National Healthcare Quality and Disparities Report
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Topics
- Access to Care (6)
- Asthma (1)
- Behavioral Health (4)
- Blood Pressure (1)
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- Cancer: Breast Cancer (1)
- Cancer: Cervical Cancer (1)
- Children's Health Insurance Program (CHIP) (1)
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- Diagnostic Safety and Quality (1)
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- (-) Medical Expenditure Panel Survey (MEPS) (26)
- Medicare (3)
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- Policy (5)
- Practice Patterns (1)
- Prevention (1)
- Primary Care (1)
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- Quality of Life (1)
- Racial and Ethnic Minorities (2)
- Research Methodologies (1)
- Respiratory Conditions (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 26 Research Studies DisplayedSelden TM, Berdahl TA, Fang Z
AHRQ Author: Selden TM, Berdahl TA, Fang Z
The risk of severe COVID-19 within households of school employees and school-age children.
Across the United States, school districts are grappling with questions of whether and how to reopen elementary and secondary schools in the 2020-21 academic year. Using pre-pandemic household data, the authors examined how often persons at risk of severe coronavirus disease 2019 (COVID-19) were connected to schools, either as employees or by living in the same households as school employees or school-age children.
AHRQ-authored.
Citation: Selden TM, Berdahl TA, Fang Z .
The risk of severe COVID-19 within households of school employees and school-age children.
Health Aff 2020 Nov;39(11):2002-09. doi: 10.1377/hlthaff.2020.01536..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, COVID-19, Public Health, Risk, Infectious Diseases
Wisk LE, Peltz A, Galbraith AA
Changes in health care-related financial burden for US families with children associated with the Affordable Care Act.
The Affordable Care Act (ACA) sought to improve access and affordability of health insurance. Although most ACA policies targeted childless adults, the extent to which these policies also impacted families with children remains unclear. The purpose of this study was to examine changes in health care-related financial burden for US families with children before and after the ACA was implemented based on income eligibility for ACA policies.
AHRQ-funded; HS024700.
Citation: Wisk LE, Peltz A, Galbraith AA .
Changes in health care-related financial burden for US families with children associated with the Affordable Care Act.
JAMA Pediatr 2020 Nov;174(11):1032-40. doi: 10.1001/jamapediatrics.2020.3973..
Keywords: Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Health Insurance, Policy, Access to Care
Hill SC, Miller GE, Ding Y
AHRQ Author: Hill SC, Miller GE, Ding Y
Net spending on retail specialty drugs grew rapidly, especially for private insurance and Medicare Part D.
This study examined net spending trends on retail specialty drugs from 2010 to 2017. Spending has been difficult to measure due to proprietary rebate payments by manufacturers by insurers, pharmacy benefit managers and state Medicaid agencies. The authors incorporated those rebates into their research. They found that specialty drugs accounted for 37.7% of retail and mail-order prescription spending net of rebates in 2016-17. The spending net of rebates tripled for Medicare Part D beneficiaries and more than doubled for people with private insurance from 2010 to 2017. Medicaid net spending of rebates had a slower increase.
AHRQ-authored.
Citation: Hill SC, Miller GE, Ding Y .
Net spending on retail specialty drugs grew rapidly, especially for private insurance and Medicare Part D.
Health Aff 2020 Nov;39(11):1970-76. doi: 10.1377/hlthaff.2019.01830..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Medication, Medicare, Health Insurance
Khouja T, Burgette JM, Donohue JM
Association between Medicaid expansion, dental coverage policies for adults, and children's receipt of preventive dental services.
Researchers examined whether low-income children's use of preventive dental services is linked to variation in state Medicaid policies that affect parents' access to dental care in Medicaid. Using MEPS data along with Area Health Resources File and Medicaid adult dental coverage policies, they found no change in children's receipt of preventive dental care associated with Medicaid expansions in states that covered vs did not cover preventive dental services for adults. They concluded that factors other than parental access to dental benefits through Medicaid may be more salient determinants of preventive dental care use among low-income children.
AHRQ-funded; HS026727.
Citation: Khouja T, Burgette JM, Donohue JM .
Association between Medicaid expansion, dental coverage policies for adults, and children's receipt of preventive dental services.
