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
51 to 75 of 90 Research Studies DisplayedHalbert CH, Bellamy S, Briggs V
A comparative effectiveness education trial for lifestyle health behavior change in African Americans.
The authors of this study compared the effects of alternate behavioral interventions on obesity-related health behaviors by conducting a comparative effectiveness education trial in a community-based sample of 530 adult African Americans. The investigators suggest that education about risk factors for chronic disease and evidence-based strategies for health behavior change may be useful for addressing obesity-related behaviors among African Americans.
AHRQ-funded; HS019339.
Citation: Halbert CH, Bellamy S, Briggs V .
A comparative effectiveness education trial for lifestyle health behavior change in African Americans.
Health Educ Res 2017 Jun 1;32(3):207-18. doi: 10.1093/her/cyx039..
Keywords: Comparative Effectiveness, Education: Patient and Caregiver, Lifestyle Changes, Lifestyle Changes, Obesity, Racial and Ethnic Minorities
Tajeu GS, Mennemeyer S, Menachemi N
Cost-effectiveness of antihypertensive medication: exploring race and sex differences using data from the REasons for Geographic and Racial Differences in Stroke Study.
The researchers compared the cost-effectiveness of antihypertensive medication treatment versus no-treatment in white and black adults. They concluded that antihypertensive medication treatment is cost-saving and increases quality-adjusted life-years (QALYs) for all groups considered in the model, particularly among black adults.
AHRQ-funded; HS013852.
Citation: Tajeu GS, Mennemeyer S, Menachemi N .
Cost-effectiveness of antihypertensive medication: exploring race and sex differences using data from the REasons for Geographic and Racial Differences in Stroke Study.
Med Care 2017 Jun;55(6):552-60. doi: 10.1097/mlr.0000000000000719.
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Keywords: Medication, Blood Pressure, Healthcare Costs, Racial and Ethnic Minorities, Stroke
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.
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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.
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Keywords: Disparities, Health Insurance, Policy, Low-Income, Racial and Ethnic Minorities
Washington DM, Paasche-Orlow MK, Liebschutz JM
Promoting progress or propagating problems: strategic plans and the advancement of academic faculty diversity in U.S. medical schools.
The aim of this study was to investigate whether academic institutions that have engaged in strategic planning for faculty diversity, as exhibited by plan presence on their websites, had a higher rate of underrepresented minorities in medicine (URM) faculty growth than institutions who do not have evidence of such planning.
AHRQ-funded; HS022242.
Citation: Washington DM, Paasche-Orlow MK, Liebschutz JM .
Promoting progress or propagating problems: strategic plans and the advancement of academic faculty diversity in U.S. medical schools.
J Natl Med Assoc 2017 Summer;109(2):72-78. doi: 10.1016/j.jnma.2016.10.001..
Keywords: Education: Curriculum, Racial and Ethnic Minorities, Workforce
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.
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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.
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Keywords: Disparities, Quality of Care, Palliative Care, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Carlson AE, Aronson BD, Unzen M
Apathy and type 2 diabetes among American Indians: exploring the protective effects of traditional cultural involvement.
In this study researchers examined relationships between traditional cultural factors, apathy, and health-related outcomes among a sample of American Indian adults with type 2 diabetes. Their model revealed significant direct effects from cultural participation to apathy, and apathy to both health-related outcomes. Cultural participation had a negative indirect effect through apathy on high blood sugar and positive indirect effects on health-related quality of life.
AHRQ-funded; HS024180.
Citation: Carlson AE, Aronson BD, Unzen M .
Apathy and type 2 diabetes among American Indians: exploring the protective effects of traditional cultural involvement.
J Health Care Poor Underserved 2017;28(2):770-83. doi: 10.1353/hpu.2017.0073.
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Keywords: Cultural Competence, Diabetes, Racial and Ethnic Minorities, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Karter AJ, Lipska KJ, O'Connor PJ
High rates of severe hypoglycemia among African American patients with diabetes: the Surveillance, Prevention, and Management of Diabetes Mellitus (SUPREME-DM) network.
