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
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 8 of 8 Research Studies DisplayedEliason EL, A Spishak-Thomas, Steenland MW
Association of the Affordable Care Act Medicaid expansions with postpartum contraceptive use and early postpartum pregnancy.
The purpose of this study was to assess the relationship of the Affordable Care Act (ACA) Medicaid expansion with postpartum contraception use and pregnancy. The researchers found that Medicaid expansion was associated with a 7.0 percentage point increase in postpartum use of the contraceptive implant and intrauterine device LARC, a 3.1 percentage point decrease in short-acting contraception, and a 3.9 percentage point decrease in non-prescription contraceptive use overall. Increases in LARC use were concentrated among non-Hispanic, White, and Black respondents. Medicaid expansion was associated with a decrease in early postpartum pregnancy only among non-Hispanic Black respondents. The researchers concluded that the ACA Medicaid expansion improved postpartum contraceptive access and led to shifts from methods with a lower upfront out-of-pocket cost for people without insurance towards methods with the higher upfront out-of-pocket cost for people without insurance. These changes suggest that Medicaid expansions increased access to the full range of contraceptive methods.
AHRQ-funded; HS027464; HS000011
Citation: Eliason EL, A Spishak-Thomas, Steenland MW .
Association of the Affordable Care Act Medicaid expansions with postpartum contraceptive use and early postpartum pregnancy.
Contraception 2022 Sep;113:42-48. doi: 10.1016/j.contraception.2022.02.012..
Keywords: Sexual Health, Pregnancy, Maternal Care, Women, Medicaid, Access to Care, Policy
Thompson I, Bryant AG, Stuebe AM
Centering the patient in postpartum contraceptive counseling.
This article discusses the timing of postpartum contraceptive counseling and the fact that many health care providers believe prevention of future pregnancies is a priority in the postpartum period and that the inpatient postpartum stay is an ideal time to discuss contraception. However, this belief is not necessarily shared by the birthing parent, and they might be unready to discuss contraceptives, especially for people whose reproduction has been marginalized. The authors state that health care providers must acknowledge this harmful and racist history to change counseling practices actively and thoughtfully to best meet patient needs while simultaneously respecting patient autonomy.
AHRQ-funded; HS027260.
Citation: Thompson I, Bryant AG, Stuebe AM .
Centering the patient in postpartum contraceptive counseling.
Clin Obstet Gynecol 2022 Sep 1;65(3):588-93. doi: 10.1097/grf.0000000000000725..
Keywords: Maternal Care, Pregnancy, Women, Sexual Health
Moniz MH, Peahl AF, Zinsser D
Social vulnerability and use of postpartum long-acting reversible contraception and sterilization.
This retrospective cohort analysis examined whether social determinants like transportation, housing quality, childcare, and structural racism may plausibly shape individuals’ postpartum contraceptive preferences and access. The authors used administrative claims data from a statewide collaborative quality initiative to identify childbirth episodes from January 2016 to December 2019. Outcomes included long-acting reversible contraceptive (LARC) and sterilization use by 60 days postpartum. They used the CDC’s Social Vulnerability Index (SVI) to evaluate associations between the outcomes and exposures to the highest quintile SVI by census tract by theme and controlling for patient characteristics. Individuals with the highest quintile of socioeconomic vulnerability and minority status and language vulnerability were the most likely to use LARCs, while those with the highest household composition vulnerability were least likely. Housing/transportation vulnerability was not associated with LARC utilization. Sterilization use was less like to be taken up by those with the highest socioeconomic vulnerability and minority status/language vulnerability, while it was for those with the highest housing/transportation vulnerability and household composition vulnerability.
AHRQ-funded; HS025465.
Citation: Moniz MH, Peahl AF, Zinsser D .
Social vulnerability and use of postpartum long-acting reversible contraception and sterilization.
Am J Obstet Gynecol 2022 Jul;227(1):111-13.e2. doi: 10.1016/j.ajog.2022.03.031..
Keywords: Sexual Health, Women
Kramer RD, Higgins JA, Everett B
A prospective analysis of the relationship between sexual acceptability and contraceptive satisfaction over time.
This analysis examined the relationship between contraceptive method and sex life satisfaction. Eligible participants were individuals in the HER Salt Lake Contraceptive Initiative who switched contraceptive methods and continued their new method for at least 1 month and completed all relevant surveys. Primary predictor variables included changes in sexual functioning, sexual satisfaction, and perceived impact of the contraceptive method of sex life at one month. The sample included 1879 individuals. At 3 months 52.1% of participants were completely satisfied with their contraceptive method, 30.7% were somewhat satisfied, and 6.2% were completely dissatisfied. Patients at 3 months who said the method improved their sex life “a lot” had 7.7 times increased odds of greater satisfaction at 3 months than patients who said their contraceptive method made their sex life “a lot” worse at 1 month. Patients whose method improved their sex life a “little” had 5.88 times increased odds of greater satisfaction. Experiencing less or no vaginal bleeding was significantly associated with increased satisfaction.
AHRQ-funded; HS027220.
