National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (2)
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- Back Health and Pain (1)
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- (-) Healthcare Utilization (31)
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- Health Services Research (HSR) (6)
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- Quality of Life (1)
- Rehabilitation (1)
- Respiratory Conditions (2)
- Sex Factors (1)
- Sickle Cell Disease (1)
- Social Determinants of Health (3)
- Substance Abuse (1)
- Surgery (1)
- Transitions of Care (1)
- Uninsured (1)
- Urinary Tract Infection (UTI) (1)
- Women (2)
- Young Adults (1)
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 31 Research Studies DisplayedStevens JP, Nyweide DJ, Maresh S
Comparison of hospital resource use and outcomes among hospitalists, primary care physicians, and other generalists.
The purpose of this study was to examine differences in the use of health care resources and outcomes among hospitalized patients cared for by hospitalists, their own primary care physicians (PCPs), or other generalists. The investigators found that a PCP's prior experience with a patient may be associated with inpatient use of resources and patient outcomes.
AHRQ-funded; HS024288.
Citation: Stevens JP, Nyweide DJ, Maresh S .
Comparison of hospital resource use and outcomes among hospitalists, primary care physicians, and other generalists.
JAMA Intern Med 2017 Dec;177(12):1781-87. doi: 10.1001/jamainternmed.2017.5824..
Keywords: Healthcare Utilization, Hospitalization, Outcomes, Primary Care
Rundell SD, Gold LS, Hansen RN
Impact of co-morbidities on resource use and adherence to guidelines among commercially insured adults with new visits for back pain.
The purpose of this study was to assess if co-morbidity is associated with higher use of back-related care and adherence to back pain guidelines. The investigators found that co-morbidity burden and the presence of specific chronic conditions, such as musculoskeletal conditions, were associated with high long-term use of back-related care and care inconsistent with guidelines.
AHRQ-funded; HS022982.
Citation: Rundell SD, Gold LS, Hansen RN .
Impact of co-morbidities on resource use and adherence to guidelines among commercially insured adults with new visits for back pain.
J Eval Clin Pract 2017 Dec;23(6):1218-26. doi: 10.1111/jep.12763..
Keywords: Back Health and Pain, Guidelines, Health Services Research (HSR), Healthcare Utilization, Patient Adherence/Compliance
Adrion ER, Kocher KE, Nallamothu BK
Rising use of observation care among the commercially insured may lead to total and out-of-pocket cost savings.
Using multipayer commercial claims for the period 2009-13, the investigators evaluated utilization and spending among patients admitted for six conditions that are commonly managed with either observation care or short-stay hospitalizations. In their study period, the use of observation care increased relative to that of short-stay hospitalizations. In addition, total and out-of-pocket spending were substantially lower for observation care, though both grew rapidly--and at rates much higher than spending in the inpatient setting--over the study period.
AHRQ-funded; HS000053.
Citation: Adrion ER, Kocher KE, Nallamothu BK .
Rising use of observation care among the commercially insured may lead to total and out-of-pocket cost savings.
Health Aff 2017 Dec;36(12):2102-09. doi: 10.1377/hlthaff.2017.0774..
Keywords: Health Insurance, Healthcare Costs, Healthcare Delivery, Healthcare Utilization, Hospitalization, Hospitals, Medicare
Lines LM, Rosen AB, Ash AS
Enhancing administrative data to predict emergency department utilization: the role of neighborhood sociodemographics.
Much of emergency department (ED) use is avoidable, and high-quality primary care can reduce it, but performance measures related to ED use may be inadequately risk-adjusted. To explore associations between ED use and neighborhood poverty, a secondary analysis of Massachusetts managed care network data, 2009-2011, was conducted.
AHRQ-funded; HS022194.
Citation: Lines LM, Rosen AB, Ash AS .
Enhancing administrative data to predict emergency department utilization: the role of neighborhood sociodemographics.
J Health Care Poor Underserved 2017;28(4):1487-508. doi: 10.1353/hpu.2017.0129..
Keywords: Emergency Department, Low-Income, Social Determinants of Health, Healthcare Utilization
Aalsma MC, Anderson VR, Schwartz K
Preventive care use among justice-involved and non-justice-involved youth.
The objective of this study was to determine how rates of well-child (WC) and emergency department visits, as well as public insurance enrollment continuity, differed between youth involved in the justice system (JIY) and youth who have never been in the system (NJIY). It found that JIY had lower use rates of WC visits and higher use rates of emergency services in comparison with NJIY. JIY had more and longer gaps in Medicaid coverage compared with NJIY.
