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)
- Cardiovascular Conditions (4)
- Children/Adolescents (1)
- Community-Acquired Infections (1)
- Disparities (2)
- Elderly (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Human Immunodeficiency Virus (HIV) (2)
- Lifestyle Changes (1)
- Maternal Care (1)
- Medicaid (1)
- Medication (1)
- Medication: Safety (1)
- Mortality (1)
- Pregnancy (1)
- (-) Racial and Ethnic Minorities (10)
- (-) Risk (10)
- Sepsis (2)
- Sexual Health (1)
- Sleep Problems (1)
- Stroke (4)
- Surgery (1)
- Urban Health (1)
- Women (1)
- 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 10 of 10 Research Studies DisplayedInterrante JD, Tuttle MS, Admon LK
Severe maternal morbidity and mortality risk at the intersection of rurality, race and ethnicity, and Medicaid.
Using maternal discharge records from childbirth hospitalizations in the HCUP National Inpatient Sample, 2007-15, researchers examined differences in rates of severe maternal morbidity and mortality by rural or urban geography, race and ethnicity, and clinical factors among Medicaid-funded births and privately insured hospital births. The highest rate of severe maternal morbidity and mortality occurred among rural Indigenous Medicaid-funded births; births among Black rural and urban residents and among Hispanic urban residents also experienced elevated rates. The researchers concluded that heightened rates of severe maternal morbidity and mortality among Medicaid-funded births indicate an opportunity for state and federal policy responses to address the maternal health challenges faced by Medicaid beneficiaries, including Black, Indigenous, and rural residents
AHRQ-funded; HS027640.
Citation: Interrante JD, Tuttle MS, Admon LK .
Severe maternal morbidity and mortality risk at the intersection of rurality, race and ethnicity, and Medicaid.
Womens Health Issues 2022 Nov-Dec;32(6):540-49. doi: 10.1016/j.whi.2022.05.003..
Keywords: Healthcare Cost and Utilization Project (HCUP), Maternal Care, Women, Pregnancy, Mortality, Risk, Racial and Ethnic Minorities, Medicaid
Kleinman LC, Howell EA
Equity and the hazard of veiled injustice: a methodological reflection on risk adjustment.
The researchers report that in the context of quality improvement research, risk adjustment (RA) methods can obscure disparities in health care. In this study the researchers address the impact of considering equity when conducting risk adjustments in pediatric health, and describe the danger of veiled justice, a type of overadjustment that takes place when risk adjustments obscure real disparities because more than one covariate, such as race and socioeconomic status, are on related causal paths. Underadjustment can occur when these same structural characteristics are not addressed when calculating models of payment. The purpose of this study was to describe the literature and present a conceptual framework that identifies these two problems for validity related to the interactions between risk adjustment and health equity in pediatric health care. The researchers conclude that the science of quality improvement must address issues of health equity as an essential construct, with the development of a specific conceptual model. Statistical analysis should be interpreted using the conceptual model, and the dynamics of child development and life course should also be addressed, as well as additional contextual and process factors such as the role of caregivers and public insurance, the epidemiology of the disease, family financial status, and others. The goal of RA is to make valid conclusions such that observed differences can be attributed to the relevant causes. When higher risk is attributed to social determinants and not disease differences, RA can obscure disparities (veiled injustice) and differences at the population level and experienced by individuals are falsely hidden. Not addressing these same structural characteristics when calculating models of payment can lead to patterns of underadjustment. The authors advise that these 2 sides of a similar coin reveal the critical importance of both the underlying model and the capacity to reliably evaluate disparities and quality.
AHRQ-funded; HS020518; 233201550088A.
Citation: Kleinman LC, Howell EA .
Equity and the hazard of veiled injustice: a methodological reflection on risk adjustment.
Pediatrics 2022 Mar;149(Suppl 3). doi: 10.1542/peds.2020-045948G.
Keywords: Children/Adolescents, Disparities, Racial and Ethnic Minorities, Risk
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
Kempker JA, Panwar B, Judd SE
Plasma 25-hydroxyvitamin d and the longitudinal risk of sepsis in the REGARDS cohort..
In this paper, researchers studied low baseline plasma 25-hydroxyvitamin D (25(OH)D) and its association with long-term risk of sepsis. Data from the Reasons for Geographic and Racial Differences in Stroke study was used. Findings reveals that, among community-dwelling US adults, low plasma 25(OH)D measured at a time of relative health was independently associated with increased risk of sepsis.
