National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (3)
- Adverse Events (1)
- Behavioral Health (4)
- Cancer (1)
- Cancer: Breast Cancer (2)
- Children/Adolescents (3)
- Chronic Conditions (2)
- Communication (1)
- Community-Based Practice (1)
- Diabetes (1)
- (-) Disparities (30)
- Ear Infections (1)
- Elderly (1)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Healthcare Cost and Utilization Project (HCUP) (3)
- Health Insurance (2)
- Health Services Research (HSR) (1)
- Health Status (5)
- Hospitalization (1)
- Imaging (1)
- Implementation (1)
- Low-Income (2)
- Medical Expenditure Panel Survey (MEPS) (3)
- Mortality (3)
- Newborns/Infants (1)
- Nursing Homes (1)
- Obesity (1)
- Osteoporosis (1)
- Outcomes (1)
- Palliative Care (1)
- Patient-Centered Outcomes Research (2)
- Patient and Family Engagement (1)
- Policy (3)
- Practice Patterns (1)
- Prevention (2)
- Provider Performance (1)
- Public Reporting (1)
- Quality Indicators (QIs) (1)
- Quality of Care (5)
- (-) Racial and Ethnic Minorities (30)
- Screening (2)
- Sepsis (1)
- Social Determinants of Health (4)
- Substance Abuse (1)
- Surgery (2)
- Transplantation (1)
- Uninsured (1)
- Urban Health (1)
- Women (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 30 Research Studies DisplayedKumar K, Holscher CM, Luo X
Persistent regional and racial disparities in nondirected living kidney donation.
Nondirected living donors (NDLDs) are an important and growing source of kidneys to help reduce the organ shortage. The authors of this study hypothesized that the initial geographic clustering and racial disparities may have improved due to an increase in NDLDs. The authors found that despite the increased number of NDLDs, racial disparities have worsened and the center-level distribution of NDLD transplants has narrowed in recent years.
AHRQ-funded; HS024600.
Citation: Kumar K, Holscher CM, Luo X .
Persistent regional and racial disparities in nondirected living kidney donation.
Clin Transplant 2017 Dec;31(12). doi: 10.1111/ctr.13135..
Keywords: Disparities, Health Services Research (HSR), Policy, Transplantation, Racial and Ethnic Minorities
Jones JM, Fingar KR, Miller MA
AHRQ Author: Miller MA; Heslin KC
Racial disparities in sepsis-related in-hospital mortality: using a broad case capture method and multivariate controls for clinical and hospital variables, 2004-2013.
The objective of this study was to use a broad method of capturing sepsis cases to estimate 2004-2013 trends in in-hospital sepsis mortality rates by race/ethnicity. Mortality rates adjusted for patient characteristics were higher for all minority groups than for white patients. After adjusting for hospital characteristics, sepsis mortality rates in 2013 were similar for white, black, and Hispanic patients.
AHRQ-authored.
Citation: Jones JM, Fingar KR, Miller MA .
Racial disparities in sepsis-related in-hospital mortality: using a broad case capture method and multivariate controls for clinical and hospital variables, 2004-2013.
Crit Care Med 2017 Dec;45(12):e1209-e17. doi: 10.1097/ccm.0000000000002699.
.
.
Keywords: Disparities, Healthcare Cost and Utilization Project (HCUP), Mortality, Racial and Ethnic Minorities, Sepsis
Tung EL, Cagney KA, Peek ME
Spatial context and health inequity: reconfiguring race, place, and poverty.
The authors build on the Chicago School of Sociology's contributions in urban research and one of its contemporary elaborations, often described as the "neighborhood effects approach," to propose a three-axis model of health inequity. This model, in alignment with Chicago School theory, postulates a dynamic and adaptive relationship between spatial context and health inequity. Compositional axes of race and poverty form the foundation of the model.
AHRQ-funded; HS023007.
Citation: Tung EL, Cagney KA, Peek ME .