Health Serv Res 2020 Oct;55(5):642-50. doi: 10.1111/1475-6773.13324..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Dental and Oral Health, Medicaid, Health Insurance, Low-Income, Access to Care, Policy
Selden TM, Berdahl TA
AHRQ Author: Selden TM, Berdahl TA
COVID-19 and racial/ethnic disparities in health risk, employment, and household composition.
In this study, the investigators used data from the Medical Expenditure Panel Survey to explore potential explanations for racial-ethnic disparities in coronavirus disease 2019 (COVID-19) hospitalizations and mortality. The authors found that black adults in every age group were more likely than whites to have health risks associated with severe COVID-19 illness. However, whites were older on average than blacks.
AHRQ-authored.
Citation: Selden TM, Berdahl TA .
COVID-19 and racial/ethnic disparities in health risk, employment, and household composition.
Health Aff 2020 Sep;39(9):1624-32. doi: 10.1377/hlthaff.2020.00897..
Keywords: Medical Expenditure Panel Survey (MEPS), COVID-19, Disparities, Racial and Ethnic Minorities, Risk
Zuvekas SH, McClellan CB, Ali MM
AHRQ Author: Zuvekas SH, McClellan CB
Medicaid expansion and health insurance coverage and treatment utilization among individuals with a mental health condition.
AHRQ-authored.
Citation: Zuvekas SH, McClellan CB, Ali MM .
Medicaid expansion and health insurance coverage and treatment utilization among individuals with a mental health condition.
J Ment Health Policy Econ 2020 Sep 1;23(3):151-82..
Keywords: Medical Expenditure Panel Survey (MEPS), Behavioral Health, Medicaid, Health Insurance, Access to Care, Healthcare Utilization, Policy, Uninsured
Pollack LM, Ekwueme DU, Hung MC Pollack LM, Ekwueme DU, Hung MC, Pollack LM, Ekwueme DU, Hung MC Pollack LM, Ekwueme DU, Hung MC, Hung MC
Estimating the impact of increasing cervical cancer screening in the National Breast and Cervical Cancer Early Detection Program among low-income women in the USA.
The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides free cervical cancer screening to low-income women. This study estimated the health benefits gained in terms of life years (LYs) saved and quality-adjusted life years (QALYs) gained if cervical cancer screening by the NBCCEDP increased to reach more eligible women. The investigators found that the reported estimates emphasized the value of cervical cancer screening program by extending LE in low-income women.
Citation: Pollack LM, Ekwueme DU, Hung MC Pollack LM, Ekwueme DU, Hung MC, Pollack LM, Ekwueme DU, Hung MC Pollack LM, Ekwueme DU, Hung MC, Hung MC .
Estimating the impact of increasing cervical cancer screening in the National Breast and Cervical Cancer Early Detection Program among low-income women in the USA.
Cancer Causes Control 2020 Jul;31(7):691-702. doi: 10.1007/s10552-020-01314-z..
Keywords: Medical Expenditure Panel Survey (MEPS), Cancer: Cervical Cancer, Cancer: Breast Cancer, Cancer, Screening, Women, Diagnostic Safety and Quality, Low-Income
Monheit AC, Grafova IB, Kumar R
How does family health care use respond to economic shocks? Realized and anticipated effects.
Using two-year panel data from the Medical Expenditure Panel Survey (MEPS) for 2004 to 2012, the investigators examined how the intra-family allocation of health care spending responded to realized and anticipated changes in family economic status. They focused on the share of total family health care spending allocated to children and measured realized economic shocks based on changes in the family’s income, employment, and health insurance status.
AHRQ-funded; HS024053.
Citation: Monheit AC, Grafova IB, Kumar R .
How does family health care use respond to economic shocks? Realized and anticipated effects.
Review of Economics of the Household 2020 Jun;18(2):307-34. doi: 10.1007/s11150-018-9438-9..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs
Zuvekas SH, Biener AI, Hicks WD
AHRQ Author: Zuvekas SH
The effects of survey enhancements on the quality of reporting in the Medical Expenditure Panel Survey, 2008–2015.
It is well established that survey respondents imperfectly recall health care use in surveys. However, careful attention to both survey design and fielding procedures can enhance recall. In this study, the investigators examined the effects of a comprehensive, multi-pronged approach to changing field procedures in the Medical Expenditure Panel Survey (MEPS) to improve quality of health care use reporting.
AHRQ-authored.
Citation: Zuvekas SH, Biener AI, Hicks WD .