AHRQ-funded; HS025240.
Citation: Kempker JA, Panwar B, Judd SE .
Plasma 25-hydroxyvitamin d and the longitudinal risk of sepsis in the REGARDS cohort..
Clin Infect Dis 2019 May 17;68(11):1926-31. doi: 10.1093/cid/ciy794..
Keywords: Community-Acquired Infections, Racial and Ethnic Minorities, Risk, Sepsis, Stroke
Skaathun B, Voisin DR, Cornwell B
A longitudinal examination of factors associated with network bridging among YMSM: implications for HIV prevention.
In this study, the investigators examined the link between social-environmental factors, network composition and HIV risk among a city-population based sample of young Black men who have sex with Men (YBMSM). The investigators found that bridging (i.e. having non-redundant contacts in one's network, indicating network instability) was associated with adverse social-environmental factors and higher HIV risk, indicating that bridging may be on the explanatory pathway.
AHRQ-funded; HS000084.
Citation: Skaathun B, Voisin DR, Cornwell B .
A longitudinal examination of factors associated with network bridging among YMSM: implications for HIV prevention.
AIDS Behav 2019 May;23(5):1326-38. doi: 10.1007/s10461-018-2258-3..
Keywords: Human Immunodeficiency Virus (HIV), Young Adults, Risk, Sexual Health, Racial and Ethnic Minorities
Patel M, Boutin-Foster C, Phillips E
Understanding of cardiovascular disease risk factors among Bangladeshi immigrants in New York City.
This study’s objective was to compare the understanding of cardiovascular disease (CVD) risk factors among Bangladeshi immigrants to the general Caucasian population in the U.S. by surveying a sample group of immigrants in Queens, NY., Scores on the knowledge instrument used for the surveyed Bangladeshis were compared with Caucasians from the Coronary Artery Risk Development in Young Adults (CARDIA) study using multivariate regression modeling. The results of the study indicate that understanding of CVD risk factors was lower among Bangladeshis than whites, driven by the surveyed Bangladeshis having less awareness of how exercise and weight contribute to CVD risk. The authors recommend that community based interventions and health partnerships target these behavioral risk factors in the Bangladeshi population.
AHRQ-funded; HS000066.
Citation: Patel M, Boutin-Foster C, Phillips E .
Understanding of cardiovascular disease risk factors among Bangladeshi immigrants in New York City.
Ethn Health 2019 May;24(4):432-42. doi: 10.1080/13557858.2017.1346191..
Keywords: Cardiovascular Conditions, Racial and Ethnic Minorities, Risk, Urban Health
Mahalingam M, Moore Jx, Donnelly JP
Frailty syndrome and risk of sepsis in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
This study examined the association between frailty (weakness, exhaustion, and low physical activity) and the risk of sepsis in stroke patients. Data from the cohort study Reasons for Geographic and Racial Differences in Stroke (REGARDS) was used. There was an associated increase in sepsis hospitalizations and 30-day case fatalities from sepsis in stroke patients with more frailty indicators.
AHRQ-funded; HS013852.
Citation: Mahalingam M, Moore Jx, Donnelly JP .
Frailty syndrome and risk of sepsis in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
J Intensive Care Med 2019 Apr;34(4):292-300. doi: 10.1177/0885066617715251..
Keywords: Elderly, Racial and Ethnic Minorities, Risk, Sepsis, Stroke
Desir FA, Lesko CR, Moore RD
One sIZE fITS (n)one: the influence of sex, age, and sexual human immunodeficiency virus (HIV) acquisition risk on racial/ethnic disparities in the HIV care continuum in the United States.
In this study the investigators examined the impact of sex, age, and sexual HIV acquisition risk (ie, heterosexual vs same-sex contact) on the magnitude of HIV-related racial/ethnic disparities. They found that racial/ethnic differences in HIV care persist in specific populations defined by sex, age, and sexual HIV acquisition risk. They suggest that clinical and public health interventions that jointly target these demographic factors are needed.
AHRQ-funded; 90047713.
Citation: Desir FA, Lesko CR, Moore RD .
One sIZE fITS (n)one: the influence of sex, age, and sexual human immunodeficiency virus (HIV) acquisition risk on racial/ethnic disparities in the HIV care continuum in the United States.
Clin Infect Dis 2019 Feb 15;68(5):795-802. doi: 10.1093/cid/ciy556..
Keywords: Disparities, Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Risk
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