National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Access to Care (3)
- Alcohol Use (1)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Disparities (5)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Health Services Research (HSR) (8)
- Kidney Disease and Health (5)
- Outcomes (2)
- Patient-Centered Outcomes Research (2)
- (-) Policy (16)
- Racial and Ethnic Minorities (1)
- Registries (4)
- (-) Transplantation (16)
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 16 of 16 Research Studies DisplayedShen NT, Bray J, Wahid NA
Evaluation of alcohol taxes as a public health opportunity to reduce liver transplant listings for alcohol-related liver disease.
Alcohol-related liver disease (ALD) is a leading indication for liver transplantation. In this study, the investigators evaluated alcohol taxes as a public health opportunity to reduce liver transplant listings for alcohol-related liver disease. The investigators concluded that transplant listings for ALD were directly associated with spirit consumption and inversely associated with spirits excise taxes. They indicate that these findings suggest a possible public health benefit of increasing excise taxes for spirits.
AHRQ-funded; HS000066.
Citation: Shen NT, Bray J, Wahid NA .
Evaluation of alcohol taxes as a public health opportunity to reduce liver transplant listings for alcohol-related liver disease.
Alcohol Clin Exp Res 2020 Nov;44(11):2307-15. doi: 10.1111/acer.14454..
Keywords: Alcohol Use, Policy, Transplantation
Chang SH, Wang M, Liu X
Racial/ethnic disparities in access and outcomes of simultaneous liver-kidney transplant among liver transplant candidates with renal dysfunction in the United States.
Since the Model for End-stage Liver Disease (MELD) allocation system was implemented, the proportion of simultaneous liver-kidney transplantation (SLKT) has increased significantly. The investigators study whether racial/ethnic disparities exist in access to SLKT and post-SLKT survival. The investigators concluded that in the MELD era, racial/ethnic differences exist in access and survival of SLKT for patients with renal dysfunction at listing for LT.
AHRQ-funded; HS022330.
Citation: Chang SH, Wang M, Liu X .
Racial/ethnic disparities in access and outcomes of simultaneous liver-kidney transplant among liver transplant candidates with renal dysfunction in the United States.
Transplantation 2019 Aug;103(8):1663-74. doi: 10.1097/tp.0000000000002574..
Keywords: Access to Care, Disparities, Kidney Disease and Health, Outcomes, Policy, Transplantation
Perito ER, Mogul DB, VanDerwerken D
The impact of increased allocation priority for children awaiting liver transplant: a Liver Simulated Allocation Model (LSAM) analysis.
This study examined the impact of prioritizing infants, children, adolescents, and the sickest adults (designated Status 1) for deceased donor livers. They compared outcomes for two “SharePeds” allocation schema to the allocation plan approved by the Organ Procurement and Transplant Network (OPTN) in December 2017. Both schemas would decrease waitlist deaths for infants, children, and Status 1 adults and increase access to all donors younger than 35 years.
AHRQ-funded; HS023876.
Citation: Perito ER, Mogul DB, VanDerwerken D .
The impact of increased allocation priority for children awaiting liver transplant: a Liver Simulated Allocation Model (LSAM) analysis.
J Pediatr Gastroenterol Nutr 2019 Apr;68(4):472-79. doi: 10.1097/mpg.0000000000002287.
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Keywords: Children/Adolescents, Transplantation, Policy
Henderson ML, DiBrito SR, Thomas AG
Landscape of living multiorgan donation in the United States: a registry-based cohort study.
This registry-based cohort study examined the patient characteristics and outcomes associated with living multiorgan donation in the United States. The authors assert that careful documentation of outcomes is needed to ensure ethical practices in selection, informed consent, and postdonation care of this unique donor community.
AHRQ-funded; HS024600.
Citation: Henderson ML, DiBrito SR, Thomas AG .
Landscape of living multiorgan donation in the United States: a registry-based cohort study.
Transplantation 2018 Jul;102(7):1148-55. doi: 10.1097/tp.0000000000002082..
Keywords: Health Services Research (HSR), Patient-Centered Outcomes Research, Policy, Registries, Transplantation
Ashlagi I, Bingaman A, Burq M
Effect of match-run frequencies on the number of transplants and waiting times in kidney exchange.
Many U.S. kidney paired donation (KPD) registries have gradually shifted to high-frequency match-runs, raising the question of whether this harms the number of transplants. The authors conducted simulations and found that longer intervals between match-runs do not increase the total number of transplants, and that prioritizing highly sensitized patients is more effective than waiting longer between match-runs for transplanting these patients. Further, increasing arrival rates of new pairs improves both the fraction of transplanted pairs and waiting times.
