National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (2)
- Cancer (6)
- Cancer: Cervical Cancer (1)
- (-) Cancer: Colorectal Cancer (15)
- Care Coordination (1)
- Colonoscopy (4)
- Community-Based Practice (2)
- Cultural Competence (1)
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- Prevention (7)
- Primary Care (3)
- Primary Care: Models of Care (2)
- Quality Improvement (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (2)
- Risk (1)
- (-) Screening (15)
- Vulnerable Populations (2)
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 15 of 15 Research Studies DisplayedHassmiller Lich K, O'Leary MC, Nambiar S
Estimating the impact of insurance expansion on colorectal cancer and related costs in North Carolina: a population-level simulation analysis.
Researchers used microsimulation to estimate the health and financial effects of insurance expansion and reduction scenarios in North Carolina (NC) for colorectal cancer screening (CRC). The full lifetime of a simulated population of residents age-eligible for CRC screening (aged 50-75) during a 5-year period were simulated. Findings indicate that the estimated cost savings--balancing increased CRC screening/testing costs against decreased cancer treatment costs--were approximately $30 M and $970 M for Medicaid expansion and Medicare-for-all scenarios, respectively, compared to status quo. The researchers concluded that insurance expansion will likely improve CRC screening both overall and in underserved populations while saving money, with the largest savings realized by Medicare.
AHRQ-funded; HS022981.
Citation: Hassmiller Lich K, O'Leary MC, Nambiar S .
Estimating the impact of insurance expansion on colorectal cancer and related costs in North Carolina: a population-level simulation analysis.
Prev Med 2019 Dec;129s:105847. doi: 10.1016/j.ypmed.2019.105847..
Keywords: Health Insurance, Cancer: Colorectal Cancer, Cancer, Healthcare Costs, Screening, Prevention, Medicaid, Medicare, Policy, Access to Care
Davis MM, Gunn R, Pham R
Key collaborative factors when Medicaid Accountable Care Organizations work with primary care clinics to improve colorectal cancer screening: relationships, data, and quality improvement infrastructure.
This study focused on ways that Medicaid Accountable Care Organizations (ACOs) are implementing interventions with primary care clinics to improve colorectal cancer screening. The researchers conducted a comparative case study of 14 Medicaid ACOs in Oregon and their contracted primary care clinics. They focused on interventions that reduced structural barriers (12 ACOs), delivered provider assessment and feedback (11 ACOs), and provided patient reminders (7 ACOs). There was an unintended consequence of potential exclusion of smaller clinics and metric focus and fatigue.
AHRQ-funded; HS022981.
Citation: Davis MM, Gunn R, Pham R .
Key collaborative factors when Medicaid Accountable Care Organizations work with primary care clinics to improve colorectal cancer screening: relationships, data, and quality improvement infrastructure.
Prev Chronic Dis 2019 Aug 15;16:E107. doi: 10.5888/pcd16.180395..
Keywords: Primary Care: Models of Care, Primary Care, Screening, Colonoscopy, Cancer: Colorectal Cancer, Cancer, Quality Improvement, Quality of Care, Care Coordination, Patient-Centered Healthcare
Bravo RI, Kietzman KG, Toy P
Linking primary care and community organizations to increase colorectal cancer screening rates: the HAPPI project.
This paper describes the Healthy Aging Partnerships in Prevention Initiative (HAPPI) which aims to increase colorectal cancer screening and other preventive services among underserved Latinos and African-Americans in South Los Angeles who are 50 years and older. It uses an evidence-based model (SPARC) to leverage existing resources and has multi-sectoral partnerships among different agencies, community health centers (CHCs), and a university. The authors engaged five CHCs in quality improvement activities and eight non-governmental organizations in networking and programming to increase awareness of these preventive services.
AHRQ-funded; HS010858.
Citation: Bravo RI, Kietzman KG, Toy P .
Linking primary care and community organizations to increase colorectal cancer screening rates: the HAPPI project.
