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 25 of 44 Research Studies DisplayedKumar K, Holscher CM, Luo X
Persistent regional and racial disparities in nondirected living kidney donation.
Nondirected living donors (NDLDs) are an important and growing source of kidneys to help reduce the organ shortage. The authors of this study hypothesized that the initial geographic clustering and racial disparities may have improved due to an increase in NDLDs. The authors found that despite the increased number of NDLDs, racial disparities have worsened and the center-level distribution of NDLD transplants has narrowed in recent years.
AHRQ-funded; HS024600.
Citation: Kumar K, Holscher CM, Luo X .
Persistent regional and racial disparities in nondirected living kidney donation.
Clin Transplant 2017 Dec;31(12). doi: 10.1111/ctr.13135..
Keywords: Disparities, Health Services Research (HSR), Policy, Transplantation, Racial and Ethnic Minorities
Jones JM, Fingar KR, Miller MA
AHRQ Author: Miller MA; Heslin KC
Racial disparities in sepsis-related in-hospital mortality: using a broad case capture method and multivariate controls for clinical and hospital variables, 2004-2013.
The objective of this study was to use a broad method of capturing sepsis cases to estimate 2004-2013 trends in in-hospital sepsis mortality rates by race/ethnicity. Mortality rates adjusted for patient characteristics were higher for all minority groups than for white patients. After adjusting for hospital characteristics, sepsis mortality rates in 2013 were similar for white, black, and Hispanic patients.
AHRQ-authored.
Citation: Jones JM, Fingar KR, Miller MA .
Racial disparities in sepsis-related in-hospital mortality: using a broad case capture method and multivariate controls for clinical and hospital variables, 2004-2013.
Crit Care Med 2017 Dec;45(12):e1209-e17. doi: 10.1097/ccm.0000000000002699.
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Keywords: Disparities, Healthcare Cost and Utilization Project (HCUP), Mortality, Racial and Ethnic Minorities, Sepsis
Parker TC, Mohammed A, Leong T
Rotavirus vaccination rate disparities seen among infants with acute gastroenteritis in Georgia.
The purpose of this study was to determine possible disparities and socio-economic differences in RV vaccination rates. The study conclude that racial disparities and socio-economic differences are not determinants in rotavirus vaccination rates; however, age and ethnicity have an effect on RV vaccine status.
AHRQ-funded; HS024338.
Citation: Parker TC, Mohammed A, Leong T .
Rotavirus vaccination rate disparities seen among infants with acute gastroenteritis in Georgia.
Ethn Health 2017 Dec;22(6):585-95. doi: 10.1080/13557858.2016.1244744..
Keywords: Disparities, Health Status, Newborns/Infants, Social Determinants of Health, Vaccination
Tung EL, Cagney KA, Peek ME
Spatial context and health inequity: reconfiguring race, place, and poverty.
The authors build on the Chicago School of Sociology's contributions in urban research and one of its contemporary elaborations, often described as the "neighborhood effects approach," to propose a three-axis model of health inequity. This model, in alignment with Chicago School theory, postulates a dynamic and adaptive relationship between spatial context and health inequity. Compositional axes of race and poverty form the foundation of the model.
AHRQ-funded; HS023007.
Citation: Tung EL, Cagney KA, Peek ME .
Spatial context and health inequity: reconfiguring race, place, and poverty.
J Urban Health 2017 Dec;94(6):757-63. doi: 10.1007/s11524-017-0210-x.
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Keywords: Disparities, Low-Income, Racial and Ethnic Minorities, Social Determinants of Health, Urban Health
Cole MB, Wilson IB, Trivedi AN
State variation in quality outcomes and disparities in outcomes in community health centers.
The researchers estimated between-state variation in hypertension, diabetes, and pregnancy outcomes and racial/ethnic disparities in these outcomes for health center patients. They found wide variation in both outcomes and racial/ethnic disparities in outcomes between states for patients seen at health centers..
AHRQ-funded; HS024652.
Citation: Cole MB, Wilson IB, Trivedi AN .
State variation in quality outcomes and disparities in outcomes in community health centers.
Med Care 2017 Dec;55(12):1001-07. doi: 10.1097/mlr.0000000000000818.
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Keywords: Community-Based Practice, Disparities, Quality of Care, Outcomes, Racial and Ethnic Minorities
Hefele JG, Ritter GA, Bishop CE
Examining racial and ethnic differences in nursing home quality.
