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Topics
- (-) Access to Care (11)
- Autism (1)
- Children/Adolescents (2)
- (-) Chronic Conditions (11)
- Community-Based Practice (1)
- COVID-19 (2)
- Diabetes (3)
- Disparities (3)
- Elderly (1)
- Eye Disease and Health (1)
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- Health Services Research (HSR) (2)
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- Medical Expenditure Panel Survey (MEPS) (1)
- Medication (1)
- Policy (1)
- Primary Care (2)
- Racial and Ethnic Minorities (2)
- Rural Health (1)
- Screening (1)
- Sickle Cell Disease (1)
- Telehealth (3)
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 11 of 11 Research Studies DisplayedWirth AN, Cushman NA, Reilley BA
Evaluation of treatment access and scope of a multistate hepatitis C virus Extension for Community Healthcare Outcomes telehealth service in the US Indian Health System, 2017-2021.
Researchers evaluated the extent to which Indian Country Extension for Community Healthcare Outcomes (ECHO) telehealth clinics increase access to hepatitis C virus (HCV) treatment and serve American Indians/Alaska Native (AI/AN) patients holistically. They conducted a retrospective descriptive analysis of Indian Country ECHO treatment recommendations from 2017 to 2021. Most patients received recommendations for HCV treatment by their primary care providers, along with recommendations beyond the scope of HCV. The researchers concluded that Indian Country ECHO telehealth clinic provided comprehensive recommendations to effectively integrate evidence-based HCV treatment with holistic care at the primary care level.
AHRQ-funded; HS026370.
Citation: Wirth AN, Cushman NA, Reilley BA .
Evaluation of treatment access and scope of a multistate hepatitis C virus Extension for Community Healthcare Outcomes telehealth service in the US Indian Health System, 2017-2021.
J Rural Health 2023 Mar;39(2):358-66. doi: 10.1111/jrh.12733.
Keywords: Hepatitis, Access to Care, Racial and Ethnic Minorities, Community-Based Practice, Telehealth, Health Information Technology (HIT), Chronic Conditions
Lock LJ, Channa R, Brennan MB
Effect of health system on the association of rurality and level of disadvantage with receipt of diabetic eye screening.
The goal of this retrospective cohort study was to determine the role of level of disadvantage in diabetic eye screening to explain the effect of health systems on rural and urban disparities. Researchers used an all-payer, statewide claims database to include adult Wisconsin residents with diabetes who had claims billed throughout the baseline and measurement years. Results indicated that patients from urban underserved clinics were more likely to receive screening than those from rural underserved clinics; similar findings emerged for both Medicare and non-Medicare subgroups. The researchers concluded that health systems, especially those that serve urban underserved populations, have an opportunity to increase screening rates by leveraging health system-level interventions and supporting patients in overcoming barriers.
AHRQ-funded; HS026279.
Citation: Lock LJ, Channa R, Brennan MB .
Effect of health system on the association of rurality and level of disadvantage with receipt of diabetic eye screening.
BMJ Open Diabetes Res Care 2022 Dec;10(6):e003174. doi: 10.1136/bmjdrc-2022-003174..
Keywords: Rural Health, Access to Care, Screening, Diabetes, Eye Disease and Health, Disparities, Chronic Conditions, Health Systems
Auty SG, Griffith KN, Shafer PR
Improving access to high-value, high-cost medicines: the use of subscription models to treat hepatitis C using direct acting antivirals in the United States.
This paper discusses the use of state-sponsored subscription models to support increased access to high-value medications such as direct acting antivirals (DAAs) which can cure chronic Hepatitis C virus (HCV). The authors discuss the use of subscription models, a type of advanced purchase commitment (APC), to support increased access to high-value DAAs to treat HCV. They provide background information on HCV, its treatment, and state financing of prescription medications. They review the implementation of HCV subscription models in two states, Louisiana and Washington, and early evidence of their impact, as DAAs can cost upwards of $90,000 for treatment course.
AHRQ-funded; HS026395.
Citation: Auty SG, Griffith KN, Shafer PR .
Improving access to high-value, high-cost medicines: the use of subscription models to treat hepatitis C using direct acting antivirals in the United States.
J Health Polit Policy Law 2022 Dec 1;47(6):691-708. doi: 10.1215/03616878-10041121..
