National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
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AHRQ Research Studies Date
Topics
- (-) Access to Care (46)
- Ambulatory Care and Surgery (1)
- Anxiety (1)
- Behavioral Health (8)
- Blood Pressure (1)
- Care Coordination (1)
- Children's Health Insurance Program (CHIP) (2)
- Children/Adolescents (10)
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- Elderly (1)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Emergency Medical Services (EMS) (2)
- Eye Disease and Health (1)
- Guidelines (1)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Costs (5)
- Healthcare Utilization (6)
- Health Insurance (8)
- Health Literacy (1)
- Health Services Research (HSR) (5)
- Health Status (1)
- Hepatitis (1)
- Hospitalization (1)
- Hospital Readmissions (1)
- Low-Income (5)
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- Medical Expenditure Panel Survey (MEPS) (5)
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- Pregnancy (1)
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- Provider: Health Personnel (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (6)
- Registries (1)
- Risk (1)
- Rural Health (4)
- Social Determinants of Health (4)
- Stroke (1)
- Substance Abuse (2)
- Surgery (1)
- Telehealth (1)
- Training (1)
- Trauma (1)
- Urban Health (1)
- Vaccination (2)
- Vulnerable Populations (3)
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
26 to 46 of 46 Research Studies DisplayedBailey SR, Marino M, Hoopes M
Healthcare utilization after a children's health insurance program expansion in Oregon.
This study used electornic health record data from 154 Oregon community health centers to evaluate children's healthcare utilization after the Children's Health Insurance Program (CHIP) expansion. The authors found that utilization among the newly-insured remained higher than the uninsured group. This finding confirms that Children's Health Insurance Program expansions are associated with increased utilization of essential pediatric primary and preventive care.
AHRQ-funded; HS021522; HS018569.
Citation: Bailey SR, Marino M, Hoopes M .
Healthcare utilization after a children's health insurance program expansion in Oregon.
Matern Child Health J 2016 May;20(5):946-54. doi: 10.1007/s10995-016-1971-7.
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Keywords: Children's Health Insurance Program (CHIP), Electronic Health Records (EHRs), Healthcare Utilization, Children/Adolescents, Access to Care
La EM, Lich KH, Wells R
Increasing access to state psychiatric hospital beds: exploring supply-side solutions.
The objective of this study was to identify supply-side interventions to reduce state psychiatric hospital admission delays. The investigators suggest that without more robust community-based hospital and residential capacity, major increases in state psychiatric hospital inpatient capacity are necessary to ensure timely admission of people in crisis.
AHRQ-funded; HS000032.
Citation: La EM, Lich KH, Wells R .
Increasing access to state psychiatric hospital beds: exploring supply-side solutions.
Psychiatr Serv 2016 May;67(5):523-8. doi: 10.1176/appi.ps.201400570..
Keywords: Access to Care, Behavioral Health
Cook BL, Kim G, Morgan KL
Measuring geographic "hot spots" of racial/ethnic disparities: an application to mental health care.
The researchers identified geographic "hot spots" of racial/ethnic disparities in mental health care access. They identified these "hot spots": Richmond, Virginia, and Columbus, Georgia, for Black-White disparities; Fresno, California, and Dallas, Texas, for Latino-White disparities; and Riverside, California, and Houston, Texas, for Asian-White mental health care disparities. They discussed the potential and limitations of these methods as tools for understanding health care disparities in other contexts.
AHRQ-funded; HS021486.
Citation: Cook BL, Kim G, Morgan KL .
Measuring geographic "hot spots" of racial/ethnic disparities: an application to mental health care.
J Health Care Poor Underserved 2016;27(2):663-84. doi: 10.1353/hpu.2016.0091.
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Keywords: Access to Care, Disparities, Behavioral Health, Racial and Ethnic Minorities
Bernard D, Selden T, Yeh S
AHRQ Author: Bernard D, Selden T
Financial burdens and barriers to care among nonelderly adults: the role of functional limitations and chronic conditions.
The researchers examined the financial burdens and barriers to care among nonelderly adults, focusing on the role of functional limitations and chronic conditions. Functional limitations and chronic conditions were associated with increased prevalence of burdens and financial barriers in all insurance categories, with the exception that an association between functional limitations and the prevalence of burdens was not observed for public coverage.
AHRQ-authored.
Citation: Bernard D, Selden T, Yeh S .
Financial burdens and barriers to care among nonelderly adults: the role of functional limitations and chronic conditions.
Disabil Health J 2016 Apr;9(2):256-64. doi: 10.1016/j.dhjo.2015.09.003.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Chronic Conditions, Access to Care, Health Services Research (HSR)
Keohane LM, Rahman M, Mor V
Reforming access: trends in Medicaid enrollment for new Medicare beneficiaries, 2008-2011.
