National Healthcare Quality and Disparities Report
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- Racial and Ethnic Minorities (17)
- Screening (3)
- Social Determinants of Health (4)
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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 25 of 27 Research Studies DisplayedSentell TL, Juarez DT, Ahn HJ
Disparities in diabetes-related preventable hospitalizations among working-age Native Hawaiians and Asians in Hawai'i.
Elderly (65+) Native Hawaiian, Filipino, and Japanese men and Filipino women have a higher risk of diabetes-related potentially preventable hospitalizations than whites. The authors sought to determine if similar disparities are seen among the non-elderly (< 65). They found that preventable hospitalizations rates were significantly higher for Native Hawaiians males compared to whites, but significantly lower for Chinese men and women, Japanese men and women, and Filipino men and women. Rates for Native Hawaiian females did not differ significantly from Whites. Disparities in diabetes-related preventable hospitalizations were seen for working-age (18-64) Native Hawaiian men even when their higher population-level diabetes prevalence was considered.
AHRQ-funded; HS019990.
Citation: Sentell TL, Juarez DT, Ahn HJ .
Disparities in diabetes-related preventable hospitalizations among working-age Native Hawaiians and Asians in Hawai'i.
Hawaii J Med Public Health 2014 Dec;73(12 Suppl 3):8-13.
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Keywords: Diabetes, Disparities, Hospitalization, Quality Indicators (QIs), Racial and Ethnic Minorities
Hines AL, Andrews RM, Moy E
AHRQ Author: Andrews RM, Moy E
Disparities in rates of inpatient mortality and adverse events: race/ethnicity and language as independent contributors.
The authors investigated inpatient mortality rates and obstetric trauma for self-reported speakers of English, Spanish, and languages of Asia and the Pacific Islands (API) and compared quality of care by language with patterns by race/ethnicity. They found that speaking a non-English principal language and having a non-White race/ethnicity did not place patients at higher risk for inpatient mortality, except for a higher stroke mortality for Japanese-speaking patients. Patients who spoke API languages or had API race/ethnicity had higher risk for obstetric trauma than English-speaking White patients, while Spanish-speaking Hispanic patients had more obstetric trauma than English-speaking Hispanic patients.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Hines AL, Andrews RM, Moy E .
Disparities in rates of inpatient mortality and adverse events: race/ethnicity and language as independent contributors.
Int J Environ Res Public Health 2014 Dec;11(12):13017-34. doi: 10.3390/ijerph111213017.
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Keywords: Communication, Disparities, Healthcare Cost and Utilization Project (HCUP), Mortality, Racial and Ethnic Minorities
McGarry BE, Temkin-Greener H, Li Y
Role of race and ethnicity in private long-term care insurance ownership.
The authors sought to determine if racial/ethnic disparities exist in the ownership of private long-term care insurance (LTCI) among current Medicare beneficiaries. They found that 12.3% of Blacks and 5.8% of Hispanics, compared with 20.2% of Whites, reported having LTCI coverage and that Hispanics were 48% less likely to have LTCI compared with Whites. Hispanic women were 81% less likely to be insured compared with White women.
AHRQ-funded; HS000044.
Citation: McGarry BE, Temkin-Greener H, Li Y .
Role of race and ethnicity in private long-term care insurance ownership.
Gerontologist 2014 Dec;54(6):1001-12. doi: 10.1093/geront/gnt102.
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Keywords: Disparities, Elderly, Health Insurance, Long-Term Care, Racial and Ethnic Minorities
Fiscella K
Tackling disparities in influenza vaccination in primary care: it takes a team.
This article discusses a study in the same issue by Maurer. Fiscella describes reasons involving influenza vaccination disparities and points out that the emergence of accountable care organizations creates opportunities for better integration of primary care and public health.
AHRQ-funded; HS022440.
Citation: Fiscella K .
Tackling disparities in influenza vaccination in primary care: it takes a team.
J Gen Intern Med 2014 Dec;29(12):1579-81. doi: 10.1007/s11606-014-2999-2.
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Keywords: Disparities, Influenza, Primary Care, Teams, Vaccination
Vargas Bustamante A, Chen J
The great recession and health spending among uninsured U.S. immigrants: implications for the Affordable Care Act implementation.
This study of the association between the timing of the Great Recession (GR) and health spending among uninsured U.S. immigrants found that the probability of any spending diminished for recent immigrants compared to citizens during the GR. For those with any spending, recent immigrants reported 27 percent higher spending during the GR.
AHRQ-funded; HS022634
Citation: Vargas Bustamante A, Chen J .
The great recession and health spending among uninsured U.S. immigrants: implications for the Affordable Care Act implementation.
