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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 45 Research Studies DisplayedMcCoy RG, Van Houten HK, Ross JS
HbA1c overtesting and overtreatment among US adults with controlled type 2 diabetes, 2001-13: observational population based study.
The researchers sought to determine the extent and effect of excessive testing for glycated hemoglobin (HbA1c) among adults with controlled type 2 diabetes. They found that in a US cohort of adults with stable and controlled type 2 diabetes, more than 60% received too many HbA1c tests, a practice associated with potential overtreatment with hypoglycemic drugs.
AHRQ-funded; HS018339.
Citation: McCoy RG, Van Houten HK, Ross JS .
HbA1c overtesting and overtreatment among US adults with controlled type 2 diabetes, 2001-13: observational population based study.
BMJ 2015 Dec 8;351:h6138. doi: 10.1136/bmj.h6138..
Keywords: Chronic Conditions, Diabetes, Healthcare Utilization, Medication, Patient-Centered Outcomes Research
Shah MN, Wasserman EB, Gillespie SM
High-intensity telemedicine decreases emergency department use for ambulatory care sensitive conditions by older adult senior living community residents.
The aim of this study was to assess the effect of a high-intensity telemedicine program for senior living community (SLC) residents on the rate of Emergency department (ED) visits for ambulatory care sensitive conditions (ACSCs). It found that providing acute illness care by high-intensity telemedicine to older adults residing in SLCs significantly decreases the rate of ED use for ACSCs over 1 year.
AHRQ-funded; HS018047.
Citation: Shah MN, Wasserman EB, Gillespie SM .
High-intensity telemedicine decreases emergency department use for ambulatory care sensitive conditions by older adult senior living community residents.
J Am Med Dir Assoc 2015 Dec;16(12):1077-81. doi: 10.1016/j.jamda.2015.07.009..
Keywords: Elderly, Telehealth, Health Information Technology (HIT), Emergency Department, Healthcare Utilization, Long-Term Care
Kuo DZ, Hall M, Agrawal R
Comparison of health care spending and utilization among children with Medicaid insurance.
This study's objectives were to assess health care and spending among children with Medicaid insurance by their resource use. It found that as resource use increases in children with Medicaid, spending rises unevenly across health services: Spending on primary care rises modestly compared with other health services.
AHRQ-funded; HS023092.
Citation: Kuo DZ, Hall M, Agrawal R .
Comparison of health care spending and utilization among children with Medicaid insurance.
Pediatrics 2015 Dec;136(6):1521-9. doi: 10.1542/peds.2015-0871.
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Keywords: Medicaid, Healthcare Utilization, Children/Adolescents, Healthcare Costs, Health Services Research (HSR)
Decker SL, Lipton BJ
AHRQ Author: Decker SL
Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health.
This article examines the effect of Medicaid adult dental coverage on use of dental care and dental health outcomes using state-level variation in dental coverage during 2000-2012. Its findings imply that dental coverage is associated with an increase in the likelihood of a recent dental visit, with the size of the effect increasing with Medicaid payment rates to dentists, and a reduction in the likelihood of untreated dental caries.
AHRQ-authored.
Citation: Decker SL, Lipton BJ .
Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health.
J Health Econ 2015 Dec;44:212-25. doi: 10.1016/j.jhealeco.2015.08.009.
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Keywords: Access to Care, Dental and Oral Health, Health Insurance, Healthcare Utilization, Medicaid, Outcomes
Cherney AR, Marin JR, Brown J
AHRQ Author: Henriksen K
Funding research in emergency diagnostic imaging: summary of a panel discussion at the 2015 Academic Emergency Medicine Consensus Conference.
As part of the 2015 Academic Emergency Medicine consensus conference "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization," a panel of representatives from several Federal agencies and organizations including AHRQ was assembled to discuss future opportunities for funding research in this particular area of interest. Representatives from these agencies and organizations discussed their missions and priorities and how they distribute funding.
AHRQ-authored.
Citation: Cherney AR, Marin JR, Brown J .
Funding research in emergency diagnostic imaging: summary of a panel discussion at the 2015 Academic Emergency Medicine Consensus Conference.
Acad Emerg Med 2015 Dec;22(12):1400-5. doi: 10.1111/acem.12825.
