National Healthcare Quality and Disparities Report
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Topics
- Access to Care (12)
- Asthma (1)
- Autism (1)
- Behavioral Health (2)
- Brain Injury (1)
- Case Study (1)
- Children's Health Insurance Program (CHIP) (11)
- (-) Children/Adolescents (42)
- Chronic Conditions (1)
- Communication (1)
- COVID-19 (1)
- Dental and Oral Health (3)
- Disabilities (1)
- Disparities (3)
- Electronic Health Records (EHRs) (2)
- Emergency Department (2)
- Healthcare Cost and Utilization Project (HCUP) (3)
- Healthcare Costs (6)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (1)
- (-) Health Insurance (42)
- Hospitalization (2)
- Hospital Readmissions (1)
- Hospitals (1)
- Low-Income (6)
- Medicaid (16)
- Medical Expenditure Panel Survey (MEPS) (6)
- Medication (2)
- Newborns/Infants (1)
- Outcomes (1)
- Payment (2)
- Policy (9)
- Quality Improvement (2)
- Quality Indicators (QIs) (1)
- Quality Measures (2)
- Quality of Care (7)
- Racial and Ethnic Minorities (3)
- Sickle Cell Disease (1)
- Sleep Problems (1)
- Social Determinants of Health (1)
- Surgery (1)
- Trauma (1)
- Uninsured (5)
- Vaccination (2)
- Vulnerable Populations (3)
- Women (1)
- Young Adults (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 25 of 42 Research Studies DisplayedDaw JR, Yekta S, Jacobson-Davies FE
Consistency and adequacy of public and commercial health insurance for US children, 2016 to 2021.
This study used the 2016 to 2021 National Survey of Children’s Health to compare overall rates, COVID-19 public health emergency-related changes, and child and family characteristics associated with inconsistent and inadequate coverage for publicly and commercially insured children. The authors were looking at inconsistent insurance, defined by failure to meet 3 criteria: (1) benefits usually/always sufficient to meet child's needs; (2) coverage usually/always allows child to access needed health care practitioners; and (3) no or usually/always reasonable annual out-of-pocket payments for child's health care. Of this nationally representative sample of 203,691 insured children, 34.5% were publicly insured (mean age 8.4 [4.1] years; 47.4% female) and 65.5% were commercially insured (mean age, 8.7 [5.6]; 49.1% female). Most publicly insured children were either non-Hispanic Black (20.9%) or Hispanic (36.4%); living with 2 married parents (38.4%) or a single parent (33.1%); and had a household income less than 200% of the federal poverty level (79%); and most commercially insured children were non-Hispanic White (62.8%), living with 2 married parents (79.0%); and had a household income of 400% of the federal poverty level or higher (49.1%). Compared with commercially insured children, publicly insured children had higher rates of inconsistent coverage (4.2% vs 1.4%; difference, 2.7 percentage points [pp]) and lower rates of inadequate coverage (12.2% vs 33.0%; difference). Compared with the period from 2016 to 2019, inconsistent insurance decreased by 42% for publicly insured children and inadequate insurance decreased by 6% for commercially insured children during the COVID-19 public health emergency (PHE) (2020-2021).
AHRQ-funded; HS029159.
Citation: Daw JR, Yekta S, Jacobson-Davies FE .
Consistency and adequacy of public and commercial health insurance for US children, 2016 to 2021.
JAMA Health Forum 2023 Nov; 4(11):e234179. doi: 10.1001/jamahealthforum.2023.4179..
Keywords: Children/Adolescents, Health Insurance, COVID-19
Vasan A, Kenyon CC, Fiks AG
Continuous eligibility and coverage policies expanded children's Medicaid enrollment.
Researchers examined children's participation in Medicaid during 2019-21. Their findings found that states that had adopted continuous Medicaid coverage for children during the COVID-19 pandemic experienced a 4.62 percent relative increase in children's Medicaid participation when compared with states with existing continuous eligibility policies.
AHRQ-funded; HS028555.
Citation: Vasan A, Kenyon CC, Fiks AG .
Continuous eligibility and coverage policies expanded children's Medicaid enrollment.
Health Aff 2023 Jun; 42(6):753-58. doi: 10.1377/hlthaff.2022.01465..
Keywords: Children/Adolescents, Medicaid, Policy, Health Insurance, Access to Care
Carlton EF, Becker NV, Moniz MH
Out-of-pocket spending for non-birth-related hospitalizations of privately insured US children, 2017 to 2019.
