National Healthcare Quality and Disparities Report
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- Access to Care (11)
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- Cancer: Cervical Cancer (1)
- Children/Adolescents (8)
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- Diagnostic Safety and Quality (2)
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- (-) Medical Expenditure Panel Survey (MEPS) (34)
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- Prevention (1)
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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 34 Research Studies DisplayedSelden TM, Berdahl TA, Fang Z
AHRQ Author: Selden TM, Berdahl TA, Fang Z
The risk of severe COVID-19 within households of school employees and school-age children.
Across the United States, school districts are grappling with questions of whether and how to reopen elementary and secondary schools in the 2020-21 academic year. Using pre-pandemic household data, the authors examined how often persons at risk of severe coronavirus disease 2019 (COVID-19) were connected to schools, either as employees or by living in the same households as school employees or school-age children.
AHRQ-authored.
Citation: Selden TM, Berdahl TA, Fang Z .
The risk of severe COVID-19 within households of school employees and school-age children.
Health Aff 2020 Nov;39(11):2002-09. doi: 10.1377/hlthaff.2020.01536..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, COVID-19, Public Health, Risk, Infectious Diseases
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
Hill SC, Miller GE, Ding Y
AHRQ Author: Hill SC, Miller GE, Ding Y
Net spending on retail specialty drugs grew rapidly, especially for private insurance and Medicare Part D.
This study examined net spending trends on retail specialty drugs from 2010 to 2017. Spending has been difficult to measure due to proprietary rebate payments by manufacturers by insurers, pharmacy benefit managers and state Medicaid agencies. The authors incorporated those rebates into their research. They found that specialty drugs accounted for 37.7% of retail and mail-order prescription spending net of rebates in 2016-17. The spending net of rebates tripled for Medicare Part D beneficiaries and more than doubled for people with private insurance from 2010 to 2017. Medicaid net spending of rebates had a slower increase.
AHRQ-authored.
Citation: Hill SC, Miller GE, Ding Y .
Net spending on retail specialty drugs grew rapidly, especially for private insurance and Medicare Part D.
Health Aff 2020 Nov;39(11):1970-76. doi: 10.1377/hlthaff.2019.01830..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Medication, Medicare, Health Insurance
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
Selden TM, Berdahl TA
AHRQ Author: Selden TM, Berdahl TA
COVID-19 and racial/ethnic disparities in health risk, employment, and household composition.
In this study, the investigators used data from the Medical Expenditure Panel Survey to explore potential explanations for racial-ethnic disparities in coronavirus disease 2019 (COVID-19) hospitalizations and mortality. The authors found that black adults in every age group were more likely than whites to have health risks associated with severe COVID-19 illness. However, whites were older on average than blacks.
AHRQ-authored.
Citation: Selden TM, Berdahl TA .
COVID-19 and racial/ethnic disparities in health risk, employment, and household composition.
Health Aff 2020 Sep;39(9):1624-32. doi: 10.1377/hlthaff.2020.00897..
Keywords: Medical Expenditure Panel Survey (MEPS), COVID-19, Disparities, Racial and Ethnic Minorities, Risk
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
Pollack LM, Ekwueme DU, Hung MC Pollack LM, Ekwueme DU, Hung MC, Pollack LM, Ekwueme DU, Hung MC Pollack LM, Ekwueme DU, Hung MC, Hung MC
Estimating the impact of increasing cervical cancer screening in the National Breast and Cervical Cancer Early Detection Program among low-income women in the USA.
The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides free cervical cancer screening to low-income women. This study estimated the health benefits gained in terms of life years (LYs) saved and quality-adjusted life years (QALYs) gained if cervical cancer screening by the NBCCEDP increased to reach more eligible women. The investigators found that the reported estimates emphasized the value of cervical cancer screening program by extending LE in low-income women.
Citation: Pollack LM, Ekwueme DU, Hung MC Pollack LM, Ekwueme DU, Hung MC, Pollack LM, Ekwueme DU, Hung MC Pollack LM, Ekwueme DU, Hung MC, Hung MC .
Estimating the impact of increasing cervical cancer screening in the National Breast and Cervical Cancer Early Detection Program among low-income women in the USA.
Cancer Causes Control 2020 Jul;31(7):691-702. doi: 10.1007/s10552-020-01314-z..
Keywords: Medical Expenditure Panel Survey (MEPS), Cancer: Cervical Cancer, Cancer: Breast Cancer, Cancer, Screening, Women, Diagnostic Safety and Quality, Low-Income
Monheit AC, Grafova IB, Kumar R
How does family health care use respond to economic shocks? Realized and anticipated effects.
