National Healthcare Quality and Disparities Report
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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 66 Research Studies DisplayedMyong C, Hull P, Price M
The impact of funding for federally qualified health centers on utilization and emergency department visits in Massachusetts.
This retrospective study examined the impact of funding for federally qualified health centers (FQHCs) on utilization and emergency department (ED) visits in Massachusetts. The authors theorized that greater funding for FQHCs could increase the local availability of clinic-based care and reduce more costly resource use, such as ED visits. Data from the Massachusetts All Payer Claims Database (APCD) 2010-2013 was used that included enrollees in 559 Massachusetts ZIP codes (2010 numbers 6,173,563). They calculated shift-share predictions of changes in FQHC funding at the ZIP code-level for FQHCs that received Community Health Center funds in any year. They found that a standard deviation increase in prior year FQHC funding (31%) was associated with a 2.3% increase in enrollees with FQHC visits and a 1.3% decrease in enrollees at EDs. However, there were no significant changes in emergent ED visit rates.
AHRQ-funded; HS025378.
Citation: Myong C, Hull P, Price M .
The impact of funding for federally qualified health centers on utilization and emergency department visits in Massachusetts.
PLoS One 2020 Dec 3;15(12):e0243279. doi: 10.1371/journal.pone.0243279..
Keywords: Community-Based Practice, Healthcare Utilization, Emergency Department, Healthcare Costs, Access to Care, Vulnerable Populations, Policy
Friedman S, Xu H, Azocar F
Carve-out plan financial requirements associated with national behavioral health parity.
The authors examined changes in carve-out financial requirements following the Mental Health Parity and Addiction Equity Act (MHPAEA). They found that the MHPAEA was associated with increased generosity in most observed financial requirements, but increased use of deductibles may have reduced generosity for some patients.
AHRQ-funded; HS024866.
Citation: Friedman S, Xu H, Azocar F .
Carve-out plan financial requirements associated with national behavioral health parity.
Health Serv Res 2020 Dec;55(6):924-31. doi: 10.1111/1475-6773.13542..
Keywords: Behavioral Health, Healthcare Costs, Health Insurance, Access to Care, Policy
Larson AE, Hoopes M, Angier H
Private/marketplace insurance in community health centers 5 years post-affordable care act in Medicaid expansion and non-expansion states.
This study compared differences in private/marketplace insurance in community health centers (CHCs) 5 years post-Affordable Care Act (ACA) in Medicaid expansion and non-expansion states. Electronic health record data from 702,663 patients in clinics across 20 states was used to explore trends in private/market insurance post-expansion and whether CHC patients retain private/marketplace insurance. The authors found that patients in non-expansion state CHCs relied more heavily on private/marketplace insurance than patients in expansive states and had increased visits from 2014 through 2018. There was a more pronounced seasonal variation in private/marketplace-insured visits too. A greater percentage of those who in non-expansion states did not retain private/marketplace insurance become uninsured, while those in expansion states gained other types of health insurance.
AHRQ-funded; HS024270.
Citation: Larson AE, Hoopes M, Angier H .
Private/marketplace insurance in community health centers 5 years post-affordable care act in Medicaid expansion and non-expansion states.
Prev Med 2020 Dec;141:106271. doi: 10.1016/j.ypmed.2020.106271..
Keywords: Medicaid, Health Insurance, Access to Care, Policy
Benson NM, Myong C, Newhouse JP
Psychiatrist participation in private health insurance markets: paucity in the land of plenty.
Using 2013 Massachusetts licensing data and the All-Payer Claims Database, researchers performed a cross-sectional analysis of licensed psychiatrists in Massachusetts to examine the extent of participation in private insurance. They found that, among Massachusetts psychiatrists, participation in the private insurance market appeared to be limited. Older psychiatrists were more likely to participate, and patients' access to psychiatrists who accept insurance could worsen as these psychiatrists retire.
AHRQ-funded; HS024725.
Citation: Benson NM, Myong C, Newhouse JP .
Psychiatrist participation in private health insurance markets: paucity in the land of plenty.
Psychiatr Serv 2020 Dec;71(12):1232-38. doi: 10.1176/appi.ps.202000022..
Keywords: Health Insurance, Behavioral Health, Access to Care, Provider: Physician, Provider
Hudson JL, Moriya AS
AHRQ Author: Hudson JL
The role of marketplace policy on welcome mat effects for children eligible for Medicaid or the Children's Health Insurance Program.
