National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
Topics
- Access to Care (2)
- Blood Pressure (1)
- Cancer (4)
- Cancer: Breast Cancer (1)
- Cancer: Lung Cancer (1)
- Cancer: Prostate Cancer (1)
- Cardiovascular Conditions (3)
- Care Management (1)
- Communication (1)
- Comparative Effectiveness (2)
- Data (2)
- Disabilities (1)
- (-) Disparities (24)
- Elderly (2)
- Evidence-Based Practice (3)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (2)
- Healthcare Delivery (1)
- Health Status (1)
- Heart Disease and Health (2)
- Hospitalization (2)
- Human Immunodeficiency Virus (HIV) (1)
- Implementation (2)
- Injuries and Wounds (1)
- Kidney Disease and Health (2)
- Labor and Delivery (1)
- Low-Income (1)
- Medication (2)
- Men's Health (1)
- Nursing (1)
- Outcomes (6)
- Palliative Care (2)
- (-) Patient-Centered Outcomes Research (24)
- Practice Patterns (2)
- Prevention (3)
- Quality Indicators (QIs) (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (12)
- Registries (1)
- Respiratory Conditions (1)
- Risk (1)
- Sex Factors (4)
- Shared Decision Making (2)
- Sleep Problems (1)
- Social Determinants of Health (1)
- Stroke (1)
- Surgery (3)
- Transplantation (1)
- Trauma (1)
- Vulnerable Populations (1)
- Women (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
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 DisplayedSterling MR, Echeverria SE, Commodore-Mensah Y
Health equity and implementation science in heart, lung, blood, and sleep-related research: emerging themes from the 2018 Saunders-Watkins Leadership Workshop.
This article discusses the key themes from a 2-day workshop that was held at the National Institutes of Health in May 2018 to promote health equity and implementation science in heart, lung, and sleep-related research. This inaugural workshop was named the Saunders-Watkins Leadership Workshop. Recommendations are offered for the future direction of this research.
AHRQ-funded; HS000066.
Citation: Sterling MR, Echeverria SE, Commodore-Mensah Y .
Health equity and implementation science in heart, lung, blood, and sleep-related research: emerging themes from the 2018 Saunders-Watkins Leadership Workshop.
Circ Cardiovasc Qual Outcomes 2019 Oct;12(10):e005586. doi: 10.1161/circoutcomes.119.005586..
Keywords: Implementation, Evidence-Based Practice, Disparities, Patient-Centered Outcomes Research, Cardiovascular Conditions, Heart Disease and Health, Respiratory Conditions, Sleep Problems
Purnell TS, Luo X, Crews DC
Neighborhood poverty and sex differences in live donor kidney transplant outcomes in the United States.
Neighborhood poverty has been associated with worse outcomes after live donor kidney transplantation (LDKT), and prior work suggests that women with kidney disease may be more susceptible to the negative influence of poverty than men. As such, our goal was to examine whether poverty differentially affects women in influencing LDKT outcomes. The investigators concluded that given their findings that poverty was more strongly associated with graft loss in women, targeted efforts are needed to specifically address mechanisms driving these disparities in LDKT outcomes.
AHRQ-funded; HS024600.
Citation: Purnell TS, Luo X, Crews DC .
Neighborhood poverty and sex differences in live donor kidney transplant outcomes in the United States.
Transplantation 2019 Oct;103(10):2183-89. doi: 10.1097/tp.0000000000002654.
.
.
Keywords: Transplantation, Kidney Disease and Health, Patient-Centered Outcomes Research, Disparities, Women, Sex Factors, Low-Income, Outcomes
Shahu A, Herrin J, Dhruva SS
Disparities in socioeconomic context and association with blood pressure control and cardiovascular outcomes in ALLHAT.