Health Serv Res. 2014 Dec;49(6):1900-24. doi: 10.1111/1475-6773.12193..
Keywords: Healthcare Costs, Uninsured, Disparities
Davis AE, Mehrotra S, Ladner DP
Changes in geographic disparity in kidney transplantation since the final rule.
The researchers assessed the significance of changes of geographic disparities for four metrics since the 1998 adoption of HHS Final Rule’s emphasizing objective priority criteria: waiting times, transplant rates, pre-transplant mortality, and organ quality. They found that the ranges of the four metrics have worsened by approximately 30% or more after the Final Rule at both the regional and donor service area levels.
AHRQ-funded; HS021078.
Citation: Davis AE, Mehrotra S, Ladner DP .
Changes in geographic disparity in kidney transplantation since the final rule.
Transplantation 2014 Nov 15;98(9):931-6. doi: 10.1097/tp.0000000000000446..
Keywords: Transplantation, Disparities, Policy, Outcomes
Mullen MT, Wiebe DJ, Bowman A
Disparities in accessibility of certified primary stroke centers.
These authors examined the proportion of the U.S. population with less than 60-minute access to Primary Stroke Centers (PSCs). They found significant geographic disparities in access to the PSCs. Stroke belt States have a higher burden of stroke and more limited access to PSCs.
AHRQ-funded; HS013852; HS017960; HS010914
Citation: Mullen MT, Wiebe DJ, Bowman A .
Disparities in accessibility of certified primary stroke centers.
Stroke. 2014 Nov;45(11):3381-8. doi: 10.1161/strokeaha.114.006021..
Keywords: Stroke, Access to Care, Disparities
Chen R, Cheadle A, Johnson D
US trends in receipt of appropriate diabetes clinical and self-care from 2001 to 2010 and racial/ethnic disparities in care.
The purpose of this study was to examine trends in the receipt of 8 recommended diabetes clinical and self-care indicators from 2001 to 2010 and assess racial/ethnic disparities in care. There were significant increases from 2001 to 2010 in A1C tests, annual foot exams, flu shots, diabetes self-management education and self management of blood glucose but declines in eye and self feet exams.
AHRQ-funded; HS013853.
Citation: Chen R, Cheadle A, Johnson D .
US trends in receipt of appropriate diabetes clinical and self-care from 2001 to 2010 and racial/ethnic disparities in care.
Diabetes Educ 2014 Nov-Dec;40(6):756-66. doi: 10.1177/0145721714546721..
Keywords: Diabetes, Patient Self-Management, Disparities, Racial and Ethnic Minorities, Racial and Ethnic Minorities
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
Horner-Johnson W, Fujiura GT, Goode TD
Promoting a new research agenda: health disparities research at the intersection of disability, race, and ethnicity.
This article introduces a special issue of Medical Care that seeks to bridge the gap between research on racial and ethnic disparities and research on disability-related health disparities. The papers examine evidence of racial and ethnic disparities within various populations of people with disabilities, and explore unique issues at the intersection of disability, race, and ethnicity.
AHRQ-funded; HS021920
Citation: Horner-Johnson W, Fujiura GT, Goode TD .
Promoting a new research agenda: health disparities research at the intersection of disability, race, and ethnicity.
Med Care. 2014 Oct;52(10 Suppl 3):S1-2. doi: 10.1097/MLR.0000000000000220..
Keywords: Disparities, Racial and Ethnic Minorities, Health Services Research (HSR)
Bakullari A, Metersky ML, Wang Y
Racial and ethnic disparities in healthcare-associated infections in the United States, 2009-2011.
This study examined racial and ethnic disparities in the occurrence of healthcare-associated infections (HAIs) in 79,019 Medicare patients hospitalized with acute cardiovascular disease, pneumonia, and major surgery. It found that Asian and Hispanic patients, but not non-Hispanic blacks, had significantly higher rates of HAIs than white non-Hispanic patients.
AHRQ-funded; 290201200003C
Citation: Bakullari A, Metersky ML, Wang Y .
Racial and ethnic disparities in healthcare-associated infections in the United States, 2009-2011.
Infect Control Hosp Epidemiol. 2014 Oct;35 Suppl 3:S10-6. doi: 10.1086/677827..
Keywords: Healthcare-Associated Infections (HAIs), Disparities, Racial and Ethnic Minorities, Critical Care, Patient Safety
Wheeler SB, Kuo TM, Goyal RK
Regional variation in colorectal cancer testing and geographic availability of care in a publicly insured population.
