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 (2)
- Asthma (1)
- Behavioral Health (3)
- Cancer (2)
- Cardiovascular Conditions (2)
- Children/Adolescents (3)
- Chronic Conditions (2)
- Clinical Decision Support (CDS) (1)
- Comparative Effectiveness (1)
- Decision Making (1)
- Depression (1)
- Disabilities (1)
- Disparities (3)
- Education (1)
- Emergency Department (2)
- Evidence-Based Practice (1)
- Healthcare Costs (14)
- Healthcare Utilization (2)
- Health Insurance (10)
- Kidney Disease and Health (1)
- Low-Income (2)
- Medicaid (2)
- (-) Medical Expenditure Panel Survey (MEPS) (29)
- Medication (3)
- Obesity (2)
- Opioids (1)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (1)
- Patient Safety (1)
- Payment (1)
- Policy (2)
- Practice Patterns (1)
- Prevention (2)
- Primary Care (5)
- Primary Care: Models of Care (1)
- Racial and Ethnic Minorities (1)
- Research Methodologies (1)
- Risk (2)
- Screening (1)
- Social Determinants of Health (2)
- Substance Abuse (1)
- Tools & Toolkits (1)
- Transplantation (1)
- Uninsured (5)
- Vulnerable Populations (1)
- Workforce (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 29 Research Studies DisplayedAbdus S, Keenan PS
AHRQ Author: Abdus S, Keenan PS
Financial burden of employer-sponsored high-deductible health plans for low-income adults with chronic health conditions.
In this research letter, the authors used 2011-2015 Medical Expenditure Panel Survey Household Component data on adults 19 to 64 years of age enrolled in employer-sponsored insurance plans throughout the year to examine the burden of high deductible health plans on low income adults with chronic health conditions.
AHRQ-authored.
Citation: Abdus S, Keenan PS .
Financial burden of employer-sponsored high-deductible health plans for low-income adults with chronic health conditions.
JAMA Intern Med 2018 Dec;178(12):1706-08. doi: 10.1001/jamainternmed.2018.4706..
Keywords: Chronic Conditions, Healthcare Costs, Health Insurance, Low-Income, Medical Expenditure Panel Survey (MEPS)
Hsu J, Newhouse J, Overhage LN
AHRQ Author: Zuvekas S
Fiscal difficulties of cities, the labor market, and health care.
Researchers investigated labor force and health outcomes in cities experiencing fiscal difficulties to assess how those difficulties might impact their employees. Using MEPS data, they found that the rate of separation from local public employment fell in the cities with downgrades relative to the comparison group. They concluded that self-reported health may have worsened, but there were no statistically significant effects on health care use or spending.
AHRQ-authored.
Citation: Hsu J, Newhouse J, Overhage LN .
Fiscal difficulties of cities, the labor market, and health care.
J Pension Econ Financ 2018 Oct;18(4):565-78..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs
Keenan PS, Jacobs PD, Miller GE
AHRQ Author: Kennan PS, Jacobs PD, Miller GE
Despite coverage gains, one-third of people in small-firm low-income families were uninsured in 2014-15.
Using data from the Medical Expenditure Panel Survey, the investigators examined health insurance coverage for workers at small firms and the self-employed and found that the overall uninsurance rate for these workers and their families declined by 5 percentage points over the past decade, but one-third of those with lower incomes remained uninsured in 2014-15.
AHRQ-authored.
Citation: Keenan PS, Jacobs PD, Miller GE .
Despite coverage gains, one-third of people in small-firm low-income families were uninsured in 2014-15.
Health Aff 2018 Oct;37(10):1673-77. doi: 10.1377/hlthaff.2018.0479..
Keywords: Health Insurance, Low-Income, Medical Expenditure Panel Survey (MEPS), Uninsured
Berdahl TA, Moriya AS
AHRQ Author: Berdahl TA, Moriya AS
Difference in uninsurance rates between full- and part-time workers declined in 2014.
This study examined uninsurance rates between full and part time workers using data from 2010-2015. The authors found that uninsurance declined more for part-time workers, with pathways to coverage varying by state Medicaid expansion status.
AHRQ-authored.
Citation: Berdahl TA, Moriya AS .
Difference in uninsurance rates between full- and part-time workers declined in 2014.
Health Aff 2018 Oct;37(10):1669-72. doi: 10.1377/hlthaff.2018.0345.
.
.
Keywords: Health Insurance, Medicaid, Medical Expenditure Panel Survey (MEPS), Uninsured
Perez Jolles M, Thomas KC
Disparities in self-reported access to patient-centered medical home care for children with special health care needs.
