National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- (-) Access to Care (17)
- Behavioral Health (4)
- Children's Health Insurance Program (CHIP) (1)
- Children/Adolescents (2)
- Chronic Conditions (1)
- Community-Based Practice (2)
- Dental and Oral Health (1)
- Depression (2)
- Diabetes (1)
- Disparities (2)
- Healthcare Utilization (2)
- Health Insurance (5)
- Health Services Research (HSR) (2)
- Low-Income (1)
- Maternal Care (1)
- (-) Medicaid (17)
- Medical Expenditure Panel Survey (MEPS) (3)
- Medication (1)
- Mortality (1)
- Patient-Centered Healthcare (1)
- Patient Experience (1)
- Policy (7)
- Pregnancy (1)
- Prevention (1)
- Primary Care (2)
- Quality of Care (2)
- Racial and Ethnic Minorities (4)
- Rural Health (1)
- Sexual Health (1)
- Substance Abuse (1)
- Uninsured (3)
- Women (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 17 of 17 Research Studies DisplayedBurgette JM, Preisser JS, Rozier RG
Access to preventive services after the integration of oral health care into early childhood education and medical care.
The authors compared children enrolled in North Carolina Early Head Start (EHS) programs with similar children enrolled in Medicaid but not EHS on the use of POHS. They analyzed 4 dependent variables (oral assessment by medical health care provider, oral assessment by oral health care provider, fluoride application by medical health care provider, fluoride application by oral health care provider) by using multivariate logistic regression that controlled for covariates.
AHRQ-funded; HS000032.
Citation: Burgette JM, Preisser JS, Rozier RG .
Access to preventive services after the integration of oral health care into early childhood education and medical care.
J Am Dent Assoc 2018 Dec;149(12):1024-31.e2. doi: 10.1016/j.adaj.2018.07.019..
Keywords: Access to Care, Children/Adolescents, Dental and Oral Health, Health Services Research (HSR), Medicaid, Patient-Centered Healthcare, Prevention
Fry CE, Sommers BD
Effect of Medicaid expansion on health insurance coverage and access to care among adults with depression.
This quasi-experimental study sought to determine the relationship between Medicaid expansion and various health and financial outcomes among low-income adults with depression. The investigators found that Medicaid expansion was associated with a significant reduction in the proportion of adults with depression who lacked health insurance. Medicaid expansion was also associated with significant reductions in delaying care and medications because of cost.
AHRQ-funded; HS021291.
Citation: Fry CE, Sommers BD .
Effect of Medicaid expansion on health insurance coverage and access to care among adults with depression.
Psychiatr Serv 2018 Nov;69(11):1146-52. doi: 10.1176/appi.ps.201800181..
Keywords: Access to Care, Depression, Health Insurance, Medicaid, Behavioral Health
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
Barnett ML, Clark KL, Sommers BD
State policies and enrollees' experiences in Medicaid: evidence from a new national survey.
This study examined patient satisfaction among Medicaid enrollees nationally from 2014-2015. Significant disparities were found among racial/ethnic groups. Managed care enrollees had higher satisfaction ratings than those with fee-for-service. If the patient had a personal doctor that increased satisfaction for an average 4.6 percent.
AHRQ-funded; HS021291.
Citation: Barnett ML, Clark KL, Sommers BD .
State policies and enrollees' experiences in Medicaid: evidence from a new national survey.
Health Aff 2018 Oct;37(10):1647-55. doi: 10.1377/hlthaff.2018.0505..
Keywords: Access to Care, Disparities, Medicaid, Patient Experience, Policy, Racial and Ethnic Minorities
Moniz MH, Kirch MA, Solway E
Association of access to family planning services with Medicaid expansion among female enrollees in Michigan.
The purpose of this study was to evaluate the association of Medicaid expansion coverage with access to birth control and family planning services among women of reproductive age enrolled in the Michigan expansion plan. The investigators found that one in 3 women of reproductive age reported better ability to access birth control and family planning services through Healthy Michigan Plan compared with before enrollment.
AHRQ-funded; HS025465.
Citation: Moniz MH, Kirch MA, Solway E .
Association of access to family planning services with Medicaid expansion among female enrollees in Michigan.
JAMA Network Open 2018 Aug 31;1(4). doi: 10.1001/jamanetworkopen.2018.1627..
Keywords: Medicaid, Women, Sexual Health, Access to Care, Policy
Biener AI, Zuvekas SH, Hill SC
AHRQ Author: Biener AI, Zuvekas SH, Hill SC
Impact of recent Medicaid expansions on office-based primary care and specialty care among the newly eligible.
The objective of this study was to quantify the effect of Medicaid expansions on office-based care among the newly eligible. The investigators concluded that State Medicaid expansions in 2014 were associated with greater likelihoods of visits with a variety of office-based providers. The estimated effects were larger among newly eligible compared with previous estimates on broader populations of low-income adults.
AHRQ-authored.
Citation: Biener AI, Zuvekas SH, Hill SC .
