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
Topics
- Cardiovascular Conditions (11)
- Depression (1)
- Diabetes (1)
- (-) Disparities (14)
- Evidence-Based Practice (1)
- Healthcare Utilization (1)
- (-) Heart Disease and Health (14)
- Hospitalization (1)
- Hospital Readmissions (1)
- Hospitals (1)
- Imaging (1)
- Implementation (1)
- Low-Income (1)
- Medical Devices (1)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medicare (1)
- Medication (1)
- Mortality (2)
- Outcomes (2)
- Patient-Centered Outcomes Research (2)
- Practice Patterns (1)
- Prevention (1)
- Quality Improvement (2)
- Quality of Care (1)
- Racial and Ethnic Minorities (6)
- Respiratory Conditions (1)
- Sex Factors (5)
- Sleep Problems (1)
- Social Determinants of Health (2)
- Stroke (1)
- Surgery (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 14 of 14 Research Studies DisplayedMarcaccio CL, Patel PB, de Guerre L
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
The purpose of this study was to identify variations in 5-year outcomes and imaging surveillance after elective endovascular aortic aneurysm repair (EVAR) by sex, race, and ethnicity and to examine possible mechanisms contributing to these variations. The primary outcome was 5-year aneurysm rupture. Secondary outcomes were 5-year reintervention and mortality, and having no aortic imaging follow-up from 6 to 24 months after EVAR. The study found that among 16,040 patients, 73% were White males, 18% were White females, 2.6% were Black males, 1.1% were Black females, 0.9% were Asian males, 0.2% were Asian females, 1.7% were Hispanic males, and 0.4% were Hispanic females. At 5 years, Black females had the highest rupture rates at 6.4% and white males had the lowest at 2.3%. Compared with White males, rupture rates were higher in White females, Black females, and Asian females. Among other groups, Black males had higher reintervention and both Black and Hispanic males had higher rates of no imaging follow-up. In adjusted analyses, White, Black, and Asian females remained at significantly higher risk for 5-year rupture. The researchers concluded that Black females had higher 5-year aneurysm rupture, reintervention, and mortality rates after elective EVAR as compared with White male patients, whereas White females had higher rupture, mortality and loss-to-imaging-follow-up compared to White male patients. Black males had higher reintervention and no imaging follow-up, and Asian females had higher rupture rates.
AHRQ-funded; HS027285.
Citation: Marcaccio CL, Patel PB, de Guerre L .
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
J Vasc Surg 2022 Nov;76(5):1205-15.e4. doi: 10.1016/j.jvs.2022.03.886..
Keywords: Disparities, Racial and Ethnic Minorities, Sex Factors, Outcomes, Imaging, Heart Disease and Health, Cardiovascular Conditions
Marcaccio CL, O'Donnell TFX, Dansey KD
Disparities in reporting and representation by sex, race, and ethnicity in endovascular aortic device trials.
The purpose of this study was to examine the demographics of patients enrolled in critical U.S. endovascular aortic device trials to explore the representation of vulnerable populations, including women and racial and ethnic minorities. The primary outcomes included the percentage of trials reporting participant sex, race, and ethnicity and the percentage of participants across sex, racial, and ethnic groups. The study found that the Food and Drug Administration (FDA) provided 29 approvals from 29 trials of 24 devices with a total of 4046 patients: 52% (15) were EVAR devices, 41% (12) were TEVAR devices, and 3.4% (1) was a FEVAR device, with 1 dissection stent (3.4%). Fifty-two percent of the trials reported the three most common racial groups (White, Black, Asian), and 48% reported Hispanic ethnicity. The TEVAR trials were the most likely to report all three racial groups and Hispanic ethnicity (92% and 75%, respectively), while the EVAR trials had the lowest reporting rates (13% and 20%, respectively). The median female enrollment was 21%, with the EVAR trials having the lowest female enrollment compared with 41% in the TEVAR trials, 21% in the FEVAR trial, and 34% in the dissection stent trial. The study concluded that in critical aortic device trials that led to FDA approval, female patients were underrepresented, especially for EVAR, and racial and ethnic minority groups were under-represented and underreported.
AHRQ-funded; HS027285.
Citation: Marcaccio CL, O'Donnell TFX, Dansey KD .
