National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (2)
- (-) Children's Health Insurance Program (CHIP) (18)
- Children/Adolescents (15)
- Dental and Oral Health (1)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (1)
- Healthcare Costs (1)
- Healthcare Utilization (1)
- Health Insurance (10)
- Hospital Discharge (1)
- Implementation (3)
- Low-Income (1)
- Medicaid (12)
- Medical Expenditure Panel Survey (MEPS) (1)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (1)
- Policy (2)
- Provider: Health Personnel (1)
- Quality Improvement (6)
- Quality Measures (5)
- Quality of Care (7)
- Racial and Ethnic Minorities (1)
- Transitions of Care (1)
- Uninsured (2)
- Vulnerable Populations (1)
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 18 of 18 Research Studies DisplayedChu J, Roby DH, Boudreaux MH
Effects of the Children's Health Insurance Reauthorization Act on immigrant children's healthcare access.
The purpose of this study was to estimate the effects of the Children's Health Insurance Reauthorization Act (CHIPRA) on insurance coverage, access, utilization, and health outcomes among immigrant children. The researchers utilized the restricted use 2000-2016 National Health Interview Survey (NHIS)with a sample which included immigrant children between the ages of 0 and 18 born outside the United States, with family income below 300% of the Federal Poverty Level (FPL). The study found that CHIPRA was related with a decrease in uninsured rates and an increase in public insurance enrollment for immigrant children. The effects of CHIPRA became small and statistically not significant 3 years after adoption. The researchers found no significant changes in health care access and utilization, and health outcomes, overall and across subgroups due to CHIPRA. The researchers concluded that the eligibility expansion of CHIPRA was related with increases in public insurance coverage for low-income children. However, no effect of CHIPRA on access to care and health was found.
AHRQ-funded; HS028532.
Citation: Chu J, Roby DH, Boudreaux MH .
Effects of the Children's Health Insurance Reauthorization Act on immigrant children's healthcare access.
Health Serv Res 2022 Dec;57(suppl 2):315-25. doi: 10.1111/1475-6773.14061..
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Access to Care, Vulnerable Populations, Uninsured
Mistry KB, Sagatov RDF, Schur C
AHRQ Author: Mistry KB, Sagatov RDF
Design and implementation of the Pediatric Quality Measures Program 2.0.
This AHRQ-authored research discusses the design and implementation of the Pediatric Quality Measures Program (PQMP) 2.0. The PQMP was established in response to the Children’s Health Insurance Program Reauthorization Act of 2009. AHRQ and CMS awarded 6 grants to Centers of Excellence (COEs) and a contract to facilitate collaboration and learning across the COEs. The COEs partnered with stakeholders from multiple levels to field test real-world implementation and refinement of pediatric quality measures and quality improvement initiatives. A PQMP Learning Collaborative (PQMP-LC) consisting of AHRQ, CMS, the 6 COEs, and L&M Policy Research, LLC was created to complete literature reviews, conduct key informant interviews, and collect data to develop reports to address the Research Foci. It also aided with development of measure implementation and quality improvement toolkits; conceptualized an implementation science framework, analysis, and roadmap; and facilitated dissemination of learnings and products. The various products created are intended to support the uptake of PQMP measures and inform future pediatric measurement and improvement work.
AHRQ-authored.
Citation: Mistry KB, Sagatov RDF, Schur C .
Design and implementation of the Pediatric Quality Measures Program 2.0.
Acad Pediatr 2022 Apr;22(3s):S59-S64. doi: 10.1016/j.acap.2021.12.021..
Keywords: Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Forrest CB, Simpson L, Mistry KB
AHRQ Author: Mistry KB
PQMP Phase 2: implementation and dissemination.
The authors provide an overview of the articles in this supplement concerning the Children’s Health Insurance Program Reauthorization Act Pediatric Quality Measures Program (PQMP). The articles examine the opportunities and challenges associated with the PQMP 2.0 work of the Centers for Excellence and how findings may advance the science for pediatric quality measurement and improvement, and, ultimately, child health outcomes.
AHRQ-authored.
Citation: Forrest CB, Simpson L, Mistry KB .
PQMP Phase 2: implementation and dissemination.
Acad Pediatr 2022 Apr;22(3s):S55-S58. doi: 10.1016/j.acap.2022.01.012..
