National Healthcare Quality and Disparities Report
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- Access to Care (3)
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- (-) Disparities (10)
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- Health Information Technology (HIT) (8)
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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 10 of 10 Research Studies DisplayedOsmanlliu E, Kalwani NM, Parameswaran V
Sociodemographic disparities in the use of cardiovascular ambulatory care and telemedicine during the COVID-19 pandemic.
Researchers examined adult cardiology visits at an academic and affiliated community practice in Northern California to assess the persistence sociodemographic disparities in telemedicine use before and during the COVID pandemic. Results indicated that sociodemographic characteristics of patients receiving cardiovascular care remained stable during both periods, but the modality of care diverged across groups. Observed disparities in the use of video-based telemedicine were greatest for patients 80 years or older, Black, with limited English proficiency, or on Medicaid. The researchers recommended that future studies examine barriers and outcomes in digital healthcare access across diverse patient groups.
AHRQ-funded; HS026128.
Citation: Osmanlliu E, Kalwani NM, Parameswaran V .
Sociodemographic disparities in the use of cardiovascular ambulatory care and telemedicine during the COVID-19 pandemic.
Am Heart J 2023 Sep; 263:169-76. doi: 10.1016/j.ahj.2023.06.011..
Keywords: COVID-19, Cardiovascular Conditions, Telehealth, Health Information Technology (HIT), Disparities, Ambulatory Care and Surgery
Giardina TD, Woodard LD, Singh H
Advancing diagnostic equity through clinician engagement, community partnerships, and connected care.
This article explores the persistent disparities in healthcare, particularly in the diagnostic process, which have been further exposed by the COVID-19 pandemic. The authors highlight the higher rates of infection, hospitalization, and death from COVID-19 among Black, Hispanic, and Asian patients, who are also less likely to be tested for the virus. Similar disparities are noted in cardiac testing, mental health diagnoses, appendicitis diagnosis, and receipt of diagnostic imaging in the Emergency Department. The authors propose a three-pronged approach to address these disparities: clinician engagement, community partnerships, and connected care. Clinician engagement involves fostering critical consciousness among healthcare providers to recognize and address systemic inequities. Community partnerships with Community Health Workers (CHWs) can help fill gaps in the diagnostic process. Lastly, connected care through telehealth can potentially eliminate traditional barriers to care, although disparities in access to technology and digital literacy remain a challenge. The authors call for further research and initiatives to address these disparities and promote diagnostic equity.
AHRQ-funded; HSP233201500022I; HS025474
Citation: Giardina TD, Woodard LD, Singh H .
Advancing diagnostic equity through clinician engagement, community partnerships, and connected care.
J Gen Intern Med 2023 Apr; 38(5):1293-95. doi: 10.1007/s11606-022-07966-8..
Keywords: Community Partnerships, Disparities, Telehealth, Health Information Technology (HIT)
Jones SA, Van Driest S, Sommer EC
Direct-to-patient telehealth equity: Reaching diverse pediatric populations in primary care.
This study’s goal was to assess disparities in direct-to-patient (DTP) telehealth experience for pediatric patients. The authors examined DTP telehealth for low-income pediatric patient-families and compared the experience of English and non-English speakers. Providers completed an electronic survey with patient feedback about the telehealth experience and their own providers for visits from April 2020 to May 2020 at a pediatric primary care clinic (80% Medicaid-insured, 40% non-English-speaking). The majority of telehealth visits were in English and English speakers had a positive experience overall. Non-English speakers had more barriers, although most telehealth visits were rated as satisfactory.
AHRQ-funded; HS026122.
Citation: Jones SA, Van Driest S, Sommer EC .
Direct-to-patient telehealth equity: Reaching diverse pediatric populations in primary care.
Fam Syst Health 2023 Mar;41(1):61-67. doi: 10.1037/fsh0000685.
Keywords: Children/Adolescents, Telehealth, Health Information Technology (HIT), Disparities
Shao CC, McLeod MC, Gleason LT
Inequity in telemedicine use among patients with cancer in the Deep South during the COVID-19 pandemic.
The authors’ goal was to characterize telemedicine use among a large oncology population in the Deep South during the COVID-19 pandemic. They found that telemedicine use, specifically with video, was significantly lower among historically vulnerable populations. They concluded that understanding barriers to telemedicine use and preferred modalities of communication among different populations will help inform insurance reimbursement and interventions at different socioecological levels to ensure that the continued evolution of telemedicine will be equitable.
AHRQ-funded; HS013852.
Citation: Shao CC, McLeod MC, Gleason LT .
Inequity in telemedicine use among patients with cancer in the Deep South during the COVID-19 pandemic.
https://www.pubmed.ncbi.nlm.nih.gov/35348793
Oncologist 2022 Jul 5;27(7):555-64. doi: 10.1093/oncolo/oyac046..
