National Healthcare Quality and Disparities Report
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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 21 of 21 Research Studies DisplayedMoriya AS, Chakravarty S
AHRQ Author: Moriya AS
Racial and ethnic disparities in preventable hospitalizations and ED visits five years after ACA Medicaid expansions,.
This AHRQ-authored paper examined whether the 2014 Affordable Care Act (ACA) Medicaid expansions mitigated existing racial or ethnic disparities in preventable hospitalizations and emergency department (ED) visits. The authors used inpatient data from twenty-nine states and ED data from twenty-six states for the period 2011 to 2018. They found that Medicaid expansions decreased disparities in preventable hospitalizations and ED visits between non-Hispanic Black and White nonelderly adults by 10 percent or more. There were no significant effects on disparities between Hispanic and non-Hispanic White nonelderly adults. Their findings highlight sustained improvements in community-level care for non-Hispanic Black populations, but also suggest access barriers experienced by Hispanic adults that need to be addressed beyond Medicaid eligibility expansion.
AHRQ-authored.
Citation: Moriya AS, Chakravarty S .
Racial and ethnic disparities in preventable hospitalizations and ED visits five years after ACA Medicaid expansions,.
Health Aff 2023 Jan; 42(1):26-34. doi: 10.1377/hlthaff.2022.00460..
Keywords: Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Emergency Department, Hospitalization, Disparities, Medicaid, Health Insurance, Access to Care
Halvorson EE, Thurtle DP, Easter A
Disparities in adverse event reporting for hospitalized children.
The authors compared the adverse event (AE) rate identified by voluntary event reporting (VER) with that identified using the Global Assessment of Pediatric Patient Safety (GAPPS) between hospitalized children by weight category, race, and English proficiency. In the population studied, they identified 288 total AEs, 270 by the GAPPS and 18 by VER. They found a disparity in AE reporting for children with limited English proficiency, with fewer AEs by VER compared with no difference in AEs by GAPPS. They identified no disparities by weight category or race. They concluded that voluntary event reporting may systematically underreport AEs in hospitalized children with limited English proficiency.
AHRQ-funded; HS026038.
Citation: Halvorson EE, Thurtle DP, Easter A .
Disparities in adverse event reporting for hospitalized children.
J Patient Saf 2022 Sep 1;18(6):e928-e33. doi: 10.1097/pts.0000000000001049..
Keywords: Children/Adolescents, Disparities, Adverse Events, Medical Errors, Patient Safety, Hospitals, Hospitalization, Inpatient Care
Song Zhang, Zhang X, Patterson LJ
Racial and ethnic disparities in hospitalization outcomes among Medicare beneficiaries during the COVID-19 pandemic.
This study assessed assess racial and ethnic differences in hospitalization outcomes during the COVID-19 pandemic among Medicare beneficiaries. Medicare claims from the Social Security Administration was used to determine in-hospital mortality and mortality inclusive of discharges to hospice and discharges to postacute care. Over 31 million Medicare recipients in the database were analyzed with over 14 million hospitalizations from January 2019 to February 2021. There was a decline in non-COVID-19 and an emergence of COVID-19 hospitalizations among beneficiaries of different racial and ethnic minority groups through February 2021. In-hospital mortality was not significantly different among Black patients relative to White patients but was 3.5 percentage points higher among Hispanic patients and other racial and ethnic minority groups. There were disparities in discharges to hospice and postacute care as well.
AHRQ-funded; HS024072.
Citation: Song Zhang, Zhang X, Patterson LJ .
Racial and ethnic disparities in hospitalization outcomes among Medicare beneficiaries during the COVID-19 pandemic.
JAMA Health Forum 2021 Dec 23;2(12):e214223. doi: 10.1001/jamahealthforum.2021.4223..
Keywords: COVID-19, Racial and Ethnic Minorities, Disparities, Medicare, Hospitalization, Outcomes, Mortality
Ingraham NE, Purcell LN, Karam BS
Racial and ethnic disparities in hospital admissions from COVID-19: determining the impact of neighborhood deprivation and primary language.
