National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
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AHRQ Research Studies Date
Topics
- Access to Care (37)
- Adverse Drug Events (ADE) (1)
- Ambulatory Care and Surgery (2)
- Antibiotics (2)
- Antimicrobial Stewardship (1)
- Asthma (2)
- Behavioral Health (12)
- Blood Thinners (1)
- Cancer (2)
- Cancer: Breast Cancer (1)
- Cancer: Cervical Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cardiovascular Conditions (3)
- Care Management (2)
- Case Study (1)
- Children's Health Insurance Program (CHIP) (2)
- Children/Adolescents (18)
- Chronic Conditions (7)
- Colonoscopy (1)
- Community-Based Practice (6)
- Community Partnerships (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- COVID-19 (3)
- Dental and Oral Health (3)
- Depression (2)
- Diabetes (2)
- Disparities (6)
- Elderly (5)
- Electronic Health Records (EHRs) (1)
- Emergency Department (5)
- Emergency Medical Services (EMS) (2)
- Evidence-Based Practice (2)
- Healthcare Cost and Utilization Project (HCUP) (7)
- Healthcare Costs (18)
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- Health Insurance (51)
- Health Services Research (HSR) (3)
- Health Status (2)
- Heart Disease and Health (1)
- Hepatitis (1)
- Hospitalization (4)
- Hospital Readmissions (4)
- Hospitals (7)
- Human Immunodeficiency Virus (HIV) (2)
- Inpatient Care (2)
- Labor and Delivery (2)
- Long-Term Care (2)
- Low-Income (19)
- Maternal Care (11)
- (-) Medicaid (123)
- Medical Expenditure Panel Survey (MEPS) (6)
- Medicare (18)
- Medication (16)
- Mortality (2)
- Neurological Disorders (1)
- Newborns/Infants (2)
- Nursing Homes (3)
- Opioids (4)
- Orthopedics (1)
- Outcomes (5)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (5)
- Patient Adherence/Compliance (1)
- Payment (7)
- Policy (27)
- Practice Patterns (1)
- Pregnancy (7)
- Prevention (4)
- Primary Care (8)
- Provider (1)
- Provider: Pharmacist (2)
- Provider: Physician (1)
- Provider Performance (1)
- Public Health (1)
- Quality Improvement (1)
- Quality Indicators (QIs) (1)
- Quality Measures (2)
- Quality of Care (11)
- Racial and Ethnic Minorities (7)
- Respiratory Conditions (2)
- Risk (1)
- Screening (2)
- Sickle Cell Disease (1)
- Social Determinants of Health (6)
- Substance Abuse (4)
- Surgery (5)
- Transitions of Care (1)
- Uninsured (15)
- Vulnerable Populations (4)
- Women (9)
- Workforce (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
101 to 123 of 123 Research Studies DisplayedFiscella K, Geiger HJ
Caring for the poor in the 21st century: enabling community health centers for a new era.
This article discusses various challenges facing community health centers (CHCs) in the 21st century. These include: potential erosion of the Medicaid prospective payment system, the failure of many States to expand Medicaid, the growth of accountable care organizations, the growth of high deductible health insurance for the privately insured, and increased competition for primary care clinicians.
AHRQ-funded; HS022440
Citation: Fiscella K, Geiger HJ .
Caring for the poor in the 21st century: enabling community health centers for a new era.
J Health Care Poor Underserved. 2014 Nov;25(4):2044-52. doi: 10.1353/hpu.2014.0182..
Keywords: Low-Income, Primary Care, Medicaid, Health Insurance
Malhotra K, Baltrus P P, Zhang S
Geographic and racial variation in asthma prevalence and emergency department use among Medicaid-enrolled children in 14 southern states.
Using 2007 Medicaid claims data from 556 counties in 14 southern states, the researchers described the local area variation in 1-year asthma prevalence rates, emergency department visit rates, and racial disparity rate ratios. They found much local area variation in asthma prevalence and asthma ED visit rates among Medicaid-enrolled children. Between black and white children, more counties had higher prevalence of asthma and higher ED visit rates among blacks.
AHRQ-funded; HS022444; HS019470
Citation: Malhotra K, Baltrus P P, Zhang S .
Geographic and racial variation in asthma prevalence and emergency department use among Medicaid-enrolled children in 14 southern states.
