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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 DisplayedJames TG, Sullivan MK, McKee MM
Emergency department patient-centred care perspectives from deaf and hard-of-hearing patients.
The objectives of this qualitative study were to describe emergency department (ED) care-seeking and patient-centered care perspectives among deaf and hard-of-hearing (DHH) patients and to explain quantitative findings related to ED outcomes among DHH and non-DHH patients. Researchers conducted semi-structured interviews with four DHH American Sign Language (ASL)-users and six DHH English speakers from north central Florida. Two themes emerged: DHH patients engage in complex decisionmaking processes to determine ED utilization and patient-centered ED care differs between DHH ASL-users and English speakers. The researchers concluded that their study underscores the importance of better understanding and intervention in DHH patient ED care seeking and delivery to improve patient outcomes.
AHRQ-funded; HS027537.
Citation: James TG, Sullivan MK, McKee MM .
Emergency department patient-centred care perspectives from deaf and hard-of-hearing patients.
Health Expect 2023 Dec; 26(6):2374-86. doi: 10.1111/hex.13842..
Keywords: Emergency Department, Patient-Centered Healthcare, Disabilities, Vulnerable Populations
Chang L, Stewart AM, Kester K
Association of homelessness with emergency department use among children in New York.
This research letter describes a cross-sectional study that was conducted to evaluate the association of homelessness with emergency department (ED) use among children in New York. The study used the HCUP State Emergency Department Database and State Inpatient Database for New York including children 18 years and younger with an ED visit between 2014 and 2018. The primary outcome was frequent ED use, defined as 4 or more visits per calendar year. The authors determined visit incident rates for all children for ambulatory care-sensitive conditions (asthma, diabetes, gastroenteritis, urinary tract infection), injuries and poisonings, and mental health problems based on ICD-9 and ICD-10 codes. Frequent ED use was more common among children experiencing homelessness, occurring in 22.1% vs 4.3% of children who were housed. Children experiencing homelessness had higher incidences of asthma, diabetes, urinary tract infections, and mental health problems and lower incidences of injuries and poisonings, which lead to higher admission rates overall (42.1% vs 0.7%) and to ICUs (4.1% vs 0.7%). Admission rates were higher across all diagnoses and to ICUs for asthma, gastroenteritis, and injuries and poisonings. ED usage rates were highest for homeless children aged 12-17 (40.2% of all children).
AHRQ-funded; HS026503.
Citation: Chang L, Stewart AM, Kester K .
Association of homelessness with emergency department use among children in New York.
JAMA Pediatr 2023 Jun; 177(6):637-40. doi: 10.1001/jamapediatrics.2023.0478..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Vulnerable Populations, Emergency Department
Sonik RA, Coleman-Jensen A, Creedon TB
SNAP participation and emergency department use.
The objectives of this study were to examine whether Supplemental Nutrition Assistance Program (SNAP) participation is associated with emergency department use among low-income children, and whether any such association is mediated by household food hardship and child health status and/or moderated by special health care needs (SHCN) status. Researched pooled cross-sectional samples of children in low-income households from 2016-19 National Survey of Children's Health. SNAP participation was found to be associated with lower likelihoods of emergency department use. The researchers concluded that food hardship relief may improve outcomes for vulnerable children as well as the health systems that serve them.
poverty food
Citation: Sonik RA, Coleman-Jensen A, Creedon TB .
SNAP participation and emergency department use.
Pediatrics 2023 Feb;151(2):e2022058247. doi: 10.1542/peds.2022-058247.
Keywords: Children/Adolescents, Nutrition, Vulnerable Populations, Low-Income, Emergency Department
James TG, Miller MD, McKee MM
Emergency department condition acuity, length of stay, and revisits among deaf and hard-of-hearing patients: a retrospective chart review.
This study assessed emergency department (ED) condition acuity, length of stay (LOS), and acute ED revisits among deaf and hard-of-hearing (DHH) patients. Findings identified that DHH American Sign Language users have longer ED LOS than non-DHH English-speakers.
AHRQ-funded; HS027537.
Citation: James TG, Miller MD, McKee MM .
Emergency department condition acuity, length of stay, and revisits among deaf and hard-of-hearing patients: a retrospective chart review.
Acad Emerg Med 2022 Nov;29(11):1290-300. doi: 10.1111/acem.14573..
Keywords: Emergency Department, Disabilities, Vulnerable Populations
Schulson L, Lin MY, Paasche-Orlow MK
Limited English proficient patient visits and emergency department admission rates for ambulatory care sensitive conditions in California: a retrospective cohort study.
Little is known about the risk of admission for emergency department (ED) visits for ambulatory care sensitive conditions (ACSCs) by limited English proficient (LEP) patients. The objective of this study was to estimate admission rates from ED for ACSCs comparing LEP and English proficient (EP) patients and examine how these rates varied at hospitals with a high versus low proportion of LEP patients.
