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
- Adverse Events (1)
- Blood Pressure (2)
- (-) Cardiovascular Conditions (15)
- Caregiving (1)
- Depression (1)
- Diabetes (3)
- Disparities (5)
- Elderly (1)
- Healthcare Costs (1)
- Health Promotion (1)
- Health Status (1)
- Heart Disease and Health (5)
- Imaging (1)
- Lifestyle Changes (1)
- Medical Devices (1)
- Medication (3)
- Medication: Safety (1)
- Outcomes (3)
- Patient Adherence/Compliance (1)
- (-) Racial and Ethnic Minorities (15)
- Respiratory Conditions (1)
- Risk (5)
- Sex Factors (3)
- Sleep Problems (1)
- Stroke (3)
- Surgery (2)
- Young Adults (1)
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 15 of 15 Research Studies DisplayedMarcaccio CL, Patel PB, de Guerre L
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
The purpose of this study was to identify variations in 5-year outcomes and imaging surveillance after elective endovascular aortic aneurysm repair (EVAR) by sex, race, and ethnicity and to examine possible mechanisms contributing to these variations. The primary outcome was 5-year aneurysm rupture. Secondary outcomes were 5-year reintervention and mortality, and having no aortic imaging follow-up from 6 to 24 months after EVAR. The study found that among 16,040 patients, 73% were White males, 18% were White females, 2.6% were Black males, 1.1% were Black females, 0.9% were Asian males, 0.2% were Asian females, 1.7% were Hispanic males, and 0.4% were Hispanic females. At 5 years, Black females had the highest rupture rates at 6.4% and white males had the lowest at 2.3%. Compared with White males, rupture rates were higher in White females, Black females, and Asian females. Among other groups, Black males had higher reintervention and both Black and Hispanic males had higher rates of no imaging follow-up. In adjusted analyses, White, Black, and Asian females remained at significantly higher risk for 5-year rupture. The researchers concluded that Black females had higher 5-year aneurysm rupture, reintervention, and mortality rates after elective EVAR as compared with White male patients, whereas White females had higher rupture, mortality and loss-to-imaging-follow-up compared to White male patients. Black males had higher reintervention and no imaging follow-up, and Asian females had higher rupture rates.
AHRQ-funded; HS027285.
Citation: Marcaccio CL, Patel PB, de Guerre L .
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
J Vasc Surg 2022 Nov;76(5):1205-15.e4. doi: 10.1016/j.jvs.2022.03.886..
Keywords: Disparities, Racial and Ethnic Minorities, Sex Factors, Outcomes, Imaging, Heart Disease and Health, Cardiovascular Conditions
Marcaccio CL, O'Donnell TFX, Dansey KD
Disparities in reporting and representation by sex, race, and ethnicity in endovascular aortic device trials.
The purpose of this study was to examine the demographics of patients enrolled in critical U.S. endovascular aortic device trials to explore the representation of vulnerable populations, including women and racial and ethnic minorities. The primary outcomes included the percentage of trials reporting participant sex, race, and ethnicity and the percentage of participants across sex, racial, and ethnic groups. The study found that the Food and Drug Administration (FDA) provided 29 approvals from 29 trials of 24 devices with a total of 4046 patients: 52% (15) were EVAR devices, 41% (12) were TEVAR devices, and 3.4% (1) was a FEVAR device, with 1 dissection stent (3.4%). Fifty-two percent of the trials reported the three most common racial groups (White, Black, Asian), and 48% reported Hispanic ethnicity. The TEVAR trials were the most likely to report all three racial groups and Hispanic ethnicity (92% and 75%, respectively), while the EVAR trials had the lowest reporting rates (13% and 20%, respectively). The median female enrollment was 21%, with the EVAR trials having the lowest female enrollment compared with 41% in the TEVAR trials, 21% in the FEVAR trial, and 34% in the dissection stent trial. The study concluded that in critical aortic device trials that led to FDA approval, female patients were underrepresented, especially for EVAR, and racial and ethnic minority groups were under-represented and underreported.
AHRQ-funded; HS027285.
Citation: Marcaccio CL, O'Donnell TFX, Dansey KD .
Disparities in reporting and representation by sex, race, and ethnicity in endovascular aortic device trials.
J Vasc Surg 2022 Nov;76(5):1244-52.e2. doi: 10.1016/j.jvs.2022.05.003..
Keywords: Disparities, Racial and Ethnic Minorities, Heart Disease and Health, Cardiovascular Conditions, Medical Devices, Sex Factors
Anjorin AC, Marcaccio CL, Patel PB
Racial and ethnic disparities in 3-year outcomes following infrainguinal bypass for chronic limb-threatening ischemia.