The effects of survey enhancements on the quality of reporting in the Medical Expenditure Panel Survey, 2008–2015.
J Surv Stat Methodol 2020 Jun;8(3):589-616..
Keywords: Medical Expenditure Panel Survey (MEPS), Research Methodologies
Cook BL, Flores M, Zuvekas SH
AHRQ Author: Zuvekas SH
The impact Of Medicare's mental health cost-sharing parity on use of mental health care services.
This study examined the impact of Medicare’s mental health cost-sharing parity on use of mental health care services, which was phased in from 2010 to 2014. The authors assessed whether the reduction in mental health cost sharing was associated with changes in specialty and primary care outpatient mental health visits and psychotropic medication fills. They compared people with Medicare and private insurance before and after implementation. Medicare beneficiaries’ use of psychotropic medication increased after implementation but there was not a detectable change in visits.
AHRQ-authored.
Citation: Cook BL, Flores M, Zuvekas SH .
The impact Of Medicare's mental health cost-sharing parity on use of mental health care services.
Health Aff 2020 May;39(5):819-27. doi: 10.1377/hlthaff.2019.01008..
Keywords: Medical Expenditure Panel Survey (MEPS), Medicare, Behavioral Health, Healthcare Costs, Policy, Health Insurance, Healthcare Utilization, Access to Care
Berdahl T, Biener A, McCormick MC
AHRQ Author: Berdahl T
Annual report on children's healthcare: healthcare access and utilization by obesity status in the United States.
This study examined access to care and utilization patterns across a set of healthcare measures by obesity status and sociodemographic characteristics among children. Data from the Medical Expenditure Panel Survey (MEPS) from 2010-2015 was used to determine obesity status, number of well-child visits, access to a usual source of care, number of preventive dental visits and prescription medication fills in the past year. It was found that uninsured adolescents with obesity were less like to have a usual source of care provider than children without obesity. Among younger children, those living in the Northeast were more than twice as likely to have had a well-child visit than those living in the West. Preventive dental care was less likely to have occurred for children with obesity than non-obese children. More prescription refills were completed for obese adolescents than for younger children.
AHRQ-authored.
Citation: Berdahl T, Biener A, McCormick MC .
Annual report on children's healthcare: healthcare access and utilization by obesity status in the United States.
Acad Pediatr 2020 Mar;20(2):175-87. doi: 10.1016/j.acap.2019.11.020..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Access to Care, Healthcare Utilization, Obesity
Grafova IB, Monheit AC, Kumar R
How do changes in income, employment and health insurance affect family mental health spending?
This study used eight two-year panels from the MEPS data for 2004 to 2012 to examine the effect of economic shocks on mental health spending by families with children. Researchers wanted to determine whether the greatest impact on mental health spending comes from income, employment, or health insurance shocks. They used two-part expenditure models to estimate that employment losses are positively related to an increase in total family mental health expenditures. But no link was found between economic shocks and mental health spending on fathers.
AHRQ-funded; HS024053.
Citation: Grafova IB, Monheit AC, Kumar R .
How do changes in income, employment and health insurance affect family mental health spending?
Rev Econ Househ 2020 Mar;18(1:239-63. doi: 10.1007/s11150-018-9436-y.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Behavioral Health, Social Determinants of Health, Health Insurance
Abdus S
AHRQ Author: Abdus S
The role of plan choice in health care utilization of high-deductible plan enrollees.
This study examined the role of plan choice in health care utilization of high-deductible plan enrollees. 2011-2016 MEPS Household Component data on nonelderly adults enrolled in employer-sponsored insurance was used. Four types of health plans were examined: high-deductible, consumer-directed, low-deductible, and no-deductible. Among adults with a choice of plans, high-deductible enrollees had lower levels of utilization compared with no-deductible enrollees for all types of services. This might be explained by favorable selection and that the enrollees are probably younger and healthier with the high-deductible plans being lower in cost than other plan types. Among adults without any choice of plans, the differences were not statistically significant.
AHRQ-authored.
Citation: Abdus S .
The role of plan choice in health care utilization of high-deductible plan enrollees.
Health Serv Res 2020 Feb;55(1):119-27. doi: 10.1111/1475-6773.13223..
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Healthcare Utilization
Selden TM
AHRQ Author: Selden TM
Differences between public and private hospital payment rates narrowed, 2012-16.