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Keywords: Imaging, Emergency Department, Health Services Research (HSR), Healthcare Utilization
Lewiss RE, Chan W, Sheng AY
Research priorities in the utilization and interpretation of diagnostic imaging: Education, assessment, and competency.
A group of radiologists, physicists, and emergency physicians convened at the 2015 Academic Emergency Medicine consensus conference to discuss and prioritize a research agenda related to education, assessment, and competency in ordering and interpreting diagnostic imaging. In this article, the authors review the supporting reliability and validity evidence and make specific recommendations for future research on the education, competency, and assessment of learning diagnostic imaging.
AHRQ-funded; HS023498.
Citation: Lewiss RE, Chan W, Sheng AY .
Research priorities in the utilization and interpretation of diagnostic imaging: Education, assessment, and competency.
Acad Emerg Med 2015 Dec;22(12):1447-54. doi: 10.1111/acem.12833.
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Keywords: Imaging, Education: Continuing Medical Education, Emergency Department, Emergency Medical Services (EMS), Healthcare Utilization, Health Services Research (HSR)
Lipton BJ, Decker SL
AHRQ Author: Decker SL
The effect of health insurance coverage on medical care utilization and health outcomes: evidence from Medicaid adult vision benefits.
The reserarchers examined the effect of vision insurance on eye care utilization and vision health outcomes by taking advantage of quasi-experimental variation in Medicaid coverage of adult vision care. They found that Medicaid beneficiaries with vision coverage are 4.4 percentage points more likely to have seen an eye doctor in the past year,and 5.3 percentage points less likely to report needing but not purchasing eyeglasses or contacts due to cost.
AHRQ-authored.
Citation: Lipton BJ, Decker SL .
The effect of health insurance coverage on medical care utilization and health outcomes: evidence from Medicaid adult vision benefits.
J Health Econ 2015 Dec;44:320-32. doi: 10.1016/j.jhealeco.2015.10.006.
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Keywords: Medicaid, Eye Disease and Health, Healthcare Utilization, Health Services Research (HSR), Outcomes
Graham JL, Shahani L, Grimes RM
The influence of trust in physicians and trust in the healthcare system on linkage, retention, and adherence to HIV care.
The present study was designed to determine if trust in physicians and the healthcare system among persons newly diagnosed with HIV infection was predictive of patients' subsequent linkage, retention, and adherence to HIV care. No significant association was found between trust-in-physicians and linkage to care or adherence to antiretroviral therapy.
AHRQ-funded; HS016093.
Citation: Graham JL, Shahani L, Grimes RM .
The influence of trust in physicians and trust in the healthcare system on linkage, retention, and adherence to HIV care.
AIDS Patient Care STDS 2015 Dec;29(12):661-7. doi: 10.1089/apc.2015.0156..
Keywords: Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Outcomes, Healthcare Utilization
Amarnath AL, Franks P, Robbins JA
Underuse and overuse of osteoporosis screening in a regional health system: a retrospective cohort study.
The researchers aimed to determine the extent to which dual-energy x-ray absorptiometry (DXA) screening is used in accordance with USPSTF recommendations within a regional health system. They concluded that DXA screening was underused in women at increased fracture risk, including women age 65 and over. Meanwhile, DXA screening was common among women at low fracture risk, such as younger women without osteoporosis risk factors.
AHRQ-funded; HS022236.
Citation: Amarnath AL, Franks P, Robbins JA .
Underuse and overuse of osteoporosis screening in a regional health system: a retrospective cohort study.
J Gen Intern Med 2015 Dec;30(12):1733-40. doi: 10.1007/s11606-015-3349-8.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Osteoporosis, Healthcare Utilization, Risk
Kerber KA, Meurer WJ, Brown DL
Stroke risk stratification in acute dizziness presentations: a prospective imaging-based study.
The researchers estimated the ability of bedside information to risk stratify stroke in acute dizziness presentations. They found that in acute dizziness presentations, the combination of ABCD(2) score, general neurologic examination, and a specialized ocular motor examination has the capacity to risk-stratify acute stroke on MRI.
AHRQ-funded; HS018334; HS017690; HS022258.