This study examined the role of marketplace policy on “welcome mat” effects for children eligible for Medicaid or the Children’s Health Insurance Program (CHIP). Data from the American Community Survey from 2013-2018 was used to estimate the relationship between Marketplace policy and increases in Medicaid/CHIP coverage among pre-ACA eligible children after the implementation of the Affordable Care Act (ACA). The sample included non-disabled citizen children ages 0-18 at 139-250% federal poverty level who were Medicaid/CHIP-eligible before and after implementation of the ACA. Marketplace policies and enrollment were compared in expansion states versus non-expansion states. Public coverage did increase more in states that empowered their Marketplace to enroll publicly-eligible applicants directly into Medicaid/CHIP. This was driven by enrollment policy, not by choice of state-based versus federal-based Marketplaces. Welcome mats were largest in expansion states and increases ranged from 9 to 13 percentage points in enrollment.
AHRQ-authored.
Citation: Hudson JL, Moriya AS .
The role of marketplace policy on welcome mat effects for children eligible for Medicaid or the Children's Health Insurance Program.
Inquiry 2020 Jan-Dec;57:46958020952920. doi: 10.1177/0046958020952920..
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Medicaid, Health Insurance, Policy, Uninsured, Access to Care
Geissler K, Ranchoff BL, Cooper MI
Association of insurance status with provision of recommended services during comprehensive postpartum visits.
Investigators examined rates of recommended services during the comprehensive postpartum visits and differences by insurance type. Data was taken from annual National Ambulatory Medical Care Surveys. Their findings suggested that receipt of recommended services during comprehensive postpartum visits was less than 50% for most services and was similar across insurance types. These findings underscored the importance of efforts to reconceptualize postpartum care to ensure that women have access to a range of supports to manage their health during this sensitive period.
AHRQ-funded; HS025515.
Citation: Geissler K, Ranchoff BL, Cooper MI .
Association of insurance status with provision of recommended services during comprehensive postpartum visits.
JAMA Netw Open 2020 Nov 2;3(11):e2025095. doi: 10.1001/jamanetworkopen.2020.25095..
Keywords: Maternal Care, Pregnancy, Women, Health Insurance, Access to Care, Healthcare Utilization
Wisk LE, Peltz A, Galbraith AA
Changes in health care-related financial burden for US families with children associated with the Affordable Care Act.
The Affordable Care Act (ACA) sought to improve access and affordability of health insurance. Although most ACA policies targeted childless adults, the extent to which these policies also impacted families with children remains unclear. The purpose of this study was to examine changes in health care-related financial burden for US families with children before and after the ACA was implemented based on income eligibility for ACA policies.
AHRQ-funded; HS024700.
Citation: Wisk LE, Peltz A, Galbraith AA .
Changes in health care-related financial burden for US families with children associated with the Affordable Care Act.
JAMA Pediatr 2020 Nov;174(11):1032-40. doi: 10.1001/jamapediatrics.2020.3973..
Keywords: Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Health Insurance, Policy, Access to Care
Rosenberg J, Rosenthal MS, Cramer LD
Disparities in mental and behavioral health treatment for children and youth in immigrant families.
Children and youth in immigrant families (CIF)-children and youth with at least one foreign-born parent-face unique psychosocial stressors. Yet little is known about access to mental/behavioral health (MBH) services for CIF. Among US CIF and non-CIF with MBH problems, the authors assessed access to MBH treatment using the National Survey of Children's Health-2016, a nationally-representative survey of predominantly English- or Spanish-speaking US parents.
AHRQ-funded; HS024332.
Citation: Rosenberg J, Rosenthal MS, Cramer LD .
Disparities in mental and behavioral health treatment for children and youth in immigrant families.
Acad Pediatr 2020 Nov-Dec;20(8):1148-56. doi: 10.1016/j.acap.2020.06.013..
Keywords: Children/Adolescents, Behavioral Health, Disparities, Racial and Ethnic Minorities, Vulnerable Populations, Access to Care
Yang J, Landrum MB, Zhou L
Disparities in outpatient visits for mental health and/or substance use disorders during the COVID surge and partial reopening in Massachusetts.
The purpose of this study was to examine changes in outpatient visits for mental health and/or substance use disorders (MH/SUD) in an integrated healthcare organization during the initial Massachusetts COVID-19 surge and partial state reopening. The investigators concluded that MH/SUD visit volume increased during the COVID surge and was supported by rapidly-scaled telemedicine.