The authors measured within-facility differences for a range of publicly reported nursing home quality measures. They found that, on average, care is delivered equally across all racial/ethnic groups in the same nursing home. They concluded that nursing home providers should attempt to identify racial/ethnic within-facility differences in care.
AHRQ-funded; HS021891.
Citation: Hefele JG, Ritter GA, Bishop CE .
Examining racial and ethnic differences in nursing home quality.
Jt Comm J Qual Patient Saf 2017 Nov;43(11):554-64. doi: 10.1016/j.jcjq.2017.06.003.
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Keywords: Disparities, Quality of Care, Nursing Homes, Racial and Ethnic Minorities, Public Reporting
Rauscher GH, Dabbous F, Dolecek TA
Absence of an anticipated racial disparity in interval breast cancer within a large health care organization.
The researchers sought to estimate the extent of an anticipated racial disparity in interval breast cancer (IBC) within a single, large health care organization. Contrary to expectation, in patient-adjusted models, there was no IBC racial disparity. The sorting of patients by race across facilities appears to have mitigated an otherwise anticipated disparity in IBC.
AHRQ-funded; HS018366.
Citation: Rauscher GH, Dabbous F, Dolecek TA .
Absence of an anticipated racial disparity in interval breast cancer within a large health care organization.
Ann Epidemiol 2017 Oct;27(10):654-58. doi: 10.1016/j.annepidem.2017.09.002.
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Keywords: Cancer: Breast Cancer, Cancer, Disparities, Racial and Ethnic Minorities, Women, Screening, Screening, Imaging
Xavier Moore J, Donnelly JP, Griffin R
Community characteristics and regional variations in sepsis.
This study aimed to determine the influence of community characteristics upon regional variations in sepsis incidence and case fatality. The study concluded that regional variations in sepsis incidence may be partly explained by community poverty. Other community characteristics do not explain regional variations in sepsis incidence or case fatality.
AHRQ-funded; HS013852.
Citation: Xavier Moore J, Donnelly JP, Griffin R .
Community characteristics and regional variations in sepsis.
Int J Epidemiol 2017 Oct 1;46(5):1607-17. doi: 10.1093/ije/dyx099..
Keywords: Disparities, Low-Income, Mortality, Sepsis, Social Determinants of Health
Wisk LE, Weitzman ER
Expectancy and achievement gaps in educational attainment and subsequent adverse health effects among adolescents with and without chronic medical conditions.
This study sought to investigate educational aspirations, expectations, and attainment among youth with and without chronic conditions and to determine if these relationships mediated subsequent disparities in health and well-being. Findings suggest an important risk mechanism through which youth with chronic medical conditions may acquire socioeconomic disadvantage as they develop and progress through educational settings.
AHRQ-funded; HS022986; HS000063.
Citation: Wisk LE, Weitzman ER .
Expectancy and achievement gaps in educational attainment and subsequent adverse health effects among adolescents with and without chronic medical conditions.
J Adolesc Health 2017 Oct;61(4):461-70. doi: 10.1016/j.jadohealth.2017.04.006..
Keywords: Children/Adolescents, Chronic Conditions, Disparities, Education, Health Status
Sobotka SA, Agarwal RK, Msall ME
Prolonged hospital discharge for children with technology dependency: a source of health care disparities.
As the population of children who use medical technology such as long-term ventilation increases, it is important to critically evaluate the systems for preparing families for home life. The authors discuss the complication of hospital discharge and how it contributes to health and developmental disparities. They also describe a hospital-to-home transitional care model, which presents a home-like environment to provide developmental support while focusing on parental training, home nursing, and public-funding arrangements.
AHRQ-funded; HS023007.
Citation: Sobotka SA, Agarwal RK, Msall ME .
Prolonged hospital discharge for children with technology dependency: a source of health care disparities.
Pediatr Ann 2017 Oct;46(10):e365-e70. doi: 10.3928/19382359-20170919-01.
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Keywords: Children/Adolescents, Disparities, Home Healthcare, Hospital Discharge, Medical Devices
Goyal MK, Johnson TJ, Chamberlain JM
Racial and ethnic differences in antibiotic use for viral illness in emergency departments.
