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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 92 Research Studies DisplayedFrank M, Loh R, Everhart R
No health without access: using a retrospective cohort to model a care continuum for people released from prison at an urban, safety net health system.
This retrospective cohort study of persons released from correctional facilities examined healthcare utilization by merging records from Denver Health (DH), an urban safety-net healthcare system, and the Colorado Department of Corrections (CDOC), for people released from January 1 to June 30, 2021. The study population was either 1) released to the Denver metro area (Denver and its five neighboring counties); or (2 assigned to the DH Regional Accountable Entity; or (3 assigned to the DH medical home based on Colorado Department of Healthcare Policy and Financing attribution methods. From January to June 2021 3242 people were released from CDOC and 2848 were included in the data exchange. 905 individuals of the total 2848 were released to the Denver metro area or attributed to DH. In the study population over three-fourths (78.1%) had a chronic medical or psychological condition. Within the first 6 months of release, 31.1% utilized any health service, 24.5% utilized at least one outpatient service, and 17.1% utilized outpatient services two or more times. Within the first 30 days of release 10.1% utilized outpatient services.
AHRQ-funded; HS027389.
Citation: Frank M, Loh R, Everhart R .
No health without access: using a retrospective cohort to model a care continuum for people released from prison at an urban, safety net health system.
Health Justice 2023 Nov 18; 11(1):49. doi: 10.1186/s40352-023-00248-3..
Keywords: Access to Care, Vulnerable Populations, Urban Health, Rural/Inner-City Residents
MacDougall H, Hanson S, Interrante JD
Rural-urban differences in health care unaffordability during the postpartum period.
The purpose of this cross-sectional study was to explore health care unaffordability for rural and urban residents and by postpartum status. The study found that postpartum people reported statistically significantly higher rates of inability to pay medical bills when compared with non-postpartum people. Rural residents also reported higher rates of inability to pay their medical bills and having problems paying medical bills as compared with urban residents. In adjusted models, the predicted probability of being unable to pay medical bills among postpartum respondents was 12.8%, which was higher than among non-postpartum respondents. Similarly, postpartum respondents had higher predicted probabilities of reporting problems paying medical bills (18.4%) than compared with non-postpartum respondents. IN adjusted models, residency in a rural area was not significantly related with the health care unaffordability outcome measures.
AHRQ-funded; HS000011.
Citation: MacDougall H, Hanson S, Interrante JD .
Rural-urban differences in health care unaffordability during the postpartum period.
Med Care 2023 Sep; 61(9):595-600. doi: 10.1097/mlr.0000000000001888..
Keywords: Rural Health, Urban Health, Rural/Inner-City Residents, Maternal Care, Healthcare Costs, Women, Access to Care
McGee-Avila JK, Richmond J, Henry KA
Disparities in geospatial patterns of cancer care within urban counties and structural inequities in access to oncology care.
This study examined geospatial patterns of cancer care utilization across diverse populations in New Jersey-a state where most residents live in urban areas. The authors used data from the New Jersey State Cancer Registry. They examined the location of cancer treatment among patients 20-65 years of age diagnosed with breast, colorectal, or invasive cervical cancer and investigated differences in geospatial patterns of care by individual and area-level (e.g., census tract-level) characteristics. They observed significant differences in geospatial patterns of cancer treatment by race/ethnicity, insurance type, and area-level factors. They found that Black patients had a 5.6% higher likelihood of receiving care within their own residential county compared to non-Hispanic White patients. Patients living in census tracts with the highest quintile of social vulnerability were 4.6% more likely to receive treatment within their residential county and were 2.7% less likely to seek out-of-state care.
AHRQ-funded; HS026122.
Citation: McGee-Avila JK, Richmond J, Henry KA .
Disparities in geospatial patterns of cancer care within urban counties and structural inequities in access to oncology care.
Health Serv Res 2023 Aug; 58(Suppl 2):152-64. doi: 10.1111/1475-6773.14182..
Keywords: Disparities, Urban Health, Rural/Inner-City Residents, Cancer, Cancer: Breast Cancer, Cancer: Colorectal Cancer, Cancer: Cervical Cancer
Hatch BA, Kenzie E, Ramalingam N
Impact of the COVID-19 vaccination mandate on the primary care workforce and differences between rural and urban settings to inform future policy decision-making.