This study used data from the randomized clinical trial ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial) to study the effect of socioeconomics and blood pressure control and cardiovascular outcomes. The study sites were stratified by their county-level median household income into income quintiles. The lowest income sites (quintile 1) were most likely to be women, black or Hispanic, have less education, to live in the South and to have fewer cardiovascular risk factors. Despite standardized treatment protocols, quintile 1 participants were less likely to have blood pressure control, and all greater all-cause mortality, heart failure hospitalizations/mortality and end-stage renal disease than the highest income participants (quintile 5).
AHRQ-funded; HS023000.
Citation: Shahu A, Herrin J, Dhruva SS .
Disparities in socioeconomic context and association with blood pressure control and cardiovascular outcomes in ALLHAT.
J Am Heart Assoc 2019 Aug 6;8(15):e012277. doi: 10.1161/jaha.119.012277..
Keywords: Blood Pressure, Cardiovascular Conditions, Disparities, Patient-Centered Outcomes Research, Medication, Prevention, Outcomes
Gordon BE, Basak R, Carpenter WR
Factors influencing prostate cancer treatment decisions for African American and white men.
This prospective, population-based cohort study examined some possible reasons for mortality outcome differences for prostate cancer between African American (AA) and white patients. A cohort of 1170 men with nonmetastatic prostate cancer were enrolled from 2011 to 2013 before treatment in North Carolina. Participants were asked to rate their aggressiveness of their cancer, and also the importance of 10 factors their treatment decision-making process. Among low-risk patients, there was no difference in perception of their cancer as “not very aggressive”. Among high-risk patients, 54% of AA patients considered their cancer to be “not very aggressive” while only 24% of white patients did. For AA patients, cost, treatment time, and recovery time were considered very important more than white patients.
AHRQ-funded.
Citation: Gordon BE, Basak R, Carpenter WR .
Factors influencing prostate cancer treatment decisions for African American and white men.
Cancer 2019 May 15;125(10):1693-700. doi: 10.1002/cncr.31932..
Keywords: Shared Decision Making, Cancer, Cancer: Prostate Cancer, Disparities, Men's Health, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Marcolini EG, Albrecht JS, Sethuraman KN
Gender disparities in trauma care: how sex determines treatment, behavior, and outcome.
This study used US and European trauma database statistics, including the National Trauma Databank, to examine sex disparities in trauma care. Their findings indicate that sex differences in risk-taking behaviors that lead to traumatic injury have been associated with males, with female menstrual cycle timing, and with cortisol levels. Differences in access to services at trauma centers, including triage or transfer and level of medical attention are associated with sex as well race, rural or urban location, and insurance status. Outcomes, such as in-hospital mortality, multiple organ failure, pneumonia, and sepsis are associated with sex disparities in the general trauma patient; outcomes after general trauma and specifically traumatic brain injury show mixed results.
AHRQ-funded; HS024560.
Citation: Marcolini EG, Albrecht JS, Sethuraman KN .
Gender disparities in trauma care: how sex determines treatment, behavior, and outcome.
Anesthesiol Clin 2019 Mar;37(1):107-17. doi: 10.1016/j.anclin.2018.09.007..
Keywords: Access to Care, Disparities, Injuries and Wounds, Outcomes, Patient-Centered Outcomes Research, Risk, Sex Factors, Trauma
Lee T, Qian J, Thamer M
Gender disparities in vascular access surgical outcomes in elderly hemodialysis patients.
In this study, the investigators assessed clinically relevant arteriovenous fistulas (AVF) and arteriovenous grafts (AVG) surgical outcomes in elderly male and female patients initiating hemodialysis with a central venous catheter (CVC). The investigators concluded that while AVFs should be considered the preferred vascular access in most circumstances, clinical AVF surgical outcomes were uniformly worse in females. They suggest that clinicians should also consider AVGs as a viable alternative in elderly female patients initiating hemodialysis with a CVC to avoid extended CVC dependence.
AHRQ-funded; HS022931; HS021229.
Citation: Lee T, Qian J, Thamer M .
