National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- (-) Access to Care (65)
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- Telehealth (1)
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- Urban Health (2)
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- Vulnerable Populations (4)
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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 65 Research Studies DisplayedJarman MP, Castillo RC
Rural risk: geographic disparities in trauma mortality.
The authors sought to quantify differences in injury mortality comparing rural and nonrural residents with traumatic injuries. They concluded that rural residents are significantly more likely than nonrural residents to die after traumatic injury, a disparity that varies by trauma center designation, injury severity, and US Census region.
AHRQ-funded; HS000029.
Citation: Jarman MP, Castillo RC .
Rural risk: geographic disparities in trauma mortality.
Surgery 2016 Dec;160(6):1551-59. doi: 10.1016/j.surg.2016.06.020.
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Keywords: Access to Care, Disparities, Emergency Medical Services (EMS), Healthcare Cost and Utilization Project (HCUP), Rural Health
Toomey SL, Elliott MN, Schwebel DC
Relationship between adolescent report of patient-centered care and of quality of primary care.
This study investigated whether adolescent self-report of patient-centered care (PCC) varied by patient characteristics and whether receipt of PCC is associated with measures of adolescent primary care quality. It found that adolescent-reported PCC positively correlates with measures of high-quality adolescent primary care. The study provides support for using adolescent-report of PCC as a measure of adolescent primary care quality.
AHRQ-funded; HS020513.
Citation: Toomey SL, Elliott MN, Schwebel DC .
Relationship between adolescent report of patient-centered care and of quality of primary care.
Acad Pediatr 2016 Nov - Dec;16(8):770-76. doi: 10.1016/j.acap.2016.01.006.
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Keywords: Children/Adolescents, Primary Care, Clinician-Patient Communication, Quality of Care, Access to Care
Kirby JB, Vistnes JP
AHRQ Author: Kirby JB, Vistnes JP
Access to care improved for people who gained Medicaid or marketplace coverage in 2014.
Newly available longitudinal survey data show that people who lacked health insurance in 2013 and gained coverage through Medicaid or the Marketplaces in 2014 were far more likely to obtain a usual source of care and receive preventive care services than their counterparts who remained uninsured in 2014.
AHRQ-authored.
Citation: Kirby JB, Vistnes JP .
Access to care improved for people who gained Medicaid or marketplace coverage in 2014.
Health Aff 2016 Oct 1;35(10):1830-34. doi: 10.1377/hlthaff.2016.0716.
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Keywords: Medical Expenditure Panel Survey (MEPS), Access to Care, Medicaid, Health Insurance
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
Beckman AL, Bilinski A, Boyko R
New hepatitis C drugs are very costly and unavailable to many state prisoners.
This study found that in the forty-one states whose departments of corrections reported data, 106,266 inmates (10 percent of their prisoners) were known to have hepatitis C on or about January 1, 2015. Only 949 of those inmates were being treated. Prices for a twelve-week course of direct-acting antivirals such as sofosbuvir and the combination drug ledipasvir/sofosbuvir varied widely as of September 30, 2015 ($43,418-$84,000 and $44,421-$94,500, respectively).
AHRQ-funded; HS000055.
Citation: Beckman AL, Bilinski A, Boyko R .
New hepatitis C drugs are very costly and unavailable to many state prisoners.
Health Aff 2016 Oct;35(10):1893-901. doi: 10.1377/hlthaff.2016.0296.
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Keywords: Access to Care, Healthcare Costs, Hepatitis, Medication, Vulnerable Populations
Ray KN, Mehrotra A
Trends in access to primary care for children in the United States, 2002-2013.
Using MEPS data, the authors described how access to primary care has changed over the last decade for children. They found no change in the proportion of children with a usual source of care (USC). Other measures improved, but out-of-pocket costs increased among privately insured children. Results suggested that after-hours accommodation within the USC is worsening, despite the promotion of patient-centered medical home initiatives. All measures of acceptability improved, consistent with a growing focus on family-centeredness of care.
AHRQ-funded; HS022989.
Citation: Ray KN, Mehrotra A .
Trends in access to primary care for children in the United States, 2002-2013.
JAMA Pediatr 2016 Oct;170(10):1023-25. doi: 10.1001/jamapediatrics.2016.0985.
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Keywords: Access to Care, Children/Adolescents, Health Services Research (HSR), Medical Expenditure Panel Survey (MEPS), Primary Care
Horner-Johnson W, Dobbertin K
Dental insurance and dental care among working-age adults: differences by type and complexity of disability.
The purpose of this study was to examine differences in dental insurance, receipt of dental checkups, and delayed and unmet needs for dental care by type and complexity of disability. It found that all disability types except hearing had significantly higher adjusted odds of being without dental insurance, as did people with complex activity limitations. Further, disparities in care were apparent even when controlling for presence of dental insurance.