The purpose of this cross-sectional study was to determine how vaccine mandates affect the healthcare workforce. Between October 28, 2021- November 18, 2021, following implementation of a COVID-19 vaccination mandate for healthcare personnel, the researchers conducted a survey of Oregon primary care clinic staff. The survey included 19 questions that assessed the clinic-level effects of the vaccination mandate. Study outcomes included job loss among staff, receipt of an approved vaccination waiver, new vaccination among staff, and the perceived significance of the policy on clinic staffing. Staff from 80 clinics across 28 counties completed surveys, representing 38 rural and 42 urban clinics. The study found that clinics reported job loss (46%), use of vaccination waivers (51%), and newly vaccinated staff (60%). Significantly more rural clinics (compared to urban) used medical and/or religious vaccination waivers (71% vs 33%) and reported significant impact on clinic staffing (45% vs 21%). There was also a non-significant trend toward more job loss for rural compared to urban clinics (53% vs. 41%). Qualitative analysis revealed a decrease in clinic morale and mixed opinions of the vaccination mandate.
AHRQ-funded; HS027080.
Citation: Hatch BA, Kenzie E, Ramalingam N .
Impact of the COVID-19 vaccination mandate on the primary care workforce and differences between rural and urban settings to inform future policy decision-making.
PLoS One 2023 Jun 27; 18(6):e0287553. doi: 10.1371/journal.pone.0287553..
Keywords: COVID-19, Vaccination, Primary Care, Policy, Rural Health, Urban Health, Rural/Inner-City Residents
McDaniel CE, Leyenaar JK, Bryan MA
Urban-rural disparities in interfacility transfers for children during COVID-19.
This study’s goal was to identify temporal trends and differences in urban and rural pediatric interfacility transfers (IFTs) before and during the COVID-19 pandemic. The authors conducted a cross-sectional analysis of IFT among children <18 years from January 2019 to June 2022 using the Pediatric Health Information System. They calculated observed-to-expected (O-E) ratios of pre-pandemic (March 2019-Feb 2020) transfers compared to pandemic year 1 (March 2020-Feb 2021) and year 2 (March 2021-February 2022) using Poisson modeling. The O-E ratio of IFT in year 1 for urban children was 14.0% and 14.8% for rural children compared to pre-pandemic. In year 2, transfers rebounded with IFTs for rural-residing children increasing more than urban-residing children (101.7%) compared to 90.7%. For mental-health indications in year 2, rural transfer ratios were higher than urban, 126% compared to 113.7%.
AHRQ-funded; HS028683.
Citation: McDaniel CE, Leyenaar JK, Bryan MA .
Urban-rural disparities in interfacility transfers for children during COVID-19.
J Rural Health 2023 Jun; 39(3):611-16. doi: 10.1111/jrh.12746..
Keywords: COVID-19, Children/Adolescents, Disparities, Rural Health, Urban Health, Rural/Inner-City Residents
Shi M, Fiori K, Kim RS
Social needs assessment and linkage to community health workers in a large urban hospital system.
The purpose of this study was to determine predictors of successful linkage with a community health worker (CHW) in patients with social needs. The researchers utilized a cross-sectional analysis of social needs assessments administered in an urban health system between April 2018 and December 2019. Social needs in the study included safety, getting along with household members, housing quality, housing instability, food insecurity, care for dependents, healthcare cost, healthcare related transportation, utilities, and legal assistance. Patients were entered into a separate database when they encountered a CHW. The main outcome was a successful "linkage," which was defined as having a positive social needs assessment in the medical record with a corresponding record in the CHW database. The study found that 25% of patients with at least 1 social need accepting help were linked to a CHW. Positive predictors included female gender, Spanish language preference compared to English, and having a food-related need. Negative predictors included age 18 to 65 and 0 to 5 compared to over 65, non-Hispanic White race compared to Hispanic race, and having needs of getting along with household members and safety.
AHRQ-funded; HS026396.
Citation: Shi M, Fiori K, Kim RS .
Social needs assessment and linkage to community health workers in a large urban hospital system.
J Prim Care Community Health 2023 Jan-Dec; 14:21501319231166918. doi: 10.1177/21501319231166918..
Keywords: Urban Health, Healthcare Delivery, Social Determinants of Health, Community-Based Practice, Rural/Inner-City Residents
Arcia A, Pho AT, Lor M
Comparison of newest vital sign and brief health literacy screen scores in a large, urban Hispanic cohort.
