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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 14 of 14 Research Studies DisplayedDecker S, Dworsky M, Gibson TB
AHRQ Author: Decker S
The Impact of the Affordable Care Act Insurance Expansions on Opioid-Related Emergency Department Visits.
The authors leveraged ACA coverage expansions, including Medicaid expansion and Marketplaces, to study the impact of health insurance on opioid-related emergency department (ED) visits. They used ZIP-code–level ED utilization data from HCUP’s State Inpatient Databases (SID) and State Emergency Department Databases (SEDD) for 29 states. They found evidence of a dose-response relationship between pre-ACA uninsured and changes in ED visit rates in both expansion and non-expansion states: areas with higher uninsured rates prior to ACA saw larger reductions in opioid-related ED visits after the ACA took effect. The authors concluded that these findings suggest that increased insurance coverage may to help mitigate the opioid crisis.
AHRQ-authored.
Citation: Decker S, Dworsky M, Gibson TB .
The Impact of the Affordable Care Act Insurance Expansions on Opioid-Related Emergency Department Visits.
American Journal of Health Economics 2023 Sum; 9(3):405–34..
Keywords: Healthcare Cost and Utilization Project (HCUP), Opioids, Policy, Health Insurance, Emergency Department, Access to Care, Medicaid, Healthcare Utilization
Boudreaux M, Gangopadhyaya A, Long SK
AHRQ Author: Karaca Z
Using data from the Healthcare Cost and Utilization Project for state health policy research.
Investigators describe the opportunities and challenges of using HCUP data to conduct state health policy research and to provide empirical examples of what can go wrong when using the national HCUP data inappropriately. Analyzing cesarean delivery rates, discharges per capita, and discharges by the payer, they found that state-level estimates are volatile and often provide misleading policy conclusions. They conclude that the Nationwide Inpatient Sample should not be used for state-level research and specified that AHRQ provides resources to assist analysts with state-specific studies using State Inpatient Database files.
AHRQ-authored.
Citation: Boudreaux M, Gangopadhyaya A, Long SK .
Using data from the Healthcare Cost and Utilization Project for state health policy research.
Med Care 2019 Nov;57(11):855-60. doi: 10.1097/mlr.0000000000001196..
Keywords: Healthcare Cost and Utilization Project (HCUP), Policy, Health Services Research (HSR), Healthcare Costs, Data, Research Methodologies
Pickens G, Karaca Z, Gibson TB
AHRQ Author: Karaca Z, Wong HS
Changes in hospital service demand, cost, and patient illness severity following health reform.
This study examined the effects of expanded Medicaid coverage and the health insurance exchange on the number of hospital inpatient and emergency department (ED) utilization rates, cost, and patient illness severity. There was a significant drop in uninsured inpatient discharges and ED visits in states where Medicaid was expanded. For all by young females, uninsured inpatient discharge rates fell by 39% or greater. In nonexpansion states, the rates remained unchanged or increased slightly. Changes in all-payer and private insurance rates were not as dramatic, as was inpatient costs per discharge and all-payer inpatient costs.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Pickens G, Karaca Z, Gibson TB .
Changes in hospital service demand, cost, and patient illness severity following health reform.
Health Serv Res 2019 Aug;54(4):739-51. doi: 10.1111/1475-6773.13165..
Keywords: Access to Care, Health Insurance, Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Healthcare Utilization, Hospitals, Medicaid, Policy, Uninsured
Kahn JM, Davis BS, Yabes JG
Association between state-mandated protocolized sepsis care and in-hospital mortality among adults with sepsis.
The purpose of this study was to evaluate the association between New York State sepsis regulations and the outcomes of patients hospitalized with sepsis. Results showed that, in New York State, mandated protocolized sepsis care was associated with a greater decrease in sepsis mortality compared with sepsis mortality in control states (Florida, Maryland, Massachusetts, and New Jersey) that did not implement sepsis regulations. The authors add that, because baseline mortality rates differ between New York and the comparison states, it is uncertain whether these findings will be generalizable to other states.
AHRQ-funded; HS025146.
Citation: Kahn JM, Davis BS, Yabes JG .
Association between state-mandated protocolized sepsis care and in-hospital mortality among adults with sepsis.
JAMA 2019 Jul 16;322(3):240-50. doi: 10.1001/jama.2019.9021..
Keywords: Guidelines, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Mortality, Outcomes, Policy, Sepsis
Delling FN, Vittinghoff E, Dewland TA
Does cannabis legalisation change healthcare utilisation? A population-based study using the healthcare cost and utilisation project in Colorado, USA.
