National Healthcare Quality and Disparities Report
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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 96 Research Studies DisplayedHerring B, Trish E
Explaining the growth in US health care spending using state-level variation in income, insurance, and provider market dynamics.
The authors estimated a regression model for state personal health care spending for 1991-2009, then used the results to produce state-level projections of health care spending for 2010-2013 and compared those average projected state values with actual national spending for 2010-2013. They found that at least 70% of the recent slowdown in health care spending can likely be explained by long-standing patterns.
AHRQ-funded; HS000046.
Citation: Herring B, Trish E .
Explaining the growth in US health care spending using state-level variation in income, insurance, and provider market dynamics.
Inquiry 2015 Dec 9;52. doi: 10.1177/0046958015618971.
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Keywords: Healthcare Costs, Health Insurance, Provider: Health Personnel, Policy, Policy
Kronick R, Casalino LP, Bindman AB
AHRQ Author: Kronick R
Apple pickers or federal judges: strong versus weak incentives in physician payment.
The authors provide an introduction for five papers commissioned by AHRQ focusing on incentives for physicians that are featured in this special issue of Health Services Research. These papers concentrate on suggesting a conceptual framework for the use of financial incentives in health care, key implications of the evidence to date on pay for performance and public reporting in health care and several related topics.
AHRQ-authored.
Citation: Kronick R, Casalino LP, Bindman AB .
Apple pickers or federal judges: strong versus weak incentives in physician payment.
Health Serv Res 2015 Dec;50 Suppl 2:2049-56. doi: 10.1111/1475-6773.12424.
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Keywords: Payment, Provider Performance, Policy, Health Services Research (HSR), Quality of Care, Healthcare Costs, Quality Improvement
Quan J, Lee AK, Handley MA
Automated telephone self-management support for diabetes in a low-income health plan: a health care utilization and cost analysis.
The objective was to determine whether automated telephone self-management support for low-income, linguistically diverse health plan members with diabetes affects health care utilization or cost. It found no significant differences in emergency department visits and hospitalizations or in costs.
AHRQ-funded; HS020684; HS017261; HS022561.
Citation: Quan J, Lee AK, Handley MA .
Automated telephone self-management support for diabetes in a low-income health plan: a health care utilization and cost analysis.
Popul Health Manag 2015 Dec;18(6):412-20. doi: 10.1089/pop.2014.0154.
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Keywords: Diabetes, Chronic Conditions, Patient Self-Management, Low-Income, Healthcare Costs
Kuo DZ, Hall M, Agrawal R
Comparison of health care spending and utilization among children with Medicaid insurance.
This study's objectives were to assess health care and spending among children with Medicaid insurance by their resource use. It found that as resource use increases in children with Medicaid, spending rises unevenly across health services: Spending on primary care rises modestly compared with other health services.
AHRQ-funded; HS023092.
Citation: Kuo DZ, Hall M, Agrawal R .
Comparison of health care spending and utilization among children with Medicaid insurance.
Pediatrics 2015 Dec;136(6):1521-9. doi: 10.1542/peds.2015-0871.
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Keywords: Medicaid, Healthcare Utilization, Children/Adolescents, Healthcare Costs, Health Services Research (HSR)
Roth JA, Ramsey SD, Carlson JJ
Cost-effectiveness of a biopsy-based 8-protein prostate cancer prognostic assay to optimize treatment decision making in Gleason 3 + 3 and 3 + 4 early stage prostate cancer.
A novel 8-protein prognostic assay generates a risk score at time of biopsy that is predictive of prostate cancer aggressiveness and can inform treatment decisions. The objective of this study was to evaluate the cost-effectiveness of using the assay to inform treatment decisions compared with usual care. The 8-protein assay strategy resulted in 0.04 more quality-adjusted life years and $700 less in costs compared with usual care.
AHRQ-funded; HS022982.
Citation: Roth JA, Ramsey SD, Carlson JJ .
Cost-effectiveness of a biopsy-based 8-protein prostate cancer prognostic assay to optimize treatment decision making in Gleason 3 + 3 and 3 + 4 early stage prostate cancer.
