Search all AHRQ sites
Menu
SHARE:
AHRQ Research Studies
Sign up: 
AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 46 Research Studies DisplayedCrook S, Dragan K, Woo JL
Long-term health care utilization after cardiac surgery in children covered under Medicaid.
The purpose of this study was to examine the long-term burden of health care expenditures and utilization after pediatric cardiac surgery to improve care and reduce outcome inequities. The study compared children under the age of 18 undergoing cardiac surgery from 2006-2019 to a similar cohort of children without cardiac surgical disease. The research concluded that children after cardiac surgery have substantial long-term health care needs than noncardiac surgical comparators.
AHRQ-funded; HS000055.
Citation: Crook S, Dragan K, Woo JL .
Long-term health care utilization after cardiac surgery in children covered under Medicaid.
J Am Coll Cardiol 2023 Apr 25; 81(16):1605-17. doi: 10.1016/j.jacc.2023.02.021..
Keywords: Children/Adolescents, Healthcare Utilization, Long-Term Care, Cardiovascular Conditions, Medicaid, Surgery
Wu AJ, Du N, Chen TY
Sociodemographic differences of hospitalization and associations of resource utilization for failure to thrive.
The objective of this study was to examine sociodemographic differences between elective and nonelective admissions for failure to thrive. Researchers investigated associations between admission type and hospital resource utilization, including length of stay and feeding tube placement. The study included data on children less than 2 years old with failure to thrive in the Kids' Inpatient Database. The findings showed differences by race and ethnicity, income, and insurance type, among other factors. Nonelective admissions had higher proportions of infants who were Black, Hispanic, and of lower-income, and were associated with longer lengths of stay. The researchers concluded that future research is needed to elucidate drivers of these differences, particularly those related to racial and ethnic disparities and structural racism.
AHRQ-funded; HS000063.
Citation: Wu AJ, Du N, Chen TY .
Sociodemographic differences of hospitalization and associations of resource utilization for failure to thrive.
J Pediatr Gastroenterol Nutr 2023 Mar;76(3):385-89. doi: 10.1097/mpg.0000000000003694.
Keywords: Newborns/Infants, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Healthcare Utilization, Children/Adolescents, Racial and Ethnic Minorities, Low-Income
Richmond J, Adams LB, Annis IE
Rapid and deferred help seeking among African American parents of children with emotional and behavioral difficulties.
The purpose of this cross-sectional survey study was to assess factors related with African American parents seeking care for their child within 30 days after identifying the child’s behavioral or emotional need and with postponing care for 1 year or more. The researchers surveyed 289 African American parents who were raising a child with emotional or developmental challenges to explore relationships between parent activation, medical mistrust, and care-seeking barriers with two outcomes: rapidly seeking care (within 30 days after identifying a child’s need) and deferring care seeking. The study found that approximately 22% of parents rapidly sought care, and 49% deferred care for 1 year or more. Parents were more likely to rapidly seek care if they had higher parent activation scores; lived with other adults with mental health challenges; or, contrary to the authors' hypothesis, mistrusted doctors. Parents were less likely to rapidly seek care if the challenge did not initially bother them much or if their health insurance would not cover the service. Parents were more likely to defer care if they feared involuntary hospitalization for their child or if their health insurance would not cover the service. Parents were less likely to defer care if they had at least some college education or lived with other adults with mental health challenges. The researchers concluded that when developing programs that support African American families, professionals should be advised about facilitators and barriers to mental health care seeking.
AHRQ-funded; HS026122.
Citation: Richmond J, Adams LB, Annis IE .
Rapid and deferred help seeking among African American parents of children with emotional and behavioral difficulties.
Psychiatr Serv 2022 Dec;73(12):1359-66. doi: 10.1176/appi.ps.202100553..
Keywords: Children/Adolescents, Racial and Ethnic Minorities, Behavioral Health, Healthcare Utilization
Angier H, Kaufmann J, Heintzman J
Association of parent preventive care with their child's recommended well-child visits.