Keywords: Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Schur C, Johnson M, Doherty J
AHRQ Author: Mistry KB
Real-world considerations for implementing pediatric quality measures: insights from key stakeholders.
This AHRQ-authored paper describes key stakeholder insights focused on measure implementation and increasing the uptake of Pediatric Quality Measures (PQM). The PQMP Learning Collaborative conducted semistructured interviews with 9 key informants (KIs) presenting states, health plans, and other potential end users. The interviews focused on obtaining KIs’ perspectives on 6 research questions focused on assessing the feasibility and usability of PQM and strengthening the connection between measurement and improvement. The KIs uniformly acknowledged the complexity of the issues raised and pinpointed multiple unresolved issues.
AHRQ-authored; AHRQ-funded; 290201400003I.
Citation: Schur C, Johnson M, Doherty J .
Real-world considerations for implementing pediatric quality measures: insights from key stakeholders.
Acad Pediatr 2022 Apr;22(3S):S76-S80. doi: 10.1016/j.acap.2021.04.007..
Keywords: Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Shenkman E, Mistry KB, Davis D
AHRQ Author: Mistry KB
Stakeholder engagement: bridging research and policy to improve measurement and dental care for children in Medicaid.
The University of Florida Child Health Quality (CHeQ) initiative, funded by the Agency for Health Care Research and Quality (AHRQ)/Centers for Medicare and Medicaid Services (CMS) Pediatric Quality Measurement Program, examined measures that states use to evaluate quality of oral health care for children in Medicaid and the Children’s Health Insurance Program (CHIP). This paper discusses stakeholder engagement in bridging research and policy to improve measurement and dental care for children in Medicaid.
AHRQ-authored; AHRQ-funded; HS025298.
Citation: Shenkman E, Mistry KB, Davis D .
Stakeholder engagement: bridging research and policy to improve measurement and dental care for children in Medicaid.
Acad Pediatr 2022 Apr;22(3S):S65-S67. doi: 10.1016/j.acap.2021.08.012..
Keywords: Children/Adolescents, Dental and Oral Health, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care
Desai AD, Simon TD, Leyenaar JK
Utilizing family-centered process and outcome measures to assess hospital-to-home transition quality.
This commentary describes the success of using 8 new caregiver-reported measures to assess the quality of hospital- and emergency department (ED)-to-home transitions in pediatric patients. This measures were originally created by the national Pediatric Quality Measures Program mandated by the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA). An original article describing these measures was published 2016 and there have been several follow-up studies. These measures are undergoing further testing.
AHRQ-funded; HS024133; HS024299; HS020506.
Citation: Desai AD, Simon TD, Leyenaar JK .
Utilizing family-centered process and outcome measures to assess hospital-to-home transition quality.
Acad Pediatr 2018 Nov - Dec;18(8):843-46. doi: 10.1016/j.acap.2018.07.013..
Keywords: Hospital Discharge, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Transitions of Care, Quality of Care, Quality Measures, Quality Improvement, Children's Health Insurance Program (CHIP), Evidence-Based Practice
Allen CD
Who loses public health insurance when states pass restrictive omnibus immigration-related laws? The moderating role of county Latino density.
Using comparative interrupted time series methods and a nationally-representative sample of US citizen, Latino children with noncitizen parents from the National Health Interview Survey (2005-2014, n=18,118), this study found that living in counties with higher co-ethnic density placed children at greater risk of losing Medicaid and Children's Health Insurance Program coverage when their states passed restrictive state omnibus immigrant laws.
AHRQ-funded; HS024248.
Citation: Allen CD .
Who loses public health insurance when states pass restrictive omnibus immigration-related laws? The moderating role of county Latino density.
Health Place 2018 Nov;54:20-28. doi: 10.1016/j.healthplace.2018.08.023..
Keywords: Access to Care, Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Medicaid, Racial and Ethnic Minorities
Hudson JL, Moriya AS
AHRQ Author: Hudson JL, Moriya AS
Association between marketplace policy and public coverage among Medicaid or Children's Health Insurance Program-eligible children and parents.
This paper examines the association between marketplace policy and public coverage among Medicaid or Children’s Health Insurance Program (CHIP)-eligible children and parents. The study’s results suggest that streamlining Medicaid/CHIP enrollment may have played a substantial role in increased take-up of public coverage.
AHRQ-authored.
Citation: Hudson JL, Moriya AS .