Spatial context and health inequity: reconfiguring race, place, and poverty.
J Urban Health 2017 Dec;94(6):757-63. doi: 10.1007/s11524-017-0210-x.
.
.
Keywords: Disparities, Low-Income, Racial and Ethnic Minorities, Social Determinants of Health, Urban Health
Cole MB, Wilson IB, Trivedi AN
State variation in quality outcomes and disparities in outcomes in community health centers.
The researchers estimated between-state variation in hypertension, diabetes, and pregnancy outcomes and racial/ethnic disparities in these outcomes for health center patients. They found wide variation in both outcomes and racial/ethnic disparities in outcomes between states for patients seen at health centers..
AHRQ-funded; HS024652.
Citation: Cole MB, Wilson IB, Trivedi AN .
State variation in quality outcomes and disparities in outcomes in community health centers.
Med Care 2017 Dec;55(12):1001-07. doi: 10.1097/mlr.0000000000000818.
.
.
Keywords: Community-Based Practice, Disparities, Quality of Care, Outcomes, Racial and Ethnic Minorities
Hefele JG, Ritter GA, Bishop CE
Examining racial and ethnic differences in nursing home quality.
The authors measured within-facility differences for a range of publicly reported nursing home quality measures. They found that, on average, care is delivered equally across all racial/ethnic groups in the same nursing home. They concluded that nursing home providers should attempt to identify racial/ethnic within-facility differences in care.
AHRQ-funded; HS021891.
Citation: Hefele JG, Ritter GA, Bishop CE .
Examining racial and ethnic differences in nursing home quality.
Jt Comm J Qual Patient Saf 2017 Nov;43(11):554-64. doi: 10.1016/j.jcjq.2017.06.003.
.
.
Keywords: Disparities, Quality of Care, Nursing Homes, Racial and Ethnic Minorities, Public Reporting
Rauscher GH, Dabbous F, Dolecek TA
Absence of an anticipated racial disparity in interval breast cancer within a large health care organization.
The researchers sought to estimate the extent of an anticipated racial disparity in interval breast cancer (IBC) within a single, large health care organization. Contrary to expectation, in patient-adjusted models, there was no IBC racial disparity. The sorting of patients by race across facilities appears to have mitigated an otherwise anticipated disparity in IBC.
AHRQ-funded; HS018366.
Citation: Rauscher GH, Dabbous F, Dolecek TA .
Absence of an anticipated racial disparity in interval breast cancer within a large health care organization.
Ann Epidemiol 2017 Oct;27(10):654-58. doi: 10.1016/j.annepidem.2017.09.002.
.
.
Keywords: Cancer: Breast Cancer, Cancer, Disparities, Racial and Ethnic Minorities, Women, Screening, Screening, Imaging
Goyal MK, Johnson TJ, Chamberlain JM
Racial and ethnic differences in antibiotic use for viral illness in emergency departments.
The researchers sought to investigate whether patient race and ethnicity was associated with differences in antibiotic prescribing for viral acute respiratory tract infections (ARTIs) in the pediatric emergency department (PED). They found that compared with non-Hispanic (NH) white children, NH black and Hispanic children were less likely to receive antibiotics for viral ARTIs in the PED.
AHRQ-funded; HS020270.
Citation: Goyal MK, Johnson TJ, Chamberlain JM .
Racial and ethnic differences in antibiotic use for viral illness in emergency departments.
Pediatrics 2017 Oct;140(4). doi: 10.1542/peds.2017-0203.
.
.
Keywords: Racial and Ethnic Minorities, Emergency Department, Children/Adolescents, Disparities, Practice Patterns
Pylypchuk Y, Kirby JB
AHRQ Author: Kirby JB
The role of marriage in explaining racial and ethnic disparities in access to health care for men in the US.
The researchers investigated the association between marriage and access to health care among men, and estimate the extent to which racial and ethnic differences in both the returns to marriage and marital rates explain differences in access and preventive service use. They found that marriage accounts for up to 24 percent of racial and ethnic differences in access and preventive use.