Salud Publica Mex 2019 Jul-Aug;61(4):427-35. doi: 10.21149/9450..
Keywords: Cancer: Colorectal Cancer, Cancer, Screening, Prevention, Primary Care: Models of Care, Primary Care, Elderly, Racial and Ethnic Minorities, Vulnerable Populations, Patient-Centered Healthcare
Huguet N, Angier H, Rdesinski R
Cervical and colorectal cancer screening prevalence before and after Affordable Care Act Medicaid expansion.
This study assessed changes in the prevalence of cervical and colorectal cancer screening from before and after the Affordable Care Act in Medicaid expansion and non-expansion states among patients seen in community health centers. Results showed that, despite increased prevalences of cervical and colorectal cancer screening in both expansion and non-expansion states across all race/ethnicity groups, rates remained suboptimal for this population of socioeconomically disadvantaged patients.
AHRQ-funded; HS024270.
Citation: Huguet N, Angier H, Rdesinski R .
Cervical and colorectal cancer screening prevalence before and after Affordable Care Act Medicaid expansion.
Prev Med 2019 Jul;124:91-97. doi: 10.1016/j.ypmed.2019.05.003..
Keywords: Cancer, Cancer: Cervical Cancer, Cancer: Colorectal Cancer, Healthcare Delivery, Healthcare Utilization, Medicaid, Policy, Prevention, Screening
O'Leary MC, Lich KH, Gu Y
Colorectal cancer screening in newly insured Medicaid members: a review of concurrent federal and state policies.
The goal of this study was to determine the impact of national and state policies enacted to increase access to Medicaid and to promote colorectal cancer (CRC) screening on newly enrolled, age-eligible Oregon Medicaid beneficiaries. 2010 - 2015 Oregon Medicaid claims data was used to conduct a cohort analysis of enrollees who turned 50 and became age-eligible for CRC screening. Individuals newly enrolled in Medicaid in 2013 or 2014 were more likely to initiate CRC screening than those enrolled by 2010, associated with the timing of policies such as Medicaid expansion and federal matching for preventive services. A primary care visit during the calendar year, one or more chronic conditions, and Hispanic ethnicity were also associated with CRC screening initiation.
AHRQ-funded; HS022981.
Citation: O'Leary MC, Lich KH, Gu Y .
Colorectal cancer screening in newly insured Medicaid members: a review of concurrent federal and state policies.
BMC Health Serv Res 2019 May 9;19(1):298. doi: 10.1186/s12913-019-4113-2..
Keywords: Access to Care, Cancer, Cancer: Colorectal Cancer, Medicaid, Policy, Prevention, Screening
Mobley LR, Kuo TM, Zhou M
What happened to disparities in CRC screening among FFS Medicare enrollees following Medicare modernization?
This study examined the effects of the change in policy for colorectal screening that was implemented in 2006 for FFS Medicare beneficiaries. This new policy eliminated copayments for colonoscopies or sigmoidoscopies. Disparities in screening by race (Blacks, Asians and Hispanics relative to Whites), and gender (Males relative to Females). The time periods 2001-2005 and 2006-2009 were compared and while there was some improvement in screening rates for minorities and women, the progress was unevenly distributed across the USA.
AHRQ-funded; HS021752.
Citation: Mobley LR, Kuo TM, Zhou M .
What happened to disparities in CRC screening among FFS Medicare enrollees following Medicare modernization?
J Racial Ethn Health Disparities 2019 Apr;6(2):273-91. doi: 10.1007/s40615-018-0522-x..
Keywords: Cancer: Colorectal Cancer, Colonoscopy, Disparities, Medicare, Screening
Davis MM, Shafer P, Renfro S
Does a transition to accountable care in Medicaid shift the modality of colorectal cancer testing?
This study investigated whether Medicaid expansion due to the Affordable Care Act (ACA) increased the number of patients who tested for colorectal cancer (CRC). Results in Oregon showed that there was an increased in statewide fecal testing mainly in Coordinated Care Organizations (CCOs).
