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AHRQ Research Studies Date
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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 7 of 7 Research Studies DisplayedKaufman A, Dickinson WP, Fagnan LJ
The role of health extension in practice transformation and community health improvement: lessons from 5 case studies.
The states of New Mexico, Oklahoma, Oregon, Colorado, and Washington stand out in stretching the boundaries of health extension; their stories reveal lessons learned regarding the successes and challenges. All states saw the need for long-term, sustained fundraising beyond grants in an environment expecting a short-term return on investment, and they were challenged operating in a shifting health system landscape where the creativity and personal relationships built with small primary care practices was hindered when these practices were purchased by larger health delivery systems.
AHRQ-funded; HS020890; HS020972; HS23904; HS023908.
Citation: Kaufman A, Dickinson WP, Fagnan LJ .
The role of health extension in practice transformation and community health improvement: lessons from 5 case studies.
Ann Fam Med 2019 Aug 12;17(Suppl 1):S67-s72. doi: 10.1370/afm.2409..
Keywords: Community-Based Practice, Health Services Research (HSR), Healthcare Delivery, Organizational Change, Primary Care, Social Determinants of Health, Practice Improvement
Huguet N, Valenzuela S, Marino M
Following uninsured patients through Medicaid expansion: ambulatory care use and diagnosed conditions.
The authors assessed ambulatory care use and diagnosed health conditions among a cohort of community health center (CHC) patients uninsured before enactment of the Affordable Care Act (ACA) and followed them after enactment. They found that, post-ACA, 20.9% of patients remained uninsured, 15.0% gained Medicaid, 12.4% gained other insurance, and 51.7% did not have a visit. The authors concluded that a significant percentage of CHC patients remained uninsured; that many who remained uninsured had diagnosed health conditions; and that one-half continued to have three or more visits to CHCs, which continue to be essential providers for uninsured patients.
AHRQ-funded; HS024270.
Citation: Huguet N, Valenzuela S, Marino M .
Following uninsured patients through Medicaid expansion: ambulatory care use and diagnosed conditions.
Ann Fam Med 2019 Jul;17(4):336-44. doi: 10.1370/afm.2385..
Keywords: Access to Care, Ambulatory Care and Surgery, Community-Based Practice, Health Insurance, Healthcare Delivery, Medicaid, Policy, Uninsured
Trinacty CM, LaWall E, Ashton M
Adding social determinants in the electronic health record in clinical care in Hawai'i: supporting community-clinical linkages in patient care.
Given its distinctive history, culture, and location, Hawai'i has unique social factors impacting population health. Local health systems are striving to address these issues to meet their patients' health needs. Yet the evidence on precisely how health care systems and communities may work together to achieve these goals are limited both generally and specifically in the Hawai'i context. This article described real-world efforts by 3 local health care delivery systems that integrated the identification of social needs into clinical care using the electronic health record (EHR).
AHRQ-funded; HS023185.
Citation: Trinacty CM, LaWall E, Ashton M .
Adding social determinants in the electronic health record in clinical care in Hawai'i: supporting community-clinical linkages in patient care.
Hawaii J Med Public Health 2019 Jun;78(6 Suppl 1):46-51..
Keywords: Social Determinants of Health, Electronic Health Records (EHRs), Health Information Technology (HIT), Community-Based Practice, Healthcare Delivery, Vulnerable Populations
Lyles CR, Handley MA, Ackerman SL
Innovative implementation studies conducted in US safety net health care settings: a systematic review.
This systematic review examined innovation/implementation studies conducted in US safety net health care settings, including community clinics or integrated safety net systems. Most of the innovations were internally developed which created more acceptability among staff/providers, higher leadership involvement, and greater amounts of customization.
AHRQ-funded; HS022047.
Citation: Lyles CR, Handley MA, Ackerman SL .
Innovative implementation studies conducted in US safety net health care settings: a systematic review.
Am J Med Qual 2019 May/Jun;34(3):293-306. doi: 10.1177/1062860618798469..
Keywords: Community-Based Practice, Healthcare Delivery
Timbie JW, Kranz AM, Mahmud A
Specialty care access for Medicaid enrollees in expansion states.
The goal of this study was to assess current levels of difficulty accessing specialty care for patients at community health centers (CHCs) by insurance type, in order to identify specific barriers and the strategies that CHCs use to overcome these barriers. A cross-sectional survey was administered to medical directors at CHCs in nine states as well as the District of Columbia, all of which had expanded Medicaid. Among the barriers reported by CHCs were few specialists in Medicaid managed care organization (MCO) networks accepting new patients and MCO administrative requirements for obtaining specialist consults. Strategies to enhance access to specialists included entering into referral agreements, developing appointment reminder systems, and participation in data exchange and other community-based initiatives. The authors conclude that payment policies and network adequacy rules may need to be reexamined to address these challenges.
AHRQ-funded; HS024067.
Citation: Timbie JW, Kranz AM, Mahmud A .
Specialty care access for Medicaid enrollees in expansion states.
Am J Manag Care 2019 Mar;25(3):e83-e87..
Keywords: Access to Care, Community-Based Practice, Healthcare Delivery, Medicaid
Fiori K, Patel M, Sanderson D
From policy statement to practice: integrating social needs screening and referral assistance with community health workers in an urban academic health center.
The authors described their experience implementing a novel social needs screening program at an academic pediatric clinic. They found that, on average, 76% of providers had their patients screened on more than half of eligible well-child visits. Their experience suggested that screening for social needs at well-child visits is feasible as part of routine primary care. They recommended that success would best be achieved by leveraging resources, obtaining provider buy-in, and defining program components to sustain activities.
AHRQ-funded; HS026396.
Citation: Fiori K, Patel M, Sanderson D .
From policy statement to practice: integrating social needs screening and referral assistance with community health workers in an urban academic health center.
J Prim Care Community Health 2019 Jan-Dec;10:2150132719899207. doi: 10.1177/2150132719899207..
Keywords: Children/Adolescents, Community-Based Practice, Healthcare Delivery, Implementation, Screening, Social Determinants of Health, Urban Health, Workflow, Primary Care
Laiteerapong N, Kirby J, Gao Y
AHRQ Author: Kirby J, Ngo-Metzger Q
Health care utilization and receipt of preventive care for patients seen at federally funded health centers compared to other sites of primary care.
The investigators compared utilization and preventive care receipt among patients of federal Section 330 health centers (HCs) versus patients of other settings. They found that HC patients had fewer office visits and hospitalizations, were more likely to receive breast cancer screening, had fewer outpatient and emergency room visits, and were more likely to receive dietary advice compared to non-HC patients.
AHRQ-authored.
Citation: Laiteerapong N, Kirby J, Gao Y .
Health care utilization and receipt of preventive care for patients seen at federally funded health centers compared to other sites of primary care.
Health Serv Res 2014 Oct;49(5):1498-518. doi: 10.1111/1475-6773.12178.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Utilization, Prevention, Community-Based Practice, Healthcare Delivery