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
376 to 400 of 417 Research Studies DisplayedToro-Diaz H, Mayorga ME, Barritt AS
Predicting liver transplant capacity using discrete event simulation.
The researchers constructed a discrete event simulation model informed by current donor characteristics to predict future liver transplant trends through the year 2030. They found that by altering assumptions about the future donor pool, their model can be used to develop policy interventions to prevent a further decline in this lifesaving therapy.
AHRQ-funded; HS019468.
Citation: Toro-Diaz H, Mayorga ME, Barritt AS .
Predicting liver transplant capacity using discrete event simulation.
Med Decis Making 2015 Aug;35(6):784-96. doi: 10.1177/0272989x14559055.
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Keywords: Access to Care, Health Services Research (HSR), Policy, Transplantation
Silverberg JI
Health care utilization, patient costs, and access to care in US adults with eczema: a population-based study.
This study examined the out-of-pocket costs, health care access and utilization in adult eczema in the United States. It found that adults with eczema had $371 to $489 higher out-of-pocket costs per person-year compared with those without eczema, with higher odds of increased out-of-pocket costs.
AHRQ-funded; HS023011.
Citation: Silverberg JI .
Health care utilization, patient costs, and access to care in US adults with eczema: a population-based study.
JAMA Dermatol 2015 Jul;151(7):743-52. doi: 10.1001/jamadermatol.2014.5432.
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Keywords: Access to Care, Healthcare Costs, Healthcare Utilization, Skin Conditions
Malecki K, Wisk LE, Walsh M
Oral health equity and unmet dental care needs in a population-based sample: findings from the Survey of the Health of Wisconsin.
The authors explored individual-, psychosocial-, and community-level predictors of oral health status in the Survey of the Health of Wisconsin Oral Health Screening project. Their results suggested that costs were a primary predictor of access to care and poor oral health status, underscoring the role that primary care, in conjunction with dental health care providers, could play in promoting oral health care, particularly in reducing barriers and promoting preventive health behaviors.
AHRQ-funded; HS000063.
Citation: Malecki K, Wisk LE, Walsh M .
Oral health equity and unmet dental care needs in a population-based sample: findings from the Survey of the Health of Wisconsin.
Am J Public Health 2015 Jul;105 Suppl 3:S466-74. doi: 10.2105/ajph.2014.302338.
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Keywords: Access to Care, Dental and Oral Health, Disparities, Healthcare Costs, Health Services Research (HSR)
Geissler KH, Holmes GM
Emergency department use in the US-Mexico border region and violence in Mexico: is there a relationship?
This study assessed the association between homicide rates in northern Mexico and potentially avoidable use of emergency departments (ED) in the US-Mexico border region. It concluded that a substantial majority of ED encounters in the US-Mexico border region were potentially avoidable. However, there was not a strong relationship between homicide rates in northern Mexico and the distribution of ED discharges in Arizona and California.
AHRQ-funded; HS021074.
Citation: Geissler KH, Holmes GM .
Emergency department use in the US-Mexico border region and violence in Mexico: is there a relationship?
J Rural Health 2015 Summer;31(3):316-25. doi: 10.1111/jrh.12109.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Medical Services (EMS), Healthcare Utilization, Access to Care, Vulnerable Populations
Ripley DC, Kwong PL, Vogel WB
How does geographic access affect in-hospital mortality for veterans with acute ischemic stroke?
This study examined the relationship between estimated travel time to admitting hospital and mortality for veterans with acute ischemic stroke. It found that even after adjusting for the confounding effects of patient, treatment, and facility characteristics, travel time from home to admitting VAMC was significantly associated with inhospital mortality.
AHRQ-funded; HS018540.
Citation: Ripley DC, Kwong PL, Vogel WB .
How does geographic access affect in-hospital mortality for veterans with acute ischemic stroke?
Med Care 2015 Jun;53(6):501-9. doi: 10.1097/mlr.0000000000000366..
Keywords: Stroke, Mortality, Access to Care
Dumas SA, Polk D
Pediatric dental clinic location and utilization in a high-resource setting.