Keywords: Hepatitis, Medication, Chronic Conditions, Access to Care
Reeves SL, Patel PN, Madden B
Telehealth use before and during the COVID-19 pandemic among children with sickle cell anemia.
This study’s goal was to determine telehealth use before and during the COVID pandemic for children ages 1-17 years old with sickle cell anemia (SCA). The authors identified children with SCA continuously enrolled in Michigan Medicaid from January 2019 to December 2020. The study population consisted of 493 children with SCA with a mean age of 8.7 years at study entry. Pre-pandemic there were 4,367 outpatient visits, with all but 19 in-person. Telehealth visits peaked in April 2020 and then began declining. The majority of telehealth visits were with hematologists, followed up adult subspecialists (27%) and pediatrics/family medicine.
AHRQ-funded; HS027632.
Citation: Reeves SL, Patel PN, Madden B .
Telehealth use before and during the COVID-19 pandemic among children with sickle cell anemia.
Telemed J E Health 2022 Aug;28(8):1166-71. doi: 10.1089/tmj.2021.0132..
Keywords: Children/Adolescents, COVID-19, Telehealth, Health Information Technology (HIT), Sickle Cell Disease, Chronic Conditions, Access to Care
Misra-Hebert AD, Hu B, Pantalone KM
Primary care health care use for patients with type 2 diabetes during the COVID-19 pandemic.
This study sought to examine factors associated with total and virtual primary care use for patients with type 2 diabetes (T2D) during the COVID-19 pandemic. This study used electronic medical records in the Cleveland Clinic Health System comparing prepandemic use from August 2019 to March 2020 (baseline period 0) to two pandemic periods: March to June 2020 (period 1) when in-person visits were converted to virtual; and July to November 2020 when in-person visits resumed (period 2). Demographic characteristics were obtained including age, sex, race, insurance type, median income estimated by zip code and baseline HbA1C. The study included 76,015 patients with T2D who completed a primary care visit in baseline period 0. Cohort median age was 66.2 years, 50.7% women, 21.7% Black, 71.0% White and 7.4 Other. Insurance distribution was 43.2% private, 46.5% Medicare, and 9.5% Medicaid. Median income was estimated at $59,000 and baseline HbA1C was ≤ 7% for 59.6% of patients. There were higher odds of Black patients, those with uncontrolled T2D, and those with Medicare and Medicare using virtual visits during the 2 postpandemic periods suggesting that virtual visits may be a preference for those groups. Older and male patients had lower odds of visit completion.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Hu B, Pantalone KM .
Primary care health care use for patients with type 2 diabetes during the COVID-19 pandemic.
Diabetes Care 2021 Sep;44(9):e173-e74. doi: 10.2337/dc21-0853..
Keywords: COVID-19, Diabetes, Primary Care, Telehealth, Health Information Technology (HIT), Healthcare Delivery, Access to Care, Chronic Conditions
Smith JM, Jarrín OF, Lin H
Racial disparities in post-acute home health care referral and utilization among older adults with diabetes.
The purpose of this study was to examine the association between race/ethnicity and hospital discharge to home health care and subsequent utilization of home health care among a cohort of adults (age 50 and older) who experienced a diabetes-related hospitalization. The investigators found that among those discharged to home health care, all non-white racial/ethnic minority patients were less likely to receive services within 14-days.
AHRQ-funded; HS022406.
Citation: Smith JM, Jarrín OF, Lin H .
Racial disparities in post-acute home health care referral and utilization among older adults with diabetes.
Int J Environ Res Public Health 2021 Mar 19;18(6):3196. doi: 10.3390/ijerph18063196..
Keywords: Elderly, Home Healthcare, Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Disparities, Access to Care, Healthcare Utilization
Krist AH, O'Loughlin K, Woolf SH
Enhanced care planning and clinical-community linkages versus usual care to address basic needs of patients with multiple chronic conditions: a clinician-level randomized controlled trial.
This paper describes the beginning of a clinician-level cluster-randomized controlled trial to evaluate how primary care clinicians can participate in community and hospital solutions to connecting patients with needed services and whether doing so is effective in controlling multiple chronic conditions. Electronic health records will be used to identify patients with these conditions, including cardiovascular disease or risks, diabetes, obesity, or depression.