AHRQ-funded; HS022981.
Citation: Horner-Johnson W, Dobbertin K .
Dental insurance and dental care among working-age adults: differences by type and complexity of disability.
J Public Health Dent 2016 Sep;76(4):330-39. doi: 10.1111/jphd.12160.
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Keywords: Access to Care, Dental and Oral Health, Disabilities, Health Insurance, Medical Expenditure Panel Survey (MEPS)
Shao H, Brown L, Diana ML
Estimating the costs of supporting safety-net transformation into patient-centered medical homes in post-Katrina New Orleans.
The authors aimed to understand the characteristics of clinics that transformed into patient-centered medical homes and the incremental cost for transformation. The estimated incremental cost for clinics that underwent transformation was $37.61 per visit per 6 months, and overall it cost $24.86 per visit per 6 months in grant funds to support a clinic's transformation.
AHRQ-funded; HS022624.
Citation: Shao H, Brown L, Diana ML .
Estimating the costs of supporting safety-net transformation into patient-centered medical homes in post-Katrina New Orleans.
Medicine 2016 Sep;95(39):e4990. doi: 10.1097/md.0000000000004990.
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Keywords: Patient-Centered Healthcare, Healthcare Costs, Access to Care, Organizational Change
Ray KN, Kahn JM, Miller E
Use of adult-trained medical subspecialists by children seeking medical subspecialty care.
The objectives of this study are to quantify the use of adult-trained medical subspecialists by children and to determine the association between geographic access to pediatric subspecialty care and the use of adult-trained subspecialists. Among medical subspecialty fields with pediatric and adult-trained subspecialists, the authors found that adult-trained subspecialists provided 10% of care to children overall and 18% of care to children living more than 90 minutes from pediatric referral centers.
AHRQ-funded; HS022989.
Citation: Ray KN, Kahn JM, Miller E .
Use of adult-trained medical subspecialists by children seeking medical subspecialty care.
J Pediatr 2016 Sep;176:173-81.e1. doi: 10.1016/j.jpeds.2016.05.073.
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Keywords: Access to Care, Children/Adolescents, Provider: Health Personnel, Children/Adolescents
Wittmeier KD, Restall G, Mulder K
Central intake to improve access to physiotherapy for children with complex needs: a mixed methods case report.
The researchers evaluated the process and impact of implementing a central intake system, using pediatric physiotherapy as a case example. They found that central intake implementation achieved the intended outcomes of streamlining processes and improving transparency and access to pediatric physiotherapy for families of children with complex needs. They recommended future research to build on this single discipline case study approach.
AHRQ-funded; HS016657.
Citation: Wittmeier KD, Restall G, Mulder K .
Central intake to improve access to physiotherapy for children with complex needs: a mixed methods case report.
BMC Health Serv Res 2016 Aug 31;16:455. doi: 10.1186/s12913-016-1700-3.
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Keywords: Access to Care, Children/Adolescents, Care Coordination, Patient Experience, Children/Adolescents
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
Sampson UK, Kaplan RM, Cooper RS
AHRQ Author: Kaplan RM
Reducing health inequities in the U.S.: recommendations from the NHLBI's health inequities think tank meeting.
The National, Heart, Lung, and Blood Institute convened a Think Tank meeting to obtain insight and recommendations regarding the objectives and design of the next generation of research aimed at reducing health inequities in the United States. Details of the panel's remarks and recommendations are provided in this report.
AHRQ-authored.
Citation: Sampson UK, Kaplan RM, Cooper RS .
Reducing health inequities in the U.S.: recommendations from the NHLBI's health inequities think tank meeting.
J Am Coll Cardiol 2016 Aug 2;68(5):517-24. doi: 10.1016/j.jacc.2016.04.059.
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Keywords: Access to Care, Disparities, Guidelines, Policy
Caldwell JT, Ford CL, Wallace SP
Intersection of living in a rural versus urban area and race/ethnicity in explaining access to health care in the United States.
The researchers examined whether living in a rural versus urban area differentially exposes populations to social conditions associated with disparities in access to health care. They cocluded that rural status confers additional disadvantage for most of the health care use measures, independently of poverty and health care supply.
AHRQ-funded; HS022811.
Citation: Caldwell JT, Ford CL, Wallace SP .
Intersection of living in a rural versus urban area and race/ethnicity in explaining access to health care in the United States.
Am J Public Health 2016 Aug;106(8):1463-9. doi: 10.2105/ajph.2016.303212.
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Keywords: Rural Health, Urban Health, Racial and Ethnic Minorities, Access to Care, Social Determinants of Health
Rivera-Hernandez M, Rahman M, Mor V
The Impact of social health insurance on diabetes and hypertension process indicators among older adults in Mexico.