This retrospective cohort study evaluated neighborhood-level deprivation and English language proficiency effects on disproportionate outcomes seen in racial and ethnic minorities diagnosed with COVID-19. Health records of 12 Midwest hospitals and 60 clinics in Minnesota between March 4 and August 19, 2020 were used. COVID-19 hospitalization rates were evaluated against the patient’s Area Deprivation Index (ADI) and primary language. A total of 5577 individuals were included, with 866 hospitalized within 45 days of diagnosis. Hospitalized patients were older, and more likely to be male. Minority/race ethnicity was associated with COVID-19 severity, but ADI was not associated with increased hospitalization. Non-English speaking significantly increased odds of hospital admission across and within minority groups.
AHRQ-funded; HS024532; HS26732; HS026379.
Citation: Ingraham NE, Purcell LN, Karam BS .
Racial and ethnic disparities in hospital admissions from COVID-19: determining the impact of neighborhood deprivation and primary language.
J Gen Intern Med 2021 Nov;36(11):3462-70. doi: 10.1007/s11606-021-06790-w..
Keywords: COVID-19, Hospitalization, Racial and Ethnic Minorities, Disparities
Dixon BE, Grannis SJ, Lembcke LR
The synchronicity of COVID-19 disparities: statewide epidemiologic trends in SARS-CoV-2 morbidity, hospitalization, and mortality among racial minorities and in rural America.
Researchers sought to examine trends in COVID-19 morbidity, hospitalization, and mortality over time for minority and rural populations, especially during the U.S. fall surge. Data were taken from a statewide cohort of adult residents in Indiana tested for SARS-CoV-2 infection. The researchers found that, by the fall of 2020, hospitalization and mortality rates in rural areas surpassed those of urban areas, and gaps between black/brown and white populations narrowed. Cumulative morbidity and mortality were highest among minority groups and in rural communities. They concluded that the synchronicity of disparities in COVID-19 by race and geography suggested that health officials explicitly measure disparities and adjust mitigation as well as vaccination strategies to protect those sub-populations with greater disease burden.
AHRQ-funded; HS025502.
Citation: Dixon BE, Grannis SJ, Lembcke LR .
The synchronicity of COVID-19 disparities: statewide epidemiologic trends in SARS-CoV-2 morbidity, hospitalization, and mortality among racial minorities and in rural America.
PLoS One 2021 Jul 23;16(7):e0255063. doi: 10.1371/journal.pone.0255063..
Keywords: COVID-19, Disparities, Racial and Ethnic Minorities, Hospitalization, Mortality, Rural Health
Kim JH, Fine DR, Li L
Disparities in United States hospitalizations for serious infections in patients with and without opioid use disorder: a nationwide observational study.
This study examined the differences in patients with and without opioid use disorder (OUD) who were hospitalized for serious infections focusing on infective endocarditis, epidural abscess, septic arthritis or osteomyelitis. The authors used the 2016 National Inpatient Sample to examine differences in length of stay (LOS), discharge disposition, and charges. Patients with OUD had a lower probability of discharge at any given LOS, and lower odds of discharge to home with higher odds of discharge to a post-acute care facility. There were no significant differences in average total hospital charges.
AHRQ-funded; HS026215.
Citation: Kim JH, Fine DR, Li L .
Disparities in United States hospitalizations for serious infections in patients with and without opioid use disorder: a nationwide observational study.
PLoS Med 2020 Aug;17(8):e1003247. doi: 10.1371/ournal.pmed.1003247.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Opioids, Substance Abuse, Hospitalization, Medication, Infectious Diseases
Walker DM, Hefner JL, Fareed N
Exploring the digital divide: age and race disparities in use of an inpatient portal.
Age and race disparities in the use of new technologies-the digital divide-may be limiting the potential of patient-facing health information technology to improve health and health care. The objective of this study was to investigate whether disparities exist in the use of patient portals designed specifically for the inpatient environment. The investigators identified lower use of the inpatient portal among African American and older patients, relative to White and younger patients, respectively.
AHRQ-funded; HS024379; HS024091; HS024349.
Citation: Walker DM, Hefner JL, Fareed N .
Exploring the digital divide: age and race disparities in use of an inpatient portal.
Telemed J E Health 2020 May;26(5):603-13. doi: 10.1089/tmj.2019.0065..