Gender disparities in vascular access surgical outcomes in elderly hemodialysis patients.
Am J Nephrol 2019;49(1):11-19. doi: 10.1159/000495261..
Keywords: Elderly, Sex Factors, Surgery, Kidney Disease and Health, Disparities, Outcomes, Patient-Centered Outcomes Research
Wahl TS, Goss LE, Morris MS
Enhanced Recovery After Surgery (ERAS) eliminates racial disparities in postoperative length of stay after colorectal surgery.
The purpose of this study was to investigate the effects of enhanced recovery after surgery (ERAS) on racial disparities in postoperative length of stay (pLOS) after colorectal surgery. The authors hypothesized that ERAS would reduce disparities in pLOS between black and white patients. They concluded that ERAS eliminated racial differences in pLOS between black and white patients undergoing colorectal surgery. Reduced pLOS occurred without increases in mortality, readmissions, and most postoperative complications.
AHRQ-funded; HS013852.
Citation: Wahl TS, Goss LE, Morris MS .
Enhanced Recovery After Surgery (ERAS) eliminates racial disparities in postoperative length of stay after colorectal surgery.
Ann Surg 2018 Dec;268(6):1026-35. doi: 10.1097/sla.0000000000002307..
Keywords: Surgery, Racial and Ethnic Minorities, Disparities, Care Management, Healthcare Delivery, Hospitalization, Patient-Centered Outcomes Research, Outcomes
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.
.
.
Keywords: Communication, Disparities, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention, Racial and Ethnic Minorities, Implementation
Kamal AH, Bull J, Wolf SP
Unmet needs of African Americans and whites at the time of palliative care consultation.
Researchers aimed to compare characteristics and palliative care needs of African Americans (AAs) and whites during initial palliative care consultation. Nearly two-thirds in both racial groups reported 3 or more symptoms of any severity; one-third reported 3 or more moderate or severe symptoms. A larger proportion of Africans than whites reported pain of any severity.
AHRQ-funded; HS023681; HS022763.
Citation: Kamal AH, Bull J, Wolf SP .
Unmet needs of African Americans and whites at the time of palliative care consultation.
Am J Hosp Palliat Care 2017 Jun;34(5):461-65. doi: 10.1177/1049909116632508.
.
.
Keywords: Disparities, Quality of Care, Palliative Care, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Bakken S, Reame N
http://www.ingentaconnect.com/content/springer/arnr/2016/00000034/00000001/art00013
The promise and potential perils of big data for advancing symptom management research in populations at risk for health disparities.
The purposes of this chapter are to (a) briefly summarize the current drivers for the use of big data in research; (b) describe the promise of big data and associated data science methods for advancing symptom management research; and (c) explicate the potential perils of big data and data science from the perspective of the ethical principles of autonomy, beneficence, and justice.
AHRQ-funded; HS022961
Citation: Bakken S, Reame N .
The promise and potential perils of big data for advancing symptom management research in populations at risk for health disparities.
Annu Rev Nurs Res 2016;34:247-60. doi: 10.1891/0739-6686.34.247..
Keywords: Data, Disparities, Nursing, Patient-Centered Outcomes Research
Goodman SM, Mandl LA, Parks ML
Disparities in TKA outcomes: census tract data show interactions between race and poverty.
Race is an important predictor of total knee arthroplasty (TKA) outcomes in the United States; however, analyses of race can be confounded by socioeconomic factors, which can result in difficulty determining the root cause of disparate outcomes after TKA. This study found that blacks and whites living in communities with little poverty have similar patient-reported TKA outcomes, whereas in communities with high levels of poverty, there are important racial disparities.
AHRQ-funded; HS016075.
Citation: Goodman SM, Mandl LA, Parks ML .
Disparities in TKA outcomes: census tract data show interactions between race and poverty.
Clin Orthop Relat Res 2016 Sep;474(9):1986-95. doi: 10.1007/s11999-016-4919-8.