AHRQ-funded; HS020610.
Citation: Ashlagi I, Bingaman A, Burq M .
Effect of match-run frequencies on the number of transplants and waiting times in kidney exchange.
Am J Transplant 2018 May;18(5):1177-86. doi: 10.1111/ajt.14566..
Keywords: Transplantation, Kidney Disease and Health, Health Services Research (HSR), Policy, Registries
Wey A, Pyke J, Schladt DP
Offer acceptance practices and geographic variability in allocation model for end-stage liver disease at transplant.
Offer acceptance practices may cause geographic variability in allocation Model for End-Stage Liver Disease (aMELD) score at transplant and could magnify the effect of donor supply and demand on aMELD variability. To evaluate these issues, offer acceptance practices of liver transplant programs and donation service areas (DSAs) were estimated using offers of livers from donors recovered between January 1, 2016, and December 31, 2016.
AHRQ-funded; HS024527.
Citation: Wey A, Pyke J, Schladt DP .
Offer acceptance practices and geographic variability in allocation model for end-stage liver disease at transplant.
Liver Transpl 2018 Apr;24(4):478-87. doi: 10.1002/lt.25010..
Keywords: Health Services Research (HSR), Policy, Transplantation
Mehrotra S, Kilambi V, Bui K
A concentric neighborhood solution to disparity in liver access that contains current UNOS districts.
Policymakers are deliberating policy reforms to reduce geographic disparity in liver allocation. This study conducted simulations comparing current allocation with the neighborhoods and sharing policies. The study concluded that the current 11 districts can be adapted systematically by adding neighboring donor service areas (DSAs) to improve geographic disparity, mortality, and airplane travel distance. Modifications to Share 35 and Share 15 policies result in further improvements.
AHRQ-funded; HS024840.
Citation: Mehrotra S, Kilambi V, Bui K .
A concentric neighborhood solution to disparity in liver access that contains current UNOS districts.
Transplantation 2018 Feb;102(2):255-78. doi: 10.1097/tp.0000000000001934..
Keywords: Access to Care, Disparities, Policy, Transplantation
Kilambi V, Bui K, Mehrotra S
LivSim: An open-source simulation software platform for community research and development for liver allocation policies.
This brief discusses LivSim, an open-source software alternative to the Liver Simulated Allocation Model (LSAM) created by the Scientific Registry of Transplant Recipients. LivSim is an open-source simulation software platform for community research and development for liver allocation policies.
AHRQ-funded; HS024840.
Citation: Kilambi V, Bui K, Mehrotra S .
LivSim: An open-source simulation software platform for community research and development for liver allocation policies.
Transplantation 2018 Feb;102(2):e47-e48. doi: 10.1097/tp.0000000000002000..
Keywords: Health Services Research (HSR), Policy, Transplantation
Kumar K, Holscher CM, Luo X
Persistent regional and racial disparities in nondirected living kidney donation.
Nondirected living donors (NDLDs) are an important and growing source of kidneys to help reduce the organ shortage. The authors of this study hypothesized that the initial geographic clustering and racial disparities may have improved due to an increase in NDLDs. The authors found that despite the increased number of NDLDs, racial disparities have worsened and the center-level distribution of NDLD transplants has narrowed in recent years.
AHRQ-funded; HS024600.
Citation: Kumar K, Holscher CM, Luo X .
Persistent regional and racial disparities in nondirected living kidney donation.
Clin Transplant 2017 Dec;31(12). doi: 10.1111/ctr.13135..
Keywords: Disparities, Health Services Research (HSR), Policy, Transplantation, Racial and Ethnic Minorities
Henderson ML, Thomas AG, Shaffer A
The national landscape of living kidney donor follow-up in the United States.
The purpose of this study was to understand the impact of the 2013 policy the Organ Procurement and Transplantation Network/United Network for Organ Sharing issued. The policy required that transplant centers collect data on living kidney donors (LKDs) at 6 months, 1 year, and 2 years postdonation, with policy-defined thresholds for the proportion of complete living donor follow-up data submitted in a timely manner (60 days before or after the expected visit date).
AHRQ-funded; HS024600.
Citation: Henderson ML, Thomas AG, Shaffer A .
The national landscape of living kidney donor follow-up in the United States.
Am J Transplant 2017 Dec;17(12):3131-40. doi: 10.1111/ajt.14356..