Keywords: Racial and Ethnic Minorities, Disparities, Health Information Technology (HIT), Inpatient Care, Hospitalization
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
Phillips AZ, Rodriguez HP
Adults with diabetes residing in "food swamps" have higher hospitalization rates.
This study examined the relationship between ‘food swamps’ and hospitalization rates among adults with diabetes. Food Swamps are defined and measured by a ratio of fast food outlets to grocery stores within a given area. Data resources for this study included the Blue Cross Blue Shield Association Community Health Management Hub(R), AHRQ’s Health Care Cost and Utilization Project State Inpatient Databases, and HHS’s Area Health Resources File. The study concludes that higher hospitalization rates among adults with diabetes are significantly associated with food swamps, more so in rural than urban communities, and that improvements to local food environments may help to reduce this disparity.
AHRQ-funded; HS022241.
Citation: Phillips AZ, Rodriguez HP .
Adults with diabetes residing in "food swamps" have higher hospitalization rates.
Health Serv Res 2019 Feb;54(Suppl 1):217-25. doi: 10.1111/1475-6773.13102..
Keywords: Chronic Conditions, Diabetes, Disparities, Nutrition, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Social Determinants of Health
Stockwell DC, Landrigan CP, Toomey SL
Racial, ethnic, and socioeconomic disparities in patient safety events for hospitalized children.
Previous studies have revealed racial/ethnic and socioeconomic disparities in quality of care and patient safety. However, these disparities have not been examined in a pediatric inpatient environment by using a measure of clinically confirmed adverse events (AEs). In this study, the investigators do so using the Global Assessment of Pediatric Patient Safety (GAPPS) Trigger Tool. The investigators concluded that the GAPPS analysis revealed racial and/or ethnic and socioeconomic disparities in rates of AEs experienced by hospitalized children across a broad range of geographic and hospital settings.
AHRQ-funded; HS020513; HS025299.
Citation: Stockwell DC, Landrigan CP, Toomey SL .
Racial, ethnic, and socioeconomic disparities in patient safety events for hospitalized children.
Hosp Pediatr 2019 Jan;9(1):1-5. doi: 10.1542/hpeds.2018-0131..
Keywords: Children/Adolescents, Disparities, Racial and Ethnic Minorities, Social Determinants of Health, Hospitalization, Patient Safety, Quality of Care, Adverse Events
Wahl TS, Goss LE, Morris MS
Enhanced Recovery After Surgery (ERAS) eliminates racial disparities in postoperative length of stay after colorectal surgery.
The purpose of this study was to investigate the effects of enhanced recovery after surgery (ERAS) on racial disparities in postoperative length of stay (pLOS) after colorectal surgery. The authors hypothesized that ERAS would reduce disparities in pLOS between black and white patients. They concluded that ERAS eliminated racial differences in pLOS between black and white patients undergoing colorectal surgery. Reduced pLOS occurred without increases in mortality, readmissions, and most postoperative complications.
AHRQ-funded; HS013852.
Citation: Wahl TS, Goss LE, Morris MS .
Enhanced Recovery After Surgery (ERAS) eliminates racial disparities in postoperative length of stay after colorectal surgery.
Ann Surg 2018 Dec;268(6):1026-35. doi: 10.1097/sla.0000000000002307..
Keywords: Surgery, Racial and Ethnic Minorities, Disparities, Care Management, Healthcare Delivery, Hospitalization, Patient-Centered Outcomes Research, Outcomes
Gounder PP, Holman RC, Seeman SM
AHRQ Author: Steiner CA
Infectious disease hospitalizations among American Indian/Alaska native and non-American Indian/Alaska native persons in Alaska, 2010-2011.
The researchers used a merged state database to determine infectious disease (ID) hospitalization rates among American Indian/Alaska native (AI/AN) and non-American Indian/Alaska native persons in Alaska. They concluded that a substantial disparity in ID hospitalization rates exists between AI/AN and non-AI/AN persons, and the most common reason for ID hospitalization among AI/AN persons was lower respiratory tract infection.
AHRQ-authored.
Citation: Gounder PP, Holman RC, Seeman SM .
Infectious disease hospitalizations among American Indian/Alaska native and non-American Indian/Alaska native persons in Alaska, 2010-2011.
