National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
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- Access to Care (2)
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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 9 of 9 Research Studies DisplayedChambers EC, Heller C, Fiori K
Chronic pediatric health conditions among youth living in public housing and receiving care in a large hospital system in Bronx, NY.
This study compared the prevalence of chronic pediatric health conditions for youth in public housing with youth not in public housing using clinical electronic health record (EHR) and housing data. Findings showed that disparities in health conditions among youth in public housing were more common in early adolescence: asthma, obesity, depression/anxiety, and behavioral disorders. Chronic pediatric conditions like asthma and obesity that lead to significant morbidity into adulthood are more common among youth living in public housing; however, this pattern is not consistent across all chronic conditions.
AHRQ-funded; HS026396.
Citation: Chambers EC, Heller C, Fiori K .
Chronic pediatric health conditions among youth living in public housing and receiving care in a large hospital system in Bronx, NY.
Glob Pediatr Health 2020 Nov 11;7:2333794x20971164. doi: 10.1177/2333794x20971164..
Keywords: Children/Adolescents, Vulnerable Populations, Chronic Conditions, Urban Health
Rosenberg J, Rosenthal MS, Cramer LD
Disparities in mental and behavioral health treatment for children and youth in immigrant families.
Children and youth in immigrant families (CIF)-children and youth with at least one foreign-born parent-face unique psychosocial stressors. Yet little is known about access to mental/behavioral health (MBH) services for CIF. Among US CIF and non-CIF with MBH problems, the authors assessed access to MBH treatment using the National Survey of Children's Health-2016, a nationally-representative survey of predominantly English- or Spanish-speaking US parents.
AHRQ-funded; HS024332.
Citation: Rosenberg J, Rosenthal MS, Cramer LD .
Disparities in mental and behavioral health treatment for children and youth in immigrant families.
Acad Pediatr 2020 Nov-Dec;20(8):1148-56. doi: 10.1016/j.acap.2020.06.013..
Keywords: Children/Adolescents, Behavioral Health, Disparities, Racial and Ethnic Minorities, Vulnerable Populations, Access to Care
Dir AL, Clifton RL
Patterns of drug screen results and court-ordered substance use treatment referrals and completion among justice-involved youth
This study examined court records of drug screens among youth to explore patterns of substance use as well as rates of court-ordered referral to substance use treatment and treatment completion. Of the studied youth with a positive oral drug screen, 96% tested positive for cannabis and 9.8% for opioids at least once; 48.5% were court-ordered to substance use treatment. Of those referred, 67% had history of completing at least one treatment episode. These results underscore the need to utilize objective measures as well as validated self-reports of substance use history in both research and justice system decision-making to aid in identifying youth in need of services.
AHRQ-funded; HS022681; HS023318.
Citation: Dir AL, Clifton RL .
Patterns of drug screen results and court-ordered substance use treatment referrals and completion among justice-involved youth
J Subst Abuse Treat 2020 Nov;118:108095. doi: 10.1016/j.jsat.2020.108095..
Keywords: Children/Adolescents, Substance Abuse, Screening, Vulnerable Populations
Magee LA, Dir AL, Clifton RL
Patterns of adolescent gun carrying and gun-related crime arrests in Indianapolis, Indiana over an 11-year time period.
This study is a descriptive epidemiology analysis that examines patterns of gun carrying and gun-related crime arrests among justice-involved youth in Marion County, Indiana. Findings indicated that the proportions of juvenile arrests for both gun carrying and gun-related crime have substantially increased compared to ten years ago. The majority of gun-related repeat offenders were first arrested for gun carrying; thus, these gun-carrying arrests may be an opportunity to intervene on an individual level by providing treatment, other needed resources, and discussing safe firearm storage with families and communities.
AHRQ-funded; HS023318; HS022681.
Citation: Magee LA, Dir AL, Clifton RL .
Patterns of adolescent gun carrying and gun-related crime arrests in Indianapolis, Indiana over an 11-year time period.
Prev Med 2020 Oct;139:106199. doi: 10.1016/j.ypmed.2020.106199..
Keywords: Children/Adolescents, Vulnerable Populations, Prevention
Chaiyachati BH, Wood JN, Mitra N
All-cause mortality among children in the US foster care system, 2003-2016.
This letter provides data from a cross-sectional analysis of the Adoption and Foster Care Analysis and Reporting System on mortality rates among children in the US foster care system compared to the general population. The rate was found to be significantly higher for children in foster care (35.4 deaths per 100,000 person-years vs 25.0 for the general population). The highest mortality rates were among African-American children at 43.8 deaths per 100,000 person-years. Older children ages 15-18 had the highest mortality rate per years. Two major limitations of the analysis are that children in foster care are unable to be excluded from the Centers for Disease Control and Prevention data file, and more deaths in foster care were excluded relative to person-years in foster care because of incomplete demographic data.
AHRQ-funded; HS026372.
Citation: Chaiyachati BH, Wood JN, Mitra N .
