National Healthcare Quality and Disparities Report
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- Behavioral Health (2)
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- Sex Factors (1)
- Social Determinants of Health (4)
- Stroke (1)
- Women (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 11 of 11 Research Studies DisplayedGaneshan S, Pierce L, Mourad M
Impact of patient portal-based self-scheduling of diagnostic imaging studies on health disparities.
The purpose of this study was to explore the impact of self-scheduling on equitable access to care. The researchers utilized an electronic health record patient portal at the University of California San Francisco which deployed a self-scheduling tool allowing patients to self-schedule diagnostic imaging studies. The study found that among all patient portal users, Latinx, Black/African American, and non-English speaking patients, as well as patients with Medi-Cal, California's Medicaid program, and Medicare insurance were less likely to self-schedule studies. were all less likely to self-schedule when compared with commercially insured patients.
AHRQ-funded; HS026383.
Citation: Ganeshan S, Pierce L, Mourad M .
Impact of patient portal-based self-scheduling of diagnostic imaging studies on health disparities.
J Am Med Inform Assoc 2022 Nov 14;29(12):2096-100. doi: 10.1093/jamia/ocac152..
Keywords: Disparities, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Severance TS, Njuguna F, Olbara G
An evaluation of the disparities affecting the underdiagnosis of pediatric cancer in Western Kenya.
This study described the international collaboration to investigate disparities affecting the underdiagnosis of pediatric cancer in Western Kenya. Estimates of cancer incidence in similar populations around the world would indicate approximately 1500 patients should be diagnosed each year. However, internal review at a large tertiary hospital noted 200-250 patients were diagnosed annually, suggesting the remaining 75-80% of patients go undiagnosed and do not receive treatment. The authors reviewed 41 malaria slides at a local referring hospital that demonstrated both morphologic and genetic evidence of leukemia. This disparity suggested a lack of education and training that were the lead factors contributing to lower rates of diagnosis.
AHRQ-funded; HS026390.
Citation: Severance TS, Njuguna F, Olbara G .
An evaluation of the disparities affecting the underdiagnosis of pediatric cancer in Western Kenya.
Pediatr Blood Cancer 2022 Oct;69(10):e29768. doi: 10.1002/pbc.29768..
Keywords: Children/Adolescents, Cancer, Disparities, Diagnostic Safety and Quality
Radhakrishnan A, Reyes-Gastelum D, Abrahamse P
Physician specialties involved in thyroid cancer diagnosis and treatment: implications for improving health care disparities.
The authors sought to characterize providers involved in diagnosing and treating thyroid cancer. Patients with differentiated thyroid cancer from the Georgia and Los Angeles County Surveillance, Epidemiology and End Results registries were surveyed. The authors found that, among thyroid cancer patients, 40.6% reported being informed of their diagnosis by their surgeon, 37.9% by their endocrinologist, and 13.5% by their primary care physician (PCP). The researchers concluded that PCPs were involved in thyroid cancer diagnosis and treatment, and their involvement was greater among older patients and patients of minority race/ethnicity.
AHRQ-funded; HS024512.
Citation: Radhakrishnan A, Reyes-Gastelum D, Abrahamse P .
Physician specialties involved in thyroid cancer diagnosis and treatment: implications for improving health care disparities.
J Clin Endocrinol Metab 2022 Feb 17;107(3):e1096-e105. doi: 10.1210/clinem/dgab781..
Keywords: Cancer, Disparities, Diagnostic Safety and Quality, Practice Patterns, Quality Improvement, Quality of Care
Goyal MK, Chamberlain JM, Webb M
Racial and ethnic disparities in the delayed diagnosis of appendicitis among children.