The purpose of this study was to examine the relationship between Newest Vital Sign (NVS) and Brief Health Literacy Screen (BHLS) scores in a large cohort of English- and Spanish-speaking urban Hispanic adults. Scores on both measures showed good internal consistency but NVS items had high difficulty; greater than 50% of respondents scored 0. The correlation between measures was weak. The study concluded that health literacy scores were poor predictors of objective scores.
AHRQ-funded; HS019853; HS022961.
Citation: Arcia A, Pho AT, Lor M .
Comparison of newest vital sign and brief health literacy screen scores in a large, urban Hispanic cohort.
Patient Educ Couns 2023 Apr; 109:107628. doi: 10.1016/j.pec.2023.107628
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Keywords: Health Literacy, Racial and Ethnic Minorities, Urban Health
Tan MS, Heise CW, Gallo T
Relationship between a risk score for QT interval prolongation and mortality across rural and urban inpatient facilities.
The objectives of this retrospective observational study were to evaluate the relationship between a modified Tisdale QTc-risk score (QTc-RS), inpatient mortality, and length of stay in a broad inpatient population with an order for a medication with a known risk of torsades de pointes (TdP). Inpatient data from 28 healthcare facilities in the western US were used. The results indicated that there is a strong relationship between increased mortality as well as longer duration of hospitalization with an increasing QTc-RS.
AHRQ-funded; HS026662.
Citation: Tan MS, Heise CW, Gallo T .
Relationship between a risk score for QT interval prolongation and mortality across rural and urban inpatient facilities.
J Electrocardiol 2023 Mar;77:4-9. doi: 10.1016/j.jelectrocard.2022.11.008.
Keywords: Heart Disease and Health, Cardiovascular Conditions, Mortality, Rural Health, Urban Health, Risk
Barton AJ, Amura CR, Willems EL
Patient and provider perceptions of COVID-19-driven telehealth use from nurse-led care models in rural, frontier, and urban Colorado communities.
The aim of this study was to describe the patient and provider encounter in the unexpected telehealth application that took place with the onset of the COVID-19 pandemic. Patients and providers from 3 nurse-led models of care (federally qualified health centers, nurse midwifery practices, and the Nurse-Family partnership program) in Colorado were surveyed. Data from the Patient Attitude toward Telehealth survey and Provider Perceptions about Telehealth were collected. Patients who resided in urban areas utilized telehealth with greater frequency than in rural or frontier areas. Across each of the 5 domains assessed, rural/frontier patients had significantly lower attitude scores than urban patients. The mode of Telehealth employed differed across location, with video calls utilized more frequently by urban providers, and phone calls utilized by rural/frontier providers.
AHRQ-funded; HS028085.
Citation: Barton AJ, Amura CR, Willems EL .
Patient and provider perceptions of COVID-19-driven telehealth use from nurse-led care models in rural, frontier, and urban Colorado communities.
J Patient Exp 2023 Jan 25; 10:23743735231151546. doi: 10.1177/23743735231151546..
Keywords: COVID-19, Telehealth, Primary Care, Patient Experience, Rural Health, Urban Health, Vulnerable Populations, Provider: Nurse
Fraze TK, Lewis VA, Wood A
Configuration and delivery of primary care in rural and urban settings.
This study examined configuration and delivery of rural primary care of Medicare beneficiaries compared to more urban settings. The study included over 27 million participants with qualifying visits who were assigned to practices. The authors characterized practices’ structures, capabilities, and payment reform participation and measured beneficiary utilization by rurality. Rural practices were smaller, more primary care dominant and system owned with more beneficiaries per practice. Rural area beneficiaries were more likely to be from high-poverty areas and disabled. There was less engagement in quality-focused payment programs than in metropolitan practices. There was less preventive care, such as fewer beneficiaries with diabetes receiving an eye exam, fewer mammograms, and higher overall and condition-specific readmissions. While most isolated beneficiaries traveled to more urban practices for outpatient care, those receiving care in rural practices had similar outpatient and inpatient utilization to urban counterparts except for readmissions and quality metrics that rely on services outside of primary care.
AHRQ-funded; HS024075.
Citation: Fraze TK, Lewis VA, Wood A .
Configuration and delivery of primary care in rural and urban settings.
J Gen Intern Med 2022 Sep;37(12):3045-53. doi: 10.1007/s11606-022-07472-x..