The researchers sought to investigate whether patient race and ethnicity was associated with differences in antibiotic prescribing for viral acute respiratory tract infections (ARTIs) in the pediatric emergency department (PED). They found that compared with non-Hispanic (NH) white children, NH black and Hispanic children were less likely to receive antibiotics for viral ARTIs in the PED.
AHRQ-funded; HS020270.
Citation: Goyal MK, Johnson TJ, Chamberlain JM .
Racial and ethnic differences in antibiotic use for viral illness in emergency departments.
Pediatrics 2017 Oct;140(4). doi: 10.1542/peds.2017-0203.
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Keywords: Racial and Ethnic Minorities, Emergency Department, Children/Adolescents, Disparities, Practice Patterns
Pylypchuk Y, Kirby JB
AHRQ Author: Kirby JB
The role of marriage in explaining racial and ethnic disparities in access to health care for men in the US.
The researchers investigated the association between marriage and access to health care among men, and estimate the extent to which racial and ethnic differences in both the returns to marriage and marital rates explain differences in access and preventive service use. They found that marriage accounts for up to 24 percent of racial and ethnic differences in access and preventive use.
AHRQ-authored.
Citation: Pylypchuk Y, Kirby JB .
The role of marriage in explaining racial and ethnic disparities in access to health care for men in the US.
Review of Economics of the Household 2017 Sep;15(3):807-32..
Keywords: Medical Expenditure Panel Survey (MEPS), Disparities, Racial and Ethnic Minorities, Access to Care
Angier H, Hoopes M, Marino M
Uninsured primary care visit disparities under the Affordable Care Act.
The researchers aimed to assess changes in insurance coverage at community health center (CHC) visits after the Patient Protection and Affordable Care Act (ACA) Medicaid expansion by race and ethnicity. After the ACA was implemented, uninsured visit rates decreased for all racial and ethnic groups. Hispanic patients experienced the greatest increases in Medicaid-insured visit rates after ACA implementation in expansion states.
AHRQ-funded; HS024270.
Citation: Angier H, Hoopes M, Marino M .
Uninsured primary care visit disparities under the Affordable Care Act.
Ann Fam Med 2017 Sep;15(5):434-42. doi: 10.1370/afm.2125.
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Keywords: Uninsured, Primary Care, Disparities, Healthcare Utilization, Access to Care
Albright KC, Howard VJ, Howard G
Age and sex disparities in discharge statin prescribing in the stroke belt: evidence from the reasons for geographic and racial differences in stroke study.
This study analyzed discharge medications for participants hospitalized for an ischemic stroke during follow-up of the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study. It found that statin discharge prescribing may differ among Stroke Belt and non-Stroke Belt residents, particularly in older Americans and men.
AHRQ-funded; HS023009; HS013852.
Citation: Albright KC, Howard VJ, Howard G .
Age and sex disparities in discharge statin prescribing in the stroke belt: evidence from the reasons for geographic and racial differences in stroke study.
J Am Heart Assoc 2017 Aug 2;6(8). doi: 10.1161/jaha.117.005523.
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Keywords: Disparities, Medication, Stroke, Elderly, Sex Factors
Castro FG, Yasui M
Advances in EBI development for diverse populations: towards a science of intervention adaptation.
This introduction examines major issues and challenges as presented in this special issue of Prevention Science, "Challenges to the Dissemination and Implementation of Evidence Based Prevention Interventions for Diverse Populations." The authors describe the Fidelity-Adaptation Dilemma that generated controversies and debates and new perspectives on the dissemination and implementation of evidence-based interventions (EBIs) within diverse populations. The five articles in this special issue address many of these controversies and challenges.
AHRQ-funded; HS023007.
Citation: Castro FG, Yasui M .
Advances in EBI development for diverse populations: towards a science of intervention adaptation.
Prev Sci 2017 Aug;18(6):623-29. doi: 10.1007/s11121-017-0809-x.
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Keywords: Communication, Disparities, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention, Racial and Ethnic Minorities, Implementation
Cook BL, Zuvekas SH, Chen J
AHRQ Author: Zuvekas SH
Assessing the individual, neighborhood, and policy predictors of disparities in mental health care.
This study assessed individual- and area-level predictors of racial/ethnic disparities in mental health care episodes for adults with psychiatric illness. It found that racial/ethnic disparities arise because minorities are more likely to live in neighborhoods where treatment initiation is low, rather than because of a differential influence of neighborhood disadvantage on treatment initiation for minorities compared with whites.