AHRQ-funded; HS025375.
Citation: Yang J, Landrum MB, Zhou L .
Disparities in outpatient visits for mental health and/or substance use disorders during the COVID surge and partial reopening in Massachusetts.
Gen Hosp Psychiatry 2020 Nov-Dec;67:100-06. doi: 10.1016/j.genhosppsych.2020.09.004..
Keywords: Behavioral Health, Substance Abuse, COVID-19, Disparities, Access to Care, Ambulatory Care and Surgery, Telehealth, Health Information Technology (HIT)
Chien AT, Pandey A, Lu S
Pediatric hospital services within a one-hour drive: a national study.
Researchers determined the proportion of US counties whose 0- to 19-year-old patients could reach pediatric hospital services within one hour of driving; then, among counties within a one-hour drive, they determined each county’s beds per 100,000 pediatric-aged population to provide a sense of hospital capacity relative to the size of their pediatric population. They concluded that the need to drive more than one hour to reach hospital-based pediatric services is more the rule than the exception.
AHRQ-funded; HS024072; HS025299.
Citation: Chien AT, Pandey A, Lu S .
Pediatric hospital services within a one-hour drive: a national study.
Pediatrics 2020 Nov;146(5). doi: 10.1542/peds.2020-1724..
Keywords: Children/Adolescents, Hospitals, Access to Care, Healthcare Delivery
Orth J, Li Y, Simning A
Severe behavioral health manifestations in nursing homes: associations with service availability?
The objective of this study was to examine associations between availability of behavioral health (BH) services and the presence of severe depression, suicidal ideation (SI), and severe aggressive behaviors (ABs) among nursing home (NH) residents. 2017 survey data on BH service availability was obtained from 1,051 NHs and the Minimum Data Set (MDS) to identify long-term stay residents in these facilities (n = 101,238). Odds of severe depression were 21% higher when NHs reported inadequate BH staff education as well as 13% higher for SI and 10% higher for severe ABs among residents in facilities reporting inadequate facility infrastructure. Facility-level factors such as staffing, training, and turnover were also statistically significant associations with these severe BH manifestations.
AHRQ-funded; HS024923.
Citation: Orth J, Li Y, Simning A .
Severe behavioral health manifestations in nursing homes: associations with service availability?
J Am Geriatr Soc 2020 Nov;68(11):2643-49. doi: 10.1111/jgs.16772..
Keywords: Elderly, Nursing Homes, Long-Term Care, Depression, Behavioral Health, Access to Care
Roberts ET, Mehrotra A
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
In this study, the investigators examined disparities in digital access (ie, access at home to technology that enables video telemedicine visits) among Medicare beneficiaries by socioeconomic and demographic characteristics. The investigators concluded that the proportion of beneficiaries who lacked digital access was higher among those with low socioeconomic status, those 85 years or older, and in communities of color.
AHRQ-funded; HS026727.
Citation: Roberts ET, Mehrotra A .
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
JAMA Intern Med 2020 Oct;180(10):1386-89. doi: 10.1001/jamainternmed.2020.2666..
Keywords: Elderly, Medicare, Telehealth, Health Information Technology (HIT), Disparities, Access to Care, Social Determinants of Health, Low-Income, Racial and Ethnic Minorities
Khouja T, Burgette JM, Donohue JM
Association between Medicaid expansion, dental coverage policies for adults, and children's receipt of preventive dental services.
Researchers examined whether low-income children's use of preventive dental services is linked to variation in state Medicaid policies that affect parents' access to dental care in Medicaid. Using MEPS data along with Area Health Resources File and Medicaid adult dental coverage policies, they found no change in children's receipt of preventive dental care associated with Medicaid expansions in states that covered vs did not cover preventive dental services for adults. They concluded that factors other than parental access to dental benefits through Medicaid may be more salient determinants of preventive dental care use among low-income children.
AHRQ-funded; HS026727.
Citation: Khouja T, Burgette JM, Donohue JM .
Association between Medicaid expansion, dental coverage policies for adults, and children's receipt of preventive dental services.
Health Serv Res 2020 Oct;55(5):642-50. doi: 10.1111/1475-6773.13324..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Dental and Oral Health, Medicaid, Health Insurance, Low-Income, Access to Care, Policy
Leeds IL, Jones C, DiBrito SR
Delay in emergency hernia surgery is associated with worse outcomes.
