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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 11 of 11 Research Studies DisplayedGrove LR, Berkowitz SA, Cuddeback G
Permanent supportive housing receipt and health care use among adults with disabilities.
This study’s objective was to assess whether permanent supportive housing (PSH) participation is associated with health service use among a population of adults with disabilities, including people transitioning into PSH from community and institutional settings. Primary data sources used were 2014 to 2018 secondary data from a PSH program in North Carolina linked to Medicaid claims. The authors used propensity score weighting to estimate the average treatment effect on the treated of PSH participation. Using weighted analysis, they found that among individuals who were institutionalized prior to PSH, PSH participation was associated with greater hospitalizations and emergency department (ED) visits and fewer primary care visits during the follow-up period, compared with similar individuals who largely remained institutionalized. There was no significantly different health service use from similar comparison group members for individuals who entered PSH from community settings during the 12-month follow-up period.
AHRQ-funded; HS000032.
Citation: Grove LR, Berkowitz SA, Cuddeback G .
Permanent supportive housing receipt and health care use among adults with disabilities.
Med Care Res Rev 2023 Dec; 80(6):596-607. doi: 10.1177/10775587231183192..
Keywords: Disabilities, Vulnerable Populations, Access to Care
Frank M, Loh R, Everhart R
No health without access: using a retrospective cohort to model a care continuum for people released from prison at an urban, safety net health system.
This retrospective cohort study of persons released from correctional facilities examined healthcare utilization by merging records from Denver Health (DH), an urban safety-net healthcare system, and the Colorado Department of Corrections (CDOC), for people released from January 1 to June 30, 2021. The study population was either 1) released to the Denver metro area (Denver and its five neighboring counties); or (2 assigned to the DH Regional Accountable Entity; or (3 assigned to the DH medical home based on Colorado Department of Healthcare Policy and Financing attribution methods. From January to June 2021 3242 people were released from CDOC and 2848 were included in the data exchange. 905 individuals of the total 2848 were released to the Denver metro area or attributed to DH. In the study population over three-fourths (78.1%) had a chronic medical or psychological condition. Within the first 6 months of release, 31.1% utilized any health service, 24.5% utilized at least one outpatient service, and 17.1% utilized outpatient services two or more times. Within the first 30 days of release 10.1% utilized outpatient services.
AHRQ-funded; HS027389.
Citation: Frank M, Loh R, Everhart R .
No health without access: using a retrospective cohort to model a care continuum for people released from prison at an urban, safety net health system.
Health Justice 2023 Nov 18; 11(1):49. doi: 10.1186/s40352-023-00248-3..
Keywords: Access to Care, Vulnerable Populations, Urban Health, Rural/Inner-City Residents
Hughes PM, Carda-Auten J, DiRosa EA
"You can get a couple of ramen noodle packs for a Buspar(Ⓡ)": a qualitative examination of medication access, policy, and procedures in southern jails.
Over10 million people are being incarcerated every year in the US, and jails are required to provide health care to them, a substantial percentage of whom require medications. However, not much is known about the medication prescription, acquisition, and administration process for incarcerated persons in jails. The purpose of this study was to characterize access to medication and related medication policies and procedures in jails. The researchers administered semi-structured interviews with administrators and health workers from 34 jails (of 125 contacted) across 5 states in the southeastern US. The qualitative interview guide encompassed all facets of healthcare in jails from entry to release, but the current study focused only on medications. The study found that 4 processes characterized medication utilization from intake to release: 1) jail entry and health screening, 2) pharmacy and medication protocols, 3) protocols specific to medication dispensing and administration, and 4) medications upon release. Many jails had processes for utilizing medications brought to the jail from home, although some jails did not agree to use those medications. Researchers discovered that contracted healthcare providers were the primary medication decision-makers in jails, and most medications were obtained from contract pharmacies. The study also found almost all jails banned narcotics, but other medication restrictions varied by jail. Most jails charged a copay for medications. Study participants shared a variety of privacy practices related to the distribution of medication, as well as approaches to the prevention of diversion of medications away from intended recipients and into the prison population. Transition planning for pre-release medication management processes ranged from no planning to sending additional prescriptions to the patient's pharmacy.
AHRQ-funded; HS000032.
Citation: Hughes PM, Carda-Auten J, DiRosa EA .
"You can get a couple of ramen noodle packs for a Buspar(Ⓡ)": a qualitative examination of medication access, policy, and procedures in southern jails.