This study evaluated whether aligning the Part D low-income subsidy and Medicaid program enrollment pathways in 2010 increased Medicaid participation among new Medicare beneficiaries. It found that the percentage of beneficiaries enrolling in limited Medicaid at the start of Medicare coverage increased in 2010 by 0.3 percentage points for individuals aging into Medicare and by 1.3 percentage points for those qualifying due to disability.
AHRQ-funded; HS000011.
Citation: Keohane LM, Rahman M, Mor V .
Reforming access: trends in Medicaid enrollment for new Medicare beneficiaries, 2008-2011.
Health Serv Res 2016 Apr;51(2):550-69. doi: 10.1111/1475-6773.12349.
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Keywords: Medicare, Medicaid, Policy, Access to Care, Social Determinants of Health
Zullig LL, Whitson HE, Hastings SN
A systematic review of conceptual frameworks of medical complexity and new model development.
The authors sought to develop a conceptual model of complexity addressing gaps identified in a review of published conceptual models. Their Cycle of Complexity model illustrated relationships between acute shocks and medical events, healthcare access and utilization, workload and capacity, and patient preferences in the context of interpersonal, organizational, and community factors.
AHRQ-funded; HS023085; HS023099.
Citation: Zullig LL, Whitson HE, Hastings SN .
A systematic review of conceptual frameworks of medical complexity and new model development.
J Gen Intern Med 2016 Mar;31(3):329-37. doi: 10.1007/s11606-015-3512-2.
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Keywords: Access to Care, Chronic Conditions, Health Services Research (HSR)
Bernard DM, Selden TM
AHRQ Author: Bernard DM, Selden TM
Access to care among nonelderly veterans.
This study compared access to care for nonelderly adult veterans versus comparable non-veterans, overall and within subgroups defined by simulated eligibility for health care from the Veterans Health Administration and by insurance status. Its results showed that uninsured Veterans, the most policy-relevant group, have better access to care than comparable non-veterans.
AHRQ-authored.
Citation: Bernard DM, Selden TM .
Access to care among nonelderly veterans.
Med Care 2016 Mar;54(3):243-52. doi: 10.1097/mlr.0000000000000508.
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Keywords: Medical Expenditure Panel Survey (MEPS), Access to Care, Social Determinants of Health, Health Status
Weintraub JA, Burgette JM, Chadwick DG
Educating North Carolina's oral health workforce in an evolving environment.
In 2014, North Carolina had 4,681 actively practicing dentists and ranked 47th among US states in dentist-to-population ratio. The need for dentists is increasing as the population grows, and underserved areas persist. This commentary discusses the impact of the state's 2 dental schools and external factors on dental workforce trends.
AHRQ-funded; HS000032.
Citation: Weintraub JA, Burgette JM, Chadwick DG .
Educating North Carolina's oral health workforce in an evolving environment.
N C Med J 2016 Mar-Apr;77(2):107-11. doi: 10.18043/ncm.77.2.107..
Keywords: Dental and Oral Health, Education, Access to Care, Rural Health, Vulnerable Populations
Li J, Maxwell AE, Glenn BA
Healthcare access and utilization among Korean Americans: The mediating role of English use and proficiency.
This study examines whether English language use and proficiency plays a mediating role in the relationships between length of hospital stay in the US and health insurance coverage, access to, and use of care. Results show that health care utilization was primarily driven by having health insurance and a usual source of care. Recommendations include a focus on increasing English use and proficiency and insurance coverage among older, female, less educated Korean Americans to mitigate health disparities associated with reduced access to health services in this population.
AHRQ-funded; HS000046.
Citation: Li J, Maxwell AE, Glenn BA .
Healthcare access and utilization among Korean Americans: The mediating role of English use and proficiency.
Int J Soc Sci Res 2016 Mar;4(1):83-97. doi: 10.5296/ijssr.v4i1.8678.
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Keywords: Access to Care, Cultural Competence, Disparities, Healthcare Utilization, Racial and Ethnic Minorities
Lyerly MJ, Wu TC, Mullen MT
The effects of telemedicine on racial and ethnic disparities in access to acute stroke care.
The authors sought to determine the effect of telemedicine on access to acute stroke care for racial and ethnic minorities in the state of Texas. They found that telemedicine increased access to acute stroke care for 1.5 million Texans, and they found no evidence of disparities in access to the acute stroke expertise afforded by telemedicine.
AHRQ-funded; HS013852.
Citation: Lyerly MJ, Wu TC, Mullen MT .
The effects of telemedicine on racial and ethnic disparities in access to acute stroke care.
J Telemed Telecare 2016 Mar;22(2):114-20. doi: 10.1177/1357633x15589534.