Disparities in reporting and representation by sex, race, and ethnicity in endovascular aortic device trials.
J Vasc Surg 2022 Nov;76(5):1244-52.e2. doi: 10.1016/j.jvs.2022.05.003..
Keywords: Disparities, Racial and Ethnic Minorities, Heart Disease and Health, Cardiovascular Conditions, Medical Devices, Sex Factors
Fitzgerald DC, Simpson AN, Baker RA DC, Simpson AN, Baker RA
Determinants of hospital variability in perioperative red blood cell transfusions during coronary artery bypass graft surgery.
This observational cohort study’s objective was to identify to what extent distinguishing patient and procedural characteristics can explain center-level transfusion variation during coronary artery bypass grafting (CABG) surgery. The study used patients from the Perfusion Measures and Outcomes Registry from 43 adult cardiac surgical programs from July 2011 through June 2017. Of the 22,272 adult patients undergoing isolate CABG surgery using cardiopulmonary bypass, 7241 (32.5%) received at least 1 U allogeneic red blood cells. Patients who received transfusions were older (68 vs 64 years), were women (41.5% vs 15.9%), and had a lower body surface area, respectively. The majority of center-level transfusion variations could not be explained through models containing both patient and intraoperative factors.
AHRQ-funded; HS026003.
Citation: Fitzgerald DC, Simpson AN, Baker RA DC, Simpson AN, Baker RA .
Determinants of hospital variability in perioperative red blood cell transfusions during coronary artery bypass graft surgery.
J Thorac Cardiovasc Surg 2022 Mar;163(3):1015-24.e1. doi: 10.1016/j.jtcvs.2020.04.141..
Keywords: Surgery, Heart Disease and Health, Cardiovascular Conditions, Hospitals, Practice Patterns, Disparities
Patel SA, Krasnow M, Long K
Excess 30-day heart failure readmissions and mortality in black patients increases with neighborhood deprivation.
Researchers examined whether neighborhood environment modifies the disparity in 30-day heart failure (HF) readmissions and mortality between Black and White patients in the Southeastern United States. They created a geocoded retrospective cohort of patients hospitalized for acute HF from 2010-2018 within Emory Healthcare. They found that excess 30-day HF readmissions and mortality were present among Black patients in every neighborhood strata and increased with progressive neighborhood socioeconomic deprivation.
AHRQ-funded; HS026081.
Citation: Patel SA, Krasnow M, Long K .
Excess 30-day heart failure readmissions and mortality in black patients increases with neighborhood deprivation.
Circ Heart Fail 2020 Dec;13(12):e007947. doi: 10.1161/circheartfailure.120.007947..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Hospital Readmissions, Racial and Ethnic Minorities, Mortality, Social Determinants of Health, Low-Income, Disparities
Ngo-Metzger Q, Zuvekas S, Shafer P
AHRQ Author: Ngo-Metzger Q, Zuvekas S, Shafer P, Tracer H, Borsky AE, Bierman AS
Ngo-Metzger Q, Zuvekas S, Shafer P, Tracer H, Borsky AE, Bierman AS. Statin use in the U.S. for secondary prevention of cardiovascular disease remains suboptimal.
Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of mortality in the United States. The purpose of this study was to examine the rates of statin use for secondary prevention of ASCVD events in the United States over the last decade and determine whether disparities in the treatment of ASCVD still persist among women and racial/ethnic minorities.
AHRQ-authored.
Citation: Ngo-Metzger Q, Zuvekas S, Shafer P .
Ngo-Metzger Q, Zuvekas S, Shafer P, Tracer H, Borsky AE, Bierman AS. Statin use in the U.S. for secondary prevention of cardiovascular disease remains suboptimal.
J Am Board Fam Med 2019 Nov-Dec;32(6):807-17. doi: 10.3122/jabfm.2019.06.180313..
Keywords: Medical Expenditure Panel Survey (MEPS), Cardiovascular Conditions, Medication, Healthcare Utilization, Prevention, Heart Disease and Health, Disparities
Sterling MR, Echeverria SE, Commodore-Mensah Y
Health equity and implementation science in heart, lung, blood, and sleep-related research: emerging themes from the 2018 Saunders-Watkins Leadership Workshop.