The researchers examined colorectal cancer (CRC) testing across regions of North Carolina by using population-based Medicare and Medicaid claims data from disabled individuals who turned 50 years of age during 2003-2008. They found that fewer than 50% of eligible individuals had evidence of CRC testing; men, African-Americans, Medicaid beneficiaries, and those living furthest away from endoscopy facilities had significantly lower odds of CRC testing, with significant regional variation.
AHRQ-funded; HS019468.
Citation: Wheeler SB, Kuo TM, Goyal RK .
Regional variation in colorectal cancer testing and geographic availability of care in a publicly insured population.
Health Place 2014 Sep;29:114-23. doi: 10.1016/j.healthplace.2014.07.001.
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Keywords: Access to Care, Cancer: Colorectal Cancer, Disparities, Screening, Social Determinants of Health
Burke JF, Vijan S, Chekan LA
Targeting high-risk employees may reduce cardiovascular racial disparities.
A possible remedy for health disparities is for employers to promote cardiovascular health among minority employees. However, this study finds that there was no significant per person differential attributable to racial disparities for heart attack and stroke. A primary implication is that targeting cardiovascular disease strategies for African Americans is unlikely to be cost saving for employers.
AHRQ-funded; HS017690
Citation: Burke JF, Vijan S, Chekan LA .
Targeting high-risk employees may reduce cardiovascular racial disparities.
Am J Manag Care. 2014 Sep;20(9):725-33..
Keywords: Cardiovascular Conditions, Disparities, Healthcare Costs, Health Promotion, Health Status, Racial and Ethnic Minorities
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.
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Keywords: Disparities, Labor and Delivery, Patient-Centered Outcomes Research, Quality Indicators (QIs), Racial and Ethnic Minorities
Davis AE, Mehrotra S, Kilambi V
The effect of the Statewide Sharing variance on geographic disparity in kidney transplantation in the United States.
This study examined the effect of Statewide Sharing on geographic allocation disparity over time between donor service areas (DSAs) within Tennessee and Florida and compared them with geographic disparity between the DSAs within a state for all states with more than one DSA (California, New York, North Carolina, Ohio, Pennsylvania, Texas, and Wisconsin). Findings suggested that changes which are untested run the risk of unintended consequences, and Statewide Sharing should be further studied and considered.
AHRQ-funded; HS021078.
Citation: Davis AE, Mehrotra S, Kilambi V .
The effect of the Statewide Sharing variance on geographic disparity in kidney transplantation in the United States.
Clin J Am Soc Nephrol 2014 Aug 7;9(8):1449-60. doi: 10.2215/cjn.05350513.
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Keywords: Chronic Conditions, Disparities, Kidney Disease and Health, Policy, Transplantation
Kenik J, Jean-Jacques M, Feinglass J
Explaining racial and ethnic disparities in cholesterol screening.
This study examining the impact of low socioeconomic status, access to care, and language on racial and ethnic disparities in cholesterol screening found that these factors explained most of those disparities. After adjusting for these factors, disparities between whites and Blacks and Hispanics but not Asians and Pacific Islanders were eliminated.
AHRQ-funded; HS021141
Citation: Kenik J, Jean-Jacques M, Feinglass J .
Explaining racial and ethnic disparities in cholesterol screening.
Prev Med. 2014 Aug;65:65-9. doi: 10.1016/j.ypmed.2014.04.026..
Keywords: Social Determinants of Health, Disparities, Racial and Ethnic Minorities, Screening, Access to Care
Zhang R, Lee JY, Jean-Jacques M
Factors influencing the increasing disparity in LDL cholesterol control between white and black patients with diabetes in a context of active quality improvement.
The authors conducted a retrospective analysis of black and white patients treated continuously between 2008 and 2010 in order to examine possible causes of an increased disparity in low-density lipoprotein (LDL) cholesterol control following a multifaceted physician-directed quality improvement (QI) initiative. They found that physician-facing, general QI interventions may be insufficient to produce equity in LDL cholesterol control, and that helping patients maintain prior success controlling cholesterol appears as important in addressing this disparity as is helping uncontrolled patients achieve control.
AHRQ-funded; HS021141.
Citation: Zhang R, Lee JY, Jean-Jacques M .
Factors influencing the increasing disparity in LDL cholesterol control between white and black patients with diabetes in a context of active quality improvement.
Am J Med Qual 2014 Jul-Aug;29(4):308-14. doi: 10.1177/1062860613498112.
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Keywords: Heart Disease and Health, Diabetes, Disparities, Quality Improvement, Racial and Ethnic Minorities
Wasserman M, Renfrew MR, Green AR
AHRQ Author: Brach C
Identifying and preventing medical errors in patients with limited English proficiency: key findings and tools for the field.