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Keywords: Access to Care, Disparities, Racial and Ethnic Minorities, Stroke, Telehealth
Geissler K, Stearns SC, Becker C
The relationship between violence in Northern Mexico and potentially avoidable hospitalizations in the USA-Mexico border region.
The authors quantified associations between violence in Mexico and decreases in access to care for border county residents. They found that increased homicide rates in Mexico were associated with increased hospitalizations for ambulatory care sensitive (ACS) conditions in the USA, although residence in a border county was associated with decreased probability of being hospitalized for an ACS condition.
AHRQ-funded; HS021074.
Citation: Geissler K, Stearns SC, Becker C .
The relationship between violence in Northern Mexico and potentially avoidable hospitalizations in the USA-Mexico border region.
J Public Health 2016 Mar;38(1):14-23. doi: 10.1093/pubmed/fdv012.
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Keywords: Access to Care, Hospitalization, Ambulatory Care and Surgery
Jiang HJ, Boutwell AE, Maxwell J
AHRQ Author: Jiang HJ
Understanding patient, provider, and system factors related to Medicaid readmissions.
This study was undertaken to understand the complexity of Medicaid readmission issues at the patient, provider, and system levels. It found that significant risk factors for Medicaid readmissions included financial stress, high prevalence of mental health and substance abuse disorders, medication nonadherence, and housing instability. Lacking awareness on Medicaid patients' high risk, a sufficient business case, and proven strategies for reducing readmissions were primary barriers for providers.
AHRQ-authored; AHRQ-funded; 290201000034I; 290201000030I.
Citation: Jiang HJ, Boutwell AE, Maxwell J .
Understanding patient, provider, and system factors related to Medicaid readmissions.
Jt Comm J Qual Patient Saf 2016 Mar;42(3):115-21.
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Keywords: Medicaid, Hospital Readmissions, Access to Care, Social Determinants of Health, Risk
Chen J, Vargas-Bustamante A, Mortensen K
Racial and ethnic disparities in health care access and utilization under the Affordable Care Act.
The objective of this study was to examine racial and ethnic disparities in health care access and utilization after the Affordable Care Act (ACA) health insurance mandate was fully implemented in 2014. Its results demonstrate that racial and ethnic disparities in access have been reduced significantly during the initial years of the ACA implementation that expanded access and mandated that individuals obtain health insurance.
AHRQ-funded; HS022135.
Citation: Chen J, Vargas-Bustamante A, Mortensen K .
Racial and ethnic disparities in health care access and utilization under the Affordable Care Act.
Med Care 2016 Feb;54(2):140-6. doi: 10.1097/mlr.0000000000000467.
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Keywords: Access to Care, Disparities, Healthcare Utilization, Health Insurance
Shaw JJ, Psoinos CM, Santry HP
It's all about location, location, location: A new perspective on trauma transport.
The objective of this study was to determine the effect of aeromedical transport on trauma mortality when accounting for geographic factors. It concluded that helicopter transport does not impart a survival benefit for trauma patients when geographic considerations are taken into account.
AHRQ-funded; HS022694.
Citation: Shaw JJ, Psoinos CM, Santry HP .
It's all about location, location, location: A new perspective on trauma transport.
Ann Surg 2016 Feb;263(2):413-8. doi: 10.1097/sla.0000000000001265..
Keywords: Trauma, Emergency Medical Services (EMS), Registries, Mortality, Access to Care
Aalsma MC, Gilbert AL, Xiao S
Parent and adolescent views on barriers to adolescent preventive health care utilization.
The objective of the study was to determine adolescent and parent views of barriers to annual adolescent preventive care. Barriers for parents and adolescents include the belief that an appointment is only needed when a child is sick and family cannot afford cost. Barriers for parents include having their child see a specialist.
AHRQ-funded; HS022681.
Citation: Aalsma MC, Gilbert AL, Xiao S .
Parent and adolescent views on barriers to adolescent preventive health care utilization.
J Pediatr 2016 Feb;169:140-5. doi: 10.1016/j.jpeds.2015.10.090.
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Keywords: Children/Adolescents, Access to Care, Prevention, Primary Care, Healthcare Utilization
Marino M, Bailey SR, Gold R
Receipt of preventive services after Oregon's randomized Medicaid experiment.
This study examined the three-year impact of Oregon's 2008 randomized Medicaid expansion (the "Oregon Experiment") on receipt of 12 preventive care services in community health centers using electronic health record data. They found that Medicaid coverage significantly increased the odds of receipt of most preventive services. They concluded that rates of preventive services receipt will likely increase as community health center patients gain insurance through Affordable Care Act expansions. They recommended continued effort to increase health insurance coverage in an effort to decrease health disparities in vulnerable populations.
AHRQ-funded; HS021522.
Citation: Marino M, Bailey SR, Gold R .
