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Search All Research Studies
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- (-) Access to Care (11)
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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
1 to 11 of 11 Research Studies DisplayedDecker S, Dworsky M, Gibson TB
AHRQ Author: Decker S
The Impact of the Affordable Care Act Insurance Expansions on Opioid-Related Emergency Department Visits.
The authors leveraged ACA coverage expansions, including Medicaid expansion and Marketplaces, to study the impact of health insurance on opioid-related emergency department (ED) visits. They used ZIP-code–level ED utilization data from HCUP’s State Inpatient Databases (SID) and State Emergency Department Databases (SEDD) for 29 states. They found evidence of a dose-response relationship between pre-ACA uninsured and changes in ED visit rates in both expansion and non-expansion states: areas with higher uninsured rates prior to ACA saw larger reductions in opioid-related ED visits after the ACA took effect. The authors concluded that these findings suggest that increased insurance coverage may to help mitigate the opioid crisis.
AHRQ-authored.
Citation: Decker S, Dworsky M, Gibson TB .
The Impact of the Affordable Care Act Insurance Expansions on Opioid-Related Emergency Department Visits.
American Journal of Health Economics 2023 Sum; 9(3):405–34..
Keywords: Healthcare Cost and Utilization Project (HCUP), Opioids, Policy, Health Insurance, Emergency Department, Access to Care, Medicaid, Healthcare Utilization
Meille G, Post B
AHRQ Author: Meille G
The effects of the Medicaid expansion on hospital utilization, employment, and capital.
This AHRQ-authored paper describes the effect of the Affordable Care Act Medicaid expansion on hospital utilization, employment, and capital. The authors conducted a difference-in-differences analysis that compared changes to hospital demand and supply in Medicaid expansion and nonexpansion states. They used 2010-2016 data from the American Hospital Association and the Healthcare Cost Report Information System to quantify changes to hospital utilization and characterize how hospitals adjusted labor and capital inputs. Medicaid expansion was associated with increases in emergency department visits and other outpatient hospital visits. They found strong evidence that hospitals met increases in demand by hiring nursing staff and weaker evidence that they increased hiring of technicians and investments in equipment. They found no evidence that hospitals adjusted hiring of physicians, support staff, or investments in other capital inputs.
AHRQ-authored.
Citation: Meille G, Post B .
The effects of the Medicaid expansion on hospital utilization, employment, and capital.
Med Care Res Rev 2023 Apr;80(2):165-74. doi: 10.1177/10775587221133165.
Keywords: Medicaid, Hospitals, Healthcare Utilization, Health Insurance, Policy, Access to Care, Uninsured
Hatch B, Hoopes M, Darney BG
Impacts of the Affordable Care Act on receipt of women's preventive services in Community Health Centers in Medicaid expansion and nonexpansion states.
Researchers assessed whether ACA implementation and Medicaid expansion were followed by greater receipt of recommended preventive services among women and girls in a large network of community health centers. Data was collected from electronic health records in 14 states. The researchers found that among female patients at community health centers, receipt of recommended preventive care improved after ACA implementation in both Medicaid expansion and non-expansion states, although the overall rates remained low. They recommended continued support to overcome barriers to preventive care in this population.
AHRQ-funded; HS025155.
Citation: Hatch B, Hoopes M, Darney BG .
Impacts of the Affordable Care Act on receipt of women's preventive services in Community Health Centers in Medicaid expansion and nonexpansion states.
Womens Health Issues 2021 Jan-Feb;31(1):9-16. doi: 10.1016/j.whi.2020.08.011..
Keywords: Cancer, Medicaid, Health Insurance, Uninsured, Access to Care, Policy, Cancer: Cervical Cancer, Prevention, Women, Healthcare Utilization
Myong C, Hull P, Price M
The impact of funding for federally qualified health centers on utilization and emergency department visits in Massachusetts.