AHRQ-authored.
Citation: Pylypchuk Y, Kirby JB .
The role of marriage in explaining racial and ethnic disparities in access to health care for men in the US.
Review of Economics of the Household 2017 Sep;15(3):807-32..
Keywords: Medical Expenditure Panel Survey (MEPS), Disparities, Racial and Ethnic Minorities, Access to Care
Castro FG, Yasui M
Advances in EBI development for diverse populations: towards a science of intervention adaptation.
This introduction examines major issues and challenges as presented in this special issue of Prevention Science, "Challenges to the Dissemination and Implementation of Evidence Based Prevention Interventions for Diverse Populations." The authors describe the Fidelity-Adaptation Dilemma that generated controversies and debates and new perspectives on the dissemination and implementation of evidence-based interventions (EBIs) within diverse populations. The five articles in this special issue address many of these controversies and challenges.
AHRQ-funded; HS023007.
Citation: Castro FG, Yasui M .
Advances in EBI development for diverse populations: towards a science of intervention adaptation.
Prev Sci 2017 Aug;18(6):623-29. doi: 10.1007/s11121-017-0809-x.
.
.
Keywords: Communication, Disparities, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention, Racial and Ethnic Minorities, Implementation
Cook BL, Zuvekas SH, Chen J
AHRQ Author: Zuvekas SH
Assessing the individual, neighborhood, and policy predictors of disparities in mental health care.
This study assessed individual- and area-level predictors of racial/ethnic disparities in mental health care episodes for adults with psychiatric illness. It found that racial/ethnic disparities arise because minorities are more likely to live in neighborhoods where treatment initiation is low, rather than because of a differential influence of neighborhood disadvantage on treatment initiation for minorities compared with whites.
AHRQ-authored; AHRQ-funded; HS021486.
Citation: Cook BL, Zuvekas SH, Chen J .
Assessing the individual, neighborhood, and policy predictors of disparities in mental health care.
Med Care Res Rev 2017 Aug;74(4):404-30. doi: 10.1177/1077558716646898.
.
.
Keywords: Disparities, Medical Expenditure Panel Survey (MEPS), Behavioral Health, Policy, Racial and Ethnic Minorities
Kim G, Dautovich N, Ford KL
Geographic variation in mental health care disparities among racially/ethnically diverse adults with psychiatric disorders.
The main purpose of this study is to examine geographic variation in unmet need for mental health care among racially/ethnically diverse adults with psychiatric disorders in the US. It found that Latinos in the South, Blacks and Latinos in the Midwest, and Latinos and Asians in the West had higher unmet need than non-Hispanic Whites, whereas no significant racial/ethnic effects were found in the Northeast.
AHRQ-funded; HS021486.
Citation: Kim G, Dautovich N, Ford KL .
Geographic variation in mental health care disparities among racially/ethnically diverse adults with psychiatric disorders.
Soc Psychiatry Psychiatr Epidemiol 2017 Aug;52(8):939-48. doi: 10.1007/s00127-017-1401-1.
.
.
Keywords: Access to Care, Disparities, Behavioral Health, Racial and Ethnic Minorities
Farias AJ, Du XL
Racial differences in adjuvant endocrine therapy use and discontinuation in association with mortality among Medicare breast cancer patients by receptor status.
The purpose of this study was to determine whether racial/ethnic differences in use and discontinuation of adjuvant endocrine therapy (AET) differed by hormone receptor status and whether discontinuation was associated with mortality. There are racial/ethnic differences in AET use and discontinuation. Discontinuing treatment was associated with higher risk of all-cause and cancer-specific mortality regardless of hormone receptor status.
AHRQ-funded; HS018956.
Citation: Farias AJ, Du XL .
Racial differences in adjuvant endocrine therapy use and discontinuation in association with mortality among Medicare breast cancer patients by receptor status.