The purpose of this retrospective, cohort study was to explore whether there is a relationship between parent preventive care and their children's well-child visits. The researchers utilized electronic health record data to identify children and link them to parents both seen in an OCHIN network of 363 clinics from 17 states, then randomly selected a child between the ages of 3 and 17 with more than 1 ambulatory medical visit between the years 2015 and 2018. The study included a sample of 75,398 linked mother only pairs, 12,438 father only pairs, and 4,156 2-parent pairs. Children in the mother only sample had a 6% greater rate of yearly well-child visits when their mother received preventive care compared to no preventive care, children in the father only sample had a 7% greater rate of yearly well-child visits when their father received preventive care versus no preventive care, and children in the two parent sample had an 11% greater rate of yearly well-child visits when both parents received preventive care compared to neither receiving preventive care. The researchers concluded that well-child visit rates may improve when care is provided for the entire family.
AHRQ-funded; HS025962.
Citation: Angier H, Kaufmann J, Heintzman J .
Association of parent preventive care with their child's recommended well-child visits.
Acad Pediatr 2022 Nov-Dec;22(8):1422-28. doi: 10.1016/j.acap.2022.03.019..
Keywords: Children/Adolescents, Prevention, Family Health and History, Healthcare Utilization
Abdus S, Selden TM
Well-child visit adherence.
This article presents updated evidence on well-child visit adherence, using MEPS data to conduct a cross-sectional study. The results indicate that average adherence increased between 2006-07 and 2016-17, but the authors note that large gaps remain in such areas as race and ethnicity, poverty level, insurance coverage, and geographic region.
AHRQ-authored.
Citation: Abdus S, Selden TM .
Well-child visit adherence.
JAMA Pediatr 2022 Nov;176(11):1143-45. doi: 10.1001/jamapediatrics.2022.2954..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Healthcare Utilization, Access to Care
Sakai-Bizmark R, Kumamaru H, Estevez D
Association between suicide attempt and previous healthcare utilization among homeless youth.
The purpose of this study was to examine the association between prior emergency department visit or hospitalization and subsequent suicide attempt among homeless youth aged 10-17 years old using New York statewide databases. Findings showed an association between prior healthcare utilization and decreased risk of suicide attempt among homeless youth.
AHRQ-funded; 900014-17-05.
Citation: Sakai-Bizmark R, Kumamaru H, Estevez D .
Association between suicide attempt and previous healthcare utilization among homeless youth.
Suicide Life Threat Behav 2022 Oct;52(5):994-1001. doi: 10.1111/sltb.12897..
Keywords: Children/Adolescents, Vulnerable Populations, Behavioral Health, Healthcare Utilization
Shankar LG, Habich M, Rosenman M
Mental health emergency department visits by children before and during the COVID-19 pandemic.
Investigators described pediatric mental health emergency department (ED) visit rates and visit characteristics before and during the COVID-19 pandemic. They found that mental health ED visit rates by children increased during the COVID-19 pandemic.
AHRQ-funded; HS026385.
Citation: Shankar LG, Habich M, Rosenman M .
Mental health emergency department visits by children before and during the COVID-19 pandemic.
Acad Pediatr 2022 Sep-Oct;22(7):1127-32. doi: 10.1016/j.acap.2022.05.022..
Keywords: COVID-19, Children/Adolescents, Emergency Department, Behavioral Health, Healthcare Utilization, Public Health
Fritz CQ, Hall M, Bettenhausen JL
Child Opportunity Index 2.0 and acute care utilization among children with medical complexity.
This cross-sectional, multicenter study examined the association between ZIP code-level opportunity and acute care utilization among children with medical complexity (CMS). The authors assessed associations between the nationally-normed, multi-dimensional ZIP code-level Child Opportunity Index 2.0 (COI) and total utilization days (hospital bed-days + emergency department (ED) discharge encounters). In adjusted analyses, patients in the lowest COI quintile (lowest opportunity) utilized care at 1.22 times the rate of those from the highest COI quintile.
AHRQ-funded; HS026122.
Citation: Fritz CQ, Hall M, Bettenhausen JL .
Child Opportunity Index 2.0 and acute care utilization among children with medical complexity.
J Hosp Med 2022 Apr;17(4):243-51. doi: 10.1002/jhm.12810..