The purpose of this study was to examine variation in caregiver service experience concordant with care in patient-centered medical home (PCMH) over time and by the characteristics of separate groups of children with special health care needs (CSHCNs). Researchers used 2003-2012 Medical Expenditures Panel Survey data for CSHCNs for cross-sectional pooled data analysis. Their conclusions suggest that disparities remain among high-need CSHCNs. Future research that focuses on a better understanding of how clinical settings tailor this care model, particularly to provide increased access and patient-centered care, is recommended.
AHRQ-funded; HS000032.
Citation: Perez Jolles M, Thomas KC .
Disparities in self-reported access to patient-centered medical home care for children with special health care needs.
Med Care 2018 Oct;56(10):840-46. doi: 10.1097/mlr.0000000000000978..
Keywords: Access to Care, Children/Adolescents, Disabilities, Disparities, Medical Expenditure Panel Survey (MEPS), Patient-Centered Healthcare, Vulnerable Populations
Zawacki AM, Vistnes JP, Buchmueller TC
AHRQ Author: Vistnes JP
Why are employer-sponsored health insurance premiums higher in the public sector than in the private sector?
This paper examines the factors explaining differences in public and private sector health insurance premiums for enrollees with single coverage using data from the 2000 and 2014 Medical Expenditure Panel Survey-Insurance Component, along with decomposition methods, to explore the relative explanatory importance of plan features and benefit generosity, such as deductibles and other forms of cost sharing, basic employee characteristics (e.g., age, gender, and education), and unionization.
AHRQ-authored.
Citation: Zawacki AM, Vistnes JP, Buchmueller TC .
Why are employer-sponsored health insurance premiums higher in the public sector than in the private sector?
Mon Labor Rev 2018 Sep. doi: 10.21916/mlr.2018.22..
Keywords: Healthcare Costs, Health Insurance, Medical Expenditure Panel Survey (MEPS)
Yonek JC, Jordan N, Dunlop D
Patient-centered medical home care for adolescents in need of mental health treatment.
The patient-centered medical home (PCMH) has emerged as an optimal primary care model for all youth; however, little is known about the extent to which adolescents in need of mental health (MH) treatment receive care consistent with the PCMH. This study assessed (1) 10-year trends in PCMH care among U.S. adolescents according to MH need and (2) variations in PCMH care and its subcomponents among adolescents with MH need, by individual and family characteristics.
AHRQ-funded; HS024183.
Citation: Yonek JC, Jordan N, Dunlop D .
Patient-centered medical home care for adolescents in need of mental health treatment.
J Adolesc Health 2018 Aug;63(2):172-80. doi: 10.1016/j.jadohealth.2018.02.006..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Behavioral Health, Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care
Miller GE, Vistnes JP, Rohde F
AHRQ Author: Miller GE, Vistnes JP, Rohde F, Keenan PS
High-deductible health plan enrollment increased from 2006 to 2016, employer-funded accounts grew in largest firms
This study used data from private-sector establishments for 2006 and 2016 from the Medical Expenditure Panel Survey-Insurance Component to examine trends in high-deductible health plans (HDHP) enrollment and heterogeneity in HDHPs by firm size. The study found that overall, HDHP enrollees in the largest firms had significant advantages relative to workers in smaller firms along all of the dimensions examined.
AHRQ-authored.
Citation: Miller GE, Vistnes JP, Rohde F .
High-deductible health plan enrollment increased from 2006 to 2016, employer-funded accounts grew in largest firms
Health Aff 2018 Aug;37(8):1231-37. doi: 10.1377/hlthaff.2018.0188..
Keywords: Healthcare Costs, Health Insurance, Medical Expenditure Panel Survey (MEPS)
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.
.
.
Keywords: Access to Care, Healthcare Utilization, Medicaid, Medical Expenditure Panel Survey (MEPS), Primary Care
Zhang Y, Baik SH, Zuvekas SH
Simulating variation in families' spending across marketplace plans.
The purpose of this study was to examine variations in premium and cost-sharing across marketplace plans available to eligible families using data from Medical Expenditure Panel Survey (MEPS), the 2011 Medicare Part D public formulary file, and 2014 health plan data from healthcare.gov. Researchers identified a nationally representative cohort of individuals in MEPS who would have been eligible for marketplace coverage; for each family, they simulated the total out-of-pocket payment under each available plan in their county of residence, assuming their pre-marketplace use. They found substantial variation in total family health care spending, especially in the premium component, across marketplace plans, even within a plan tier.
AHRQ-authored.
