National Healthcare Quality and Disparities Report
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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 8 of 8 Research Studies DisplayedChatterjee P, Liao JM, Wang E
Characteristics, utilization, and concentration of outpatient care for dual-eligible Medicare beneficiaries.
The purpose of this study was to describe the distribution of outpatient care for dual-eligible Medicare beneficiaries ("duals") and characterize the intensity of outpatient care utilization of duals vs non-dual-eligible beneficiaries ("nonduals"). The researchers assessed the distribution of outpatient care across physician practices and compared the use of different outpatient services between duals and nonduals. The study found that nearly 80% of outpatient visits for duals were provided by 35% of practices. Compared with low-dual and no-dual practices, high-dual practices served more patients, with morhe comorbidities. Duals had 2 less outpatient visits per year compared with nonduals with substantially fewer subspecialty care visits despite having more comorbidities.
AHRQ-funded; HS027595.
Citation: Chatterjee P, Liao JM, Wang E .
Characteristics, utilization, and concentration of outpatient care for dual-eligible Medicare beneficiaries.
Am J Manag Care 2022 Oct;28(10):e370-e77. doi: 10.37765/ajmc.2022.89189..
Keywords: Ambulatory Care and Surgery, Medicare, Medicaid, Care Management, Healthcare Utilization
Levine DM, Chalasani R, Linder JA
Association of the Patient Protection and Affordable Care Act with ambulatory quality, patient experience, utilization, and cost, 2014-2016.
The national impact of the Patient Protection and Affordable Care Act (ACA) continues to be debated. The purpose of this cross-sectional study was to determine the relationship between the ACA and ambulatory quality, patient experience, utilization, and cost by comparing outcomes before (2011-2013) and after (2014-2016) ACA implementation. The study focused on United States adults between 18 and 64 years of age with income less than and greater than or equal to 400% of the federal poverty level (FPL), who had responded to the annual Medical Expenditure Panel Survey. Researchers conducted analysis of data from a sample of 123,171 individuals between January 2021 and March 2022. The study found that after the implementation of ACA, adults with income levels less than 400% of the FPL received increased high value care such as diagnostic and preventive testing when compared with adults with income 400% or higher of the FPL, and there were no differences in the other quality measures. Individuals with income less than 400% of the FPL had greater improvements in access, experience, and communication measures compared with those who had income greater than or equal to 400% of the FPL. Receipt of primary care services increased for individuals with lower income compared to individuals with higher income and for those with lower income compared to those with higher income, total out-of-pocket expenditures decreased. There were no other differences in utilization or cost between those groups. The researchers concluded that in this study, the ACA was not associated with changes in utilization, quality, or cost, but was related to decreased out-of-pocket expenditures and improved patient access, communication, and experience.
AHRQ-funded; 233201500020I; HS026506; HS028127.
Citation: Levine DM, Chalasani R, Linder JA .
Association of the Patient Protection and Affordable Care Act with ambulatory quality, patient experience, utilization, and cost, 2014-2016.
JAMA Netw Open 2022 Jun 1;5(6):e2218167. doi: 10.1001/jamanetworkopen.2022.18167..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Healthcare Utilization, Ambulatory Care and Surgery, Health Insurance, 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
Hongs S AS, Froehlich T, Clayton Hobbs S
Impact of a cancer urgent care clinic on regional emergency department visits.
In this study, the researchers investigated whether the creation of an urgent care clinic specifically for patients with cancer affected emergency department visits among adults newly diagnosed with cancer? They concluded that although only one in eight emergency department-visiting patients also used the urgent care clinic, the growth rate of emergency department visits fell by half after the urgent care clinic was established.
AHRQ-funded; HS022418.
Citation: Hongs S AS, Froehlich T, Clayton Hobbs S .
Impact of a cancer urgent care clinic on regional emergency department visits.
J Oncol Pract 2019 Jun;15(6):e501-e09. doi: 10.1200/jop.18.00743..
Keywords: Cancer, Emergency Department, Hospitalization, Healthcare Utilization, Ambulatory Care and Surgery
Hill CE, Lin CC, Burke JF
Claims data analyses unable to properly characterize the value of neurologists in epilepsy care.
