National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (8)
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Anxiety (1)
- Autism (2)
- Behavioral Health (3)
- Cancer (4)
- Cancer: Breast Cancer (2)
- Cancer: Lung Cancer (1)
- Cardiovascular Conditions (2)
- Care Coordination (2)
- Caregiving (7)
- Case Study (1)
- Children/Adolescents (23)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
- Communication (1)
- Community-Based Practice (1)
- Complementary and Alternative Medicine (2)
- COVID-19 (1)
- Decision Making (4)
- Dental and Oral Health (1)
- Diabetes (1)
- (-) Disabilities (73)
- Disparities (4)
- Elderly (5)
- Electronic Health Records (EHRs) (1)
- Emergency Department (5)
- Evidence-Based Practice (1)
- Family Health and History (2)
- Genetics (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (3)
- Healthcare Delivery (2)
- Healthcare Utilization (3)
- Health Information Technology (HIT) (5)
- Health Insurance (3)
- Health Literacy (2)
- Health Services Research (HSR) (2)
- Health Status (4)
- Home Healthcare (1)
- Hospital Readmissions (1)
- Imaging (2)
- Implementation (1)
- Labor and Delivery (4)
- Long-Term Care (3)
- Low-Income (5)
- Maternal Care (3)
- Medicaid (1)
- Medical Devices (1)
- Medical Expenditure Panel Survey (MEPS) (6)
- Medicare (2)
- Medication (1)
- Neurological Disorders (2)
- Newborns/Infants (2)
- Nursing (1)
- Nutrition (3)
- Obesity (2)
- Obesity: Weight Management (2)
- Outcomes (5)
- Pain (1)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (6)
- Patient and Family Engagement (3)
- Patient Safety (1)
- Payment (1)
- Policy (2)
- Pregnancy (10)
- Prevention (2)
- Provider: Physician (1)
- Provider Performance (1)
- Quality of Care (1)
- Quality of Life (2)
- Racial and Ethnic Minorities (4)
- Rehabilitation (2)
- Rural/Inner-City Residents (1)
- Rural Health (3)
- Screening (4)
- Sexual Health (3)
- Social Determinants of Health (5)
- Social Stigma (2)
- Stroke (3)
- Surgery (4)
- Telehealth (2)
- Vulnerable Populations (18)
- Women (12)
- Workforce (1)
- Young Adults (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 73 Research Studies DisplayedKakara M, Venkataramani AS
Earnings of US physicians with and without disabilities.
The researchers report that across industries, workers with disabilities earn less than workers without disabilities. As greater numbers of people with disabilities enter medicine, they face substantial challenges in medical education and higher risks of mistreatment at work. As physicians in older age groups grows, the incidence of disability increases. The purpose of this study was to explore possible disability earnings gaps in medicine. The study cohort included 92,469 physicians, 2.0% of whom reported having a disability. The study found that in the adjusted analyses of employed physicians, annual earned income was 20.8% lower and hourly earned income was 13.3% lower among physicians with disabilities. Physicians reporting disabilities worked an average of 110 hours fewer per year compared with those without disabilities. Estimated differences in annual income by disability status were similar after adjusting for hours worked and surgical specialty status and across age groups; estimates were much greater for disabilities affecting cognitive function, ambulation, independent living, and self-care than vision or hearing.
AHRQ-funded; HS026116.
Citation: Kakara M, Venkataramani AS .
Earnings of US physicians with and without disabilities.
JAMA Health Forum 2023 Dec; 4(12):e233954. doi: 10.1001/jamahealthforum.2023.3954..
Keywords: Provider: Physician, Disabilities
James 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
Frehn JL, Li JN, Liu KR
Implementation of a universal screening and follow-up care system for pediatric developmental and behavioral health in federally qualified health center sites.
This study assessed the results of implementing an intervention to increase screening of developmental delays in children at six federally qualified health center (FQHC) sites in Northern California from April 2014 to April 2017. The goals of the intervention were to increase (a) standardized developmental screening at recommended intervals and (b) follow-up care and support for early intervention services. The aim was to optimize each site's screening processes, supported by an automated electronic tablet-based system. Social workers were hired to conduct follow-up clinical assessments, provide psychosocial education and treatment, provide referrals, provide case management support, and collaborate with service partners. During the last year of the intervention, when tablet-based screening was adopted, the sites screened an estimated 6,550 children ages 0-18 at 23 intervals in three domains (developmental, autism, and psychosocial/behavioral), compared to a baseline where they screened children ages 0-3 at four intervals in one domain. Screening rates increased from 65.3% to 75.5% after automation was extended from the first to the second site and continued its’ increase to 91.8% after automation was expanded to the remaining sites. Ranges for follow-up visits were between 74% and 88%.