This retrospective study examined the impact of funding for federally qualified health centers (FQHCs) on utilization and emergency department (ED) visits in Massachusetts. The authors theorized that greater funding for FQHCs could increase the local availability of clinic-based care and reduce more costly resource use, such as ED visits. Data from the Massachusetts All Payer Claims Database (APCD) 2010-2013 was used that included enrollees in 559 Massachusetts ZIP codes (2010 numbers 6,173,563). They calculated shift-share predictions of changes in FQHC funding at the ZIP code-level for FQHCs that received Community Health Center funds in any year. They found that a standard deviation increase in prior year FQHC funding (31%) was associated with a 2.3% increase in enrollees with FQHC visits and a 1.3% decrease in enrollees at EDs. However, there were no significant changes in emergent ED visit rates.
AHRQ-funded; HS025378.
Citation: Myong C, Hull P, Price M .
The impact of funding for federally qualified health centers on utilization and emergency department visits in Massachusetts.
PLoS One 2020 Dec 3;15(12):e0243279. doi: 10.1371/journal.pone.0243279..
Keywords: Community-Based Practice, Healthcare Utilization, Emergency Department, Healthcare Costs, Access to Care, Vulnerable Populations, Policy
Zuvekas SH, McClellan CB, Ali MM
AHRQ Author: Zuvekas SH, McClellan CB
Medicaid expansion and health insurance coverage and treatment utilization among individuals with a mental health condition.
AHRQ-authored.
Citation: Zuvekas SH, McClellan CB, Ali MM .
Medicaid expansion and health insurance coverage and treatment utilization among individuals with a mental health condition.
J Ment Health Policy Econ 2020 Sep 1;23(3):151-82..
Keywords: Medical Expenditure Panel Survey (MEPS), Behavioral Health, Medicaid, Health Insurance, Access to Care, Healthcare Utilization, Policy, Uninsured
Maclean JC, Halpern MT, Hill SC
AHRQ Author: Hill SC
The effect of Medicaid expansion on prescriptions for breast cancer hormonal therapy medications.
The purpose of this study was to quantify the effects of the Affordable Care Act Medicaid expansion on prescriptions for effective breast cancer hormonal therapies (tamoxifen and aromatase inhibitors) among Medicaid enrollees. Data from the Medicaid State Drug Utilization Database was used. Findings showed that Medicaid expansion may have had a meaningful impact on the ability of lower-income women to access effective hormonal therapies used to treat breast cancer.
AHRQ-authored.
Citation: Maclean JC, Halpern MT, Hill SC .
The effect of Medicaid expansion on prescriptions for breast cancer hormonal therapy medications.
Health Serv Res 2020 Jun;55(3):399-410. doi: 10.1111/1475-6773.13289..
Keywords: Medicaid, Cancer: Breast Cancer, Cancer, Medication, Policy, Women, Healthcare Utilization, Access to Care, Health Insurance
Bailey SR, Marino M, Ezekiel-Herrera D
Tobacco cessation in Affordable Care Act Medicaid expansion states versus non-expansion states.
This study examined whether states that expanded Medicaid eligibility under the ACA had increased smoking quit rates, tobacco cessation medication orders, and greater health care utilization compared to patients in non-expansion states. The researchers used electronic health record (EHR) data from 219 community health centers (CHCs) in 10 states that expanded Medicaid as of January 2014. They identified patients aged 19-64 with tobacco use status in their records within six months prior to ACA Medicaid expansion and 1 or more visits. They found that patients in expansion states had increased adjusted odds of quitting, having a medication ordered and having follow-up visits compared to patients in non-expansion states.
AHRQ-funded; HS024270.
Citation: Bailey SR, Marino M, Ezekiel-Herrera D .
Tobacco cessation in Affordable Care Act Medicaid expansion states versus non-expansion states.
Nicotine Tob Res 2020 Jun;22(6):1016-22. doi: 10.1093/ntr/ntz087..
Keywords: Tobacco Use: Smoking Cessation, Tobacco Use, Substance Abuse, Medication, Medicaid, Policy, Healthcare Utilization, Access to Care, Health Insurance
Cook BL, Flores M, Zuvekas SH
AHRQ Author: Zuvekas SH
The impact Of Medicare's mental health cost-sharing parity on use of mental health care services.
