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- Access to Care (5)
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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 10 of 10 Research Studies DisplayedDecker SL, Zuvekas SH
AHRQ Author: Decker SL, Zuvekas SH
Primary care spending in the US population.
This AHRQ-authored research letter describes an analysis of primary care spending estimates in the US population using MEPS data. This survey study looked at the entire population, regardless of insurance source. The authors reported 2019 estimates of primary care spending, total medical spending, percentage of medical spending on primary care visits, and percentage with 0 spending on primary care visits. They analyzed race and ethnicity data to test whether primary care spending was greater in some groups compared with others. A total of 28,512 MEPS participants were included in the sample with a mean age of 38.6 and weighted percentages of 51.1% female, 18.5% Hispanic, 12.3% non-Hispanic Black, 59.7% non-Hispanic White, and 9.6% non-Hispanic individuals of other races and ethnicities. Primary care spending totaled $439 per person in 2019. Spending was highest for the Medicare population, Hispanics (52.7%), non-Hispanic Black (49.0%), and non-Hispanic other (44.3%), 79.9% for uninsured individuals and lowest for the uninsured. Average spending was $461 for those with group private insurance. The percentage of medical spending on primary care was 7.0% for the population and was lower for those younger than age 65 (5.1%), those in worse health (5.6%), and those with Medicare (5.3%). Almost 41% of the population had no primary care spending.
AHRQ-authored.
Citation: Decker SL, Zuvekas SH .
Primary care spending in the US population.
JAMA Intern Med 2023 Aug; 183(8):880-81. doi: 10.1001/jamainternmed.2023.1551..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Primary Care
Han B, Chen PG, Yu H
Access to after-hours primary care: a key determinant of children's medical home status.
Researchers sought to identify individual survey items or domains that best predict medical home (MH) status for children and use them to develop brief markers of MH status. Using MEPS data, they found that accessibility, especially the ability to access health care after regular office hours, appeared to be the major predictor of having a MH among children. They recommended that the ongoing efforts to promote the MH model target improving accessibility of health care after regular hours for children overall and especially for Latino children.
AHRQ-funded; HS023336.
Citation: Han B, Chen PG, Yu H .
Access to after-hours primary care: a key determinant of children's medical home status.
BMC Health Serv Res 2021 Feb 27;21(1):185. doi: 10.1186/s12913-021-06192-y..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare, Access to Care, Healthcare Delivery, Disparities, Racial and Ethnic Minorities
Kirby JB, Yabroff KR
AHRQ Author: Kirby JB
Rural-urban differences in access to primary care: beyond the usual source of care provider.
This study used 2014-2016 MEPS data to analyze differences between rural and urban areas to primary care access beyond the usual source of care provider. While rural residents were more likely to have a usual source of care, they were less likely to have a provider with office hours on nights and weekends.
AHRQ-authored.
Citation: Kirby JB, Yabroff KR .
Rural-urban differences in access to primary care: beyond the usual source of care provider.
Am J Prev Med 2020 Jan;58(1):89-96. doi: 10.1016/j.amepre.2019.08.026..
Keywords: Medical Expenditure Panel Survey (MEPS), Access to Care, Primary Care, Rural Health, Urban Health, Health Services Research (HSR)
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
Biener AI, Zuvekas SH, Hill SC
AHRQ Author: Biener AI, Zuvekas SH, Hill SC
Impact of recent Medicaid expansions on office-based primary care and specialty care among the newly eligible.
The objective of this study was to quantify the effect of Medicaid expansions on office-based care among the newly eligible. The investigators concluded that State Medicaid expansions in 2014 were associated with greater likelihoods of visits with a variety of office-based providers. The estimated effects were larger among newly eligible compared with previous estimates on broader populations of low-income adults.
AHRQ-authored.
Citation: Biener AI, Zuvekas SH, Hill SC .
Impact of recent Medicaid expansions on office-based primary care and specialty care among the newly eligible.
Health Serv Res 2018 Aug;53(4):2426-45. doi: 10.1111/1475-6773.12793.
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Keywords: Access to Care, Healthcare Utilization, Medicaid, Medical Expenditure Panel Survey (MEPS), Primary Care
Borsky A, Zhan C, Miller T
AHRQ Author: Borsky A, Zhan C, Miller T, Ngo-Metzger Q, Bierman AS, Meyers D
Few Americans receive all high-priority, appropriate clinical preventive services.
As of 2015, only 8 percent of US adults ages thirty-five and older had received all of the high-priority, appropriate clinical preventive services recommended for them. Nearly 5 percent of adults did not receive any such services. Further delivery system-level efforts are needed to increase the use of preventive services.
AHRQ-authored.
Citation: Borsky A, Zhan C, Miller T .
Few Americans receive all high-priority, appropriate clinical preventive services.
Health Aff 2018 Jun;37(6):925-28. doi: 10.1377/hlthaff.2017.1248.
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Keywords: Evidence-Based Practice, Medical Expenditure Panel Survey (MEPS), Prevention, Primary Care
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
Yawn BP, Wollan PC, Rank MA
Use of asthma APGAR tools in primary care practices: a cluster-randomized controlled trial.
The purpose of this study was to assess patient and practice outcomes after introducing the Asthma APGAR (Activities, Persistent, triGGers, Asthma medications, Response to therapy) tools into primary care practices. It concluded that introduction of the Asthma APGAR tools improves rates of asthma control; reduces asthma-related ED, urgent care, and hospital visits; and increases practices' adherence to asthma management guidelines.
AHRQ-funded; HS022126.
Citation: Yawn BP, Wollan PC, Rank MA .
Use of asthma APGAR tools in primary care practices: a cluster-randomized controlled trial.
Ann Fam Med 2018 Mar;16(2):100-10. doi: 10.1370/afm.2179.
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Keywords: Asthma, Patient-Centered Outcomes Research, Primary Care, Medical Expenditure Panel Survey (MEPS), Tools & Toolkits
Ray KN, Mehrotra A
Trends in access to primary care for children in the United States, 2002-2013.
Using MEPS data, the authors described how access to primary care has changed over the last decade for children. They found no change in the proportion of children with a usual source of care (USC). Other measures improved, but out-of-pocket costs increased among privately insured children. Results suggested that after-hours accommodation within the USC is worsening, despite the promotion of patient-centered medical home initiatives. All measures of acceptability improved, consistent with a growing focus on family-centeredness of care.
AHRQ-funded; HS022989.
Citation: Ray KN, Mehrotra A .
Trends in access to primary care for children in the United States, 2002-2013.
JAMA Pediatr 2016 Oct;170(10):1023-25. doi: 10.1001/jamapediatrics.2016.0985.
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Keywords: Access to Care, Children/Adolescents, Health Services Research (HSR), Medical Expenditure Panel Survey (MEPS), Primary Care
Robin Yabroff K, Short PF, Machlin S
AHRQ Author: Machlin S
Access to preventive health care for cancer survivors.
The researchers evaluated the association between cancer survivorship and access to primary and preventive health care. They concluded that, although access and preventive care use in cancer survivors is generally equivalent or greater compared to that of other individuals, disparities for uninsured and publicly insured cancer survivors aged 18-64 years suggest that improvements in survivor care are needed.
AHRQ-authored.
Citation: Robin Yabroff K, Short PF, Machlin S .
Access to preventive health care for cancer survivors.
Am J Prev Med 2013 Sep;45(3):304-12. doi: 10.1016/j.amepre.2013.04.021.
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Keywords: Access to Care, Cancer, Medical Expenditure Panel Survey (MEPS), Prevention, Primary Care