National Healthcare Quality and Disparities Report
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Topics
- Access to Care (7)
- Antibiotics (2)
- Antimicrobial Stewardship (2)
- Arthritis (2)
- Behavioral Health (5)
- Cancer (6)
- Cancer: Breast Cancer (3)
- Cancer: Cervical Cancer (1)
- Cancer: Colorectal Cancer (4)
- Cancer: Lung Cancer (2)
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- Children's Health Insurance Program (CHIP) (1)
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- Cultural Competence (1)
- Data (1)
- Decision Making (5)
- Dental and Oral Health (2)
- Depression (1)
- Diagnostic Safety and Quality (2)
- Digestive Disease and Health (1)
- Disparities (3)
- Education (1)
- Education: Patient and Caregiver (1)
- Elderly (7)
- Electronic Health Records (EHRs) (3)
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- Emergency Medical Services (EMS) (4)
- Guidelines (2)
- Healthcare Cost and Utilization Project (HCUP) (4)
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- (-) Healthcare Utilization (69)
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- Hospitalization (4)
- Human Immunodeficiency Virus (HIV) (1)
- Imaging (7)
- Intensive Care Unit (ICU) (2)
- Lifestyle Changes (1)
- Long-Term Care (1)
- Low-Income (3)
- Medicaid (12)
- Medical Expenditure Panel Survey (MEPS) (3)
- Medicare (2)
- Medication (10)
- Men's Health (1)
- Mortality (4)
- Neonatal Intensive Care Unit (NICU) (1)
- Neurological Disorders (2)
- Newborns/Infants (1)
- Opioids (1)
- Outcomes (1)
- Pain (1)
- Palliative Care (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (7)
- Patient and Family Engagement (1)
- Patient Safety (1)
- Payment (1)
- Policy (2)
- Practice Patterns (2)
- Pregnancy (1)
- Prevention (5)
- Primary Care (2)
- Provider Performance (1)
- Quality Improvement (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (4)
- Registries (1)
- Rehabilitation (1)
- Rural Health (1)
- Screening (7)
- Sickle Cell Disease (2)
- Social Determinants of Health (1)
- Surgery (7)
- Telehealth (2)
- Tobacco Use (2)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Uninsured (3)
- Urban Health (1)
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- Vulnerable Populations (1)
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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 69 Research Studies DisplayedSchmajuk G, Tonner C, Miao Y
Folic acid supplementation is suboptimal in a national cohort of older veterans receiving low dose oral methotrexate.
The authors aimed to determine the prevalence, predictors of, and persistence of folic acid use in a population-based cohort of methotrexate (MTX) users with rheumatic diseases. They found that patients who did not see a rheumatologist were 23% less likely to receive folic acid compared to patients who did have a rheumatologist visit during the baseline period, and after 20 months, only 50% of patients continued to receive folic acid. The authors recommend improving patient safety for users of MTX by standardizing workflows for folic acid supplementation.
AHRQ-funded; HS024412.
Citation: Schmajuk G, Tonner C, Miao Y .
Folic acid supplementation is suboptimal in a national cohort of older veterans receiving low dose oral methotrexate.
PLoS One 2016 Dec 15;11(12):e0168369. doi: 10.1371/journal.pone.0168369.
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Keywords: Elderly, Healthcare Utilization, Medication, Arthritis
Kessler R, Stowell JR, Vogel JA
Effect of interventional program on the utilization of PACS in point-of-care ultrasound.
The study’s objective was to determine if a simple interventional program would influence the utilization of Picture Archiving and Communication Systems (PACS) in point-of-care ultrasound. It concluded that a simple interventional program for emergency physicians can significantly increase and sustain the utilization of PACS for point-of-care ultrasound.
AHRQ-funded; HS023901.
Citation: Kessler R, Stowell JR, Vogel JA .
Effect of interventional program on the utilization of PACS in point-of-care ultrasound.