AHRQ-funded; HS023318.
Citation: Aalsma MC, Anderson VR, Schwartz K .
Preventive care use among justice-involved and non-justice-involved youth.
Pediatrics 2017 Nov;140(5):pii: e20171107. doi: 10.1542/peds.2017-1107.
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Keywords: Children/Adolescents, Emergency Department, Healthcare Utilization, Medicaid
Adam SS, Flahiff CM, Kamble S
Depression, quality of life, and medical resource utilization in sickle cell disease.
Researchers performed an analytic epidemiologic prospective study to determine the prevalence of depression in adult patients with sickle cell disease and its association with health-related quality of life (HRQoL) and medical resource utilization. They found that depression was associated with worse physical and mental HRQoL scores and during the 6 months following diagnosis, mean total health care costs were significantly higher in depressed patients than in nondepressed patients.
AHRQ-funded; HS017645.
Citation: Adam SS, Flahiff CM, Kamble S .
Depression, quality of life, and medical resource utilization in sickle cell disease.
Blood Adv 2017 Oct 12;1(23):1983-92. doi: 10.1182/bloodadvances.2017006940.
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Keywords: Depression, Healthcare Costs, Healthcare Utilization, Quality of Life, Sickle Cell Disease
Bachmann JM, Huang S, Gupta DK
Association of neighborhood socioeconomic context with participation in cardiac rehabilitation.
This study investigated the association of neighborhood socioeconomic context with Cardiac Rehabilitation (CR) participation in the Southern Community Cohort Study- a prospective cohort study of 84 569 adults in the southeastern United States from 2002 to 2009, 52 117 of whom have Medicare or Medicaid claims. The study found that lower neighborhood socioeconomic context was associated with decreased CR participation independent of individual socioeconomic status. These data invite research on interventions to increase CR access in deprived communities.
AHRQ-funded; HS022990.
Citation: Bachmann JM, Huang S, Gupta DK .
Association of neighborhood socioeconomic context with participation in cardiac rehabilitation.
J Am Heart Assoc 2017 Oct 11;6(10). doi: 10.1161/jaha.117.006260..
Keywords: Cardiovascular Conditions, Healthcare Utilization, Patient-Centered Outcomes Research, Rehabilitation, Social Determinants of Health
Keohane LM, Trivedi AN, Mor V
Recent health care use and Medicaid entry of Medicare beneficiaries.
The purpose of this study was to examine the relationship between Medicaid entry and recent health care use among Medicare beneficiaries. Although recent health care use predicted greater likelihood of Medicaid entry, half of new Medicaid participants used no hospital or nursing home care during the study period.
AHRQ-funded; HS023016.
Citation: Keohane LM, Trivedi AN, Mor V .
Recent health care use and Medicaid entry of Medicare beneficiaries.
Gerontologist 2017 Oct 1;57(5):977-86. doi: 10.1093/geront/gnw189..
Keywords: Elderly, Healthcare Utilization, Health Services Research (HSR), Medicaid, Medicare
Schoenbaum M, Sutherland JM, Chappel A
AHRQ Author: Sutherland JM
Twelve-month health care use and mortality in commercially insured young people with incident psychosis in the United States.
This study assessed 12-month mortality and patterns of outpatient and inpatient treatment among young people experiencing an incident episode of psychosis in the United States. The hugely elevated mortality observed, when compared to the general population, underscores that young people experiencing psychosis warrant intensive clinical attention-yet the researchers found low rates of pharmacotherapy and limited use of psychosocial treatment.
AHRQ-authored.
Citation: Schoenbaum M, Sutherland JM, Chappel A .
Twelve-month health care use and mortality in commercially insured young people with incident psychosis in the United States.
Schizophr Bull 2017 Oct;43(6):1262-72. doi: 10.1093/schbul/sbx009.
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Keywords: Healthcare Utilization, Health Insurance, Health Services Research (HSR), Behavioral Health, Young Adults
Ross WT, Meister MR, Shepherd JP
Utilization of apical vaginal support procedures at time of inpatient hysterectomy performed for benign conditions: a national estimate.
The researchers sought to estimate trends and factors associated with use of apical support procedures at time of inpatient hysterectomy for benign indications in a large national database. Their study demonstrated that apical support procedures are not routinely performed at time of inpatient hysterectomy regardless of presence of prolapse diagnosis.
AHRQ-funded; HS019455.
Citation: Ross WT, Meister MR, Shepherd JP .
Utilization of apical vaginal support procedures at time of inpatient hysterectomy performed for benign conditions: a national estimate.