J Asthma. 2014 Nov;51(9):913-21. doi: 10.3109/02770903.2014.930479..
Keywords: Asthma, Medicaid, Social Determinants of Health, Emergency Department, Emergency Medical Services (EMS)
Epstein AM, Sommers BD, Kuznetsov Y
Low-income residents in three states view Medicaid as equal to or better than private coverage, support expansion.
The authors explored what low-income Americans think about Medicaid. They found that nearly 80 percent of their telephone survey sample favored Medicaid expansion, and approximately two-thirds of uninsured respondents said that they planned to apply for either Medicaid or subsidized private coverage in 2014. Most viewed having Medicaid as better than being uninsured and at least as good as private insurance in overall quality and affordability.
AHRQ-funded; HS021291.
Citation: Epstein AM, Sommers BD, Kuznetsov Y .
Low-income residents in three states view Medicaid as equal to or better than private coverage, support expansion.
Health Aff 2014 Nov;33(11):2041-7. doi: 10.1377/hlthaff.2014.0747.
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Keywords: Health Insurance, Policy, Low-Income, Medicaid, Uninsured
Werth SR, Sachdeva N, Roberts AW
North Carolina Medicaid recipient management lock-in program: the pharmacist's perspective.
The objectives of this study were (a) evaluate pharmacists’ perceptions of the implementation of the North Carolina (NC) recipient management lock-in program (MLIP) and (b) determine how the beliefs and attitudes of pharmacists could promote or inhibit its success. It concluded that, although possible improvements were identified, the NC MLIP has strong potential for success as it utilizes pharmacists’ medication gate-keeping role, while minimizing the effort required for successful implementation.
AHRQ-funded; HS000032.
Citation: Werth SR, Sachdeva N, Roberts AW .
North Carolina Medicaid recipient management lock-in program: the pharmacist's perspective.
J Manag Care Spec Pharm 2014 Nov;20(11):1122-9..
Keywords: Medicaid, Medication, Opioids, Provider: Pharmacist, Substance Abuse
Beil H, Rozier RG, Preisser JS
Effects of early dental office visits on dental caries experience.
This study determined the association between timing of a first dentist office visit before age 5 and dental disease in kindergarten. It found that children with early dental visits (before age 2) had higher rates of tooth decay than those who had later visits (between ages 3 and 5).
AHRQ-funded; HS018076.
Citation: Beil H, Rozier RG, Preisser JS .
Effects of early dental office visits on dental caries experience.
Am J Public Health. 2014 Oct;104(10):1979-85. doi: 10.2105/AJPH.2013.301325..
Keywords: Dental and Oral Health, Children/Adolescents, Access to Care, Medicaid, Prevention
Gold R, Bailey SR, O'Malley JP
Estimating demand for care after a Medicaid expansion: lessons from Oregon.
In order to estimate how the Affordable Care Act's Medicaid expansions will affect demand for services, the authors measured ambulatory care utilization among adult patients who gained insurance during Oregon's 2008 Medicaid expansion. They found that, in comparisons of the pre- and postcoverage periods, the mean annual encounters among persons who gained insurance increased 22% to 35%, but declined in the comparison groups.
AHRQ-funded; HS021522.
Citation: Gold R, Bailey SR, O'Malley JP .
Estimating demand for care after a Medicaid expansion: lessons from Oregon.
J Ambul Care Manage 2014 Oct-Dec;37(4):282-92. doi: 10.1097/jac.0000000000000023.
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Keywords: Access to Care, Healthcare Utilization, Policy, Health Services Research (HSR), Medicaid
Vanderwerker L, Akincigil A, Olfson M
Foster care, externalizing disorders, and antipsychotic use among Medicaid-enrolled youths.
The researchers investigated the extent to which clinical diagnoses of externalizing disorders explain higher rates of antipsychotic use by foster care youths. They found that foster care youths had higher rates of externalizing disorders than the comparison group and greater antipsychotic use. Foster care remained a significant predictor of antipsychotic use after control for demographic and diagnostic covariates.
AHRQ-funded; HS017918; HS019937; HS021112.
Citation: Vanderwerker L, Akincigil A, Olfson M .
Foster care, externalizing disorders, and antipsychotic use among Medicaid-enrolled youths.
Psychiatr Serv 2014 Oct;65(10):1281-4. doi: 10.1176/appi.ps.201300455.