AHRQ-authored; AHRQ-funded; HS021486.
Citation: Cook BL, Zuvekas SH, Chen J .
Assessing the individual, neighborhood, and policy predictors of disparities in mental health care.
Med Care Res Rev 2017 Aug;74(4):404-30. doi: 10.1177/1077558716646898.
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Keywords: Disparities, Medical Expenditure Panel Survey (MEPS), Behavioral Health, Policy, Racial and Ethnic Minorities
Davis MM, Renfro S, Pham R
Geographic and population-level disparities in colorectal cancer testing: a multilevel analysis of Medicaid and commercial claims data.
This study used Medicaid and commercial claims data to examine individual and geographic factors associated with colorectal cancer testing rates in Oregon. CRC testing in newly age-eligible Medicaid and commercial members remains markedly low. Disparities exist by gender, geographic residence, insurance coverage, and access to primary care.
AHRQ-funded; HS022981.
Citation: Davis MM, Renfro S, Pham R .
Geographic and population-level disparities in colorectal cancer testing: a multilevel analysis of Medicaid and commercial claims data.
Prev Med 2017 Aug;101:44-52. doi: 10.1016/j.ypmed.2017.05.001.
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Disparities, Medicaid, Social Determinants of Health
Kim G, Dautovich N, Ford KL
Geographic variation in mental health care disparities among racially/ethnically diverse adults with psychiatric disorders.
The main purpose of this study is to examine geographic variation in unmet need for mental health care among racially/ethnically diverse adults with psychiatric disorders in the US. It found that Latinos in the South, Blacks and Latinos in the Midwest, and Latinos and Asians in the West had higher unmet need than non-Hispanic Whites, whereas no significant racial/ethnic effects were found in the Northeast.
AHRQ-funded; HS021486.
Citation: Kim G, Dautovich N, Ford KL .
Geographic variation in mental health care disparities among racially/ethnically diverse adults with psychiatric disorders.
Soc Psychiatry Psychiatr Epidemiol 2017 Aug;52(8):939-48. doi: 10.1007/s00127-017-1401-1.
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Keywords: Access to Care, Disparities, Behavioral Health, Racial and Ethnic Minorities
Novak P, Williams-Parry KF, Chen J
AHRQ Author: Novak P
Racial and ethnic disparities among the remaining uninsured young adults with behavioral health disorders after the ACA expansion of dependent coverage.
The objective of this study is to explore the population characteristics of the remaining uninsured individuals with and without behavioral health disorders (BHDs) and to examine whether the factors that contribute to racial and ethnic disparities in the likelihood of being uninsured were different after ACA. The major factor associated with the ethnic disparity among those with BHDs was the immigrant status of Latinos, and the major factor associated with racial disparity was geographic location.
AHRQ-authored; AHRQ-funded; HS022135.
Citation: Novak P, Williams-Parry KF, Chen J .
Racial and ethnic disparities among the remaining uninsured young adults with behavioral health disorders after the ACA expansion of dependent coverage.
J Racial Ethn Health Disparities 2017 Aug;4(4):607-14. doi: 10.1007/s40615-016-0264-6.
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Keywords: Behavioral Health, Disparities, Policy, Medical Expenditure Panel Survey (MEPS), Uninsured
Farias AJ, Du XL
Racial differences in adjuvant endocrine therapy use and discontinuation in association with mortality among Medicare breast cancer patients by receptor status.
The purpose of this study was to determine whether racial/ethnic differences in use and discontinuation of adjuvant endocrine therapy (AET) differed by hormone receptor status and whether discontinuation was associated with mortality. There are racial/ethnic differences in AET use and discontinuation. Discontinuing treatment was associated with higher risk of all-cause and cancer-specific mortality regardless of hormone receptor status.
AHRQ-funded; HS018956.
Citation: Farias AJ, Du XL .
Racial differences in adjuvant endocrine therapy use and discontinuation in association with mortality among Medicare breast cancer patients by receptor status.
Cancer Epidemiol Biomarkers Prev 2017 Aug;26(8):1266-75. doi: 10.1158/1055-9965.epi-17-0280.
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Keywords: Cancer: Breast Cancer, Disparities, Elderly, Mortality, Racial and Ethnic Minorities
Rice WS, Goldfarb SS, Brisendine AE
Disparities in infant mortality by race among Hispanic and non-Hispanic infants.