AHRQ-funded; HS000046.
Citation: Frehn JL, Li JN, Liu KR .
Implementation of a universal screening and follow-up care system for pediatric developmental and behavioral health in federally qualified health center sites.
Fam Syst Health 2023 Dec; 41(4):454-66. doi: 10.1037/fsh0000803..
Keywords: Children/Adolescents, Disabilities, Screening, Implementation
Grove LR, Berkowitz SA, Cuddeback G
Permanent supportive housing receipt and health care use among adults with disabilities.
This study’s objective was to assess whether permanent supportive housing (PSH) participation is associated with health service use among a population of adults with disabilities, including people transitioning into PSH from community and institutional settings. Primary data sources used were 2014 to 2018 secondary data from a PSH program in North Carolina linked to Medicaid claims. The authors used propensity score weighting to estimate the average treatment effect on the treated of PSH participation. Using weighted analysis, they found that among individuals who were institutionalized prior to PSH, PSH participation was associated with greater hospitalizations and emergency department (ED) visits and fewer primary care visits during the follow-up period, compared with similar individuals who largely remained institutionalized. There was no significantly different health service use from similar comparison group members for individuals who entered PSH from community settings during the 12-month follow-up period.
AHRQ-funded; HS000032.
Citation: Grove LR, Berkowitz SA, Cuddeback G .
Permanent supportive housing receipt and health care use among adults with disabilities.
Med Care Res Rev 2023 Dec; 80(6):596-607. doi: 10.1177/10775587231183192..
Keywords: Disabilities, Vulnerable Populations, Access to Care
Fabius CD, Okoye SM, Wu MMJ
The role of place in person- and family-oriented long-term services and supports.
The authors developed a conceptual framework to identify environmental domains contributing to the use, care quality, and care experiences of long-term services and supports (LTSS). They found that LTSS-relevant environmental characteristics are differentially relevant to the care experiences of older adults with disabilities. Measures of neighborhood social and economic deprivation were highly associated with adverse consequences due to unmet care needs. Measures of health care and social services delivery environment were inversely associated with participation restrictions in valued activities. The authors concluded that greater attention should be given to strengthening state- and community-based policies and practices that support aging in place.
AHRQ-funded; HS000029.
Citation: Fabius CD, Okoye SM, Wu MMJ .
The role of place in person- and family-oriented long-term services and supports.
Milbank Q 2023 Dec; 101(4):1076-138. doi: 10.1111/1468-0009.12664..
Keywords: Long-Term Care, Elderly, Disabilities
Zondlak AN, Oh EJ, Neiman PU
Association of intellectual disability with delayed presentation and worse outcomes in emergency general surgery.
Individuals with intellectual disabilities may be at higher risk of delayed presentation and worse outcomes for emergency general surgery (EGS) conditions. The purpose of this study was to explore the relationship between intellectual disability and both severity of disease and clinical outcomes in patients presenting with typical EGS conditions. The study found that of 1,317,572 adult EGS admissions, 0.38% of patients had an ICD-9/-10 code consistent with current intellectual disability. EGS patients with intellectual disabilities had 31% greater odds of more severe disease at presentation when compared with neurotypical patients. Intellectual disability was also related with a higher likelihood of complications and mortality, longer lengths of stay, lower rate of discharge to home, and higher inpatient costs.
AHRQ-funded; HS028672; HS027788.
Citation: Zondlak AN, Oh EJ, Neiman PU .
Association of intellectual disability with delayed presentation and worse outcomes in emergency general surgery.
Ann Surg 2023 Nov 1; 278(5):e1118-e22. doi: 10.1097/sla.0000000000005863..
Keywords: Healthcare Cost and Utilization Project (HCUP), Disabilities, Surgery, Outcomes
Barnett S, Matthews K, DeWindt L
Deaf Weight Wise: a novel randomized clinical trial with Deaf sign language users.