Keywords: Children/Adolescents, Hospitalization, Healthcare Utilization
Bardach NS, Harder VS, McCulloch CE
Follow-up after asthma emergency department visits and its relationship with subsequent asthma-related utilization.
Researchers sought to assess the association between follow-up after an asthma-related emergency department (ED) visit and the likelihood of subsequent asthma-related ED utilization. Using data from California Medicaid, Vermont, and Massachusetts all-payer claims databases, they found a protective association between outpatient 14-day follow-up and asthma-related ED revisits. They suggested that this may reflect improved asthma control as providers follow the NHLBI guideline stepwise approach.
AHRQ-funded; HS025297; HS020518.
Citation: Bardach NS, Harder VS, McCulloch CE .
Follow-up after asthma emergency department visits and its relationship with subsequent asthma-related utilization.
Acad Pediatr 2022 Apr;22(3S):S125-S32. doi: 10.1016/j.acap.2021.10.015..
Keywords: Children/Adolescents, Asthma, Emergency Department, Respiratory Conditions, Healthcare Utilization
Thomson J, Butts B, Camara S
Neighborhood socioeconomic deprivation and health care utilization of medically complex children.
The authors sought to assess the association between neighborhood socioeconomic deprivation and health care utilization in a cohort of children with medical complexity. They found no association between area-level deprivation and emergency department visits, hospitalizations, or inpatient bed-days. However, there was a 13% relative increase in the missed clinic visit rate for every 0.1 unit increase in Deprivation Index. They concluded that a child's socioeconomic context is associated with adherence to patient-centered medical home visits.
AHRQ-funded; HS025138.
Citation: Thomson J, Butts B, Camara S .
Neighborhood socioeconomic deprivation and health care utilization of medically complex children.
Pediatrics 2022 Apr;149(4). doi: 10.1542/peds.2021-052592..
Keywords: Children/Adolescents, Healthcare Utilization, Hospitalization
Holland JE, Varni SE, Pulcini CD
Assessing the relationship between well-care visit and emergency department utilization among adolescents and young adults.
This study investigated the association between adolescent and young adult (AYA) well-care visits and emergency department (ED) utilization. Vermont’s all-payer claims data for 2018 was used to evaluate visits for 49,089 AYAs (aged 12-21 years) with a health-care claim. Nearly half (49%) of AYAs who engaged with the health-care system did not have a well-care visit in 2018. Those AYAs had 24% greater odds of going to the ED at least once in 2018, controlling for age, sex, insurance type, and medical complexity. Late adolescents and young adults (aged 18-21) who did not attend a well-care visit had 47% greater odds of ED visits, middle adolescents (15-17 years) had 9% greater odds, and early adolescents (12-14 years) had 16% greater odds.
AHRQ-funded; HS024575.
Citation: Holland JE, Varni SE, Pulcini CD .
Assessing the relationship between well-care visit and emergency department utilization among adolescents and young adults.
J Adolesc Health 2022 Jan;70(1):64-69. doi: 10.1016/j.jadohealth.2021.08.011..
Keywords: Children/Adolescents, Young Adults, Emergency Department, Healthcare Utilization, Medicaid, Prevention
Bayer ND, Hall M, LI Y
Trends in health care use and spending for young children with neurologic impairment.
This retrospective study examined trends in health care use and spending for young children with neurologic impairment (NI) during their first 5 years of life. This study of 13,947 children with NI used data in the multistate IBM Medicaid MarketScan Database from 2009 to 2017. Inpatient service use decreased from 66.8% during the first year down to 5.8% during the fifth year. Emergency department (ED) use decreased more gradually from 67.8% during the first year to 44.4% during the fifth year. Per-member-per-year spending decreased from $83,352 during the first year down to $1944 in the fifth year.
AHRQ-funded; HS025138.
Citation: Bayer ND, Hall M, LI Y .
Trends in health care use and spending for young children with neurologic impairment.
Pediatrics 2022 Jan;149(1). doi: 10.1542/peds.2021-050905.
AHRQ-funded; HS025138..
AHRQ-funded; HS025138..
Keywords: Children/Adolescents, Healthcare Costs, Healthcare Utilization, Neurological Disorders
Hoffmann JA, Hall M, Lorenz D
Emergency department visits for suicidal ideation and self-harm in rural and urban youths.
