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 12 of 12 Research Studies DisplayedKim N, Jacobson M
Comparison of catastrophic out-of-pocket medical expenditure among older adults in the United States and South Korea: what affects the apparent difference?
In the United States seniors aged 65 and older have Medicare and almost-universal coverage, and in South Korea all residents have national health insurance. The purpose of this study was to compare catastrophic out-of-pocket medical spending (defined as out-of-pocket medical spending over the past two years that exceeded 50% of household income) among adults 65 and older in the United States with the same senior-aged population in South Korea. The study found that the proportion of participants with catastrophic out-of-pocket medical expenditures was 5.8% in the US and 3.0% in South Korea. The researchers concluded that exposure to that level of expenditures was significantly higher in the US than South Korea, with the difference attributed to unobservable system level factors rather than observable sociodemographic characteristics.
AHRQ-funded; HS026488.
Citation: Kim N, Jacobson M .
Comparison of catastrophic out-of-pocket medical expenditure among older adults in the United States and South Korea: what affects the apparent difference?
BMC Health Serv Res 2022 Sep 26;22(1):1202. doi: 10.1186/s12913-022-08575-1..
Keywords: Elderly, Healthcare Costs, Access to Care, Low-Income
Cornelio N, McInerney MP, Mellor JM
Increasing Medicaid's stagnant asset test for people eligible for Medicare and Medicaid will help vulnerable seniors.
Researchers examined states' income and asset tests for full-benefit Medicaid during the period 2006-18 and examined how alternative asset tests would affect eligibility for community-dwelling Medicare beneficiaries ages sixty-five and older. They found that increasing asset limits would lessen restrictions on Medicaid eligibility that arise from stagnant asset tests, broadening eligibility for certain low-income Medicare beneficiaries and allowing them to retain higher, yet still modest, savings.
AHRQ-funded; HS025422; HS026727; HS027698.
Citation: Cornelio N, McInerney MP, Mellor JM .
Increasing Medicaid's stagnant asset test for people eligible for Medicare and Medicaid will help vulnerable seniors.
Health Affairs 2021 Dec;40(12):1943-52. doi: 10.1377/hlthaff.2021.00841..
Keywords: Elderly, Medicaid, Medicare, Low-Income, Vulnerable Populations
McInerney M, Mellor JM, Sabik LM. M, Mellor JM, Sabik LM
Welcome mats and on-ramps for older adults: the impact of the Affordable Care Act's Medicaid Expansions on Dual Enrollment in Medicare and Medicaid.
The authors examined whether Medicaid participation by low-income adults age 65 and up increased as a result of Medicaid expansions to working-age adults under the Affordable Care Act (ACA). Using American Community Survey data and state variation in ACA Medicaid expansions, they found that Medicaid expansions to working-age adults increased Medicaid participation among low-income older adults by 4.4 percent. They also found evidence of an “on-ramp” effect, which is an important mechanism behind welcome mat effects among some older adults.
AHRQ-funded; HS025422.
Citation: McInerney M, Mellor JM, Sabik LM. M, Mellor JM, Sabik LM .
Welcome mats and on-ramps for older adults: the impact of the Affordable Care Act's Medicaid Expansions on Dual Enrollment in Medicare and Medicaid.
J Policy Anal Manage 2021 Win;40(1):12-41. doi: 10.1002/pam.22259..
Keywords: Elderly, Medicaid, Medicare, Low-Income, Health Insurance, Policy
McCoy RG, Van Houten HK, Deng Y
Comparison of diabetes medications used by adults with commercial insurance vs Medicare Advantage, 2016 to 2019.
Investigators sought to compare trends in initiation of treatment with GLP-1RA, SGLT2i, and DPP-4i by older adults with type 2 diabetes insured by Medicare Advantage vs commercial health plans. They found that Medicare Advantage beneficiaries may be less likely than commercially insured beneficiaries to be treated with newer medications to lower glucose levels, with greater disparities among lower-income patients. They recommended further investigation of nonclinical factors contributing to treatment decisions and efforts to promote greater equity in diabetes management.
AHRQ-funded; HS025164.
Citation: McCoy RG, Van Houten HK, Deng Y .
Comparison of diabetes medications used by adults with commercial insurance vs Medicare Advantage, 2016 to 2019.
JAMA Netw Open 2021 Feb;4(2):e2035792. doi: 10.1001/jamanetworkopen.2020.35792..
Keywords: Elderly, Diabetes, Chronic Conditions, Medication, Medicare, Health Insurance, Disparities, Low-Income
Roberts ET, McGarry BE, Glynn A
Cognition and take-up of the Medicare Savings Programs.
In this study, the investigators examined the association between cognition and Medicare Savings Program (MSP) enrollment among elderly Medicare beneficiaries who qualified for these programs. They also examined enrollment in the Low-Income Subsidy (LIS), a separate program that provides premium and cost-sharing assistance in Medicare Part D that Medicare beneficiaries automatically received if they are enrolled in an MSP.
AHRQ-funded; HS026727.
Citation: Roberts ET, McGarry BE, Glynn A .
Cognition and take-up of the Medicare Savings Programs.
JAMA Intern Med 2020 Nov;180(11):1529-31. doi: 10.1001/jamainternmed.2020.2783..
Keywords: Elderly, Medicare, Health Insurance, Healthcare Costs, Low-Income, Dementia, Neurological Disorders
Roberts ET, Mehrotra A
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
In this study, the investigators examined disparities in digital access (ie, access at home to technology that enables video telemedicine visits) among Medicare beneficiaries by socioeconomic and demographic characteristics. The investigators concluded that the proportion of beneficiaries who lacked digital access was higher among those with low socioeconomic status, those 85 years or older, and in communities of color.
AHRQ-funded; HS026727.