This study examined dental utilization by Medicaid-insured children living in a high-resource area and characterized distance and travel-related variables to accessing care. It concluded that closer proximity may contribute to the higher utilization of services observed compared with national rates.
AHRQ-funded; HS019486.
Citation: Dumas SA, Polk D .
Pediatric dental clinic location and utilization in a high-resource setting.
J Public Health Dent 2015 Summer;75(3):183-90. doi: 10.1111/jphd.12086.
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Keywords: Children/Adolescents, Healthcare Utilization, Dental and Oral Health, Access to Care, Medicaid
Suskind AM, Zhang Y, Dunn RL
Understanding the diffusion of ambulatory surgery centers.
The objective of this study was to understand potential facilitators and/or barriers to the introduction of freestanding ambulatory surgical centers (ASCs) in the United States. It found that ASCs were more likely to open in hospital service areas that were urban, had higher per capita income, and less competition for outpatient surgery.
AHRQ-funded; HS020927; HS018726.
Citation: Suskind AM, Zhang Y, Dunn RL .
Understanding the diffusion of ambulatory surgery centers.
Surg Innov 2015 Jun;22(3):257-65. doi: 10.1177/1553350614546004..
Keywords: Ambulatory Care and Surgery, Access to Care, Surgery
Sylvia LG, Thase ME, Reilly-Harrington NA
Psychotherapy use in bipolar disorder: association with functioning and illness severity.
The researchers examined characteristics of individuals with bipolar disorder who sought psychotherapy versus those who did not. Their data suggest that a minority of individuals with bipolar disorder attend psychotherapy services, and those that do have greater illness burden.
AHRQ-funded; HS019371.
Citation: Sylvia LG, Thase ME, Reilly-Harrington NA .
Psychotherapy use in bipolar disorder: association with functioning and illness severity.
Aust N Z J Psychiatry 2015 May;49(5):453-61. doi: 10.1177/0004867415569803..
Keywords: Access to Care, Healthcare Utilization, Behavioral Health
Mullen MT, Branas CC, Kasner SE
Optimization modeling to maximize population access to comprehensive stroke centers.
This report demonstrates how mathematical optimization modeling can inform the strategic development of the US network of stroke centers by simulating the conversion of primary stroke centers into comprehensive stroke centers (CSCs). Optimal system simulation can be used to develop efficient care systems that maximize accessibility. Under optimal conditions, a large proportion of the US population will be unable to access a CSC within 60 minutes.
AHRQ-funded; HS013852; HS017960; HS010914.
Citation: Mullen MT, Branas CC, Kasner SE .
Optimization modeling to maximize population access to comprehensive stroke centers.
Neurology 2015 Mar 24;84(12):1196-205. doi: 10.1212/wnl.0000000000001390..
Keywords: Stroke, Access to Care, Health Services Research (HSR)
Panattoni L, Stone A, Chung S
Patients report better satisfaction with part-time primary care physicians, despite less continuity of care and access.
The researchers examined the relationships between a physicians’ clinical full-time equivalent (FTE), continuity of care, access to care, and patient satisfaction with the physician. Their results suggest that PCPs who choose to work fewer clinical hours may have worse continuity and access, but they may provide a better patient experience.
AHRQ-funded; HS019815; HS019167.
Citation: Panattoni L, Stone A, Chung S .
Patients report better satisfaction with part-time primary care physicians, despite less continuity of care and access.
J Gen Intern Med 2015 Mar;30(3):327-33. doi: 10.1007/s11606-014-3104-6..
Keywords: Patient Experience, Primary Care, Access to Care
Olenik NL, Gonzalvo JD, Snyder ME
Perceptions of Spanish-speaking clientele of patient care services in a community pharmacy.
This study aimed to identify perceptions of Spanish-speaking patients living in the U.S. with a focus on the care provided in community pharmacies, as well as to determine their satisfaction with community pharmacies. Based on 12 interviews, it found that primary themes included lack of insurance coupled with high medical care costs serving as a barrier for acquisition of health care and difficulty accessing timely and convenient primary care.
AHRQ-funded; HS022119.