This seven-year surveillance study (2005-2011) evaluated race/ethnic differences in the trends in rates of severe hypoglycemia (SH) in a population of insured, at-risk adults with diabetes. Annual SH rates ranged from 1.8 percent to 2.1 percent during this 7-year observation period. African Americans had consistently higher SH rates compared with Whites, while Latinos and Asians had consistently lower rates compared with Whites in each of the 7 years.
AHRQ-funded; HS019859.
Citation: Karter AJ, Lipska KJ, O'Connor PJ .
High rates of severe hypoglycemia among African American patients with diabetes: the Surveillance, Prevention, and Management of Diabetes Mellitus (SUPREME-DM) network.
J Diabetes Complications 2017 May;31(5):869-73. doi: 10.1016/j.jdiacomp.2017.02.009.
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Keywords: Chronic Conditions, Diabetes, Healthcare Delivery, Health Status, Racial and Ethnic Minorities
Sawchuk CN, Roy-Byrne P, Noonan C
Panic attacks and panic disorder in the American Indian community.
The purpose of this study is to describe the epidemiology, clinical features, and comorbidities of panic attacks and panic disorder in two large American Indian tribes. It found that the prevalence and clinical features of panic attacks and panic disorder in American Indians were similar to epidemiologic studies with majority populations. However, in contrast to earlier research, panic symptoms were similar in both males and females, and different patterns of comorbidity emerged.
AHRQ-funded; HS010854.
Citation: Sawchuk CN, Roy-Byrne P, Noonan C .
Panic attacks and panic disorder in the American Indian community.
J Anxiety Disord 2017 May;48:6-12. doi: 10.1016/j.janxdis.2016.10.004.
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Keywords: Anxiety, Behavioral Health, Racial and Ethnic Minorities, Racial and Ethnic Minorities, Stress
Heerman WJ, Taylor JL, Wallston KA
Parenting self-efficacy, parent depression, and healthy childhood behaviors in a low-income minority population: a cross-sectional analysis.
The study’s objective was to measure the associations between parenting self-efficacy, parent depressive symptoms, and preschool child behaviors that support healthy growth. It found that in this minority population, higher parenting self-efficacy was associated with longer child sleep and fewer meals in front of the TV, but parent depressive symptoms mitigated that protective effect for child sleep duration.
AHRQ-funded; HS022990.
Citation: Heerman WJ, Taylor JL, Wallston KA .
Parenting self-efficacy, parent depression, and healthy childhood behaviors in a low-income minority population: a cross-sectional analysis.
Matern Child Health J 2017 May;21(5):1156-65. doi: 10.1007/s10995-016-2214-7.
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Keywords: Children/Adolescents, Family Health and History, Depression, Racial and Ethnic Minorities, Low-Income
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.
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Keywords: Chronic Conditions, Disparities, Health Status, Medical Expenditure Panel Survey (MEPS), Obesity, Racial and Ethnic Minorities
Hoffman AS, Lowenstein LM, Kamath GR
An entertainment-education colorectal cancer screening decision aid for African American patients: a randomized controlled trial.
The purpose of this study was to assess whether an entertainment-education decision aid tailored for African American patients improved patients' decision making, attitudes, intentions, or colorectal cancer screening behavior. It found that viewing the culturally tailored decision aid significantly increased African American patients' knowledge of colorectal cancer screening recommendations and options. It also significantly reduced their decisional conflict and improved their self-advocacy.
AHRQ-funded; HS022134.
Citation: Hoffman AS, Lowenstein LM, Kamath GR .
An entertainment-education colorectal cancer screening decision aid for African American patients: a randomized controlled trial.
Cancer 2017 Apr 15;123(8):1401-08. doi: 10.1002/cncr.30489.
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Keywords: Cancer: Colorectal Cancer, Shared Decision Making, Education: Patient and Caregiver, Racial and Ethnic Minorities, Screening
Goins RT, Noonan C, Gonzales K
Association of depressive symptomology and psychological trauma with diabetes control among older American Indian women: does social support matter?