.
.
Keywords: Disparities, Racial and Ethnic Minorities, Social Determinants of Health, Patient-Centered Outcomes Research, Surgery
Chin MH, Lopez FY, Nathan AG
Improving shared decision making with LGBT racial and ethnic minority patients.
In 2014, the authors' team at the University of Chicago, supported by funds from AHRQ and the Patient-Centered Outcomes Research Trust Fund, began examining how to reduce disparities for LGBT racial/ethnic minority patients through improved shared decisionmaking (SDM). Their three goals are to review what is known, to perform interviews and focus groups of patients and clinicians, and to develop tools and resources. The three articles in this issue’s JGIM symposium on "Improving Shared Decision Making with LGBT Racial and Ethnic Minority Patients" reflect their initial foundational work.
AHRQ-funded; HS023050.
Citation: Chin MH, Lopez FY, Nathan AG .
Improving shared decision making with LGBT racial and ethnic minority patients.
J Gen Intern Med 2016 Jun;31(6):591-3. doi: 10.1007/s11606-016-3607-4.
.
.
Keywords: Shared Decision Making, Disparities, Racial and Ethnic Minorities, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Albright KC, Boehme AK, Tanner RM
Addressing stroke risk factors in black and white Americans: Findings from the National Health and Nutrition Examination Survey, 2009-2010.
The authors examined racial differences in risk factors being addressed among stroke survivors and those at risk for stroke. They found that addressed hypertension and hyperlipidemia in stroke-naïve participants were significantly lower in blacks than in whites. They concluded that a better understanding of this information is critical to preventing stroke and other vascular diseases.
AHRQ-funded; HS023009; HS013852.
Citation: Albright KC, Boehme AK, Tanner RM .
Addressing stroke risk factors in black and white Americans: Findings from the National Health and Nutrition Examination Survey, 2009-2010.
Ethn Dis 2016 Jan 21;26(1):9-16. doi: 10.18865/ed.26.1.9.
.
.
Keywords: Disparities, Racial and Ethnic Minorities, Patient-Centered Outcomes Research, Prevention, Stroke
Bakken S, Reame N
The promise and potential perils of big data for advancing symptom management research in populations at risk for health disparities.
The purposes of this chapter are to (a) briefly summarize the current drivers for the use of big data in research; (b) describe the promise of big data and associated data science methods for advancing symptom management research; and (c) explicate the potential perils of big data and data science from the perspective of the ethical principles of autonomy, beneficence, and justice.
AHRQ-funded; HS022961.
Citation: Bakken S, Reame N .
The promise and potential perils of big data for advancing symptom management research in populations at risk for health disparities.
Annu Rev Nurs Res 2016;34:247-60. doi: 10.1891/0739-6686.34.247..
Keywords: Disparities, Data, Patient-Centered Outcomes Research, Registries
Dimou F, Sineshaw H, Parmar AD
Trends in receipt and timing of multimodality therapy in early-stage pancreatic cancer.
The researchers described treatment patterns and time trends with regard to age and treatment center in the receipt of multimodality therapy for early-stage pancreatic cancer. They concluded that despite increased use of multimodality therapy, it remains underutilized in all patients and especially in older patients. Receipt of multimodality therapy and neoadjuvant therapy is highly dependent on treatment at NCI-designated cancer centers.
AHRQ-funded; HS022134.
Citation: Dimou F, Sineshaw H, Parmar AD .
Trends in receipt and timing of multimodality therapy in early-stage pancreatic cancer.
J Gastrointest Surg 2016 Jan;20(1):93-103; discussion 03. doi: 10.1007/s11605-015-2952-7.
.
.
Keywords: Cancer, Disparities, Practice Patterns, Elderly, Patient-Centered Outcomes Research
Du XL, Parikh RC, Lairson DR
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
The authors examined racial/ethnic and geographical disparities in cancer care and costs during the last 6 months of life for lung cancer decedents after the FDA's approval of bevacizumab. They found that there were substantial racial/ethnic and geographic disparities in the types of cancer care and costs in the last 6 months of life among lung cancer decedents, regardless of the length of survival times and hospice care status.
