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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 DisplayedWheeler SB, Kohler RE, Reeder-Hayes KE
Endocrine therapy initiation among Medicaid-insured breast cancer survivors with hormone receptor-positive tumors.
The researchers sought to characterize endocrine therapy (ET) use in a low-income Medicaid-insured population in North Carolina. They found that, of 222 women meeting the inclusion criteria, only 50 percent filled a prescription for ET. Results suggest substantial underutilization of ET in this population.
AHRQ-funded; HS019468.
Citation: Wheeler SB, Kohler RE, Reeder-Hayes KE .
Endocrine therapy initiation among Medicaid-insured breast cancer survivors with hormone receptor-positive tumors.
J Cancer Surviv 2014 Dec;8(4):603-10. doi: 10.1007/s11764-014-0365-3..
Keywords: Cancer: Breast Cancer, Healthcare Utilization, Medicaid, Medication, Patient-Centered Outcomes Research
Fischer SH, Tjia J, Reed G
Factors associated with ordering laboratory monitoring of high-risk medications.
This study examined physician and patient factors associated with ordering recommended laboratory monitoring tests for high-risk medications. Test ordering was associated with higher provider prescribing volume for study drugs and specialist status. Patients with higher comorbidity burden and older patients were more likely to have appropriate tests ordered.
AHRQ-funded; HS017203; HS017817; HS017906
Citation: Fischer SH, Tjia J, Reed G .
Factors associated with ordering laboratory monitoring of high-risk medications.
J Gen Intern Med. 2014 Dec;29(12):1589-98. doi: 10.1007/s11606-014-2907-9..
Keywords: Medication, Patient Safety, Healthcare Utilization
Saloner B, Matone M, Kreider AR
Second-generation antipsychotic use among stimulant-using children, by organization of Medicaid mental health.
The authors compared differences in second-generation antipsychotic utilization among Medicaid-enrolled children across fee-for-service, integrated managed care, and managed behavioral health carve-out organizational structures. They found that carve-outs, versus other arrangements, were associated with lower second-generation antipsychotic use.
AHRQ-funded; HS020269; HS018550.
Citation: Saloner B, Matone M, Kreider AR .
Second-generation antipsychotic use among stimulant-using children, by organization of Medicaid mental health.
Psychiatr Serv 2014 Dec;65(12):1458-64. doi: 10.1176/appi.ps.201300574.
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Keywords: Children/Adolescents, Healthcare Utilization, Medicaid, Medication, Behavioral Health
Bradford WD, Lastrapes WD
A prescription for unemployment? Recessions and the demand for mental health drugs.
The authors estimated the relationship between mental health drug prescriptions and the level of labor market activity in the USA. They found that the number of mental health drug prescriptions rises by about 10% when employment falls by 1% and when unemployment rises by 100 basis points, but only for patients in the Northeast region.
AHRQ-funded; HS011326.
Citation: Bradford WD, Lastrapes WD .
A prescription for unemployment? Recessions and the demand for mental health drugs.
Health Econ 2014 Nov;23(11):1301-25. doi: 10.1002/hec.2983.
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Keywords: Medication, Healthcare Utilization, Health Services Research (HSR), Behavioral Health
Rabin BA, Ellis JL, Steiner JF
Health-care utilization by prognosis profile in a managed care setting: using the Surveillance, Epidemiology and End Results Cancer Survival Calculator SEER*CSC.
The authors described health service utilization patterns of subgroups of prostate cancer and colorectal cancer (CRC) patients with different relative probabilities of dying of their cancer or other conditions. They found that although a new diagnosis of cancer increased utilization of cancer-related services for an extended time period, the timing of cancer diagnosis did not appear to affect other types of utilization.
AHRQ-funded; HS019520.
Citation: Rabin BA, Ellis JL, Steiner JF .
Health-care utilization by prognosis profile in a managed care setting: using the Surveillance, Epidemiology and End Results Cancer Survival Calculator SEER*CSC.
J Natl Cancer Inst Monogr 2014 Nov;2014(49):275-81. doi: 10.1093/jncimonographs/lgu023.
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Keywords: Cancer: Prostate Cancer, Cancer: Colorectal Cancer, Cancer, Healthcare Utilization, Mortality, Healthcare Delivery
Thompson CA, Gomez SL, Chan A
Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans.