Oncologist 2015 Dec;20(12):1355-64. doi: 10.1634/theoncologist.2015-0214.
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Keywords: Cancer, Cancer: Prostate Cancer, Patient-Centered Outcomes Research, Healthcare Costs, Decision Making
Lairson DR, Parikh RC, Cormier JN
Cost-effectiveness of chemotherapy for breast cancer and age effect in older women.
The researchers assessed the cost-effectiveness of chemotherapy regimens by age and disease stage under "real-world" conditions for patients with breast cancer. They found that anthracycline-based chemotherapy was found cost-effective for elderly patients with early stage (stage I, II, IIIa) breast cancer considering the US threshold of $100,000 per QALY.
AHRQ-funded; HS018956.
Citation: Lairson DR, Parikh RC, Cormier JN .
Cost-effectiveness of chemotherapy for breast cancer and age effect in older women.
Value Health 2015 Dec;18(8):1070-8. doi: 10.1016/j.jval.2015.08.008..
Keywords: Cancer: Breast Cancer, Treatments, Healthcare Costs, Elderly, Social Determinants of Health
Levy DE, Munshi VN, Ashburner JM
Health IT-assisted population-based preventive cancer screening: a cost analysis.
The researchers analyzed costs from a randomized trial of 2 health IT strategies to improve cancer screening compared with usual care from the perspective of a primary care network. They found that over the course of the study year, the value of reduced physician time devoted to preventive cancer screening outweighed the costs of the interventions.
AHRQ-funded; HS020308; HS018161.
Citation: Levy DE, Munshi VN, Ashburner JM .
Health IT-assisted population-based preventive cancer screening: a cost analysis.
Am J Manag Care 2015 Dec;21(12):885-91..
Keywords: Health Information Technology (HIT), Cancer, Screening, Prevention, Healthcare Costs
Guy GP, Jr., Yabroff KR, Ekwueme DU
AHRQ Author: Soni A
Healthcare expenditure burden among non-elderly cancer survivors, 2008-2012.
This study presented nationally representative estimates of annual out-of-pocket (OOP) burden among non-elderly cancer survivors and assessed the association between high OOP burden and access to care and preventive service utilization. It found that, among cancer survivors, high OOP burden was associated with being unable to obtain necessary medical care, delaying necessary medical care, and lower breast cancer screening rates among women.
AHRQ-authored.
Citation: Guy GP, Jr., Yabroff KR, Ekwueme DU .
Healthcare expenditure burden among non-elderly cancer survivors, 2008-2012.
Am J Prev Med 2015 Dec;49(6s5):S489-s97. doi: 10.1016/j.amepre.2015.09.002.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Cancer, Access to Care
Eaton EF, Kulczycki A, Saag M
Immunization costs and programmatic barriers at an urban HIV clinic.
This study estimated costs of providing Gardasil, Prevnar, and Zostavax to eligible patients at a US Ryan White Part C academically affiliated HIV clinic in 2013. Its cost analysis of 3 vaccines showed great variation in insurance coverage, with potential losses of almost $100 000 for one HIV clinic if eligible patients received vaccinations in one calendar year.
AHRQ-funded; HS013852.
Citation: Eaton EF, Kulczycki A, Saag M .
Immunization costs and programmatic barriers at an urban HIV clinic.
Clin Infect Dis 2015 Dec;61(11):1726-31. doi: 10.1093/cid/civ637.
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Keywords: Human Immunodeficiency Virus (HIV), Healthcare Costs, Medication, Vaccination
Smith MJ, Gerber JS, Hersh AL
Inpatient antimicrobial stewardship in pediatrics: a systematic review.
The purpose of this paper was to describe the clinical and economic outcomes associated with pediatric antimicrobial stewardship programs and other supplemental antimicrobial stewardship interventions. The authors concluded that the studies researched demonstrated reductions in antimicrobial utilization, cost, and prescribing errors with no apparent negative impact on patient safety.
AHRQ-funded; HS023320.
Citation: Smith MJ, Gerber JS, Hersh AL .