J Digit Imaging 2016 Dec;29(6):701-05. doi: 10.1007/s10278-016-9893-x.
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Keywords: Emergency Medical Services (EMS), Imaging, Healthcare Utilization, Health Information Technology (HIT)
Nocon RS, Lee SM, Sharma R
AHRQ Author: Ngo-Metzger Q
Health care use and spending for medicaid enrollees in federally qualified health centers versus other primary care settings.
This study compared health care use and spending of Medicaid enrollees seen at federally qualified health centers versus non-health center settings in a context of significant growth. It found that health center patients had lower use and spending than did non-health center patients across all services, with 22 percent fewer visits and 33 percent lower spending on specialty.
AHRQ-authored.
Citation: Nocon RS, Lee SM, Sharma R .
Health care use and spending for medicaid enrollees in federally qualified health centers versus other primary care settings.
Am J Public Health 2016 Nov;106(11):1981-89. doi: 10.2105/ajph.2016.303341.
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Keywords: Medicaid, Healthcare Costs, Primary Care, Healthcare Utilization
O'Malley JP, O'Keeffe-Rosetti M, Lowe RA
Health care utilization rates after Oregon's 2008 Medicaid expansion: within-group and between-group differences over time among new, returning, and continuously insured enrollees.
The authors sought to assess changes in emergency department, primary care, mental and behavioral health care, and specialist care visit rates among individuals gaining Medicaid over 24 months postinsurance gain and also to evaluate the association of previous insurance with utilization. They found that primary care visit rates in both newly and returning insured individuals significantly exceeded those of the continuously insured in months 4 through 12, but were not significantly elevated in the second year. In contrast, emergency department utilization rates were significantly higher in returning insured compared with newly or continuously insured individuals and remained elevated over time. New visits to primary and specialist care were higher among those who gained Medicaid compared with the continuously insured throughout the study period. They concluded that expansion evaluations should allow for rate stabilization.
AHRQ-funded; HS021522.
Citation: O'Malley JP, O'Keeffe-Rosetti M, Lowe RA .
Health care utilization rates after Oregon's 2008 Medicaid expansion: within-group and between-group differences over time among new, returning, and continuously insured enrollees.
Med Care 2016 Nov;54(11):984-91. doi: 10.1097/mlr.0000000000000600.
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Keywords: Medicaid, Healthcare Delivery, Healthcare Utilization, Emergency Department, Emergency Medical Services (EMS)
Volk RJ, Linder SK, Lopez-Olivo MA
Patient decision aids for colorectal cancer screening: a systematic review and meta-analysis.
This systematic review describes studies evaluating patient decision aids for colorectal cancer screening in average-risk adults and their impact on knowledge, screening intentions, and uptake. It concluded that decision aids improve knowledge and interest in screening, and lead to increased screening over no information, but their impact on screening is similar to general colorectal cancer screening information.
AHRQ-funded; HS022134.
Citation: Volk RJ, Linder SK, Lopez-Olivo MA .
Patient decision aids for colorectal cancer screening: a systematic review and meta-analysis.
Am J Prev Med 2016 Nov;51(5):779-91. doi: 10.1016/j.amepre.2016.06.022.
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Keywords: Cancer: Colorectal Cancer, Decision Making, Education: Patient and Caregiver, Healthcare Utilization, Screening
Sommers BD, Blendon RJ, Orav EJ
Changes in utilization and health among low-income adults after Medicaid expansion or expanded private insurance.
The researchers assessed changes in access to care, utilization, and self-reported health among low-income adults in 3 states taking alternative approaches to the ACA. They concluded that in the second year of expansion, Kentucky's Medicaid program and Arkansas's private option were associated with significant increases in outpatient utilization, preventive care, and improved health care quality; reductions in emergency department use; and improved self-reported health.
AHRQ-funded; HS021291.
Citation: Sommers BD, Blendon RJ, Orav EJ .
Changes in utilization and health among low-income adults after Medicaid expansion or expanded private insurance.