Res Social Adm Pharm 2023 Sep; 19(9):1298-306. doi: 10.1016/j.sapharm.2023.05.013..
Keywords: Medication, Vulnerable Populations, Access to Care
Borah L, Zebib L, Sanders HM
State restrictions and geographic access to gender-affirming care for transgender youth.
This research letter described a study that estimated changes in geographic access and drive times to gender clinics after 20 states enacted legislation to restrict puberty-suppressing medications and hormones for those under the age of 18. Access to appropriate medical and social services for transgender youths was associated with mental health benefits and decreased levels of suicidality.
AHRQ-funded; HS028748.
Citation: Borah L, Zebib L, Sanders HM .
State restrictions and geographic access to gender-affirming care for transgender youth.
JAMA 2023 Jul 25; 330(4):375-78. doi: 10.1001/jama.2023.11299..
Keywords: Children/Adolescents, Vulnerable Populations, Access to Care, Policy
Rich KM, Guardado R, Bigham ZR
The impact of incarceration on readmissions among patients with inflammatory bowel disease hospitalized at a community hospital.
The purpose of this study was to compare the frequency of readmissions in patients with inflammatory bowel disease (IBD) receiving care at a community hospital who were and were not incarcerated when they were hospitalized. The primary study outcome was all cause readmission at 1 year following an IBD-related admission. The secondary outcomes included 1. all-cause readmission at 30 days, 2. IBD-related readmission at 30 days, and 3. IBD-related readmission at 1 year. The study indicator of interest was incarceration. The study found that individuals who were incarcerated had a greater rate of all-cause readmissions at 1 year than those who were not incarcerated at the time of hospitalization.
AHRQ-funded; HS026008.
Citation: Rich KM, Guardado R, Bigham ZR .
The impact of incarceration on readmissions among patients with inflammatory bowel disease hospitalized at a community hospital.
Gastro Hep Advances 2023; 2(5):660-65..
Keywords: Vulnerable Populations, Hospital Readmissions, Access to Care
Myong C, Hull P, Price M
The impact of funding for federally qualified health centers on utilization and emergency department visits in Massachusetts.
This retrospective study examined the impact of funding for federally qualified health centers (FQHCs) on utilization and emergency department (ED) visits in Massachusetts. The authors theorized that greater funding for FQHCs could increase the local availability of clinic-based care and reduce more costly resource use, such as ED visits. Data from the Massachusetts All Payer Claims Database (APCD) 2010-2013 was used that included enrollees in 559 Massachusetts ZIP codes (2010 numbers 6,173,563). They calculated shift-share predictions of changes in FQHC funding at the ZIP code-level for FQHCs that received Community Health Center funds in any year. They found that a standard deviation increase in prior year FQHC funding (31%) was associated with a 2.3% increase in enrollees with FQHC visits and a 1.3% decrease in enrollees at EDs. However, there were no significant changes in emergent ED visit rates.
AHRQ-funded; HS025378.
Citation: Myong C, Hull P, Price M .
The impact of funding for federally qualified health centers on utilization and emergency department visits in Massachusetts.
PLoS One 2020 Dec 3;15(12):e0243279. doi: 10.1371/journal.pone.0243279..
Keywords: Community-Based Practice, Healthcare Utilization, Emergency Department, Healthcare Costs, Access to Care, Vulnerable Populations, Policy
Rosenberg J, Rosenthal MS, Cramer LD
Disparities in mental and behavioral health treatment for children and youth in immigrant families.
Children and youth in immigrant families (CIF)-children and youth with at least one foreign-born parent-face unique psychosocial stressors. Yet little is known about access to mental/behavioral health (MBH) services for CIF. Among US CIF and non-CIF with MBH problems, the authors assessed access to MBH treatment using the National Survey of Children's Health-2016, a nationally-representative survey of predominantly English- or Spanish-speaking US parents.
AHRQ-funded; HS024332.
Citation: Rosenberg J, Rosenthal MS, Cramer LD .
Disparities in mental and behavioral health treatment for children and youth in immigrant families.
Acad Pediatr 2020 Nov-Dec;20(8):1148-56. doi: 10.1016/j.acap.2020.06.013..
Keywords: Children/Adolescents, Behavioral Health, Disparities, Racial and Ethnic Minorities, Vulnerable Populations, Access to Care
Desai AD, Zhou C, Haaland W
Social disadvantage, access to care, and disparities in physical functioning among children hospitalized with respiratory illness.
