National Healthcare Quality and Disparities Report
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- Access to Care (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 13 of 13 Research Studies DisplayedGoyal MK, Drendel AL, Chamberlain JM
Racial/ethnic differences in ED opioid prescriptions for long bone fractures: trends over time.
The purpose of this study was to investigate whether racial and/or ethnic differences in provision of outpatient opioid prescriptions for children discharged from the ED with long bone fractures have decreased over time. Findings showed that, as provision of opioid prescriptions declined over time, previously marked racial and/or ethnic disparities in opioid
prescription rates at ED discharge decreased.
prescription rates at ED discharge decreased.
AHRQ-funded; HS020270.
Citation: Goyal MK, Drendel AL, Chamberlain JM .
Racial/ethnic differences in ED opioid prescriptions for long bone fractures: trends over time.
Pediatrics 2021 Nov;148(5):e2021052481. doi: 10.1542/peds.2021-052481..
Keywords: Children/Adolescents, Opioids, Emergency Department, Racial and Ethnic Minorities, Injuries and Wounds, Pain, Medication
Goyal MK, Chamberlain JM, Webb M
Racial and ethnic disparities in the delayed diagnosis of appendicitis among children.
The objective of this 3-year multicenter retrospective cohort study of children was to determine if there are race/ethnicity differences in rates of appendiceal perforation, delayed diagnosis of appendicitis, and diagnostic imaging during prior visit(s). Delayed diagnosis was defined as having at least one emergency department (ED) visit within 7 days preceding the appendicitis diagnosis. Out of 7,298 patients diagnosed with appendicitis and documented race/ethnicity, 2,567 had appendiceal perforation. Non-Hispanic (NH) Black children had a higher likelihood of perforation (36.5% versus 34.9%) then non-Hispanic whites. They also were over twice as likely to have delayed diagnosis (4.7% versus 2.0%). Eighty-nine patients (43.2%) patients with delayed diagnosis had abdominal imaging during the prior visits. However, NH-Black children were less likely to have any imaging (28.2% versus 46.2%) or definitive imaging (10.3% versus 35.9%).
Acad Emerg Med 2021 Sep;28(9):949-56. doi: 10.1111/acem.14142.
Citation: Goyal MK, Chamberlain JM, Webb M .
Racial and ethnic disparities in the delayed diagnosis of appendicitis among children.
Acad Emerg Med 2021 Sep;28(9):949-56. doi: 10.1111/acem.14142..
Keywords: Children/Adolescents, Racial and Ethnic Minorities, Disparities, Diagnostic Safety and Quality
Hickey EJ, Stransky M, Kuhn J
Parent stress and coping trajectories in Hispanic and non-Hispanic families of children at risk of autism spectrum disorder.
This study examined trajectories of parenting stress, coping, and perceived family impact over time throughout the autism diagnostic process among Hispanic and non-Hispanic families. Findings showed that Hispanic families reported lower levels of parenting stress, coping, and negative family impact across time. Further, there were differences in the change in use of coping and the amount of negative family impact reported between Hispanic and non-Hispanic parents over time.
AHRQ-funded; HS022242.
Citation: Hickey EJ, Stransky M, Kuhn J .
Parent stress and coping trajectories in Hispanic and non-Hispanic families of children at risk of autism spectrum disorder.
Autism 2021 Aug;25(6):1694-708. doi: 10.1177/13623613211001611..
Keywords: Children/Adolescents, Autism, Stress, Behavioral Health, Racial and Ethnic Minorities
Tremblay ES, Ruiz J, Dykeman B
Hispanic caregivers' experience of pediatric type 1 diabetes: a qualitative study.
It is widely recognized that Type 1 Diabetes (T1D) outcomes are worse among Hispanic children; however, little is published about the perspectives of these patients and their caregivers. The intent of this study was to characterize the lived experience of Hispanic caregivers of children with T1D, focusing on the role of language and culture and their perspectives on current medical care and alternative care models.
AHRQ-funded; HS000063.
Citation: Tremblay ES, Ruiz J, Dykeman B .
Hispanic caregivers' experience of pediatric type 1 diabetes: a qualitative study.
Pediatr Diabetes 2021 Jul 7;22(7):1040-50. doi: 10.1111/pedi.13247..
Keywords: Children/Adolescents, Diabetes, Caregiving, Chronic Conditions, Racial and Ethnic Minorities, Cultural Competence
Javalkar K, Robson VK, Gaffney L
Socioeconomic and racial and/or ethnic disparities in multisystem inflammatory syndrome.