The purpose of this research was to address the lack of scientifically supported weight management programs specifically designed for the Deaf population. The researchers developed the Deaf Weight Wise (DWW) trial and intervention which was informed by community-based participatory research. The primary focus of DWW is promoting a healthy lifestyle and weight management through dietary adjustments and physical activity. A total of 104 Deaf adults aged 40 to 70 years, with a BMI ranging from 25 to 45, were recruited from community settings in Rochester, New York. Participants were randomized into either immediate intervention (n = 48) or a 1-year delayed intervention group (n = 56). The latter group served as a no-intervention control until the trial's midpoint. Data were collected at five time points (every six months) from baseline to 24 months. All DWW intervention leaders and participants were Deaf individuals using American Sign Language (ASL). The study found that at the 6-month mark, the average weight change difference between the immediate-intervention group and the delayed-intervention group (no intervention yet) was -3.4 kg. A majority (61.6%) of those in the immediate intervention group lost ≥5% of their baseline weight, compared to 18.1% in the no-intervention-yet group. Indicators of participant engagement included an average attendance of 11/16 sessions (69%), and 92% completed the 24-month data collection. The researchers concluded that the DWW program, which is community-engaged, culturally tailored, and provides language accessibility, successfully supported weight loss among Deaf ASL users.
AHRQ-funded; HS015700
Citation: Barnett S, Matthews K, DeWindt L .
Deaf Weight Wise: a novel randomized clinical trial with Deaf sign language users.
Obesity 2023 Apr;31(4):965-76. doi: 10.1002/oby.23702.
Keywords: Obesity: Weight Management, Disabilities, Obesity
Creedon TB, Zuvekas SH, Hill SC
AHRQ Author: Zuvekas SH, Hill SC, McClellan C
Effects of Medicaid expansion on insurance coverage and health services use among adults with disabilities newly eligible for Medicaid.
The purpose of this study was to explore the impact of Affordable Care Act (ACA) Medicaid expansion on insurance coverage and health services use for adults with disabilities newly eligible for Medicaid. The researchers utilized the 2008-2018 Medical Expenditure Panel Survey data and the Agency for Healthcare Research and Quality (AHRQ) PUBSIM model to identify adults between the ages of 26-64 years with disabilities who were newly Medicaid-eligible in expansion states or would have been eligible in non-expansion states if those states had opted in to ACA Medicaid expansion. The study found that among adults with disabilities who were newly eligible for Medicaid, Medicaid expansion was associated with significant increases in full-year Medicaid coverage, receipt of primary care, receipt of flu shots and a significant decrease in out-of-pocket spending. There were greater improvements for adults with disabilities compared to those without disabilities in full-year Medicaid coverage and receipt of flu shots. The researchers concluded that Medicaid expansion was associated with improvements in full-year insurance coverage, receipt of primary and preventive care, and out-of-pocket spending for adults with disabilities who were newly eligible for Medicaid, and there were greater improvements for adults with disabilities than for adults without disabilities.
AHRQ-authored.
Citation: Creedon TB, Zuvekas SH, Hill SC .
Effects of Medicaid expansion on insurance coverage and health services use among adults with disabilities newly eligible for Medicaid.
Health Serv Res 2022 Dec;57(suppl 2):183-94. doi: 10.1111/1475-6773.14034..
Keywords: Medical Expenditure Panel Survey (MEPS), Medicaid, Health Insurance, Disabilities, Policy, Access to Care
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
Valdez RS, Lyon SE, Wellbeloved-Stone C
Engaging the disability community in informatics research: rationales and practical steps.
There is an opportunity for the informatics community to expand its impact by focusing on the disability community as a health disparity population. Digital health technologies can be enhanced by approaching disability from a more holistic framework, simultaneously accounting for multiple forms of disability and the ways that disability intersects with other forms of identity. The authors offer a set of guidelines for effective engagement and argue that such engagement is critical to creating digital health technologies which more fully meet the needs of all disabled individuals.
AHRQ-funded; HS023849.
Citation: Valdez RS, Lyon SE, Wellbeloved-Stone C .
Engaging the disability community in informatics research: rationales and practical steps.
J Am Med Inform Assoc 2022 Oct 7;29(11):1989-95. doi: 10.1093/jamia/ocac136..
Keywords: Patient and Family Engagement, Disabilities, Health Information Technology (HIT)
Horner-Johnson W, Garg B, Darney BG BG
Severe maternal morbidity and other perinatal complications among women with physical, sensory, or intellectual and developmental disabilities.