This study examined the impact of Medicare’s mental health cost-sharing parity on use of mental health care services, which was phased in from 2010 to 2014. The authors assessed whether the reduction in mental health cost sharing was associated with changes in specialty and primary care outpatient mental health visits and psychotropic medication fills. They compared people with Medicare and private insurance before and after implementation. Medicare beneficiaries’ use of psychotropic medication increased after implementation but there was not a detectable change in visits.
AHRQ-authored.
Citation: Cook BL, Flores M, Zuvekas SH .
The impact Of Medicare's mental health cost-sharing parity on use of mental health care services.
Health Aff 2020 May;39(5):819-27. doi: 10.1377/hlthaff.2019.01008..
Keywords: Medical Expenditure Panel Survey (MEPS), Medicare, Behavioral Health, Healthcare Costs, Policy, Health Insurance, Healthcare Utilization, Access to Care
Holderness H, Angier H, Huguet N
Where do Oregon Medicaid Enrollees seek outpatient care post-Affordable Care Act Medicaid expansion?
The purpose of this study was to understand where Oregon Medicaid beneficiaries sought care after the Patient Protection and Affordable Care Act Medicaid expansion (emergency department, primary care, or specialist) and the interaction between primary care establishment and outpatient care utilization. Results showed that most newly and returning-insured Medicaid enrollees sought primary care rather than emergency department services and most became established with primary care, suggesting that both insurance and primary care continuity play a role in where patients seek health care services.
AHRQ-funded; HS024270.
Citation: Holderness H, Angier H, Huguet N .
Where do Oregon Medicaid Enrollees seek outpatient care post-Affordable Care Act Medicaid expansion?
Med Care 2019 Oct;57(10):788-94. doi: 10.1097/mlr.0000000000001189..
Keywords: Access to Care, Ambulatory Care and Surgery, Health Insurance, Healthcare Utilization, Medicaid, Policy
Pickens G, Karaca Z, Gibson TB
AHRQ Author: Karaca Z, Wong HS
Changes in hospital service demand, cost, and patient illness severity following health reform.
This study examined the effects of expanded Medicaid coverage and the health insurance exchange on the number of hospital inpatient and emergency department (ED) utilization rates, cost, and patient illness severity. There was a significant drop in uninsured inpatient discharges and ED visits in states where Medicaid was expanded. For all by young females, uninsured inpatient discharge rates fell by 39% or greater. In nonexpansion states, the rates remained unchanged or increased slightly. Changes in all-payer and private insurance rates were not as dramatic, as was inpatient costs per discharge and all-payer inpatient costs.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Pickens G, Karaca Z, Gibson TB .
Changes in hospital service demand, cost, and patient illness severity following health reform.
Health Serv Res 2019 Aug;54(4):739-51. doi: 10.1111/1475-6773.13165..
Keywords: Access to Care, Health Insurance, Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Healthcare Utilization, Hospitals, Medicaid, Policy, Uninsured
Gold R, Bailey SR, O'Malley JP
Estimating demand for care after a Medicaid expansion: lessons from Oregon.
In order to estimate how the Affordable Care Act's Medicaid expansions will affect demand for services, the authors measured ambulatory care utilization among adult patients who gained insurance during Oregon's 2008 Medicaid expansion. They found that, in comparisons of the pre- and postcoverage periods, the mean annual encounters among persons who gained insurance increased 22% to 35%, but declined in the comparison groups.
AHRQ-funded; HS021522.
Citation: Gold R, Bailey SR, O'Malley JP .
Estimating demand for care after a Medicaid expansion: lessons from Oregon.
J Ambul Care Manage 2014 Oct-Dec;37(4):282-92. doi: 10.1097/jac.0000000000000023.
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Keywords: Access to Care, Healthcare Utilization, Policy, Health Services Research (HSR), Medicaid