Public Health Rep 2017 Jan/Feb;132(1):65-75. doi: 10.1177/0033354916679807.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Hospitalization, Disparities, Racial and Ethnic Minorities
Just E, Casarett DJ, Asch DA
Differences in terminal hospitalization care between U.S. men and women.
The authors sought to determine whether men and women receive different care during terminal hospitalizations by examining sex-based differences in lengths of stay, resuscitation status, and intensive interventions and processes of care. They found that. compared with men, women had slightly shorter hospitalizations and were more likely to have a do-not-resuscitate order. Women remained less likely to receive care in an intensive care unit, cardiopulmonary resuscitation, mechanical ventilation, hemodialysis, or surgical procedures. The researchers concluded that men who die in hospitals receive more aggressive care than women.
AHRQ-funded; HS018425.
Citation: Just E, Casarett DJ, Asch DA .
Differences in terminal hospitalization care between U.S. men and women.
J Pain Symptom Manage 2016 Aug;52(2):205-11. doi: 10.1016/j.jpainsymman.2016.01.013.
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Keywords: Disparities, Palliative Care, Hospitalization, Sex Factors, Elderly
Hsu D, Brieva J, Silverberg JI
Costs of care for hospitalization for pemphigus in the United States.
The purpose of this study was to determine the incidence of and risk factors for hospitalization with pemphigus and cost of care. It concluded that there is a significant inpatient burden for pemphigus in the United States. Moreover, there appear to be racial/ethnic and health care disparities with respect to pemphigus, such that poor, nonwhite, and/or uninsured or underinsured patients have higher odds of hospitalization.
AHRQ-funded; HS023011.
Citation: Hsu D, Brieva J, Silverberg JI .
Costs of care for hospitalization for pemphigus in the United States.
JAMA Dermatol 2016 Jun;152(6):645-54. doi: 10.1001/jamadermatol.2015.5240..
Keywords: Healthcare Costs, Hospitalization, Disparities, Healthcare Cost and Utilization Project (HCUP), Risk
Spatz ES, Beckman AL, Wang Y
Geographic variation in trends and disparities in acute myocardial infarction hospitalization and mortality by income levels, 1999-2013.
The researchers sought to determine whether trends in US county-level, risk-standardized acute myocardial infarction (AMI) hospitalization and mortality rates varied by county-based median income level. They concluded that hospitalization and mortality rates of AMI declined among counties of all income levels, although hospitalization rates among low-income counties lag behind those of the higher income groups.
AHRQ-funded; HS023000.
Citation: Spatz ES, Beckman AL, Wang Y .
Geographic variation in trends and disparities in acute myocardial infarction hospitalization and mortality by income levels, 1999-2013.
JAMA Cardiol 2016 Jun 1;1(3):255-65. doi: 10.1001/jamacardio.2016.0382.
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Keywords: Disparities, Hospitalization, Heart Disease and Health, Mortality, Social Determinants of Health
Heo HH, Sentell TL, Li D
Disparities in potentially preventable hospitalizations for chronic conditions among Korean Americans, Hawaii, 2010-2012.
The researchers compared preventable hospitalizations for chronic conditions in aggregate and for congestive heart failure (CHF) for Korean Americans and whites in Hawaii. They found that older Korean American patients may have significant disparities in preventable hospitalizations, which suggests poor access to or poor quality of primary health care.
AHRQ-funded; HS019990.
Citation: Heo HH, Sentell TL, Li D .
Disparities in potentially preventable hospitalizations for chronic conditions among Korean Americans, Hawaii, 2010-2012.
Prev Chronic Dis 2015 Sep 17;12:E152. doi: 10.5888/pcd12.150057.
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Keywords: Disparities, Racial and Ethnic Minorities, Hospitalization, Prevention, Chronic Conditions
Moore JX, Donnelly JP, Griffin R
Black-white racial disparities in sepsis: a prospective analysis of the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
The researchers sought to characterize racial differences in incident sepsis in a large cohort of adult community-dwelling adults. They found that in the REGARDS cohort, black participants were less likely than white participants to experience infection and sepsis events.
AHRQ-funded; HS013852.
Citation: Moore JX, Donnelly JP, Griffin R .