Among older American Indian women with type 2 diabetes (T2DM), the researchers examined the association between mental health and T2DM control and if social support modifies the association. They found that there was not a significant association between depressive symptomatology and higher HbA1c although increased depressive symptomatology was associated with higher HbA1c values among participants with low social support.
AHRQ-funded; HS000078.
Citation: Goins RT, Noonan C, Gonzales K .
Association of depressive symptomology and psychological trauma with diabetes control among older American Indian women: does social support matter?
J Diabetes Complications 2017 Apr;31(4):669-74. doi: 10.1016/j.jdiacomp.2017.01.004.
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Keywords: Diabetes, Elderly, Behavioral Health, Racial and Ethnic Minorities, Trauma
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.
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Keywords: Chronic Conditions, Disparities, Health Status, Racial and Ethnic Minorities, Social Determinants of Health
Stepanikova I, Oates GR, Bateman LB
Does one size fit all? The role of body mass index and waist circumference in systemic inflammation in midlife by race and gender.
This study investigated the associations of body mass index (BMI) and waist circumference (WC) with markers of systemic inflammation in midlife by race and gender. Compared to White men, Black women have higher BMI and higher levels of all four inflammation markers; White women have lower BMI, lower WC, and lower E-selectin and fibrinogen but higher C-reactive protein, and Black men have higher fibrinogen.
AHRQ-funded; HS023009.
Citation: Stepanikova I, Oates GR, Bateman LB .
Does one size fit all? The role of body mass index and waist circumference in systemic inflammation in midlife by race and gender.
Ethn Health 2017 Apr;22(2):169-83. doi: 10.1080/13557858.2016.1235681.
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Keywords: Health Status, Racial and Ethnic Minorities, Risk, Sex Factors
Masterson Creber RM, Fleck E, Liu J
Identifying the complexity of multiple risk factors for obesity among urban Latinas.
The prevalence of obesity is rising rapidly among Hispanics/Latinas. Researchers evaluated the prevalence of being obese or overweight and associated risk factors among 630 low-income, Latina women. They found that being obese was strongly associated with having hypertension, pre-hypertension, diabetes and moderate/moderately severe/severe depression. Women who reported that finding time was a barrier to physical activity were also more likely to be obese.
AHRQ-funded; HS019853.
Citation: Masterson Creber RM, Fleck E, Liu J .
Identifying the complexity of multiple risk factors for obesity among urban Latinas.
J Immigr Minor Health 2017 Apr;19(2):275-84. doi: 10.1007/s10903-016-0433-z.
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Keywords: Racial and Ethnic Minorities, Obesity, Risk, Racial and Ethnic Minorities, Urban 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.
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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.
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Keywords: Disparities, Health Insurance, Racial and Ethnic Minorities, Uninsured
Johnson TJ, Winger DG, Hickey RW
Comparison of physician implicit racial bias toward adults versus children.
This study compared implicit racial bias toward adults versus children among resident physicians working in a pediatric emergency department. It found that resident physicians have implicit racial bias against black children, similar to levels of bias against black adults. Bias in the study did not vary by resident demographic characteristics, including specialty, suggesting that pediatric residents are as susceptible as other physicians to implicit bias.
AHRQ-funded; HS017587.
Citation: Johnson TJ, Winger DG, Hickey RW .
Comparison of physician implicit racial bias toward adults versus children.
Acad Pediatr 2017 Mar;17(2):120-26. doi: 10.1016/j.acap.2016.08.010.
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Keywords: Children/Adolescents, Emergency Department, Provider: Health Personnel, Children/Adolescents, Racial and Ethnic Minorities
Cook BL, Carson NJ, Kafali EN
Examining psychotropic medication use among youth in the U.S. by race/ethnicity and psychological impairment.
This study examined racial/ethnic differences in the prescription of psychotropic medications among youth with and without psychological impairment. Compared to Black and Latino youth with psychological impairment, White youth were more likely to be prescribed psychotropic medications when impaired. Among youth never having psychological impairment, White youth were also more likely to be prescribed medications compared to their racial/ethnic minority counterparts.