AHRQ-funded; HS022981.
Citation: Davis MM, Shafer P, Renfro S .
Does a transition to accountable care in Medicaid shift the modality of colorectal cancer testing?
BMC Health Serv Res 2019 Jan 21;19(1):54. doi: 10.1186/s12913-018-3864-5..
Keywords: Cancer: Colorectal Cancer, Healthcare Utilization, Medicaid, Prevention, Screening
Martens CE, Crutchfield TM, Laping JL
Why wait until our community gets cancer?: Exploring CRC screening barriers and facilitators in the Spanish-speaking community in North Carolina.
The objectives for this paper were: (1) to improve understanding of preferences regarding potential colorectal cancer (CRC) screening program characteristics, and (2) to improve understanding of the barriers and facilitators around CRC screening with the Hispanic, immigrant community in North Carolina. They found that Hispanics may have a general awareness of and interest in CRC screening, but multiple barriers prevent them from getting screened, and recommended that special attention be given to designing culturally and linguistically appropriate programs to improve access to healthcare resources, insurance, and associated costs among Hispanics.
AHRQ-funded; HS019468.
Citation: Martens CE, Crutchfield TM, Laping JL .
Why wait until our community gets cancer?: Exploring CRC screening barriers and facilitators in the Spanish-speaking community in North Carolina.
J Cancer Educ 2016 Dec;31(4):652-59. doi: 10.1007/s13187-015-0890-4.
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Keywords: Cancer: Colorectal Cancer, Cultural Competence, Racial and Ethnic Minorities, Racial and Ethnic Minorities, Screening
Volk RJ, Linder SK, Lopez-Olivo MA
Patient decision aids for colorectal cancer screening: a systematic review and meta-analysis.
This systematic review describes studies evaluating patient decision aids for colorectal cancer screening in average-risk adults and their impact on knowledge, screening intentions, and uptake. It concluded that decision aids improve knowledge and interest in screening, and lead to increased screening over no information, but their impact on screening is similar to general colorectal cancer screening information.
AHRQ-funded; HS022134.
Citation: Volk RJ, Linder SK, Lopez-Olivo MA .
Patient decision aids for colorectal cancer screening: a systematic review and meta-analysis.
Am J Prev Med 2016 Nov;51(5):779-91. doi: 10.1016/j.amepre.2016.06.022.
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Keywords: Cancer: Colorectal Cancer, Decision Making, Education: Patient and Caregiver, Healthcare Utilization, Screening
Halm EA, Beaber EF, McLerran D
Association between primary care visits and colorectal cancer screening outcomes in the era of population health outreach.
The researchers assessed associations between primary care provider (PCP) visits and receipt of colorectal cancer (CRC) screening and colonoscopy after a positive fecal immunochemical (FIT) or fecal occult blood test (FOBT). They found that patients with a greater number of PCP visits had higher rates of both incident CRC screening and colonoscopy after positive FIT/FOBT, even in health systems with active population health outreach programs.
AHRQ-funded; HS022418.
Citation: Halm EA, Beaber EF, McLerran D .
Association between primary care visits and colorectal cancer screening outcomes in the era of population health outreach.
J Gen Intern Med 2016 Oct;31(10):1190-7. doi: 10.1007/s11606-016-3760-9..
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Patient-Centered Outcomes Research, Primary Care, Screening
Liss DT, Brown T, Lee JY
Diagnostic colonoscopy following a positive fecal occult blood test in community health center patients.
Fecal occult blood testing (FOBT) is a pragmatic screening option for many community health centers (CHCs), but FOBT screening programs will not reduce mortality if patients with positive results do not undergo diagnostic colonoscopy (DC). This study was conducted to investigate DC completion among CHC patients. It found that DC completion was low overall, which raises concerns about whether FOBT can reduce CRC mortality in practice.
AHRQ-funded; HS021141.
