National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (3)
- (-) Children's Health Insurance Program (CHIP) (18)
- Children/Adolescents (17)
- Dental and Oral Health (1)
- Disparities (1)
- Electronic Health Records (EHRs) (2)
- Healthcare Costs (1)
- Healthcare Utilization (1)
- Health Insurance (1)
- Health Services Research (HSR) (3)
- Implementation (3)
- Low-Income (3)
- Medicaid (7)
- Medical Expenditure Panel Survey (MEPS) (1)
- Quality Improvement (5)
- Quality Indicators (QIs) (3)
- Quality Measures (11)
- Quality of Care (11)
- Uninsured (1)
- Vulnerable Populations (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 DisplayedChu J, Roby DH, Boudreaux MH
Effects of the Children's Health Insurance Reauthorization Act on immigrant children's healthcare access.
The purpose of this study was to estimate the effects of the Children's Health Insurance Reauthorization Act (CHIPRA) on insurance coverage, access, utilization, and health outcomes among immigrant children. The researchers utilized the restricted use 2000-2016 National Health Interview Survey (NHIS)with a sample which included immigrant children between the ages of 0 and 18 born outside the United States, with family income below 300% of the Federal Poverty Level (FPL). The study found that CHIPRA was related with a decrease in uninsured rates and an increase in public insurance enrollment for immigrant children. The effects of CHIPRA became small and statistically not significant 3 years after adoption. The researchers found no significant changes in health care access and utilization, and health outcomes, overall and across subgroups due to CHIPRA. The researchers concluded that the eligibility expansion of CHIPRA was related with increases in public insurance coverage for low-income children. However, no effect of CHIPRA on access to care and health was found.
AHRQ-funded; HS028532.
Citation: Chu J, Roby DH, Boudreaux MH .
Effects of the Children's Health Insurance Reauthorization Act on immigrant children's healthcare access.
Health Serv Res 2022 Dec;57(suppl 2):315-25. doi: 10.1111/1475-6773.14061..
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Access to Care, Vulnerable Populations, Uninsured
Mistry KB, Sagatov RDF, Schur C
AHRQ Author: Mistry KB, Sagatov RDF
Design and implementation of the Pediatric Quality Measures Program 2.0.
This AHRQ-authored research discusses the design and implementation of the Pediatric Quality Measures Program (PQMP) 2.0. The PQMP was established in response to the Children’s Health Insurance Program Reauthorization Act of 2009. AHRQ and CMS awarded 6 grants to Centers of Excellence (COEs) and a contract to facilitate collaboration and learning across the COEs. The COEs partnered with stakeholders from multiple levels to field test real-world implementation and refinement of pediatric quality measures and quality improvement initiatives. A PQMP Learning Collaborative (PQMP-LC) consisting of AHRQ, CMS, the 6 COEs, and L&M Policy Research, LLC was created to complete literature reviews, conduct key informant interviews, and collect data to develop reports to address the Research Foci. It also aided with development of measure implementation and quality improvement toolkits; conceptualized an implementation science framework, analysis, and roadmap; and facilitated dissemination of learnings and products. The various products created are intended to support the uptake of PQMP measures and inform future pediatric measurement and improvement work.
AHRQ-authored.
Citation: Mistry KB, Sagatov RDF, Schur C .
Design and implementation of the Pediatric Quality Measures Program 2.0.
Acad Pediatr 2022 Apr;22(3s):S59-S64. doi: 10.1016/j.acap.2021.12.021..
Keywords: Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Forrest CB, Simpson L, Mistry KB
AHRQ Author: Mistry KB
PQMP Phase 2: implementation and dissemination.
The authors provide an overview of the articles in this supplement concerning the Children’s Health Insurance Program Reauthorization Act Pediatric Quality Measures Program (PQMP). The articles examine the opportunities and challenges associated with the PQMP 2.0 work of the Centers for Excellence and how findings may advance the science for pediatric quality measurement and improvement, and, ultimately, child health outcomes.
AHRQ-authored.
Citation: Forrest CB, Simpson L, Mistry KB .
PQMP Phase 2: implementation and dissemination.
Acad Pediatr 2022 Apr;22(3s):S55-S58. doi: 10.1016/j.acap.2022.01.012..
Keywords: Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Schur C, Johnson M, Doherty J
AHRQ Author: Mistry KB
Real-world considerations for implementing pediatric quality measures: insights from key stakeholders.
This AHRQ-authored paper describes key stakeholder insights focused on measure implementation and increasing the uptake of Pediatric Quality Measures (PQM). The PQMP Learning Collaborative conducted semistructured interviews with 9 key informants (KIs) presenting states, health plans, and other potential end users. The interviews focused on obtaining KIs’ perspectives on 6 research questions focused on assessing the feasibility and usability of PQM and strengthening the connection between measurement and improvement. The KIs uniformly acknowledged the complexity of the issues raised and pinpointed multiple unresolved issues.
AHRQ-authored; AHRQ-funded; 290201400003I.
Citation: Schur C, Johnson M, Doherty J .
Real-world considerations for implementing pediatric quality measures: insights from key stakeholders.
Acad Pediatr 2022 Apr;22(3S):S76-S80. doi: 10.1016/j.acap.2021.04.007..