This study’s objective was to determine the differences in 3-year outcomes after open infrainguinal bypass for chronic limb-threatening ischemia (CLTI) stratified by race/ethnicity and explored the potential factors contributing to these differences to help determine reasons why outcomes are worse for racial and ethnic minorities. The authors identified all CLTI patients who had undergone primary open infrainguinal bypass in the Vascular Quality Initiative registry from 2003 to 2017 with linkage to Medicare claims through 2018 for the 3-year outcomes. Primary outcomes were the 3-year rates of major amputation, reintervention, and mortality. They also recorded 30-day major adverse limb events (MALE) defined as major amputation or reintervention. Of the 7108 patients with CLTI 79% were non-Hispanic White, 15% were Black, 1% were Asian, and 6% were Hispanic. Compared with White patients, Black patients had higher rates of 3-year major amputation (Black vs White, 32% vs 19%), reintervention (Black vs White, 61% vs 57%), and 30-day MALE (Black vs White, 8.1% vs 4.9%) but lower mortality (Black vs White, 38% vs 42%). Hispanic patients also experienced higher rates of amputation (Hispanic vs White, 27% vs 19%), reintervention (Hispanic vs White, 70% vs 57%), and MALE (Hispanic vs White, 8.7% vs 4.9%). However, mortality was similar between Hispanic vs White groups. A higher presence of comorbidities in Black and Hispanic patients with CLTI is considered the greatest contributing factors to higher amputation and reintervention rates.
AHRQ-funded; HS027285.
Citation: Anjorin AC, Marcaccio CL, Patel PB .
Racial and ethnic disparities in 3-year outcomes following infrainguinal bypass for chronic limb-threatening ischemia.
J Vasc Surg 2022 Nov;76(5):1335-46.e7. doi: 10.1016/j.jvs.2022.06.026..
Keywords: Racial and Ethnic Minorities, Disparities, Outcomes, Surgery, Cardiovascular Conditions
Mallela DP, Canner JK, Zarkowsky DS
Association between race and perioperative outcomes after carotid endarterectomy for asymptomatic carotid artery stenosis in NSQIP.
This study investigated the association of race on carotid endarterectomy (CEA) outcomes. Perioperative outcomes (at 30 days) were compared for Black vs. White patients adjusting for age/sex, comorbidities and disease characteristics. Out of 16,764 patients from the ACS-NSQIP targeted vascular database (2011-2019), 95.2% were White and 4.8% were Black. Black patients were slightly younger and more frequently (79.5% vs 74.0%) had high-grade carotid artery stenosis compared to White patients. Comorbidities including hypertension, diabetes, kidney disease, congestive heart failure, and coronary artery disease were all more prevalent among Black patients. Crude perioperative stroke and stroke/death were higher for Black patients, but myocardial infarction leading to death were similar. After adjusting for baseline differences between groups, the risk of perioperative stroke and stroke/death remained significantly higher for Black patients than White patients.
AHRQ-funded; HS024547.
Citation: Mallela DP, Canner JK, Zarkowsky DS .
Association between race and perioperative outcomes after carotid endarterectomy for asymptomatic carotid artery stenosis in NSQIP.
J Am Coll Surg 2022 Jan;234(1):65-73. doi: 10.1097/xcs.0000000000000016..
Keywords: Racial and Ethnic Minorities, Surgery, Cardiovascular Conditions, Stroke, Risk, Adverse Events
Steinberg RS, Nayak A, Burke MA
Association of race and gender with primary caregiver relationships and eligibility for advanced heart failure therapies.
Caregiver support is considered necessary after heart transplant (HT) and left ventricular assist device (LVAD) for patients with end-stage heart failure (HF). Few studies have demonstrated how caregivers differ by gender and race, and whether that impacts therapy eligibility. In this study, the investigators examined caregiver relationships among 674 patients (32% women, 55% Black) evaluated at Emory University from 2011 to 2017.
AHRQ-funded; HS026081.
Citation: Steinberg RS, Nayak A, Burke MA .
Association of race and gender with primary caregiver relationships and eligibility for advanced heart failure therapies.
Clin Transplant 2022 Jan;36(1):e14502. doi: 10.1111/ctr.14502..
Keywords: Caregiving, Racial and Ethnic Minorities, Heart Disease and Health, Cardiovascular Conditions
Womack VY, De Chavez PJ, Albrecht SS
A longitudinal relationship between depressive symptoms and development of metabolic syndrome: the Coronary Artery Risk Development in Young Adults study.
