doi: 10.1136/bmjopen-2015-008677.
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Keywords: Disparities, Transplantation, Kidney Disease and Health, Access to Care, Guidelines
Waljee JF, Chang KW, Kim HM
Gender disparities in academic practice.
The authors sought to examine differences in faculty position and professional satisfaction among academic physicians by gender. They found that men more often held tenure track positions compared with women and women reported lower levels of professional satisfaction in academic practice compared with men.
AHRQ-funded; HS023313.
Citation: Waljee JF, Chang KW, Kim HM .
Gender disparities in academic practice.
Plast Reconstr Surg 2015 Sep;136(3):380e-87e. doi: 10.1097/prs.0000000000001530..
Keywords: Disparities, Provider, Provider Performance, Sex Factors
Sofolahan-Oladeinde Y, Mullins CD, Baquet CR
Using community-based participatory research in patient-centered outcomes research to address health disparities in under-represented communities.
The authors proposed ways by which patient-centered outcomes research can effectively use community-based participatory research principles to engage patients in general, and specifically patients from underserved communities, in the hope that this will help to reduce and eventually eliminate health disparities.
AHRQ-funded; HS022135.
Citation: Sofolahan-Oladeinde Y, Mullins CD, Baquet CR .
Using community-based participatory research in patient-centered outcomes research to address health disparities in under-represented communities.
J Comp Eff Res 2015 Sep;4(5):515-23. doi: 10.2217/cer.15.31.
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Keywords: Access to Care, Disparities, Evidence-Based Practice, Patient-Centered Outcomes Research, Vulnerable Populations
Rust G, Zhang S, Malhotra K
Paths to health equity: local area variation in progress toward eliminating breast cancer mortality disparities, 1990-2009.
The researchers examined county-level, age-adjusted breast cancer mortality rates for women who were 35 to 74 years old during the period of 1989-2010. They found that more than half of the counties (54%) showed persistent, unchanging disparities. Roughly 1 in 4 (24%) had a divergent pattern of worsening black/white disparities.
AHRQ-funded; HS022444.
Citation: Rust G, Zhang S, Malhotra K .
Paths to health equity: local area variation in progress toward eliminating breast cancer mortality disparities, 1990-2009.
Cancer 2015 Aug 15;121(16):2765-74. doi: 10.1002/cncr.29405..
Keywords: Cancer: Breast Cancer, Disparities, Racial and Ethnic Minorities, Mortality, Racial and Ethnic Minorities
Davis AE, Mehrotra S, Friedewald JJ
Improving geographic equity in kidney transplantation using alternative kidney sharing and optimization modeling.
The authors analyzed current kidney allocation and developed an alternative kidney sharing strategy using a multiperiod linear optimization model, KSHARE, which aims to improve geographic equity in kidney transplantation while also respecting transplant system constraints and priorities. They used Organ Procurement and Transplant Network data to determine that enhancing the practice of sharing kidneys by the KSHARE model may increase geographic equity in kidney transplantation.
AHRQ-funded; HS021078.
Citation: Davis AE, Mehrotra S, Friedewald JJ .
Improving geographic equity in kidney transplantation using alternative kidney sharing and optimization modeling.
Med Decis Making 2015 Aug;35(6):797-807. doi: 10.1177/0272989x14557696.
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Keywords: Access to Care, Disparities, Health Services Research (HSR), Social Determinants of Health, Transplantation
Wielen LM, Gilchrist EC, Nowels MA
Not near enough: racial and ethnic disparities in access to nearby behavioral health care and primary care.
The authors addressed disparities associated with integrated behavioral health and primary care services. They found that primary care providers practicing in neighborhoods with higher percentages of African Americans and Hispanics were less likely to have geographically proximate behavioral health professionals; this also applied to rural areas. They concluded that additional behavioral health professionals are needed in racial/ethnic minority neighborhoods and rural areas to provide access to behavioral health services, and to progress toward more integrated primary care.
AHRQ-funded; HS022444.
Citation: Wielen LM, Gilchrist EC, Nowels MA .
Not near enough: racial and ethnic disparities in access to nearby behavioral health care and primary care.
J Health Care Poor Underserved 2015 Aug;26(3):1032-47. doi: 10.1353/hpu.2015.0083.
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Keywords: Behavioral Health, Disparities, Primary Care, Racial and Ethnic Minorities
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
Lyles C, Schillinger D, Sarkar U
Connecting the dots: health information technology expansion and health disparities.
The authors argue that early evidence links EHR and portal use to better healthcare processes and health outcomes. Promoting patient engagement with health technology such as portals is challenging, and rapid expansion of portals could exacerbate existing healthcare disparities if only well-resourced individuals use these websites.
AHRQ-funded; HS023558; HS022408; HS022047.
Citation: Lyles C, Schillinger D, Sarkar U .
Connecting the dots: health information technology expansion and health disparities.
PLoS Med 2015 Jul 14;12(7):e1001852. doi: 10.1371/journal.pmed.1001852..
Keywords: Disparities, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient and Family Engagement, Web-Based
Moore JX, Donnelly JP, Griffin R
Black-white racial disparities in sepsis: a prospective analysis of the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
The researchers sought to characterize racial differences in incident sepsis in a large cohort of adult community-dwelling adults. They found that in the REGARDS cohort, black participants were less likely than white participants to experience infection and sepsis events.
AHRQ-funded; HS013852.
Citation: Moore JX, Donnelly JP, Griffin R .
Black-white racial disparities in sepsis: a prospective analysis of the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
Crit Care 2015 Jul 10;19:279. doi: 10.1186/s13054-015-0992-8..
Keywords: Racial and Ethnic Minorities, Disparities, Hospitalization, Racial and Ethnic Minorities
Berkowitz SA, Percac-Lima S, Ashburner JM
Building equity improvement into quality improvement: reducing socioeconomic disparities in colorectal cancer screening as part of population health management.
The aim of this study was to determine if implementation of a system-wide screening intervention could reduce disparities in the setting of improved overall screening rates. It found that a multifaceted population management intervention sensitive to the needs of vulnerable patients modestly narrowed disparities in colorectal cancer screening, while also increasing overall screening rates.
AHRQ-funded; HS018161.
Citation: Berkowitz SA, Percac-Lima S, Ashburner JM .
Building equity improvement into quality improvement: reducing socioeconomic disparities in colorectal cancer screening as part of population health management.
J Gen Intern Med 2015 Jul;30(7):942-9. doi: 10.1007/s11606-015-3227-4..
Keywords: Disparities, Screening, Social Determinants of Health, Colonoscopy
Hicks CW, Hashmi ZG, Hui X
Explaining the paradoxical age-based racial disparities in survival after trauma: The role of the treating facility.
This study sought to determine if differences in outcomes at treating facilities can help explain age-based racial disparities in survival after trauma. For example, among patients older than 65 years, blacks had decreased odds of mortality compared with whites. It found that facility-based differences do not seem to explain this paradoxical age-based racial disparity after trauma observed in the older population.
AHRQ-funded; HS017952.
Citation: Hicks CW, Hashmi ZG, Hui X .
Explaining the paradoxical age-based racial disparities in survival after trauma: The role of the treating facility.
AHRQ-funded; HS017952..
Keywords: Disparities, Comparative Effectiveness, Patient-Centered Outcomes Research, Healthcare Cost and Utilization Project (HCUP)