National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (9)
- Adverse Events (1)
- Behavioral Health (3)
- Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cancer: Lung Cancer (1)
- Children/Adolescents (3)
- Chronic Conditions (1)
- Clinician-Patient Communication (1)
- Communication (6)
- Comparative Effectiveness (1)
- Data (1)
- Decision Making (7)
- Diagnostic Safety and Quality (1)
- Disparities (4)
- Elderly (1)
- Emergency Department (4)
- Emergency Medical Services (EMS) (4)
- Evidence-Based Practice (5)
- Guidelines (3)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (11)
- Healthcare Delivery (5)
- Healthcare Utilization (2)
- Health Information Technology (HIT) (2)
- Health Insurance (19)
- Health Services Research (HSR) (6)
- Health Status (2)
- Hospitalization (1)
- Hospitals (2)
- Human Immunodeficiency Virus (HIV) (2)
- Imaging (1)
- Infectious Diseases (1)
- Intensive Care Unit (ICU) (1)
- Kidney Disease and Health (2)
- Labor and Delivery (1)
- Long-Term Care (1)
- Low-Income (5)
- Medicaid (16)
- Medical Devices (1)
- Medical Errors (2)
- Medical Expenditure Panel Survey (MEPS) (3)
- Medical Liability (3)
- Medicare (3)
- Medication (12)
- Medication: Safety (2)
- Mortality (2)
- Nursing Homes (1)
- Nutrition (1)
- Opioids (2)
- Organizational Change (1)
- Outcomes (1)
- Patient-Centered Healthcare (3)
- Patient and Family Engagement (1)
- Patient Safety (3)
- Payment (4)
- (-) Policy (73)
- Practice-Based Research Network (PBRN) (1)
- Practice Patterns (4)
- Pregnancy (1)
- Prevention (2)
- Primary Care (2)
- Provider (1)
- Provider: Nurse (1)
- Provider: Pharmacist (1)
- Provider: Physician (1)
- Public Health (4)
- Public Reporting (1)
- Quality of Care (3)
- Racial and Ethnic Minorities (3)
- Registries (1)
- Research Methodologies (2)
- Screening (1)
- Social Determinants of Health (2)
- Substance Abuse (4)
- Surgery (1)
- Tobacco Use (1)
- Transplantation (4)
- Uninsured (5)
- Vaccination (1)
- Vulnerable Populations (1)
- Women (2)
- Young Adults (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 73 Research Studies DisplayedCaliff RM, Robb MA, Bindman AB
AHRQ Author: Bindman AB, Dymek C
Transforming evidence generation to support health and health care decisions.
Collaborations among federal health agencies involved in biomedical research and health care delivery with regard to data sharing, research infrastructure, and computational capabilities require combining expertise and resources and will entail substantial changes to the culture of clinical research, In this article, the authors propose a set of core principles for data collaboration and system organizational design that they believe will further enable research efforts by both the private sector and government agencies.
AHRQ-authored.
Citation: Califf RM, Robb MA, Bindman AB .
Transforming evidence generation to support health and health care decisions.
N Engl J Med 2016 Dec 15;375(24):2395-400. doi: 10.1056/NEJMsb1610128.
.
.
Keywords: Healthcare Delivery, Decision Making, Evidence-Based Practice, Policy
Khatibzadeh S, Saheb Kashaf M, Micha R
A global database of food and nutrient consumption.
The authors conducted an empirical assessment of dietary intakes in order for evidence-based policy-making to address global health challenges. They derived The Global Dietary Database, which combines broad global coverage with estimates of food and nutrient consumption by age, sex and time. They believe that these data provide an empirical basis for global dietary surveillance, policy-making and priority setting to address diet-related burdens of disease.
AHRQ-funded; HS000062.
Citation: Khatibzadeh S, Saheb Kashaf M, Micha R .
A global database of food and nutrient consumption.
Bull World Health Organ 2016 Dec;94(12):931-34. doi: 10.2471/blt.15.156323.
.
.