Keywords: Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Shenkman E, Mistry KB, Davis D
AHRQ Author: Mistry KB
Stakeholder engagement: bridging research and policy to improve measurement and dental care for children in Medicaid.
The University of Florida Child Health Quality (CHeQ) initiative, funded by the Agency for Health Care Research and Quality (AHRQ)/Centers for Medicare and Medicaid Services (CMS) Pediatric Quality Measurement Program, examined measures that states use to evaluate quality of oral health care for children in Medicaid and the Children’s Health Insurance Program (CHIP). This paper discusses stakeholder engagement in bridging research and policy to improve measurement and dental care for children in Medicaid.
AHRQ-authored; AHRQ-funded; HS025298.
Citation: Shenkman E, Mistry KB, Davis D .
Stakeholder engagement: bridging research and policy to improve measurement and dental care for children in Medicaid.
Acad Pediatr 2022 Apr;22(3S):S65-S67. doi: 10.1016/j.acap.2021.08.012..
Keywords: Children/Adolescents, Dental and Oral Health, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care
Shah AY, LLanos K, Dougherty D
AHRQ Author: Dougherty D
State challenges to child health quality measure reporting and recommendations for improvement.
The authors sought to assess reporting barriers of the Children's Health Insurance Program (CHIP) and to identify potential opportunities for improvement. They found that low reporting states believed they had inadequate staffing and that data collection and extraction was too time-consuming. They concluded that possible solutions to improve reporting would include funding and staff support, refining the technical assistance provided, and creating venues for state-to-state interaction.
AHRQ-authored.
Citation: Shah AY, LLanos K, Dougherty D .
State challenges to child health quality measure reporting and recommendations for improvement.
Healthc 2016 Sep;4(3):217-24. doi: 10.1016/j.hjdsi.2016.03.001.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Quality of Care, Medicaid, Quality Indicators (QIs)
Bailey SR, Marino M, Hoopes M
Healthcare utilization after a children's health insurance program expansion in Oregon.
This study used electornic health record data from 154 Oregon community health centers to evaluate children's healthcare utilization after the Children's Health Insurance Program (CHIP) expansion. The authors found that utilization among the newly-insured remained higher than the uninsured group. This finding confirms that Children's Health Insurance Program expansions are associated with increased utilization of essential pediatric primary and preventive care.
AHRQ-funded; HS021522; HS018569.
Citation: Bailey SR, Marino M, Hoopes M .
Healthcare utilization after a children's health insurance program expansion in Oregon.
Matern Child Health J 2016 May;20(5):946-54. doi: 10.1007/s10995-016-1971-7.
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Keywords: Children's Health Insurance Program (CHIP), Electronic Health Records (EHRs), Healthcare Utilization, Children/Adolescents, Access to Care
Wherry LR, Kenney GM, Sommers BD
The role of public health insurance in reducing child poverty.
The researchers reviewed a growing body of evidence that public health insurance provides important financial benefits to low-income families and also reviewed the potential poverty-reducing effects of public health insurance coverage. They found that Medicaid plays a significant role in decreasing poverty for many children and families. They also reviewed emerging evidence that access to public health insurance in childhood has long-term effects for health and economic outcomes in adulthood. They concluded that the nation's public health insurance programs have many important short- and long-term poverty-reducing benefits for low-income families with children.
AHRQ-funded; HS021291.
Citation: Wherry LR, Kenney GM, Sommers BD .
The role of public health insurance in reducing child poverty.
Acad Pediatr 2016 Apr;16(3 Suppl):S98-s104. doi: 10.1016/j.acap.2015.12.011.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Low-Income, Medicaid
Kreider AR, French B, Aysola J
Quality of health insurance coverage and access to care for children in low-income families.
This study compared health care access, quality, and cost outcomes by insurance type (Medicaid, CHIP, private, and uninsured) for children in households with low to moderate incomes. It found that children with all insurance types experienced challenges in access to specialty care, with caregivers of children insured by the Children’s Health Insurance Program reporting the highest rates of difficulty accessing specialty care, problems obtaining a referral, and frustration obtaining health care services.
AHRQ-funded; HS021706.
Citation: Kreider AR, French B, Aysola J .
Quality of health insurance coverage and access to care for children in low-income families.
JAMA Pediatr 2016 Jan;170(1):43-51. doi: 10.1001/jamapediatrics.2015.3028..
Keywords: Children's Health Insurance Program (CHIP), Children/Adolescents, Access to Care, Low-Income
Bailey LC, Mistry KB, Tinoco A
AHRQ Author: Mistry KB
Addressing electronic clinical information in the construction of quality measures.
The authors draw on the experience of Centers of Excellence to review both structural and pragmatic considerations in e-measurement. They suggest that addressing these challenges will require investment by vendors, researchers, and clinicians alike in developing better pediatric content for standard terminologies and data models, encouraging wider adoption of technical standards that support reliable quality measurement, better harmonizing data collection with clinical work flow in EHRs, and better understanding the behavior and potential of e-measures.
AHRQ-authored.
Citation: Bailey LC, Mistry KB, Tinoco A .
Addressing electronic clinical information in the construction of quality measures.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S82-9. doi: 10.1016/j.acap.2014.06.006.
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Keywords: Children's Health Insurance Program (CHIP), Electronic Health Records (EHRs), Quality Improvement, Quality Indicators (QIs), Quality Measures
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