This article discusses the key themes from a 2-day workshop that was held at the National Institutes of Health in May 2018 to promote health equity and implementation science in heart, lung, and sleep-related research. This inaugural workshop was named the Saunders-Watkins Leadership Workshop. Recommendations are offered for the future direction of this research.
AHRQ-funded; HS000066.
Citation: Sterling MR, Echeverria SE, Commodore-Mensah Y .
Health equity and implementation science in heart, lung, blood, and sleep-related research: emerging themes from the 2018 Saunders-Watkins Leadership Workshop.
Circ Cardiovasc Qual Outcomes 2019 Oct;12(10):e005586. doi: 10.1161/circoutcomes.119.005586..
Keywords: Implementation, Evidence-Based Practice, Disparities, Patient-Centered Outcomes Research, Cardiovascular Conditions, Heart Disease and Health, Respiratory Conditions, Sleep Problems
Desai NR, Udell JA, Wang Y
Trends in performance and opportunities for improvement on a composite measure of acute myocardial infarction care.
This study sought to examine trends in patient- and hospital-level performance on a composite defect-free care measure, identify disparities in the performance across sociodemographic groups, and identify opportunities to improve quality and outcomes. Using data from the Chest Pain - Myocardial Infarction Registry, the researchers found that, despite improvements in the proportion of patients with acute myocardial infarction receiving defect-free care overall and across sociodemographic groups, nearly 1 in 4 patients did not receive optimal care; absolute performance was consistently lower among older patients, women, black, and Hispanic patients. They conclude that composite measures of cardiovascular care can illuminate opportunities to improve quality of care.
AHRQ-funded; HS023000.
Citation: Desai NR, Udell JA, Wang Y .
Trends in performance and opportunities for improvement on a composite measure of acute myocardial infarction care.
Circ Cardiovasc Qual Outcomes 2019 Mar;12(3):e004983. doi: 10.1161/circoutcomes.118.004983..
Keywords: Cardiovascular Conditions, Disparities, Heart Disease and Health, Quality of Care, Quality Improvement
Gupta A, Barrabes JA, Strait K
Sex differences in timeliness of reperfusion in young patients with ST-segment-elevation myocardial infarction by initial electrocardiographic characteristics.
Investigators aimed to determine the electrocardiographic correlates of delay in reperfusion in young patients with ST-segment-elevation myocardial infarction. They found that sex disparities in timeliness to reperfusion in young patients with ST-segment-elevation myocardial infarction persisted, despite adjusting for initial electrocardiographic characteristics. They concluded that left ventricular hypertrophy by voltage criteria and absence of prehospital ECG are strongly positively correlated and ST elevation in lateral leads is negatively correlated with reperfusion delay.
AHRQ-funded; HS023000.
Citation: Gupta A, Barrabes JA, Strait K .
Sex differences in timeliness of reperfusion in young patients with ST-segment-elevation myocardial infarction by initial electrocardiographic characteristics.
J Am Heart Assoc 2018 Mar 7;7(6). doi: 10.1161/jaha.117.007021..
Keywords: Sex Factors, Heart Disease and Health, Cardiovascular Conditions, Disparities
Spatz ES, Beckman AL, Wang Y
Geographic variation in trends and disparities in acute myocardial infarction hospitalization and mortality by income levels, 1999-2013.
The researchers sought to determine whether trends in US county-level, risk-standardized acute myocardial infarction (AMI) hospitalization and mortality rates varied by county-based median income level. They concluded that hospitalization and mortality rates of AMI declined among counties of all income levels, although hospitalization rates among low-income counties lag behind those of the higher income groups.
AHRQ-funded; HS023000.
Citation: Spatz ES, Beckman AL, Wang Y .
Geographic variation in trends and disparities in acute myocardial infarction hospitalization and mortality by income levels, 1999-2013.
JAMA Cardiol 2016 Jun 1;1(3):255-65. doi: 10.1001/jamacardio.2016.0382.
.
.
Keywords: Disparities, Hospitalization, Heart Disease and Health, Mortality, Social Determinants of Health
Wallaert JB, Nolan BW, Stone DH
Physician specialty and variation in carotid revascularization technique selected for Medicare patients.
