National Healthcare Quality and Disparities Report
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Search All Research Studies
AHRQ Research Studies Date
Topics
- (-) Access to Care (13)
- Behavioral Health (1)
- Brain Injury (1)
- Children's Health Insurance Program (CHIP) (1)
- (-) Children/Adolescents (13)
- Dental and Oral Health (2)
- Disparities (3)
- Evidence-Based Practice (1)
- Family Health and History (1)
- Healthcare Costs (1)
- Healthcare Delivery (2)
- Healthcare Utilization (1)
- Health Insurance (5)
- Hospitalization (1)
- Hospitals (1)
- Low-Income (1)
- Medicaid (3)
- Medical Expenditure Panel Survey (MEPS) (4)
- Obesity (1)
- Outcomes (2)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Policy (3)
- Primary Care (1)
- Primary Care: Models of Care (1)
- Quality of Life (1)
- Racial and Ethnic Minorities (2)
- Registries (1)
- Respiratory Conditions (1)
- Sexual Health (1)
- Surgery (1)
- Transplantation (1)
- Trauma (1)
- Uninsured (2)
- Vulnerable Populations (2)
- 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 13 of 13 Research Studies DisplayedLipton BJ, Finlayson TL
AHRQ Author: Decker SL
The association between Medicaid adult dental coverage and children's oral health.
This study examined the association of Medicaid adult dental coverage and children’s oral health as Medicaid-eligible children are more likely to experience tooth decay than children in higher-income families. Data from the 1996-2016 National Health and Nutrition Examination Survey and the 2003, 2007, and 2011-12 waves of the National Survey of Children’s Health was used. Adult dental coverage was associated with a 5-percentage-point reduction in the prevalence of untreated caries among children after Medicaid-enrolled adults had access to dental coverage for at least one year. Children under twelve years of age were the most affected.
AHRQ-authored.
Citation: Lipton BJ, Finlayson TL .
The association between Medicaid adult dental coverage and children's oral health.
Health Aff 2021 Nov;40(11):1731-39. doi: 10.1377/hlthaff.2021.01135..
Keywords: Children/Adolescents, Dental and Oral Health, Medicaid, Health Insurance, Access to Care
Küng SA, Saavedra-Avendano B, Vélez EA
Factors associated with support for adolescent access to contraception among Mexican Catholic parents.
Researchers used a nationally representative survey of 2186 Mexican Catholic parents to assess two outcomes: support for adolescent access to modern contraception and whether adolescents unaccompanied by an adult should have access to contraceptive methods. They found that Mexican Catholic parents support adolescent access to modern contraception, but support for unaccompanied access to contraception is lower. This may reflect an interest in being involved, and not necessarily opposition to contraceptive use.
AHRQ-funded; HS025155; HS022981.
Citation: Küng SA, Saavedra-Avendano B, Vélez EA .
Factors associated with support for adolescent access to contraception among Mexican Catholic parents.
J Relig Health 2021 Jun;60(3):1600-12. doi: 10.1007/s10943-021-01186-w..
Keywords: Children/Adolescents, Access to Care, Sexual Health, Women
Han B, Chen PG, Yu H
Access to after-hours primary care: a key determinant of children's medical home status.
Researchers sought to identify individual survey items or domains that best predict medical home (MH) status for children and use them to develop brief markers of MH status. Using MEPS data, they found that accessibility, especially the ability to access health care after regular office hours, appeared to be the major predictor of having a MH among children. They recommended that the ongoing efforts to promote the MH model target improving accessibility of health care after regular hours for children overall and especially for Latino children.
AHRQ-funded; HS023336.
Citation: Han B, Chen PG, Yu H .
Access to after-hours primary care: a key determinant of children's medical home status.
BMC Health Serv Res 2021 Feb 27;21(1):185. doi: 10.1186/s12913-021-06192-y..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare, Access to Care, Healthcare Delivery, Disparities, Racial and Ethnic Minorities
Hudson JL, Moriya AS
AHRQ Author: Hudson JL
The role of marketplace policy on welcome mat effects for children eligible for Medicaid or the Children's Health Insurance Program.
This study examined the role of marketplace policy on “welcome mat” effects for children eligible for Medicaid or the Children’s Health Insurance Program (CHIP). Data from the American Community Survey from 2013-2018 was used to estimate the relationship between Marketplace policy and increases in Medicaid/CHIP coverage among pre-ACA eligible children after the implementation of the Affordable Care Act (ACA). The sample included non-disabled citizen children ages 0-18 at 139-250% federal poverty level who were Medicaid/CHIP-eligible before and after implementation of the ACA. Marketplace policies and enrollment were compared in expansion states versus non-expansion states. Public coverage did increase more in states that empowered their Marketplace to enroll publicly-eligible applicants directly into Medicaid/CHIP. This was driven by enrollment policy, not by choice of state-based versus federal-based Marketplaces. Welcome mats were largest in expansion states and increases ranged from 9 to 13 percentage points in enrollment.
AHRQ-authored.
Citation: Hudson JL, Moriya AS .
