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AHRQ Research Studies Date
Topics
- Access to Care (5)
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- Autism (1)
- (-) Behavioral Health (24)
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- Policy (5)
- Practice Patterns (2)
- Primary Care (2)
- Primary Care: Models of Care (1)
- Racial and Ethnic Minorities (7)
- Rural Health (1)
- Social Determinants of Health (1)
- Substance Abuse (2)
- Uninsured (2)
- Women (1)
- Young Adults (1)
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 24 of 24 Research Studies DisplayedZuvekas SH
AHRQ Author: Zuvekas SH
COVID-19, mental health, and mental health treatment among adults.
This AHRQ-authored paper seeks to examine the impact of the COVID-19 pandemic on mental health status and mental health treatment among adults residing in the U.S. civilian, non-institutionalized population. Data from the 2019-2020 MEPS was used. The author examined unadjusted and regression-adjusted differences between 2019 and 2020 in perceived mental health status (excellent, very good, good, fair, poor) and in the K6 general psychological distress, the PHQ-2 depression screener, and the VR-12 mental component summary score. Similarly, using the detailed MEPS data on health care encounters and prescription drug fills, he examined differences in mental health use treatment between 2019 and 2020. He focused specifically on changes in continuity of treatment among those already in treatment in January and February, before the pandemic fully struck, as well differences in the initiation of new episodes of treatment after the pandemic began. Results were that all four mental health scales included in the MEPS showed statistically significant declines in mental health between 2019 and 2020, particularly among younger adults. However, the percentage of US adults receiving mental health treatment did not change significantly. Continuity of treatment increased slightly in 2020, with 87.1% of adults in treatment January or February still receiving care in the second quarter, an increase of 2.5 percentage points. However, there were significant declines in the initiation of new treatment, especially in the second quarter of 2020.
AHRQ-authored.
Citation: Zuvekas SH .
COVID-19, mental health, and mental health treatment among adults.
J Ment Health Policy Econ 2023 Dec 1; 26(4):159-83..
Keywords: Medical Expenditure Panel Survey (MEPS), COVID-19, Behavioral Health
Olfson M, Zuvekas SH, McClellan C
AHRQ Author: Zuvekas SH, McClellan C
Racial-ethnic disparities in outpatient mental health care in the United States.
Using data from the 2018-19 Medical Expenditure Panel Survey, researchers compared national rates and patterns of use for outpatient mental health care among Hispanic, non-Hispanic Black, and non-Hispanic White individuals. Analyses focused on individuals using psychotropic medications, psychotherapy, or both, and receipt of minimally adequate mental health care. The results showed that the rate of outpatient mental health service use was more than twice as high for White individuals, and that Black and Hispanic patients were significantly less likely to receive psychotropic medications; Black and Hispanic patients were more likely to receive psychotherapy. No significant differences were found in patients who received minimally adequate treatment for depression, anxiety, attention-deficit hyperactivity disorder, or disruptive behavior disorders. The authors concluded that achieving racial-ethnic equity will require dedicated efforts to promote greater mental health service access for Black and Hispanic persons in need.
AHRQ-authored.
Citation: Olfson M, Zuvekas SH, McClellan C .
Racial-ethnic disparities in outpatient mental health care in the United States.
Psychiatr Serv 2023 Jul; 74(7):674-83. doi: 10.1176/appi.ps.20220365..
Keywords: Medical Expenditure Panel Survey (MEPS), Racial and Ethnic Minorities, Disparities, Behavioral Health, Ambulatory Care and Surgery
McClellan C, Moriya A, Simon K
AHRQ Author: McClellan C Moriya A
Users of retail medications for opioid use disorders faced high out-of-pocket prescription spending in 2011-2017.
This paper provides national estimates of financial costs faced by the population receiving retail medications for opioid use disorders (MOUD). Using MEPS data, findings showed that patients with retail MOUD prescriptions spent 3.4 times more out-of-pocket for prescriptions on average than the rest of the U.S. population, with 18.8% of this population paying entirely out-of-pocket for their MOUD prescriptions. Insurance coverage was associated with reduced annual out-of-pocket MOUD expenditures. Future policies that expand insurance and address out-of-pocket spending on MOUD could increase access to medications among individuals with opioid use disorders.