Inpatient antimicrobial stewardship in pediatrics: a systematic review.
J Pediatric Infect Dis Soc 2015 Dec;4(4):e127-35. doi: 10.1093/jpids/piu141.
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Keywords: Antimicrobial Stewardship, Children/Adolescents, Healthcare Costs, Patient-Centered Outcomes Research, Children/Adolescents
Jacobs PD, Banthin JS, Trachtman S
AHRQ Author: Jacobs PD
Insurer competition in federally run marketplaces is associated with lower premiums.
The researchers studied insurer participation and premiums during the first two years of the Marketplaces. They found that the addition of a single insurer in a county was associated with a 1.2 percent lower premium for the average silver plan and a 3.5 percent lower premium for the benchmark plan in the federally run Marketplaces.
AHRQ-authored.
Citation: Jacobs PD, Banthin JS, Trachtman S .
Insurer competition in federally run marketplaces is associated with lower premiums.
Health Aff 2015 Dec;34(12):2027-35. doi: 10.1377/hlthaff.2015.0548..
Keywords: Healthcare Costs, Health Insurance
Neprash HT, Wallace J, Chernew ME
Measuring prices in health care markets using commercial claims data.
The objective of this study was to compare methods of price measurement in health care markets. It concluded that market-level price measures reflecting broad sets of services are likely to rank markets similarly. Price indices relying on individual sentinel services may be more appropriate for examining specialty- or service-specific drivers of prices.
AHRQ-funded; HS000055.
Citation: Neprash HT, Wallace J, Chernew ME .
Measuring prices in health care markets using commercial claims data.
Health Serv Res 2015 Dec;50(6):2037-47. doi: 10.1111/1475-6773.12304..
Keywords: Data, Healthcare Costs, Health Insurance, Health Services Research (HSR)
Torio C
AHRQ Author: Torio C
Paediatric pain-related conditions impact healthcare expenditures.
The author comments on a cross-sectional study (Groenewald et al., Pain 2015; 156:951–7) that highlights the impact of pediatric pain-related conditions on national healthcare expenditures. She argues that to reduce the national toll of pain on the US economy, future studies should determine the most effective strategies to reduce on a population-level disruption and the personal, financial and social costs of pain.
AHRQ-authored.
Citation: Torio C .
Paediatric pain-related conditions impact healthcare expenditures.
Evid Based Med 2015 Dec;20(6):229. doi: 10.1136/ebmed-2015-110207..
Keywords: Pain, Children/Adolescents, Healthcare Costs, Children/Adolescents
Berdahl C, Schuur JD, Fisher NL
Policy measures and reimbursement for emergency medical imaging in the era of payment reform: proceedings from a panel discussion of the 2015 Academic Emergency Medicine Consensus Conference.
In May 2015, Academic Emergency Medicine convened a consensus conference titled "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." As part of the conference, a panel of health care policy leaders and emergency physicians discussed the effect of the Affordable Casre Act and other quality programs on ED diagnostic imaging. This article discusses the content of the panel's presentations.
AHRQ-funded; HS023498.
Citation: Berdahl C, Schuur JD, Fisher NL .
Policy measures and reimbursement for emergency medical imaging in the era of payment reform: proceedings from a panel discussion of the 2015 Academic Emergency Medicine Consensus Conference.
Acad Emerg Med 2015 Dec;22(12):1393-9. doi: 10.1111/acem.12829.
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Keywords: Emergency Department, Healthcare Costs, Payment, Policy, Imaging, Policy, Quality Improvement
Du XL, Parikh RC, Lairson DR
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
The authors examined racial/ethnic and geographical disparities in cancer care and costs during the last 6 months of life for lung cancer decedents after the FDA's approval of bevacizumab. They found that there were substantial racial/ethnic and geographic disparities in the types of cancer care and costs in the last 6 months of life among lung cancer decedents, regardless of the length of survival times and hospice care status.
AHRQ-funded; HS018956.
Citation: Du XL, Parikh RC, Lairson DR .