Citation: Kerber KA, Meurer WJ, Brown DL .
Stroke risk stratification in acute dizziness presentations: a prospective imaging-based study.
Neurology 2015 Nov 24;85(21):1869-78. doi: 10.1212/wnl.0000000000002141..
Keywords: Stroke, Risk, Healthcare Utilization, Decision Making
Desai NR, Bradley SM, Parzynski CS
Appropriate use criteria for coronary revascularization and trends in utilization, patient selection, and appropriateness of percutaneous coronary intervention.
The researchers examined trends in percutaneous coronary intervention (PCI) utilization, patient selection, and procedural appropriateness following the introduction of Appropriate Use Criteria. They concluded that there have been significant reductions in the volume of nonacute PCI. The proportion of nonacute PCIs classified as inappropriate has declined, although hospital-level variation in inappropriate PCI persists.
AHRQ-funded; HS023000.
Citation: Desai NR, Bradley SM, Parzynski CS .
Appropriate use criteria for coronary revascularization and trends in utilization, patient selection, and appropriateness of percutaneous coronary intervention.
JAMA 2015 Nov 17;314(19):2045-53. doi: 10.1001/jama.2015.13764.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Healthcare Utilization
Kohler RE, Goyal RK, Lich KH
Association between medical home enrollment and health care utilization and costs among breast cancer patients in a state Medicaid program.
The objective of this study was to examine health care utilization and expenditures as a function of patient-centered medical home (PCMH) enrollment among breast cancer patients in North Carolina’s Medicaid program. It found that PCMH enrollment was significantly associated with greater outpatient service use, but there was no difference in the probability of inpatient hospitalizations or ED visits.
AHRQ-funded; HS019468.
Citation: Kohler RE, Goyal RK, Lich KH .
Association between medical home enrollment and health care utilization and costs among breast cancer patients in a state Medicaid program.
Cancer 2015 Nov 15;121(22):3975-81. doi: 10.1002/cncr.29596..
Keywords: Cancer, Cancer: Breast Cancer, Healthcare Utilization, Medicaid, Patient-Centered Healthcare
Wexler R, Hefner JL, Sieck C
Connecting emergency department patients to primary care.
The researchers developed and evaluated a system change innovation designed to remove system barriers to primary care access for Medicaid patients. The intervention did not decrease ED visits nor increase primary care use over the 12 months of the study period. The qualitative results provide insight into nonurgent ED utilization by patients with Medicaid, suggesting potential future interventions.
AHRQ-funded; HS020693.
Citation: Wexler R, Hefner JL, Sieck C .
Connecting emergency department patients to primary care.
J Am Board Fam Med 2015 Nov-Dec;28(6):722-32. doi: 10.3122/jabfm.2015.06.150044.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Primary Care, Health Information Technology (HIT), Healthcare Utilization
Carls GS, Henke RM, Karaca Z
AHRQ Author: Karaca Z, Wong HS
The relationship between local economic conditions and acute myocardial infarction hospital utilization by adults and seniors in the United States, 1995-2011.
The researchers assessed the association between unemployment and hospital discharges for acute myocardial infarction (AMI) among adults and seniors, 1995–2011. They found that for both adults and seniors, a 1 percent increase in the unemployment rate was associated with a statistically significant decline in AMI hospitalization during the first half of the study but was unrelated to the economic cycle in the second half of the study period.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Carls GS, Henke RM, Karaca Z .
The relationship between local economic conditions and acute myocardial infarction hospital utilization by adults and seniors in the United States, 1995-2011.
Health Serv Res 2015 Oct;50(5):1688-709. doi: 10.1111/1475-6773.12298..
Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Healthcare Utilization, Hospitalization
Mehta AB, Syeda SN, Bajpayee L
Trends in tracheostomy for mechanically ventilated patients in the United States, 1993-2012.
This study investigated trends in tracheostomy use, timing, and outcomes in the United States. It found that over the past two decades, tracheostomy use rose substantially in the United States until 2008, when use began to decline. In addition, there was an observed dramatic increase in discharge of tracheostomy patients to long-term care facilities.
AHRQ-funded; HS020672.
Citation: Mehta AB, Syeda SN, Bajpayee L .