Oncologist 2022 Jul 5;27(7):555-64. doi: 10.1093/oncolo/oyac046..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Cancer, Disparities
Hsueh L, Huang J, Millman AK
Disparities in use of video telemedicine among patients with limited English proficiency during the COVID-19 pandemic.
The authors hypothesized that limited English proficiency (LEP) would be associated with lower video use compared with telephone, especially among patients without prior video visit experience. They found that one-third of patients with LEP scheduled a visit by video instead of telephone. Patients with LEP chose video less often than patients without LEP, even after adjusting for technology factors. However, among patients with prior video visit experience, no significant difference in video visit use by LEP was found.
AHRQ-funded; HS025189.
Citation: Hsueh L, Huang J, Millman AK .
Disparities in use of video telemedicine among patients with limited English proficiency during the COVID-19 pandemic.
JAMA Netw Open 2021 Nov;4(11):e2133129. doi: 10.1001/jamanetworkopen.2021.33129..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Disparities, Communication
Yang J, Landrum MB, Zhou L
Disparities in outpatient visits for mental health and/or substance use disorders during the COVID surge and partial reopening in Massachusetts.
The purpose of this study was to examine changes in outpatient visits for mental health and/or substance use disorders (MH/SUD) in an integrated healthcare organization during the initial Massachusetts COVID-19 surge and partial state reopening. The investigators concluded that MH/SUD visit volume increased during the COVID surge and was supported by rapidly-scaled telemedicine.
AHRQ-funded; HS025375.
Citation: Yang J, Landrum MB, Zhou L .
Disparities in outpatient visits for mental health and/or substance use disorders during the COVID surge and partial reopening in Massachusetts.
Gen Hosp Psychiatry 2020 Nov-Dec;67:100-06. doi: 10.1016/j.genhosppsych.2020.09.004..
Keywords: Behavioral Health, Substance Abuse, COVID-19, Disparities, Access to Care, Ambulatory Care and Surgery, Telehealth, Health Information Technology (HIT)
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
Senft N, Abrams J, Katz
eHealth activity among African American and white cancer survivors: a new application of theory.
eHealth is a promising resource for cancer survivors and may contribute to reducing racial disparities in cancer survivorship. This research applied the Unified Theory of Acceptance and Use of Technology (UTAUT) to examine eHealth activity among African American (AfAm) and White cancer survivors.
AHRQ-funded; HS022955.
Citation: Senft N, Abrams J, Katz .
eHealth activity among African American and white cancer survivors: a new application of theory.
Health Commun 2020 Mar;35(3):350-55. doi: 10.1080/10410236.2018.1563031..
Keywords: Racial and Ethnic Minorities, Cancer, Disparities, Health Status, Telehealth, Health Information Technology (HIT)
Jonassaint CR, Belnap BH, Huang Y
Racial differences in the effectiveness of Internet-delivered mental health care.
The purpose of this study was to examine race differences in the impact of computerized cognitive behavioral therapy (cCBT) use on mental health outcomes among White and African American primary care patients. Participants were patients aged 18-75 who were referred by their primary care physicians and who met the eligibility criteria. Findings showed that, compared to usual care, cCBT had no effect on quality of life, depression, or anxiety for Whites. However, for African American patients, cCBT was associated with a significant 6-month decrease in depression and anxiety scores; thus, cCBT may be an efficient and scalable first step to eliminating disparities in mental health care.
AHRQ-funded; HS022989.
Citation: Jonassaint CR, Belnap BH, Huang Y .
Racial differences in the effectiveness of Internet-delivered mental health care.
J Gen Intern Med 2020 Feb;35(2):490-97. doi: 10.1007/s11606-019-05542-1..
Keywords: Behavioral Health, Telehealth, Racial and Ethnic Minorities, Disparities, Primary Care, Treatments
Lyerly MJ, Wu TC, Mullen MT
The effects of telemedicine on racial and ethnic disparities in access to acute stroke care.
The authors sought to determine the effect of telemedicine on access to acute stroke care for racial and ethnic minorities in the state of Texas. They found that telemedicine increased access to acute stroke care for 1.5 million Texans, and they found no evidence of disparities in access to the acute stroke expertise afforded by telemedicine.
AHRQ-funded; HS013852.
Citation: Lyerly MJ, Wu TC, Mullen MT .
The effects of telemedicine on racial and ethnic disparities in access to acute stroke care.
J Telemed Telecare 2016 Mar;22(2):114-20. doi: 10.1177/1357633x15589534.
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Keywords: Access to Care, Disparities, Racial and Ethnic Minorities, Stroke, Telehealth