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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 7 of 7 Research Studies DisplayedMacDougall 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
Levander XA, Foot CA, Magnusson SL
Contraception and healthcare utilization by reproductive-age women who use drugs in rural communities: a cross-sectional survey.
This study’s goal was to compare contraceptive use prevalence among women who use drugs (WWUD) in rural communities with women who do not use drugs from similar rural areas. The authors used survey data from the Rural Opioids Initiative (ROI), a cross-sectional survey using respondent-driven sampling (RDS) involving eight rural U.S. regions (January 2018-March 2020) and the National Survey on Family Growth (NSFG), a nationally representative U.S. household reproductive health survey (2017-2019). Women aged 18-49 with prior 30-day non-prescribed opioid and/or non-opioid injection drug use were included. Of 855 women in the ROI, 36.8% and 38.6% reported contraceptive use, compared to 66% of rural women in the NSFG sample. Among the ROI women, 27% had received prior 30-day SUD treatment via outpatient counseling or inpatient program and these women had increased odds of contraceptive use. There was a positive association between contraception use and recent medications for opioid use disorder and prior 6-month primary care utilization that did not meet the threshold for statistical significance.
AHRQ-funded; HS02637; HS027088.
Citation: Levander XA, Foot CA, Magnusson SL .
Contraception and healthcare utilization by reproductive-age women who use drugs in rural communities: a cross-sectional survey.
J Gen Intern Med 2023 Jan; 38(1):98-106. doi: 10.1007/s11606-022-07558-6..
Keywords: Sexual Health, Women, Healthcare Utilization, Rural Health
Roberson ML, Nichols HB, Olshan AF
Trends in surgical treatment of early-stage breast cancer reveal decreasing mastectomy use between 2003 and 2016 by age, race, and rurality.
The authors sought to examine trends in the surgical treatment of breast cancer by age, rurality, and among Black women in a populous, racially diverse, state in the Southeastern United States of America. Using data from the North Carolina Central Cancer Registry, they found declining mastectomy rates in the early 2000s in a Southern US state with a racially and geographically diverse population. These decreasing trends were consistent among key subgroups affected by cancer inequities, including Black and White rural women.
AHRQ-funded; HS027299.
Citation: Roberson ML, Nichols HB, Olshan AF .
Trends in surgical treatment of early-stage breast cancer reveal decreasing mastectomy use between 2003 and 2016 by age, race, and rurality.
Breast Cancer Res Treat 2022 Jun;193(2):445-54. doi: 10.1007/s10549-022-06564-w..
Keywords: Cancer: Breast Cancer, Cancer, Women, Surgery, Racial and Ethnic Minorities, Rural Health
Bunting AM, Dickson M, Staton M
Polysubstance use and re-incarceration in the 12-months after release from jail: a latent transition analysis of rural Appalachian women.
The purpose of this study was to: 1) identify the patterns of polysubstance use of rural Appalachian justice-involved women, 2) examine how women's participation in polysubstance use changed in the 12-months after initial release from jail, and 3) determine if changes in women's substance use patterns were correlated with re-incarceration during the 12-months of follow-up after release. The researchers randomly recruited 339 women with a recent history of substance use from three rural jails, and analyzed their substance use from baseline (in jail) to 6 and 12-months. The study found three latent classes: High Polysubstance/injection drug use (IDU) (36.3% baseline), Opioid/Benzo (Benzodiazepine) Involved Polysubstance Use (57.3% baseline), and Low Use (6.4% baseline). After release, and especially in the first 6 months, women transitioned to latent classes of reduced substance use and/or reduced injection drug use. Women who were re-incarcerated during follow-up were likely to remain engaged in, or transition to, the High Polysubstance/IDU class. The researchers concluded that a crucial period for changes in substance use lies in the six-months post-release.
AHRQ-funded; HS026120.
Citation: Bunting AM, Dickson M, Staton M .
Polysubstance use and re-incarceration in the 12-months after release from jail: a latent transition analysis of rural Appalachian women.
Am J Drug Alcohol Abuse 2022 May 4;48(3):356-66. doi: 10.1080/00952990.2021.1995402..
Keywords: Substance Abuse, Behavioral Health, Rural Health, Women
Longacre CF, Neprash HT, Shippee ND
Evaluating travel distance to radiation facilities among rural and urban breast cancer patients in the Medicare population.
This study characterizes the actual distance older breast cancer patients traveled to radiation treatment and the minimum distance necessary to reach radiation care, and examines whether any patient demographic or clinical factors are associated with greater travel distance. Findings showed that patients living in rural areas traveled on average nearly 3 times as far as those from urban areas, and their nearest facility was more than 4 times farther away. Older age, being single or widowed, and lower household income were significantly associated with shorter actual travel distance, while increasing rurality was significantly associated with greater actual and minimum travel distance to radiation treatment.
AHRQ-funded; HS026660.
Citation: Longacre CF, Neprash HT, Shippee ND .
Evaluating travel distance to radiation facilities among rural and urban breast cancer patients in the Medicare population.
J Rural Health 2020 Jun;36(3):334-46. doi: 10.1111/jrh.12413..
Keywords: Rural Health, Cancer: Breast Cancer, Cancer, Elderly, Women, Access to Care, Disparities
Lee SC, Higashi RT, Sanders JM
Effects of program scale-up on time to resolution for patients with abnormal screening mammography results.
Effects of geographic program expansion to rural areas on mammogram screening program outcomes are understudied. The authors of this study sought to determine whether time-to-resolution (TTR) varied significantly by service delivery time period, location, and participant characteristics across 19 North Texas counties.
AHRQ-funded; HS022418.
Citation: Lee SC, Higashi RT, Sanders JM .
Effects of program scale-up on time to resolution for patients with abnormal screening mammography results.
Cancer Causes Control 2018 Oct;29(10):995-1005. doi: 10.1007/s10552-018-1074-4..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Screening, Women, Rural Health, Access to Care, Prevention
Stringer KL, Azuero A, Ott C
Feasibility and acceptability of real-time antiretroviral adherence monitoring among depressed women living with HIV in the deep south of the US.
The purpose of this study was to present feasibility and acceptability data on the use of an electronic adherence monitor (EAM) among African American women in remote areas of the Southeastern United States with HIV and co-occurring depression. EAM and self-reported antiretroviral therapy (ART) adherence was monitored among 25 participants recruited at four HIV clinics in Alabama. Intra-class correlation showed a low degree of concordance between EAM and self-reported adherence. 83% of data collected via EAM was transmitted in real-time; the remainder was delayed though technological failures or was lost entirely. The authors conclude that EAM monitoring is feasible in a rural US setting but that technological difficulties may impede the device's usefulness for just-in-time adherence interventions.
AHRQ-funded; HS013852.
Citation: Stringer KL, Azuero A, Ott C .
Feasibility and acceptability of real-time antiretroviral adherence monitoring among depressed women living with HIV in the deep south of the US.
AIDS Behav 2018 May;23(5):1306-14. doi: 10.1007/s10461-018-2322-z..
Keywords: Depression, Health Information Technology (HIT), Human Immunodeficiency Virus (HIV), Medication, Behavioral Health, Patient Adherence/Compliance, Rural Health, Telehealth, Women