Researchers studied whether the legalization of cannabis in Colorado has affected healthcare utilization compared to two states where it is still illegal (New York and Oklahoma). ICD-9 was used to determine changes in healthcare utilization relative to various medical diagnoses. According to the National Academy of Science (NAS), legal cannabis use creates an increase in cannabis abuse hospitalizations and also linked to motor vehicle accidents, alcohol abuse, and overdose injury and that was true in CO. There was not a change in hospital stays and costs in CO compared to NY and OK.
AHRQ-funded.
Citation: Delling FN, Vittinghoff E, Dewland TA .
Does cannabis legalisation change healthcare utilisation? A population-based study using the healthcare cost and utilisation project in Colorado, USA.
BMJ Open 2019 May 15;9(5):e027432. doi: 10.1136/bmjopen-2018-027432..
Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Healthcare Utilization, Policy, Substance Abuse
Coupet E, Karp D, Wiebe DJ
Shift in U.S. payer responsibility for the acute care of violent injuries after the Affordable Care Act: Implications for prevention.
In this study, the investigators determined the total annual charges for the acute care of injuries from interpersonal violence and the shift in financial responsibility for these charges after the Medicaid expansion from the Affordable Care Act in 2014. After Medicaid expansion, taxpayers are now accountable for nearly half of the $10.7 billion in annual charges for the acute care of violent injury in the U.S. The investigators suggest that these findings highlight the benefit to state Medicaid programs of preventing interpersonal violence.
AHRQ-funded; HS000028.
Citation: Coupet E, Karp D, Wiebe DJ .
Shift in U.S. payer responsibility for the acute care of violent injuries after the Affordable Care Act: Implications for prevention.
Am J Emerg Med 2018 Dec;36(12):2192-96. doi: 10.1016/j.ajem.2018.03.070..
Keywords: Domestic Violence, Emergency Department, Healthcare Costs, Policy, Healthcare Cost and Utilization Project (HCUP), Medicaid
Angraal S, Khera R, Zhou S
Trends in 30-day readmission rates for Medicare and non-Medicare patients in the era of the Affordable Care Act.
In this study the investigators we assessed trends in all-cause readmission rates for 1 of the 3 HRRP conditions or conditions not targeted by the HRRP in age-insurance groups defined by age group (>/=65 years or <65 years) and payer (Medicare, Medicaid, or private insurance). The investigators concluded that there appeared to be a systematic improvement in readmission rates for patient groups beyond the population of fee-for-service, older, Medicare beneficiaries included in the HRRP.
AHRQ-funded; HS022882.
Citation: Angraal S, Khera R, Zhou S .
Trends in 30-day readmission rates for Medicare and non-Medicare patients in the era of the Affordable Care Act.
Am J Med 2018 Nov;131(11):1324-31.e14. doi: 10.1016/j.amjmed.2018.06.013..
Keywords: Policy, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Medicaid, Medicare
Wu VY, Fingar KR, Jiang HJ
AHRQ Author: Jiang HJ
Early impact of the Affordable Care Act coverage expansion on safety-net hospital inpatient payer mix and market shares.
The purpose of the study was to examine the impact of the Affordable Care Act's coverage expansion on safety-net hospitals (SNHs). The investigators concluded that postexpansion, non-SNHs experienced a greater percentage increase in Medicaid stays than did SNHs, which may reflect patients choosing non-SNHs over SNHs or a crowd-out of private insurance.
AHRQ-authored; AHRQ-funded; 290201300002.
Citation: Wu VY, Fingar KR, Jiang HJ .
Early impact of the Affordable Care Act coverage expansion on safety-net hospital inpatient payer mix and market shares.
Health Serv Res 2018 Oct;53(5):3617-39. doi: 10.1111/1475-6773.12812..
Keywords: Policy, Healthcare Cost and Utilization Project (HCUP), Hospitals, Medicaid
Pickens G, Karaca Z, Cutler E
AHRQ Author: Karaca Z, Wong HS
Changes in hospital inpatient utilization following health care reform.
The purpose of this retrospective study was to estimate the effects of 2014 Medicaid expansions on inpatient outcomes using population and unemployment data from HCUP’s State Inpatient Databases. Outcomes included total admissions, referral-sensitive surgical and preventable admissions, length of stay, cost, and severity of patient illness. The authors conclude that Medicaid expansions did not change all-payer admission volumes, but expansions were associated with increased Medicaid and decreased uninsured volumes. The results of the study suggest that previously uninsured persons with a greater need for inpatient services were the most likely to gain coverage.