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Keywords: Children/Adolescents, Medication, Medicaid, Vulnerable Populations, Behavioral Health
Snyder ME, Frail CK, Jaynes H
Predictors of medication-related problems among Medicaid patients participating in a pharmacist-provided telephonic medication therapy management program.
The objective of this study was to identify predictors of medication-related problems (MRPs) among Medicaid patients participating in a telephonic medication therapy management (MTM) program. The analysis of study results supports the relative importance of number of medications as a predictor of MRPs in the Medicaid population and identifies other predictors.
AHRQ-funded; HS022119.
Citation: Snyder ME, Frail CK, Jaynes H .
Predictors of medication-related problems among Medicaid patients participating in a pharmacist-provided telephonic medication therapy management program.
Pharmacotherapy 2014 Oct;34(10):1022-32. doi: 10.1002/phar.1462..
Keywords: Adverse Drug Events (ADE), Care Management, Community-Based Practice, Medicaid, Medication, Provider: Pharmacist
Regenstein M, Andres E
Reducing hospital readmissions among Medicaid patients: a review of the literature.
This review aims to identify factors related to readmissions that are unique to Medicaid populations to inform efforts to reduce Medicaid readmissions. It concluded that much of the Medicaid readmissions literature focuses on patients with mental health or substance abuse issues, who are often high utilizers of health care within the Medicaid population.
AHRQ-funded; 290202010000301.
Citation: Regenstein M, Andres E .
Reducing hospital readmissions among Medicaid patients: a review of the literature.
Qual Manag Health Care 2014 Oct-Dec;23(4):203-25. doi: 10.1097/qmh.0000000000000043..
Keywords: Hospital Readmissions, Medicaid, Behavioral Health, Substance Abuse, Social Determinants of Health
Reeves S, Garcia E, Kleyn M
Identifying sickle cell disease cases using administrative claims.
The authors developed and tested the accuracy of administrative claims method for identifying children with sickle cell disease (SCD) to enable quality of care assessments among children enrolled in Medicaid. They found that their definition can be used to facilitate a more accurate identification of children with SCD in future studies.
AHRQ-funded; HS020516.
Citation: Reeves S, Garcia E, Kleyn M .
Identifying sickle cell disease cases using administrative claims.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S61-7. doi: 10.1016/j.acap.2014.02.008.
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Keywords: Children/Adolescents, Health Insurance, Medicaid, Sickle Cell Disease
Aliu O, Auger KA, Sun GH
The effect of pre-Affordable Care Act (ACA) Medicaid eligibility expansion in New York State on access to specialty surgical care.
Using the natural experiment of Medicaid expansion in New York (NY) State in October 2001, the study investigators examined whether Medicaid expansion increased access to common musculoskeletal procedures for Medicaid beneficiaries. They concluded that Medicaid expansion in NY State significantly improved access to common musculoskeletal procedures for Medicaid beneficiaries.
AHRQ-funded; HS020672.
Citation: Aliu O, Auger KA, Sun GH .
The effect of pre-Affordable Care Act (ACA) Medicaid eligibility expansion in New York State on access to specialty surgical care.
Med Care 2014 Sep;52(9):790-5. doi: 10.1097/mlr.0000000000000175..
Keywords: Access to Care, Policy, Medicaid, Surgery
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
Trudnak T, Kelley D, Zerzan J
AHRQ Author: Jiang HJ
Medicaid admissions and readmissions: understanding the prevalence, payment, and most common diagnoses.
The authors characterized acute care hospital admissions and thirty-day readmissions in the Medicaid population through a retrospective analysis in nineteen states. They found that Medicaid readmissions were both prevalent and costly, and that they represented 12.5 percent of Medicaid payments for all hospitalizations, with the most prevalent diagnostic categories being mental and behavioral disorders and diagnoses related to pregnancy, childbirth, and their complications.
AHRQ-authored; AHRQ-funded; 29020090015C.
Citation: Trudnak T, Kelley D, Zerzan J .
Medicaid admissions and readmissions: understanding the prevalence, payment, and most common diagnoses.
Health Aff 2014 Aug;33(8):1337-44. doi: 10.1377/hlthaff.2013.0632.