Impact of recent Medicaid expansions on office-based primary care and specialty care among the newly eligible.
Health Serv Res 2018 Aug;53(4):2426-45. doi: 10.1111/1475-6773.12793.
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Keywords: Access to Care, Healthcare Utilization, Medicaid, Medical Expenditure Panel Survey (MEPS), Primary Care
Andrews CM, Grogan CM, Smith BT
Medicaid benefits for addiction treatment expanded after implementation of the Affordable Care Act.
This study looked at the effects the Affordable Care Act (ACA) had on Medicaid benefits for addiction treatment. The ACA established a minimum standard of benefits and required state Medicaid programs to make changes to their treatment benefits. Researchers surveyed all 50 states and the District of Columbia in 2014 and 2017 when the ACA requirements came into effect. There was a substantial increase in benefits with a decrease in annual service limits of over 50 percent. There was a large reduction in preauthorization requirements for medications to treat opioid use disorder as well as other reductions in preauthorizations.
AHRQ-funded; HS000084.
Citation: Andrews CM, Grogan CM, Smith BT .
Medicaid benefits for addiction treatment expanded after implementation of the Affordable Care Act.
Health Aff 2018 Aug;37(8):1216-22. doi: 10.1377/hlthaff.2018.0272..
Keywords: Access to Care, Behavioral Health, Health Insurance, Medicaid, Policy, Substance Abuse
Myerson R, Lu T, Tonnu-Mihara I
Medicaid eligibility expansions may address gaps in access to diabetes medications.
The purpose of this study was to examine the impacts of Medicaid expansion on access to diabetes medications, researchers analyzed data on over ninety-six million prescription fills using Medicaid insurance in the period January 2008-December 2015. The researchers found that the increase in prescription fills grew significantly over time. Overall, fills for insulin and for newer medications increased by 40 percent and 39 percent, respectively.
AHRQ-funded; HS023964.
Citation: Myerson R, Lu T, Tonnu-Mihara I .
Medicaid eligibility expansions may address gaps in access to diabetes medications.
Health Aff 2018 Aug;37(8):1200-07. doi: 10.1377/hlthaff.2018.0154..
Keywords: Access to Care, Diabetes, Policy, Medicaid, Medication
Yucel A, Essien EJ, Sanyal S
Racial/ethnic differences in the treatment of adolescent major depressive disorders (MDD) across healthcare providers participating in the Medicaid program.
The purpose of this study was to examine whether racial/ethnic differences in receipt of major depressive disorder (MDD) treatment could be explained by the specialty of provider diagnosing the adolescent. The investigators found that for adolescents with MDD, being first diagnosed by a psychiatrist was associated with higher treatment rate and reduced racial/ethnic variation in the utilization of pharmacotherapy.
AHRQ-funded; HS025251.
Citation: Yucel A, Essien EJ, Sanyal S .
Racial/ethnic differences in the treatment of adolescent major depressive disorders (MDD) across healthcare providers participating in the Medicaid program.
J Affect Disord 2018 Aug 1;235:155-61. doi: 10.1016/j.jad.2018.04.045..
Keywords: Access to Care, Depression, Disparities, Medicaid, Behavioral Health, Racial and Ethnic Minorities
Cole MB, Wright B, Wilson IB
Medicaid expansion and community health centers: care quality and service use increased for rural patients.
Investigators studied the impact of Medicaid expansion in rural areas. Data from 2011-2015 found that there was an 11.4% decline in uninsured patients and a 13.5% increase in Medicaid patients at community health centers (CHCs). Relative improvements were shown in patients with chronic conditions such as asthma and hypertension; and an increase in visits for mammograms and substance abuse disorders.
AHRQ-funded; HS024652.
Citation: Cole MB, Wright B, Wilson IB .
Medicaid expansion and community health centers: care quality and service use increased for rural patients.
Health Aff 2018 Jun;37(6):900-07. doi: 10.1377/hlthaff.2017.1542..
Keywords: Medicaid, Community-Based Practice, Rural Health, Access to Care, Quality of Care, Healthcare Utilization, Primary Care
Selden TM, Lipton BJ, Decker SL
AHRQ Author: Selden TM, Lipton BJ, Decker SL
Medicaid expansion and marketplace eligibility both increased coverage, with trade-offs in access, affordability.
The researchers found that as of 2015, adults with incomes of 100-138 percent of the federal poverty level had experienced large declines in uninsurance rates in both expansion and nonexpansion states. Adults in expansion and nonexpansion states also experienced similar increases in having a usual source of care and primary care visits, and similar reductions in delayed receipt of medical care due to cost.
AHRQ-authored.
Citation: Selden TM, Lipton BJ, Decker SL .
Medicaid expansion and marketplace eligibility both increased coverage, with trade-offs in access, affordability.
Health Aff 2017 Dec;36(12):2069-77. doi: 10.1377/hlthaff.2017.0830.