This article describes the development, content, and testing of two new evidence-based AHRQ tools for limited English proficiency (LEP) patient safety in the hospital setting. These tools contain recommendations to improve detection and prevention of medical errors across diverse populations and to improve team communication through incorporating interpreters in the care process.
AHRQ-authored
Citation: Wasserman M, Renfrew MR, Green AR .
Identifying and preventing medical errors in patients with limited English proficiency: key findings and tools for the field.
J Healthc Qual. 2014 May-Jun;36(3):5-16. doi: 10.1111/jhq.12065..
Keywords: Disparities, Evidence-Based Practice, Patient Safety, Clinician-Patient Communication, TeamSTEPPS
McGarry BE, Strawderman RL, Li Y
Lower Hispanic participation in Medicare Part D may reflect program barriers.
This study found that Hispanics were 35 percent less likely than non-Hispanic whites to have Medicare Part D coverage. This difference may be driven by ethnic disparities among those eligible for the low-income Part D subsidy but not automatically enrolled in it.
AHRQ-funded; HS00044
Citation: McGarry BE, Strawderman RL, Li Y .
Lower Hispanic participation in Medicare Part D may reflect program barriers.
Health Aff. 2014 May;33(5):856-62. doi: 10.1377/hlthaff.2013.0671..
Keywords: Medicare, Disparities, Racial and Ethnic Minorities, Low-Income, Healthcare Costs
Yaghjyan L, Wolin K, Chang SH
Racial disparities in healthy behaviors and cancer screening among breast cancer survivors and women without cancer: National Health Interview Survey 2005.
This study aimed to compare healthy behaviors and cancer screening practices among breast cancer survivors and respondents without cancer separately in Caucasian, African American, and Hispanic women. It found that most differences were suggestive and do not differ by race.
AHRQ-funded; HS022330.
Citation: Yaghjyan L, Wolin K, Chang SH .
Racial disparities in healthy behaviors and cancer screening among breast cancer survivors and women without cancer: National Health Interview Survey 2005.
Cancer Causes Control. 2014 May;25(5):605-14. doi: 10.1007/s10552-014-0365-7..
Keywords: Cancer: Breast Cancer, Cancer, Racial and Ethnic Minorities, Women, Disparities, Screening
Zhang SM, McGoy SL, Dawes D
The potential for elimination of racial-ethnic disparities in HIV treatment initiation in the Medicaid population among 14 southern states.
This study explored racial/ethnic disparities in the initiation of antiretroviral treatment among HIV-infected Medicaid enrollees in 14 Southern States. It found no significant differences between blacks and non-Hispanic whites but Hispanic/Latino persons were significantly less likely to receive antiretroviral treatment.
AHRQ-funded; HS022444; HS019470
Citation: Zhang SM, McGoy SL, Dawes D .
The potential for elimination of racial-ethnic disparities in HIV treatment initiation in the Medicaid population among 14 southern states.
PLoS One. 2014 Apr 25;9(4):e96148. doi: 10.1371/journal.pone.0096148..
Keywords: Human Immunodeficiency Virus (HIV), Disparities, Racial and Ethnic Minorities, Medicaid
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.
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Keywords: Disabilities, Disparities, Health Status, Patient-Centered Outcomes Research
Bushnell CD, Reeves MJ, Zhao X
Sex differences in quality of life after ischemic stroke.
This study compared quality of life (QOL) in men and women at 3 and 12 months after stroke, and the change in QOL over time between men and women. It found that women have worse QOL than men up to 12 months after stroke, even after adjusting for important sociodemographic variables and stroke severity.
AHRQ-funded; HS016964.
Citation: Bushnell CD, Reeves MJ, Zhao X .
Sex differences in quality of life after ischemic stroke.
Neurology 2014 Mar 18;82(11):922-31. doi: 10.1212/wnl.0000000000000208..
Keywords: Stroke, Disparities, Women, Social Determinants of Health
Dougherty D, Chen X, Gray DT
AHRQ Author: Dougherty D, Gray DT
Child and adolescent health care quality and disparities: are we making progress?
The authors sought to examine trends over time in health care quality and disparities by race, Hispanic ethnicity, income, insurance, gender, rurality, and special health care needs. Using data from the 2011 National Healthcare Quality Report and Naitonal Healthcare Disparities Reprot, they found that there was some progress in health care quality and reducing disparities in children's health care quality from 2000 to 2009, but opportunities for targeting improvement strategies remain.
AHRQ-authored.
Citation: Dougherty D, Chen X, Gray DT .
Child and adolescent health care quality and disparities: are we making progress?
Acad Pediatr 2014 Mar-Apr;14(2):137-48. doi: 10.1016/j.acap.2013.11.008.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Disparities, Quality of Care
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