The authors assessed differences in severe maternal morbidity (SMM) and other perinatal complications by presence and type of disability in a retrospective cohort study of California births from 2000-2012. They found that SMM and other perinatal complications were more common among women with disabilities than among women without disabilities.
AHRQ-funded; HS022981.
Citation: Horner-Johnson W, Garg B, Darney BG BG .
Severe maternal morbidity and other perinatal complications among women with physical, sensory, or intellectual and developmental disabilities.
Paediatr Perinat Epidemiol 2022 Sep;36(5):759-68. doi: 10.1111/ppe.12873..
Keywords: Maternal Care, Disabilities, Adverse Events, Pregnancy, Women
Herb J, Holmes M, Stitzenberg K
Trends in rural-urban disparities among surgical specialties treating cancer, 2004-2017.
The purpose of this study was to assess trends over time in rural and urban disparities in the supply of surgeons treating patients with cancer. The researchers utilized the Area Health Resource File to conduct a retrospective observational study of medical workforce changes from 2004-2017. The study found that the density of surgical specialists in rural areas declined from 16 to 14 per 100,000 population and in urban areas from 33 to 31 per 100,000 population for a rural-urban disparity increase of 8%. The percentage increase in the supply disparity between the rural and urban workforce was largest for colorectal surgeons (66%) and general surgeons (72%). The study concluded that temporal changes in the rural-urban physician workforce depend on community factors, region, and area of specialization.
AHRQ-funded; HS000032.
Citation: Herb J, Holmes M, Stitzenberg K .
Trends in rural-urban disparities among surgical specialties treating cancer, 2004-2017.
J Rural Health 2022 Sep;38(4):838-44. doi: 10.1111/jrh.12658..
Keywords: Rural Health, Disabilities, Surgery, Cancer, Workforce
Chao GF, Chhabra KR, Yang J
Bariatric surgery in Medicare patients: examining safety and healthcare utilization in the disabled and elderly.
The purpose of this study was to compare safety and healthcare use after sleeve gastrectomy versus Roux-en-Y gastric bypass in a national Medicare cohort. The researchers analyzed Medicare claims from 2012-2017 for 30,105 bariatric surgery patients receiving benefits due to age or disability and compared all outcomes between sleeve and bypass for each benefit group at 30 days, 1 year, and 3 years. The study found that among the disabled patients (n = 21,595), sleeve gastrectomy was associated with lower 3-year ED utilization, complications, reinterventions, rehospitalizations, and mortality. Cumulative expenditures were $46,277 after sleeve gastrectomy and $48,211 after gastric bypass. Among the elderly (n = 8510), sleeve was associated with lower 3-year ED utilization, complications, reinterventions, and rehospitalizations. Expenditures were $38,632 after sleeve gastrectomy and $39,270 after gastric bypass. Procedure treatment effect significantly differed by benefit group for paraesophageal hernia repair, revision, and mortality. The study concluded that healthcare utilization benefits of sleeve over bypass are maintained across Medicare elderly populations and Medicare disabled subpopulations.
AHRQ-funded; HS025778.
Citation: Chao GF, Chhabra KR, Yang J .
Bariatric surgery in Medicare patients: examining safety and healthcare utilization in the disabled and elderly.
Ann Surg 2022 Jul 1;276(1):133-39. doi: 10.1097/sla.0000000000004526..
Keywords: Obesity: Weight Management, Obesity, Surgery, Medicare, Elderly, Disabilities
James TG, McKee MM, Miller MD
Emergency department utilization among deaf and hard-of-hearing patients: a retrospective chart review.
This retrospective study investigated the differences in emergency department (ED) utilization among deaf and hard-of-hearing (DHH) patients compared to non-DHH patients. A chart review was conducted using data from a large academic medical center in the southeastern United States. A total of 277 DHH ASL-users, 1000 DHH English speakers, and 1000 non-DHH English speakers were included. DHH ASL users and DHH English speakers had higher adjusted odds ratio of using the ED in the past 36 months than non-DHH English speakers. Abdominal pain was the most common principal diagnosis code for DHH English speakers.
AHRQ-funded; HS027537.
Citation: James TG, McKee MM, Miller MD .
Emergency department utilization among deaf and hard-of-hearing patients: a retrospective chart review.
Disabil Health J 2022 Jul;15(3):101327. doi: 10.1016/j.dhjo.2022.101327..