Using two-year panel data from the Medical Expenditure Panel Survey (MEPS) for 2004 to 2012, the investigators examined how the intra-family allocation of health care spending responded to realized and anticipated changes in family economic status. They focused on the share of total family health care spending allocated to children and measured realized economic shocks based on changes in the family’s income, employment, and health insurance status.
AHRQ-funded; HS024053.
Citation: Monheit AC, Grafova IB, Kumar R .
How does family health care use respond to economic shocks? Realized and anticipated effects.
Review of Economics of the Household 2020 Jun;18(2):307-34. doi: 10.1007/s11150-018-9438-9..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs
Zuvekas SH, Biener AI, Hicks WD
AHRQ Author: Zuvekas SH
The effects of survey enhancements on the quality of reporting in the Medical Expenditure Panel Survey, 2008–2015.
It is well established that survey respondents imperfectly recall health care use in surveys. However, careful attention to both survey design and fielding procedures can enhance recall. In this study, the investigators examined the effects of a comprehensive, multi-pronged approach to changing field procedures in the Medical Expenditure Panel Survey (MEPS) to improve quality of health care use reporting.
AHRQ-authored.
Citation: Zuvekas SH, Biener AI, Hicks WD .
The effects of survey enhancements on the quality of reporting in the Medical Expenditure Panel Survey, 2008–2015.
J Surv Stat Methodol 2020 Jun;8(3):589-616..
Keywords: Medical Expenditure Panel Survey (MEPS), Research Methodologies
Cook BL, Flores M, Zuvekas SH
AHRQ Author: Zuvekas SH
The impact Of Medicare's mental health cost-sharing parity on use of mental health care services.
This study examined the impact of Medicare’s mental health cost-sharing parity on use of mental health care services, which was phased in from 2010 to 2014. The authors assessed whether the reduction in mental health cost sharing was associated with changes in specialty and primary care outpatient mental health visits and psychotropic medication fills. They compared people with Medicare and private insurance before and after implementation. Medicare beneficiaries’ use of psychotropic medication increased after implementation but there was not a detectable change in visits.
AHRQ-authored.
Citation: Cook BL, Flores M, Zuvekas SH .
The impact Of Medicare's mental health cost-sharing parity on use of mental health care services.
Health Aff 2020 May;39(5):819-27. doi: 10.1377/hlthaff.2019.01008..
Keywords: Medical Expenditure Panel Survey (MEPS), Medicare, Behavioral Health, Healthcare Costs, Policy, Health Insurance, Healthcare Utilization, Access to Care
Berdahl T, Biener A, McCormick MC
AHRQ Author: Berdahl T
Annual report on children's healthcare: healthcare access and utilization by obesity status in the United States.
This study examined access to care and utilization patterns across a set of healthcare measures by obesity status and sociodemographic characteristics among children. Data from the Medical Expenditure Panel Survey (MEPS) from 2010-2015 was used to determine obesity status, number of well-child visits, access to a usual source of care, number of preventive dental visits and prescription medication fills in the past year. It was found that uninsured adolescents with obesity were less like to have a usual source of care provider than children without obesity. Among younger children, those living in the Northeast were more than twice as likely to have had a well-child visit than those living in the West. Preventive dental care was less likely to have occurred for children with obesity than non-obese children. More prescription refills were completed for obese adolescents than for younger children.
AHRQ-authored.
Citation: Berdahl T, Biener A, McCormick MC .
Annual report on children's healthcare: healthcare access and utilization by obesity status in the United States.
Acad Pediatr 2020 Mar;20(2):175-87. doi: 10.1016/j.acap.2019.11.020..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Access to Care, Healthcare Utilization, Obesity
Grafova IB, Monheit AC, Kumar R
How do changes in income, employment and health insurance affect family mental health spending?
This study used eight two-year panels from the MEPS data for 2004 to 2012 to examine the effect of economic shocks on mental health spending by families with children. Researchers wanted to determine whether the greatest impact on mental health spending comes from income, employment, or health insurance shocks. They used two-part expenditure models to estimate that employment losses are positively related to an increase in total family mental health expenditures. But no link was found between economic shocks and mental health spending on fathers.
AHRQ-funded; HS024053.
Citation: Grafova IB, Monheit AC, Kumar R .
How do changes in income, employment and health insurance affect family mental health spending?