This study’s goal was to estimate out-of-pocket spending for non-birth pediatric hospitalizations of privately insured children from 2017 to 2019. This study used data from the IBM MarketScan Commercial Database. Among 183,780 hospitalizations, half were for female children, with a median age of 12 (4-16) years. Most (79.0%) hospitalizations were for children with a chronic condition and 24.1% were covered by a high-deductible health plan. Mean (SD) and median (IQR) out-of-pocket spending per hospitalization was $1313 and $656 respectively. Out-of-pocket spending exceeded $3000 for 14.0% of hospitalizations. Factors associated with higher out-of-pocket spending included hospitalization in quarter 1 compared with quarter 4 (average marginal effect [AME], $637) and lack of chronic conditions compared with having a complex chronic condition (AME, $732). Hospitalizations covered by the least generous plans (deductible of $3000 or more and coinsurance of 20% or more) found mean out-of-pocket spending was $1974, while the most generous plans (deductible less than $1000 and coinsurance of 1-19%), mean out-of-pocket spending was found to be $826.
AHRQ-funded; HS025465; HS028817.
Citation: Carlton EF, Becker NV, Moniz MH .
Out-of-pocket spending for non-birth-related hospitalizations of privately insured US children, 2017 to 2019.
JAMA Pediatr 2023 May; 177(5):516-25. doi: 10.1001/jamapediatrics.2023.0130..
Keywords: Children/Adolescents, Healthcare Costs, Hospitalization, Health Insurance
Chu J, Roby DH, Boudreaux MH
Effects of the Children's Health Insurance Reauthorization Act on immigrant children's healthcare access.
The purpose of this study was to estimate the effects of the Children's Health Insurance Reauthorization Act (CHIPRA) on insurance coverage, access, utilization, and health outcomes among immigrant children. The researchers utilized the restricted use 2000-2016 National Health Interview Survey (NHIS)with a sample which included immigrant children between the ages of 0 and 18 born outside the United States, with family income below 300% of the Federal Poverty Level (FPL). The study found that CHIPRA was related with a decrease in uninsured rates and an increase in public insurance enrollment for immigrant children. The effects of CHIPRA became small and statistically not significant 3 years after adoption. The researchers found no significant changes in health care access and utilization, and health outcomes, overall and across subgroups due to CHIPRA. The researchers concluded that the eligibility expansion of CHIPRA was related with increases in public insurance coverage for low-income children. However, no effect of CHIPRA on access to care and health was found.
AHRQ-funded; HS028532.
Citation: Chu J, Roby DH, Boudreaux MH .
Effects of the Children's Health Insurance Reauthorization Act on immigrant children's healthcare access.
Health Serv Res 2022 Dec;57(suppl 2):315-25. doi: 10.1111/1475-6773.14061..
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Access to Care, Vulnerable Populations, Uninsured
Chang L, Rees CA, Michelson KA
Association of socioeconomic characteristics with where children receive emergency care.
This study’s objective was to characterize national associations of neighborhood income and insurance type for children with the characteristics of emergency departments (EDs) from which they receive care. The authors conducted a cross-sectional study of ED visits by children from 2014 to 2017 using the Nationwide Emergency Department Sample. Emergency department characteristics were characterized by pediatric volume category. There was a total of 107.6 million ED visits from 2014 to 2017. Children outside of the wealthiest neighborhood income quartile had lower proportions of visits to high-volume pediatric EDs and greater proportions of visits to low-volume pediatric EDs than children in the wealthiest quartile. Publicly insured children were modestly more likely to visit higher-volume pediatric EDs than privately insurance and uninsured children. This association appears to be principally driven by urban-rural differences in access to pediatric emergency care.
AHRQ-funded; HS026503.
Citation: Chang L, Rees CA, Michelson KA .
Association of socioeconomic characteristics with where children receive emergency care.
Pediatr Emerg Care 2022 Jan;38(1):e264-e67. doi: 10.1097/pec.0000000000002244..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Health Insurance, Uninsured, Low-Income
Lipton 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
Schechter SB, Pantell MS, Parikh K
Impact of a national quality collaborative on pediatric asthma care quality by insurance status.
The objective of this study was to assess whether disparities in asthma care and outcomes based on insurance type existed before a national quality improvement (QI) collaborative, and to determine the effects of the collaborative on these disparities. The investigators concluded that at baseline, children with public insurance had higher asthma health care utilization than those with private insurance, despite receiving more evidence-based care.
AHRQ-funded; HS026383; HS024554; HS024592.