AHRQ-authored.
Citation: McClellan C, Moriya A, Simon K .
Users of retail medications for opioid use disorders faced high out-of-pocket prescription spending in 2011-2017.
J Subst Abuse Treat 2022 Jan;132:108645. doi: 10.1016/j.jsat.2021.108645..
Keywords: Medical Expenditure Panel Survey (MEPS), Opioids, Substance Abuse, Behavioral Health, Healthcare Costs, Medication
Zuvekas SH, Grosse SD, Lavelle TA
AHRQ Author: Zuvekas SH
Healthcare costs of pediatric autism spectrum disorder in the United States, 2003-2015.
Published healthcare cost estimates for children with autism spectrum disorder (ASD) vary widely. One possible contributor is different methods of case ascertainment. In this study, autism spectrum disorder (ASD) case status was determined using two sources of parent reports among 45,944 children ages 3-17 years in the Medical Expenditure Panel Survey (MEPS) linked to the National Health Interview Survey (NHIS) Sample Child Core questionnaire. In this paper, the investigators describe their process and conclusions.
AHRQ-authored.
Citation: Zuvekas SH, Grosse SD, Lavelle TA .
Healthcare costs of pediatric autism spectrum disorder in the United States, 2003-2015.
J Autism Dev Disord 2021 Aug;51(8):2950-58. doi: 10.1007/s10803-020-04704-z..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Autism, Healthcare Costs, Behavioral Health
Zuvekas SH, McClellan CB, Ali MM
AHRQ Author: Zuvekas SH, McClellan CB
Medicaid expansion and health insurance coverage and treatment utilization among individuals with a mental health condition.
AHRQ-authored.
Citation: Zuvekas SH, McClellan CB, Ali MM .
Medicaid expansion and health insurance coverage and treatment utilization among individuals with a mental health condition.
J Ment Health Policy Econ 2020 Sep 1;23(3):151-82..
Keywords: Medical Expenditure Panel Survey (MEPS), Behavioral Health, Medicaid, Health Insurance, Access to Care, Healthcare Utilization, Policy, Uninsured
Cook BL, Flores M, Zuvekas SH
AHRQ Author: Zuvekas SH
The impact Of Medicare's mental health cost-sharing parity on use of mental health care services.
This study examined the impact of Medicare’s mental health cost-sharing parity on use of mental health care services, which was phased in from 2010 to 2014. The authors assessed whether the reduction in mental health cost sharing was associated with changes in specialty and primary care outpatient mental health visits and psychotropic medication fills. They compared people with Medicare and private insurance before and after implementation. Medicare beneficiaries’ use of psychotropic medication increased after implementation but there was not a detectable change in visits.
AHRQ-authored.
Citation: Cook BL, Flores M, Zuvekas SH .
The impact Of Medicare's mental health cost-sharing parity on use of mental health care services.
Health Aff 2020 May;39(5):819-27. doi: 10.1377/hlthaff.2019.01008..
Keywords: Medical Expenditure Panel Survey (MEPS), Medicare, Behavioral Health, Healthcare Costs, Policy, Health Insurance, Healthcare Utilization, Access to Care
Grafova IB, Monheit AC, Kumar R
How do changes in income, employment and health insurance affect family mental health spending?
This study used eight two-year panels from the MEPS data for 2004 to 2012 to examine the effect of economic shocks on mental health spending by families with children. Researchers wanted to determine whether the greatest impact on mental health spending comes from income, employment, or health insurance shocks. They used two-part expenditure models to estimate that employment losses are positively related to an increase in total family mental health expenditures. But no link was found between economic shocks and mental health spending on fathers.
AHRQ-funded; HS024053.
Citation: Grafova IB, Monheit AC, Kumar R .
How do changes in income, employment and health insurance affect family mental health spending?
Rev Econ Househ 2020 Mar;18(1:239-63. doi: 10.1007/s11150-018-9436-y.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Behavioral Health, Social Determinants of Health, Health Insurance
Kirby JB, Zuvekas SH, Borsky AE
AHRQ Author: Kirby JB, Zuvekas SH, Borsky AE, Ngo-Metzger Q.
Rural residents with mental health needs have fewer care visits than urban counterparts.