AHRQ-authored; AHRQ-funded.
Citation: Pickens G, Karaca Z, Cutler E .
Changes in hospital inpatient utilization following health care reform.
Health Serv Res 2018 Jun 30;53(4):2446-69. doi: 10.1111/1475-6773.12734..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Inpatient Care, Medicaid, Policy
Henke RM, Karaca Z, Gibson TB
AHRQ Author: Karaca Z, Wong HS
Medicare Advantage penetration and hospital costs before and after the Affordable Care Act.
This study investigated the relationship between Medicare Advantage (MA) program growth and inpatient hospital costs and utilization before and after the ACA. Its results suggest that MA enrollment growth is associated with diminished spillover reductions in hospital admission costs after the ACA. Researchers did not observe a strong relationship between MA enrollment and inpatient days per enrollee
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Henke RM, Karaca Z, Gibson TB .
Medicare Advantage penetration and hospital costs before and after the Affordable Care Act.
Med Care 2018 Apr;56(4):321-28. doi: 10.1097/mlr.0000000000000885.
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Keywords: Healthcare Costs, Policy, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Medicare
Agimi Y, Albert SM, Youk AO
AHRQ Author: Steiner CA
Dementia and motor vehicle crash hospitalizations: role of physician reporting laws.
This study sought to determine the effect of physician reporting laws and state licensing requirements on crash hospitalizations among drivers with dementia. It concluded that physician reporting laws, mandated or legally protected, were not associated with a lower likelihood of dementia among crash hospitalized drivers. Vision testing at in-person renewal and in-person renewal requirements were significantly related with a lower prevalence of dementia in hospitalized older drivers.
AHRQ-authored.
Citation: Agimi Y, Albert SM, Youk AO .
Dementia and motor vehicle crash hospitalizations: role of physician reporting laws.
Neurology 2018 Feb 27;90(9):e808-e13. doi: 10.1212/wnl.0000000000005022.
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Keywords: Dementia, Elderly, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Policy
Hellinger FJ
AHRQ Author: Hellinger FJ
In four ACA expansion states, the percentage of uninsured hospitalizations for people with HIV declined, 2012-14.
This study examines the influence of the Affordable Care Act's optional state Medicaid expansion on insurance coverage and health outcomes for hospitalized patients with HIV. It found that the percentage of hospitalizations of uninsured people with HIV in the four expansion states fell from 13.7 percent to 5.5 percent in the study period, while the percentage in the two nonexpanding states increased from 14.5 percent to 15.7 percent.
AHRQ-authored.
Citation: Hellinger FJ .
In four ACA expansion states, the percentage of uninsured hospitalizations for people with HIV declined, 2012-14.
Health Aff 2015 Dec;34(12):2061-8. doi: 10.1377/hlthaff.2015.0718..
Keywords: Policy, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Human Immunodeficiency Virus (HIV), Medicaid, Uninsured
Ellimoottil C, Miller S, Davis M
Insurance expansion and the utilization of inpatient surgery: evidence for a "Woodwork" effect?
The researchers examined rates of elective surgery in previously insured individuals before and after Massachusetts health care reform. They observed no increase in the overall rate of selected discretionary inpatient surgeries in Massachusetts versus control states for the entire population , as well as among the white and low-income subgroups.
AHRQ-funded; HS018346.
Citation: Ellimoottil C, Miller S, Davis M .
Insurance expansion and the utilization of inpatient surgery: evidence for a "Woodwork" effect?
Surg Innov 2015 Dec;22(6):588-92. doi: 10.1177/1553350615573579.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Health Insurance, Policy, Hospitalization
Hernandez-Boussard T, Burns CS, Wang NE
The Affordable Care Act reduces emergency department use by young adults: evidence from three States.
The authors tested the impact of the Affordable Care Act (ACA) on how young adults used ED services. They found that the largest relative decreases were found in women and blacks. This relative decrease in ED use implies a total reduction of more than 60,000 visits from young adults across three states in 2011.
AHRQ-funded; HS018558.
Citation: Hernandez-Boussard T, Burns CS, Wang NE .
The Affordable Care Act reduces emergency department use by young adults: evidence from three States.
Health Aff 2014 Sep;33(9):1648-54. doi: 10.1377/hlthaff.2014.0103.
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Keywords: Emergency Department, Health Insurance, Policy, Healthcare Cost and Utilization Project (HCUP), Young Adults