JAMA Intern Med 2016 Oct;176(10):1501-09. doi: 10.1001/jamainternmed.2016.4419.
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Keywords: Healthcare Utilization, Low-Income, Health Insurance, Medicaid, Access to Care
Bailey SR, Hoopes MJ, Marino M
Effect of gaining insurance coverage on smoking cessation in community health centers: a cohort study.
This study aimed to determine if uninsured community health center (CHC) patients who gain Medicaid coverage experience greater primary care utilization, receive more cessation medication orders, and achieve higher quit rates, compared to continuously uninsured smokers. It found that newly insured patients had increased odds of quit smoking status over 24 months of follow-up than those who remained uninsured.
AHRQ-funded; HS021522; HS024270.
Citation: Bailey SR, Hoopes MJ, Marino M .
Effect of gaining insurance coverage on smoking cessation in community health centers: a cohort study.
J Gen Intern Med 2016 Oct;31(10):1198-205. doi: 10.1007/s11606-016-3781-4.
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Keywords: Tobacco Use, Health Insurance, Community-Based Practice, Medicaid, Healthcare Utilization
Mannion ML, Xie F, Baddley J
Analysis of health care claims during the peri-transfer stage of transition from pediatric to adult care among juvenile idiopathic arthritis patients.
This study investigated the utilization of health care services before and after transfer from pediatric to adult rheumatology care in clinical practice. It found that individuals with juvenile idiopathic arthritis (JIA) who transferred to adult care were more likely receive a diagnosis of rheumatoid arthritis instead of juvenile rheumatoid arthritis and were less likely to receive NSAIDs, but had no significant immediate changes to other medication use.
AHRQ-funded; HS021110.
Citation: Mannion ML, Xie F, Baddley J .
Analysis of health care claims during the peri-transfer stage of transition from pediatric to adult care among juvenile idiopathic arthritis patients.
Pediatr Rheumatol Online J 2016 Sep 5;14(1):49. doi: 10.1186/s12969-016-0107-3.
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Keywords: Healthcare Utilization, Arthritis, Children/Adolescents
Burns ME, Huskamp HA, Smith JC
The effects of the transition from Medicaid to Medicare on health care use for adults with mental illness.
The researchers estimated the effect of dual coverage after Medicaid enrollment during the required waiting period among adults with serious mental illness on health care use, overall and related to mental health and substance use disorders. They found that after 12 months of dual coverage, the probability of outpatient care use increased in both states from 4 percent to 9 percent.
AHRQ-funded; HS018577.
Citation: Burns ME, Huskamp HA, Smith JC .
The effects of the transition from Medicaid to Medicare on health care use for adults with mental illness.
Med Care 2016 Sep;54(9):868-77. doi: 10.1097/mlr.0000000000000572.
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Keywords: Behavioral Health, Medicaid, Medicare, Hospitalization, Healthcare Utilization
Nadpara PA, Madhavan SS, Tworek C
Tobacco-use cessation counseling service usage.
The authors evaluated patterns of receipt of Tobacco-use Cessation Counseling (TCC) services among elderly lung cancer patients. They found a critical need to address disparities in receipt of TCC services among elderly. They concluded that, although lung cancer preventive services are covered under the Medicare program, these services are underutilized.
AHRQ-funded; HS018622.
Citation: Nadpara PA, Madhavan SS, Tworek C .
Tobacco-use cessation counseling service usage.
W V Med J 2016 Sep-Oct;112(5):66-71.
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Keywords: Cancer, Cancer: Lung Cancer, Elderly, Healthcare Utilization, Lifestyle Changes, Tobacco Use
Kelly JP, Hammill BG, Doll JA
The potential impact of expanding cardiac rehabilitation in heart failure.
The authors sought to characterize the patient population newly eligible for cardiac rehabilitation (CR) based on the 2014 CMS expanded coverage criteria. Their findings suggested that expansion of coverage for the newly eligible group is an important systems process to undertake to rapidly increase the participating eligible patients and that extension of CR coverage to the ineligible group should be considered.