The objective of this 3-year multicenter retrospective cohort study of children was to determine if there are race/ethnicity differences in rates of appendiceal perforation, delayed diagnosis of appendicitis, and diagnostic imaging during prior visit(s). Delayed diagnosis was defined as having at least one emergency department (ED) visit within 7 days preceding the appendicitis diagnosis. Out of 7,298 patients diagnosed with appendicitis and documented race/ethnicity, 2,567 had appendiceal perforation. Non-Hispanic (NH) Black children had a higher likelihood of perforation (36.5% versus 34.9%) then non-Hispanic whites. They also were over twice as likely to have delayed diagnosis (4.7% versus 2.0%). Eighty-nine patients (43.2%) patients with delayed diagnosis had abdominal imaging during the prior visits. However, NH-Black children were less likely to have any imaging (28.2% versus 46.2%) or definitive imaging (10.3% versus 35.9%).
Acad Emerg Med 2021 Sep;28(9):949-56. doi: 10.1111/acem.14142.
Citation: Goyal MK, Chamberlain JM, Webb M .
Racial and ethnic disparities in the delayed diagnosis of appendicitis among children.
Acad Emerg Med 2021 Sep;28(9):949-56. doi: 10.1111/acem.14142..
Keywords: Children/Adolescents, Racial and Ethnic Minorities, Disparities, Diagnostic Safety and Quality
Lacson R, Shi J, Kapoor N
Exacerbation of inequities in use of diagnostic radiology during the early stages of reopening after COVID-19.
Researchers assessed diagnostic radiology examination utilization and associated social determinants of health during the early stages of reopening after state-mandated shutdown of nonurgent services because of COVID-19. They found that, despite resumption of nonurgent services, a marked decrease in radiology examination utilization persisted in all care settings post-shutdown, with more significantly decreased odds ratios for having examinations in inpatient and outpatient settings versus in the emergency department. Inequities worsened, with patients from communities with high rates of poverty, unemployment, and chronic disease having significantly lower odds of undergoing radiology examinations post-shutdown. Patients of Asian race and Hispanic ethnicity had significantly lower odds ratios for having examinations post-shutdown compared with White and non-Hispanic patients, respectively.
AHRQ-funded; HS024722.
Citation: Lacson R, Shi J, Kapoor N .
Exacerbation of inequities in use of diagnostic radiology during the early stages of reopening after COVID-19.
J Am Coll Radiol 2021 May;18(5):696-703. doi: 10.1016/j.jacr.2020.12.009..
Keywords: COVID-19, Disparities, Diagnostic Safety and Quality, Racial and Ethnic Minorities, Social Determinants of Health
Marin JR, Rodean J, Hall M
Racial and ethnic differences in emergency department diagnostic imaging at US children's hospitals, 2016-2019.
Researchers evaluated racial and ethnic differences in the performance of common ED imaging studies and examined patterns across diagnoses. In this study, which evaluated visits by nonhospitalized patients younger than 18 years in 44 US children's hospital EDs, they found that non-Hispanic Black and Hispanic children were less likely to receive diagnostic imaging during ED visits compared with non-Hispanic White children. They recommended further investigation to understand and mitigate these potential disparities in health care delivery and to evaluate the effect of these differential imaging patterns on patient outcomes.
AHRQ-funded; HS026006.
Citation: Marin JR, Rodean J, Hall M .
Racial and ethnic differences in emergency department diagnostic imaging at US children's hospitals, 2016-2019.
JAMA Netw Open 2021 Jan 4(1):e2033710. doi: 10.1001/jamanetworkopen.2020.33710..
Keywords: Children/Adolescents, Hospitals, Emergency Department, Imaging, Racial and Ethnic Minorities, Disparities, Diagnostic Safety and Quality
Fraiman YS, Wojcik MH
The influence of social determinants of health on the genetic diagnostic odyssey: who remains undiagnosed, why, and to what effect?
This review article synthesizes the available evidence regarding population disparities in genetic testing for pediatric rare disease diagnosis and identifies gaps in care. The influence of social determinants of health is known, but this study’s goal is to examine the prevalence and nature of disparities in diagnostic testing. It synthesizes the available evidence regarding disparities, defining the need for further, prospective studies.
AHRQ-funded; HS000063.
Citation: Fraiman YS, Wojcik MH .
The influence of social determinants of health on the genetic diagnostic odyssey: who remains undiagnosed, why, and to what effect?