This study examined associations between social disadvantage, access to care, and disparities in physical functioning among children hospitalized with acute respiratory illness. The study cohort included children ages 8-16 years and/or caregivers of children 2 weeks to 16 years admitted to five tertiary care children’s hospitals for three common respiratory illnesses from July 2014 through June 2016. Surveys were completed within 2 to 8 weeks after discharge. The survey assessed social disadvantage, difficulty/delays accessing care, and baseline and follow-up health-related quality of life (HRQoL), and physical functioning using the Pediatric Quality of Life Inventory (PedsQL). A total of 1,325 patients and/or their caregivers completed both PedsQL surveys. Adjusted mean baseline PedsQL scores were significantly lower for patients with social disadvantage (minority race/ethnicity, limited English proficiency, low education, and low income), than for patients with none. There were also disadvantage markers or difficulty/delays accessing care which were associated with lower physical functioning. However, these differences were reduced after hospital discharge.
AHRQ-funded; HS024299.
Citation: Desai AD, Zhou C, Haaland W .
Social disadvantage, access to care, and disparities in physical functioning among children hospitalized with respiratory illness.
J Hosp Med 2020 Apr;15(4):211-18. doi: 10.12788/jhm.3359..
Keywords: Children/Adolescents, Respiratory Conditions, Hospitalization, Access to Care, Disparities, Vulnerable Populations, Quality of Life
Ellis RJ, Schlick CJR, Feinglass J
Failure to administer recommended chemotherapy: acceptable variation or cancer care quality blind spot?
This study examined hospital variation in cancer patients who did not receive recommended chemotherapy. Patients with breast, colon, and lung cancers who did not receive chemotherapy from 2000 to 2015 were identified from the National Cancer Database. A total of 183,148 patients at 1281 hospitals were included. For breast cancer, 3.5% of patients failed to receive recommended chemotherapy, and 6.6% with colon, and 10.7% with lung cancer. Sociodemographic factors showed that patients were less likely to receive chemotherapy if they were uninsured or on Medicaid, as were non-Hispanic black patients with both breast and colon cancer. There was also significant hospital variation with failure to administer as high as 21.8% for breast, 40.2% for colon, and 40.0% for lung cancer.
AHRQ-funded; HS000078; HS026385.
Citation: Ellis RJ, Schlick CJR, Feinglass J .
Failure to administer recommended chemotherapy: acceptable variation or cancer care quality blind spot?
BMJ Qual Saf 2020 Feb;29(2):103-12. doi: 10.1136/bmjqs-2019-009742..
Keywords: Treatments, Cancer, Healthcare Delivery, Access to Care, Healthcare Utilization, Social Determinants of Health, Vulnerable Populations, Uninsured, Hospitals, Quality of Care
Sofolahan-Oladeinde Y, Mullins CD, Baquet CR
Using community-based participatory research in patient-centered outcomes research to address health disparities in under-represented communities.
The authors proposed ways by which patient-centered outcomes research can effectively use community-based participatory research principles to engage patients in general, and specifically patients from underserved communities, in the hope that this will help to reduce and eventually eliminate health disparities.
AHRQ-funded; HS022135.
Citation: Sofolahan-Oladeinde Y, Mullins CD, Baquet CR .
Using community-based participatory research in patient-centered outcomes research to address health disparities in under-represented communities.
J Comp Eff Res 2015 Sep;4(5):515-23. doi: 10.2217/cer.15.31.
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Keywords: Access to Care, Disparities, Evidence-Based Practice, Patient-Centered Outcomes Research, Vulnerable Populations
Geissler KH, Holmes GM
Emergency department use in the US-Mexico border region and violence in Mexico: is there a relationship?
This study assessed the association between homicide rates in northern Mexico and potentially avoidable use of emergency departments (ED) in the US-Mexico border region. It concluded that a substantial majority of ED encounters in the US-Mexico border region were potentially avoidable. However, there was not a strong relationship between homicide rates in northern Mexico and the distribution of ED discharges in Arizona and California.
AHRQ-funded; HS021074.
Citation: Geissler KH, Holmes GM .
Emergency department use in the US-Mexico border region and violence in Mexico: is there a relationship?
J Rural Health 2015 Summer;31(3):316-25. doi: 10.1111/jrh.12109.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Medical Services (EMS), Healthcare Utilization, Access to Care, Vulnerable Populations