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Keywords: Healthcare Costs, Hospitalization, Medicaid, Hospital Readmissions
Schiltz NK, Finkelstein Rosenthal B, Crowley MA
Rehospitalization during the first year of life by insurance status.
The authors assessed the association of insurance status on infant rehospitalization in a population-based setting. They found that Medicaid coverage and being uninsured were strong predictors of rehospitalizations, with Medicaid bearing a disproportionate share of the economic burden. Normal birth weight infants had the lowest risk. They further found that jaundice and acute bronchiolitis were the leading causes of rehospitalization within 30 days and 1 year, respectively.
AHRQ-funded; HS000059.
Citation: Schiltz NK, Finkelstein Rosenthal B, Crowley MA .
Rehospitalization during the first year of life by insurance status.
Clin Pediatr 2014 Aug;53(9):845-53. doi: 10.1177/0009922814536924.
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Keywords: Health Insurance, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Newborns/Infants, Medicaid, Newborns/Infants
Heintzman J, Bailey SR, Hoopes MJ
Agreement of Medicaid claims and electronic health records for assessing preventive care quality among adults.
The researchers sought to compare the agreement of electronic health records (EHR) data versus Medicaid claims data in documenting adult preventive care. For services performed in the primary care setting, EHR data compared favorably to Medicaid claims in documenting the percentage of patients with service receipt; services that were referred out were less frequently observed in the EHR.
AHRQ-funded; HS021522
Citation: Heintzman J, Bailey SR, Hoopes MJ .
Agreement of Medicaid claims and electronic health records for assessing preventive care quality among adults.
J Am Med Inform Assoc. 2014 Jul-Aug;21(4):720-4. doi: 10.1136/amiajnl-2013-002333..
Keywords: Electronic Health Records (EHRs), Health Insurance, Medicaid, Prevention, Primary Care
Palmsten K, Huybrechts KF, Kowal MK
Validity of maternal and infant outcomes within nationwide Medicaid data.
The researchers aimed to assess the validity of preeclampsia, congenital cardiac malformations, and persistent pulmonary hypertension of the newborn diagnoses in the U.S. Medicaid Analytic eXtract (MAX), a database that may be useful for perinatal research. The positive predictive values were conservative, particularly when restricting to infants not transferred to another facility shortly after birth because only records from a single hospitalization were reviewed.
AHRQ-funded; HS018533
Citation: Palmsten K, Huybrechts KF, Kowal MK .
Validity of maternal and infant outcomes within nationwide Medicaid data.
Pharmacoepidemiol Drug Saf 2014 Jun;23(6):646-55. doi: 10.1002/pds.3627..
Keywords: Newborns/Infants, Maternal Care, Outcomes, Medicaid
Desai RJ, Hernandez-Diaz S, Bateman BT
Increase in prescription opioid use during pregnancy among Medicaid-enrolled women.
The researchers reported the prevalence of prescription opioid use and evaluated the trends in a large cohort of Medicaid-enrolled pregnant women. They observed high and increasing number of filled prescriptions for opioids during pregnancy among Medicaid-enrolled women and recommended further safety evaluations of these drugs and their effects on the developing fetus.
AHRQ-funded; HS018533.
Citation: Desai RJ, Hernandez-Diaz S, Bateman BT .
Increase in prescription opioid use during pregnancy among Medicaid-enrolled women.
Obstet Gynecol 2014 May;123(5):997-1002. doi: 10.1097/aog.0000000000000208.
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Keywords: Healthcare Utilization, Medicaid, Medication, Opioids, Pregnancy
Zhang SM, McGoy SL, Dawes D
The potential for elimination of racial-ethnic disparities in HIV treatment initiation in the Medicaid population among 14 southern states.
This study explored racial/ethnic disparities in the initiation of antiretroviral treatment among HIV-infected Medicaid enrollees in 14 Southern States. It found no significant differences between blacks and non-Hispanic whites but Hispanic/Latino persons were significantly less likely to receive antiretroviral treatment.
AHRQ-funded; HS022444; HS019470
Citation: Zhang SM, McGoy SL, Dawes D .
The potential for elimination of racial-ethnic disparities in HIV treatment initiation in the Medicaid population among 14 southern states.
PLoS One. 2014 Apr 25;9(4):e96148. doi: 10.1371/journal.pone.0096148..