The role of marketplace policy on welcome mat effects for children eligible for Medicaid or the Children's Health Insurance Program.
Inquiry 2020 Jan-Dec;57:46958020952920. doi: 10.1177/0046958020952920..
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Medicaid, Health Insurance, Policy, Uninsured, Access to Care
Wisk LE, Peltz A, Galbraith AA
Changes in health care-related financial burden for US families with children associated with the Affordable Care Act.
The Affordable Care Act (ACA) sought to improve access and affordability of health insurance. Although most ACA policies targeted childless adults, the extent to which these policies also impacted families with children remains unclear. The purpose of this study was to examine changes in health care-related financial burden for US families with children before and after the ACA was implemented based on income eligibility for ACA policies.
AHRQ-funded; HS024700.
Citation: Wisk LE, Peltz A, Galbraith AA .
Changes in health care-related financial burden for US families with children associated with the Affordable Care Act.
JAMA Pediatr 2020 Nov;174(11):1032-40. doi: 10.1001/jamapediatrics.2020.3973..
Keywords: Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Health Insurance, Policy, Access to Care
Rosenberg J, Rosenthal MS, Cramer LD
Disparities in mental and behavioral health treatment for children and youth in immigrant families.
Children and youth in immigrant families (CIF)-children and youth with at least one foreign-born parent-face unique psychosocial stressors. Yet little is known about access to mental/behavioral health (MBH) services for CIF. Among US CIF and non-CIF with MBH problems, the authors assessed access to MBH treatment using the National Survey of Children's Health-2016, a nationally-representative survey of predominantly English- or Spanish-speaking US parents.
AHRQ-funded; HS024332.
Citation: Rosenberg J, Rosenthal MS, Cramer LD .
Disparities in mental and behavioral health treatment for children and youth in immigrant families.
Acad Pediatr 2020 Nov-Dec;20(8):1148-56. doi: 10.1016/j.acap.2020.06.013..
Keywords: Children/Adolescents, Behavioral Health, Disparities, Racial and Ethnic Minorities, Vulnerable Populations, Access to Care
Chien AT, Pandey A, Lu S
Pediatric hospital services within a one-hour drive: a national study.
Researchers determined the proportion of US counties whose 0- to 19-year-old patients could reach pediatric hospital services within one hour of driving; then, among counties within a one-hour drive, they determined each county’s beds per 100,000 pediatric-aged population to provide a sense of hospital capacity relative to the size of their pediatric population. They concluded that the need to drive more than one hour to reach hospital-based pediatric services is more the rule than the exception.
AHRQ-funded; HS024072; HS025299.
Citation: Chien AT, Pandey A, Lu S .
Pediatric hospital services within a one-hour drive: a national study.
Pediatrics 2020 Nov;146(5). doi: 10.1542/peds.2020-1724..
Keywords: Children/Adolescents, Hospitals, Access to Care, Healthcare Delivery
Khouja T, Burgette JM, Donohue JM
Association between Medicaid expansion, dental coverage policies for adults, and children's receipt of preventive dental services.
Researchers examined whether low-income children's use of preventive dental services is linked to variation in state Medicaid policies that affect parents' access to dental care in Medicaid. Using MEPS data along with Area Health Resources File and Medicaid adult dental coverage policies, they found no change in children's receipt of preventive dental care associated with Medicaid expansions in states that covered vs did not cover preventive dental services for adults. They concluded that factors other than parental access to dental benefits through Medicaid may be more salient determinants of preventive dental care use among low-income children.
AHRQ-funded; HS026727.
Citation: Khouja T, Burgette JM, Donohue JM .
Association between Medicaid expansion, dental coverage policies for adults, and children's receipt of preventive dental services.
Health Serv Res 2020 Oct;55(5):642-50. doi: 10.1111/1475-6773.13324..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Dental and Oral Health, Medicaid, Health Insurance, Low-Income, Access to Care, Policy
Mogul DB, Perito ER, Wood N
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
In December 2018, UNOS approved an allocation scheme based on recipients' geographic distance from a deceased donor ("acuity circles"). Previous analyses suggested acuity circles (AC) would reduce waitlist mortality overall, but their impact on pediatric subgroups was not considered. In this study, the investigators applied Scientific Registry of Transplant Recipients data from 2011-2016 towards the Liver Simulated Allocation Model (LSAM) to compare outcomes by age and illness severity for the UNOS-approved AC and the existing Donor Service Area (DSA)/Region-based allocation schemes.
AHRQ-funded; HS023876.
Citation: Mogul DB, Perito ER, Wood N .
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
Transplantation 2020 Aug;104(8):1627-32. doi: 10.1097/tp.0000000000003079..
Keywords: Children/Adolescents, Transplantation, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Registries, Surgery, Access to Care
Porter A, Brown CC, Tilford JM
Association of insurance status with treatment and outcomes in pediatric patients with severe traumatic brain injury.