Am J Obstet Gynecol 2017 Oct;217(4):436.e1-36.e8. doi: 10.1016/j.ajog.2017.07.010.
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Keywords: Healthcare Utilization, Practice Patterns, Surgery, Women
Balaban RB, Zhang F, Vialle-Valentin CE
Impact of a patient navigator program on hospital-based and outpatient utilization over 180 days in a safety-net health system.
The objective of this study was to determine the effect of a care transition program using patient navigators (PNs) on health service utilization among high-risk safety-net patients over a 180-day period. The investigators concluded that a PN program serving high-risk safety-net patients differentially impacted patients based on age, and among younger patients, outcomes varied over time. The investigators suggest that their findings highlight the importance for future research to evaluate care transition programs among different subpopulations and over longer time peri
AHRQ-funded; HS020628.
Citation: Balaban RB, Zhang F, Vialle-Valentin CE .
Impact of a patient navigator program on hospital-based and outpatient utilization over 180 days in a safety-net health system.
J Gen Intern Med 2017 Sep;32(9):981-89. doi: 10.1007/s11606-017-4074-2..
Keywords: Care Management, Healthcare Delivery, Healthcare Utilization, Hospital Readmissions, Patient-Centered Healthcare, Transitions of Care
Friedman S, Xu H, Harwood JM
The Mental Health Parity and Addiction Equity Act evaluation study: impact on specialty behavioral healthcare utilization and spending among enrollees with substance use disorders.
The purpose of this study was to determine whether Mental Health Parity and Addiction Equity Act (MHPAEA) was associated with increased behavioral health expenditures and utilization among a population with substance use disorder (SUD) diagnoses. The investigators found that MHPAEA was associated with modest increases in total, plan, and patient out-of-pocket spending and outpatient and inpatient utilization.
AHRQ-funded; HS024866.
Citation: Friedman S, Xu H, Harwood JM .
The Mental Health Parity and Addiction Equity Act evaluation study: impact on specialty behavioral healthcare utilization and spending among enrollees with substance use disorders.
J Subst Abuse Treat 2017 Sep;80:67-78. doi: 10.1016/j.jsat.2017.06.006..
Keywords: Behavioral Health, Healthcare Costs, Healthcare Utilization, Health Insurance, Policy, Health Services Research (HSR), Substance Abuse
Angier H, Hoopes M, Marino M
Uninsured primary care visit disparities under the Affordable Care Act.
The researchers aimed to assess changes in insurance coverage at community health center (CHC) visits after the Patient Protection and Affordable Care Act (ACA) Medicaid expansion by race and ethnicity. After the ACA was implemented, uninsured visit rates decreased for all racial and ethnic groups. Hispanic patients experienced the greatest increases in Medicaid-insured visit rates after ACA implementation in expansion states.
AHRQ-funded; HS024270.
Citation: Angier H, Hoopes M, Marino M .
Uninsured primary care visit disparities under the Affordable Care Act.
Ann Fam Med 2017 Sep;15(5):434-42. doi: 10.1370/afm.2125.
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Keywords: Uninsured, Primary Care, Disparities, Healthcare Utilization, Access to Care
Albrecht JS, Khokhar B, Huang TY
Adherence and healthcare utilization among older adults with COPD and depression.
The researchers quantified the independent effects of adherence to antidepressants and chronic obstructive pulmonary disease (COPD) maintenance medications on healthcare utilization among individuals co-diagnosed with COPD and depression. They found that, compared to no use,higher levels of adherence to COPD maintenance medications were associated with decreased risk of ED visits and hospitalizations. Similarly, higher levels of adherence to antidepressants resulted in decreased risk of ED visits and hospitalization.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Khokhar B, Huang TY .
Adherence and healthcare utilization among older adults with COPD and depression.
Respir Med 2017 Aug;129:53-58. doi: 10.1016/j.rmed.2017.06.002.
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Keywords: Elderly, Healthcare Utilization, Respiratory Conditions, Depression, Patient Adherence/Compliance
Robinson M, Greenhawt M, Stukus DR
Factors associated with epinephrine administration for anaphylaxis in children before arrival to the emergency department.
Researchers evaluated factors associated with anaphylaxis management before arrival at the emergency department (ED) or urgent care center (UCC). Reactions occurring at home were less likely to be treated with epinephrine compared with reactions occurring at school. The odds of receiving epinephrine before arrival at the ED or UCC were significantly lower with a 2-organ system or 3-organ system presentation compared with 1-organ system involvement.
AHRQ-funded; HS024599.
Citation: Robinson M, Greenhawt M, Stukus DR .