Rev Econ Househ 2020 Mar;18(1:239-63. doi: 10.1007/s11150-018-9436-y.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Behavioral Health, Social Determinants of Health, Health Insurance
Abdus S
AHRQ Author: Abdus S
The role of plan choice in health care utilization of high-deductible plan enrollees.
This study examined the role of plan choice in health care utilization of high-deductible plan enrollees. 2011-2016 MEPS Household Component data on nonelderly adults enrolled in employer-sponsored insurance was used. Four types of health plans were examined: high-deductible, consumer-directed, low-deductible, and no-deductible. Among adults with a choice of plans, high-deductible enrollees had lower levels of utilization compared with no-deductible enrollees for all types of services. This might be explained by favorable selection and that the enrollees are probably younger and healthier with the high-deductible plans being lower in cost than other plan types. Among adults without any choice of plans, the differences were not statistically significant.
AHRQ-authored.
Citation: Abdus S .
The role of plan choice in health care utilization of high-deductible plan enrollees.
Health Serv Res 2020 Feb;55(1):119-27. doi: 10.1111/1475-6773.13223..
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Healthcare Utilization
Selden TM
AHRQ Author: Selden TM
Differences between public and private hospital payment rates narrowed, 2012-16.
In 2000-12 payments for inpatient hospital stays, emergency department visits, and outpatient hospital care for privately insured patients grew much faster than payments for Medicare and Medicaid patients. This widening of private-public payment gaps slowed or even reversed itself in 2012-16. In this paper, the author discusses the differences between public and private hospital payment rates, 2012-2016.
AHRQ-authored.
Citation: Selden TM .
Differences between public and private hospital payment rates narrowed, 2012-16.
Health Aff 2020 Jan;39(1):94-99. doi: 10.1377/hlthaff.2019.00415..
Keywords: Medical Expenditure Panel Survey (MEPS), Hospitals, Payment, Healthcare Costs, Medicaid, Medicare
Cheng BT, Smith SS, Fishbein AB
Functional burden and limitations in children with chronic sinusitis.
The objective of this study was to use a validated pediatric quality of life (QOL) tool to quantify the impact of pediatric chronic rhinosinusitis (CRS) in a representative epidemiological sample. Findings showed that pediatric CRS was associated with substantial QOL burden across multiple psychosocial and cognitive domains and that CRS children with lower family income and comorbid asthma, anxiety, and depression had higher Columbia Impairment Scale scores associated with even greater functional impairment. These findings suggested that pediatric CRS might be a population requiring greater attention and screening for mental health symptoms.
AHRQ-funded; HS023011.
Citation: Cheng BT, Smith SS, Fishbein AB .
Functional burden and limitations in children with chronic sinusitis.
Pediatr Allergy Immunol 2020 Jan;31(1):103-05. doi: 10.1111/pai.13121..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Quality of Life, Healthcare Costs, Respiratory Conditions, Chronic Conditions
Kirby JB, Yabroff KR
AHRQ Author: Kirby JB
Rural-urban differences in access to primary care: beyond the usual source of care provider.
This study used 2014-2016 MEPS data to analyze differences between rural and urban areas to primary care access beyond the usual source of care provider. While rural residents were more likely to have a usual source of care, they were less likely to have a provider with office hours on nights and weekends.
AHRQ-authored.
Citation: Kirby JB, Yabroff KR .
Rural-urban differences in access to primary care: beyond the usual source of care provider.
Am J Prev Med 2020 Jan;58(1):89-96. doi: 10.1016/j.amepre.2019.08.026..
Keywords: Medical Expenditure Panel Survey (MEPS), Access to Care, Primary Care, Rural Health, Urban Health, Health Services Research (HSR)
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.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Screening, Women, Policy, Prevention
Abdus S, Selden TM, Keenan P
AHRQ Author: Abdus S, Selden TM, Keenan P
The financial burdens of high-deductible plans.
The increased prevalence of high-deductible health plans raises concerns regarding high financial burdens from health care, particularly for low-income adults.
AHRQ-authored.
Citation: Abdus S, Selden TM, Keenan P .
The financial burdens of high-deductible plans.
Health Aff 2016 Dec;35(12):2297-301. doi: 10.1377/hlthaff.2016.0842.
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Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Healthcare Costs, Social Determinants of Health
Kirby JB, Vistnes JP
AHRQ Author: Kirby JB, Vistnes JP
Access to care improved for people who gained Medicaid or marketplace coverage in 2014.
Newly available longitudinal survey data show that people who lacked health insurance in 2013 and gained coverage through Medicaid or the Marketplaces in 2014 were far more likely to obtain a usual source of care and receive preventive care services than their counterparts who remained uninsured in 2014.