AHRQ-funded; HS022242.
Citation: Schulson L, Lin MY, Paasche-Orlow MK .
Limited English proficient patient visits and emergency department admission rates for ambulatory care sensitive conditions in California: a retrospective cohort study.
J Gen Intern Med 2021 Sep;36(9):2683-91. doi: 10.1007/s11606-020-06523-5..
Keywords: Emergency Department, Vulnerable Populations, Communication
Walter LA, Schoenfeld EM, Smith CH
Emergency department-based interventions affecting social determinants of health in the United States: a scoping review.
Emergency departments (EDs) function as the safety nets of the American health care system, caring for many vulnerable populations. ED-based interventions to assess social risk and mitigate social needs have been reported in the literature. However, the breadth and scope of these interventions have not been evaluated. As the field of social emergency medicine (SEM) expands, a mapping and categorization of previous interventions may help shape future research. In this study, the investigators sought to identify, summarize, and characterize ED-based interventions aimed at mitigating negative social determinants of health.
AHRQ-funded; HS025701; HS013852.
Citation: Walter LA, Schoenfeld EM, Smith CH .
Emergency department-based interventions affecting social determinants of health in the United States: a scoping review.
Acad Emerg Med 2021 Jun;28(6):666-74. doi: 10.1111/acem.14201..
Keywords: Emergency Department, Social Determinants of Health, Vulnerable Populations, Low-Income
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
Moulin A, Evans EJ, Xing G
Substance use, homelessness, mental illness and Medicaid coverage: a set-up for high emergency department utilization.
The objective of this study was to identify characteristics unique to patients with psychiatric illness who are frequent emergency department (ED) users for mental health care. The authors suggest that understanding unique features of this population could lead to better care and lower healthcare costs. The authors concluded that patients with substance use disorders, homelessness and public healthcare coverage were more likely to be frequent users of EDs for mental illness.
AHRQ-funded; HS022236.
Citation: Moulin A, Evans EJ, Xing G .
Substance use, homelessness, mental illness and Medicaid coverage: a set-up for high emergency department utilization.
West J Emerg Med 2018 Nov;19(6):902-06. doi: 10.5811/westjem.2018.9.38954..
Keywords: Emergency Department, Medicaid, Healthcare Utilization, Behavioral Health, Substance Abuse, Vulnerable Populations
Malik S, Lee DC, Doran KM
Vulnerability of older adults in disasters: emergency department utilization by geriatric patients after Hurricane Sandy.
Older adults are a potentially medically vulnerable population with increased mortality rates during and after disasters. To evaluate the impact of a natural disaster on this population, the authors of this study performed a temporal and geospatial analysis of emergency department (ED) use by adults aged 65 years and older in New York City (NYC) following Hurricane Sandy's landfall.
AHRQ-funded; HS024172.
Citation: Malik S, Lee DC, Doran KM .
Vulnerability of older adults in disasters: emergency department utilization by geriatric patients after Hurricane Sandy.
Disaster Med Public Health Prep 2018 Apr;12(2):184-93. doi: 10.1017/dmp.2017.44..
Keywords: Elderly, Emergency Department, Vulnerable Populations, Public Health, Healthcare Utilization
Castaneda-Guarderas A, Glassbereg J, Grudzen CR
Shared decision making with vulnerable populations in the emergency department.
The authors introduce a research agenda that includes community-engaged approaches, mixed-methods studies, and cost-effectiveness analyses to address questions of shared decision making (SDM) among vulnerable groups at a disadvantage in the healthcare system, as well as changes that are needed, and how to cultivate and teach these competencies.
AHRQ-funded; HS024172.
Citation: Castaneda-Guarderas A, Glassbereg J, Grudzen CR .
Shared decision making with vulnerable populations in the emergency department.
Acad Emerg Med 2016 Dec;23(12):1410-16. doi: 10.1111/acem.13134.
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Keywords: Cultural Competence, Decision Making, Emergency Department, Patient and Family Engagement, Vulnerable Populations
Figueiredo R, Dempster L, Quinonez C
Emergency department use for dental problems among homeless individuals: a population-based cohort study.
The researchers evaluated emergency department (ED) visits for dental problems among Toronto's homeless population (Ontario, Canada). They found that over 80% of the ED visits by homeless people were for odontogenic infections, and 46% of homeless people had more than one such visit. They concluded that access to dental care is inadequate and that ED settings are ineffective for treatment of dental problems.
AHRQ-funded; HS014129.
Citation: Figueiredo R, Dempster L, Quinonez C .
Emergency department use for dental problems among homeless individuals: a population-based cohort study.
J Health Care Poor Underserved 2016;27(2):860-8. doi: 10.1353/hpu.2016.0081.
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Keywords: Access to Care, Dental and Oral Health, Emergency Department, Vulnerable Populations