Keywords: Emergency Department, Disabilities
Adolphe S, Fernandez-Pastrana I, Scott H
EASE-ing the way for pediatric providers and parents: the Engagement and Access to Special Education (EASE) Clinic.
Primary Care Providers (PCPs) are tasked by the American Academy of Pediatrics to identify children who need special education and ensure that those children receive appropriate related services provided by the Individuals with Disabilities Education Act (IDEA). The IDEA entitles children between the ages of 3 and 21 to free education through individualized education programs (IEPs), and other related supports. The extent of PCP knowledge about the IDEA, special education, and available related support services and how to assess them, is largely unknown. Existing research indicates there is a lack of knowledge, training, and confidence in providers about special education. Boston Medical Center’s (BMC) Engagement and Access to Special Education (EASE) clinic was developed to provide support to the parents and PCPs of children with special education needs. The purpose of this article was to introduce and describe the EASE clinical model as a useful method for PCPs to strengthen their ability to provide appropriate and available comprehensive care to their patients requiring special education. The authors reported that of the 14,000 pediatric patients at the Boston Medical Center, 308 children were referred to the EASE clinic between its inception in 2017 and May 2021. The majority of children were Black non-Hispanic, English-speaking, and male, with an average age of 8.3 at first clinic. During that same time 452 total visits were completed, with a waiting list of less than 90 days. The authors conclude that for primary care practices with patients with special education needs, the BMC EASE clinic can serve as a useful model for improving their ability to provide care.
AHRQ-funded; HS022242.
Citation: Adolphe S, Fernandez-Pastrana I, Scott H .
EASE-ing the way for pediatric providers and parents: the Engagement and Access to Special Education (EASE) Clinic.
Acad Pediatr 2022 May-Jun;24(4):705-07. doi: 10.1016/j.acap.2022.02.011..
Keywords: Children/Adolescents, Caregiving, Patient and Family Engagement, Vulnerable Populations, Disabilities
Grove LR, Berkowitz SA, Cuddeback G
Permanent supportive housing tenure among a heterogeneous population of adults with disabilities.
This study analyzed the permanent supportive housing (PSH) tenure among a heterogenous population of 2093 adults with disabilities participating in a North Carolina PSH program between 2015 and 2018. Participants had a 71% probability of remaining in the housing after 2 years. A lower hazard of PSH departure was associated with older age, female gender, and non-Hispanic/Black race/ethnicity. Severe mental illness was associated with greater departure hazard.
AHRQ-funded; HS000032.
Citation: Grove LR, Berkowitz SA, Cuddeback G .
Permanent supportive housing tenure among a heterogeneous population of adults with disabilities.
Popul Health Manag 2022 Apr;25(2):227-34. doi: 10.1089/pop.2021.0348..
Keywords: Disabilities, Vulnerable Populations
Kenney MK, Chanlongbutra A, Fanflick PL
AHRQ Author: Chanlongbutra A
Systems of care among children and youth with special health care needs with and without adverse childhood events: National Survey of Children's Health 2016-2017.
The purpose of the study was to compare Children and Youth with Special Health Care Needs (CYSHCN) with non-CYSHCN in the likelihood of experiencing Adverse Childhood Events (ACEs), and then document the differences in receiving recommended and needed health care services among CYSHCS with and without ACEs. The researchers studied a sample of 16,304 CYSHCN from the 2016 and 2017 National Survey of Children’s Health (N=71,181). The study found that CYHSCN had a greater likelihood of having each of the measured Adverse Childhood Events, and greater likelihood of experiencing aggregated levels of ACE’s than non-CYSHCN. In addition, an increase in ACEs was related to a decrease in the likelihood of a CYSHCN having a medical home with family-centered and coordinated care. Having one or greater ACEs increased the likelihood of having unmet mental health care needs. The study concluded that the researcher’s findings extend the current understanding of the relationship between CYSHCN and ACEs, and that the need for additional work to establish care systems for this vulnerable population continues.
AHRQ-authored.
Citation: Kenney MK, Chanlongbutra A, Fanflick PL .
Systems of care among children and youth with special health care needs with and without adverse childhood events: National Survey of Children's Health 2016-2017.
Disabil Health J 2022 Apr;15(2):101226. doi: 10.1016/j.dhjo.2021.101226..