This analysis compared the number of adults with mental health needs living in rural areas compared to those in urban areas. A nationally representative sample of adults showed that there were fewer ambulatory mental health visits for rural residents, even with those already on prescription medications for mental health conditions.
AHRQ-authored.
Citation: Kirby JB, Zuvekas SH, Borsky AE .
Rural residents with mental health needs have fewer care visits than urban counterparts.
Health Aff 2019 Dec;38(12):2057-60. doi: 10.1377/hlthaff.2019.00369..
Keywords: Medical Expenditure Panel Survey (MEPS), Behavioral Health, Rural Health, Access to Care, Healthcare Utilization
Biener AI, Zuvekas SH
AHRQ Author: Zuvekas SH
Do racial and ethnic disparities in mental health treatment vary with underlying mental health?
AHRQ-authored.
Citation: Biener AI, Zuvekas SH .
Do racial and ethnic disparities in mental health treatment vary with underlying mental health?
Med Care Res Rev 2021 Aug;78(4):392-403. doi: 10.1177/1077558720903589..
Keywords: Medical Expenditure Panel Survey (MEPS), Behavioral Health, Disparities, Racial and Ethnic Minorities, Access to Care
Adams JS, Chien AT, Wisk LE
Mental illness among youth with chronic physical conditions.
Using MEPS data, the authors compared the risk of incident mental health conditions (MHCs) in youth with and without chronic physical conditions (CPCs), and explored whether activity limitations might contribute to any association. They found that youth with CPCs have increased risk for MHCs and that limitations on activity may play a role in MHC development. They recommended that youth with CPCs may benefit from services that bolster their ability to participate in developmentally important activities and that may help to detect and treat new onset MHCs.
AHRQ-funded; HS022986.
Citation: Adams JS, Chien AT, Wisk LE .
Mental illness among youth with chronic physical conditions.
Pediatrics 2019 Jul;141(1):pii: e20181819. doi: 10.1542/peds.2018-1819..
Keywords: Children/Adolescents, Chronic Conditions, Medical Expenditure Panel Survey (MEPS), Behavioral Health
Yonek JC, Jordan N, Dunlop D
Patient-centered medical home care for adolescents in need of mental health treatment.
The patient-centered medical home (PCMH) has emerged as an optimal primary care model for all youth; however, little is known about the extent to which adolescents in need of mental health (MH) treatment receive care consistent with the PCMH. This study assessed (1) 10-year trends in PCMH care among U.S. adolescents according to MH need and (2) variations in PCMH care and its subcomponents among adolescents with MH need, by individual and family characteristics.
AHRQ-funded; HS024183.
Citation: Yonek JC, Jordan N, Dunlop D .
Patient-centered medical home care for adolescents in need of mental health treatment.
J Adolesc Health 2018 Aug;63(2):172-80. doi: 10.1016/j.jadohealth.2018.02.006..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Behavioral Health, Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care
Axeen S, Seabury SA, Menchine M
Emergency department contribution to the prescription opioid epidemic.
The investigators used MEPS data to characterize the relative contribution of emergency departments (EDs) to national opioid prescribing, to estimate trends in opioid prescribing by site of care, and to examine whether higher-risk opioid users receive a disproportionate quantity of their opioids from ED settings. During the study period, they found that the relative contribution of EDs to the prescription opioid problem was modest and declining. They therefore recommended that further efforts to reduce the quantity of opioids prescribed focus on office-based settings.
AHRQ-funded; HS024251.
Citation: Axeen S, Seabury SA, Menchine M .
Emergency department contribution to the prescription opioid epidemic.
Ann Emerg Med 2018 Jun;71(6):659-67.e3. doi: 10.1016/j.annemergmed.2017.12.007..
Keywords: Behavioral Health, Emergency Department, Medical Expenditure Panel Survey (MEPS), Medication, Opioids, Practice Patterns, Substance Abuse
Jones AL, Cochran SD, Leibowitz A
Racial, ethnic, and nativity differences in mental health visits to primary care and specialty mental health providers: analysis of the Medical Expenditures Panel Survey, 2010-2015.
The researchers sought to guide post-ACA efforts to address mental health service disparities, by using a nationally representative sample to characterize baseline race-, ethnicity-, and nativity-associated differences in mental health services in the context of primary care. They found that all racial/ethnic groups were less likely than non-Latino Whites to have any primary care (PC) visit. Their conclusion was that racial-, ethnic-, and nativity-associated disparities persist in PC provided mental health services.