The researchers investigated whether the choice of carotid artery stenting (CAS) vs. carotid endarterectomy (CEA) varies as a function of treating physician specialty, which would result in regional variation in the relative use of these treatment types They found that the proportion of all carotid revascularization procedures performed as CAS varies markedly by geographic region, and regions with the highest proportion of cardiologists perform the most CAS procedures.
AHRQ-funded; HS021581.
Citation: Wallaert JB, Nolan BW, Stone DH .
Physician specialty and variation in carotid revascularization technique selected for Medicare patients.
J Vasc Surg 2016 Jan;63(1):89-97. doi: 10.1016/j.jvs.2015.08.068.
.
.
Keywords: Heart Disease and Health, Medicare, Cardiovascular Conditions, Disparities, Outcomes
Bhave PD, Lu X, Girotra S
Race- and sex-related differences in care for patients newly diagnosed with atrial fibrillation.
The researchers sought to determine whether significant race and sex differences exist in the treatment of newly diagnosed AF in Medicare beneficiaries. They found that there were statistically significant differences in the use of AF-related services by both race and sex, with white patients and male patients receiving the most care.
AHRQ-funded; HS021992.
Citation: Bhave PD, Lu X, Girotra S .
Race- and sex-related differences in care for patients newly diagnosed with atrial fibrillation.
Heart Rhythm 2015 Jul;12(7):1406-12. doi: 10.1016/j.hrthm.2015.03.031..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Racial and Ethnic Minorities, Sex Factors, Disparities
Sims M, Redmond N, Khodneva Y
Depressive symptoms are associated with incident coronary heart disease or revascularization among blacks but not among whites in the Reasons for Geographical and Racial Differences in Stroke study.
The authors examined the association of depressive symptoms with coronary heart disease (CHD) end points by race and income. They found that high depressive symptoms were associated with higher risk of CHD or revascularization for blacks but not whites.
AHRQ-funded; HS023009.
Citation: Sims M, Redmond N, Khodneva Y .
Depressive symptoms are associated with incident coronary heart disease or revascularization among blacks but not among whites in the Reasons for Geographical and Racial Differences in Stroke study.
Ann Epidemiol 2015 Jun;25(6):426-32. doi: 10.1016/j.annepidem.2015.03.014.
.
.
Keywords: Depression, Disparities, Heart Disease and Health, Racial and Ethnic Minorities, Stroke
D'Onofrio G, Safdar B, Lichtman JH
Sex differences in reperfusion in young patients with ST-segment-elevation myocardial infarction: results from the VIRGO study.
Sex disparities in reperfusion therapy for patients with acute ST-segment-elevation myocardial infarction have been documented. The authors tested these patterns in the comparison of young women with men.They found that young women with ST-segment-elevation myocardial infarction are less likely to receive reperfusion therapy and more likely to have reperfusion delays than similarly aged men.
AHRQ-funded; HS023000.
Citation: D'Onofrio G, Safdar B, Lichtman JH .
Sex differences in reperfusion in young patients with ST-segment-elevation myocardial infarction: results from the VIRGO study.
Circulation 2015 Apr 14;131(15):1324-32. doi: 10.1161/circulationaha.114.012293.
.
.
Keywords: Cardiovascular Conditions, Disparities, Heart Disease and Health, Patient-Centered Outcomes Research, Sex Factors
Zhang R, Lee JY, Jean-Jacques M
Factors influencing the increasing disparity in LDL cholesterol control between white and black patients with diabetes in a context of active quality improvement.
The authors conducted a retrospective analysis of black and white patients treated continuously between 2008 and 2010 in order to examine possible causes of an increased disparity in low-density lipoprotein (LDL) cholesterol control following a multifaceted physician-directed quality improvement (QI) initiative. They found that physician-facing, general QI interventions may be insufficient to produce equity in LDL cholesterol control, and that helping patients maintain prior success controlling cholesterol appears as important in addressing this disparity as is helping uncontrolled patients achieve control.
AHRQ-funded; HS021141.
Citation: Zhang R, Lee JY, Jean-Jacques M .
Factors influencing the increasing disparity in LDL cholesterol control between white and black patients with diabetes in a context of active quality improvement.
Am J Med Qual 2014 Jul-Aug;29(4):308-14. doi: 10.1177/1062860613498112.
.
.
Keywords: Heart Disease and Health, Diabetes, Disparities, Quality Improvement, Racial and Ethnic Minorities