The purpose of this study was to determine if the variation in timing of urgent surgery impacts surgical outcomes. The National Surgical Quality Improvement Program (NSQIP) database was searched for emergent surgeries in 2011-2016 for abdominal hernia resulting in obstruction or gangrene by primary post-op diagnosis. Findings showed that delayed surgery was associated with increased rates of major complications, longer operative times, longer postoperative lengths of stay, increased re-operations, increased readmissions, and increased 30-day mortality. Next-day surgery and surgery delayed more than one day were associated with increased odds of a major complication.
AHRQ-funded; HS024547.
Citation: Leeds IL, Jones C, DiBrito SR .
Delay in emergency hernia surgery is associated with worse outcomes.
Surg Endosc 2020 Oct;34(10):4562-73. doi: 10.1007/s00464-019-07245-4..
Keywords: Surgery, Quality Improvement, Quality of Care, Critical Care, Access to Care, Digestive Disease and Health, Outcomes
Lee H, Caldwell JT, Maene C
Racial/ethnic inequities in access to high-quality dialysis treatment in Chicago: does neighborhood racial/ethnic composition matter?
Investigators examined whether neighborhood racial composition contributes to racial/ethnic inequities in access to high-quality dialysis care in Chicago. Data from the United States Renal Data System was merged with the ESRD Quality Incentive Program file and the American Community Survey (2005-2009) for facility and neighborhood characteristics. The investigators concluded that expanding opportunities for Blacks and Hispanics to gain access to racially integrated and minority neighborhoods may help alleviate racial/ethnic inequities in access to quality care among kidney disease patients.
AHRQ-funded; HS00078.
Citation: Lee H, Caldwell JT, Maene C .
Racial/ethnic inequities in access to high-quality dialysis treatment in Chicago: does neighborhood racial/ethnic composition matter?
J Racial Ethn Health Disparities 2020 Oct;7(5):854-64. doi: 10.1007/s40615-020-00708-8..
Keywords: Racial and Ethnic Minorities, Access to Care, Urban Health, Dialysis, Disparities, Quality of Care, Kidney Disease and Health
Li J, Qi M, Werner RM
Assessment of receipt of the first home health care visit after hospital discharge among older adults.
Investigators examined how often patients referred to home health care at hospital discharge receive it and whether there is evidence of disparities. Their study used Medicare data regarding the postacute home health care setting; participants were Medicare fee-for-service and Medicare Advantage beneficiaries discharged from the hospital with a referral to home health care. They found that only 54% of patients discharged received home health care services within 14 days of discharge. Of the remaining 46% discharged, 37.7% never received any home health care, while 8.3% were institutionalized or died within 14 days without a preceding home health care visit. Patients who were Black or Hispanic received home health at lower rates than did patients who were White. They concluded that disparities in the use of home health care remain an issue in the US.
AHRQ-funded; HS024266; HS026836.
Citation: Li J, Qi M, Werner RM .
Assessment of receipt of the first home health care visit after hospital discharge among older adults.
JAMA Netw Open 2020 Sep;3(9):e2015470. doi: 10.1001/jamanetworkopen.2020.15470..
Keywords: Elderly, Hospital Discharge, Home Healthcare, Disparities, Access to Care, Racial and Ethnic Minorities
Cha P, Brindis CD
Early Affordable Care Act Medicaid: coverage effects for low- and moderate-income young adults.
This study examined the effects of early Medicaid expansions on low- and moderate-income young adults. They used the American Community Survey 2008-2013 to study three early expansion states: California, Connecticut and Minnesota. Results shows that Medicaid expansion reduced uninsurance in all three states and increased public insurance in California and Minnesota. Young men benefitted more than young women, who historically tend to be uninsured.
AHRQ-funded; HS022241.
Citation: Cha P, Brindis CD .
Early Affordable Care Act Medicaid: coverage effects for low- and moderate-income young adults.
J Adolesc Health 2020 Sep;67(3):425-31. doi: 10.1016/j.jadohealth.2020.05.029..
Keywords: Young Adults, Policy, Medicaid, Uninsured, Access to Care
Herb JN, Dunham LN, Mody G
Lung cancer surgical regionalization disproportionately worsens travel distance for rural patients.