AHRQ-funded; HS021092.
Citation: Kelly JP, Hammill BG, Doll JA .
The potential impact of expanding cardiac rehabilitation in heart failure.
J Am Coll Cardiol 2016 Aug 30;68(9):977-8. doi: 10.1016/j.jacc.2016.05.081.
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Keywords: Cardiovascular Conditions, Elderly, Healthcare Utilization, Heart Disease and Health, Rehabilitation
Rosenthal MB, Landrum MB, Robbins JA
Pay for performance in Medicaid: evidence from three natural experiments.
This study examined the impact of pay for performance in Medicaid on the quality and utilization of care. Primary outcomes of interest were Healthcare Effectiveness Data and Information Set (HEDIS)-like process measures of quality, utilization by service category, and ambulatory care-sensitive admissions and emergency department visits. Its findings were mixed, with no measurable quality improvements across the three states (Pennsylvania, Minnesota, Alabama), but reductions in hospital admissions in two programs.
AHRQ-funded.
Citation: Rosenthal MB, Landrum MB, Robbins JA .
Pay for performance in Medicaid: evidence from three natural experiments.
Health Serv Res 2016 Aug;51(4):1444-66. doi: 10.1111/1475-6773.12426.
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Keywords: Medicaid, Payment, Provider Performance, Healthcare Utilization, Quality of Care, Hospitalization, Emergency Department
Zhang W, Lyman S, Boutin-Foster C
Racial and ethnic disparities in utilization rate, hospital volume, and perioperative outcomes after total knee arthroplasty.
The researchers sought to study racial disparities in the utilization of total knee arthroplasty (TKA), the use of high-volume hospitals, and TKA outcomes, including mortality and complications, using all-payer databases. They found that minorities had lower rates of TKA utilization but higher rates of adverse health outcomes associated with the procedure, even after adjusting for patient-related and health-care system-related characteristics.
AHRQ-funded; HS021734.
Citation: Zhang W, Lyman S, Boutin-Foster C .
Racial and ethnic disparities in utilization rate, hospital volume, and perioperative outcomes after total knee arthroplasty.
J Bone Joint Surg Am 2016 Aug 3;98(15):1243-52. doi: 10.2106/jbjs.15.01009.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Healthcare Utilization, Surgery, Access to Care
Melnick ER, O'Brien EG, Kovalerchik O
The association between physician empathy and variation in imaging use.
This paper's objective was to describe empathy in a cohort of emergency physicians and evaluate its association with CT utilization. The authors found that, on the four psychometric scales used, performance was not predictive of risk-adjusted CT utilization in the emergency department. They concluded that the underlying physician-based factors that mediate interphysician variation remain to be clearly identified.
AHRQ-funded; HS021271.
Citation: Melnick ER, O'Brien EG, Kovalerchik O .
The association between physician empathy and variation in imaging use.
Acad Emerg Med 2016 Aug;23(8):895-904. doi: 10.1111/acem.13017.
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Keywords: Decision Making, Emergency Medical Services (EMS), Healthcare Utilization, Imaging, Practice Patterns
Jonassaint CR, Jones VL, Leong S
A systematic review of the association between depression and health care utilization in children and adults with sickle cell disease.
The authors sought to determine whether depression or depressive symptoms are associated with health care utilization among children and adults with sickle cell disease (SCD). They found that, overall, depressive symptoms are common in SCD and may increase risk for poor outcomes including health care utilization. They further found a modest association between depression and health care utilization in SCD.
AHRQ-funded; HS022989.
Citation: Jonassaint CR, Jones VL, Leong S .
A systematic review of the association between depression and health care utilization in children and adults with sickle cell disease.
Br J Haematol 2016 Jul;174(1):136-47. doi: 10.1111/bjh.14023.