Keywords: Data, Evidence-Based Practice, Nutrition, Policy, Public Health
Meisel ZF, Metlay JP, Sinnenberg L
A randomized trial testing the effect of narrative vignettes versus guideline summaries on provider response to a professional organization clinical policy for safe opioid prescribing.
The authors compared whether narrative vignettes embedded in the American College of Emergency Physicians (ACEP) daily e-newsletter improved dissemination of the clinical policy to ACEP members, and engagement of members with the clinical policy, compared with traditional summary text. They found that the vignettes outperformed traditional guideline text in promoting engagement with an evidence-based clinical guideline related to opioid prescriptions.
AHRQ-funded; HS021956.
Citation: Meisel ZF, Metlay JP, Sinnenberg L .
A randomized trial testing the effect of narrative vignettes versus guideline summaries on provider response to a professional organization clinical policy for safe opioid prescribing.
Ann Emerg Med 2016 Dec;68(6):719-28. doi: 10.1016/j.annemergmed.2016.03.007.
.
.
Keywords: Communication, Evidence-Based Practice, Guidelines, Opioids, Medication, Medication: Safety, Policy, Provider
Melnick ER, Probst MA, Schoenfeld E
Development and testing of shared decision making interventions for use in emergency care: a research agenda.
This article provides background on decision aids and the conclusions of the 2016 Academic Emergency Medicine consensus conference SDM in practice work group regarding "Shared Decision Making in the Emergency Department: Development of a Policy-Relevant, Patient-Centered Research Agenda."
AHRQ-funded; HS021271; HS024311.
Citation: Melnick ER, Probst MA, Schoenfeld E .
Development and testing of shared decision making interventions for use in emergency care: a research agenda.
Acad Emerg Med 2016 Dec;23(12):1346-53. doi: 10.1111/acem.13045.
.
.
Keywords: Decision Making, Emergency Department, Emergency Medical Services (EMS), Patient-Centered Healthcare, Policy
Kasiske BL, Salkowski N, Wey A
Potential implications of recent and proposed changes in the regulatory oversight of solid organ transplantation in the United States.
The authors reviewed the details and implications of changes in transplant program oversight.
AHRQ-funded; HS024527.
Citation: Kasiske BL, Salkowski N, Wey A .
Potential implications of recent and proposed changes in the regulatory oversight of solid organ transplantation in the United States.
Am J Transplant 2016 Dec;16(12):3371-77. doi: 10.1111/ajt.13955.
.
.
Keywords: Health Services Research (HSR), Policy, Registries, Policy, Transplantation
Grudzen CR, Anderson JR, Carpenter CR
The 2016 Academic Emergency Medicine Consensus Conference, Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda May 10, 2016, New Orleans, LA.
The authors described the current state of shared decision making in the emergency department context and provided an overview of the conference. They explained that the results of the conference published in the same journal issue provided an essential summary of the future research priorities for shared decision making to increase quality of care and patient-centered outcomes.
AHRQ-funded; HS024172.
Citation: Grudzen CR, Anderson JR, Carpenter CR .
The 2016 Academic Emergency Medicine Consensus Conference, Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda May 10, 2016, New Orleans, LA.
Acad Emerg Med 2016 Dec;23(12):1313-19. doi: 10.1111/acem.13047.
.
.
Keywords: Decision Making, Emergency Department, Emergency Medical Services (EMS), Patient-Centered Healthcare, Policy
Kirby JB, Davidoff AJ, Basu J
AHRQ Author: Kirby JB, Basu J
The ACA's zero cost-sharing mandate and trends in out-of-pocket expenditures on well-child and screening mammography visits.
This study used a nationally representative sample of ambulatory care visits to estimate the impact of the zero cost-sharing mandate on out-of-pocket expenditures on well-child and screening mammography visits. It concluded that the Affordable Care Act's zero cost-sharing mandate for preventive care has had a large impact on out-of-pocket expenditures for well-child and mammography visits.
AHRQ-authored.
Citation: Kirby JB, Davidoff AJ, Basu J .