Citation: Olenik NL, Gonzalvo JD, Snyder ME .
Perceptions of Spanish-speaking clientele of patient care services in a community pharmacy.
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Keywords: Access to Care, Community-Based Practice, Provider: Pharmacist, Racial and Ethnic Minorities
Chang E, Chan KS, Han HR
Effect of acculturation on variations in having a usual source of care among Asian Americans and non-Hispanic whites in California.
This study explored factors influencing the disparity between Asian American and non-Hispanic whites in having a usual source of care (USC). The researchers found that the disparity in having a USC to be statistically nonsignificant after adding acculturation factors such as English proficiency and length of residence. Increasing levels of education and insurance were not associated with better access among Asian Americans.
AHRQ-funded; HS021684
Citation: Chang E, Chan KS, Han HR .
Effect of acculturation on variations in having a usual source of care among Asian Americans and non-Hispanic whites in California.
Am J Pub Health. 2015 Feb;105(2):398-407. doi: 10.2105/ajph.2014.301950..
Keywords: Disparities, Social Determinants of Health, Racial and Ethnic Minorities, Access to Care
Boss EF, Benke JR, Tunkel DE
Public insurance and timing of polysomnography and surgical care for children with sleep-disordered breathing.
The purpose of this study was (1) to evaluate receipt and timing of polysomnography (PSG) in relation to ultimate surgical therapy with adenotonsillectomy for children undergoing evaluation for sleep-disordered breathing and (2) to evaluate differences based on socioeconomic status. It found that referral for PSG resulted in significant loss to follow-up for all children and delayed definitive surgical treatment for children with public insurance.
AHRQ-funded; HS022932.
Citation: Boss EF, Benke JR, Tunkel DE .
Public insurance and timing of polysomnography and surgical care for children with sleep-disordered breathing.
JAMA Otolaryngol Head Neck Surg 2015 Feb;141(2):106-11. doi: 10.1001/jamaoto.2014.3085..
Keywords: Children/Adolescents, Sleep Problems, Social Determinants of Health, Access to Care, Health Insurance, Surgery
Binswanger IA, Whitley E, Haffey PR
A patient navigation intervention for drug-involved former prison inmates.
The researchers designed a randomized controlled trial of patient navigation to reduce barriers to health care and hospitalizations for former prison inmates. They found recruitment of former inmates highly feasible, but found that follow-up was limited by rearrests. They concluded that their results suggest a significantly lower rate of hospitalizations among navigation participants, although the rate of emergency department/urgent care visits was not improved.
AHRQ-funded; HS019464.
Citation: Binswanger IA, Whitley E, Haffey PR .
A patient navigation intervention for drug-involved former prison inmates.
Subst Abus 2015;36(1):34-41. doi: 10.1080/08897077.2014.932320.
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Keywords: Access to Care, Emergency Medical Services (EMS), Healthcare Utilization, Hospitalization, Substance Abuse
Angier H, Hoopes M, Gold R
An early look at rates of uninsured safety net clinic visits after the Affordable Care Act.
The researchers tested the hypothesis that rates of uninsured safety net clinic visits would significantly decrease in states that implemented Medicaid expansion, compared with states that did not. They found that, overall, clinics in the expansion states had a 40% decrease in the rate of uninsured visits in the postexpansion period and a 36% increase in the rate of Medicaid-covered visits, while clinics in the nonexpansion states had a significant 16% decline in the rate of uninsured visits but no change in the rate of Medicaid-covered visits. They concluded that their findings suggest that Affordable Care Act-related Medicaid expansions have successfully decreased the number of uninsured safety net patients in the United States.
AHRQ-funded; HS021522.
Citation: Angier H, Hoopes M, Gold R .
An early look at rates of uninsured safety net clinic visits after the Affordable Care Act.
Ann Fam Med 2015 Jan-Feb;13(1):10-6. doi: 10.1370/afm.1741.
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Keywords: Uninsured, Community-Based Practice, Primary Care, Medicaid, Access to Care
Scott JW, Sommers BD, Tsai TC
Dependent coverage provision led to uneven insurance gains and unchanged mortality rates in young adult trauma patients.