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Keywords: Children/Adolescents, Depression, Healthcare Utilization, Patient-Centered Healthcare, Sickle Cell Disease
Wang SY, Aldridge MD, Gross CP
End-of-life care intensity and hospice use: a regional-level analysis.
The authors sought to examine regional variation in intensive end-of-life care and determine its associations with hospice use patterns. They concluded that at the regional level, increased end-of-life care intensity was consistently associated with very short hospice use.
AHRQ-funded; HS023900.
Citation: Wang SY, Aldridge MD, Gross CP .
End-of-life care intensity and hospice use: a regional-level analysis.
Med Care 2016 Jul;54(7):672-8. doi: 10.1097/mlr.0000000000000547.
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Keywords: Elderly, Healthcare Utilization, Health Services Research (HSR)
Lyu PF, Hockenberry JM, Gaydos LM
Impact of a sequential intervention on albumin utilization in critical care.
The authors evaluated the effect of a sequential multifaceted intervention on decreasing albumin use in the intensive care unit. They found that a sequential intervention achieved significant reductions in albumin use and cost savings without changes in patient outcomes, supporting the combination of financial and nonfinancial strategies to align providers with evidence-based practices.
AHRQ-funded; HS000055.
Citation: Lyu PF, Hockenberry JM, Gaydos LM .
Impact of a sequential intervention on albumin utilization in critical care.
Crit Care Med 2016 Jul;44(7):1307-13. doi: 10.1097/ccm.0000000000001638.
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Keywords: Critical Care, Healthcare Utilization, Intensive Care Unit (ICU), Patient-Centered Outcomes Research, Practice Patterns
Simianu VV, Fichera A, Bastawrous AL
Number of diverticulitis episodes before resection and factors associated with earlier interventions.
The authors described patterns of episodes of diverticulitis before surgery and factors associated with earlier interventions using inpatient, outpatient, and antibiotic prescription claims. They found that 56.3% of elective resections for uncomplicated diverticulitis occurred after fewer than 3 episodes. Further, they determined that earlier surgery was not explained by younger age, laparoscopy, time between the last 2 episodes preceding surgery, or financial risk-bearing for patients.
AHRQ-funded; HS020025.
Citation: Simianu VV, Fichera A, Bastawrous AL .
Number of diverticulitis episodes before resection and factors associated with earlier interventions.
JAMA Surg 2016 Jul;151(7):604-10. doi: 10.1001/jamasurg.2015.5478.
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Keywords: Decision Making, Digestive Disease and Health, Health Systems, Healthcare Utilization, Surgery
Healy MA, Yin H, Reddy RM
Use of positron emission tomography to detect recurrence and associations with survival in patients with lung and esophageal cancers.
The researchers sought to evaluate utilization of positron emission tomography (PET) to detect recurrence in asymptomatic patients and relationships with survival for patients with lung and esophageal cancers. Despite statistically significant variation in use of PET to detect tumor recurrence, there was no association with improved two-year survival.
AHRQ-funded; HS020937.
Citation: Healy MA, Yin H, Reddy RM .
Use of positron emission tomography to detect recurrence and associations with survival in patients with lung and esophageal cancers.
J Natl Cancer Inst 2016 Jul;108(7). doi: 10.1093/jnci/djv429.
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Keywords: Imaging, Cancer, Cancer: Lung Cancer, Healthcare Utilization
Blosnich JR, Hammer J, Yu L
Health care use, health behaviors, and medical conditions among individuals in same-sex and opposite-sex partnerships: a cross-sectional observational analysis of the Medical Expenditures Panel Survey (MEPS), 2003-2011.
Thsi study's objective was to examine associations between sexual minority status and medical conditions. The researchers used MEPS data to determine measures of health risk, health services utilization, and the presence of 15 medical conditions. They found that individuals in same-sex partnerships had 67% increased odds of past-year emergency department utilization and 51% greater odds of three or more physician visits in the last year compared with opposite-sex partnered individuals.