The authors sought to compare emergency department (ED) visit rates for suicidal ideation and/or self-harm among youth by urban-rural location of residence. Data was taken from the Nationwide Emergency Department Sample. They found that, compared with youths living in urban areas, youths living in rural areas had higher ED visit rates for self-harm, including self-inflicted firearm injuries. The researchers recommended preventive approaches for self-harm based in community and ED settings in order to help address these differences.
AHRQ-funded; HS026385.
Citation: Hoffmann JA, Hall M, Lorenz D .
Emergency department visits for suicidal ideation and self-harm in rural and urban youths.
J Pediatr 2021 Nov;238:282-89.e1. doi: 10.1016/j.jpeds.2021.07.013..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Behavioral Health, Rural Health, Urban Health, Healthcare Utilization
Feldman AG, Marsh R, Kempe A
Barriers to pretransplant immunization: a qualitative interview study of pediatric solid organ transplant stakeholders.
Investigators described the experiences and beliefs of pediatric transplant stakeholders regarding factors that contribute to low pre-transplant immunization rates. Five central themes emerged: gaps in knowledge about timing and safety of pre-transplant immunizations; lack of communication, coordination, and follow-up between team members; lack of centralized immunization records; subspecialty clinics functioning as the medical home for transplant candidates, but not able to provide all needed immunizations; and differences between organ type in prioritization and completion of pre-transplant immunization. The authors recommended new tools to overcome these barriers and to increase immunization rates in transplant candidates.
AHRQ-funded; HS026510.
Citation: Feldman AG, Marsh R, Kempe A .
Barriers to pretransplant immunization: a qualitative interview study of pediatric solid organ transplant stakeholders.
J Pediatr 2020 Dec;227:60-68. doi: 10.1016/j.jpeds.2020.07.038..
Keywords: Children/Adolescents, Transplantation, Surgery, Healthcare Delivery, Healthcare Utilization
Shah AN, Auger KA, Sucharew HJ
Effect of parental adverse childhood experiences and resilience on a child's healthcare reutilization.
Adverse childhood experiences (ACEs) are associated with poor health outcomes in adults. Resilience may mitigate this effect. There is limited evidence regarding how parents' ACEs and resilience may be associated with their children's health outcomes. The objective of this study was to determine the association of parental ACEs and resilience with their child's risk of unanticipated healthcare reutilization.
AHRQ-funded; HS024735; HS026393.
Citation: Shah AN, Auger KA, Sucharew HJ .
Effect of parental adverse childhood experiences and resilience on a child's healthcare reutilization.
J Hosp Med 2020 Nov;15(11):645-51. doi: 10.12788/jhm.3396..
Keywords: Children/Adolescents, Family Health and History, Healthcare Utilization
Ramgopal S, Aronson PL, Marin JR
United States' emergency department visits for fever by young children 2007-2017.
The authors estimated rates of emergency department (ED) visits for fever by children less than 2 years of age and evaluated frequencies of testing and treatment during these visits. They found that, given existing guidelines, blood and urine culture performance was low for infants up to 90 days old. For children 91 days up to 2 years, rates of radiography and antibiotic use were higher in general EDs compared to pediatric EDs. They concluded that their findings suggest opportunities to improve care among febrile young children in the ED.
AHRQ-funded; HS026006.
Citation: Ramgopal S, Aronson PL, Marin JR .
United States' emergency department visits for fever by young children 2007-2017.
West J Emerg Med 2020 Oct 27;21(6):146-51. doi: 10.5811/westjem.2020.8.47455..
Keywords: Children/Adolescents, Emergency Department, Healthcare Utilization
Riddle SW, Sherman SN, Moore MJ
A qualitative study of increased pediatric reutilization after a postdischarge home nurse visit.
The Hospital to Home Outcomes (H2O) trial was a 2-arm, randomized controlled trial that assessed the effects of a nurse home visit after a pediatric hospital discharge. Children randomized to the intervention had higher 30-day postdischarge reutilization rates compared with those with standard discharge. The investigators sought to understand perspectives on why postdischarge home nurse visits resulted in higher reutilization rates and to elicit suggestions on how to improve future interventions.