This study explored possible implications of racial identification for the health of U.S. born Hispanic compared to non-Hispanic infants. It concluded that the risk of infant mortality varies among Hispanic infants by race, with poorer outcomes experienced by Hispanic black infants. Compared to non-Hispanic infants of the same race, Hispanic black infants experience a smaller health disadvantage and Hispanic white infants have better or similar infant health outcomes.
AHRQ-funded; HS013852.
Citation: Rice WS, Goldfarb SS, Brisendine AE .
Disparities in infant mortality by race among Hispanic and non-Hispanic infants.
Matern Child Health J 2017 Jul;21(7):1581-88. doi: 10.1007/s10995-017-2290-3.
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Keywords: Disparities, Newborns/Infants, Mortality, Newborns/Infants, Racial and Ethnic Minorities
Beckman AL, Herrin J, Nasir K
Trends in cardiovascular health of US adults by income, 2005-2014.
This research letter discusses the trends in cardiovascular health of US adults by income from 2005-2014. The investigators assessed national trends in cardiovascular risk factors by income level among adults aged 25 years and older using data from the National Health and Nutrition Examination Surveys, a nationally representative, multistage probability sample of the US population, across 5 periods: 2005 to 2006, 2007 to 2008, 2009 to 2010, 2011 to 2012, and 2013 to 2014.
AHRQ-funded; HS023000.
Citation: Beckman AL, Herrin J, Nasir K .
Trends in cardiovascular health of US adults by income, 2005-2014.
JAMA Cardiol 2017 Jul;2(7):814-16. doi: 10.1001/jamacardio.2017.1654..
Keywords: Cardiovascular Conditions, Risk, Disparities, Health Status, Blood Pressure, Obesity, Diabetes, Low-Income, Tobacco Use
Schpero WL, Morden NE, Sequist TD
For selected services, blacks and Hispanics more likely to receive low-value care than whites.
US minority populations receive fewer effective health services than whites. Using Medicare administrative data for 2006-11, the researchers found no consistent, corresponding protection against the receipt of ineffective health services. Compared with whites, blacks and Hispanics were often more likely to receive the low-value services studied.
AHRQ-funded; HS017589.
Citation: Schpero WL, Morden NE, Sequist TD .
For selected services, blacks and Hispanics more likely to receive low-value care than whites.
Health Aff 2017 Jun;36(6):1065-69. doi: 10.1377/hlthaff.2016.1416.
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Keywords: Disparities, Racial and Ethnic Minorities, Quality of Care, Racial and Ethnic Minorities
Heintzman J, Bailey SR, DeVoe J
In low-income Latino patients, post-affordable care act insurance disparities may be reduced even more than broader national estimates: evidence from Oregon.
This study compared the insurance status of low-income patients served in 23 community health centers (CHCs) in Oregon, by race/ethnicity and language, over a period of 6 years straddling the implementation of ACA-related Medicaid expansion in 2014. It found that among previously uninsured low-income patients returning to Oregon CHCs, insurance disparities were eliminated after Medicaid expansion, especially in Spanish-speaking Latinos.
AHRQ-funded; HS021522; HS024270.
Citation: Heintzman J, Bailey SR, DeVoe J .
In low-income Latino patients, post-affordable care act insurance disparities may be reduced even more than broader national estimates: evidence from Oregon.
J Racial Ethn Health Disparities 2017 Jun;4(3):329-36. doi: 10.1007/s40615-016-0232-1.
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Keywords: Disparities, Health Insurance, Policy, Low-Income, Racial and Ethnic Minorities
Cram P, Saag KG, Lou Y
Racial differences and disparities in osteoporosis-related bone health: results from the PAADRN randomized controlled trial.
The researchers examined whether providing dual-energy x-ray absorptiometry (DXA) test results directly to patients might reduce or eliminate racial differences in osteoporosis-related health care. They found that black women were still less likely to know their actual DXA result and less likely to be on guideline-concordant therapy, but black women had greater patient activation.
AHRQ-funded; HS023009.
Citation: Cram P, Saag KG, Lou Y .
Racial differences and disparities in osteoporosis-related bone health: results from the PAADRN randomized controlled trial.
Med Care 2017 Jun;55(6):561-68. doi: 10.1097/mlr.0000000000000718.
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Keywords: Racial and Ethnic Minorities, Disparities, Osteoporosis, Health Status