AHRQ-funded; HS026223.
Citation: Krist AH, O'Loughlin K, Woolf SH .
Enhanced care planning and clinical-community linkages versus usual care to address basic needs of patients with multiple chronic conditions: a clinician-level randomized controlled trial.
Trials 2020 Jun 11;21(1):517. doi: 10.1186/s13063-020-04463-3..
Keywords: Chronic Conditions, Primary Care, Health Promotion, Access to Care
Lindly OJ, Zuckerman KE, Kuhlthau KA
Healthcare access and services use among US children with autism spectrum disorder.
This study’s goal was to examine healthcare access and service use among US children with autism spectrum disorder. Data was analyzed from the 2011-2014 National Health Interview Survey data on 651 children with autism spectrum disorder aged 2-17 years. Three measures of healthcare access problems were used: delays accessing healthcare, difficulty affording healthcare, and trouble finding a healthcare provider. Five service measures were used: 4 office visits, 1 well-child visit, flu vaccine, prescription medication, and 1 emergency department visit. Twenty-nine percent of children were found to have had 1 healthcare access problem. This healthcare access problem was associated with lower adjusted odds of 1 well-child visit or prescription medications but higher adjusted odds for 1 emergency department visit or 4 office visits. The association between healthcare access problems and emergency department use were higher for those with higher economic status and White, non-Hispanic subgroups.
AHRQ-funded; HS000063.
Citation: Lindly OJ, Zuckerman KE, Kuhlthau KA .
Healthcare access and services use among US children with autism spectrum disorder.
Autism 2019 Aug;23(6):1419-30. doi: 10.1177/1362361318815237..
Keywords: Children/Adolescents, Autism, Access to Care, Chronic Conditions, Disparities
Hatch B, Marino M, Killerby M
Medicaid's impact on chronic disease biomarkers: a cohort study of community health center patients.
This study assessed changes in biomarkers of chronic disease among community health center (CHC) patients who gained Medicaid coverage with the Oregon Medicaid expansion (2008-2011). It found that patients with uncontrolled chronic conditions experienced objective health improvements over time. In two of three chronic disease cohorts, those who gained Medicaid coverage were more likely to achieve a controlled measurement than those who remained uninsured.
AHRQ-funded; HS024270.
Citation: Hatch B, Marino M, Killerby M .
Medicaid's impact on chronic disease biomarkers: a cohort study of community health center patients.
J Gen Intern Med 2017 Aug;32(8):940-47. doi: 10.1007/s11606-017-4051-9.
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Keywords: Medicaid, Chronic Conditions, Access to Care, Policy
Bernard D, Selden T, Yeh S
AHRQ Author: Bernard D, Selden T
Financial burdens and barriers to care among nonelderly adults: the role of functional limitations and chronic conditions.
The researchers examined the financial burdens and barriers to care among nonelderly adults, focusing on the role of functional limitations and chronic conditions. Functional limitations and chronic conditions were associated with increased prevalence of burdens and financial barriers in all insurance categories, with the exception that an association between functional limitations and the prevalence of burdens was not observed for public coverage.
AHRQ-authored.
Citation: Bernard D, Selden T, Yeh S .
Financial burdens and barriers to care among nonelderly adults: the role of functional limitations and chronic conditions.
Disabil Health J 2016 Apr;9(2):256-64. doi: 10.1016/j.dhjo.2015.09.003.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Chronic Conditions, Access to Care, Health Services Research (HSR)
Zullig LL, Whitson HE, Hastings SN
A systematic review of conceptual frameworks of medical complexity and new model development.
The authors sought to develop a conceptual model of complexity addressing gaps identified in a review of published conceptual models. Their Cycle of Complexity model illustrated relationships between acute shocks and medical events, healthcare access and utilization, workload and capacity, and patient preferences in the context of interpersonal, organizational, and community factors.
AHRQ-funded; HS023085; HS023099.
Citation: Zullig LL, Whitson HE, Hastings SN .
A systematic review of conceptual frameworks of medical complexity and new model development.
J Gen Intern Med 2016 Mar;31(3):329-37. doi: 10.1007/s11606-015-3512-2.
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Keywords: Access to Care, Chronic Conditions, Health Services Research (HSR)