AHRQ-funded; HS021721.
Citation: Jones AL, Cochran SD, Leibowitz A .
Racial, ethnic, and nativity differences in mental health visits to primary care and specialty mental health providers: analysis of the Medical Expenditures Panel Survey, 2010-2015.
Healthcare 2018 Mar 22;6(2). doi: 10.3390/healthcare6020029.
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Keywords: Disparities, Medical Expenditure Panel Survey (MEPS), Behavioral Health, Primary Care, Racial and Ethnic Minorities
Gonzales G, Golberstein E, Hill SC
AHRQ Author: Hill, SC; Zuvekas, SH
Psychological distress and enrollment in Medicaid.
Adults with poor mental health may want and need insurance to obtain care, but symptoms may impede enrollment into public health insurance. The enrollment response to Medicaid expansions prior to the Affordable Care Act was stronger for adults symptomatic of psychological distress compared with adults without distress and compared to adults with chronic physical health problems.
AHRQ-authored.
Citation: Gonzales G, Golberstein E, Hill SC .
Psychological distress and enrollment in Medicaid.
J Behav Health Serv Res 2017 Oct;44(4):523-35. doi: 10.1007/s11414-016-9532-9.
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Keywords: Access to Care, Policy, Medicaid, Medical Expenditure Panel Survey (MEPS), Behavioral Health
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
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
Cook BL, Carson NJ, Kafali EN
Examining psychotropic medication use among youth in the U.S. by race/ethnicity and psychological impairment.
This study examined racial/ethnic differences in the prescription of psychotropic medications among youth with and without psychological impairment. Compared to Black and Latino youth with psychological impairment, White youth were more likely to be prescribed psychotropic medications when impaired. Among youth never having psychological impairment, White youth were also more likely to be prescribed medications compared to their racial/ethnic minority counterparts.
AHRQ-funded; HS021486.
Citation: Cook BL, Carson NJ, Kafali EN .
Examining psychotropic medication use among youth in the U.S. by race/ethnicity and psychological impairment.
Gen Hosp Psychiatry 2017 Mar - Apr;45:32-39. doi: 10.1016/j.genhosppsych.2016.12.004.
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Keywords: Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Medication, Behavioral Health, Racial and Ethnic Minorities
Ali MM, Chen J, Mutter R
AHRQ Author: Novak P
The ACA's dependent coverage expansion and out-of-pocket spending by young adults with behavioral health conditions.
The authors analyzed out-of-pocket spending as a share of total health care expenditures for young adults with behavioral health conditions before and after the implementation of the ACA dependent care provision. They found that the extension of health insurance coverage to young adults with behavioral health disorders has provided them with additional financial protection, which can be important given the low incomes and high debt burden that characterize the age group.
AHRQ-authored.
Citation: Ali MM, Chen J, Mutter R .
The ACA's dependent coverage expansion and out-of-pocket spending by young adults with behavioral health conditions.
Psychiatr Serv 2016 Sep;67(9):977-82. doi: 10.1176/appi.ps.201500346.
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Keywords: Behavioral Health, Healthcare Costs, Health Insurance, Medical Expenditure Panel Survey (MEPS), Young Adults
Zuvekas SH
AHRQ Author: Zuvekas SH
The take-up of employer-sponsored insurance among Americans with mental disorders: Implications for health care reform.
This study used data from the 2004-2008 Medical Expenditure Panel Survey to examine differences in offers and take-up of employer-sponsored health insurance (ESI) coverage among adults aged 27-54 by mental health status. It found little difference in the take-up of offers of ESI coverage between those with and without mental disorders.
AHRQ-authored
Citation: Zuvekas SH .
The take-up of employer-sponsored insurance among Americans with mental disorders: Implications for health care reform.
J of Behav Health Serv and Res. 2015 Jul;42(3):279-91. doi: 10.1007/s11414-015-9459-6..
Keywords: Behavioral Health, Medical Expenditure Panel Survey (MEPS), Health Insurance
Olfson M, Druss BG, Marcus SC
Trends in mental health care among children and adolescents.