The ACA's zero cost-sharing mandate and trends in out-of-pocket expenditures on well-child and screening mammography visits.
Med Care 2016 Dec;54(12):1056-62. doi: 10.1097/mlr.0000000000000610.
.
.
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Screening, Women, Policy, Prevention
. .
Why did the Affordable Care Act raise coverage?
This article discusses NBER Working Paper No. 22213 on Premium Subsidies, the Mandate,and Medicaid Expansion: Coverage Effects of the Affordable Care Act by researchers Molly Frean, Jonathan Gruber, and Benjamin Sommers. The study’s key result is that the ACA’s premium subsidies led to a 0.85 percentage point increase in coverage, while the expansion of Medicaid to newly eligible individuals led to a 0.44 point increase.
AHRQ-funded; HS021291.
Citation: . . .
Why did the Affordable Care Act raise coverage?
Natl Bur Econ Res Bull Aging Health 2016(2):3.
.
.
Keywords: Medicaid, Health Insurance, Policy, Healthcare Costs
Harrison KL, Taylor HA
Healthcare resource allocation decisions affecting uninsured services.
The authors described resource allocation and policy decisions related to providing health services for the uninsured. They recommend that how healthcare decisions are actually made can be matched with literature that describes how healthcare resource decisions ought to be made, in order to provide a normative grounding for future decisions.
AHRQ-funded; HS000029.
Citation: Harrison KL, Taylor HA .
Healthcare resource allocation decisions affecting uninsured services.
J Health Organ Manag 2016 Nov 21;30(8):1162-82. doi: 10.1108/jhom-01-2016-0003.
.
.
Keywords: Decision Making, Health Services Research (HSR), Policy, Uninsured
O'Shea L, Bindman AB
AHRQ Author: Bindman AB
Personal health budgets for patients with complex needs.
Some of the highest cost patients have functional impairments and social needs that necessitate long-term services and supports. One approach from England entails the creation of “personal health budgets,” a model for self-directed support that may be worth considering in the United States. The authors discuss this approach and conclude that the evidence from England suggests that patients themselves can help to design higher-value care.
AHRQ-authored.
Citation: O'Shea L, Bindman AB .
Personal health budgets for patients with complex needs.
N Engl J Med 2016 Nov 10;375(19):1815-17. doi: 10.1056/NEJMp1606040.
.
.
Keywords: Healthcare Costs, Policy, Policy
Vistnes JP, Cohen JW
AHRQ Author: Vistnes JP, Cohen JW
Gaining coverage in 2014: new estimates of marketplace and Medicaid transitions.
The researchers used data from the Medical Expenditure Panel Survey-Household Component to examine coverage transitions for nonelderly US adults. They found that 71.5 percent of Marketplace enrollees in 2014 had some period of uninsurance before enrollment. In Medicaid expansion states, 17.4 percent of adults who were uninsured throughout 2013 gained Medicaid coverage in 2014, compared with only 5.6 percent in those states between 2012 and 2013.
AHRQ-authored.
Citation: Vistnes JP, Cohen JW .
Gaining coverage in 2014: new estimates of marketplace and Medicaid transitions.
Health Aff 2016 Oct 1;35(10):1825-29. doi: 10.1377/hlthaff.2016.0500.
.
.
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Medicaid, Uninsured, Policy
Sommers BD, Gourevitch R, Maylone B
Insurance churning rates for low-income adults under health reform: lower than expected but still harmful for many.
The researchers explored the frequency and implications of changes in insurance coverage over time (i.e., "churning,")through surveying low-income adults in Kentucky, which used a traditional expansion of Medicaid; Arkansas, which chose a "private option" expansion that enrolled beneficiaries in private Marketplace plans; and Texas, which opted not to expand. They found that churning was associated with disruptions in physician care and medication adherence, and increased emergency department use.
AHRQ-funded; HS021291.
Citation: Sommers BD, Gourevitch R, Maylone B .
Insurance churning rates for low-income adults under health reform: lower than expected but still harmful for many.