The researchers tested whether baseline and time-varying depressive symptoms were associated with metabolic syndrome incidence in black and white men and women from the Coronary Artery Risk Development in Young Adults study. They found that, over 15 years, the incidence rate of metabolic syndrome varied by race and sex, with the highest rate in black women followed by white men, black men, and white women. Depressive symptoms were associated with incident metabolic syndrome in white men and white women. However, they found no significant association between depression and metabolic syndrome among black men or black women.
AHRQ-funded; HS023009.
Citation: Womack VY, De Chavez PJ, Albrecht SS .
A longitudinal relationship between depressive symptoms and development of metabolic syndrome: the Coronary Artery Risk Development in Young Adults study.
Psychosom Med 2016 Sep;78(7):867-73. doi: 10.1097/psy.0000000000000347.
.
.
Keywords: Cardiovascular Conditions, Depression, Racial and Ethnic Minorities, Sex Factors, Young Adults
Adedinsewo D, Taka N, Agasthi P
Prevalence and factors associated with statin use among a nationally representative sample of US Adults: National Health and Nutrition Examination Survey, 2011-2012.
The researchers estimated the prevalence and likelihood of statin use among a statin benefit group with diabetes and a second group with arteriosclerosis. In adjusted models, uninsured and Hispanic adults were less likely to be on a statin compared with white adults; 59.5 percent of all adults in the diabetes statin benefit group, and 63.5 percent of all adults in the srteriosclerosis group were on a statin.
AHRQ-funded; HS022444.
Citation: Adedinsewo D, Taka N, Agasthi P .
Prevalence and factors associated with statin use among a nationally representative sample of US Adults: National Health and Nutrition Examination Survey, 2011-2012.
Clin Cardiol 2016 Sep;39(9):491-6. doi: 10.1002/clc.22577.
.
.
Keywords: Cardiovascular Conditions, Diabetes, Medication, Disparities, Racial and Ethnic Minorities
Kabra R, Girotra S, Vaughan Sarrazin M
Refining stroke prediction in atrial fibrillation patients by addition of African-American ethnicity to CHA2DS2-VASc score.
The authors hypothesized that the addition of African-American ethnicity to the CHA2DS2-VASc score might improve stroke prediction in patients with atrial fibrillation (AF). They found that, in patients over age 65 with newly diagnosed AF, the addition of ethnicity to CHA2DS2-VASc score significantly improved stroke prediction.
AHRQ-funded; HS023104.
Citation: Kabra R, Girotra S, Vaughan Sarrazin M .
Refining stroke prediction in atrial fibrillation patients by addition of African-American ethnicity to CHA2DS2-VASc score.
J Am Coll Cardiol 2016 Aug 2;68(5):461-70. doi: 10.1016/j.jacc.2016.05.044.
.
.
Keywords: Stroke, Heart Disease and Health, Racial and Ethnic Minorities, Risk, Cardiovascular Conditions
Redmond N, Booth JN, 3rd, Tanner RM
Prevalence of masked hypertension and its association with subclinical cardiovascular disease in African Americans: results from the Jackson Heart Study.
Using data from the Jackson Heart Study, an exclusively African American population-based cohort, the researchers evaluated the association of masked hypertension and prehypertension with left ventricular mass index and common carotid intima media thickness. Masked hypertension was common among African Americans with prehypertension and also normal clinic blood pressure, and was associated with subclinical cardiovascular disease.
AHRQ-funded; HS023009.
Citation: Redmond N, Booth JN, 3rd, Tanner RM .
Prevalence of masked hypertension and its association with subclinical cardiovascular disease in African Americans: results from the Jackson Heart Study.
J Am Heart Assoc 2016 Mar 29;5(3):e002284. doi: 10.1161/jaha.115.002284.
.
.
Keywords: Blood Pressure, Heart Disease and Health, Cardiovascular Conditions, Racial and Ethnic Minorities
Lafata JE, Karter AJ, O'Connor PJ
Medication adherence does not explain black-white differences in cardiometabolic risk factor control among insured patients with diabetes.
The researchers examined whether medication adherence, controlling for treatment intensification, could explain differences in risk factor control between black and white patients with diabetes. They found poorer medication adherence among black patients than white patients. They concluded that medication adherence failed to explain observed racial differences in the achievement of HbA1c, LDL-C, and SBP control among insured patients with diabetes.
AHRQ-funded; HS019859.
Citation: Lafata JE, Karter AJ, O'Connor PJ .
Medication adherence does not explain black-white differences in cardiometabolic risk factor control among insured patients with diabetes.
J Gen Intern Med 2016 Feb;31(2):188-95. doi: 10.1007/s11606-015-3486-0.
.
.
Keywords: Cardiovascular Conditions, Diabetes, Medication, Patient Adherence/Compliance, Racial and Ethnic Minorities
Booth JN, 3rd, Redmond N, Sims M
The association of reduced lung function with blood pressure variability in African Americans: data from the Jackson Heart Study.