AHRQ-funded; HS022989.
Citation: Blosnich JR, Hammer J, Yu L .
Health care use, health behaviors, and medical conditions among individuals in same-sex and opposite-sex partnerships: a cross-sectional observational analysis of the Medical Expenditures Panel Survey (MEPS), 2003-2011.
Med Care 2016 Jun;54(6):547-54. doi: 10.1097/mlr.0000000000000529.
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Keywords: Healthcare Delivery, Disparities, Healthcare Utilization, Medical Expenditure Panel Survey (MEPS)
Gillespie SM, Shah MN, Wasserman EB
Reducing emergency department utilization through engagement in telemedicine by senior living communities.
High-intensity telemedicine has been shown to reduce the need for emergency department (ED) care for older adult senior living community (SLC) residents with acute illnesses. In this study, the investigators evaluated the effect of SLC engagement in a telemedicine program on ED use rates. The investigators concluded that individuals residing in more engaged SLCs experienced a greater decrease in ED use compared with subjects residing in less engaged SLCs or those without access to high-intensity telemedicine for acute illnesses.
AHRQ-funded; HS018047.
Citation: Gillespie SM, Shah MN, Wasserman EB .
Reducing emergency department utilization through engagement in telemedicine by senior living communities.
Telemed J E Health 2016 Jun;22(6):489-96. doi: 10.1089/tmj.2015.0152..
Keywords: Elderly, Emergency Department, Health Information Technology (HIT), Healthcare Utilization, Patient and Family Engagement, Telehealth
Jonassaint CR, Beach MC, Haythornthwaite JA
The association between educational attainment and patterns of emergency department utilization among adults with sickle cell disease.
The authors aimed to determine what factors are related to emergency department visits in hopes of guiding treatments and early interventions. They concluded that early interventions addressing disparities in academic performance, especially for those children most at risk, may lead to improved long-term health outcomes in this population.
AHRQ-funded; HS022989.
Citation: Jonassaint CR, Beach MC, Haythornthwaite JA .
The association between educational attainment and patterns of emergency department utilization among adults with sickle cell disease.
Int J Behav Med 2016 Jun;23(3):300-09. doi: 10.1007/s12529-016-9538-y.
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Keywords: Education, Emergency Department, Healthcare Utilization, Pain, Sickle Cell Disease
Freedman S
Capacity and utilization in health care: the effect of empty beds on neonatal intensive care admission.
In this paper, the author exploited short-term variation in Neonatal Intensive Care Unit (NICU) capacity that is unlikely to be correlated with unobserved demand determinants. He found that available NICU beds have little to no effect on NICU utilization for the sickest infants, but do increase utilization for those in the range of birth weights where admission decisions are likely to be more discretionary.
AHRQ-funded; HS018266.
Citation: Freedman S .
Capacity and utilization in health care: the effect of empty beds on neonatal intensive care admission.
Am Econ J Econ Policy 2016 May 1;8(2):154-85. doi: 10.1257/pol.20120393.
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Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Healthcare Utilization, Critical Care, Decision Making
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
Kim EH, Vetter JM, Kuxhausen AN
Limited use of surveillance imaging following nephrectomy for renal cell carcinoma.
The researchers evaluated the utilization of follow-up imaging after nephrectomy for renal cell carcinoma (RCC) in nationally representative data. Using Surveillance, Epidemiology, End Results (SEER) data, they found that, in the Medicare population, surveillance imaging is performed in a limited number of patients following nephrectomy for RCC but that increasing tumor stage is predictive of both increased chest and abdominal imaging surveillance.
AHRQ-funded; HS019455.
Citation: Kim EH, Vetter JM, Kuxhausen AN .
Limited use of surveillance imaging following nephrectomy for renal cell carcinoma.
Urol Oncol 2016 May;34(5):237.e11-8. doi: 10.1016/j.urolonc.2015.11.017.
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Keywords: Cancer, Healthcare Utilization, Imaging, Medicare