The authors sought to determine the association of a neurologist visit with health care use and cost outcomes for patients with incident epilepsy using health care claims data for individuals insured by United Healthcare from 2001 to 2016. They found that patients with epilepsy who visited a neurologist had greater subsequent health care use, medical costs, and care escalation than controls. They conclude that their comparison using administrative claims was plausibly confounded by case disease severity, as suggested by higher non-epilepsy care costs, and that linking patient-centered outcomes to claims data may provide the clinical resolution to assess care value within a heterogeneous population.
AHRQ-funded; HS017690; HS022258.
Citation: Hill CE, Lin CC, Burke JF .
Claims data analyses unable to properly characterize the value of neurologists in epilepsy care.
Neurology 2019 Feb 26;92(9):e973-e87. doi: 10.1212/wnl.0000000000007004..
Keywords: Neurological Disorders, Ambulatory Care and Surgery, Healthcare Utilization
Stone C, Gebretsadik T, Lee RL
Trends in health care utilization for asthma exacerbations among diverse populations with asthma in the United States.
This article discusses trends in asthma hospitalization and outpatient visit rates from 2004 to 2010. The rates for all populations included in this study went down during the time period, in particular the population from the Tennessee Medicaid program (49%). Other populations used in the study included subjects 4 to 50 years enrolled in the US Department of Defense Military Health System (MHS), and 3 large integrated health delivery systems (IHCDS) of the Population Based Effectiveness in Asthma and Lung Diseases (PEAL) Network. The 3 PEAL health plans included Harvard Pilgrim Health Care, Kaiser Permanente Georgia, and Kaiser Permanent Northern California. A total of 473,524 subjects in those 3 study populations were identified. These downward trends are encouraging but need to continue, particularly in diverse populations.
AHRQ-funded; HS019669; HS022093.
Citation: Stone C, Gebretsadik T, Lee RL .
Trends in health care utilization for asthma exacerbations among diverse populations with asthma in the United States.
J Allergy Clin Immunol Pract 2018 Jan - Feb;6(1):295-97.e5. doi: 10.1016/j.jaip.2017.07.038..
Keywords: Asthma, Healthcare Utilization, Hospitalization, Healthcare Delivery, Chronic Conditions, Ambulatory Care and Surgery
Martsolf G, Fingar KR, Coffey R
AHRQ Author: Elixhauser A
Association between the opening of retail clinics and low-acuity emergency department visits.
This study assessed whether the opening of retail clinics near emergency departments (ED) is associated with decreased ED utilization for low-acuity conditions. It concluded that with increased patient demand resulting from the expansion of health insurance coverage, retail clinics may emerge as an important care location, but to date, they have not been associated with a meaningful reduction in low-acuity ED visits.
AHRQ-authored; AHRQ-funded.
Citation: Martsolf G, Fingar KR, Coffey R .
Association between the opening of retail clinics and low-acuity emergency department visits.
Ann Emerg Med 2017 Apr;69(4):397-403.e5. doi: 10.1016/j.annemergmed.2016.08.462.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Utilization, Emergency Medical Services (EMS), Health Services Research (HSR), Ambulatory Care and Surgery
Beadles CA, Ellis AR, Lichstein JC
First outpatient follow-up after psychiatric hospitalization: does one size fit all?
This study examined the timing of first outpatient follow-up and subsequent health care utilization for adults with serious mental illness (major depression or schizophrenia) and comorbid general medical conditions. It found that for patients not readmitted within 30 days, follow-up within 30 days appeared to be beneficial on the basis of subsequent service utilization.
AHRQ-funded; HS019659; HS000032.
Citation: Beadles CA, Ellis AR, Lichstein JC .
First outpatient follow-up after psychiatric hospitalization: does one size fit all?
Psychiatr Serv 2015 Apr;66(4):364-72. doi: 10.1176/appi.ps.201400081..
Keywords: Hospitalization, Behavioral Health, Healthcare Utilization, Ambulatory Care and Surgery