AHRQ-funded; HS024735.
Citation: Riddle SW, Sherman SN, Moore MJ .
A qualitative study of increased pediatric reutilization after a postdischarge home nurse visit.
J Hosp Med 2020 Sep;15(9):518-25. doi: 10.12788/jhm.3370..
Keywords: Children/Adolescents, Home Healthcare, Hospital Discharge, Healthcare Utilization, Hospitals
Coon ER, Stoddard G, Brady PW
Intensive care unit utilization after adoption of a ward-based high-flow nasal cannula protocol.
This study examined whether the adoption of ward-based high-flow nasal cannula (HFNC) protocol in pediatric intensive care units (ICUs) reduced ICU utilization. This retrospective cohort study included infants aged 3 to 24 months hospitalized with bronchiolitis at hospitals in the Pediatric Health Information System database. There was a 93% response rate with the 44 hospitals contacted for the survey, of which 18 were categorized as non-adopting hospitals and 12 were categorized as adopting hospitals. Ward-based HFNC protocol data were included from the 2010-2011 and 2015-2016 respiratory seasons. Early protocols were paradoxically associated with increased ICU utilization.
AHRQ-funded; HS023827.
Citation: Coon ER, Stoddard G, Brady PW .
Intensive care unit utilization after adoption of a ward-based high-flow nasal cannula protocol.
J Hosp Med 2020 Jun;15(6):325-30. doi: 10.12788/jhm.3417..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Respiratory Conditions, Healthcare Utilization, Newborns/Infants, Inpatient Care
Taylor WM, Lu Y, Wang S
Long-term healthcare utilization by Medicaid enrolled children with neonatal abstinence syndrome.
The purpose of this study was to evaluate healthcare utilization in Medicaid enrolled children with neonatal abstinence syndrome (NAS) in the first 2 years of life. The investigators concluded that a diagnosis of NAS did not appear to be an independent predictor of increased healthcare utilization in the first 2 years of life. They indicated that their results differed from some other published studies.
AHRQ-funded; HS022941.
Citation: Taylor WM, Lu Y, Wang S .
Long-term healthcare utilization by Medicaid enrolled children with neonatal abstinence syndrome.
J Pediatr 2020 Jun;221:55-63.e6. doi: 10.1016/j.jpeds.2020.02.077..
Keywords: Children/Adolescents, Healthcare Utilization, Medicaid, Newborns/Infants, Substance Abuse
Kovalerchik O, Powers E, Holland ML
Differences in frequency of visits to pediatric primary care practices and emergency departments by body mass index.
The purpose of this retrospective study was to examine differences in utilization across health care settings among children by body mass index (BMI) categories to help identify opportunities for interventions. The authors concluded that the children's BMI categories were associated with health care utilization, specifically primary care visits, ED visits, and hospitalizations.
AHRQ-funded; HS024332.
Citation: Kovalerchik O, Powers E, Holland ML .
Differences in frequency of visits to pediatric primary care practices and emergency departments by body mass index.
Acad Pediatr 2020 May-Jun;20(4):532-39. doi: 10.1016/j.acap.2019.12.011..
Keywords: Children/Adolescents, Primary Care, Emergency Department, Obesity, Healthcare Utilization
Berdahl T, Biener A, McCormick MC
Annual report on children's healthcare: healthcare access and utilization by obesity status in the United States.
This study examined access to care and utilization patterns across a set of healthcare measures by obesity status and sociodemographic characteristics among children. Data from the Medical Expenditure Panel Survey (MEPS) from 2010-2015 was used to determine obesity status, number of well-child visits, access to a usual source of care, number of preventive dental visits and prescription medication fills in the past year. It was found that uninsured adolescents with obesity were less like to have a usual source of care provider than children without obesity. Among younger children, those living in the Northeast were more than twice as likely to have had a well-child visit than those living in the West. Preventive dental care was less likely to have occurred for children with obesity than non-obese children. More prescription refills were completed for obese adolescents than for younger children.
AHRQ-authored.
Citation: Berdahl T, Biener A, McCormick MC .