Citation: Roberts ET, Mehrotra A .
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
JAMA Intern Med 2020 Oct;180(10):1386-89. doi: 10.1001/jamainternmed.2020.2666..
Keywords: Elderly, Medicare, Telehealth, Health Information Technology (HIT), Disparities, Access to Care, Social Determinants of Health, Low-Income, Racial and Ethnic Minorities
Rivera-Hernandez M, Rahman M, Galarraga O
Preventive healthcare-seeking behavior among poor older adults in Mexico: the impact of Seguro Popular, 2000-2012.
This study examined the effect of the Seguro Popular (SP) program in Mexico on preventive care utilization among low-income and uninsured elder beneficiaries. Results of three rounds of the Mexican National Health and Nutrition Survey from 2000, 2006, and 2012 was used. The findings show there was no significant effect on the use of preventive services, including screening for diabetes, hypertension, breast cancer and cervical cancer for adults aged 50 to 75 years.
AHRQ-funded; HS000011.
Citation: Rivera-Hernandez M, Rahman M, Galarraga O .
Preventive healthcare-seeking behavior among poor older adults in Mexico: the impact of Seguro Popular, 2000-2012.
Salud Publica Mex 2019 Jan-Feb;61(1):46-53. doi: 10.21149/9185..
Keywords: Elderly, Low-Income, Prevention, Healthcare Utilization, Access to Care, Uninsured
Berridge C
Active subjects of passive monitoring: responses to a passive monitoring system in low-income independent living.
The researchers examined the range of ways older adults relate to passive monitoring in low-income independent-living residences is presented. They found that assumptions built into the technology about how older adults live presented a problem for many users who experience unwanted disruptions and threats to their behavioral autonomy. Also, the resident responses challenged the dominant image of residents as passive subjects of a passive monitoring system.
AHRQ-funded; HS000011.
Citation: Berridge C .
Active subjects of passive monitoring: responses to a passive monitoring system in low-income independent living.
Ageing Soc 2017 Mar;37(3):537-60. doi: 10.1017/s0144686x15001269.
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Keywords: Caregiving, Elderly, Health Information Technology (HIT), Low-Income
Ndumele CD, Sommers BD, Trivedi AN
The ACA's 65th birthday challenge: moving from Medicaid to Medicare.
Following the Affordable Care Act’s coverage expansion, many newly-insured older enrollees will lose Medicaid coverage on their 65th birthday and transition from Medicaid to Medicare as their primary insurer. This article discusses the transition in primary health insurance coverage that includes changes to benefits, patient cost-sharing, and provider reimbursement, which could have profound consequences on the use of health services and associated health outcomes for low-income seniors.
AHRQ-funded; HS021291.
Citation: Ndumele CD, Sommers BD, Trivedi AN .
The ACA's 65th birthday challenge: moving from Medicaid to Medicare.
J Gen Intern Med 2015 Nov;30(11):1704-6. doi: 10.1007/s11606-015-3328-0..
Keywords: Health Insurance, Medicare, Elderly, Low-Income
Buys DR, Howard VJ, McClure LA
Association between neighborhood disadvantage and hypertension prevalence, awareness, treatment, and control in older adults: results from the University of Alabama at Birmingham Study of Aging.
The investigators evaluated the effect of neighborhood disadvantage (ND) on older adults' prevalence, awareness, treatment, and control of hypertension. Using data from the University of Alabama at Birmingham Study of Aging along with US Census data, they created tertiles of ND and found that living in mid-ND and high-ND tertiles was associated with higher hypertension prevalence, and living in high-ND tertiles was further associated with lower odds of controlled hypertension.
AHRQ-funded; HS019465; HS013852.
Citation: Buys DR, Howard VJ, McClure LA .
Association between neighborhood disadvantage and hypertension prevalence, awareness, treatment, and control in older adults: results from the University of Alabama at Birmingham Study of Aging.
Am J Public Health 2015 Jun;105(6):1181-8. doi: 10.2105/ajph.2014.302048.
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Keywords: Elderly, Blood Pressure, Low-Income, Social Determinants of Health, Cardiovascular Conditions, Chronic Conditions
Latulipe C, Gatto A, Nguyen HT
Design considerations for patient portal adoption by low-income, older adults.
This paper describes the results of an interview study investigating facilitators and barriers to adoption of patient portals among low-income, older adults in rural and urban populations in the southeastern United States. The authors then present a set of considerations for designing the patient portal user experience, aimed at helping healthcare clinics to meet U.S. federally-mandated 'meaningful use' requirements.
AHRQ-funded; HS021679.
Citation: Latulipe C, Gatto A, Nguyen HT .
Design considerations for patient portal adoption by low-income, older adults.
Proc SIGCHI Conf Hum Factor Comput Syst 2015 Apr;2015:3859-68. doi: 10.1145/2702123.2702392..
Keywords: Health Information Technology (HIT), Web-Based, Low-Income, Elderly
Lyles CR, Schafer AL, Seligman HK
Income, food insecurity, and osteoporosis among older adults in the 2007-2008 National Health and Nutrition Examination Survey (NHANES).
The researchers investigated osteoporosis and low socioeconomic status (SES). They concluded that income and food insecurity may have significant implications not just for immediate nutritional outcomes, but also for conditions such as osteoporosis that develop over the lifespan.
AHRQ-funded; HS022408.
Citation: Lyles CR, Schafer AL, Seligman HK .
Income, food insecurity, and osteoporosis among older adults in the 2007-2008 National Health and Nutrition Examination Survey (NHANES).
J Health Care Poor Underserved 2014 Nov;25(4):1530-41. doi: 10.1353/hpu.2014.0174.
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Keywords: Elderly, Nutrition, Osteoporosis, Social Determinants of Health, Low-Income