All-cause mortality among children in the US foster care system, 2003-2016.
JAMA Pediatr 2020 Sep;174(9):896-98. doi: 10.1001/jamapediatrics.2020.0715..
Keywords: Children/Adolescents, Vulnerable Populations, Mortality
Wisk LE, Magane KM, Levy S
Alcohol use behaviors and reasons to abstain from or limit drinking among medically vulnerable youth.
Youth with chronic medical conditions (YCMC) use alcohol at levels similar to their healthy peers but face elevated risk for adverse health consequences. As salient reasons to abstain from or limit drinking (RALD) among YCMC are unknown, the investigators sought to identify clusters of RALD and test associations with use behaviors. The investigators concluded that for YCMC, RALD were complex but endorsement of multiple general and health-related RALD was associated with less use, and health concerns are especially prevalent.
AHRQ-funded; HS022986.
Citation: Wisk LE, Magane KM, Levy S .
Alcohol use behaviors and reasons to abstain from or limit drinking among medically vulnerable youth.
J Addict Med 2020 Jul/Aug;14(4):311-18. doi: 10.1097/adm.0000000000000603..
Keywords: Children/Adolescents, Alcohol Use, Behavioral Health, Vulnerable Populations, Substance Abuse
Luk JW, Parker EO, Richardson LP
Sexual attraction and experiences in the primary care setting: examining disparities in satisfaction with provider and health self-efficacy.
This study examines whether sexual minority adolescents report lower satisfaction with primary care providers and lower health self-efficacy compared to heterosexual males and females. Data from 535 adolescents who participated in one of two randomized clinical trials were analyzed. Both sets of adolescents reported high satisfaction with providers. Relative to heterosexual males, sexual minority males reported lower self-efficacy in reaching health goals. Sexual minority females reported lower confidence in positively impacting their own health and lower self-efficacy in setting health goals compared to heterosexual females.
AHRQ-funded; HS023383.
Citation: Luk JW, Parker EO, Richardson LP .
Sexual attraction and experiences in the primary care setting: examining disparities in satisfaction with provider and health self-efficacy.
J Adolesc 2020 Jun;81:96-100. doi: 10.1016/j.adolescence.2020.04.009..
Keywords: Children/Adolescents, Patient Experience, Primary Care, Clinician-Patient Communication, Vulnerable Populations, Disparities
Desai AD, Zhou C, Haaland W
Social disadvantage, access to care, and disparities in physical functioning among children hospitalized with respiratory illness.
This study examined associations between social disadvantage, access to care, and disparities in physical functioning among children hospitalized with acute respiratory illness. The study cohort included children ages 8-16 years and/or caregivers of children 2 weeks to 16 years admitted to five tertiary care children’s hospitals for three common respiratory illnesses from July 2014 through June 2016. Surveys were completed within 2 to 8 weeks after discharge. The survey assessed social disadvantage, difficulty/delays accessing care, and baseline and follow-up health-related quality of life (HRQoL), and physical functioning using the Pediatric Quality of Life Inventory (PedsQL). A total of 1,325 patients and/or their caregivers completed both PedsQL surveys. Adjusted mean baseline PedsQL scores were significantly lower for patients with social disadvantage (minority race/ethnicity, limited English proficiency, low education, and low income), than for patients with none. There were also disadvantage markers or difficulty/delays accessing care which were associated with lower physical functioning. However, these differences were reduced after hospital discharge.
AHRQ-funded; HS024299.
Citation: Desai AD, Zhou C, Haaland W .
Social disadvantage, access to care, and disparities in physical functioning among children hospitalized with respiratory illness.
J Hosp Med 2020 Apr;15(4):211-18. doi: 10.12788/jhm.3359..
Keywords: Children/Adolescents, Respiratory Conditions, Hospitalization, Access to Care, Disparities, Vulnerable Populations, Quality of Life
Mackie TI, Cook S, Crystal S
Antipsychotic use among youth in foster care enrolled in a specialized managed care organization intervention.
This study examined a multimodal antipsychotic intervention implemented by a specialized Medicaid managed care organization (MMCO) for youths in foster care with routine mental health screening, health passports, elective psychiatric consultation line, and retrospective drug utilization reviews to determine whether this multimodal intervention significantly reduced antipsychotic dispensing for youths with conditions without US Food and Drug Administration (FDA)-approved indications. Findings showed that MMCO implementation significantly reduced antipsychotic medications without FDA-indicated conditions prescribed to youths, while not significantly affecting antipsychotic medications prescribed to youths with FDA-indicated conditions.
AHRQ-funded; HS026001.
Citation: Mackie TI, Cook S, Crystal S .
Antipsychotic use among youth in foster care enrolled in a specialized managed care organization intervention.
J Am Acad Child Adolesc Psychiatry 2020 Jan;59(1):166-76.e3. doi: 10.1016/j.jaac.2019.04.022..
Keywords: Children/Adolescents, Behavioral Health, Medication, Vulnerable Populations, Medicaid, Health Insurance