Cancer Epidemiol Biomarkers Prev 2017 Aug;26(8):1266-75. doi: 10.1158/1055-9965.epi-17-0280.
.
.
Keywords: Cancer: Breast Cancer, Disparities, Elderly, Mortality, Racial and Ethnic Minorities
Rice WS, Goldfarb SS, Brisendine AE
Disparities in infant mortality by race among Hispanic and non-Hispanic infants.
This study explored possible implications of racial identification for the health of U.S. born Hispanic compared to non-Hispanic infants. It concluded that the risk of infant mortality varies among Hispanic infants by race, with poorer outcomes experienced by Hispanic black infants. Compared to non-Hispanic infants of the same race, Hispanic black infants experience a smaller health disadvantage and Hispanic white infants have better or similar infant health outcomes.
AHRQ-funded; HS013852.
Citation: Rice WS, Goldfarb SS, Brisendine AE .
Disparities in infant mortality by race among Hispanic and non-Hispanic infants.
Matern Child Health J 2017 Jul;21(7):1581-88. doi: 10.1007/s10995-017-2290-3.
.
.
Keywords: Disparities, Newborns/Infants, Mortality, Newborns/Infants, Racial and Ethnic Minorities
Schpero WL, Morden NE, Sequist TD
For selected services, blacks and Hispanics more likely to receive low-value care than whites.
US minority populations receive fewer effective health services than whites. Using Medicare administrative data for 2006-11, the researchers found no consistent, corresponding protection against the receipt of ineffective health services. Compared with whites, blacks and Hispanics were often more likely to receive the low-value services studied.
AHRQ-funded; HS017589.
Citation: Schpero WL, Morden NE, Sequist TD .
For selected services, blacks and Hispanics more likely to receive low-value care than whites.
Health Aff 2017 Jun;36(6):1065-69. doi: 10.1377/hlthaff.2016.1416.
.
.
Keywords: Disparities, Racial and Ethnic Minorities, Quality of Care, Racial and Ethnic Minorities
Heintzman J, Bailey SR, DeVoe J
In low-income Latino patients, post-affordable care act insurance disparities may be reduced even more than broader national estimates: evidence from Oregon.
This study compared the insurance status of low-income patients served in 23 community health centers (CHCs) in Oregon, by race/ethnicity and language, over a period of 6 years straddling the implementation of ACA-related Medicaid expansion in 2014. It found that among previously uninsured low-income patients returning to Oregon CHCs, insurance disparities were eliminated after Medicaid expansion, especially in Spanish-speaking Latinos.
AHRQ-funded; HS021522; HS024270.
Citation: Heintzman J, Bailey SR, DeVoe J .
In low-income Latino patients, post-affordable care act insurance disparities may be reduced even more than broader national estimates: evidence from Oregon.
J Racial Ethn Health Disparities 2017 Jun;4(3):329-36. doi: 10.1007/s40615-016-0232-1.
.
.
Keywords: Disparities, Health Insurance, Policy, Low-Income, Racial and Ethnic Minorities
Cram P, Saag KG, Lou Y
Racial differences and disparities in osteoporosis-related bone health: results from the PAADRN randomized controlled trial.
The researchers examined whether providing dual-energy x-ray absorptiometry (DXA) test results directly to patients might reduce or eliminate racial differences in osteoporosis-related health care. They found that black women were still less likely to know their actual DXA result and less likely to be on guideline-concordant therapy, but black women had greater patient activation.
AHRQ-funded; HS023009.
Citation: Cram P, Saag KG, Lou Y .
Racial differences and disparities in osteoporosis-related bone health: results from the PAADRN randomized controlled trial.
Med Care 2017 Jun;55(6):561-68. doi: 10.1097/mlr.0000000000000718.
.
.
Keywords: Racial and Ethnic Minorities, Disparities, Osteoporosis, Health Status
Kamal AH, Bull J, Wolf SP
Unmet needs of African Americans and whites at the time of palliative care consultation.
