National Healthcare Quality and Disparities Report
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Topics
- (-) Access to Care (6)
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- COVID-19 (3)
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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 6 of 6 Research Studies DisplayedAmu-Nnadi CN, Ross ES, Garcia NH
Health system integration and cancer center access for rural hospitals.
This study’s goal was to assess health system integration and cancer center access for rural hospitals. The authors compared health systems with and without cancer centers based on rural hospital presence. They found that 90% of cancer centers are in a health system, and 72% of health systems (434/607) have a cancer center. Larger health systems with more trainees more often have cancer centers but are no more likely to include rural hospitals (11% vs 6%). The minority of cancer centers not in health systems (N = 95) more often serve low complexity patient populations in non-metropolitan areas.
AHRQ-funded; HS013852.
Citation: Amu-Nnadi CN, Ross ES, Garcia NH .
Health system integration and cancer center access for rural hospitals.
Am Surg 2024 May; 90(5):1023-29. doi: 10.1177/00031348231216497..
Keywords: Health Systems, Cancer, Rural Health, Rural/Inner-City Residents, Access to Care
King CA, Beetham T, Smith N
Adolescent residential addiction treatment in the US: uneven access, waitlists, and high costs.
This study examined adolescent residential addiction treatment facilities in the United States, and their accessibility and cost. The authors used the Substance Abuse and Mental Health Services Administration's treatment locator and search engine advertising data to identify 160 residential addiction treatment facilities that treated adolescents with opioid use disorder as of December 2022. They called facilities while role-playing as the aunt or uncle of a sixteen-year-old child with a recent nonfatal overdose to inquire about policies and costs. A little over half (54.5%) had a bed immediately available. The mean wait time for a bed was 28.4 days among sites with a waitlist. Of the facilities that provided cost information, the mean cost of treatment per day was $878, with daily costs among for-profit facilities triple of nonprofit facilities. Half of facilities required up-front payments by noninsured patients, with a mean up-front cost of $28,731. They were unable to identify any facilities for adolescents in ten states or Washington, D.C.
AHRQ-funded; HS017589.
Citation: King CA, Beetham T, Smith N .
Adolescent residential addiction treatment in the US: uneven access, waitlists, and high costs.
Health Aff 2024 Jan; 43(1):64-71. doi: 10.1377/hlthaff.2023.00777..
Keywords: Children/Adolescents, Substance Abuse, Healthcare Costs, Access to Care
Adams DR
Availability and accessibility of mental health services for youth: a descriptive survey of safety-net health centers during the COVID-19 pandemic.
The goal of this study was to assess the availability of outpatient mental health services for children and adolescents at safety-net health centers in a large metropolitan county. A comprehensive sample of Community Mental Health Centers (CMHCs) and Federally Qualified Health Centers (FQHCs) received a 5-minute survey approximately one year after the beginning of the COVID-19 pandemic. The response indicated that 10% of health centers had closed and 20% reported that they were not offering outpatient mental health services. Reported wait times were longer at CMHCs than FQHCs. The author concluded that these findings suggested that online directories such as the SAMHSA Treatment Locator are often inaccurate or out-of-date.
AHRQ-funded; HS000084.
Citation: Adams DR .
Availability and accessibility of mental health services for youth: a descriptive survey of safety-net health centers during the COVID-19 pandemic.
Community Ment Health J 2024 Jan; 60(1):88-97. doi: 10.1007/s10597-023-01127-9..
Keywords: Children/Adolescents, Behavioral Health, Access to Care, COVID-19, Public Health
Eliason EL, Agostino J, Vivier P
Infant health care disruptions by race and ethnicity, income, and insurance during the COVID-19 pandemic.
This cross-sectional study examined the impact that the COVID-19 pandemic had on infant health care, and broke it down by race and ethnicity, income, and insurance type. This study used the Pregnancy Risk Assessment Monitoring System COVID-19 supplement with data from 29 jurisdictions to examine infant health care disruptions due to the pandemic: 1) well visits/checkups canceled or delayed, 2) well visits/checkups changed to virtual appointments, and 3) postponed immunizations. The authors found that among 12,053 parental respondents with infants born from April to December 2020, 7.25% reported cancelations or delays in infant well visits/checkups, 5.49% reported changes to virtual infant care appointments, and 5.33% reported postponing immunizations, with significant differences by race and ethnicity, income, and insurance type. They found higher odds of canceling/delaying visits and postponing immunizations among non-Hispanic Black infants and infants whose parents were uninsured or had Medicaid-paid deliveries. The odds of switching to virtual appointments was also significantly higher among Hispanic infants and infants whose parents had Medicaid-paid deliveries.
AHRQ-funded; HS000011.
Citation: Eliason EL, Agostino J, Vivier P .
Infant health care disruptions by race and ethnicity, income, and insurance during the COVID-19 pandemic.
Acad Pediatr 2024 Jan-Feb; 24(1):105-10. doi: 10.1016/j.acap.2023.07.005..
Keywords: Newborns/Infants, Racial and Ethnic Minorities, COVID-19, Access to Care, Uninsured, Health Insurance, Healthcare Delivery
Cron DC, Braun HJ, Ascher NL
Sex-based disparities in access to liver transplantation for waitlisted patients with model for end-stage liver disease score of 40.
The objective of this study was to determine association of sex with access to liver transplantation among candidates with the highest possible model for end-stage liver disease score (MELD 40). Using national transplant registry data, researchers compared liver offer acceptance and waitlist outcomes by sex for waitlisted liver transplant candidates who reached MELD 40. Results showed that even among candidates with high disease severity and equally high MELD scores, women have reduced access to liver transplantation and worse outcomes compared with men. The researchers concluded that policies addressing this disparity should consider factors beyond MELD score adjustments.
AHRQ-funded; HS028476.
Citation: Cron DC, Braun HJ, Ascher NL .
Sex-based disparities in access to liver transplantation for waitlisted patients with model for end-stage liver disease score of 40.
Ann Surg 2024 Jan; 279(1):112-18. doi: 10.1097/sla.0000000000005933..
Keywords: Disparities, Access to Care, Sex Factors, Transplantation
Mitchell JM, Kranz AM, Steiner ED
Barriers and strategies used to continue school-based health services during the COVID-19 pandemic.
This study examined perceived barriers and strategies adopted to continue the delivery of school-based health services when schools reopened in Fall of 2021 during the COVID-19 pandemic and to assess whether these barriers and strategies varied by locality. The authors developed and subsequently conducted an online survey of school nurses who worked at the 1178 public elementary schools in Virginia in May 2021 to describe the impact of the COVID-19 pandemic on the delivery of school-based health services. They compared perceived barriers, strategies adopted and the effectiveness of strategies to continue the delivery of school-based health services by geographic locality (city vs. rural; suburban vs. rural and city vs. suburban). More than half of urban schools expected nine of ten potential barriers to affect the delivery of school-based health services during Fall 2021. More than half of responding schools located in urban, suburban, and rural areas indicated that external barriers outside of their control, including insufficient funding and families not able to bring students to school, were likely to be barriers to delivering care. There was no variation in strategies identified as “very effective” by locality.
AHRQ-funded; HS025430.
Citation: Mitchell JM, Kranz AM, Steiner ED .
Barriers and strategies used to continue school-based health services during the COVID-19 pandemic.
Matern Child Health J 2024 Jan; 28(1):155-64. doi: 10.1007/s10995-023-03824-z.
Keywords: COVID-19, Children/Adolescents, Access to Care