Citation: Schechter SB, Pantell MS, Parikh K .
Impact of a national quality collaborative on pediatric asthma care quality by insurance status.
Acad Pediatr 2021 Aug;21(6):1018-24. doi: 10.1016/j.acap.2021.02.009..
Keywords: Children/Adolescents, Asthma, Chronic Conditions, Disparities, Quality Improvement, Quality of Care, Health Insurance
Zachrison KS, Boggs KM, Gao j
Patient insurance status is associated with care received after transfer among pediatric patients in the emergency department.
The objective of this study was to determine whether frequency of interfacility transfer varied by insurance status among pediatric emergency department (ED) patients. Secondarily, the investigators tested for an association between insurance status and odds of transfer with discharge from the second ED without observation or admission. The investigators concluded that among ED-to-ED transfers, pediatric patients with public or without insurance were more often kept for observation or admission at the second hospital after transfer.
AHRQ-funded; HS024561.
Citation: Zachrison KS, Boggs KM, Gao j .
Patient insurance status is associated with care received after transfer among pediatric patients in the emergency department.
Acad Pediatr 2021 Jul;21(5):877-84. doi: 10.1016/j.acap.2020.11.010..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Health Insurance, Emergency Department
Peltz A, Kan K, Garg A
Racial and ethnic differences in managed care enrollment among US children.
The authors used national survey data to compare rates of HMO enrollment, by race and ethnicity, for children with commercial and public coverage. They found that, when adjusted for sociodemographic characteristics, Hispanic children with public coverage, non-Hispanic Black children with commercial coverage, and Hispanic children with commercial coverage were more likely to be enrolled in HMOs than non-Hispanic White children. They recommended future study to examine the degree to which the observed national imbalance in HMO enrollment results from state-specific policies, family preferences, or coverage affordability.
AHRQ-funded; HS026385.
Citation: Peltz A, Kan K, Garg A .
Racial and ethnic differences in managed care enrollment among US children.
JAMA Netw Open 2021 Apr;4(4):e214162. doi: 10.1001/jamanetworkopen.2021.4162..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Health Insurance, Racial and Ethnic Minorities
Grosse SD, Ji X, Zuvekas
AHRQ Author: Zuvekas SH
Spending on young children with autism spectrum disorder in employer-sponsored plans, 2011-2017.
This study looked at spending trends on young children with autism spectrum disorder (ASD) in employer-sponsored plans from 2011 to 2017. This cross-section analysis examined claims data from large-employer-sponsored health plans and assessed changes in annual expenditures by service type for children ages 3-5 enrolled for 1 year or more, and with two or more claims with ASD billing codes within a calendar year and compared it to all children. Mean spending per children with ASD increased by 51% in 2017 US dollars in 2017, while for all children the increase was 8%. ASD spending accounted for 41% of spending growth for children ages 3-7 during 2011-2017. Outpatient behavioral intervention-related spending increased by 376% during the time period, while spending on all other services increased by 2%.
AHRQ-authored.
Citation: Grosse SD, Ji X, Zuvekas .
Spending on young children with autism spectrum disorder in employer-sponsored plans, 2011-2017.
Psychiatr Serv 2021 Jan;72(1):16-22. doi: 10.1176/appi.ps.202000099.
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Keywords: Children/Adolescents, Autism, Health Insurance, Healthcare Costs
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
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
Bucholz EM,, Schuster MA, Toomey SL
Trends in 30-day readmission for Medicaid and privately insured pediatric patients: 2010-2017.
This study examined trends in 30-day readmission rates for Medicaid and privately insured pediatric patients from 2010 to 2017. The HCUP Nationwide Readmissions Database was used to compare hospital-level risk-adjusted readmission rates. Higher readmission rates were found for Medicaid beneficiaires compared to privately insured pediatric patients during the time period.
AHRQ-funded; HS020513; HS025299.
Citation: Bucholz EM,, Schuster MA, Toomey SL .
Trends in 30-day readmission for Medicaid and privately insured pediatric patients: 2010-2017.
Pediatrics 2020 Aug;146(2). doi: 10.1542/peds.2020-0270..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Hospital Readmissions, Health Insurance, Medicaid, Hospitals
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
Mackie TI, Cook S, Crystal S
Antipsychotic use among youth in foster care enrolled in a specialized managed care organization intervention.