Citation: Liss DT, Brown T, Lee JY .
Diagnostic colonoscopy following a positive fecal occult blood test in community health center patients.
Cancer Causes Control 2016 Jul;27(7):881-7. doi: 10.1007/s10552-016-0763-0.
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Community-Based Practice, Screening
Brenner AT, Gupta S, Ko LK
Development of a practical model for targeting patient decision support interventions to promote colorectal cancer screening in vulnerable populations.
The authors sought to develop a practical model for predicting probability of colorectal cancer (CRC) screening completion in a diverse safety-net population and a subsequent framework for targeting screening promotion interventions. Their model and framework may be useful for designing and delivering targeted interventions to promote CRC screening.
AHRQ-funded; HS013853.
Citation: Brenner AT, Gupta S, Ko LK .
Development of a practical model for targeting patient decision support interventions to promote colorectal cancer screening in vulnerable populations.
J Health Care Poor Underserved 2016;27(2):465-78. doi: 10.1353/hpu.2016.0090.
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Keywords: Cancer: Colorectal Cancer, Decision Making, Health Promotion, Screening, Vulnerable Populations
Abdelsattar ZM, Wong SL, Regenbogen SE
Colorectal cancer outcomes and treatment patterns in patients too young for average-risk screening.
The researchers investigated the national treatment patterns and outcomes of patients younger than 50 with colorectal cancer (CRC). They found that patients with CRC diagnosed at age <50 years are more likely to present with advanced-stage disease. However, they receive more aggressive therapy and achieve longer disease-specific survival, despite the greater percentage of patients with advanced-stage disease.
AHRQ-funded; HS000053; HS020937.
Citation: Abdelsattar ZM, Wong SL, Regenbogen SE .
Colorectal cancer outcomes and treatment patterns in patients too young for average-risk screening.
Cancer 2016 Mar 15;122(6):929-34. doi: 10.1002/cncr.29716.
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Keywords: Cancer: Colorectal Cancer, Diagnostic Safety and Quality, Patient-Centered Outcomes Research, Risk, Screening
Liss DT, French DD, Buchanan DR
Outreach for annual colorectal cancer screening: a budget impact analysis for community health centers.
This budget impact analysis investigated benefits and costs of fecal immunochemical testing (FIT) outreach-with FIT kits mailed to patients, followed by reminders and phone calls-compared with point-of-care (POC) strategies. Cost per patient screened was $20.60 for POC and $71.84 for outreach ($51.24 difference). Outreach costs decreased by approximately one fourth under optimized workflows.
AHRQ-funded; HS021141.
Citation: Liss DT, French DD, Buchanan DR .
Outreach for annual colorectal cancer screening: a budget impact analysis for community health centers.
Am J Prev Med 2016 Feb;50(2):e54-61. doi: 10.1016/j.amepre.2015.07.003.
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Keywords: Cancer: Colorectal Cancer, Community-Based Practice, Health Promotion, Prevention, Screening
Singal AG, Gupta S, Tiro JA
Outreach invitations for FIT and colonoscopy improve colorectal cancer screening rates: a randomized controlled trial in a safety-net health system.
Among a racially diverse and socioeconomically disadvantaged cohort of patients, the researchers compared the effectiveness of fecal immunochemical test (FIT) outreach and colonoscopy outreach to increase screening participation rates, compared with usual visit-based care. Mailed outreach invitations appear to significantly increase colorectal cancer screening rates among underserved populations. In the current study, FIT-based outreach was found to be more effective than colonoscopy-based outreach.
AHRQ-funded; HS022418.
Citation: Singal AG, Gupta S, Tiro JA .
Outreach invitations for FIT and colonoscopy improve colorectal cancer screening rates: a randomized controlled trial in a safety-net health system.
Cancer 2016 Feb 1;122(3):456-63. doi: 10.1002/cncr.29770.
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Keywords: Cancer: Colorectal Cancer, Cancer, Screening, Prevention