Citation: Zhang Y, Baik SH, Zuvekas SH .
Simulating variation in families' spending across marketplace plans.
Health Serv Res 2018 Aug;53(4):2285-302. doi: 10.1111/1475-6773.12831..
Keywords: Health Insurance, Healthcare Costs, Medical Expenditure Panel Survey (MEPS)
Zhao X, Wang W, Liu L
A flexible quantile regression model for medical costs with application to Medical Expenditure Panel Survey study.
This study applied a flexible quantile regression model for medical costs to a dataset from the Medical Expenditure Panel Survey. The model can be used to analyze medical costs.
AHRQ-funded; HS020263.
Citation: Zhao X, Wang W, Liu L .
A flexible quantile regression model for medical costs with application to Medical Expenditure Panel Survey study.
Stat Med 2018 Jul 30;37(17):2645-66. doi: 10.1002/sim.7670..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Research Methodologies
Monheit AC, Grafova IB
Education and family health care spending.
Using data from the 2004 to 2012 Medical Expenditure Panel Survey (MEPS), the investigators examined the association between parental education and family health care spending in single-mother and two-parent families. Controlling for family income and health insurance status, they found consistent evidence that parental education beyond 12 years of schooling was associated with increases in family health care spending and with reductions in the likelihood of adverse health conditions.
AHRQ-funded; HS02405.
Citation: Monheit AC, Grafova IB .
Education and family health care spending.
Southern Economic Journal 2018 Jul;85(1):71-92. doi: doi:10.1002/soej.12300..
Keywords: Education, Healthcare Costs, Medical Expenditure Panel Survey (MEPS)
Murphy CC, Fullington HM, Alvarez CA
Polypharmacy and patterns of prescription medication use among cancer survivors.
The population of cancer survivors is rapidly growing in the United States. Long-term and late effects of cancer, combined with the ongoing management of other chronic conditions, make survivors particularly vulnerable to polypharmacy and its adverse effects. In the current study, the authors examined patterns of prescription medication use and polypharmacy in a population-based sample of cancer survivors.
AHRQ-funded; HS022418.
Citation: Murphy CC, Fullington HM, Alvarez CA .
Polypharmacy and patterns of prescription medication use among cancer survivors.
Cancer 2018 Jul 1;124(13):2850-57. doi: 10.1002/cncr.31389..
Keywords: Cancer, Healthcare Costs, Medical Expenditure Panel Survey (MEPS), Medication
Vistnes JP, Cohen JW
AHRQ Author: Vistnes JP, Cohen JW
Duration of uninsured spells for nonelderly adults declined after 2014.
Using MEPS data, the authors found that nonelderly respondents in 2014-15, following implementation of ACA coverage provisions, experienced shorter periods of being uninsured than did respondents in 2012-13 and 2013-14, especially for people with preexisting health conditions.
AHRQ-authored.
Citation: Vistnes JP, Cohen JW .
Duration of uninsured spells for nonelderly adults declined after 2014.
Health Aff 2018 Jun;37(6):951-55. doi: 10.1377/hlthaff.2017.1638.
.
.
Keywords: Health Insurance, Policy, Medical Expenditure Panel Survey (MEPS), Uninsured
Axeen S, Seabury SA, Menchine M
Emergency department contribution to the prescription opioid epidemic.
The investigators used MEPS data to characterize the relative contribution of emergency departments (EDs) to national opioid prescribing, to estimate trends in opioid prescribing by site of care, and to examine whether higher-risk opioid users receive a disproportionate quantity of their opioids from ED settings. During the study period, they found that the relative contribution of EDs to the prescription opioid problem was modest and declining. They therefore recommended that further efforts to reduce the quantity of opioids prescribed focus on office-based settings.
AHRQ-funded; HS024251.
Citation: Axeen S, Seabury SA, Menchine M .
Emergency department contribution to the prescription opioid epidemic.
Ann Emerg Med 2018 Jun;71(6):659-67.e3. doi: 10.1016/j.annemergmed.2017.12.007..
Keywords: Behavioral Health, Emergency Department, Medical Expenditure Panel Survey (MEPS), Medication, Opioids, Practice Patterns, Substance Abuse
Borsky A, Zhan C, Miller T
AHRQ Author: Borsky A, Zhan C, Miller T, Ngo-Metzger Q, Bierman AS, Meyers D
Few Americans receive all high-priority, appropriate clinical preventive services.
As of 2015, only 8 percent of US adults ages thirty-five and older had received all of the high-priority, appropriate clinical preventive services recommended for them. Nearly 5 percent of adults did not receive any such services. Further delivery system-level efforts are needed to increase the use of preventive services.