AHRQ-authored.
Citation: Kirby JB, Vistnes JP .
Access to care improved for people who gained Medicaid or marketplace coverage in 2014.
Health Aff 2016 Oct 1;35(10):1830-34. doi: 10.1377/hlthaff.2016.0716.
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Keywords: Medical Expenditure Panel Survey (MEPS), Access to Care, Medicaid, Health Insurance
Hanmer J, Hess R, Sullivan S
Benchmarking health-related quality-of-life data from a clinical setting.
This paper's objective was to construct a nationally representative health-related quality of life (HRQoL) benchmark for use with a clinical sample. The results showed that HRQoL benchmarks can be created from current public datasets, and subgroups in national samples may provide more valid benchmarks for clinical populations.
AHRQ-funded; HS022989.
Citation: Hanmer J, Hess R, Sullivan S .
Benchmarking health-related quality-of-life data from a clinical setting.
Am J Manag Care 2016 Oct;22(10):669-75.
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Keywords: Health Status, Medical Expenditure Panel Survey (MEPS), Quality of Life
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.
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Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Medicaid, Uninsured, Policy
Olfson M, Blanco C, Marcus SC
Treatment of adult depression in the United States.
The researchers characterized the treatment of adult depression in the United States. They concluded that most US adults who screen positive for depression did not receive treatment for depression, whereas most who were treated did not screen positive. In light of these findings, it is important to strengthen efforts to align depression care with each patient's clinical needs.
AHRQ-funded; HS02112.
Citation: Olfson M, Blanco C, Marcus SC .
Treatment of adult depression in the United States.
JAMA Intern Med 2016 Oct;176(10):1482-91. doi: 10.1001/jamainternmed.2016.5057.
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Keywords: Medication, Depression, Diagnostic Safety and Quality, Medical Expenditure Panel Survey (MEPS)
Ray KN, Mehrotra A
Trends in access to primary care for children in the United States, 2002-2013.
Using MEPS data, the authors described how access to primary care has changed over the last decade for children. They found no change in the proportion of children with a usual source of care (USC). Other measures improved, but out-of-pocket costs increased among privately insured children. Results suggested that after-hours accommodation within the USC is worsening, despite the promotion of patient-centered medical home initiatives. All measures of acceptability improved, consistent with a growing focus on family-centeredness of care.
AHRQ-funded; HS022989.
Citation: Ray KN, Mehrotra A .
Trends in access to primary care for children in the United States, 2002-2013.
JAMA Pediatr 2016 Oct;170(10):1023-25. doi: 10.1001/jamapediatrics.2016.0985.
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Keywords: Access to Care, Children/Adolescents, Health Services Research (HSR), Medical Expenditure Panel Survey (MEPS), Primary Care
Horner-Johnson W, Dobbertin K
Dental insurance and dental care among working-age adults: differences by type and complexity of disability.
The purpose of this study was to examine differences in dental insurance, receipt of dental checkups, and delayed and unmet needs for dental care by type and complexity of disability. It found that all disability types except hearing had significantly higher adjusted odds of being without dental insurance, as did people with complex activity limitations. Further, disparities in care were apparent even when controlling for presence of dental insurance.
AHRQ-funded; HS022981.
Citation: Horner-Johnson W, Dobbertin K .
Dental insurance and dental care among working-age adults: differences by type and complexity of disability.
J Public Health Dent 2016 Sep;76(4):330-39. doi: 10.1111/jphd.12160.
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Keywords: Access to Care, Dental and Oral Health, Disabilities, Health Insurance, Medical Expenditure Panel Survey (MEPS)
Ali MM, Chen J, Mutter R
AHRQ Author: Novak P
The ACA's dependent coverage expansion and out-of-pocket spending by young adults with behavioral health conditions.
The authors analyzed out-of-pocket spending as a share of total health care expenditures for young adults with behavioral health conditions before and after the implementation of the ACA dependent care provision. They found that the extension of health insurance coverage to young adults with behavioral health disorders has provided them with additional financial protection, which can be important given the low incomes and high debt burden that characterize the age group.
AHRQ-authored.
Citation: Ali MM, Chen J, Mutter R .
The ACA's dependent coverage expansion and out-of-pocket spending by young adults with behavioral health conditions.
Psychiatr Serv 2016 Sep;67(9):977-82. doi: 10.1176/appi.ps.201500346.
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Keywords: Behavioral Health, Healthcare Costs, Health Insurance, Medical Expenditure Panel Survey (MEPS), Young Adults