This study examined a multimodal antipsychotic intervention implemented by a specialized Medicaid managed care organization (MMCO) for youths in foster care with routine mental health screening, health passports, elective psychiatric consultation line, and retrospective drug utilization reviews to determine whether this multimodal intervention significantly reduced antipsychotic dispensing for youths with conditions without US Food and Drug Administration (FDA)-approved indications. Findings showed that MMCO implementation significantly reduced antipsychotic medications without FDA-indicated conditions prescribed to youths, while not significantly affecting antipsychotic medications prescribed to youths with FDA-indicated conditions.
AHRQ-funded; HS026001.
Citation: Mackie TI, Cook S, Crystal S .
Antipsychotic use among youth in foster care enrolled in a specialized managed care organization intervention.
J Am Acad Child Adolesc Psychiatry 2020 Jan;59(1):166-76.e3. doi: 10.1016/j.jaac.2019.04.022..
Keywords: Children/Adolescents, Behavioral Health, Medication, Vulnerable Populations, Medicaid, Health Insurance
Olin S, Storfer-Isser A, Morden E
Quality measures for managing prescription of antipsychotic medication among youths: factors associated with health plan performance.
This study examined the performance of health plans on two Healthcare Effectiveness Data and Information Set (HEDIS) measures: metabolic monitoring of children and adolescents prescribed an antipsychotic and use of first-line psychosocial care for children and adolescents prescribed an antipsychotic for a nonindicated use. This study then identified key plan characteristics and other contextual factors associated with health plan performance on quality measures related to pediatric antipsychotic prescribing. Findings suggested that quality measures, in conjunction with policies such as prior authorization, can encourage better care delivery to vulnerable populations.
ARHQ-funded; HS020503; HS025296.
Citation: Olin S, Storfer-Isser A, Morden E .
Quality measures for managing prescription of antipsychotic medication among youths: factors associated with health plan performance.
Psychiatr Serv 2019 Nov;70(11):1020-26. doi: 10.1176/appi.ps.201900089..
Keywords: Children/Adolescents, Medication, Behavioral Health, Quality Measures, Quality of Care, Health Insurance
Kemmick Pintor J, Call KT
State-level immigrant prenatal health care policy and inequities in health insurance among children in mixed-status families.
Investigators sought to measure differences in insurance by mother's documentation status among a nationally representative sample of US-born children in immigrant families and to examine the role of state-level immigrant access to prenatal coverage. They found that, in states with nonrestrictive prenatal coverage for immigrants, there were no differences in children's insurance by mother's documentation status, while large inequities were observed within states with restrictive policies.
AHRQ-funded; HS021973.
Citation: Kemmick Pintor J, Call KT .
State-level immigrant prenatal health care policy and inequities in health insurance among children in mixed-status families.
Glob Pediatr Health 2019 Sep 26;6:2333794x19873535. doi: 10.1177/2333794x19873535..
Keywords: Policy, Health Insurance, Children/Adolescents, Access to Care, Vulnerable Populations, Disparities
Chien AT, Toomey SL, Kuo DZ
Care quality and spending among commercially insured children with disabilities.
Researchers examined the prevalence of children with disabilities (CWD) within a commercially insured population and compared outpatient care quality and annual health plan spending levels for CWD relative to children with complex medical conditions without disabilities; children with chronic conditions that are not complex; and children without disabling, complex, or chronic conditions. The cross-sectional study comprised over 1M person-years of Blue Cross Blue Shield Massachusetts data for beneficiaries aged from 1 to 19 years. The researchers found that CWD were prevalent in the commercially insured population, with these children experiencing suboptimal levels of care which were comparable to non-CWD groups. They concluded that improving the care value for CWD involves a deeper understanding of what higher spending delivers and additional aspects of care quality.
AHRQ-funded; HS025299.
Citation: Chien AT, Toomey SL, Kuo DZ .
Care quality and spending among commercially insured children with disabilities.
Acad Pediatr 2019 Apr;19(3):291-99. doi: 10.1016/j.acap.2018.06.004..
Keywords: Quality of Care, Children/Adolescents, Disabilities, Healthcare Costs, Health Insurance
Allen CD
Who loses public health insurance when states pass restrictive omnibus immigration-related laws? The moderating role of county Latino density.
Using comparative interrupted time series methods and a nationally-representative sample of US citizen, Latino children with noncitizen parents from the National Health Interview Survey (2005-2014, n=18,118), this study found that living in counties with higher co-ethnic density placed children at greater risk of losing Medicaid and Children's Health Insurance Program coverage when their states passed restrictive state omnibus immigrant laws.
AHRQ-funded; HS024248.
Citation: Allen CD .