Health Aff 2016 Oct;35(10):1816-24. doi: 10.1377/hlthaff.2016.0455.
.
.
Keywords: Medicaid, Uninsured, Policy, Health Insurance
McManus KA, Rodney RC, Rhodes A
Affordable Care Act qualified health plan enrollment for AIDS Drug Assistance Program clients: Virginia's experience and best practices.
This article highlighted the benefits of the Affordable Care Act (ACA) for persons living with HIV and described the range of strategies employed by states to enroll patients in Qualified Health Plans (QHPs). It used the Virginia AIDS Drug Assistance Program ACA implementation to illustrate one program's shift to purchasing QHPs. The authors provided practical details of Virginia's implementation as well as insights and best practices at both the state and clinic level.
AHRQ-funded; HS024196.
Citation: McManus KA, Rodney RC, Rhodes A .
Affordable Care Act qualified health plan enrollment for AIDS Drug Assistance Program clients: Virginia's experience and best practices.
AIDS Res Hum Retroviruses 2016 Sep;32(9):885-91. doi: 10.1089/aid.2016.0033.
.
.
Keywords: Human Immunodeficiency Virus (HIV), Medication, Policy
Adler-Milstein J, Embi PJ, Middleton B
Crossing the health IT chasm: considerations and policy recommendations to overcome current challenges and enable value-based care.
There is a chasm between the current health IT ecosystem and the health IT ecosystem. In this paper, the authors identify a set of focal goals and associated near-term achievable actions that are critical to pursue in order to enable the health IT ecosystem to meet the acute needs of modern health care delivery. These ideas emerged from discussions that occurred during the 2015 American Medical Informatics Association Policy Invitational Meeting.
AHRQ-funded; HS023969.
Citation: Adler-Milstein J, Embi PJ, Middleton B .
Crossing the health IT chasm: considerations and policy recommendations to overcome current challenges and enable value-based care.
J Am Med Inform Assoc 2017 Sep 1;24(5):1036-43. doi: 10.1093/jamia/ocx017.
.
.
Keywords: Healthcare Delivery, Health Information Technology (HIT), Patient and Family Engagement, Policy, Health Information Technology (HIT)
Chandrasekar E, Kim KE, Song S
First year open enrollment findings: health insurance coverage for Asian Americans and the role of navigators.
The role of navigators has been shown to increase enrollment rates of public insurance programs. Cambodian, Chinese, Vietnamese, Korean, and Laotian community-based organizations were able to reach individuals for whom the percentage of uninsured is disproportionately high. A community-level intervention was implemented that was associated with increases in first year marketplace enrollment and greater likelihood of obtaining a primary care physician.
AHRQ-funded; HS022063.
Citation: Chandrasekar E, Kim KE, Song S .
First year open enrollment findings: health insurance coverage for Asian Americans and the role of navigators.
J Racial Ethn Health Disparities 2016 Sep;3(3):537-45. doi: 10.1007/s40615-015-0172-1.
.
.
Keywords: Health Insurance, Policy, Patient-Centered Healthcare, Racial and Ethnic Minorities
Gaglioti AH, Werner JJ, Rust G
Practice-based research networks (PBRNs) bridging the gaps between communities, funders, and policymakers.
In this commentary, the authors propose that practice-based research networks (PBRNs) engage with funders and policymakers by applying the same engagement strategies they have successfully used to build relationships with community stakeholders. A community engagement approach to achieve new funding streams for PBRNs should include a strategy to engage key stakeholders from the communities of funders, thought leaders, and policymakers using collaborative principles and methods.
AHRQ-funded; HS021639; HS021641; HS021648.
Citation: Gaglioti AH, Werner JJ, Rust G .
Practice-based research networks (PBRNs) bridging the gaps between communities, funders, and policymakers.
J Am Board Fam Med 2016 Sep-Oct;29(5):630-5. doi: 10.3122/jabfm.2016.05.160080.
.
.