Keywords: Primary Care, Healthcare Delivery, Rural Health, Urban Health, Medicare
Kim B, Mulready-Ward C, Thorpe LE
Housing environments and asthma outcomes within population-based samples of adults and children in NYC.
This study assessed the relationship between housing type (i.e., home ownership, public housing, rental assistance, rent-controlled housing, and other rental housing) and asthma outcomes among New York City (NYC) adults and children (ages 1-13). The authors used the 2019 NYC Community Health Survey (CHS) and 2019 NYC KIDS survey to analyze associations between housing type and ever having been diagnosed with asthma (“ever asthma”) and experiencing an asthma attack within the past year. They also examined whether associations were modified by smoking status (among adults), smoking within the house (among children), and overweight/obesity. Among adults, living in public housing, compared to home ownership, was associated with higher odds of ever asthma and past-year asthma attack. Rental assistance housing living was also significantly associated with ever asthma. Public or rental assistance housing associations and ever asthma were marginally significant among children but were more pronounced among ever smokers than among never smokers.
AHRQ-funded; HS026120.
Citation: Kim B, Mulready-Ward C, Thorpe LE .
Housing environments and asthma outcomes within population-based samples of adults and children in NYC.
Prev Med 2022 Aug;161:107147. doi: 10.1016/j.ypmed.2022.107147..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Social Determinants of Health, Vulnerable Populations, Urban Health, Chronic Conditions
Heller CG, Rehm CD, Parsons AH
The association between social needs and chronic conditions in a large, urban primary care population.
This study sought to understand the association between social needs and chronic health conditions using a screening tool and clinical data from Electronic Health Records. From April 2018 to December 2019, 33,550 adult patients completed a 10-item social needs screening tool during primary visits in Bronx and Westchester Counties, NY. A positive, cumulative association between social needs and each of the eight outcomes asked about was found. The relationship was strongest for elevated PHQ-2 (depression screening), alcohol/drug use disorder, and smoking. Those with 3 or greater social needs were 3.9 times more likely to have an elevated PHQ-2 than those without needs. Healthcare transportation challenges was associated with each condition and was the most strongly associated need with half of conditions in the fully-adjusted models. Examples included those with an alcohol/drug use disorder (84% more likely), and smokers (41% more likely).
AHRQ-funded; HS026396.
Citation: Heller CG, Rehm CD, Parsons AH .
The association between social needs and chronic conditions in a large, urban primary care population.
Prev Med 2021 Dec;153:106752. doi: 10.1016/j.ypmed.2021.106752..
Keywords: Chronic Conditions, Urban Health, Primary Care, Low-Income, Social Determinants of Health, Screening
Greenwood-Ericksen M, Kamdar N, Lin P
Association of rural and critical access hospital status with patient outcomes after emergency department visits among Medicare beneficiaries.
This study compared 30-day mortality rates after emergency department (ED) visits to rural or critical access hospitals (CAHs) compared to urban hospitals for Medicare beneficiaries. A 20% sample of Medicare beneficiaries was used from January 2011 to October 31, 2015. The primary outcome measured was 30-day mortality. Secondary outcome examined was ED visits with and without rehospitalization. Mortality rates were comparable with both groups, although patients in rural EDs experienced more transfers and less hospitalization.
AHRQ-funded; HS024160.
Citation: Greenwood-Ericksen M, Kamdar N, Lin P .
Association of rural and critical access hospital status with patient outcomes after emergency department visits among Medicare beneficiaries.
JAMA Netw Open 2021 Nov;4(11):e2134980. doi: 10.1001/jamanetworkopen.2021.34980..
Keywords: Hospitals, Rural Health, Urban Health, Emergency Department, Mortality, Outcomes
Hoffmann JA, Hall M, Lorenz D
Emergency department visits for suicidal ideation and self-harm in rural and urban youths.
The authors sought to compare emergency department (ED) visit rates for suicidal ideation and/or self-harm among youth by urban-rural location of residence. Data was taken from the Nationwide Emergency Department Sample. They found that, compared with youths living in urban areas, youths living in rural areas had higher ED visit rates for self-harm, including self-inflicted firearm injuries. The researchers recommended preventive approaches for self-harm based in community and ED settings in order to help address these differences.
AHRQ-funded; HS026385.
Citation: Hoffmann JA, Hall M, Lorenz D .
