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 12 of 12 Research Studies DisplayedBayer 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
Chen HF, Rose AM, Waisbren S
Newborn screening and treatment of phenylketonuria: projected health outcomes and cost-effectiveness.
This study’s objective was to evaluate the cost-effectiveness of newborn screening and treatment for phenylketonuria (PKU) in the context of new data on adherence to a recommended diet treatment and a newly available drug (sapropterin dihydrochloride). A computer simulation model was developed to project outcomes for a hypothetical cohort of newborns which compared four strategies. The strategies compared were: 1) clinical identification (CI) with diet treatment; 2) newborn screening (NBS) with diet treatment; 3) CI with diet and medication; and 4) NBS with diet and medication. The range of incremental cost-effectiveness ratio went from $6400/QALY for newborn screening with diet treatment compared to clinical identification with diet treatment up to $16,000,000/QALY for adding medication to NBS with diet treatment. Future research is needed to consider conditions under which sapropterin dihydrochloride would be more economically attractive.
AHRQ-funded; HS020644.
Citation: Chen HF, Rose AM, Waisbren S .
Newborn screening and treatment of phenylketonuria: projected health outcomes and cost-effectiveness.
Children 2021 May 12;8(5). doi: 10.3390/children8050381..
Keywords: Newborns/Infants, Neurological Disorders, Screening, Healthcare Costs
Hill CE, Reynolds EL, Burke JF
Increasing out-of-pocket costs for neurologic care for privately insured patients.
This study examined out-of-pocket (OOP) costs of evaluation and management (E/M) services and common diagnostic testing for neurology patients. Patients with a neurologist visit or diagnostic test from 2001 to 2016 were identified from a large, privately insured health care claims database. Inflation-adjusted OOP costs were assessed. The database identified 3,724,342 patients. The most frequent services used were E/M (78.5%), EMG/nerve conduction studies (NCS) (7.7%), MRIs (5.3%), and EEGs (4.5%). Mean OOP cost increased over time, most substantially for EEG, MRI, and E/M. The range of OOP costs in 2016 varied considerably. For example, for an MRI, the 50th percentile paid $103.10 and the 95th percentile paid $875.40.
AHRQ-funded; HS022258.
Citation: Hill CE, Reynolds EL, Burke JF .
Increasing out-of-pocket costs for neurologic care for privately insured patients.
Neurology 2021 Jan 19;96(3):e322-e32. doi: 10.1212/wnl.0000000000011278..
Keywords: Healthcare Costs, Health Insurance, Neurological Disorders
Roberts ET, McGarry BE, Glynn A
Cognition and take-up of the Medicare Savings Programs.
In this study, the investigators examined the association between cognition and Medicare Savings Program (MSP) enrollment among elderly Medicare beneficiaries who qualified for these programs. They also examined enrollment in the Low-Income Subsidy (LIS), a separate program that provides premium and cost-sharing assistance in Medicare Part D that Medicare beneficiaries automatically received if they are enrolled in an MSP.
AHRQ-funded; HS026727.
Citation: Roberts ET, McGarry BE, Glynn A .
Cognition and take-up of the Medicare Savings Programs.
JAMA Intern Med 2020 Nov;180(11):1529-31. doi: 10.1001/jamainternmed.2020.2783..
Keywords: Elderly, Medicare, Health Insurance, Healthcare Costs, Low-Income, Dementia, Neurological Disorders
Reynolds EL, JF JF, Banerjee M
Association of out-of-pocket costs on adherence to common neurologic medications.
The objective of this training was to determine the association between out-of-pocket costs and medication adherence in 3 common neurologic diseases. The investigators concluded that higher out-of-pocket costs were associated with lower medication adherence in 3 common neurologic conditions. The investigators also observed racial/ethnic disparities and recommended that minority populations receive additional focus in future intervention efforts to improve adherence.
AHRQ-funded; HS017690; HS022258.
Citation: Reynolds EL, JF JF, Banerjee M .
Association of out-of-pocket costs on adherence to common neurologic medications.
Neurology 2020 Mar 31;94(13):e1415-e26. doi: 10.1212/wnl.0000000000009039..
Keywords: Medication, Healthcare Costs, Patient Adherence/Compliance, Neurological Disorders, Dementia
Callaghan BC, Reynolds E, Banerjee M
Out-of-pocket costs are on the rise for commonly prescribed neurologic medications.
The purpose of this study was to determine out-of-pocket costs for neurologic medications in 5 common neurologic diseases. The investigators concluded that out-of-pocket costs for neurologic medications have increased considerably over the last 12 years, particularly for those in high-deductible health plans. Out-of-pocket costs vary widely both across and within conditions. They assert that to minimize patient financial burden, neurologists require access to precise cost information when making treatment decisions.
AHRQ-funded; HS022258.
Citation: Callaghan BC, Reynolds E, Banerjee M .
Out-of-pocket costs are on the rise for commonly prescribed neurologic medications.
Neurology 2019 May 28;92(22):e2604-e13. doi: 10.1212/wnl.0000000000007564.
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Keywords: Health Insurance, Healthcare Costs, Medication, Neurological Disorders
Williams CN, Piantino J, McEvoy C
The burden of pediatric neurocritical care in the United States.