Keywords: Health Services Research (HSR), Practice-Based Research Network (PBRN), Primary Care, Policy
Alpert A
The anticipatory effects of Medicare Part D on drug utilization.
While health care policies are frequently signed into law well before they are implemented, such lags are ignored in most empirical work. This paper demonstrates the importance of implementation lags in the context of Medicare Part D, the prescription drug benefit that took effect two years after it was signed into law.
AHRQ-funded; HS019681.
Citation: Alpert A .
The anticipatory effects of Medicare Part D on drug utilization.
J Health Econ 2016 Sep;49:28-45. doi: 10.1016/j.jhealeco.2016.06.004..
Keywords: Policy, Medicare, Medication, Policy, Policy
McGinty EE, Samples H, Bandara SN
The emerging public discourse on state legalization of marijuana for recreational use in the US: analysis of news media coverage, 2010-2014.
The authors assessed the volume and content of US news media coverage on recreational marijuana policy. In the news outlets studies, they found that 53% of news stories mentioned pro-legalization arguments and 47% mentioned anti-legalization arguments. They concluded that it is critical for the public health community to develop communication strategies to convey accurately the rapidly evolving research evidence regarding recreational marijuana policy.
AHRQ-funded; HS000029.
Citation: McGinty EE, Samples H, Bandara SN .
The emerging public discourse on state legalization of marijuana for recreational use in the US: analysis of news media coverage, 2010-2014.
Prev Med 2016 Sep;90:114-20. doi: 10.1016/j.ypmed.2016.06.040.
.
.
Keywords: Communication, Policy, Policy, Public Health
Trogdon JG, Shafer PR, Shah PD
Are state laws granting pharmacists authority to vaccinate associated with HPV vaccination rates among adolescents?
Researchers explored whether state laws allowing pharmacists to administer human papillomavirus (HPV) vaccinations to adolescents are associated with a higher likelihood of HPV vaccine uptake. They concluded that, as currently implemented, state laws allowing pharmacists to administer HPV vaccine to adolescents were not associated with uptake.
AHRQ-funded; HS000032.
Citation: Trogdon JG, Shafer PR, Shah PD .
Are state laws granting pharmacists authority to vaccinate associated with HPV vaccination rates among adolescents?
Vaccine 2016 Aug 31;34(38):4514-19. doi: 10.1016/j.vaccine.2016.07.056.
.
.
Keywords: Children/Adolescents, Infectious Diseases, Policy, Provider: Pharmacist, Vaccination
Sampson UK, Kaplan RM, Cooper RS
AHRQ Author: Kaplan RM
Reducing health inequities in the U.S.: recommendations from the NHLBI's health inequities think tank meeting.
The National, Heart, Lung, and Blood Institute convened a Think Tank meeting to obtain insight and recommendations regarding the objectives and design of the next generation of research aimed at reducing health inequities in the United States. Details of the panel's remarks and recommendations are provided in this report.
AHRQ-authored.
Citation: Sampson UK, Kaplan RM, Cooper RS .
Reducing health inequities in the U.S.: recommendations from the NHLBI's health inequities think tank meeting.
J Am Coll Cardiol 2016 Aug 2;68(5):517-24. doi: 10.1016/j.jacc.2016.04.059.
.
.
Keywords: Access to Care, Disparities, Guidelines, Policy
Colla CH, Lewis VA, Bergquist SL
Accountability across the continuum: the participation of postacute care providers in accountable care organizations.
The authors examined the extent to which accountable care organizations (ACOs) formally incorporate postacute care providers. They found that ACOs with a relationship with a postacute care provider are more likely to have advanced transition management, end of life planning, readmission prevention, and care management capabilities. However, many ACOs have not formally engaged postacute care.
AHRQ-funded; HS024075.
Citation: Colla CH, Lewis VA, Bergquist SL .
Accountability across the continuum: the participation of postacute care providers in accountable care organizations.
Health Serv Res 2016 Aug;51(4):1595-611. doi: 10.1111/1475-6773.12442.
.
.