Receipt of preventive services after Oregon's randomized Medicaid experiment.
Am J Prev Med 2016 Feb;50(2):161-70. doi: 10.1016/j.amepre.2015.07.032.
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Keywords: Access to Care, Community-Based Practice, Health Insurance, Medicaid, Prevention
Lipton BJ, Decker SL
AHRQ Author: Decker SL
The effect of Medicaid adult vision coverage on the likelihood of appropriate correction of distance vision: evidence from the National Health and Nutrition Examination Survey.
This paper examined whether providing adult vision benefits is associated with an increase in the percentage of low-income individuals with appropriately corrected distance vision as measured during an eye exam. Findings imply that Medicaid adult vision coverage is associated with a significant increase in the percentage of Medicaid beneficiaries with appropriately corrected distance vision.
AHRQ-authored.
Citation: Lipton BJ, Decker SL .
The effect of Medicaid adult vision coverage on the likelihood of appropriate correction of distance vision: evidence from the National Health and Nutrition Examination Survey.
Soc Sci Med 2016 Feb;150:258-67. doi: 10.1016/j.socscimed.2015.10.055.
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Keywords: Access to Care, Eye Disease and Health, Health Insurance, Low-Income, Medicaid
Finnerty M, Neese-Todd S, Pritam R
Access to psychosocial services prior to starting antipsychotic treatment among Medicaid-insured youth.
The researchers sought to examine rates and predictors of receiving a psychosocial service before initiating antipsychotic treatment among young people in the Medicaid program. They found that less than one-half of youth received a psychosocial service before initiating antipsychotic treatment, and youth diagnosed with stress disorders were significantly more likely than those diagnosed with psychotic or bipolar disorders to have received a psychosocial service before starting an antipsychotic. They concluded that this service pattern highlights a critical gap in access to psychosocial services.
AHRQ-funded; HS019937; HS020503; HS021112.
Citation: Finnerty M, Neese-Todd S, Pritam R .
Access to psychosocial services prior to starting antipsychotic treatment among Medicaid-insured youth.
J Am Acad Child Adolesc Psychiatry 2016 Jan;55(1):69-76.e3. doi: 10.1016/j.jaac.2015.09.020.
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Keywords: Access to Care, Children/Adolescents, Medication, Behavioral Health
Sommers BD, Blendon RJ, Orav EJ
Both the 'private option' and traditional Medicaid expansions improved access to care for low-income adults.
This study found that other than coverage type and trouble paying medical bills (which decreased more in Kentucky than in Arkansas), there were no significant differences between Kentucky's traditional Medicaid expansion and Arkansas's private option, which suggests that both approaches improved access among low-income adults.
AHRQ-funded; HS021291.
Citation: Sommers BD, Blendon RJ, Orav EJ .
Both the 'private option' and traditional Medicaid expansions improved access to care for low-income adults.
Health Aff 2016 Jan;35(1):96-105. doi: 10.1377/hlthaff.2015.0917.
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Keywords: Medicaid, Low-Income, Healthcare Costs, Access to Care, Policy
Sommers BD, Kronick R
AHRQ Author: Kronick R
Measuring Medicaid physician participation rates and implications for policy.
The authors’ objective was to describe several alternative measures of provider participation in Medicaid using recently publicly available data, to compare state rankings across these different metrics, and to discuss potential advantages and disadvantages of each measure for research and policy purposes. Overall, they found that Medicaid participation as measured by raw percentages of physicians taking new Medicaid patients is only weakly correlated with population-based measures that account for both participation rates and the numbers of physicians per capita or physicians per Medicaid beneficiary.
AHRQ-authored.
Citation: Sommers BD, Kronick R .
Measuring Medicaid physician participation rates and implications for policy.
J Health Polit Policy Law 2016 Jan 5;41(2):211-24. doi: 10.1215/03616878-3476117.
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Keywords: Medicaid, Policy, Access to Care, Practice Patterns, Policy
Kreider AR, French B, Aysola J
Quality of health insurance coverage and access to care for children in low-income families.
This study compared health care access, quality, and cost outcomes by insurance type (Medicaid, CHIP, private, and uninsured) for children in households with low to moderate incomes. It found that children with all insurance types experienced challenges in access to specialty care, with caregivers of children insured by the Children’s Health Insurance Program reporting the highest rates of difficulty accessing specialty care, problems obtaining a referral, and frustration obtaining health care services.
AHRQ-funded; HS021706.
Citation: Kreider AR, French B, Aysola J .
Quality of health insurance coverage and access to care for children in low-income families.
JAMA Pediatr 2016 Jan;170(1):43-51. doi: 10.1001/jamapediatrics.2015.3028..
Keywords: Children's Health Insurance Program (CHIP), Children/Adolescents, Access to Care, Low-Income