Annual report on children's healthcare: healthcare access and utilization by obesity status in the United States.
Acad Pediatr 2020 Mar;20(2):175-87. doi: 10.1016/j.acap.2019.11.020..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Access to Care, Healthcare Utilization, Obesity
Crego N, Douglas C, Bonnabeau E
Sickle-cell disease co-management, health care utilization, and hydroxyurea use.
Sickle-cell disease (SCD) causes significant morbidity, premature mortality, and high disease burden, resulting in frequent health care use. Comanagement may improve utilization and patient adherence with treatments such as Hydroxyurea. The purpose of this study was to describe acute-care utilization in Medicaid-enrolled patients with SCD, patient factors associated with comanagement, and adherence to Hydroxyurea. The investigators concluded that comanagement was a factor in predicting HUadherence, but further studies are needed to identify the frequency and components of comanagement needed to increase adherence and reduce acute care utilization.
AHRQ-funded; HS024501.
Citation: Crego N, Douglas C, Bonnabeau E .
Sickle-cell disease co-management, health care utilization, and hydroxyurea use.
J Am Board Fam Med 2020 Jan-Feb;33(1):91-105. doi: 10.3122/jabfm.2020.01.190143..
Keywords: Sickle Cell Disease, Children/Adolescents, Medication, Healthcare Utilization, Patient Adherence/Compliance
Silber JH, Rosenbaum PR, Pimentel SD
Comparing resource use in medical admissions of children with complex chronic conditions.
In this study, the investigators explored whether some hospitals display a significantly different pattern of resource utilization than others when caring for similar children with complex chronic conditions (CCCs) admitted for medical diagnoses. The investigators concluded that hospitals treating similar patients with CCCs admitted for similar medical diagnoses, varied greatly in resource utilization. They suggest that Template Matching can aid chief quality officers benchmarking their hospitals to peer institutions and can help determine types of their patients having the most aberrant outcomes, facilitating quality initiatives to target these patients.
AHRQ-funded; HS020508.
Citation: Silber JH, Rosenbaum PR, Pimentel SD .
Comparing resource use in medical admissions of children with complex chronic conditions.
Med Care 2019 Aug;57(8):615-24. doi: 10.1097/mlr.0000000000001149..
Keywords: Children/Adolescents, Chronic Conditions, Hospitals, Healthcare Utilization, Hospitalization
Durojaiye AB, Levin S, Toerper M
Evaluation of multidisciplinary collaboration in pediatric trauma care using EHR data.
This study electronic health record (EHR) data to compare usage patterns from pediatric trauma patients with minor injuries at a Level I pediatric trauma center. The data was used to compare demographics, clinical and network characteristics, and emergency department (ED) length of stay (LOS). Three distinct groups were compared: fully connected, partially connected, and disconnected. The fully connected group had a decreased ED LOS compared with the partially connected group.
AHRQ-funded; HS023837.
Citation: Durojaiye AB, Levin S, Toerper M .
Evaluation of multidisciplinary collaboration in pediatric trauma care using EHR data.
J Am Med Inform Assoc 2019 Jun;26(6):506-15. doi: 10.1093/jamia/ocy184..
Keywords: Children/Adolescents, Trauma, Electronic Health Records (EHRs), Health Information Technology (HIT), Emergency Department, Healthcare Utilization
Berry JG, Goodman DM, Coller RJ
Association of home respiratory equipment and supply use with health care resource utilization in children.
The purpose of this cohort study was to compare health care use and spending in children using vs not using respiratory medical equipment and supplies (RMES). The investigators found that the use of RMES was associated with high health care spending, especially with hospital and home health care. They suggest that population health initiatives in children may benefit from consideration of RMES in comprehensive risk assessment for health care spending.
AHRQ-funded; HS02513.
Citation: Berry JG, Goodman DM, Coller RJ .
Association of home respiratory equipment and supply use with health care resource utilization in children.
J Pediatr 2019 Apr;207:169-75.e2. doi: 10.1016/j.jpeds.2018.11.046..
Keywords: Children/Adolescents, Healthcare Costs, Healthcare Utilization, Home Healthcare, Respiratory Conditions