AHRQ-authored.
Citation: Borsky A, Zhan C, Miller T .
Few Americans receive all high-priority, appropriate clinical preventive services.
Health Aff 2018 Jun;37(6):925-28. doi: 10.1377/hlthaff.2017.1248.
.
.
Keywords: Evidence-Based Practice, Medical Expenditure Panel Survey (MEPS), Prevention, Primary Care
Jones AL, Cochran SD, Leibowitz A
Racial, ethnic, and nativity differences in mental health visits to primary care and specialty mental health providers: analysis of the Medical Expenditures Panel Survey, 2010-2015.
The researchers sought to guide post-ACA efforts to address mental health service disparities, by using a nationally representative sample to characterize baseline race-, ethnicity-, and nativity-associated differences in mental health services in the context of primary care. They found that all racial/ethnic groups were less likely than non-Latino Whites to have any primary care (PC) visit. Their conclusion was that racial-, ethnic-, and nativity-associated disparities persist in PC provided mental health services.
AHRQ-funded; HS021721.
Citation: Jones AL, Cochran SD, Leibowitz A .
Racial, ethnic, and nativity differences in mental health visits to primary care and specialty mental health providers: analysis of the Medical Expenditures Panel Survey, 2010-2015.
Healthcare 2018 Mar 22;6(2). doi: 10.3390/healthcare6020029.
.
.
Keywords: Disparities, Medical Expenditure Panel Survey (MEPS), Behavioral Health, Primary Care, Racial and Ethnic Minorities
Kato E, Borsky AE, Zuvekas SH
AHRQ Author: Kato E, Borsky AE, Zuvekas SH, Soni A, Ngo-Metzger Q
Missed opportunities for depression screening and treatment in the United States.
This study estimates the prevalence of depression assessment in adults age 35 and older and how prevalence varies by sociodemographic characteristics and depressive symptoms. It found that approximately 50 percent of US adults aged 35+ were being assessed for depression in 2014-2015. Certain populations were more likely to be missed, including men, people over 75 years old, minorities, and the uninsured.
AHRQ-authored.
Citation: Kato E, Borsky AE, Zuvekas SH .
Missed opportunities for depression screening and treatment in the United States.
J Am Board Fam Med 2018 May-Jun;31(3):389-97. doi: 10.3122/jabfm.2018.03.170406.
.
.
Keywords: Depression, Medical Expenditure Panel Survey (MEPS), Prevention, Screening, Social Determinants of Health
Abdus S, Decker SL
AHRQ Author: Abdus S, Decker SL
The long-term uninsured were less likely than the short-term uninsured to gain insurance in 2014.
This study assessed the probability of having insurance in at least 1 month of 2014 for a sample of US citizens aged 19–63 who were uninsured in December 2013. It found that among those uninsured at the end of 2013, 2014 insurance take-up was lower the longer a person had been uninsured.
AHRQ-authored.
Citation: Abdus S, Decker SL .
The long-term uninsured were less likely than the short-term uninsured to gain insurance in 2014.
J Gen Intern Med 2018 May;33(5):593-95. doi: 10.1007/s11606-018-4365-2.
.
.
Keywords: Healthcare Costs, Health Insurance, Medical Expenditure Panel Survey (MEPS), Uninsured
Singh J, Valero-Elizondo J, Salami JA
Favorable modifiable cardiovascular risk profile is associated with lower healthcare costs among cancer patients: the 2012-2013 Medical Expenditure Panel Survey.
Atherosclerotic cardiovascular disease (ASCVD) and cancer are among the leading causes of economic burden, morbidity, and mortality in the United States. In this study, the investigators aimed to quantify the overall impact of cardiovascular modifiable risk factor (CRF) profile on healthcare expenditures among those with and without ASCVD and/or cancer. The investigators concluded that in a nationally representative US adult population, absence of ASCVD and a favorable CRF profile were associated with significantly lower medical expenditure among cancer patients.
AHRQ-funded; HS023000.
Citation: Singh J, Valero-Elizondo J, Salami JA .
Favorable modifiable cardiovascular risk profile is associated with lower healthcare costs among cancer patients: the 2012-2013 Medical Expenditure Panel Survey.
J Am Heart Assoc 2018 Apr 23;7(9). doi: 10.1161/jaha.117.007874..
Keywords: Medical Expenditure Panel Survey (MEPS), Cardiovascular Conditions, Risk, Healthcare Costs, Cancer
Wey A, Salkowski N, Kremers WK
A kidney offer acceptance decision tool to inform the decision to accept an offer or wait for a better kidney.