Trends in tracheostomy for mechanically ventilated patients in the United States, 1993-2012.
Am J Respir Crit Care Med 2015 Aug 15;192(4):446-54. doi: 10.1164/rccm.201502-0239OC..
Keywords: Healthcare Cost and Utilization Project (HCUP), Outcomes, Healthcare Utilization, Respiratory Conditions
Hudson JL, Abdus S
AHRQ Author: Hudson JL
Coverage and care consequences for families in which children have mixed eligibility for public insurance.
The researchers used data from the Medical Expenditure Panel Survey (MEPS) Household Component for 2001–12 to examine insurance coverage, access to care, and health care use for eligible children in families with mixed eligible siblings compared to those in families where all siblings were eligible for one program. They found that mixed eligibility has a significant dampening effect for eligible children.
AHRQ-authored
Citation: Hudson JL, Abdus S .
Coverage and care consequences for families in which children have mixed eligibility for public insurance.
Health Aff 2015 Aug;34(8):1340-8. doi: 10.1377/hlthaff.2015.0128..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Health Insurance, Access to Care, Healthcare Utilization
Orman ES, Mayorga ME, Wheeler SB
Declining liver graft quality threatens the future of liver transplantation in the United States.
This study used the United Network for Organ Sharing (UNOS) database to inform a 20-year discrete event simulation estimating liver transplantation (LT) volume from 2010 to 2030. It found that if donor liver utilization practices remain constant, utilization will fall from 78 percent to 44 percent by 2030, resulting in 2,230 fewer LTs.
AHRQ-funded; HS019468.
Citation: Orman ES, Mayorga ME, Wheeler SB .
Declining liver graft quality threatens the future of liver transplantation in the United States.
Liver Transpl 2015 Aug;21(8):1040-50. doi: 10.1002/lt.24160..
Keywords: Healthcare Utilization, Health Services Research (HSR), Transplantation
Erickson KF, Mell M, Winkelmayer WC
Provider visits and early vascular access placement in maintenance hemodialysis.
This study examined whether patients seen more frequently by their nephrologist or advanced practitioner in the first 90 days of hemodialysis were more likely to undergo surgery to create an AV fistula or place an AV graft during that period. It concluded that patients seen more frequently by care providers in the first 90 days of hemodialysis undergo earlier AV fistula creation or graft placement.
AHRQ-funded; HS019178.
Citation: Erickson KF, Mell M, Winkelmayer WC .
Provider visits and early vascular access placement in maintenance hemodialysis.
J Am Soc Nephrol 2015 Aug;26(8):1990-7. doi: 10.1681/asn.2014050464..
Keywords: Care Management, Kidney Disease and Health, Healthcare Utilization, Outcomes
DeVoe JE, Marino M, Gold R
Community health center use after Oregon's randomized medicaid experiment.
To better understand the effect of new Medicaid coverage on community health center (CHC)use over time, the researchers studied Oregon’s 2008 randomized Medicaid expansion (the “Oregon Experiment”). Their results suggest that use of many different types of CHC services will increase as patients gain Medicaid through Affordable Care Act expansions.
AHRQ-funded; HS021522.
Citation: DeVoe JE, Marino M, Gold R .
Community health center use after Oregon's randomized medicaid experiment.
Ann Fam Med 2015 Jul;13(4):312-20. doi: 10.1370/afm.1812..
Keywords: Community-Based Practice, Healthcare Utilization, Medicaid, Primary Care
Silverberg JI
Health care utilization, patient costs, and access to care in US adults with eczema: a population-based study.
This study examined the out-of-pocket costs, health care access and utilization in adult eczema in the United States. It found that adults with eczema had $371 to $489 higher out-of-pocket costs per person-year compared with those without eczema, with higher odds of increased out-of-pocket costs.
AHRQ-funded; HS023011.
Citation: Silverberg JI .
Health care utilization, patient costs, and access to care in US adults with eczema: a population-based study.
JAMA Dermatol 2015 Jul;151(7):743-52. doi: 10.1001/jamadermatol.2014.5432.
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Keywords: Access to Care, Healthcare Costs, Healthcare Utilization, Skin Conditions
Holden TR, Smith MA, Bartels CM
Hospice enrollment, local hospice utilization patterns, and rehospitalization in Medicare patients.