The researchers examined the impact of Seguro Popular (Mexican social health insurance for the poor) on diabetes and hypertension care, They concluded that social health insurance for the poor improved some but not all health care process indicators among diabetic and hypertensive older people in Mexico.
AHRQ-funded; HS000011.
Citation: Rivera-Hernandez M, Rahman M, Mor V .
The Impact of social health insurance on diabetes and hypertension process indicators among older adults in Mexico.
Health Serv Res 2016 Aug;51(4):1323-46. doi: 10.1111/1475-6773.12404.
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Keywords: Health Insurance, Diabetes, Blood Pressure, Elderly, Access to Care
Haidari LA, Brown ST, Constenla D
The economic value of increasing geospatial access to tetanus toxoid immunization in Mozambique.
The researchers assessed how well tetanus toxoid (TT) immunization locations meet population demand in Mozambique. They found that TT immunization locations are not geographically accessible by a significant proportion of pregnant women, resulting in substantial healthcare and productivity costs that could potentially be averted by adding or reconfiguring TT immunization locations.
AHRQ-funded; HS023317.
Citation: Haidari LA, Brown ST, Constenla D .
The economic value of increasing geospatial access to tetanus toxoid immunization in Mozambique.
Vaccine 2016 Jul 29;34(35):4161-65. doi: 10.1016/j.vaccine.2016.06.065.
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Keywords: Access to Care, Healthcare Costs, Health Services Research (HSR), Pregnancy, Vaccination
Mueller LE, Haidari LA, Wateska AR
The impact of implementing a demand forecasting system into a low-income country's supply chain.
The authors evaluated the potential impact and value of applications of data from demand forecasting systems implemented in a lower-income country's vaccine supply chain with different levels of population change to urban areas. They used their HERMES software to study Niger's entire vaccine supply chain and found that demand forecasting systems have the potential to greatly improve vaccine demand fulfilment, and decrease logistics cost/dose, when implemented with storage and transportation increases.
AHRQ-funded; HS023317.
Citation: Mueller LE, Haidari LA, Wateska AR .
The impact of implementing a demand forecasting system into a low-income country's supply chain.
Vaccine 2016 Jul 12;34(32):3663-9. doi: 10.1016/j.vaccine.2016.05.027.
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Keywords: Access to Care, Health Services Research (HSR), Low-Income, Medication, Vaccination
Hung D, Chung S, Martinez M
Effect of organizational culture on patient access, care continuity, and experience of primary care.
The authors examined relationships between organizational culture and patient-centered outcomes in primary care. They found that, compared with a "Group-oriented" culture, a "Rational" culture type was associated with longer appointment wait times, and both "Hierarchical" and "Developmental" culture types were associated with less care continuity, but better patient experiences with care.
AHRQ-funded; HS019815; HS019167.
Citation: Hung D, Chung S, Martinez M .
Effect of organizational culture on patient access, care continuity, and experience of primary care.
J Ambul Care Manage 2016 Jul-Sep;39(3):242-52. doi: 10.1097/jac.0000000000000116.
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Keywords: Access to Care, Organizational Change, Patient-Centered Healthcare, Patient Experience, Primary Care
Creedon TB, Cook BL
Access to mental health care increased but not for substance use, while disparities remain.
The researchers assessed whether early implementation of Affordable Care Act (ACA) Medicaid expansion and state health insurance exchanges increased access to mental health and substance use treatment among those in need and whether these changes differed by racial/ethnic group. They found that mental health treatment rates increased significantly but found no evidence of a reduction in the wide racial/ethnic disparities in mental health treatment that preceded ACA expansion from 2005 to 2013.
AHRQ-funded; HS021486.
Citation: Creedon TB, Cook BL .
Access to mental health care increased but not for substance use, while disparities remain.
Health Aff 2016 Jun;35(6):1017-21. doi: 10.1377/hlthaff.2016.0098.
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Keywords: Access to Care, Disparities, Health Insurance, Policy, Medicaid, Behavioral Health, Substance Abuse
Davis MM, Spurlock M, Dulacki K
Disparities in alcohol, drug use, and mental health condition prevalence and access to care in rural, isolated, and reservation areas: Findings from the South Dakota Health Survey.
The authors studied alcohol, drug use, and mental health (ADM) condition prevalence and access to care across diverse geographies in a predominantly rural state. They concluded that geographic disparities in ADM conditions are related to differences in access as opposed to prevalence, particularly for individuals in isolated and reservation areas.
AHRQ-funded; HS022981.
Citation: Davis MM, Spurlock M, Dulacki K .
Disparities in alcohol, drug use, and mental health condition prevalence and access to care in rural, isolated, and reservation areas: Findings from the South Dakota Health Survey.
J Rural Health 2016 Jun;32(3):287-302. doi: 10.1111/jrh.12157.