Emergency department visits for suicidal ideation and self-harm in rural and urban youths.
J Pediatr 2021 Nov;238:282-89.e1. doi: 10.1016/j.jpeds.2021.07.013..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Behavioral Health, Rural Health, Urban Health, Healthcare Utilization
Anderson MC, Evans E, Zonfrillo MR
Rural/urban differences in discharge from rehabilitation in older adults with traumatic brain injury.
This study compared differences in outcomes for older adults with traumatic brain injury (TBI) in rural and urban settings by 1) comparing the rates of successful community discharge; and 2) reasons for not achieving successful discharge. This retrospective national cohort study looked at skilled nursing facility (SNF) patients aged 66 and older using Medicare inpatient claims with Minimum Data Set assessments. A total of 11,771 SNFs were identified with a total population of 61,021 Medicare beneficiaries discharged to a SNF following hospitalization for TBI between 2011 and 2015. Patients in rural settings had lower rates of successful discharge compared with patients in urban settings (52.1% vs 58.5%). Reasons for unsuccessful discharge differed between rural and urban settings with rural patients less likely to discharged from SNF within 100 days although they were less likely to be rehospitalized within 30 days of SNF discharge.
AHRQ-funded; HS000011.
Citation: Anderson MC, Evans E, Zonfrillo MR .
Rural/urban differences in discharge from rehabilitation in older adults with traumatic brain injury.
J Am Geriatr Soc 2021 Jun;69(6):1601-08. doi: 10.1111/jgs.17065..
Keywords: Elderly, Brain Injury, Trauma, Rural Health, Urban Health, Rehabilitation, Nursing Homes
Costello WG, Zhang L, Schnipper J
Post-discharge adverse events among African American and Caucasian patients of an urban community hospital.
This study compared post-discharge adverse events (AEs) among African American and Caucasian patients at an urban community hospital. This prospective cohort study was conducted from December 2011 to October 2012. The cohort included 589 English-speaking patients who were discharged home and could be contacted after discharge for evaluation. Two nurses performed 30-day post-discharge telephone interviews, and two physicians reviewed health records to determine AEs using a previous methodology. African Americans had a slightly higher incidence of post-discharge AEs than Caucasian patients (30.6 vs. 29.9%) but it was not statistically significant.
AHRQ-funded; HS018694.
Citation: Costello WG, Zhang L, Schnipper J .
Post-discharge adverse events among African American and Caucasian patients of an urban community hospital.
J Racial Ethn Health Disparities 2021 Apr;8(2):439-47. doi: 10.1007/s40615-020-00800-z..
Keywords: Adverse Events, Racial and Ethnic Minorities, Urban Health, Disparities, Hospital Discharge
Olmos-Ochoa TT, Miake-Lye IM, Glenn BA
Sustaining successful clinical-community partnerships in medically underserved urban areas: a qualitative case study.
This qualitative case study examines the Faith Community Health Partnership, which is a collaboration between faith-community nurses and community organizations sustained over 25 years. Factors supporting partnership sustainability were identified through semi-structured interviews with 18 FHCP partners. Factors include maintaining partners’ commitment over time; strategic resource-sharing; facilitating engagement; and preserving partnership flexibility.
AHRQ-funded; HS000046.
Citation: Olmos-Ochoa TT, Miake-Lye IM, Glenn BA .
Sustaining successful clinical-community partnerships in medically underserved urban areas: a qualitative case study.
J Community Health Nurs 2021 Jan-Mar;38(1):1-12. doi: 10.1080/07370016.2021.1869423.
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Keywords: Community Partnerships, Vulnerable Populations, Urban Health, Case Study, Access to Care, Healthcare Delivery
Loo S, Brochier A, Wexler MG
Addressing unmet basic needs for children with sickle cell disease in the United States: clinic and staff perspectives.
The purpose of this study was to assess pediatric hematology clinic staff's perspectives regarding barriers and facilitators in addressing unmet basic needs for children with sickle cell disease. Six focus groups were held at urban pediatric hematology clinics in the Northeastern region of the U.S. Four themes emerged: families of children with SCD have numerous unmet basic needs; clinic staff felt they had a role to play in addressing these needs; staff felt their ability to address these needs depended upon caregivers' capacity to act on staff recommendations; clinic staff's ability to address these needs was limited by organizational and systemic factors beyond their control. These findings have important implications for how best to address adverse social determinants of health for this vulnerable pediatric population so that urban-based pediatric hematology clinics can more equitably support families.