Keywords: Children/Adolescents, Disabilities, Healthcare Delivery, Vulnerable Populations
Davidson L, Haynes SC, Favila-Meza A
Parent experience and cost savings associated with a novel tele-physiatry program for children living in rural and underserved communities.
This study investigated patient and therapist experience and cost savings from the payer perspective associated with a novel tele-physiatry program for children living in rural and underserved communities. Study setting was four school-based clinics in Northern California with a total of 268 encounters (124 telemedicine and 144 in-person). Parent and therapists reported no difference in experience and perceived quality of care between telemedicine and in-person encounters. For parents whose children received a telemedicine encounter, 54.8% reported no preference for their child’s subsequent encounter, 28.8% preferred a physiatrist telemedicine visit, and 12 preferred a physiatrist in-person visit. There was also an average cost savings of $100 per clinic owing to physician milage for in-person visits.
AHRQ-funded; HS025714.
Citation: Davidson L, Haynes SC, Favila-Meza A .
Parent experience and cost savings associated with a novel tele-physiatry program for children living in rural and underserved communities.
Arch Phys Med Rehabil 2022 Jan;103(1):8-13. doi: 10.1016/j.apmr.2021.07.807..
Keywords: Children/Adolescents, Telehealth, Health Information Technology (HIT), Healthcare Costs, Rural Health, Vulnerable Populations, Disabilities, Rural/Inner-City Residents
Lindly O, Eaves MC, Xu Y
Therapy use for U.S. school-aged children with developmental disabilities: state variation and determinants.
This study’s objective was to determine geographic variability and determinants of therapy use among school-aged U.S. children with development disabilities (DD). The authors aimed to (1) determine if therapy use varies significantly by state and (2) examine associations of health determinants with therapy use among U.S. school-aged children with DD. They conducted a secondary analysis of 2016 and 2017 National Survey of Children's Health data, with the sample including 9984 children with DD ages 6-17 years old. They found that overall, 34.6% of children used therapy services, with therapy use varying significantly across states. There were higher adjusted odds of therapy access associated with younger age, public insurance, functional limitations, individualized education program, frustration accessing services, and care coordination need. There were higher estimated annual Medicaid Home and Community-Based Service waiver costs associated with lower adjusted odds of therapy use in states with those waivers.
AHRQ-funded; HS000063.
Citation: Lindly O, Eaves MC, Xu Y .
Therapy use for U.S. school-aged children with developmental disabilities: state variation and determinants.
Disabil Health J 2022 Jan; 15(1):101198. doi: 10.1016/j.dhjo.2021.101198..
Keywords: Children/Adolescents, Disabilities
James TG, Sullivan MK, Butler JD
Promoting health equity for deaf patients through the electronic health record.
This perspective article outlines barriers to health equity research serving deaf and hard-of-hearing (DHH) American Sign Language users due to systems developed by large-scale informatics networks and to institutional policies on self-serve cohort discovery tools. The authors list potential ways to help adequate capture of language status of DHH American Sign Language users in order to promote health equity for this population.
AHRQ-funded; HS027537.
Citation: James TG, Sullivan MK, Butler JD .
Promoting health equity for deaf patients through the electronic health record.
J Am Med Inform Assoc 2021 Dec 28;29(1):213-16. doi: 10.1093/jamia/ocab239..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Disabilities
James TG, Varnes JR, Sullivan MK
Conceptual model of emergency department utilization among deaf and hard-of-hearing patients: a critical review.
10.3390/ijerph182412901.
This study’s purpose was to develop a conceptual model describing patient and non-patient factors influencing emergency department (ED) utilization and care processes among deaf and hard-of-hearing (DHH) populations. This critical review used Andersen’s Behavioral Model of Health Services Use and the PRECEDE-PROCEED Model to classify factors based on their theoretical and/or empirically described role. The conceptual model developed provides predisposing, enabling, and reinforcing factors influencing DHH patient care, ED care seeking, and ED care processes.
This study’s purpose was to develop a conceptual model describing patient and non-patient factors influencing emergency department (ED) utilization and care processes among deaf and hard-of-hearing (DHH) populations. This critical review used Andersen’s Behavioral Model of Health Services Use and the PRECEDE-PROCEED Model to classify factors based on their theoretical and/or empirically described role. The conceptual model developed provides predisposing, enabling, and reinforcing factors influencing DHH patient care, ED care seeking, and ED care processes.
AHRQ-funded; HS027537.
Citation: James TG, Varnes JR, Sullivan MK .