The Affordable Care Act (ACA) allows young adults to remain covered under their parents’ plans until age 26. This study conducted a difference-in-differences analysis of coverage rates among trauma patients ages 19-25 (compared to patients ages 26 to 34) and examined trauma-relevant outcomes. It found a 3.4 percent decrease in uninsurance status among younger trauma patients following the ACA policy change.
AHRQ-funded; HS000055
Citation: Scott JW, Sommers BD, Tsai TC .
Dependent coverage provision led to uneven insurance gains and unchanged mortality rates in young adult trauma patients.
Health Aff. 2015 Jan;34(1):125-33. doi: 10.1377/hlthaff.2014.0880..
Keywords: Access to Care, Healthcare Costs, Health Insurance, Outcomes
Kranz AM, Rozier RG, Preisser JS
Examining continuity of care for Medicaid-enrolled children receiving oral health services in medical offices.
To understand continuity of oral health services for Medicaid-enrolled children utilizing the North Carolina (NC) Into the Mouths of Babes (IMB) preventive oral health program, the researchers examined the time to a dentist visit after a child’s third birthday. They found that children with only IMB visits compared to only dentist visits before age 3 had lower rates of dentist visits after their third birthday.
AHRQ-funded; HS000032.
Citation: Kranz AM, Rozier RG, Preisser JS .
Examining continuity of care for Medicaid-enrolled children receiving oral health services in medical offices.
Matern Child Health J 2015 Jan;19(1):196-203. doi: 10.1007/s10995-014-1510-3..
Keywords: Access to Care, Children/Adolescents, Community-Based Practice, Dental and Oral Health, Medicaid
Dy CY, Marx RG, Ghomrawi HM
The potential influence of regionalization strategies on delivery of care for elective total joint arthroplasty.
Regionalization of total joint arthroplasty (TJA) to high volume hospitals (HVHs) may affect access to care and complication risk. Using administrative data, the authors found that the complication risk was higher if patients went to a local low volume hospital. Black and Medicaid patients were more likely to utilize the local low volume hospital than a local HVH. Utilizing a local HVH is associated with lower complication risks, but patients from vulnerable groups were less likely to utilize these patterns.
AHRQ-funded; HS016075.
Citation: Dy CY, Marx RG, Ghomrawi HM .
The potential influence of regionalization strategies on delivery of care for elective total joint arthroplasty.
J Arthroplasty 2015 Jan;30(1):1-6. doi: 10.1016/j.arth.2014.08.017.
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Keywords: Access to Care, Disparities, Healthcare Delivery, Orthopedics, Surgery
Angier H, Gregg J, Gold R
Understanding how low-income families prioritize elements of health care access for their children via the optimal care model.
The researchers explored low-income parents’ perspectives on accessing health care. Interviews with 29 Oregon parents revealed that affordability and limited availability were seen as barriers to care; while a continuous relationship with a health care provider helped them overcome these barriers. Parents also described the difficult decisions they made between affordability and acceptability in order to get the best care they could for their children.
AHRQ-funded; HS018569.
Citation: Angier H, Gregg J, Gold R .
Understanding how low-income families prioritize elements of health care access for their children via the optimal care model.
BMC Health Serv Res 2014 Nov 19;14:585. doi: 10.1186/s12913-014-0585-2..
Keywords: Access to Care, Children/Adolescents, Low-Income, Social Determinants of Health, Healthcare Costs
Qato DM, Daviglus ML, Wilder J
'Pharmacy deserts' are prevalent in Chicago's predominantly minority communities, raising medication access concerns.
The authors examined whether trends in the availability of pharmacies varied across communities in Chicago with different racial or ethnic compositions and whether "pharmacy deserts," or low-access neighborhoods, were more common in segregated black and Hispanic communities than elsewhere. They found that in 2012 there were disproportionately more pharmacy deserts in segregated black communities, as well as in low-income communities and federally designated Medically Underserved Areas. These findings suggest that public policies aimed at improving access to prescription medications may need to address factors beyond insurance coverage and medication affordability.
AHRQ-funded; HS021093.
