National Healthcare Quality and Disparities Report
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Search All Research Studies
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- Ambulatory Care and Surgery (1)
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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 DisplayedOke I, Lutz SM, Hunter DG
Use and costs of instrument-based vision screening for US children aged 12 to 36 months.
This research letter describes a cohort study that examined patterns and out-of-pocket costs of instrument-based vision screening among US children 12 to 36 months. The authors used 2018 MarketScan Commerical Claims and Encounters data as of January 1, 2018 and excluded those with fewer than 12 months of continuous insurance coverage, enrollment in capitated insurance plans, no preventive care encounters, or missing data on residents. The study included 246,077 children. Instrument-based vision screening was received by 19.5% (n = 48,101) of children during 2018. Median (IQR) practitioner payment for instrument-based vision screening claims was $13. Screening incurred out-of-pocket expenses for 7% of children; 30% of these children had expenses related to co-payment, 20.2% to coinsurance, and 50.7% to deductibles. Median (IQR) out-of-pocket expense was $11. Increased odds of vision screening were associated with older age, high-deductible plan enrollment, having more than 1 preventative visit, and receiving care within an area in the highest quartile of practitioner payment. This study was limited by use of commercial claims data, which excluded 45% of children with public or no coverage. Nationwide prevalence of vision screening therefore may differ for the general population.
AHRQ-funded; HS000063.
Citation: Oke I, Lutz SM, Hunter DG .
Use and costs of instrument-based vision screening for US children aged 12 to 36 months.
JAMA Pediatr 2023 Jul; 177(7):728-30. doi: 10.1001/jamapediatrics.2023.0808..
Keywords: Newborns/Infants, Eye Disease and Health, Screening, Prevention, Healthcare Costs
Mafi JN, Godoy-Travieso P, Wei E
Evaluation of an intervention to reduce low-value preoperative care for patients undergoing cataract surgery at a safety-net health system.
This study analyzed the effects of an intervention program to reduce preoperative costs for care in patients undergoing cataract surgery. Most surgery centers require a battery of tests before surgery is approved. All patients must undergo primary care visits with chest x-rays, laboratory tests, and electrocardiograms required for many of them depending on age and presence of other conditions. This case-control study was conducted at 2 academic safety-net medical centers, Los Angeles County and University of Southern California (LAC-USC) (intervention, n = 469) and Harbor-UCLA (University of California, Los Angeles) (control, n = 585), from April 13, 2015, through April 12, 2016, with 12 additional months (April 13, 2016, through April 13, 2017) to assess sustainability (intervention, n = 1002; control, n = 511). All preoperative care decreased in the intervention group and mostly decreased in the control group. Financial losses occurred at these centers, but there was an overall savings for patients and society. These findings suggest that this may be a barrier to eliminating low-value care.
AHRQ-funded; HS024067.
Citation: Mafi JN, Godoy-Travieso P, Wei E .
Evaluation of an intervention to reduce low-value preoperative care for patients undergoing cataract surgery at a safety-net health system.
JAMA Intern Med 2019 May;179(5):648-57. doi: 10.1001/jamainternmed.2018.8358..
Keywords: Healthcare Costs, Surgery, Eye Disease and Health, Quality Improvement, Quality of Care
Slota C, Davis SA, Blalock SJ
Patient-physician communication on medication cost during glaucoma visits.
The aim of this secondary analysis was to describe the frequency and nature of patient-physician communication regarding medication cost during glaucoma office visits. Most participants did not discuss medication cost during their glaucoma office visit. The majority of the subjects who discussed cost had mild disease severity (51 percent), took one glaucoma medication (63 percent), and had Medicare (49 percent) as well as a form of prescription insurance (78 percent).
AHRQ-funded; HS023054.
Citation: Slota C, Davis SA, Blalock SJ .
Patient-physician communication on medication cost during glaucoma visits.
Optom Vis Sci 2017 Dec;94(12):1095-101. doi: 10.1097/opx.0000000000001139.
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Keywords: Eye Disease and Health, Healthcare Costs, Medication, Patient and Family Engagement, Clinician-Patient Communication
Robinson JC, Brown T, Whaley C
Reference-based benefit design changes consumers' choices and employers' payments for ambulatory surgery.
The researchers analyzed the impact of reference-based benefit (RBB) designs on cataract surgery patients choice of less-expensive ambulatory surgery centers over more expensive hospital outpatient departments. Examining two groups of patients, one in plans incorporating RBB and the other in non-RBB plans, they found that the shift to RBB led to an 8.6 percent increase in ambulatory surgery centers as well as a 19.7 percent decrease in payments per procedure.
AHRQ-funded; HS022098
Citation: Robinson JC, Brown T, Whaley C .
Reference-based benefit design changes consumers' choices and employers' payments for ambulatory surgery.
Health Aff. 2015 Mar;34(3):415-22. doi: 10.1377/hlthaff.2014.1198..
Keywords: Ambulatory Care and Surgery, Eye Disease and Health, Health Insurance, Healthcare Costs, Health Insurance
Pershing S, Pal Chee C, Asch SM
Treating age-related macular degeneration: comparing the use of two drugs among Medicare and Veterans Affairs populations.
The researchers examined the diffusion of new biologics ranibizumab and bevacizumab, both for the treatment of macular degeneration but differing in price, in fee-for-service Medicare and Veterans Affairs (VA) systems during 2005-11, in part to assess the impact that differing financial incentives had on prescribing. Their analysis indicated that there are opportunities in both the VA and Medicare to adopt more value-conscious treatment patterns and that multiple mechanisms exist to influence utilization.
AHRQ-funded; HS018434.
Citation: Pershing S, Pal Chee C, Asch SM .
Treating age-related macular degeneration: comparing the use of two drugs among Medicare and Veterans Affairs populations.
Health Aff 2015 Feb;34(2):229-38. doi: 10.1377/hlthaff.2014.1032.
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Keywords: Healthcare Costs, Eye Disease and Health, Medicare, Medication
Pershing S, Enns EA, Matesic B
Cost-effectiveness of treatment of diabetic macular edema.
The researchers sought to determine the cost-effectiveness of different treatments of diabetic macular edema (DME). They found that vascular endothelial growth factor (VEGF) inhibitors with or without laser treatment provide important health benefits with favorable cost-effectiveness, costing less per QALY gained than many accepted therapies.
AHRQ-funded; HS000028.
Citation: Pershing S, Enns EA, Matesic B .
Cost-effectiveness of treatment of diabetic macular edema.
Ann Intern Med 2014 Jan 7;160(1):18-29. doi: 10.7326/m13-0768..
Keywords: Diabetes, Eye Disease and Health, Healthcare Costs, Quality of Life, Treatments
Mennemeyer ST, Owsley C, McGwin Jr G
Reducing older driver motor vehicle collisions via earlier cataract surgery.
The researchers used a Monte Carlo simulation model to examine a hypothetical situation where rules in place in the U.S. for authorizing payment for cataract surgery were relaxed in favor of allowing surgery earlier for less bothersome complaints of visual difficulties in doing daily activities. They found that motor vehicle collisions, fatalities, and total societal costs can all be reduced by earlier cataract surgery.
AHRQ-funded; HS017962
Citation: Mennemeyer ST, Owsley C, McGwin Jr G .
Reducing older driver motor vehicle collisions via earlier cataract surgery.
Accid Anal Prev. 2013 Dec;61:203-11. doi: 10.1016/j.aap.2013.01.002..
Keywords: Elderly, Eye Disease and Health, Healthcare Costs