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
Lung Cancer 2015 Dec;90(3):442-50. doi: 10.1016/j.lungcan.2015.09.017.
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Keywords: Cancer, Cancer: Lung Cancer, Disparities, Healthcare Costs, Medication, Palliative Care, Patient-Centered Outcomes Research, Practice Patterns, Racial and Ethnic Minorities
Vistnes J, Selden TM, Zawacki A
AHRQ Author: Vistnes J, Selden TM
Several factors responsible for the recent slowdown in premium growth in employer-sponsored insurance.
Researchers have been seeking to identify which factors behind the recent spending slowdown . This study found that the slowdown in premium growth that preceded the recession reflected declining growth rates in per policyholder premiums. For 2009-11, however, the dominant contributors to the slowdown were factors underlying declining employee enrollment: a sharp downturn in employment in 2009, followed by eroding offer and eligibility rates.
AHRQ-authored.
Citation: Vistnes J, Selden TM, Zawacki A .
Several factors responsible for the recent slowdown in premium growth in employer-sponsored insurance.
Health Aff 2015 Dec;34(12):2036-43. doi: 10.1377/hlthaff.2015.0436..
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Healthcare Costs, Health Insurance
Selden TM, Karaca Z, Keenan P
AHRQ Author: Selden TM, Karaca Z, Keenan P, Kronick R
The growing difference between public and private payment rates for inpatient hospital care.
The difference between private and public (Medicare and Medicaid) payment rates for inpatient hospital stays widened between 1996 and 2012. Medical Expenditure Panel Survey data reveal that standardized private insurer payment rates in 2012 were approximately 75 percent greater than Medicare's-a sharp increase from the differential of approximately 10 percent in the period 1996-2001.
AHRQ-authored.
Citation: Selden TM, Karaca Z, Keenan P .
The growing difference between public and private payment rates for inpatient hospital care.
Health Aff 2015 Dec;34(12):2147-50. doi: 10.1377/hlthaff.2015.0706.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Inpatient Care, Hospitalization
Kerlin MP, Cooke CR
Understanding costs when seeking value in critical care.
The authors discuss a study by Gershengorn and colleagues about daily ICU costs in five ICUs within a single medical center. They argue that although the authors should be commended on advancing the understanding of ICU costs, we should also recognize that efforts to reduce ICU length of stay will necessarily be insufficient to make a real dent in our health care economy.
AHRQ-funded; HS020672.
Citation: Kerlin MP, Cooke CR .
Understanding costs when seeking value in critical care.
Ann Am Thorac Soc 2015 Dec;12(12):1743-4. doi: 10.1513/AnnalsATS.201510-660ED.
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Keywords: Critical Care, Healthcare Costs, Intensive Care Unit (ICU)
Grenda TR, Pradarelli JC, Thumma JR
Variation in hospital episode costs with bariatric surgery.
This study examined hospital variation in episode costs for a common high-risk procedure that is a prime candidate for bundled payment programs (ie, bariatric surgery). It found that mean total payments for bariatric procedures varied from $11,086 to $13,073 per episode of care, resulting in a mean difference of $1,987 (16.5 percent difference) per episode of care between the lowest and highest hospital quartiles.
AHRQ-funded; HS000053.
Citation: Grenda TR, Pradarelli JC, Thumma JR .
Variation in hospital episode costs with bariatric surgery.
JAMA Surg 2015 Dec;150(12):1109-15. doi: 10.1001/jamasurg.2015.2394.
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Keywords: Surgery, Obesity, Healthcare Costs
Robinson JC, Brown TT, Whaley C
Association of reference payment for colonoscopy with consumer choices, insurer spending, and procedural complications.
The researchers ascertained the effect of reference payment on facility choice, insurer spending, consumer cost sharing, and procedural complications for colonoscopy. They concluded that Implementation of reference payment for colonoscopy was associated with reduced spending and no change in complications.
AHRQ-funded; HS022098.
Citation: Robinson JC, Brown TT, Whaley C .
Association of reference payment for colonoscopy with consumer choices, insurer spending, and procedural complications.