AHRQ-funded; HS018956.
Citation: Du XL, Parikh RC, Lairson DR .
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
Lung Cancer 2015 Dec;90(3):442-50. doi: 10.1016/j.lungcan.2015.09.017.
.
.
Keywords: Cancer, Cancer: Lung Cancer, Disparities, Healthcare Costs, Medication, Palliative Care, Patient-Centered Outcomes Research, Practice Patterns, Racial and Ethnic Minorities
Sofolahan-Oladeinde Y, Mullins CD, Baquet CR
Using community-based participatory research in patient-centered outcomes research to address health disparities in under-represented communities.
The authors proposed ways by which patient-centered outcomes research can effectively use community-based participatory research principles to engage patients in general, and specifically patients from underserved communities, in the hope that this will help to reduce and eventually eliminate health disparities.
AHRQ-funded; HS022135.
Citation: Sofolahan-Oladeinde Y, Mullins CD, Baquet CR .
Using community-based participatory research in patient-centered outcomes research to address health disparities in under-represented communities.
J Comp Eff Res 2015 Sep;4(5):515-23. doi: 10.2217/cer.15.31.
.
.
Keywords: Access to Care, Disparities, Evidence-Based Practice, Patient-Centered Outcomes Research, Vulnerable Populations
Hicks CW, Hashmi ZG, Hui X
Explaining the paradoxical age-based racial disparities in survival after trauma: The role of the treating facility.
This study sought to determine if differences in outcomes at treating facilities can help explain age-based racial disparities in survival after trauma. For example, among patients older than 65 years, blacks had decreased odds of mortality compared with whites. It found that facility-based differences do not seem to explain this paradoxical age-based racial disparity after trauma observed in the older population.
AHRQ-funded; HS017952.
Citation: Hicks CW, Hashmi ZG, Hui X .
Explaining the paradoxical age-based racial disparities in survival after trauma: The role of the treating facility.
AHRQ-funded; HS017952..
Keywords: Disparities, Comparative Effectiveness, Patient-Centered Outcomes Research, Healthcare Cost and Utilization Project (HCUP)
Pisu M, Kenzik KM, Oster RA
Economic hardship of minority and non-minority cancer survivors 1 year after diagnosis: another long-term effect of cancer?
The authors investigated economic hardships experienced by racial/ethnic minority cancer survivors compared to whites. They found that economic hardship was evident in almost 1 in 2 cancer survivors 1 year after diagnosis, especially African Americans. They recommended that future research evaluate and address risk factors and their impact on survival and survivorship outcomes.
AHRQ-funded; HS013852.
Citation: Pisu M, Kenzik KM, Oster RA .
Economic hardship of minority and non-minority cancer survivors 1 year after diagnosis: another long-term effect of cancer?
Cancer 2015 Apr 15;121(8):1257-64. doi: 10.1002/cncr.29206.
.
.
Keywords: Cancer, Disparities, Healthcare Costs, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
D'Onofrio G, Safdar B, Lichtman JH
Sex differences in reperfusion in young patients with ST-segment-elevation myocardial infarction: results from the VIRGO study.
Sex disparities in reperfusion therapy for patients with acute ST-segment-elevation myocardial infarction have been documented. The authors tested these patterns in the comparison of young women with men.They found that young women with ST-segment-elevation myocardial infarction are less likely to receive reperfusion therapy and more likely to have reperfusion delays than similarly aged men.
AHRQ-funded; HS023000.
Citation: D'Onofrio G, Safdar B, Lichtman JH .
Sex differences in reperfusion in young patients with ST-segment-elevation myocardial infarction: results from the VIRGO study.
Circulation 2015 Apr 14;131(15):1324-32. doi: 10.1161/circulationaha.114.012293.