Researchers aimed to compare characteristics and palliative care needs of African Americans (AAs) and whites during initial palliative care consultation. Nearly two-thirds in both racial groups reported 3 or more symptoms of any severity; one-third reported 3 or more moderate or severe symptoms. A larger proportion of Africans than whites reported pain of any severity.
AHRQ-funded; HS023681; HS022763.
Citation: Kamal AH, Bull J, Wolf SP .
Unmet needs of African Americans and whites at the time of palliative care consultation.
Am J Hosp Palliat Care 2017 Jun;34(5):461-65. doi: 10.1177/1049909116632508.
.
.
Keywords: Disparities, Quality of Care, Palliative Care, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Chang SH, Yu YC, Carlsson NP
Racial disparity in life expectancies and life years lost associated with multiple obesity-related chronic conditions.
This study investigated racial disparity in life expectancies (LEs) and life years lost associated with multiple obesity-related chronic conditions. It found that black individuals had higher risks of developing diabetes, hypertension, and stroke. This disparity in LE between white and black participants was largest in men age 40 to 49 with at least stroke: black men lived 3.12 years shorter than white men.
AHRQ-funded; HS022330.
Citation: Chang SH, Yu YC, Carlsson NP .
Racial disparity in life expectancies and life years lost associated with multiple obesity-related chronic conditions.
Obesity 2017 May;25(5):950-57. doi: 10.1002/oby.21822.
.
.
Keywords: Chronic Conditions, Disparities, Health Status, Medical Expenditure Panel Survey (MEPS), Obesity, Racial and Ethnic Minorities
Jackson BE, Oates GR, Singh KP
Disparities in chronic medical conditions in the Mid-South.
This study examined differences in socio-demographic characteristics and health behaviors relevant to chronic medical conditions (CMCs) in the Mid-South region (Alabama, Mississippi, Louisiana, Kentucky, Tennessee, and Arkansas), and identified subpopulations with increased burden of chronic disease. It concluded that in the Mid-South, race and gender disparities in the top five chronic conditions are more prominent among higher-income rather than lower-income individuals.
AHRQ-funded; HS023009.
Citation: Jackson BE, Oates GR, Singh KP .
Disparities in chronic medical conditions in the Mid-South.
Ethn Health 2017 Apr;22(2):196-208. doi: 10.1080/13557858.2016.1232805.
.
.
Keywords: Chronic Conditions, Disparities, Health Status, Racial and Ethnic Minorities, Social Determinants of Health
Tung EL, Baig AA, Huang ES
Racial and ethnic disparities in diabetes screening between asian americans and other adults: BRFSS 2012-2014.
The researchers assessed racial and ethnic disparities in diabetes screening between Asian Americans and other adults. They found that Asian Americans were the least likely racial and ethnic group to receive recommended diabetes screening. Overall, Asian Americans had 34 percent lower adjusted odds of receiving recommended diabetes screening compared to non-Hispanic whites.
AHRQ-funded; HS000078.
Citation: Tung EL, Baig AA, Huang ES .
Racial and ethnic disparities in diabetes screening between asian americans and other adults: BRFSS 2012-2014.
J Gen Intern Med 2017 Apr;32(4):423-29. doi: 10.1007/s11606-016-3913-x.
.
.
Keywords: Racial and Ethnic Minorities, Diabetes, Screening, Disparities, Prevention
Sohn H
Racial and ethnic disparities in health insurance coverage: dynamics of gaining and losing coverage over the life-course.
This article describes age- and group-specific dynamics of insurance gain and loss that contribute to inequalities found in traditional cross-sectional studies. The authors assert that a formal decomposition on increment-decrement life-tables of insurance gain and loss shows that coverage disparities are predominately driven by minority groups' greater propensity to lose the insurance that they already have. They note that uninsured African Americans were faster to gain insurance than non-Hispanic whites but their high rates of insurance loss more than negated this advantage.
AHRQ-funded; HS000046.