Citation: Kramer RD, Higgins JA, Everett B .
A prospective analysis of the relationship between sexual acceptability and contraceptive satisfaction over time.
Am J Obstet Gynecol 2022 Mar;226(3):396.31-96.e11. doi: 10.1016/j.ajog.2021.10.008..
Keywords: Sexual Health, Women
Moniz MH, Dalton VK, Smith RD
Feasibility and acceptability of a toolkit-based process to implement patient-centered, immediate postpartum long-acting reversible contraception services.
The objectives of this single-site study were to develop a theory-informed toolkit, to evaluate the feasibility of toolkit-based implementation of immediate postpartum long-acting reversible contraception services, and to refine the toolkit. The study was conducted at a large academic medical center. The authors concluded that the toolkit-based process was associated with high acceptability but mixed healthcare quality outcomes. They suggested that future research should test the effectiveness of the refined toolkit in a multisite, prospective trial.
AHRQ-funded; HS025465.
Citation: Moniz MH, Dalton VK, Smith RD .
Feasibility and acceptability of a toolkit-based process to implement patient-centered, immediate postpartum long-acting reversible contraception services.
Am J Obstet Gynecol 2022 Mar; 226(3):394.e1-94.e16. doi: 10.1016/j.ajog.2021.10.009..
Keywords: Maternal Care, Patient-Centered Healthcare, Women, Sexual Health
Sanders JN, Kean J, Zhang C
Measuring the sexual acceptability of contraception: psychometric examination and development of a valid and reliable prospective instrument.
This study’s objective was to develop and examine the psychometric properties of reliability, separation, and item fit of a new Contractive Sexual Acceptability (CSA) instrument among enrolled participants of the longitudinal cohort study HER Salt Lake. Study elements included the Female Sexual Function Index, the New Sexual Satisfaction Scale, measures of physical and mood-related side effects, and self-reported perceptions of contraception's sexual impacts. The authors evaluated (i) the reproducibility of relative measure location on the modeled linear latent variable, (ii) the number of statistically unique performance levels that can be distinguished by the measure, and (iii) the discrepancy between item responses and expectations of the model. They developed a 10-item CSA scale that exceeded the thresholds and sufficiently covered domains for use in contraceptive research and clinical settings. Starting with data on 39-items from 4,387 individuals, they identified 10-items that best measured the CSA latent construct. Final items included questions with scaled responses about pleasure and orgasm (orgasm quality, orgasm frequency, giving partner pleasure), physical (arousal and function) and psychological (emotional connection, surrender) components, general questions of satisfaction and frequency, and a measure of perceived impact of contraception on sexual experiences in the previous 4 weeks.
AHRQ-funded; HS027220.
Citation: Sanders JN, Kean J, Zhang C .
Measuring the sexual acceptability of contraception: psychometric examination and development of a valid and reliable prospective instrument.
J Sex Med 2022 Mar; 19(3):507-20. doi: 10.1016/j.jsxm.2021.12.007..
Keywords: Sexual Health, Women
Dude AM, Schueler K, Schumm LP
Preconception care and severe maternal morbidity in the United States.
This study’s objective was to measure the association between preconception care and the odds of severe maternal morbidity among women with Medicaid using a secondary analysis of Medicaid claims using Medicaid Analytic Extract files. Findings showed that contraceptive services in the year before conception and routine exams for women with chronic disease were associated with decreased odds of severe maternal morbidity or death for Medicaid enrollees.
AHRQ-funded; HS027027.
Citation: Dude AM, Schueler K, Schumm LP .
Preconception care and severe maternal morbidity in the United States.
Am J Obstet Gynecol MFM 2022 Mar;4(2):100549. doi: 10.1016/j.ajogmf.2021.100549..
Keywords: Maternal Care, Pregnancy, Women, Labor and Delivery, Sexual Health
Tabaac AR, Sutter ME, Haneuse S
The interaction of sexual orientation and provider-patient communication on sexual and reproductive health in a sample of U.S. women of diverse sexual orientations.
This study’s goal was to examine associations among provider-patient communication, past-year contraceptive use, and lifetime sexually transmitted infection. The authors analyzed data cross-sectionally from 22,554 women in the Growing Up Today Study and Nurses' Health Study 3 for the follow-up period of 1996 to 2020. Provider-patient communication was associated with higher likelihood of using all methods of past-year contraceptive use and lifetime STI diagnosis. Completely heterosexual women were 13% more likely than lesbians and 4% less likely than other groups to report a provider ever discussed their sexual and reproductive health (SRH). Sexual minority women whose providers discussed their SRH were less likely to report contraceptive non-use in the past year.
AHRQ-funded; HS026120.
Citation: Tabaac AR, Sutter ME, Haneuse S .
The interaction of sexual orientation and provider-patient communication on sexual and reproductive health in a sample of U.S. women of diverse sexual orientations.
Patient Educ Couns 2022 Feb; 105(2):466-73. doi: 10.1016/j.pec.2021.05.022..
Keywords: Sexual Health, Women, Clinician-Patient Communication, Communication