Conceptual model of emergency department utilization among deaf and hard-of-hearing patients: a critical review.
Int J Environ Res Public Health 2021 Dec 7;18(24). doi: 10.3390/ijerph182412901..
Keywords: Emergency Department, Disabilities, Healthcare Utilization
Horner-Johnson W, Klein KA, Campbell J
Experiences of women with disabilities in accessing and receiving contraceptive care.
This study explored the experiences of women with different types of disability when they attempted to obtain contraceptive care. Four semistructured focus groups were created to sample 17 women with different types of disabilities: physical, intellectual and developmental, blind or low vision, and deaf or hard of hearing. Three main themes were identified in challenges to obtaining high-quality contraceptive care: Accessibility and Accommodations, Clinician Attitudes, and Health Insurance. Different challenges occurred with different types of disabilities such as inaccessible clinic rooms and examination tables, and inaccessible clinic forms and information. Processes and infrastructure of contraceptive care are based on an assumption of an able-bodied norm.
AHRQ-funded; HS022981.
Citation: Horner-Johnson W, Klein KA, Campbell J .
Experiences of women with disabilities in accessing and receiving contraceptive care.
J Obstet Gynecol Neonatal Nurs 2021 Nov;50(6):732-41. doi: 10.1016/j.jogn.2021.07.005..
Keywords: Access to Care, Disabilities, Vulnerable Populations, Women, Sexual Health
Abdul-Chani MM, Moreno CP, Reeder JA
Perceived community disability stigma in multicultural, low-income populations: measure development and validation.
Investigators sought to develop and validate a brief bilingual (English/Spanish) perceived disability stigma measure, to compare perceived disability and autism stigma, and to examine perceived disability stigma by parent sociodemographic characteristics and disability familiarity. They found that perceived autism stigma was greater than perceived disability stigma, with Latino parents reporting less perceived disability stigma than white parents. They concluded that their perceived disability stigma scale demonstrated sound psychometric properties, with results suggesting differences in how stigma is perceived across sociodemographic characteristics and disability familiarity.
AHRQ-funded; HS000063.
Citation: Abdul-Chani MM, Moreno CP, Reeder JA .
Perceived community disability stigma in multicultural, low-income populations: measure development and validation.
Res Dev Disabil 2021 Aug;115:103997. doi: 10.1016/j.ridd.2021.103997..
Keywords: Disabilities, Low-Income, Vulnerable Populations, Social Stigma
Valdez RS, Roger CC, Claypool H
Ensuring full participation of people with disabilities in an era of telehealth.
This paper discusses the benefits and drawbacks that the widespread use of telehealth resulting from the COVID-19 pandemic has on people with disabilities. For some it may result in reduced barriers to care, but for others inadequate attention to the design, implementation, and policy dimensions may be detrimental.
AHRQ-funded; HS023849.
Citation: Valdez RS, Roger CC, Claypool H .
Ensuring full participation of people with disabilities in an era of telehealth.
J Am Med Inform Assoc 2021 Feb 15;28(2):389-92. doi: 10.1093/jamia/ocaa297..
Keywords: Disabilities, Telehealth, Health Information Technology (HIT), Access to Care, Policy, COVID-19
Lindly OJ, Martin AJ, Lally K
A profile of care coordination, missed school days, and unmet needs among Oregon children with special health care needs with behavioral and mental health conditions.
In order to inform Oregon's Title V needs assessment activities, researchers sought to characterize the state's subpopulation of children with special health care needs (CSHCN) with behavioral and mental health conditions (B/MHC) and to determine associations of care coordination with missed school days and unmet needs for this subpopulation. They found that among Oregon CSHCN with B/MHC, 48.9% missed 4 or more school days, 25% had one or more unmet health services need, and 14.8% had one or more unmet family support services need. They concluded that their approach to identify Oregon CSHCN with B/MHC may be adopted by other states endeavoring to improve health for this vulnerable subpopulation.
AHRQ-funded; HS000063.
Citation: Lindly OJ, Martin AJ, Lally K .
A profile of care coordination, missed school days, and unmet needs among Oregon children with special health care needs with behavioral and mental health conditions.
Community Ment Health J 2020 Nov;56(8):1571-80. doi: 10.1007/s10597-020-00609-4..
Keywords: Children/Adolescents, Disabilities, Behavioral Health, Care Coordination, Healthcare Delivery