Citation: Qato DM, Daviglus ML, Wilder J .
'Pharmacy deserts' are prevalent in Chicago's predominantly minority communities, raising medication access concerns.
Health Aff 2014 Nov;33(11):1958-65. doi: 10.1377/hlthaff.2013.1397.
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Keywords: Access to Care, Medication, Provider: Pharmacist, Racial and Ethnic Minorities, Urban Health
Mullen MT, Wiebe DJ, Bowman A
Disparities in accessibility of certified primary stroke centers.
These authors examined the proportion of the U.S. population with less than 60-minute access to Primary Stroke Centers (PSCs). They found significant geographic disparities in access to the PSCs. Stroke belt States have a higher burden of stroke and more limited access to PSCs.
AHRQ-funded; HS013852; HS017960; HS010914
Citation: Mullen MT, Wiebe DJ, Bowman A .
Disparities in accessibility of certified primary stroke centers.
Stroke. 2014 Nov;45(11):3381-8. doi: 10.1161/strokeaha.114.006021..
Keywords: Stroke, Access to Care, Disparities
Beil H, Rozier RG, Preisser JS
Effects of early dental office visits on dental caries experience.
This study determined the association between timing of a first dentist office visit before age 5 and dental disease in kindergarten. It found that children with early dental visits (before age 2) had higher rates of tooth decay than those who had later visits (between ages 3 and 5).
AHRQ-funded; HS018076.
Citation: Beil H, Rozier RG, Preisser JS .
Effects of early dental office visits on dental caries experience.
Am J Public Health. 2014 Oct;104(10):1979-85. doi: 10.2105/AJPH.2013.301325..
Keywords: Dental and Oral Health, Children/Adolescents, Access to Care, Medicaid, Prevention
Gold R, Bailey SR, O'Malley JP
Estimating demand for care after a Medicaid expansion: lessons from Oregon.
In order to estimate how the Affordable Care Act's Medicaid expansions will affect demand for services, the authors measured ambulatory care utilization among adult patients who gained insurance during Oregon's 2008 Medicaid expansion. They found that, in comparisons of the pre- and postcoverage periods, the mean annual encounters among persons who gained insurance increased 22% to 35%, but declined in the comparison groups.
AHRQ-funded; HS021522.
Citation: Gold R, Bailey SR, O'Malley JP .
Estimating demand for care after a Medicaid expansion: lessons from Oregon.
J Ambul Care Manage 2014 Oct-Dec;37(4):282-92. doi: 10.1097/jac.0000000000000023.
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Keywords: Access to Care, Healthcare Utilization, Policy, Health Services Research (HSR), Medicaid
Kesselheim AS, Tan YT, Darrow JJ
Existing FDA pathways have potential to ensure early access to, and appropriate use of, specialty drugs.
The researchers reviewed the different strategies that the FDA can use to approve and influence the post-approval prescribing of specialty drugs, including expediting the drugs' availability to patients through expanded access programs and expedited approval pathways, limiting the scope of the drugs' indications, and encouraging the development of companion diagnostic tests to indicate which patients should receive the drugs.
AHRQ-funded; HS018465.
Citation: Kesselheim AS, Tan YT, Darrow JJ .
Existing FDA pathways have potential to ensure early access to, and appropriate use of, specialty drugs.
Health Aff 2014 Oct;33(10):1770-8. doi: 10.1377/hlthaff.2014.0529.
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Keywords: Access to Care, Medication, Policy
Adeoye O, Albright KC, Carr BG
Geographic access to acute stroke care in the United States.
In this article the authors describe access of the US population to all facilities that actually provide intravenous recombinant tissue-type plasminogen activator (r-tPA) or endovascular therapy for acute ischemic stroke. The investigators concluded that more than half of the US population has geographic access to hospitals that actually deliver acute stroke care but treatment rates remain low.
AHRQ-funded; HS013852.
Citation: Adeoye O, Albright KC, Carr BG .
Geographic access to acute stroke care in the United States.
Stroke 2014 Oct;45(10):3019-24. doi: 10.1161/strokeaha.114.006293.
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Keywords: Access to Care, Stroke