Researchers characterized the socioeconomic and racial and/or ethnic disparities impacting the diagnosis and outcomes of multisystem inflammatory syndrome in children (MIS-C). They found that lower socioeconomic status or higher social vulnerability index, Hispanic ethnicity, and Black race independently increased risk for MIS-C. They recommended additional studies to target interventions to improve health equity for children.
AHRQ-funded; HS000063.
Citation: Javalkar K, Robson VK, Gaffney L .
Socioeconomic and racial and/or ethnic disparities in multisystem inflammatory syndrome.
Pediatrics 2021 May;147(5). doi: 10.1542/peds.2020-039933..
Keywords: Children/Adolescents, Social Determinants of Health, Disparities, Racial and Ethnic Minorities, Risk
Peltz A, Kan K, Garg A
Racial and ethnic differences in managed care enrollment among US children.
The authors used national survey data to compare rates of HMO enrollment, by race and ethnicity, for children with commercial and public coverage. They found that, when adjusted for sociodemographic characteristics, Hispanic children with public coverage, non-Hispanic Black children with commercial coverage, and Hispanic children with commercial coverage were more likely to be enrolled in HMOs than non-Hispanic White children. They recommended future study to examine the degree to which the observed national imbalance in HMO enrollment results from state-specific policies, family preferences, or coverage affordability.
AHRQ-funded; HS026385.
Citation: Peltz A, Kan K, Garg A .
Racial and ethnic differences in managed care enrollment among US children.
JAMA Netw Open 2021 Apr;4(4):e214162. doi: 10.1001/jamanetworkopen.2021.4162..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Health Insurance, Racial and Ethnic Minorities
Fraiman YS, Litt JS, Davis JM
Racial and ethnic disparities in adult COVID-19 and the future impact on child health.
This article discusses the impact of the COVID-19 pandemic on children who are racial and ethnic minorities and the disproportionate harm to them. The authors urge that COVID-19-focused research consider racial and ethnic disparity. The paper discusses the lasting and intergenerational impact of COVID-19 on communities of color, especially children, due to increase in stress, material hardship, food insecurity, and long-term school readiness.
AHRQ-funded; HS000063.
Citation: Fraiman YS, Litt JS, Davis JM .
Racial and ethnic disparities in adult COVID-19 and the future impact on child health.
Pediatr Res 2021 Apr;89(5):1052-54. doi: 10.1038/s41390-021-01377-x..
Keywords: COVID-19, Children/Adolescents, Racial and Ethnic Minorities, Disparities, Health Status, Social Determinants of Health
Ragavan M, Syed-Swift Y, Elwy AR
The influence of culture on healthy relationship formation and teen dating violence: a qualitative analysis of South Asian female youth residing in the United States.
Teen dating violence (TDV) has well-documented detrimental health effects. Scant research has examined the perspectives of ethnically diverse youth about the impact of culture on TDV. In this study, the investigators sought to explore the intersection between culture and TDV specifically for South Asian youth residing in the United States by conducting semi-structured interviews with South Asian youth aged 16 to 21 years.
AHRQ-funded; HS022242.
Citation: Ragavan M, Syed-Swift Y, Elwy AR .
The influence of culture on healthy relationship formation and teen dating violence: a qualitative analysis of South Asian female youth residing in the United States.
J Interpers Violence 2021 Apr;36(7-8):Np4336-np62. doi: 10.1177/0886260518787815..
Keywords: Children/Adolescents, Domestic Violence, Racial and Ethnic Minorities
Feinberg E, Kuhn J, Eilenberg JS
Improving family navigation for children with autism: a comparison of two pilot randomized controlled trials.
This study looked at impacts of a modification to a pilot program called Family Navigation to help low-income, minority children needing autism-related diagnostic services receive those services. An advisory group recommended modifications to recruitment criteria and study conditions. 40 parent-child dyad participants were randomized between the two pilots to receive usual care (UC) or modified FN. Participant enrollment, satisfaction with clinical care, and timely completion of the diagnostic assessment were compared. Recruitment improved significantly with the modified protocol (4.8% vs. 19.5%) and no participants were excluded from study enrollment compared to the first pilot (43.6%). Families in the second pilot were more likely to complete diagnostic assessment and report greater satisfaction with clinical care.