In 2000-12 payments for inpatient hospital stays, emergency department visits, and outpatient hospital care for privately insured patients grew much faster than payments for Medicare and Medicaid patients. This widening of private-public payment gaps slowed or even reversed itself in 2012-16. In this paper, the author discusses the differences between public and private hospital payment rates, 2012-2016.
AHRQ-authored.
Citation: Selden TM .
Differences between public and private hospital payment rates narrowed, 2012-16.
Health Aff 2020 Jan;39(1):94-99. doi: 10.1377/hlthaff.2019.00415..
Keywords: Medical Expenditure Panel Survey (MEPS), Hospitals, Payment, Healthcare Costs, Medicaid, Medicare
Cheng BT, Smith SS, Fishbein AB
Functional burden and limitations in children with chronic sinusitis.
The objective of this study was to use a validated pediatric quality of life (QOL) tool to quantify the impact of pediatric chronic rhinosinusitis (CRS) in a representative epidemiological sample. Findings showed that pediatric CRS was associated with substantial QOL burden across multiple psychosocial and cognitive domains and that CRS children with lower family income and comorbid asthma, anxiety, and depression had higher Columbia Impairment Scale scores associated with even greater functional impairment. These findings suggested that pediatric CRS might be a population requiring greater attention and screening for mental health symptoms.
AHRQ-funded; HS023011.
Citation: Cheng BT, Smith SS, Fishbein AB .
Functional burden and limitations in children with chronic sinusitis.
Pediatr Allergy Immunol 2020 Jan;31(1):103-05. doi: 10.1111/pai.13121..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Quality of Life, Healthcare Costs, Respiratory Conditions, Chronic Conditions
Kirby JB, Yabroff KR
AHRQ Author: Kirby JB
Rural-urban differences in access to primary care: beyond the usual source of care provider.
This study used 2014-2016 MEPS data to analyze differences between rural and urban areas to primary care access beyond the usual source of care provider. While rural residents were more likely to have a usual source of care, they were less likely to have a provider with office hours on nights and weekends.
AHRQ-authored.
Citation: Kirby JB, Yabroff KR .
Rural-urban differences in access to primary care: beyond the usual source of care provider.
Am J Prev Med 2020 Jan;58(1):89-96. doi: 10.1016/j.amepre.2019.08.026..
Keywords: Medical Expenditure Panel Survey (MEPS), Access to Care, Primary Care, Rural Health, Urban Health, Health Services Research (HSR)
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
Abdus S, Hudson J, Hill SC
AHRQ Author: Abdus S, Hudson J, Hill SC, Selden TM
Children's health insurance program premiums adversely affect enrollment, especially among lower-income children.
Using MEPS data, the authors showed that the relationship between premiums and coverage varies considerably by income level and by parental access to employer-sponsored insurance. They found that the increase in uninsurance is largest among children whose parents lack offers of employer coverage.
AHRQ-authored.
Citation: Abdus S, Hudson J, Hill SC .
Children's health insurance program premiums adversely affect enrollment, especially among lower-income children.
Health Aff 2014 Aug;33(8):1353-60. doi: 10.1377/hlthaff.2014.0182.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Healthcare Costs, Medical Expenditure Panel Survey (MEPS), Low-Income
Sarpong EM
AHRQ Author: Sarpong EM
The impact of obesity on medication use and expenditures among nonelderly adults with asthma.
The author examined the impact of obesity on medication use and expenditures among nonelderly adults with asthma using the Medical Expenditure Panel Survey. He found that obese classes II/III individuals were more likely to have current asthma, seek treatment for asthma, use more medications, and have higher medication and health care expenditures compared with normal weight individuals. His results suggested that reduction in body weight may help reduce health resource use and expenditures for nonelderly adults with asthma.
AHRQ-authored.
Citation: Sarpong EM .
The impact of obesity on medication use and expenditures among nonelderly adults with asthma.
J Health Care Poor Underserved 2014 Aug;25(3):1245-61. doi: 10.1353/hpu.2014.0142.
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Keywords: Asthma, Healthcare Costs, Medical Expenditure Panel Survey (MEPS), Medication, Obesity
Manski RJ, Cohen LA, Brown E
AHRQ Author: Brown E, Carper KV
Dental service mix among older adults aged 65 and over, United States, 1999 and 2009.