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Keywords: Access to Care, Health Insurance, Policy, Low-Income, Medicaid, Uninsured
Kirby JB, Sharma R
AHRQ Author: Kirby JB
The availability of community health center services and access to medical care.
This study examined the associations between the availability of Community Health Centers (CHCs) services in communities and two key measures of ambulatory care access - having a usual source of care and having any office-based medical visits over a one year period. It found that the availability of CHC services was positively associated with both measures of access among those with no insurance coverage.
AHRQ-authored.
Citation: Kirby JB, Sharma R .
The availability of community health center services and access to medical care.
Healthc 2017 Dec;5(4):174-82. doi: 10.1016/j.hjdsi.2016.12.006.
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Keywords: Access to Care, Community-Based Practice, Medicaid, Medical Expenditure Panel Survey (MEPS), Uninsured
Roman LA, Raffo JE, Dertz K
Understanding perspectives of African American Medicaid-insured women on the process of perinatal care: an opportunity for systems improvement.
The purpose of this study was to explore the perspectives of Medicaid-insured women about their experiences of perinatal care across a continuum of clinical and community-based services. It found that many women experienced difficulties engaging in early care, getting more help, and understanding and communicating with their providers, with some reporting socio-economic and racial bias in care.
AHRQ-funded; HS020208.
Citation: Roman LA, Raffo JE, Dertz K .
Understanding perspectives of African American Medicaid-insured women on the process of perinatal care: an opportunity for systems improvement.
Matern Child Health J 2017 Dec;21(Suppl 1):81-92. doi: 10.1007/s10995-017-2372-2.
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Keywords: Access to Care, Maternal Care, Medicaid, Pregnancy, Racial and Ethnic Minorities
Gonzales G, Golberstein E, Hill SC
AHRQ Author: Hill, SC; Zuvekas, SH
Psychological distress and enrollment in Medicaid.
Adults with poor mental health may want and need insurance to obtain care, but symptoms may impede enrollment into public health insurance. The enrollment response to Medicaid expansions prior to the Affordable Care Act was stronger for adults symptomatic of psychological distress compared with adults without distress and compared to adults with chronic physical health problems.
AHRQ-authored.
Citation: Gonzales G, Golberstein E, Hill SC .
Psychological distress and enrollment in Medicaid.
J Behav Health Serv Res 2017 Oct;44(4):523-35. doi: 10.1007/s11414-016-9532-9.
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Keywords: Access to Care, Policy, Medicaid, Medical Expenditure Panel Survey (MEPS), Behavioral Health
Hatch B, Marino M, Killerby M
Medicaid's impact on chronic disease biomarkers: a cohort study of community health center patients.
This study assessed changes in biomarkers of chronic disease among community health center (CHC) patients who gained Medicaid coverage with the Oregon Medicaid expansion (2008-2011). It found that patients with uncontrolled chronic conditions experienced objective health improvements over time. In two of three chronic disease cohorts, those who gained Medicaid coverage were more likely to achieve a controlled measurement than those who remained uninsured.
AHRQ-funded; HS024270.
Citation: Hatch B, Marino M, Killerby M .
Medicaid's impact on chronic disease biomarkers: a cohort study of community health center patients.
J Gen Intern Med 2017 Aug;32(8):940-47. doi: 10.1007/s11606-017-4051-9.
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Keywords: Medicaid, Chronic Conditions, Access to Care, Policy
Barnett ML, Linder JA, Clark CR
Low-value medical services in the safety-net population.
The objective of this study was to measure rates of low-value care and high-value care received by patients without insurance or with Medicaid, compared with privately insured patients, and provided by safety-net physicians vs non-safety-net physicians. The study concluded that rates of low-value and high-value care were similar among physicians serving vulnerable patients and other physicians. Overuse of low-value care is a potentially important focus for state Medicaid programs and safety-net institutions to pursue cost savings and improved quality of health care delivery.
AHRQ-funded; HS021291.
Citation: Barnett ML, Linder JA, Clark CR .
Low-value medical services in the safety-net population.
JAMA Intern Med 2017 Jun;177(6):829-37. doi: 10.1001/jamainternmed.2017.0401..
Keywords: Access to Care, Uninsured, Medicaid, Quality of Care
Sohn H
Medicaid's lasting impressions: population health and insurance at birth.
This article examines lasting mortality improvements associated with availability of Medicaid at time and place of birth. Being born after Medicaid was associated with between 2.03 and 3.64 fewer deaths per 100,000 person-years in childhood and between 1.35 and 3.86 fewer deaths per 100,000 person-years in the thirties. The association between Medicaid at birth and mortality was the strongest in the oldest age group (36-40) in this study.
AHRQ-funded; HS000046.
Citation: Sohn H .
Medicaid's lasting impressions: population health and insurance at birth.
Soc Sci Med 2017 Mar;177:205-12. doi: 10.1016/j.socscimed.2017.01.043.
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Keywords: Access to Care, Health Insurance, Health Services Research (HSR), Medicaid, Mortality