Association between marketplace policy and public coverage among Medicaid or Children's Health Insurance Program-eligible children and parents.
JAMA Pediatr 2018 Sep;172(9):881-82. doi: 10.1001/jamapediatrics.2018.1497..
Keywords: Children's Health Insurance Program (CHIP), Health Insurance, Medicaid, Policy
Silber JH, Zeigler AE, Reiter JG
Using appendicitis to improve estimates of childhood Medicaid participation rates.
This study introduces appendectomy-based participation (ABP) to estimate statewide Medicaid/Children's Health Insurance Program participation rates using claims by taking advantage of a natural experiment around statewide appendicitis admissions to improve the accuracy of participation rate estimates. The study concluded that using the ABP rate derived from Medicaid Analytic eXtract (MAX) administrative claims is a valid method to estimate statewide public insurance participation rates in children.
AHRQ-funded; HS023258; HS021112.
Citation: Silber JH, Zeigler AE, Reiter JG .
Using appendicitis to improve estimates of childhood Medicaid participation rates.
Acad Pediatr 2018 Jul;18(5):593-600. doi: 10.1016/j.acap.2018.03.008..
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Medicaid
Ireys HT, Brach C, Anglin G
AHRQ Author: Brach C
After the demonstration: what states sustained after the end of federal grants to improve children's health care quality.
As part of the CHIPRA Quality Demonstration Grant Program’s multifaceted evaluation, this study examined the extent to which states sustained key program activities after the demonstration ended. It concluded that as a result of the federal government's investment in this grant program, many demonstration states are in a strong position to extend and spread specific strategies for improving the quality of care for children in Medicaid and CHIP.
AHRQ-authored; AHRQ-funded; 29020090002191.
Citation: Ireys HT, Brach C, Anglin G .
After the demonstration: what states sustained after the end of federal grants to improve children's health care quality.
Matern Child Health J 2018 Feb;22(2):195-203. doi: 10.1007/s10995-017-2391-z.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Quality of Care, Health Insurance, Medicaid
Burton RA, Peters RA, Devers KJ
Perspectives on implementing quality improvement collaboratives effectively: qualitative findings from the CHIPRA quality demonstration grant program.
The most frequently pursued intervention in the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) quality demonstration (2010-2015) was quality improvement collaboratives. This study was conducted to identify which aspects of these collaboratives were viewed by organizers and participants as working well and which were not. It found that aspects of collaboratives that interviewees valued were aimed at attracting participation, maintaining engagement, or facilitating learning.
AHRQ-funded; 2902009000191.
Citation: Burton RA, Peters RA, Devers KJ .
Perspectives on implementing quality improvement collaboratives effectively: qualitative findings from the CHIPRA quality demonstration grant program.
Jt Comm J Qual Patient Saf 2018 Jan;44(1):12-22. doi: 10.1016/j.jcjq.2017.08.004.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Quality of Care, Quality Improvement
Christensen AL, Zickafoose JS, Natzke B
Associations between practice-reported medical homeness and health care utilization among publicly insured children.
This study assessed the relationship between having a patient-centered medical home and use of health services by children enrolled in Medicaid in three States. The researchers found that medical homeness was not associated with the likelihood of receiving well-child care. Association of medical homeness with non-urgent, preventable, or avoidable emergency department visits varied.
AHRQ-funded; 290200900019I
Citation: Christensen AL, Zickafoose JS, Natzke B .
Associations between practice-reported medical homeness and health care utilization among publicly insured children.
Acad Pediatr. 2015 May-Jun;15(3):267-74. doi: 10.1016/j.acap.2014.12.001..
Keywords: Children/Adolescents, Medicaid, Patient-Centered Healthcare, Children's Health Insurance Program (CHIP), Healthcare Utilization
Hudson JL, Hill SC, Selden TM
AHRQ Author: Hudson JL, Hill SC, Selden TM
If rollbacks go forward, up to 14 million children could become ineligible for public or subsidized coverage by 2019.
This study investigated the potential health insurance options available to low-income children if federal CHIP funding ends in 2017 or if federal requirements change in 2019, allowing states to roll back Medicaid- and CHIP-eligibility thresholds to minimum levels. It found that the percentage of low-income children ineligible for public coverage or subsidized Marketplace coverage would increase from 22 percent in 2014 (12.5 million children) to 46 percent after 2019 (26.5 million children).
Citation: Hudson JL, Hill SC, Selden TM .