This study examined national trends in the use of outpatient mental health services by children and adolescents, focusing on the severity of mental health impairment. It found that outpatient mental health treatment and psychotropic-medication use in children and adolescents increased in the United States between 1996–1998 and 2010–2012. Youths with less severe or no impairment accounting for most of the absolute increase in service use.
AHRQ-funded; HS021112.
Citation: Olfson M, Druss BG, Marcus SC .
Trends in mental health care among children and adolescents.
N Engl J Med 2015 May 21;372(21):2029-38. doi: 10.1056/NEJMsa1413512..
Keywords: Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Behavioral Health, Ambulatory Care and Surgery
Cook BL, Liu Z, Lessios AS
The costs and benefits of reducing racial-ethnic disparities in mental health care.
The investigators examined whether reducing racial-ethnic disparities in mental health care offsets costs of care. They found that, for blacks and Latinos, the potential savings from eliminating disparities in inpatient general medical expenditures are substantial, as much as $1 billion nationwide, suggesting that financial and equity considerations can be aligned when planning disparity reduction programs.
AHRQ-funded; HS021486.
Citation: Cook BL, Liu Z, Lessios AS .
The costs and benefits of reducing racial-ethnic disparities in mental health care.
Psychiatr Serv 2015 Apr;66(4):389-96. doi: 10.1176/appi.ps.201400070.
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Keywords: Disparities, Healthcare Costs, Racial and Ethnic Minorities, Medical Expenditure Panel Survey (MEPS), Behavioral Health
Torio CM, Encinosa WE, Berdahl T
AHRQ Author: Torio CM, Encinosa WE, Berdahl T
Annual report on health care for children and youth in the United States: national estimates of cost, utilization and expenditures for children with mental health conditions.
This study examined national trends in hospital utilization, costs, and expenditures for children with mental health conditions between 2006 and 2011. It found that hospitalizations for all listed mental health conditions increased by nearly 50 percent among children aged 10 to 14 years and by 21 percent for emergency department visits.
AHRQ-authored
Citation: Torio CM, Encinosa WE, Berdahl T .
Annual report on health care for children and youth in the United States: national estimates of cost, utilization and expenditures for children with mental health conditions.
Acad Pediatr. 2015 Jan-Feb;15(1):19-35. doi: 10.1016/j.acap.2014.07.007..
Keywords: Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Medical Expenditure Panel Survey (MEPS), Behavioral Health
Atkins EV, Sambamoorthi U, Bhattacharya R
Variations of depression treatment among women with hypertension.
This study examined depression treatment patterns among women with hypertension utilizing the Medical Expenditures Panel Survey (MEPS), a nationally representative survey of families and individuals, their medical providers, and employers across the United States. It found that 23.9 percent had no depression treatment, 56.8 percent had antidepressant use only, and 19.3 percent had psychotherapy with or without antidepressants.
AHRQ-funded; HS018622.
Citation: Atkins EV, Sambamoorthi U, Bhattacharya R .
Variations of depression treatment among women with hypertension.
Health Care Women Int 2015;36(6):730-50. doi: 10.1080/07399332.2015.1005303..
Keywords: Medical Expenditure Panel Survey (MEPS), Depression, Blood Pressure, Women, Behavioral Health
Cook BL, Zuvekas SH, Carson N
AHRQ Author: Zuvekas SH
Assessing racial/ethnic disparities in treatment across episodes of mental health care.
The authors investigated disparities in mental health care episodes, aligning their analyses with decisions to start or drop treatment, and choices made during treatment. Using MEPS data, they found that, compared with whites, blacks and Latinos had less initiation and adequacy of care. Black and Latino episodes were shorter and had fewer psychotropic drug fills; black episodes had a greater proportion of specialist visits and Latino episodes had a greater proportion of primary care physician visits. Blacks were more likely to have an episode with acute psychiatric care.
AHRQ-authored.
Citation: Cook BL, Zuvekas SH, Carson N .
Assessing racial/ethnic disparities in treatment across episodes of mental health care.
Health Serv Res 2014 Feb;49(1):206-29. doi: 10.1111/1475-6773.12095.
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Keywords: Disparities, Medical Expenditure Panel Survey (MEPS), Behavioral Health, Practice Patterns, Racial and Ethnic Minorities