Pediatr Res 2021 Jan;89(2):295-300. doi: 10.1038/s41390-020-01151-5..
Keywords: Children/Adolescents, Social Determinants of Health, Genetics, Diagnostic Safety and Quality, Screening, Disparities
Bolstad CJ, Moak R, Brown CJ
Neighborhood disadvantage is associated with depressive symptoms but not depression diagnosis in older adults.
This study tested how neighborhood disadvantage (ND) relates to depressive symptomology and diagnosis to assess for neighborhood disparities in mental health care cross-sectionally. Using data from the University of Alabama at Birmingham Study of Aging, the investigators found living in the high and mid-ND tertiles to be associated with depressive symptomology, yet ND had no significant relation to depression diagnosis. They concluded that older adults living in high and mid-disadvantaged neighborhoods may be more likely to experience depressive symptomology but not receive a diagnosis, indicating a possible disparity in mental health care.
AHRQ-funded; HS013852.
Citation: Bolstad CJ, Moak R, Brown CJ .
Neighborhood disadvantage is associated with depressive symptoms but not depression diagnosis in older adults.
Int J Environ Res Public Health 2020 Aug 8;17(16). doi: 10.3390/ijerph17165745..
Keywords: Elderly, Depression, Behavioral Health, Diagnostic Safety and Quality, Disparities, Social Determinants of Health
Klawetter S, McNitt C, Hoffman JA
Perinatal depression in low-income women: a literature review and innovative screening approach.
This paper is a literature review of perinatal depression prevalence, consequences, and screening among low-income women and women of color. The Warm Connections program has an innovative perinatal depression screening protocol and was used with WIC participants. The literature showed mixed findings of perinatal prevalence among low-income women and women of color. There were lower perinatal depression rates in the Warm Connections program in studies using less specific perinatal depression screening instruments with similar samples.
AHRQ-funded; HS026370.
Citation: Klawetter S, McNitt C, Hoffman JA .
Perinatal depression in low-income women: a literature review and innovative screening approach.
Curr Psychiatry Rep 2020 Jan 7;22(1):1. doi: 10.1007/s11920-019-1126-9.
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Keywords: Depression, Pregnancy, Women, Low-Income, Social Determinants of Health, Screening, Behavioral Health, Maternal Care, Disparities, Diagnostic Safety and Quality
Nadpara P, Madhavan SS, Tworek C
Guideline-concordant timely lung cancer care and prognosis among elderly patients in the United States: a population-based study.
This study evaluated the variations in guideline-concordant timely lung cancer care and prognosis among elderly in the US. It found that the time to diagnosis and treatment varied significantly among the elderly. However, 77.5 percent received guideline-concordant timely lung cancer care. The likelihood of receiving timely care significantly decreased with early stage diagnosis, increasing age, non-white race, higher comorbidity score, and lower income.
AHRQ-funded; HS018622.
Citation: Nadpara P, Madhavan SS, Tworek C .
Guideline-concordant timely lung cancer care and prognosis among elderly patients in the United States: a population-based study.
Cancer Epidemiol 2015 Dec;39(6):1136-44. doi: 10.1016/j.canep.2015.06.005.
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Keywords: Cancer: Lung Cancer, Elderly, Guidelines, Disparities, Diagnostic Safety and Quality
Govindarajan P, Friedman BT, Delgadillo JQ
Race and sex disparities in prehospital recognition of acute stroke.
The investigators examined prehospital provider recognition of stroke by race and sex. They found that correct prehospital recognition of stroke was lower among Hispanic patients, Asians, and others, when compared with non-Hispanic whites, and also in women compared with men. They concluded that significant disparities exist in prehospital stroke recognition.
AHRQ-funded; HS017965.
Citation: Govindarajan P, Friedman BT, Delgadillo JQ .
Race and sex disparities in prehospital recognition of acute stroke.
Acad Emerg Med 2015 Mar;22(3):264-72. doi: 10.1111/acem.12595.
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Keywords: Diagnostic Safety and Quality, Disparities, Racial and Ethnic Minorities, Sex Factors, Stroke