The reseaerchers evaluated the association between percent predicted lung-function and 24-hour blood pressure variability (BPV) in 1008 African Americans enrolled in the Jackson Heart Study who underwent ambulatory blood pressure (BP) monitoring. They found that lung-function was not associated with increased 24-hour BPV.
AHRQ-funded; HS023009.
Citation: Booth JN, 3rd, Redmond N, Sims M .
The association of reduced lung function with blood pressure variability in African Americans: data from the Jackson Heart Study.
BMC Cardiovasc Disord 2016 Jan 12;16:6. doi: 10.1186/s12872-015-0182-2.
.
.
Keywords: Cardiovascular Conditions, Blood Pressure, Racial and Ethnic Minorities, Risk, Respiratory Conditions
Newhall K, Spangler E, Dzebisashvili N
Amputation rates for patients with diabetes and peripheral arterial disease: the effects of race and region.
The authors examined national trends in care of patients with both peripheral artery disease (PAD) and diabetes. They found that the prevalence of concurrent PAD and diabetes is increasing, but amputation rates and amputation-free survival vary significantly by both race and hospital referral region.
AHRQ-funded; HS021581.
Citation: Newhall K, Spangler E, Dzebisashvili N .
Amputation rates for patients with diabetes and peripheral arterial disease: the effects of race and region.
Ann Vasc Surg 2016 Jan;30:292-8.e1. doi: 10.1016/j.avsg.2015.07.040.
.
.
Keywords: Cardiovascular Conditions, Diabetes, Elderly, Racial and Ethnic Minorities, Outcomes
Patel M, Phillips-Caesar E, Boutin-Foster C
Attitudes and beliefs regarding cardiovascular risk factors among Bangladeshi immigrants in the US.
The researchers conducted a qualitative study using individual in-depth interviews to explore attitudes towards and difficulties with modifying cardiovascular disease related behaviors among a Bangladeshi cohort. Bangladeshi individuals in this study cited a combination of internal and external factors as barriers to lifestyle modification. The authors recommended interventions to address these barriers that simultaneously address self-efficacy and work-life balance.
AHRQ-funded; HS000066.
Citation: Patel M, Phillips-Caesar E, Boutin-Foster C .
Attitudes and beliefs regarding cardiovascular risk factors among Bangladeshi immigrants in the US.
J Immigr Minor Health 2014 Oct;16(5):994-1000. doi: 10.1007/s10903-013-9868-7.
.
.
Keywords: Cardiovascular Conditions, Lifestyle Changes, Racial and Ethnic Minorities, Risk
Petrov ME, Howard VJ, Kleindorfer D
Over-the-counter and prescription sleep medication and incident stroke: the REasons for Geographic and Racial Differences in Stroke study.
The authors investigated the relation between sleep medication use and incident stroke. At the sleep assessment, 9.6% of the participants used prescription sleep medication and 11.1% used over-the-counter sleep aids. Over an average follow-up of 3.3 ± 1.0 years, 297 stroke events occurred. The authors found that over-the-counter sleep medication use was associated with increased risk of incident stroke; however, there was no significant association with prescription sleep medications. They concluded that over-the-counter sleep medication use may independently increase the risk of stroke beyond other risk factors in middle-aged to older individuals with no history of stroke.
AHRQ-funded; HS013852.
Citation: Petrov ME, Howard VJ, Kleindorfer D .
Over-the-counter and prescription sleep medication and incident stroke: the REasons for Geographic and Racial Differences in Stroke study.
J Stroke Cerebrovasc Dis 2014 Sep;23(8):2110-6. doi: 10.1016/j.jstrokecerebrovasdis.2014.03.025.
.
.
Keywords: Medication: Safety, Medication, Risk, Sleep Problems, Stroke, Cardiovascular Conditions, Racial and Ethnic Minorities
Burke JF, Vijan S, Chekan LA
Targeting high-risk employees may reduce cardiovascular racial disparities.
A possible remedy for health disparities is for employers to promote cardiovascular health among minority employees. However, this study finds that there was no significant per person differential attributable to racial disparities for heart attack and stroke. A primary implication is that targeting cardiovascular disease strategies for African Americans is unlikely to be cost saving for employers.
AHRQ-funded; HS017690
Citation: Burke JF, Vijan S, Chekan LA .
Targeting high-risk employees may reduce cardiovascular racial disparities.
Am J Manag Care. 2014 Sep;20(9):725-33..
Keywords: Cardiovascular Conditions, Disparities, Healthcare Costs, Health Promotion, Health Status, Racial and Ethnic Minorities