If rollbacks go forward, up to 14 million children could become ineligible for public or subsidized coverage by 2019.
Health Aff 2015 May;34(5):864-70. doi: 10.1377/hlthaff.2015.0004..
Keywords: Children's Health Insurance Program (CHIP), Children/Adolescents, Health Insurance, Low-Income
Pati S, Wong AT, Calixte RE
Medicaid and CHIP retention among children in 12 states.
The authors sought to determine reproducibility of public insurance retention rates for children using 3 different metrics at the state and county level. They found that all 3 metrics demonstrated reproducible estimates at the state level. Reproducibility of relative rankings for child health insurance retention of counties within states were sensitive to county child population size and the amount of variability in retention rates within the county and at the state level.
AHRQ-funded; HS020508.
Citation: Pati S, Wong AT, Calixte RE .
Medicaid and CHIP retention among children in 12 states.
Acad Pediatr 2015 May-Jun;15(3):249-57. doi: 10.1016/j.acap.2014.09.012.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Policy, Medicaid
Selden TM, Dubay L, Miller GE
AHRQ Author: Selden TM, Miller GE
Many families may face sharply higher costs if public health insurance for their children is rolled back.
If possible cuts to the Children’s Health Insurance Program (CHIP) and elimination of the Affordable Care Act’s “maintenance of effort” provisions regarding Medicaid and CHIP take place; this study shows that many families would face sharply higher costs of providing insurance coverage for their children.
AHRQ Author
Citation: Selden TM, Dubay L, Miller GE .
Many families may face sharply higher costs if public health insurance for their children is rolled back.
Health Aff. 2015 Apr;34(4):697-706. doi: 10.1377/hlthaff.2015.0003..
Keywords: Children's Health Insurance Program (CHIP), Healthcare Costs, Children/Adolescents
DeVoe JE, Tillotson CJ, Angier H
Predictors of children's health insurance coverage discontinuity in 1998 versus 2009: parental coverage continuity plays a major role.
This study examines the strength of association between known and potential predictors of children’s health insurance continuity in both 1998 and 2009. It found that, compared to children with at least one parent continuously covered, children whose parents did not have continuous coverage had a significantly higher relative risk of a coverage gap.
AHRQ-funded; HS018569.
Citation: DeVoe JE, Tillotson CJ, Angier H .
Predictors of children's health insurance coverage discontinuity in 1998 versus 2009: parental coverage continuity plays a major role.
Matern Child Health J 2015 Apr;19(4):889-96. doi: 10.1007/s10995-014-1590-0.
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Keywords: Medical Expenditure Panel Survey (MEPS), Children's Health Insurance Program (CHIP), Uninsured, Health Insurance
DeVoe JE, Marino M, Angier H
Effect of expanding Medicaid for parents on children's health insurance coverage: lessons from the Oregon Experiment.
This study estimated the effect on a child’s health insurance coverage status when (1) a parent randomly gains access to health insurance and (2) a parent obtains coverage. It found that children’s odds of having Medicaid or CHIP coverage increased when their parents were randomly selected to apply for Medicaid. Children whose parents were selected and subsequently obtained coverage benefited most.
AHRQ-funded; HS018569
Citation: DeVoe JE, Marino M, Angier H .
Effect of expanding Medicaid for parents on children's health insurance coverage: lessons from the Oregon Experiment.
JAMA Surg. 2015 Mar;150(3):223-8. doi: 10.1001/jamasurg.2014.2239..
Keywords: Medicaid, Health Insurance, Children's Health Insurance Program (CHIP), Children/Adolescents
Miller D, Noonan K, Fiks AG
Increasing pediatrician participation in EHR incentive programs.
The authors addressed potential causes of the variability of pediatrician registration in the meaningful use (MU) program and suggested specific solutions to support effective pediatric electronic health record implementation across all states. They concluded that implementing their proposed solutions would support pediatricians’ use of electronic health records, with an ultimate goal of improving child health.
AHRQ-funded; HS022689.
Citation: Miller D, Noonan K, Fiks AG .
Increasing pediatrician participation in EHR incentive programs.
Pediatrics 2015 Jan;135(1):e1-4. doi: 10.1542/peds.2014-2438.
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Keywords: Children's Health Insurance Program (CHIP), Electronic Health Records (EHRs), Provider: Health Personnel, Medicaid, Children/Adolescents