The researchers performed multivariable modeling to evaluate potential predictors (at the provider- and patient-level) of screening completion among Asian patients. They concluded that language- and gender-concordant primary care providers and culturally tailored online health resources may help improve preventive cancer screening in Asian patient populations.
AHRQ-funded; HS019815.
Citation: Thompson CA, Gomez SL, Chan A .
Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans.
Cancer Epidemiol Biomarkers Prev 2014 Nov;23(11):2208-17. doi: 10.1158/1055-9965.epi-14-0487..
Keywords: Cancer: Breast Cancer, Cancer: Cervical Cancer, Cancer: Colorectal Cancer, Healthcare Utilization, Screening
Griffey RT, Kennedy SK, D'Agostino McGowan L, Good RT, Kennedy SK, D'Agostino McGowan L
Is low health literacy associated with increased emergency department utilization and recidivism?
The study objective was to determine whether patients with low health literacy have higher emergency department (ED) use and higher ED recidivism than patients with adequate health literacy. It found that patients with inadequate health literacy had higher ED use compared to those with adequate health literacy.
AHRQ-funded; HS020309
Citation: Griffey RT, Kennedy SK, D'Agostino McGowan L, Good RT, Kennedy SK, D'Agostino McGowan L .
Is low health literacy associated with increased emergency department utilization and recidivism?
Acad Emerg Med. 2014 Oct;21(10):1109-15. doi: 10.1111/acem..
Keywords: Health Literacy, Emergency Department, Emergency Medical Services (EMS), Healthcare Utilization
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
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
Zhang Y, Fu SS, Du XL
Increasing utilization and predictors of hematopoietic growth factors in patients diagnosed with colorectal cancer: findings from a large national population-based cohort in the USA, 1992-2009.
The authors examined the temporal trend and predictors of receiving hematopoietic growth factors in a large nationwide and population-based cohort of patients with colorectal cancer in the USA from 1992 to 2009. They found that gender, marital status, comorbidity scores, geographic area, year of diagnosis, tumor stage, number of lymph nodes, and risk profile for febrile neutropenia were statistically significant predictors of using colony-stimulating factors and erythropoiesis-stimulating agents.
AHRQ-funded; HS018956.
Citation: Zhang Y, Fu SS, Du XL .
Increasing utilization and predictors of hematopoietic growth factors in patients diagnosed with colorectal cancer: findings from a large national population-based cohort in the USA, 1992-2009.
Med Oncol 2014 Oct;31(10):242. doi: 10.1007/s12032-014-0242-y.
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Keywords: Cancer: Colorectal Cancer, Healthcare Utilization, Medication, Patient-Centered Outcomes Research
Heintzman J, Marino M, Hoopes M
Using electronic health record data to evaluate preventive service utilization among uninsured safety net patients.
This study used EHR data to compare the preventive service utilization of uninsured patients receiving care at Oregon community health centers (CHCs) in 2008 through 2011 with that of continuously insured patients at the same CHCs in the same period. The results showed that CHCs provided many preventive services to uninsured patients, but that uninsured patients were less likely than continuously insured patients to receive 5 of 11 preventive services. The authors concluded that lack of insurance is a barrier to preventive service utilization, even in patients who can access care at a CHC.
AHRQ-funded; HS021522.
Citation: Heintzman J, Marino M, Hoopes M .
Using electronic health record data to evaluate preventive service utilization among uninsured safety net patients.
Prev Med 2014 Oct;67:306-10. doi: 10.1016/j.ypmed.2014.08.006.
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Keywords: Community-Based Practice, Electronic Health Records (EHRs), Healthcare Utilization, Prevention, Uninsured
Crisp GD, Roberts AW, Esserman DA
The University of North Carolina's Health Care Pharmacy Assistance Program.
This study examined a program providing financial assistance to uninsured residents of North Carolina who need prescription medications. It found that from 2009 to 2011, the program served 7,180 patients in 81 counties. These patients received a mean of 23 prescriptions at an average cost of $754 per recipient per year.
AHRQ-funded; HS000032
Citation: Crisp GD, Roberts AW, Esserman DA .
The University of North Carolina's Health Care Pharmacy Assistance Program.