Keywords: Policy, Healthcare Delivery, Health Insurance
Colla CH, Lewis VA, Kao LS
Association between Medicare accountable care organization implementation and spending among clinically vulnerable beneficiaries.
The purpose of this cohort study was to examine the effect of Medicare accountable care organization (ACO) contracts on both spending and high-cost institutional utilization for all Medicare beneficiaries and for clinically vulnerable beneficiaries. The main outcomes and measures for this study were total spending per beneficiary-quarter, spending categories, utilization of hospitals and emergency departments, ambulatory care sensitive admissions, and 30-day readmissions. The study found that total spending decreased by $34 per beneficiary-quarter after implementation of ACO contracts across the overall Medicare population and decreased $114 in clinically vulnerable patients. In the overall Medicare cohort, hospitalizations and emergency department visits decreased by 1.3 and 3.0 events per 1000 beneficiaries per quarter, respectively. Hospitalizations and emergency department visits decreased in the clinically vulnerable cohort by 2.9 and 4.1 events per 1000 beneficiaries per quarter, respectively. Variations in total spending related with ACOs did not differ by clinical condition of beneficiaries.
AHRQ-funded; HS024075.
Citation: Colla CH, Lewis VA, Kao LS .
Association between Medicare accountable care organization implementation and spending among clinically vulnerable beneficiaries.
JAMA Intern Med 2016 Aug;176(8):1167-75. doi: 10.1001/jamainternmed.2016.2827.
.
.
Keywords: Medicare, Policy, Healthcare Costs, Payment, Vulnerable Populations
Fleischman W, Ross JS, Melnick ER
Financial ties between emergency physicians and industry: insights from open payments data.
The authors sought to describe nonresearch, nonroyalty Open Payments made to emergency physicians in the United States. They found that nearly a third of emergency physicians received such payments from industry in 2014, and that most payments were of small monetary value and for activities related to the marketing of antithrombotic drugs.
AHRQ-funded; HS021271.
Citation: Fleischman W, Ross JS, Melnick ER .
Financial ties between emergency physicians and industry: insights from open payments data.
Ann Emerg Med 2016 Aug;68(2):153-58.e4. doi: 10.1016/j.annemergmed.2016.01.014.
.
.
Keywords: Emergency Medical Services (EMS), Medication, Policy, Practice Patterns, Provider: Physician
Jacobs PD, Duchovny N, Lipton BJ
AHRQ Author: Jacobs PD
Changes in health status and care use after ACA expansions among the insured and uninsured.
The authors investigated average health status and use of health care following the Affordable Care Act's insurance expansion provisions in 2014, finding that Medicaid enrollees and the uninsured were both healthier in 2014 than those respective groups were in 2013, but that those with individual private insurance coverage appeared less healthy as a group.
AHRQ-authored.
Citation: Jacobs PD, Duchovny N, Lipton BJ .
Changes in health status and care use after ACA expansions among the insured and uninsured.
Health Aff 2016 Jul;35(7):1184-8. doi: 10.1377/hlthaff.2015.1539.
.
.
Keywords: Healthcare Costs, Health Insurance, Policy, Health Status, Medicaid
Kim HS, Monte AA
Colorado cannabis legalization and its effect on emergency care.
The authors noted that increased marijuana use after legalization has been accompanied by increases in emergency department visits and hospitalizations due to marijuana intoxication. They recommended that providers in states with impending legalization measures should become familiar with the symptoms and management of acute marijuana intoxication, as well as understand the effects on chronic diseases frequently observed in the emergency department. Further, they suggested that residency program directors should make an effort to integrate this topic into their residency curricula.
AHRQ-funded; HS000078.
Citation: Kim HS, Monte AA .
Colorado cannabis legalization and its effect on emergency care.
Ann Emerg Med 2016 Jul;68(1):71-5. doi: 10.1016/j.annemergmed.2016.01.004.
.
.
Keywords: Emergency Department, Emergency Medical Services (EMS), Hospitalization, Policy, Substance Abuse