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Keywords: Disparities, Behavioral Health, Rural Health, Access to Care, Substance Abuse
Yun K, Paul P, Subedi P
Help-seeking behavior and health care navigation by Bhutanese refugees.
The objective of this study was to document barriers to care, help-seeking behaviors, and the impact of a community-based patient navigation intervention on patient activation levels among Bhutanese refugees in the U.S. Following the intervention, only one-third reported the lowest level of patient activation and one-third were highly activated. Bhutanese refugees overcome healthcare access barriers by seeking help from a network of support that begins within the community.
AHRQ-funded; HS021706.
Citation: Yun K, Paul P, Subedi P .
Help-seeking behavior and health care navigation by Bhutanese refugees.
J Community Health 2016 Jun;41(3):526-34. doi: 10.1007/s10900-015-0126-x.
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Keywords: Access to Care, Cultural Competence, Education: Patient and Caregiver, Health Literacy, Racial and Ethnic Minorities
Kennedy-Hendricks A, Huskamp HA, Rutkow L
Improving access to care and reducing involvement in the criminal justice system for people with mental illness.
The authors summarized current knowledge about the involvement of people with mental illness in the criminal justice system and considered the recent opportunities presented by national and local policies that aim to lower the proportion of such people who are incarcerated.
AHRQ-funded; HS000029.
Citation: Kennedy-Hendricks A, Huskamp HA, Rutkow L .
Improving access to care and reducing involvement in the criminal justice system for people with mental illness.
Health Aff 2016 Jun;35(6):1076-83. doi: 10.1377/hlthaff.2016.0006.
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Keywords: Access to Care, Policy, Behavioral Health
Rodriguez HP, Knox M, Hurley V
The use of enhanced appointment access strategies by medical practices.
The authors examined practice use of open access scheduling and after-hours care. They found that system-owned practices and practices with greater use of team-based care, health information technology capabilities, and public reporting were more likely to use open access scheduling, while accountable care organization-affiliated practices and practices with greater use of public reporting and P4P were more likely to provide after-hours care.
AHRQ-funded; HS022241.
Citation: Rodriguez HP, Knox M, Hurley V .
The use of enhanced appointment access strategies by medical practices.
Med Care 2016 Jun;54(6):632-8. doi: 10.1097/mlr.0000000000000527.
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Keywords: Access to Care, Patient-Centered Healthcare
Salloum A, Johnco C, Lewin AB
Barriers to access and participation in community mental health treatment for anxious children.
The authors examined common barriers to treatment access and participation among anxious children who participated in computer-assisted cognitive behavioral therapy. They found that the most common access barrier was parents not knowing where or from whom to seek services. They concluded that accessible, time-efficient, cost-effective service delivery methods that minimize stigma and maximize engagement when delivering evidence-based treatment for pediatric anxiety are needed.
AHRQ-funded; HS018665.
Citation: Salloum A, Johnco C, Lewin AB .
Barriers to access and participation in community mental health treatment for anxious children.
J Affect Disord 2016 May 15;196:54-61. doi: 10.1016/j.jad.2016.02.026.
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Keywords: Access to Care, Anxiety, Children/Adolescents, Community-Based Practice, Behavioral Health
Olin SC, O'Connor BC, Storfer-Isser A
Access to care for youth in a state mental health system: a simulated patient approach.
The researchers examined access to psychiatric care for adolescents with depression in outpatient specialty clinics within a state mental health system, using a simulated patient approach. They concluded that access to psychiatric care for youth with depression was variable in a state system. State-sponsored trainings on strategies to reduce wait times appear to improve care access.
AHRQ-funded; HS020503.
Citation: Olin SC, O'Connor BC, Storfer-Isser A .
Access to care for youth in a state mental health system: a simulated patient approach.
J Am Acad Child Adolesc Psychiatry 2016 May;55(5):392-9. doi: 10.1016/j.jaac.2016.02.014.
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Keywords: Access to Care, Children/Adolescents, Behavioral Health, Depression, Training
Figueiredo R, Dempster L, Quinonez C
Emergency department use for dental problems among homeless individuals: a population-based cohort study.
The researchers evaluated emergency department (ED) visits for dental problems among Toronto's homeless population (Ontario, Canada). They found that over 80% of the ED visits by homeless people were for odontogenic infections, and 46% of homeless people had more than one such visit. They concluded that access to dental care is inadequate and that ED settings are ineffective for treatment of dental problems.
AHRQ-funded; HS014129.
Citation: Figueiredo R, Dempster L, Quinonez C .
Emergency department use for dental problems among homeless individuals: a population-based cohort study.
J Health Care Poor Underserved 2016;27(2):860-8. doi: 10.1353/hpu.2016.0081.
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Keywords: Access to Care, Dental and Oral Health, Emergency Department, Vulnerable Populations