The researchers developed a kidney offer acceptance decision tool to predict the probability of graft survival and patient survival for first-time kidney-alone candidates after an offer is accepted or declined, and they characterized the effect of restricting the donor pool with a maximum acceptable kidney donor profile index (KDPI). Donor pool restrictions were associated with worse 3-year outcomes, especially for candidates with high allocation priority.
AHRQ-funded; HS024527.
Citation: Wey A, Salkowski N, Kremers WK .
A kidney offer acceptance decision tool to inform the decision to accept an offer or wait for a better kidney.
Am J Transplant 2018 Apr;18(4):897-906. doi: 10.1111/ajt.14506.
.
.
Keywords: Clinical Decision Support (CDS), Decision Making, Kidney Disease and Health, Medical Expenditure Panel Survey (MEPS), Transplantation
Kirby JB, Cohen JW
AHRQ Author: Kirby JB, Cohen JW
Do people with health insurance coverage who live in areas with high uninsurance rates pay more for emergency department visits?
This study investigated the relationship between the percent uninsured in a county and expenditures associated with the typical emergency department visit. Among those with private insurance, it found that an increase of 1 percentage point in the county uninsurance rate is associated with a $20 increase in the mean emergency department payment. No such association was observed among visits covered by other insurance types.
AHRQ-authored.
Citation: Kirby JB, Cohen JW .
Do people with health insurance coverage who live in areas with high uninsurance rates pay more for emergency department visits?
Health Serv Res 2018 Apr;53(2):768-86. doi: 10.1111/1475-6773.12659.
.
.
Keywords: Emergency Department, Healthcare Costs, Health Insurance, Medical Expenditure Panel Survey (MEPS), Uninsured
Kafali N, Progovac A, Hou SS
Long-run trends in antidepressant use among youths after the FDA black box warning.
This study analyzed long-run trends in antidepressant use among children before and after the black box warning for those with and without severe psychological impairment. It concluded that in the long run (2008-2011), however, there was no statistically significant difference. This return to the rates before the black box warning raises concern that the impact of the warning may have dissipated over time.
AHRQ-funded; HS021486.
Citation: Kafali N, Progovac A, Hou SS .
Long-run trends in antidepressant use among youths after the FDA black box warning.
Psychiatr Serv 2018 Apr;69(4):389-95. doi: 10.1176/appi.ps.201700089.
.
.
Keywords: Medication, Children/Adolescents, Healthcare Utilization, Medical Expenditure Panel Survey (MEPS), Policy
Yawn BP, Wollan PC, Rank MA
Use of asthma APGAR tools in primary care practices: a cluster-randomized controlled trial.
The purpose of this study was to assess patient and practice outcomes after introducing the Asthma APGAR (Activities, Persistent, triGGers, Asthma medications, Response to therapy) tools into primary care practices. It concluded that introduction of the Asthma APGAR tools improves rates of asthma control; reduces asthma-related ED, urgent care, and hospital visits; and increases practices' adherence to asthma management guidelines.
AHRQ-funded; HS022126.
Citation: Yawn BP, Wollan PC, Rank MA .
Use of asthma APGAR tools in primary care practices: a cluster-randomized controlled trial.
Ann Fam Med 2018 Mar;16(2):100-10. doi: 10.1370/afm.2179.
.
.
Keywords: Asthma, Patient-Centered Outcomes Research, Primary Care, Medical Expenditure Panel Survey (MEPS), Tools & Toolkits
Valero-Elizondo J, Hong JC, Spatz ES
Persistent socioeconomic disparities in cardiovascular risk factors and health in the United States: Medical Expenditure Panel Survey 2002-2013.
This study aimed to describe the trends in prevalence of cardiovascular risk factors (CRFs) among US adults by SES from 2002 to 2013. It found that the proportion of individuals with obesity, diabetes and hypertension increased overall, with low-income groups representing a higher prevalence for each CRF. Of note, physical inactivity had the highest prevalence increase, with the "lowest-income" group observing a relative percent increase of 71.1 percent.
AHRQ-funded; HS023000.
Citation: Valero-Elizondo J, Hong JC, Spatz ES .
Persistent socioeconomic disparities in cardiovascular risk factors and health in the United States: Medical Expenditure Panel Survey 2002-2013.
Atherosclerosis 2018 Feb;269:301-05. doi: 10.1016/j.atherosclerosis.2017.12.014.
.
.
Keywords: Disparities, Cardiovascular Conditions, Medical Expenditure Panel Survey (MEPS), Risk, Social Determinants of Health