Factors associated with epinephrine administration for anaphylaxis in children before arrival to the emergency department.
Ann Allergy Asthma Immunol 2017 Aug;119(2):164-69. doi: 10.1016/j.anai.2017.06.001.
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Keywords: Children/Adolescents, Emergency Medical Services (EMS), Healthcare Utilization, Medication, Patient-Centered Outcomes Research
Flieger SP
Impact of a patient-centered medical home pilot on utilization, quality, and costs and variation in medical homeness.
This study evaluated the impact of a patient-centered medical home (PCMH) pilot on utilization, costs, and quality and assessed variation in PCMH components. There were no statistically significant findings for utilization, cost, or quality in the expected direction. Medical Home Index (MHI) scores suggest variation in type and level of implemented features.
AHRQ-funded; HS021385.
Citation: Flieger SP .
Impact of a patient-centered medical home pilot on utilization, quality, and costs and variation in medical homeness.
J Ambul Care Manage 2017 Jul/Sep;40(3):228-37. doi: 10.1097/jac.0000000000000162.
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Keywords: Patient-Centered Healthcare, Quality of Care, Primary Care, Healthcare Costs, Healthcare Utilization
Gao YN, Nocon RS, Sharma R
What factors are associated with Medicaid patients' use of health centers?.
This study identified patient and neighborhood factors associated with health center (HC) use. Dually eligible patients and those with high chronic disease burden had lower odds of HC use. Temporary Assistance for Needy Families participants and Hispanic beneficiaries had higher odds. Local HC presence predicted higher HC use.
AHRQ-funded; HS000084.
Citation: Gao YN, Nocon RS, Sharma R .
What factors are associated with Medicaid patients' use of health centers?.
J Prim Care Community Health 2017 Jul;8(3):141-46. doi: 10.1177/2150131916687919.
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Keywords: Community-Based Practice, Healthcare Utilization, Medicaid, Primary Care, Social Determinants of Health
Nuckols TK, Fingar KR, Barrett M
AHRQ Author: Steiner CA, Stocks C, Owens PL
The shifting landscape in utilization of inpatient, observation, and emergency department services across payers.
Using data from four states from AHRQ’s Healthcare Cost and Utilization Project, this study compared the payer-specific population-based rates of adults using inpatient, observation, and emergency department (ED) services for 10 common medical conditions in 2009 and in 2013. Inpatient admissions declined, and care shifted toward treat-and-release observation stays and ED visits. The percentage of hospitalizations that began with an observation stay increased.
AHRQ-authored.
Citation: Nuckols TK, Fingar KR, Barrett M .
The shifting landscape in utilization of inpatient, observation, and emergency department services across payers.
J Hosp Med 2017 Jun;12(6):443-46. doi: 10.12788/jhm.2751.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Medical Services (EMS), Healthcare Utilization, Hospitalization, Payment
Morgan DJ, Leppin AL, Smith CD
A practical framework for understanding and reducing medical overuse: conceptualizing overuse through the patient-clinician interaction.
The authors used an iterative, expert-informed, evidence-based process to develop a framework for conceptualizing interventions to reduce medical overuse. Given the complexity of defining and identifying overused care in nuanced clinical situations and the need to define care appropriateness in the context of an individual patient, this framework conceptualizes the patient-clinician interaction as the nexus of decisions regarding inappropriate care.
AHRQ-funded; HS018111.
Citation: Morgan DJ, Leppin AL, Smith CD .
A practical framework for understanding and reducing medical overuse: conceptualizing overuse through the patient-clinician interaction.
J Hosp Med 2017 May;12(5):346-51. doi: 10.12788/jhm.2738.
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Keywords: Decision Making, Healthcare Delivery, Quality of Care, Healthcare Utilization, Clinician-Patient Communication
Westney G, Foreman MG, Xu J
Impact of comorbidities among Medicaid enrollees with chronic obstructive pulmonary disease, United States, 2009.
Researchers quantified the cost of Medicaid-insured patients with chronic obstructive pulmonary disease (COPD) co-diagnosed with other chronic disorders. They concluded that comorbidities markedly increased health services use among people with COPD insured with Medicaid, although ED visits in this study were predominantly unrelated to COPD. Acute care, hospital bed days, and total Medicaid-reimbursed costs increased as the number of comorbidities increased.
AHRQ-funded; HS022444.
Citation: Westney G, Foreman MG, Xu J .
Impact of comorbidities among Medicaid enrollees with chronic obstructive pulmonary disease, United States, 2009.