AHRQ-funded; HS021486.
Citation: Cook BL, Carson NJ, Kafali EN .
Examining psychotropic medication use among youth in the U.S. by race/ethnicity and psychological impairment.
Gen Hosp Psychiatry 2017 Mar - Apr;45:32-39. doi: 10.1016/j.genhosppsych.2016.12.004.
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Keywords: Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Medication, Behavioral Health, Racial and Ethnic Minorities
Diaz KM, Booth JN, 3rd, Seals SR
Physical activity and incident hypertension in African Americans: the Jackson Heart Study.
The purpose of this study was to examine the association of physical activity with incident hypertension among African Americans. It found no statistically significant associations observed for overall physical activity, or work, active living, and household-related physical activities. Results suggest that regular moderate-vigorous physical activity or sport/exercise-related physical activity may reduce the risk of developing hypertension in African Americans.
AHRQ-funded; HS023009.
Citation: Diaz KM, Booth JN, 3rd, Seals SR .
Physical activity and incident hypertension in African Americans: the Jackson Heart Study.
Hypertension 2017 Mar;69(3):421-27. doi: 10.1161/hypertensionaha.116.08398.
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Keywords: Blood Pressure, Lifestyle Changes, Racial and Ethnic Minorities, Risk
Tucker JS, Shadel WG, Galvan FH
Pilot evaluation of a brief intervention to improve nicotine patch adherence among smokers living with HIV/AIDS.
This article presents results from a pilot evaluation of a brief smoking cessation treatment to improve adherence to the nicotine patch among Latino smokers living with HIV/AIDS. Although this small pilot was conducted to estimate effect sizes and was not powered to detect group differences, results were promising and suggested that adding a 10-min module focused on nicotine patch adherence to a standard 5 As protocol could increase abstinence rates.
AHRQ-funded; HS000062.
Citation: Tucker JS, Shadel WG, Galvan FH .
Pilot evaluation of a brief intervention to improve nicotine patch adherence among smokers living with HIV/AIDS.
Psychol Addict Behav 2017 Mar;31(2):148-53. doi: 10.1037/adb0000221.
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Keywords: Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Racial and Ethnic Minorities, Tobacco Use
Lion KC, Wright DR, Desai AD
Costs of care for hospitalized children associated with preferred language and insurance type.
The study sought to determine whether preferred language for care and insurance type are associated with cost among hospitalized children. It concluded that hospital costs varied significantly according to preferred language and insurance type, even adjusting for length of stay and medical complexity. These differences in the amount of billable care provided to medically similar patients may represent either underprovision or overprovision of care.
AHRQ-funded; HS024299.
Citation: Lion KC, Wright DR, Desai AD .
Costs of care for hospitalized children associated with preferred language and insurance type.
Hosp Pediatr 2017 Feb;7(2):70-78. doi: 10.1542/hpeds.2016-0051.
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Keywords: Children/Adolescents, Communication, Health Insurance, Hospitalization, Racial and Ethnic Minorities
Musey PI, Jr., Kline JA
Do gender and race make a difference in acute coronary syndrome pretest probabilities in the emergency department?
The objective was to test for significant differences in subjective and objective pretest probabilities for acute coronary syndrome (ACS) in chest pain patients. Despite consistently estimating the risk for ACS to be lower for both females and minorities concordantly with calculated objective pretest assessments, there does not appear to have been any significant decrease in subsequent evaluation of these perceived lower-risk groups when radiation exposure and costs are taken into account.
AHRQ-funded; HS018519.
Citation: Musey PI, Jr., Kline JA .
Do gender and race make a difference in acute coronary syndrome pretest probabilities in the emergency department?
Acad Emerg Med 2017 Feb;24(2):142-51. doi: 10.1111/acem.13131.
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Keywords: Sex Factors, Racial and Ethnic Minorities, Cardiovascular Conditions, Emergency Medical Services (EMS)