AHRQ-funded; HS022155; HS022242.
Citation: Feinberg E, Kuhn J, Eilenberg JS .
Improving family navigation for children with autism: a comparison of two pilot randomized controlled trials.
Acad Pediatr 2021 Mar;21(2):265-71. doi: 10.1016/j.acap.2020.04.007..
Keywords: Children/Adolescents, Autism, Patient-Centered Healthcare, Care Coordination, Racial and Ethnic Minorities, Low-Income, Patient and Family Engagement, Chronic Conditions
Han B, Chen PG, Yu H
Access to after-hours primary care: a key determinant of children's medical home status.
Researchers sought to identify individual survey items or domains that best predict medical home (MH) status for children and use them to develop brief markers of MH status. Using MEPS data, they found that accessibility, especially the ability to access health care after regular office hours, appeared to be the major predictor of having a MH among children. They recommended that the ongoing efforts to promote the MH model target improving accessibility of health care after regular hours for children overall and especially for Latino children.
AHRQ-funded; HS023336.
Citation: Han B, Chen PG, Yu H .
Access to after-hours primary care: a key determinant of children's medical home status.
BMC Health Serv Res 2021 Feb 27;21(1):185. doi: 10.1186/s12913-021-06192-y..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare, Access to Care, Healthcare Delivery, Disparities, Racial and Ethnic Minorities
Marin JR, Rodean J, Hall M
Racial and ethnic differences in emergency department diagnostic imaging at US children's hospitals, 2016-2019.
Researchers evaluated racial and ethnic differences in the performance of common ED imaging studies and examined patterns across diagnoses. In this study, which evaluated visits by nonhospitalized patients younger than 18 years in 44 US children's hospital EDs, they found that non-Hispanic Black and Hispanic children were less likely to receive diagnostic imaging during ED visits compared with non-Hispanic White children. They recommended further investigation to understand and mitigate these potential disparities in health care delivery and to evaluate the effect of these differential imaging patterns on patient outcomes.
AHRQ-funded; HS026006.
Citation: Marin JR, Rodean J, Hall M .
Racial and ethnic differences in emergency department diagnostic imaging at US children's hospitals, 2016-2019.
JAMA Netw Open 2021 Jan 4(1):e2033710. doi: 10.1001/jamanetworkopen.2020.33710..
Keywords: Children/Adolescents, Hospitals, Emergency Department, Imaging, Racial and Ethnic Minorities, Disparities, Diagnostic Safety and Quality
Fritz SA, Hogan PG, Singh LN
Contamination of environmental surfaces with Staphylococcus aureus in households with children infected with methicillin-resistant S aureus.
This study of the households of 50 children with active or recent culture-positive community-associated methicillin-resistant staphylococcus aureus (MRSA) infection found MRSA-contaminated surfaces in 23 of the 50 households, most frequently form the bed linens (18 percent), television remote control (16 percent), and bathroom hand towel (15 percent).
AHRQ-funded; HS021736
Citation: Fritz SA, Hogan PG, Singh LN .
Contamination of environmental surfaces with Staphylococcus aureus in households with children infected with methicillin-resistant S aureus.
JAMA Pediatr. 2014 Nov;168(11):1030-8. doi: 10.1001/jamapediatrics.2014.1218..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Children/Adolescents, Racial and Ethnic Minorities
McCormick EV, Dickinson LM, Haemer MA
What can providers learn from childhood body mass index trajectories: a study of a large, safety-net clinical population.
The investigators described childhood weight gain using body mass index (BMI) z-score trajectories in a low-income urban safety-net population and identified among gender- and race/ethnicity-specific groups any trends for increased risk. They found that all gender and race/ethnicity subgroups showed increasing average BMI z-scores during childhood, with Hispanic boys and black girls showing the most significant increase during this observation period. They further found that many obese children were already overweight by age 3, and persistence of obesity after 3 years of age was high. They concluded that intervention before age 3 may be essential to curbing unhealthy weight trajectories.
AHRQ-funded; HS021138.
Citation: McCormick EV, Dickinson LM, Haemer MA .
What can providers learn from childhood body mass index trajectories: a study of a large, safety-net clinical population.
Acad Pediatr 2014 Nov-Dec;14(6):639-45. doi: 10.1016/j.acap.2014.06.009.
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Keywords: Children/Adolescents, Obesity, Racial and Ethnic Minorities, Social Determinants of Health, Obesity: Weight Management