Researchers hypothesized that lung cancer patients have been traveling further for surgery over time as regionalization has occurred, and this increased travel has primarily impacted rural patients. Using data from a North Carolina all-payer state discharge database, they found that the number of hospitals performing lung cancer resections decreased from 49 to 31 over the study period, and the proportion of patients receiving care at high-volume centers increased. Rural patient travel distance increased over time by 8.5 miles, with no change in urban patient travel distance. They concluded that, in North Carolina, lung cancer surgical regionalization occurred over the study period and was accompanied by increases in travel distance for rural patients only. They recommended further work to determine the effects of greater travel distance on patterns of cancer care for rural patients.
AHRQ-funded; HS000032.
Citation: Herb JN, Dunham LN, Mody G .
Lung cancer surgical regionalization disproportionately worsens travel distance for rural patients.
J Rural Health 2020 Sep;36(4):496-505. doi: 10.1111/jrh.12440..
Keywords: Cancer: Lung Cancer, Cancer, Rural Health, Surgery, Access to Care
Zuvekas SH, McClellan CB, Ali MM
AHRQ Author: Zuvekas SH, McClellan CB
Medicaid expansion and health insurance coverage and treatment utilization among individuals with a mental health condition.
AHRQ-authored.
Citation: Zuvekas SH, McClellan CB, Ali MM .
Medicaid expansion and health insurance coverage and treatment utilization among individuals with a mental health condition.
J Ment Health Policy Econ 2020 Sep 1;23(3):151-82..
Keywords: Medical Expenditure Panel Survey (MEPS), Behavioral Health, Medicaid, Health Insurance, Access to Care, Healthcare Utilization, Policy, Uninsured
Green TC, Donovan E, Klug B
Revisiting pharmacy-based naloxone with pharmacists and naloxone consumers in 2 states: 2017 perspectives and evolving approaches.
The authors sought to examine similarities and differences in experiences obtaining naloxone at the pharmacy over a 1-year period in 2 states, and to explore reactions from people with opioid use disorder, patients taking opioids for chronic pain, caregivers of opioid users, and pharmacists to communication tools and patient outreach materials designed to improve naloxone uptake. Through focus groups in Massachusetts and Rhode Island, they found that experiences dispensing naloxone are quickly evolving, and a greater diversity of patients are obtaining pharmacy naloxone. They concluded that persistent stigma-related concerns underscore the need for tools to help pharmacists offer naloxone, facilitate patient requests, and provide reassurance when getting naloxone.
AHRQ-funded; HS024021.
Citation: Green TC, Donovan E, Klug B .
Revisiting pharmacy-based naloxone with pharmacists and naloxone consumers in 2 states: 2017 perspectives and evolving approaches.
J Am Pharm Assoc (2003) 2020 Sep-Oct;60(5):740-49. doi: 10.1016/j.japh.2020.03.005..
Keywords: Opioids, Medication, Substance Abuse, Community-Based Practice, Healthcare Delivery, Social Stigma, Access to Care
Patterson ES, Papautsky EL, Krok-Schoen JL
Scheduling delayed treatment and surgeries post-pandemic: a stakeholder analysis.
The purpose of this study was to assess diverse stakeholder perspectives regarding how to trade off risks and benefits to patients, healthcare providers, and the local community. The study found that there exists a high number of different categories of stakeholders affected by the post-pandemic decisions to reschedule delayed treatments and surgeries. The primary stakeholders for a delayed surgery are the surgeon with knowledge of the clinical benefits of undertaking an operation and the patient's willingness to tolerate uncertainty and the increased risk of infection. For decisions about capacity in the operating rooms and inpatient setting after the surgery, the primary factors are reducing staff infections, preventing patients from contracting COVID-19 during operations and during post-surgical recovery at the hospital, conserving critical resources such as Personal Protective Equipment (PPE), and addressing the quality of life needs of hospital staff, such as childcare and preventing infecting members of their household. The timing and selection of elective surgery cases has an effect on the ability of hospitals to manage finances, which impacts decisions about staff employment when resources such as rooms are not being utilized.
AHRQ-funded; HS024379.
Citation: Patterson ES, Papautsky EL, Krok-Schoen JL .
Scheduling delayed treatment and surgeries post-pandemic: a stakeholder analysis.
Proc Int Symp Hum Factors Ergon Healthc 2020 Sep;9(1):10-14. doi: 10.1177/2327857920091066..
Keywords: COVID-19, Surgery, Public Health, Access to Care
Mogul DB, Perito ER, Wood N
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
In December 2018, UNOS approved an allocation scheme based on recipients' geographic distance from a deceased donor ("acuity circles"). Previous analyses suggested acuity circles (AC) would reduce waitlist mortality overall, but their impact on pediatric subgroups was not considered. In this study, the investigators applied Scientific Registry of Transplant Recipients data from 2011-2016 towards the Liver Simulated Allocation Model (LSAM) to compare outcomes by age and illness severity for the UNOS-approved AC and the existing Donor Service Area (DSA)/Region-based allocation schemes.