N C Med J. 2014 Sep-Oct;75(5):303-9..
Keywords: Healthcare Costs, Uninsured, Medication, Healthcare Utilization
Ellimoottil C, Miller S, Ayanian JZ
Effect of insurance expansion on utilization of inpatient surgery.
The researchers examined the differential effect of the Massachusetts insurance expansion on the use of discretionary vs. nondiscretionary surgical procedures. They found that discretionary surgery increased 9.3 percent while nondiscretionary surgery decreased by 4.5 percent. The greatest increase in discretionary surgery was observed for nonwhite participants.
AHRQ-funded; HS018346.
Citation: Ellimoottil C, Miller S, Ayanian JZ .
Effect of insurance expansion on utilization of inpatient surgery.
JAMA Surg. 2014 Aug;149(8):829-36. doi: 10.1001/jamasurg.2014.857..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Health Insurance, Healthcare Utilization
Allgood KL, Rauscher GH, Whitman S
Validating self-reported mammography use in vulnerable communities: findings and recommendations.
The researchers examined the potential extent of overreporting of mammography use in low-income African-American and Latina women, and whether self-report inaccuracies might bias estimated associations between patient characteristics and mammography use. They found that although 73% of women self-reported a mammogram in the last 2 years, only 44% of self-reports were documented. Overreporting of mammography use was observed for all ethnic groups studied.
AHRQ-funded; HS018366.
Citation: Allgood KL, Rauscher GH, Whitman S .
Validating self-reported mammography use in vulnerable communities: findings and recommendations.
Cancer Epidemiol Biomarkers Prev 2014 Aug;23(8):1649-58. doi: 10.1158/1055-9965.epi-13-1253.
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Keywords: Healthcare Utilization, Vulnerable Populations, Racial and Ethnic Minorities, Women, Low-Income, Urban Health
Yehia BR, Herati RS, Fleishman JA
AHRQ Author: Fleishman JA
Hepatitis C virus testing in adults living with HIV: a need for improved screening efforts.
The authors sought to understand hepatitis C virus (HCV) testing practices in people living with HIV (PLWH) in order to improve compliance with guidelines and help identify areas for future intervention. They concluded that additional efforts to improve compliance with HCV testing guidelines are needed.
AHRQ-authored; AHRQ-funded; 290201100007C.
Citation: Yehia BR, Herati RS, Fleishman JA .
Hepatitis C virus testing in adults living with HIV: a need for improved screening efforts.
PLoS One 2014 Jul 17;9(7):e102766. doi: 10.1371/journal.pone.0102766.
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Keywords: Guidelines, Healthcare Utilization, Hepatitis, Human Immunodeficiency Virus (HIV), Screening
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
Villatoro AP, Morales ES, Mays VM
Family culture in mental health help-seeking and utilization in a nationally representative sample of Latinos in the United States: the NLAAS.
This study examined the role of behavioral familismo, the level of perceived family support, in the use of mental health services of Latinos in the United States. High behavioral familismo was significantly associated with increased odds of using informal or religious services, but not specialty or medical services. Self-perceived need and social perceptions of need for care within close networks also were significant predictors of service use.
AHRQ-funded; HS000083; HS000046.
Citation: Villatoro AP, Morales ES, Mays VM .
Family culture in mental health help-seeking and utilization in a nationally representative sample of Latinos in the United States: the NLAAS.
Am J Orthopsychiatry 2014 Jul;84(4):353-63. doi: 10.1037/h0099844..
Keywords: Racial and Ethnic Minorities, Behavioral Health, Healthcare Utilization
Martin BI, Franklin GM, Deyo RA
How do coverage policies influence practice patterns, safety, and cost of initial lumbar fusion surgery? A population-based comparison of workers' compensation systems.
In response to increasing use of lumbar fusion for improving back pain, despite unclear efficacy, particularly among injured workers, this study compared the use of complex fusion techniques, adverse outcomes within 3 months, and costs for California and Washington State with workers’ compensation policies that differed in their coverage restrictions. The researchers found that California’s broader coverage policy was associated with more aggressive practice, higher rates of reoperation, readmission and other complications.
AHRQ-funded; HS018405
Citation: Martin BI, Franklin GM, Deyo RA .