This study’s objective was to determine if a health insurance disparity exists among pediatric patients with severe traumatic brain injury using data from the National Trauma Data Bank. The Bank contains data from more than 800 trauma centers in the United States. Isolated traumatic brain injury was defined as patients with a head Abbreviated Injury Scale score of 3+. Procedure codes were used to identify four primary treatment approaches combined into 2 classifications: craniotomy or craniectomy and external or intracranial ventricular draining. Condition at admission was defined including hypotension, Glasgow Coma Scale, mechanism and intent of injury, and Injury Severity Scale. Among the cohort of 12,449 patients, 91% had insurance and 9% were uninsured. Children without insurance had worse condition at admission with higher rates of hypotension and higher Injury Severity Score when compared with publicly and privately insured patients. Having insurance was associated with a 32% increase in the odds of cranial procedures, and 54% increase in the odds of monitor placement. Insurance coverage was associated 25% lower odds of inpatient mortality. Further study is needed to determine what factors lead to worse condition at admission.
Citation: Porter A, Brown CC, Tilford JM .
Association of insurance status with treatment and outcomes in pediatric patients with severe traumatic brain injury.
Crit Care Med 2020 Jul;48(7):e584-e91. doi: 10.1097/ccm.0000000000004398..
Keywords: Children/Adolescents, Brain Injury, Trauma, Health Insurance, Access to Care, Uninsured, Outcomes
Lindly OJ, Crossman MK, Shui AM
Healthcare access and adverse family impact among U.S. children ages 0-5 years by prematurity status.
This study examined healthcare access and adverse family impact among U.S. children aged 0-5 years by prematurity status. A sample of 19,842 U.S. children from the 2016 and 2017 National Survey of Children’s Health was used to identify 242 very low birthweight (VBLW) and 2205 low birthweight and/or preterm (LBW/PTB) children. Adverse family impacts measured were ≥ $1000 in annual out-of-pocket medical costs, having a parent cut back or stop work, parental aggravation, and maternal or paternal health not excellent. Only VBLW children had a significantly higher risk of a parent cut back or stop work, but all premature birth children fared worse than other children in terms of the other adverse family impacts.
AHRQ-funded; HS000063.
Citation: Lindly OJ, Crossman MK, Shui AM .
Healthcare access and adverse family impact among U.S. children ages 0-5 years by prematurity status.
BMC Pediatr 2020 Apr 17;20(1):168. doi: 10.1186/s12887-020-02058-0..
Keywords: Children/Adolescents, Access to Care, Family Health and History
Desai AD, Zhou C, Haaland W
Social disadvantage, access to care, and disparities in physical functioning among children hospitalized with respiratory illness.
This study examined associations between social disadvantage, access to care, and disparities in physical functioning among children hospitalized with acute respiratory illness. The study cohort included children ages 8-16 years and/or caregivers of children 2 weeks to 16 years admitted to five tertiary care children’s hospitals for three common respiratory illnesses from July 2014 through June 2016. Surveys were completed within 2 to 8 weeks after discharge. The survey assessed social disadvantage, difficulty/delays accessing care, and baseline and follow-up health-related quality of life (HRQoL), and physical functioning using the Pediatric Quality of Life Inventory (PedsQL). A total of 1,325 patients and/or their caregivers completed both PedsQL surveys. Adjusted mean baseline PedsQL scores were significantly lower for patients with social disadvantage (minority race/ethnicity, limited English proficiency, low education, and low income), than for patients with none. There were also disadvantage markers or difficulty/delays accessing care which were associated with lower physical functioning. However, these differences were reduced after hospital discharge.
AHRQ-funded; HS024299.
Citation: Desai AD, Zhou C, Haaland W .
Social disadvantage, access to care, and disparities in physical functioning among children hospitalized with respiratory illness.
J Hosp Med 2020 Apr;15(4):211-18. doi: 10.12788/jhm.3359..
Keywords: Children/Adolescents, Respiratory Conditions, Hospitalization, Access to Care, Disparities, Vulnerable Populations, Quality of Life
Berdahl T, Biener A, McCormick MC
AHRQ Author: Berdahl T
Annual report on children's healthcare: healthcare access and utilization by obesity status in the United States.
This study examined access to care and utilization patterns across a set of healthcare measures by obesity status and sociodemographic characteristics among children. Data from the Medical Expenditure Panel Survey (MEPS) from 2010-2015 was used to determine obesity status, number of well-child visits, access to a usual source of care, number of preventive dental visits and prescription medication fills in the past year. It was found that uninsured adolescents with obesity were less like to have a usual source of care provider than children without obesity. Among younger children, those living in the Northeast were more than twice as likely to have had a well-child visit than those living in the West. Preventive dental care was less likely to have occurred for children with obesity than non-obese children. More prescription refills were completed for obese adolescents than for younger children.
AHRQ-authored.
Citation: Berdahl T, Biener A, McCormick MC .
Annual report on children's healthcare: healthcare access and utilization by obesity status in the United States.
Acad Pediatr 2020 Mar;20(2):175-87. doi: 10.1016/j.acap.2019.11.020..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Access to Care, Healthcare Utilization, Obesity