To establish a baseline and provide data for oral health workforce models, this report describes the types of dental procedures received by US adults 65 years and older in 2009 and looks at trends since 1999. It found that between 1999 and 2009, the proportion of preventive services significantly increased, whereas the proportion of restorative and endodontic services significantly decreased.
Citation: Manski RJ, Cohen LA, Brown E .
Dental service mix among older adults aged 65 and over, United States, 1999 and 2009.
J Public Health Dent 2014 Sum;74(3):219-26. doi: 10.1111/jphd.12049..
Keywords: Medical Expenditure Panel Survey (MEPS), Dental and Oral Health, Healthcare Utilization
Ekwueme DU, Yabroff KR, Guy GP, Jr.
AHRQ Author: Soni A, Davidoff A
Medical costs and productivity losses of cancer survivors--United States, 2008-2011.
In order to estimate annual medical costs and productivity losses among male and female cancer survivors and persons without a cancer history, the CDC, along with other organizations, analyzed data from the 2008-2011 Medical Expenditure Panel Survey (MEPS) and found that the economic burden of cancer survivorship is substantial among all survivors. These findings identified a need to develop and evaluate health and employment intervention programs aimed at improving outcomes for cancer survivors and their families.
AHRQ-authored.
Citation: Ekwueme DU, Yabroff KR, Guy GP, Jr. .
Medical costs and productivity losses of cancer survivors--United States, 2008-2011.
MMWR Morb Mortal Wkly Rep 2014 Jun 13;63(23):505-10.
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Keywords: Cancer, Healthcare Costs, Medical Expenditure Panel Survey (MEPS)
McGuire TG, Newhouse JP, Normand SL
AHRQ Author: Zuvekas S
Assessing incentives for service-level selection in private health insurance exchanges.
The authors used MEPS data to measure plan incentives by constructing predictive ratios and by measuring incentives based on the predictability and predictiveness of various medical diagnoses. They found that, among the chronic diseases studied, plans have the greatest incentive to skimp on care for cancer, mental health, and substance abuse.
AHRQ-authored.
Citation: McGuire TG, Newhouse JP, Normand SL .
Assessing incentives for service-level selection in private health insurance exchanges.
J Health Econ 2014 May;35:47-63. doi: 10.1016/j.jhealeco.2014.01.009.
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Keywords: Chronic Conditions, Health Insurance, Health Status, Medical Expenditure Panel Survey (MEPS)
Bernard DM, Johansson P, Fang Z
AHRQ Author: Bernard DM
Out-of-pocket healthcare expenditure burdens among nonelderly adults with hypertension.
The investigators examined the prevalence of high out-of-pocket burdens and self-perceived financial barriers to care among patients receiving hypertension treatment. They found that the prevalence of high total burdens was significantly greater for persons receiving treatment for hypertension compared with other chronically ill and well patients. Among hypertension patients with high total burdens, 15.7% said they were unable to get care and 13.6% said they delayed care due to financial reasons.
AHRQ-authored.
Citation: Bernard DM, Johansson P, Fang Z .
Out-of-pocket healthcare expenditure burdens among nonelderly adults with hypertension.
Am J Manag Care 2014 May;20(5):406-13.
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Keywords: Medical Expenditure Panel Survey (MEPS), Blood Pressure, Healthcare Costs, Health Insurance
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)
Cook BL, Zuvekas SH, Carson N
AHRQ Author: Zuvekas SH
Assessing racial/ethnic disparities in treatment across episodes of mental health care.
The authors investigated disparities in mental health care episodes, aligning their analyses with decisions to start or drop treatment, and choices made during treatment. Using MEPS data, they found that, compared with whites, blacks and Latinos had less initiation and adequacy of care. Black and Latino episodes were shorter and had fewer psychotropic drug fills; black episodes had a greater proportion of specialist visits and Latino episodes had a greater proportion of primary care physician visits. Blacks were more likely to have an episode with acute psychiatric care.
AHRQ-authored.
Citation: Cook BL, Zuvekas SH, Carson N .
Assessing racial/ethnic disparities in treatment across episodes of mental health care.
Health Serv Res 2014 Feb;49(1):206-29. doi: 10.1111/1475-6773.12095.
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Keywords: Disparities, Medical Expenditure Panel Survey (MEPS), Behavioral Health, Practice Patterns, Racial and Ethnic Minorities