Who loses public health insurance when states pass restrictive omnibus immigration-related laws? The moderating role of county Latino density.
Health Place 2018 Nov;54:20-28. doi: 10.1016/j.healthplace.2018.08.023..
Keywords: Access to Care, Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Medicaid, Racial and Ethnic Minorities
Silber JH, Zeigler AE, Reiter JG
Using appendicitis to improve estimates of childhood Medicaid participation rates.
This study introduces appendectomy-based participation (ABP) to estimate statewide Medicaid/Children's Health Insurance Program participation rates using claims by taking advantage of a natural experiment around statewide appendicitis admissions to improve the accuracy of participation rate estimates. The study concluded that using the ABP rate derived from Medicaid Analytic eXtract (MAX) administrative claims is a valid method to estimate statewide public insurance participation rates in children.
AHRQ-funded; HS023258; HS021112.
Citation: Silber JH, Zeigler AE, Reiter JG .
Using appendicitis to improve estimates of childhood Medicaid participation rates.
Acad Pediatr 2018 Jul;18(5):593-600. doi: 10.1016/j.acap.2018.03.008..
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Medicaid
Wisk LE, Finkelstein JA, Toomey SL
Impact of an individual mandate and other health reforms on dependent coverage for adolescents and young adults
The purpose of this study is to determine the effect of state-level dependent coverage expansion (DCE), with and without other state health reforms, on exit from dependent coverage for adolescents and young adults (AYA). The study found that an individual mandate and other reforms may enhance the effect of DCE in preventing loss of coverage among AYA.
AHRQ-funded; HS000063; HS025299.
Citation: Wisk LE, Finkelstein JA, Toomey SL .
Impact of an individual mandate and other health reforms on dependent coverage for adolescents and young adults
Health Serv Res 2018 Jun;53(3):1581-99. doi: 10.1111/1475-6773.12723..
Keywords: Children/Adolescents, Health Insurance, Policy, Policy, Young Adults
Ireys HT, Brach C, Anglin G
AHRQ Author: Brach C
After the demonstration: what states sustained after the end of federal grants to improve children's health care quality.
As part of the CHIPRA Quality Demonstration Grant Program’s multifaceted evaluation, this study examined the extent to which states sustained key program activities after the demonstration ended. It concluded that as a result of the federal government's investment in this grant program, many demonstration states are in a strong position to extend and spread specific strategies for improving the quality of care for children in Medicaid and CHIP.
AHRQ-authored; AHRQ-funded; 29020090002191.
Citation: Ireys HT, Brach C, Anglin G .
After the demonstration: what states sustained after the end of federal grants to improve children's health care quality.
Matern Child Health J 2018 Feb;22(2):195-203. doi: 10.1007/s10995-017-2391-z.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Quality of Care, Health Insurance, Medicaid
Burton RA, Peters RA, Devers KJ
Perspectives on implementing quality improvement collaboratives effectively: qualitative findings from the CHIPRA quality demonstration grant program.
The most frequently pursued intervention in the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) quality demonstration (2010-2015) was quality improvement collaboratives. This study was conducted to identify which aspects of these collaboratives were viewed by organizers and participants as working well and which were not. It found that aspects of collaboratives that interviewees valued were aimed at attracting participation, maintaining engagement, or facilitating learning.
AHRQ-funded; 2902009000191.
Citation: Burton RA, Peters RA, Devers KJ .
Perspectives on implementing quality improvement collaboratives effectively: qualitative findings from the CHIPRA quality demonstration grant program.
Jt Comm J Qual Patient Saf 2018 Jan;44(1):12-22. doi: 10.1016/j.jcjq.2017.08.004.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Quality of Care, Quality Improvement
Hudson JL, Moriya AS
AHRQ Author: Hudson JL, Moriya AS
Medicaid expansion for adults had measurable 'welcome mat' effects on their children.
This study used data from the 2013-15 American Community Survey to provide the first national-level (analytical) estimates of welcome-mat effects on children's coverage post Affordable Care Act (ACA). It estimated that 710,000 low-income children gained coverage through these effects. The study was also the first to show a link between parents' eligibility for Medicaid and welcome-mat effects for their children under the ACA.
AHRQ-authored.
Citation: Hudson JL, Moriya AS .
Medicaid expansion for adults had measurable 'welcome mat' effects on their children.
Health Aff 2017 Sep;36(9):1643-51. doi: 10.1377/hlthaff.2017.0347.
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Keywords: Children/Adolescents, Health Insurance, Policy, Low-Income