AHRQ-funded; HS022242.
Citation: Loo S, Brochier A, Wexler MG .
Addressing unmet basic needs for children with sickle cell disease in the United States: clinic and staff perspectives.
BMC Health Serv Res 2021 Jan 12;21(1):55. doi: 10.1186/s12913-020-06055-y..
Keywords: Children/Adolescents, Sickle Cell Disease, Chronic Conditions, Social Determinants of Health, Provider: Clinician, Provider: Physician, Provider, Urban Health
Chambers EC, Heller C, Fiori K
Chronic pediatric health conditions among youth living in public housing and receiving care in a large hospital system in Bronx, NY.
This study compared the prevalence of chronic pediatric health conditions for youth in public housing with youth not in public housing using clinical electronic health record (EHR) and housing data. Findings showed that disparities in health conditions among youth in public housing were more common in early adolescence: asthma, obesity, depression/anxiety, and behavioral disorders. Chronic pediatric conditions like asthma and obesity that lead to significant morbidity into adulthood are more common among youth living in public housing; however, this pattern is not consistent across all chronic conditions.
AHRQ-funded; HS026396.
Citation: Chambers EC, Heller C, Fiori K .
Chronic pediatric health conditions among youth living in public housing and receiving care in a large hospital system in Bronx, NY.
Glob Pediatr Health 2020 Nov 11;7:2333794x20971164. doi: 10.1177/2333794x20971164..
Keywords: Children/Adolescents, Vulnerable Populations, Chronic Conditions, Urban Health
Aguirre A, Trupin L, Margaretten M
Using process improvement and systems redesign to improve rheumatology care quality in a safety net clinic.
Researchers sought to develop and evaluate interventions to improve quality of care in four priority areas in an urban safety net adult rheumatology clinic serving a racially/ethnically and socioeconomically diverse patient population. Clinical processes were redesigned to achieve pre-specified benchmarks in the following four areas: 13-valent pneumococcal conjugate vaccine (PCV13) administered to immunocompromised patients; Clinical Disease Activity Index (CDAI) disease activity monitoring for patients with rheumatoid arthritis; latent tuberculosis infection (LTBI) screening for new biologic users with rheumatoid arthritis; reproductive health counseling among women receiving potentially teratogenic medications. Through an interprofessional approach, the researchers achieved durable improvements in key rheumatology quality measures largely by enhancing workflow, engaging non-physician providers, and managing practice variation.
AHRQ-funded; HS024412; HS025638.
Citation: Aguirre A, Trupin L, Margaretten M .
Using process improvement and systems redesign to improve rheumatology care quality in a safety net clinic.
J Rheumatol 2020 Nov;47(11):1712-20. doi: 10.3899/jrheum.190472..
Keywords: Urban Health, Rural/Inner-City Residents, Quality Improvement, Quality of Care, Healthcare Delivery
Lara OD, O'Cearbhaill RE, Smith MJ
COVID-19 outcomes of patients with gynecologic cancer in New York City.
Researchers studied clinical characteristics and outcomes of vulnerable populations with gynecologic cancer who developed COVID-19 infections. Among patients from six New York City area hospital systems with known gynecologic cancer and a COVID-19 diagnosis, the researchers found a case fatality rate of 14 percent, with no association between cytotoxic chemotherapy and cancer-directed surgery and COVID-19 severity or death. They recommended that patients be counseled regarding the safety of continued anticancer treatments during the pandemic, as the ability to continue cancer therapies for cancer control and cure is critical.
AHRQ-funded; HS026120.
Citation: Lara OD, O'Cearbhaill RE, Smith MJ .
COVID-19 outcomes of patients with gynecologic cancer in New York City.
Cancer 2020 Oct 1;126(19):4294-303. doi: 10.1002/cncr.33084..
Keywords: COVID-19, Respiratory Conditions, Cancer, Women, Vulnerable Populations, Outcomes, Urban Health
Lee H, Caldwell JT, Maene C
Racial/ethnic inequities in access to high-quality dialysis treatment in Chicago: does neighborhood racial/ethnic composition matter?