Black-white racial disparities in sepsis: a prospective analysis of the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
Crit Care 2015 Jul 10;19:279. doi: 10.1186/s13054-015-0992-8..
Keywords: Racial and Ethnic Minorities, Disparities, Hospitalization, Racial and Ethnic Minorities
Sentell TL, Juarez DT, Ahn HJ
Disparities in diabetes-related preventable hospitalizations among working-age Native Hawaiians and Asians in Hawai'i.
Elderly (65+) Native Hawaiian, Filipino, and Japanese men and Filipino women have a higher risk of diabetes-related potentially preventable hospitalizations than whites. The authors sought to determine if similar disparities are seen among the non-elderly (< 65). They found that preventable hospitalizations rates were significantly higher for Native Hawaiians males compared to whites, but significantly lower for Chinese men and women, Japanese men and women, and Filipino men and women. Rates for Native Hawaiian females did not differ significantly from Whites. Disparities in diabetes-related preventable hospitalizations were seen for working-age (18-64) Native Hawaiian men even when their higher population-level diabetes prevalence was considered.
AHRQ-funded; HS019990.
Citation: Sentell TL, Juarez DT, Ahn HJ .
Disparities in diabetes-related preventable hospitalizations among working-age Native Hawaiians and Asians in Hawai'i.
Hawaii J Med Public Health 2014 Dec;73(12 Suppl 3):8-13.
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Keywords: Diabetes, Disparities, Hospitalization, Quality Indicators (QIs), Racial and Ethnic Minorities
Sentell T, Marten L, Ahn HJ
Disparities in hospitalizations among HIV positive individuals for native Hawaiians and Asians compared to whites in Hawaii.
This study investigated characteristics and disparities in hospitalizations among HIV positive individuals for Asian American subgroups and Native Hawaiians using data from all hospitalizations in Hawai‘i between December 2006 and December 2010. It concluded that disparities appear to exist in rates of hospitalizations among HIV positive individuals for Native Hawaiians and Asians, as well as in the demographic and, to some degree, the clinical characteristics of those hospitalized.
AHRQ-funded; HS019990.
Citation: Sentell T, Marten L, Ahn HJ .
Disparities in hospitalizations among HIV positive individuals for native Hawaiians and Asians compared to whites in Hawaii.
Hawaii J Med Public Health 2014 Oct;73(10):308-14..
Keywords: Hospitalization, Human Immunodeficiency Virus (HIV), Disparities, Racial and Ethnic Minorities, Patient-Centered Outcomes Research
Moy E, Mau MK, Raetzman S
AHRQ Author: Moy E, Andrews R
Ethnic differences in potentially preventable hospitalizations among Asian Americans, Native Hawaiians, and other Pacific Islanders: implications for reducing health care disparities.
This study aimed to produce reliable estimates of health care quality among Native Hawaiian (NH), Other Pacific Islander (PI), and Asian American (AA) small population subgroups. Results showed that, despite efforts to reduce racial/ethnic health care disparities, significant gaps remain in potentially preventable hospitalization rates.
AHRQ-authored.
Citation: Moy E, Mau MK, Raetzman S .
Ethnic differences in potentially preventable hospitalizations among Asian Americans, Native Hawaiians, and other Pacific Islanders: implications for reducing health care disparities.
Ethn Dis 2013 Winter;23(1):6-11.
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Keywords: Disparities, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Quality Indicators (QIs), Racial and Ethnic Minorities
Sentell T, Unick GJ, Ahn HJ
Illness severity and psychiatric hospitalization rates among Asian Americans and Pacific Islanders.
This study of mental illness severity and psychiatric hospitalization among Asian Americans and Pacific Islanders (AA/PIs) in Hawaii found that AA/PI subgroups (Chinese, Japanese, Filipino, and Native Hawaiians) had lower psychiatric hospitalization rates than whites, but rates varied across AA/PI subgroups.
AHRQ-funded; HS019990
Citation: Sentell T, Unick GJ, Ahn HJ .
Illness severity and psychiatric hospitalization rates among Asian Americans and Pacific Islanders.
Psychiatr Serv. 2013 Nov;64(11):1095-102. doi: 10.1176/appi.ps.201200408..
Keywords: Behavioral Health, Hospitalization, Racial and Ethnic Minorities, Disparities