How do coverage policies influence practice patterns, safety, and cost of initial lumbar fusion surgery? A population-based comparison of workers' compensation systems.
Spine J. 2014 Jul;14(7):1237-46. doi: 10.1016/j.spinee.2013.08..
Keywords: Health Insurance, Surgery, Healthcare Costs, Healthcare Utilization
Wernli KJ, Hubbard RA, Johnson E
Patterns of colorectal cancer screening uptake in newly eligible men and women.
The researchers describe patterns of colorectal cancer screening uptake in a U.S. insured population as individuals become newly eligible for screening at age 50 and assess temporal trends and patient characteristics with screening uptake. Their results suggest that characteristics of newly eligible individuals who initiate colorectal cancer screening are similar to the characteristics of all U.S. adults who receive colorectal cancer screening tests.
AHRQ-funded; HS019482.
Citation: Wernli KJ, Hubbard RA, Johnson E .
Patterns of colorectal cancer screening uptake in newly eligible men and women.
Cancer Epidemiol Biomarkers Prev 2014 Jul;23(7):1230-7. doi: 10.1158/1055-9965.epi-13-1360..
Keywords: Screening, Colonoscopy, Diagnostic Safety and Quality, Healthcare Utilization
Barnett ML, Linder JA
Antibiotic prescribing for adults with acute bronchitis in the United States, 1996-2010.
To estimate the association of ongoing CDC efforts to reduce antibiotic prescribing for acute bronchitis, the researchers evaluated the change in antibiotic prescribing rates for this condition in the U.S. between 1996 and 2010. They found that the antibiotic prescribing rate for this condition was 71 percent initially and increased during the study period.
AHRQ-funded; HS018419
Citation: Barnett ML, Linder JA .
Antibiotic prescribing for adults with acute bronchitis in the United States, 1996-2010.
JAMA. 2014 May 21;311(19):2020-2. doi: 10.1001/jama.2013.286141..
Keywords: Antibiotics, Antimicrobial Stewardship, Healthcare Utilization, Medication
Callaghan BC, Kerber KA, Pace RJ
Headaches and neuroimaging: high utilization and costs despite guidelines.
Little is known about recent headache neuroimaging utilization, associated expenditures, and temporal trends. Looking at 51.1 million outpatient headache visits over 4 years, this study found that neuroimaging is ordered during 12% of these visits, costs $1 billion annually, and is increasing over time.
AHRQ-funded; HS017690
Citation: Callaghan BC, Kerber KA, Pace RJ .
Headaches and neuroimaging: high utilization and costs despite guidelines.
JAMA Intern Med. 2014 May;174(5):819-21. doi: 10.1001/jamainternmed.2014.173..
Keywords: Neurological Disorders, Healthcare Utilization, Guidelines, Healthcare Costs, Chronic Conditions
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
Lyon SM, Wunsch H, Asch DA
Use of intensive care services and associated hospital mortality after Massachusetts healthcare reform.
This study examined the impact of increased insurance coverage on intensive care unit (ICU) usage and mortality in Massachusetts where health insurance reform had expanded coverage. It found that reform was not associated with either significant changes in ICU use or changed hospital mortality for ICU patients.
AHRQ-funded; HS020672
Citation: Lyon SM, Wunsch H, Asch DA .
Use of intensive care services and associated hospital mortality after Massachusetts healthcare reform.
Crit Care Med. 2014 Apr;42(4):763-70. doi: 10.1097/CCM.0000000000000044..
Keywords: Intensive Care Unit (ICU), Health Insurance, Healthcare Utilization, Mortality, Policy
Barnett ML, Linder JA
Antibiotic prescribing to adults with sore throat in the United States, 1997-2010.
In only about 10 percent of cases of sore throat (those related to A Streptococcus infection) are antibiotics indicated. However, a new study, combined with an earlier study, finds that despite efforts to reduce overprescribing, antibiotic use dropped from roughly 80 to 70 percent around 1993 and then to around 60 percent by 2000 where it has remained as of 2010.
AHRQ-funded; HS018419
Citation: Barnett ML, Linder JA .
Antibiotic prescribing to adults with sore throat in the United States, 1997-2010.
JAMA Intern Med. 2014 Jan;174(1):138-40. doi: 10.1001/jamainternmed.2013.11673..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Healthcare Utilization
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