Citation: Sohn H .
Racial and ethnic disparities in health insurance coverage: dynamics of gaining and losing coverage over the life-course.
Popul Res Policy Rev 2017 Apr;36(2):181-201. doi: 10.1007/s11113-016-9416-y.
.
.
Keywords: Disparities, Health Insurance, Racial and Ethnic Minorities, Uninsured
Mays VM, Jones AL, Delany-Brumsey A
Perceived discrimination in health care and mental health/substance abuse treatment among blacks, Latinos, and whites.
The researchers investigated whether perceived discrimination in mental health/substance abuse visits contributes to participants' ratings of treatment helpfulness and stopped treatment. They found that fifteen percent of California adults reported discrimination during a health care visit and 4% specifically during mental health/substance abuse visits. Latinos, the uninsured, and those with past year mental disorders were twice as likely as others to report health care discrimination.
AHRQ-funded; HS021721.
Citation: Mays VM, Jones AL, Delany-Brumsey A .
Perceived discrimination in health care and mental health/substance abuse treatment among blacks, Latinos, and whites.
Med Care 2017 Feb;55(2):173-81. doi: 10.1097/mlr.0000000000000638.
.
.
Keywords: Racial and Ethnic Minorities, Substance Abuse, Behavioral Health, Disparities
Witt WP, Coffey RM, Lopez-Gonzalez L
AHRQ Author: Andrews RM, Washington RE
Understanding racial and ethnic disparities in postsurgical complications occurring in U.S. hospitals.
This study of 5,474,067 inpatient surgical discharges examined the role of patient, hospital, and community characteristics on racial and ethnic disparities in in-hospital postsurgical complications. It concluded that race does not appear to be an important determinant of in-hospital postsurgical complications, but insurance and community characteristics have an effect.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Witt WP, Coffey RM, Lopez-Gonzalez L .
Understanding racial and ethnic disparities in postsurgical complications occurring in U.S. hospitals.
Health Serv Res 2017 Feb;52(1):220-43. doi: 10.1111/1475-6773.12475.
.
.
Keywords: Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Disparities, Surgery, Adverse Events
Lewis VA, Fraze T, Fisher ES
ACOs serving high proportions of racial and ethnic minorities lag in quality performance.
Researchers analyzed racial and ethnic disparities in health care outcomes among accountable care organizations (ACOs). Their findings suggest that ACOs with a high share of minority patients may struggle with quality performance under ACO contracts, especially during their early years of participation-maintaining or potentially exacerbating current inequities.
AHRQ-funded; HS024075.
Citation: Lewis VA, Fraze T, Fisher ES .
ACOs serving high proportions of racial and ethnic minorities lag in quality performance.
Health Aff 2017 Jan;36(1):57-66. doi: 10.1377/hlthaff.2016.0626.
.
.
Keywords: Disparities, Racial and Ethnic Minorities, Provider Performance, Quality Indicators (QIs), Quality of Care
Gounder PP, Holman RC, Seeman SM
AHRQ Author: Steiner CA
Infectious disease hospitalizations among American Indian/Alaska native and non-American Indian/Alaska native persons in Alaska, 2010-2011.
The researchers used a merged state database to determine infectious disease (ID) hospitalization rates among American Indian/Alaska native (AI/AN) and non-American Indian/Alaska native persons in Alaska. They concluded that a substantial disparity in ID hospitalization rates exists between AI/AN and non-AI/AN persons, and the most common reason for ID hospitalization among AI/AN persons was lower respiratory tract infection.
AHRQ-authored.
Citation: Gounder PP, Holman RC, Seeman SM .
Infectious disease hospitalizations among American Indian/Alaska native and non-American Indian/Alaska native persons in Alaska, 2010-2011.
Public Health Rep 2017 Jan/Feb;132(1):65-75. doi: 10.1177/0033354916679807.
.
.
Keywords: Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Hospitalization, Disparities, Racial and Ethnic Minorities