Keywords: Health Services Research (HSR), Patient-Centered Outcomes Research, Policy, Registries, Transplantation
Rees MA, Dunn TB, Kuhr CS
Kidney exchange to overcome financial barriers to kidney transplantation.
Organ shortage is the major limitation to kidney transplantation in the developed world. This proposal leverages the cost savings achieved through earlier transplantation over dialysis to fund the cost of kidney exchange between developed-world patient-donor pairs with immunological barriers and developing-world patient-donor pairs with financial barriers.
AHRQ-funded; HS020610.
Citation: Rees MA, Dunn TB, Kuhr CS .
Kidney exchange to overcome financial barriers to kidney transplantation.
Am J Transplant 2017 Mar;17(3):782-90. doi: 10.1111/ajt.14106.
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Keywords: Transplantation, Healthcare Costs, Policy, Kidney Disease and Health, Kidney Disease and Health
Kasiske BL, Salkowski N, Wey A
Potential implications of recent and proposed changes in the regulatory oversight of solid organ transplantation in the United States.
The authors reviewed the details and implications of changes in transplant program oversight.
AHRQ-funded; HS024527.
Citation: Kasiske BL, Salkowski N, Wey A .
Potential implications of recent and proposed changes in the regulatory oversight of solid organ transplantation in the United States.
Am J Transplant 2016 Dec;16(12):3371-77. doi: 10.1111/ajt.13955.
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Keywords: Health Services Research (HSR), Policy, Registries, Policy, Transplantation
Melcher ML, Roberts JP, Leichtman AB
Utilization of deceased donor kidneys to initiate living donor chains.
The authors proposed that some deceased donor kidneys be allocated to initiate nonsimultaneous extended altruistic donor chains of living donor kidney transplants. They hypothesized that a pilot program would show a positive impact on patients of all ethnicities and blood types.
AHRQ-funded; HS020610.
Citation: Melcher ML, Roberts JP, Leichtman AB .
Utilization of deceased donor kidneys to initiate living donor chains.
Am J Transplant 2016 May;16(5):1367-70. doi: 10.1111/ajt.13740.
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Keywords: Healthcare Delivery, Kidney Disease and Health, Policy, Transplantation
Toro-Diaz H, Mayorga ME, Barritt AS
Predicting liver transplant capacity using discrete event simulation.
The researchers constructed a discrete event simulation model informed by current donor characteristics to predict future liver transplant trends through the year 2030. They found that by altering assumptions about the future donor pool, their model can be used to develop policy interventions to prevent a further decline in this lifesaving therapy.
AHRQ-funded; HS019468.
Citation: Toro-Diaz H, Mayorga ME, Barritt AS .
Predicting liver transplant capacity using discrete event simulation.
Med Decis Making 2015 Aug;35(6):784-96. doi: 10.1177/0272989x14559055.
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Keywords: Access to Care, Health Services Research (HSR), Policy, Transplantation
Davis AE, Mehrotra S, Ladner DP
Changes in geographic disparity in kidney transplantation since the final rule.
The researchers assessed the significance of changes of geographic disparities for four metrics since the 1998 adoption of HHS Final Rule’s emphasizing objective priority criteria: waiting times, transplant rates, pre-transplant mortality, and organ quality. They found that the ranges of the four metrics have worsened by approximately 30% or more after the Final Rule at both the regional and donor service area levels.
AHRQ-funded; HS021078.
Citation: Davis AE, Mehrotra S, Ladner DP .
Changes in geographic disparity in kidney transplantation since the final rule.
Transplantation 2014 Nov 15;98(9):931-6. doi: 10.1097/tp.0000000000000446..
Keywords: Transplantation, Disparities, Policy, Outcomes
Davis AE, Mehrotra S, Kilambi V
The effect of the Statewide Sharing variance on geographic disparity in kidney transplantation in the United States.
This study examined the effect of Statewide Sharing on geographic allocation disparity over time between donor service areas (DSAs) within Tennessee and Florida and compared them with geographic disparity between the DSAs within a state for all states with more than one DSA (California, New York, North Carolina, Ohio, Pennsylvania, Texas, and Wisconsin). Findings suggested that changes which are untested run the risk of unintended consequences, and Statewide Sharing should be further studied and considered.
AHRQ-funded; HS021078.
Citation: Davis AE, Mehrotra S, Kilambi V .
The effect of the Statewide Sharing variance on geographic disparity in kidney transplantation in the United States.
Clin J Am Soc Nephrol 2014 Aug 7;9(8):1449-60. doi: 10.2215/cjn.05350513.
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Keywords: Chronic Conditions, Disparities, Kidney Disease and Health, Policy, Transplantation