Keywords: Human Immunodeficiency Virus (HIV), Disparities, Racial and Ethnic Minorities, Medicaid
Hill SC, Abdus S, Hudson JL
AHRQ Author: Hill SC, Hudson JL, Selden TM
Adults in the income range for the Affordable Care Act's Medicaid expansion are healthier than pre-ACA enrollees.
The investigators used MEPS data to compare nondisabled adults enrolled in Medicaid prior to the ACA with two other groups: adults who were eligible for Medicaid but not enrolled in it, and adults who were in the income range for the ACA's Medicaid expansion and thus newly eligible for coverage. They found that both the newly eligible and those eligible before the ACA but not enrolled were healthier on several measures than pre-ACA enrollees. They concluded that by expanding Medicaid eligibility, states could provide coverage to millions of healthier adults as well as to millions who have chronic conditions and who need care.
AHRQ-authored.
Citation: Hill SC, Abdus S, Hudson JL .
Adults in the income range for the Affordable Care Act's Medicaid expansion are healthier than pre-ACA enrollees.
Health Aff 2014 Apr;33(4):691-9. doi: 10.1377/hlthaff.2013.0743.
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Keywords: Health Insurance, Policy, Health Status, Low-Income, Medicaid, Medical Expenditure Panel Survey (MEPS)
Gellad WF, Choi P, Mizah M
Assessing the chiral switch: approval and use of single-enantiomer drugs, 2001 to 2011.
The researchers studied the prevalence of chiral switching in the United States over the past decade, including trends in use of, and expenditures on these products in Medicaid. They found that recently approved single-enantiomer drugs showed no evidence of superior efficacy over the older racemic precursors in the pivotal trials leading to their approval.
AHRQ-funded; HS018465.
Citation: Gellad WF, Choi P, Mizah M .
Assessing the chiral switch: approval and use of single-enantiomer drugs, 2001 to 2011.
Am J Manag Care 2014 Mar;20(3):e90-7..
Keywords: Medicaid, Medication
Hartung DM, Zerzan J, Yamashita T
Characteristics and trends of low-dose quetiapine use in two western state Medicaid programs.
This study characterized longitudinal trends in low-dose second-generation antipsychotic medications, and, in particular, quetiapine in two western State Medicaid programs over a 5-year period. The researchers found that when one State suspended off-label promotional activities, there was a significant decline in the initiation of low-dose quetiapine use.
AHRQ-funded; HS019456; HS019464.
Citation: Hartung DM, Zerzan J, Yamashita T .
Characteristics and trends of low-dose quetiapine use in two western state Medicaid programs.
Pharmacoepidemiol Drug Saf. 2014 Jan;23(1):87-94. doi: 10.1002/pds.3538..
Keywords: Medication, Medicaid, Behavioral Health
Schwartz AL, Sommers BD
Moving for Medicaid? Recent eligibility expansions did not induce migration from other states.
This study used 26 measures of low value services to examine service use and associated spending detected by these measures in Medicaid. In the six categories of care measured, services detected by a limited number of measures of low-value care constituted modest proportions of overall spending (2.7 percent) but affected 42 percent of beneficiaries.
AHRQ-funded; HS00055; HS021291
Citation: Schwartz AL, Sommers BD .
Moving for Medicaid? Recent eligibility expansions did not induce migration from other states.
Health Aff. 2014 Jan;33(1):88-94. doi: 10.1377/hlthaff.2013.0910..
Keywords: Medicaid, Healthcare Costs, Low-Income, Healthcare Utilization
Sommers BD, Kenney GM, Epstein AM
New evidence on the Affordable Care Act: coverage impacts of early Medicaid expansions.
Since 2010 California, Connecticut, Minnesota, and Washington, D.C., have taken advantage of the Affordable Care Act’s option to expand coverage earlier to a portion of low-income childless adults. The researchers present new data on these expansions focusing on several questions including the extent to which childless adults’ new enrollment in Medicaid result from extending coverage to uninsured people as opposed to replacing private coverage.
AHRQ-funded; HS021291.
Citation: Sommers BD, Kenney GM, Epstein AM .
New evidence on the Affordable Care Act: coverage impacts of early Medicaid expansions.
Health Aff 2014 Jan;33(1):78-87. doi: 10.1377/hlthaff.2013.1087..
Keywords: Low-Income, Uninsured, Medicaid, Health Insurance