AHRQ-funded; HS023876.
Citation: Mogul DB, Perito ER, Wood N .
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
Transplantation 2020 Aug;104(8):1627-32. doi: 10.1097/tp.0000000000003079..
Keywords: Children/Adolescents, Transplantation, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Registries, Surgery, Access to Care
Porter A, Brown CC, Tilford JM
Association of insurance status with treatment and outcomes in pediatric patients with severe traumatic brain injury.
This study’s objective was to determine if a health insurance disparity exists among pediatric patients with severe traumatic brain injury using data from the National Trauma Data Bank. The Bank contains data from more than 800 trauma centers in the United States. Isolated traumatic brain injury was defined as patients with a head Abbreviated Injury Scale score of 3+. Procedure codes were used to identify four primary treatment approaches combined into 2 classifications: craniotomy or craniectomy and external or intracranial ventricular draining. Condition at admission was defined including hypotension, Glasgow Coma Scale, mechanism and intent of injury, and Injury Severity Scale. Among the cohort of 12,449 patients, 91% had insurance and 9% were uninsured. Children without insurance had worse condition at admission with higher rates of hypotension and higher Injury Severity Score when compared with publicly and privately insured patients. Having insurance was associated with a 32% increase in the odds of cranial procedures, and 54% increase in the odds of monitor placement. Insurance coverage was associated 25% lower odds of inpatient mortality. Further study is needed to determine what factors lead to worse condition at admission.
Citation: Porter A, Brown CC, Tilford JM .
Association of insurance status with treatment and outcomes in pediatric patients with severe traumatic brain injury.
Crit Care Med 2020 Jul;48(7):e584-e91. doi: 10.1097/ccm.0000000000004398..
Keywords: Children/Adolescents, Brain Injury, Trauma, Health Insurance, Access to Care, Uninsured, Outcomes
Govindarajan P, Shiboski S, Grimes B
Effect of acute stroke care regionalization on intravenous alteplase use in two urban counties.
Investigators sought to determine whether increasing access to primary stroke centers (regionalization) led to an increase in intravenous alteplase use in acute ischemic stroke patients. Studying two urban counties in the western region of US that regionalized acute stroke care, they found that in Santa Clara County, intravenous alteplase was administered to 1.7% of patients in the pre-regionalization period and 2.1% in the post-regionalization period, while in San Mateo County, the numbers were 1.3% and 3.2%, respectively. In the post-regionalization phase, San Mateo County had greater change in paramedic stroke detection, higher number of transports to primary stroke centers, and more frequent use of intravenous alteplase at stroke centers. They concluded that greater post-regionalization improvements in San Mateo County contributed to significantly improved county-level thrombolysis use than Santa Clara County.
AHRQ-funded; HS026207; HS017965.
Citation: Govindarajan P, Shiboski S, Grimes B .
Effect of acute stroke care regionalization on intravenous alteplase use in two urban counties.
Prehosp Emerg Care 2020 Jul-Aug;24(4):505-14. doi: 10.1080/10903127.2019.1679303..
Keywords: Stroke, Cardiovascular Conditions, Urban Health, Access to Care, Emergency Medical Services (EMS), Critical Care
Fiori KP, Heller CG, Rehm CD
Unmet social needs and no-show visits in primary care in a US Northeastern urban health system, 2018-2019.
This study used results from a 10-item social needs screener conducted across 19 primary care practices in Bronx County, New York to determine reasons for no-show appointments between April 2018 and July 2019. They examined the association between unmet needs and a 2-year history of missed appointments from 41,637 patients. Overall, the no-show appointment rate was 26.6%. Patients with 1 or more unmet social needs had a significantly higher no-show proportion (31.5%) than those without (26.3%). The strongest association with no-shows was with transportation problems.
AHRQ-funded; HS026396.
Citation: Fiori KP, Heller CG, Rehm CD .
Unmet social needs and no-show visits in primary care in a US Northeastern urban health system, 2018-2019.
Am J Public Health 2020 Jul;110(S2):S242-s50. doi: 10.2105/ajph.2020.305717..
Keywords: Urban Health, Primary Care, Access to Care, Social Determinants of Health