JAMA Intern Med 2015 Nov;175(11):1783-9. doi: 10.1001/jamainternmed.2015.4588..
Keywords: Colonoscopy, Healthcare Costs, Adverse Events, Health Insurance
Anderson GF, Ballreich J, Bleich S
Attributes common to programs that successfully treat high-need, high-cost individuals.
The authors identified 8 attributes common to programs that successfully treat high-need, high-cost individuals. They then illustrated these attributes with specific examples.
AHRQ-funded; HS000029.
Citation: Anderson GF, Ballreich J, Bleich S .
Attributes common to programs that successfully treat high-need, high-cost individuals.
Am J Manag Care 2015 Nov;21(11):e597-600.
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Keywords: Healthcare Costs, Patient-Centered Healthcare
Poonawalla IB, Parikh RC, Du XL
Cost effectiveness of chemotherapeutic agents and targeted biologics in ovarian cancer: a systematic review.
The authors evaluated the cost-effectiveness of various chemotherapeutic and targeted therapy alternatives for ovarian cancer. They found that standard platinum-taxane combination chemotherapy for first-line treatment was most cost-effective.
AHRQ-funded; HS018956.
Citation: Poonawalla IB, Parikh RC, Du XL .
Cost effectiveness of chemotherapeutic agents and targeted biologics in ovarian cancer: a systematic review.
Pharmacoeconomics 2015 Nov;33(11):1155-85. doi: 10.1007/s40273-015-0304-9.
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Keywords: Treatments, Healthcare Costs, Medication, Cancer: Ovarian Cancer
Miller GE, Sarpong EM, Hill SC
AHRQ Author: Miller GE, Sarpong EM, Hill SC
Does increased adherence to medications change health care financial burdens for adults with diabetes?
The aim of the present study was to investigate increased out-of-pocket drug costs and financial burdens of achieving adherence to oral antidiabetic medications and medications for prevalent comorbidities. The researchers found that the mean simulated additional out-of-pocket drug costs of achieving adherence were $310 for uninsured adults treated for diabetes. These additional drug costs would increase the percentage of uninsured adults with financial burden.
AHRQ-authored.
Citation: Miller GE, Sarpong EM, Hill SC .
Does increased adherence to medications change health care financial burdens for adults with diabetes?
J Diabetes 2015 Nov;7(6):872-80. doi: 10.1111/1753-0407.12292..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Diabetes, Patient Adherence/Compliance, Medication
Chen LM, Meara E, Birkmeyer JD
Medicare's Bundled Payments for Care Improvement initiative: expanding enrollment suggests potential for large impact.
The researchers examined the cross-sectional association between Bundled Payments for Care Improvement (BPCI) participation and providers' structural and cost characteristics. Overall participation in BPCI increased from about 400 in October 2013 to more than 2000 in June 2014. The authors concluded that growing participation in BPCI suggests strong interest in bundled payments.
AHRQ-funded; HS020671.
Citation: Chen LM, Meara E, Birkmeyer JD .
Medicare's Bundled Payments for Care Improvement initiative: expanding enrollment suggests potential for large impact.
Am J Manag Care 2015 Nov;21(11):814-20.
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Keywords: Healthcare Costs, Payment, Medicare, Quality Improvement
Golberstein E, Gonzales G, Sommers BD
California's early ACA expansion increased coverage and reduced out-of-pocket spending for the state's low-income population.
The researchers used data from the National Health Interview Survey to examine the impact of California’s Low Income Health Program. Their study demonstrates that the county-by-county rollout of expanded public insurance coverage in California significantly increased coverage, by 7 percentage points, and significantly reduced the likelihood of any family out-of-pocket medical spending in the previous year, by 10 percentage points, among low-income adults.
AHRQ-funded; HS021291.
Citation: Golberstein E, Gonzales G, Sommers BD .
California's early ACA expansion increased coverage and reduced out-of-pocket spending for the state's low-income population.
Health Aff 2015 Oct;34(10):1688-94. doi: 10.1377/hlthaff.2015.0290..
Keywords: Low-Income, Healthcare Costs, Health Insurance, Uninsured