This article attempts to quantify the burden of pediatric neurocritical care (PNCC) by developing national estimates of disease incidence, evaluating use of critical care interventions (CCI), and examining hospital outcomes. The Kids Inpatient Database (KID) was analyzed to evaluate cohorts with the following conditions: traumatic brain injury, neuro-infection, or inflammatory diseases; status epilepticus; stroke; hypoxic ischemic injury after cardiac arrest; or spinal cord injury.
AHRQ-funded; HS022981.
Citation: Williams CN, Piantino J, McEvoy C .
The burden of pediatric neurocritical care in the United States.
Pediatr Neurol 2018 Dec;89:31-38. doi: 10.1016/j.pediatrneurol.2018.07.013..
Keywords: Children/Adolescents, Critical Care, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Neurological Disorders, Stroke, Trauma
Mahmoud L, Zullo AR, Thompson BB
Outcomes of protocolised analgesia and sedation in a neurocritical care unit.
Researchers conducted a retrospective cohort study of 1197 mechanically ventilated patients admitted to a 12-bed neurocritical care unit (NCCU) over four years in order to evaluate the effect of an analgesia-based sedation protocol on medication use and costs in the NCCU. The protocol resulted in increased in fentanyl use and decreased in propofol use, but their findings indicate no effect on healthcare utilization, healthcare costs, or in-hospital mortality. Based on these results, the researchers suggest that similar NCCUs should consider using population-specific protocols to manage analgesia and sedation.
AHRQ-funded; HS022998.
Citation: Mahmoud L, Zullo AR, Thompson BB .
Outcomes of protocolised analgesia and sedation in a neurocritical care unit.
Brain Inj 2018;32(7):941-47. doi: 10.1080/02699052.2018.1469167..
Keywords: Care Management, Brain Injury, Critical Care, Healthcare Costs, Intensive Care Unit (ICU), Medication, Neurological Disorders, Outcomes, Patient-Centered Outcomes Research
Jutkowitz E, Kuntz KM, Dowd B
Effects of cognition, function, and behavioral and psychological symptoms on out-of-pocket medical and nursing home expenditures and time spent caregiving for persons with dementia.
This study used cross-sectional data (Aging, Demographics, and Memory Study) to estimate probabilities of experiencing outcomes by clinical features. It found that no clinical feature predicted the probability of having out-of-pocket medical expenditures. For those with medical expenditures, higher cognition and poorer function were associated with more spending.
AHRQ-funded; HS024165.
Citation: Jutkowitz E, Kuntz KM, Dowd B .
Effects of cognition, function, and behavioral and psychological symptoms on out-of-pocket medical and nursing home expenditures and time spent caregiving for persons with dementia.
Alzheimers Dement 2017 Jul;13(7):801-09. doi: 10.1016/j.jalz.2016.12.011.
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Keywords: Caregiving, Dementia, Elderly, Healthcare Costs, Long-Term Care, Neurological Disorders, Nursing Homes
Schlitz NK, Kaiboriboon K, Koroukian SM
Long-term reduction of health care costs and utilization after epilepsy surgery.
This study assessed long-term direct medical costs, health care utilization, and mortality following resective surgery in persons with uncontrolled epilepsy. It found that the mean direct medical cost difference between the surgical group and control group was $6,806 after risk-set matching. The incidence rate ratio of inpatient, emergency room, and outpatient utilization was lower among the surgical group in both unadjusted and adjusted analyses.
AHRQ-funded; HS000059.
Citation: Schlitz NK, Kaiboriboon K, Koroukian SM .
Long-term reduction of health care costs and utilization after epilepsy surgery.
Epilepsia 2016 Feb;57(2):316-24. doi: 10.1111/epi.13280.
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Keywords: Healthcare Costs, Healthcare Utilization, Mortality, Neurological Disorders, Outcomes, Surgery
Callaghan BC, Kerber KA, Burke JF
Headaches and neuroimaging—reply.
The authors of this letter, replying to two letters commenting on their earlier article on headaches and neuroimaging, find that they all share the view that neuroimaging is overused in headache presentations. They also discuss the potential downsides of interventions to reduce use, the impact of medical malpractice on overuse of tests, and the lack of consensus in defining low-value tests.
AHRQ-funded; HS017690
Citation: Callaghan BC, Kerber KA, Burke JF .
Headaches and neuroimaging—reply.
JAMA Intern Med. 2015 Feb;175(2):313-4. doi: 10.1001/jamainternmed.2014.7014..
Keywords: Neurological Disorders, Healthcare Costs, Chronic Conditions, Guidelines
Callaghan BC, Kerber KA, Pace RJ
Headaches and neuroimaging: high utilization and costs despite guidelines.
Little is known about recent headache neuroimaging utilization, associated expenditures, and temporal trends. Looking at 51.1 million outpatient headache visits over 4 years, this study found that neuroimaging is ordered during 12% of these visits, costs $1 billion annually, and is increasing over time.
AHRQ-funded; HS017690
Citation: Callaghan BC, Kerber KA, Pace RJ .
Headaches and neuroimaging: high utilization and costs despite guidelines.
JAMA Intern Med. 2014 May;174(5):819-21. doi: 10.1001/jamainternmed.2014.173..
Keywords: Neurological Disorders, Healthcare Utilization, Guidelines, Healthcare Costs, Chronic Conditions