.
.
Keywords: Cardiovascular Conditions, Disparities, Heart Disease and Health, Patient-Centered Outcomes Research, Sex Factors
Sentell T, Marten L, Ahn HJ
Disparities in hospitalizations among HIV positive individuals for native Hawaiians and Asians compared to whites in Hawaii.
This study investigated characteristics and disparities in hospitalizations among HIV positive individuals for Asian American subgroups and Native Hawaiians using data from all hospitalizations in Hawai‘i between December 2006 and December 2010. It concluded that disparities appear to exist in rates of hospitalizations among HIV positive individuals for Native Hawaiians and Asians, as well as in the demographic and, to some degree, the clinical characteristics of those hospitalized.
AHRQ-funded; HS019990.
Citation: Sentell T, Marten L, Ahn HJ .
Disparities in hospitalizations among HIV positive individuals for native Hawaiians and Asians compared to whites in Hawaii.
Hawaii J Med Public Health 2014 Oct;73(10):308-14..
Keywords: Hospitalization, Human Immunodeficiency Virus (HIV), Disparities, Racial and Ethnic Minorities, Patient-Centered Outcomes Research
Sentell T, Chang A, Cheng Y
Maternal quality and safety outcomes for Asians and Pacific Islanders in Hawaii: an observational study from five years of statewide data.
The authors investigated maternal quality and safety outcomes across heterogeneous Asian and Pacific Islanders subgroups in the United States. They found significant variation for Asian and Pacific Islander subgroups across maternal quality and safety outcomes.
AHRQ-funded; HS019990; HS021903.
Citation: Sentell T, Chang A, Cheng Y .
Maternal quality and safety outcomes for Asians and Pacific Islanders in Hawaii: an observational study from five years of statewide data.
BMC Pregnancy Childbirth 2014 Aug 30;14:298. doi: 10.1186/1471-2393-14-298.
.
.
Keywords: Disparities, Labor and Delivery, Patient-Centered Outcomes Research, Quality Indicators (QIs), Racial and Ethnic Minorities
Rowland M, Peterson-Besse J, Dobbertin K
Health outcome disparities among subgroups of people with disabilities: a scoping review.
The authors described recent research activity that has examined health outcome disparities within populations of people with disabilities. They found that the health outcomes most frequently examined were diabetes and heart disease, and the most frequently examined disparity factors were the type of disabling condition and gender. Identifying that there are significant gaps in available research, they concluded that building a body of research that identifies disparities and potentially vulnerable subgroups may improve understanding of the causes of disparities and contribute to efforts to improve quality of life and health outcomes for individuals with disabilities.
AHRQ-funded.
Citation: Rowland M, Peterson-Besse J, Dobbertin K .
Health outcome disparities among subgroups of people with disabilities: a scoping review.
Disabil Health J 2014 Apr;7(2):136-50. doi: 10.1016/j.dhjo.2013.09.003.
.
.
Keywords: Disabilities, Disparities, Health Status, Patient-Centered Outcomes Research
Nurgalieva ZZ, Franzini L, Morgan RO
Utilization of lymph node dissection, race/ethnicity, and breast cancer outcomes.
This study reports on the impact of nodal surgery utilization on survival among white, African American, Hispanic, and Asian women in a large population of women with breast cancer. It found that the disparities in survival among African American and Hispanic women with breast cancer are not explained by nodal surgery utilization among women with micrometastasis and macrometastasis in sentinel lymph nodes.
AHRQ-funded; HS018956.
Citation: Nurgalieva ZZ, Franzini L, Morgan RO .
Utilization of lymph node dissection, race/ethnicity, and breast cancer outcomes.
Am J Manag Care 2013 Oct;19(10):805-10..
Keywords: Cancer: Breast Cancer, Comparative Effectiveness, Disparities, Patient-Centered Outcomes Research, Racial and Ethnic Minorities