The study objective was to examine the association between hospice enrollment, local hospice utilization patterns and 30-day rehospitalization in Medicare patients. It found that area-level hospice utilization is inversely proportional to rehospitalization rates. This relationship is not fully explained by direct hospice enrollment, and may reflect a spillover effect of the benefits of hospice extending to nonenrollees.
AHRQ-funded; HS000083.
Citation: Holden TR, Smith MA, Bartels CM .
Hospice enrollment, local hospice utilization patterns, and rehospitalization in Medicare patients.
J Palliat Med 2015 Jul;18(7):601-12. doi: 10.1089/jpm.2014.0395..
Keywords: Long-Term Care, Palliative Care, Hospital Readmissions, Medicare, Healthcare Utilization
Roth JA, Sullivan SD, Goulart BH
Projected clinical, resource use, and fiscal impacts of implementing low-dose computed tomography lung cancer screening in Medicare.
The Centers for Medicare and Medicaid Services (CMS) recently issued a national coverage determination that provides reimbursement for low-dose computed tomography (CT) lung cancer screening for enrollees age 55 to 77 years. This study’s simulation model projected that over 5 years, that low-dose CT screening will result in 10.7 million more low-dose CT scans, 52,000 more lung cancers detected, and increased overall expenditure of $6.8 billion.
AHRQ-funded; HS022982.
Citation: Roth JA, Sullivan SD, Goulart BH .
Projected clinical, resource use, and fiscal impacts of implementing low-dose computed tomography lung cancer screening in Medicare.
J Oncol Pract 2015 Jul;11(4):267-72. doi: 10.1200/jop.2014.002600.
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Keywords: Cancer: Lung Cancer, Screening, Medicare, Healthcare Costs, Healthcare Utilization
Conover MM, Jonsson Funk M, Kinlaw AC
Trends and patterns of urodynamic studies in U.S. males, 2000-2012.
This study evaluate trends in urodynamic procedures in U.S. males from 2000–2012 and determine if a 2010 decline in reimbursement was associated with decreased utilization. It found that Utilization of urodynamic procedures increased until 2010 and decreased thereafter. Utilization was greatest among men older than 65.
AHRQ-funded; HS017950.
Citation: Conover MM, Jonsson Funk M, Kinlaw AC .
Trends and patterns of urodynamic studies in U.S. males, 2000-2012.
PLoS One 2015 Jul 21;10(7):e0133657. doi: 10.1371/journal.pone.0133657..
Keywords: Healthcare Utilization, Payment
Lee DJ, Najari BB, Davison WL
Trends in the utilization of penile prostheses in the treatment of erectile dysfunction in the United States.
This study assessed the national temporal trends in the surgical management of ED utilizing penile prosthesis (PP). It found that the surgical management of ED with PP changed significantly between 2001 and 2010. Also, the overall utilization of PP decreased, but its use in patients with significant medical comorbidities increased.
AHRQ-funded; HS000066.
Citation: Lee DJ, Najari BB, Davison WL .
Trends in the utilization of penile prostheses in the treatment of erectile dysfunction in the United States.
J Sex Med 2015 Jul;12(7):1638-45. doi: 10.1111/jsm.12921..
Keywords: Healthcare Utilization, Men's Health, Patient-Centered Healthcare, Sexual Health, Surgery
Geissler KH, Holmes GM
Emergency department use in the US-Mexico border region and violence in Mexico: is there a relationship?
This study assessed the association between homicide rates in northern Mexico and potentially avoidable use of emergency departments (ED) in the US-Mexico border region. It concluded that a substantial majority of ED encounters in the US-Mexico border region were potentially avoidable. However, there was not a strong relationship between homicide rates in northern Mexico and the distribution of ED discharges in Arizona and California.
AHRQ-funded; HS021074.
Citation: Geissler KH, Holmes GM .
Emergency department use in the US-Mexico border region and violence in Mexico: is there a relationship?
J Rural Health 2015 Summer;31(3):316-25. doi: 10.1111/jrh.12109.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Medical Services (EMS), Healthcare Utilization, Access to Care, Vulnerable Populations