Prev Chronic Dis 2017 Apr 13;14:E31. doi: 10.5888/pcd14.160333.
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Keywords: Chronic Conditions, Respiratory Conditions, Healthcare Utilization, Medicaid
Martsolf G, Fingar KR, Coffey R
AHRQ Author: Elixhauser A
Association between the opening of retail clinics and low-acuity emergency department visits.
This study assessed whether the opening of retail clinics near emergency departments (ED) is associated with decreased ED utilization for low-acuity conditions. It concluded that with increased patient demand resulting from the expansion of health insurance coverage, retail clinics may emerge as an important care location, but to date, they have not been associated with a meaningful reduction in low-acuity ED visits.
AHRQ-authored; AHRQ-funded.
Citation: Martsolf G, Fingar KR, Coffey R .
Association between the opening of retail clinics and low-acuity emergency department visits.
Ann Emerg Med 2017 Apr;69(4):397-403.e5. doi: 10.1016/j.annemergmed.2016.08.462.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Utilization, Emergency Medical Services (EMS), Health Services Research (HSR), Ambulatory Care and Surgery
Zullo AR, Lee Y, Daiello LA
Beta-blocker use in U.S. Nursing home residents after myocardial infarction: a national study.
This study evaluated how often beta-blockers were started after acute myocardial infarction (AMI) in nursing home (NH) residents who previously did not use these drugs and to evaluate which factors were associated with post-AMI use of beta-blockers. It found that almost half of older NH residents in the United States do not initiate a beta-blocker after AMI.
AHRQ-funded; HS022998.
Citation: Zullo AR, Lee Y, Daiello LA .
Beta-blocker use in U.S. Nursing home residents after myocardial infarction: a national study.
J Am Geriatr Soc 2017 Apr;65(4):754-62. doi: 10.1111/jgs.14671.
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Keywords: Elderly, Healthcare Utilization, Nursing Homes, Heart Disease and Health, Medication
Furuno JP, Noble BN, Bearden DT
Feasibility of retrospective pharmacovigilance studies in hospice care: a case study of antibiotics for the treatment of urinary tract infections.
In this letter to the editor, the authors assert that pharmacovigilance may be useful to improve the evidence base for medication use in hospice care and an efficient alternative to expensive and logistically complicated clinical trials. They discuss the feasibility of retrospective pharmacovigilance studies in hospice care and provide a case study of antibiotics for the treatment of urinary tract infections.
AHRQ-funded; HS023366.
Citation: Furuno JP, Noble BN, Bearden DT .
Feasibility of retrospective pharmacovigilance studies in hospice care: a case study of antibiotics for the treatment of urinary tract infections.
J Palliat Med 2017 Apr;20(4):316-17. doi: 10.1089/jpm.2016.0531..
Keywords: Antibiotics, Evidence-Based Practice, Healthcare Utilization, Medication, Palliative Care, Urinary Tract Infection (UTI)
Mendelson A, Kondo K, Damberg C
The effects of pay-for-performance programs on health, health care use, and processes of care: a systematic review.
This review updated and expanded a prior review examining the effects of P4P programs targeted at the physician, group, managerial, or institutional level on process-of-care and patient outcomes in ambulatory and inpatient settings. It found that pay-for-performance programs may be associated with improved processes of care in ambulatory settings, but consistently positive associations with improved health outcomes have not been demonstrated in any setting.
AHRQ-funded; HS022981.
Citation: Mendelson A, Kondo K, Damberg C .
The effects of pay-for-performance programs on health, health care use, and processes of care: a systematic review.
Ann Intern Med 2017 Mar 7;166(5):341-53. doi: 10.7326/m16-1881.
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Keywords: Payment, Provider Performance, Healthcare Utilization, Quality of Care
Yim CK, Barron Y, Moore S
Hospice enrollment in patients with advanced heart failure decreases acute medical service utilization.
Patients with advanced heart failure (HF) enroll in hospice at low rates, and data on their acute medical service utilization after hospice enrollment is limited. This descriptive analysis of Medicare fee-for-service beneficiaries found that home health care Medicare beneficiaries with advanced HF who enrolled in hospice had lower acute medical service utilization after their enrollment.
AHRQ-funded; HS020257.
Citation: Yim CK, Barron Y, Moore S .
Hospice enrollment in patients with advanced heart failure decreases acute medical service utilization.
Circ Heart Fail 2017 Mar;10(3). doi: 10.1161/circheartfailure.116.003335.
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Keywords: Cardiovascular Conditions, Heart Disease and Health, Healthcare Utilization, Medicare, Palliative Care