Investigators examined whether neighborhood racial composition contributes to racial/ethnic inequities in access to high-quality dialysis care in Chicago. Data from the United States Renal Data System was merged with the ESRD Quality Incentive Program file and the American Community Survey (2005-2009) for facility and neighborhood characteristics. The investigators concluded that expanding opportunities for Blacks and Hispanics to gain access to racially integrated and minority neighborhoods may help alleviate racial/ethnic inequities in access to quality care among kidney disease patients.
AHRQ-funded; HS00078.
Citation: Lee H, Caldwell JT, Maene C .
Racial/ethnic inequities in access to high-quality dialysis treatment in Chicago: does neighborhood racial/ethnic composition matter?
J Racial Ethn Health Disparities 2020 Oct;7(5):854-64. doi: 10.1007/s40615-020-00708-8..
Keywords: Racial and Ethnic Minorities, Access to Care, Urban Health, Dialysis, Disparities, Quality of Care, Kidney Disease and Health
Koller KR, Day GE, Hiratsuka VY
Increase in diabetes among urban Alaska Native people in the Alaska EARTH follow-up study: a call for prediabetes screening, diagnosis, and referral for intervention.
This study estimated incidence of diabetes (DM) and pre-DM relative to DM risk factors among relatively healthy Alaska Native and American Indian (AN) adults living in urban south-central Alaska. Results showed that, controlling for age and sex, obesity, abdominal adiposity, pre-DM, and metabolic syndrome independently increased DM risk. Recommendations included advising health care providers of AN populations to seize the opportunity to screen, refer, and treat individuals with pre-DM and other modifiable DM risk factors prior to DM diagnosis in order to alter the epidemiologic course of disease progression in this urban AN population.
AHRQ-funded; HS000084.
Citation: Koller KR, Day GE, Hiratsuka VY .
Increase in diabetes among urban Alaska Native people in the Alaska EARTH follow-up study: a call for prediabetes screening, diagnosis, and referral for intervention.
Diabetes Res Clin Pract 2020 Sep;167:108357. doi: 10.1016/j.diabres.2020.108357..
Keywords: Diabetes, Racial and Ethnic Minorities, Urban Health, Risk, Prevention, Screening, Diagnostic Safety and Quality, Chronic Conditions
Govindarajan P, Shiboski S, Grimes B
Effect of acute stroke care regionalization on intravenous alteplase use in two urban counties.
Investigators sought to determine whether increasing access to primary stroke centers (regionalization) led to an increase in intravenous alteplase use in acute ischemic stroke patients. Studying two urban counties in the western region of US that regionalized acute stroke care, they found that in Santa Clara County, intravenous alteplase was administered to 1.7% of patients in the pre-regionalization period and 2.1% in the post-regionalization period, while in San Mateo County, the numbers were 1.3% and 3.2%, respectively. In the post-regionalization phase, San Mateo County had greater change in paramedic stroke detection, higher number of transports to primary stroke centers, and more frequent use of intravenous alteplase at stroke centers. They concluded that greater post-regionalization improvements in San Mateo County contributed to significantly improved county-level thrombolysis use than Santa Clara County.
AHRQ-funded; HS026207; HS017965.
Citation: Govindarajan P, Shiboski S, Grimes B .
Effect of acute stroke care regionalization on intravenous alteplase use in two urban counties.
Prehosp Emerg Care 2020 Jul-Aug;24(4):505-14. doi: 10.1080/10903127.2019.1679303..
Keywords: Stroke, Cardiovascular Conditions, Urban Health, Access to Care, Emergency Medical Services (EMS), Critical Care
Fiori KP, Heller CG, Rehm CD
Unmet social needs and no-show visits in primary care in a US Northeastern urban health system, 2018-2019.
This study used results from a 10-item social needs screener conducted across 19 primary care practices in Bronx County, New York to determine reasons for no-show appointments between April 2018 and July 2019. They examined the association between unmet needs and a 2-year history of missed appointments from 41,637 patients. Overall, the no-show appointment rate was 26.6%. Patients with 1 or more unmet social needs had a significantly higher no-show proportion (31.5%) than those without (26.3%). The strongest association with no-shows was with transportation problems.
AHRQ-funded; HS026396.
Citation: Fiori KP, Heller CG, Rehm CD .
Unmet social needs and no-show visits in primary care in a US Northeastern urban health system, 2018-2019.
Am J Public Health 2020 Jul;110(S2):S242-s50. doi: 10.2105/ajph.2020.305717..
Keywords: Urban Health, Primary Care, Access to Care, Social Determinants of Health