National Healthcare Quality and Disparities Report
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Search All Research Studies
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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 7 of 7 Research Studies DisplayedDavidson L, Haynes SC, Favila-Meza A
Parent experience and cost savings associated with a novel tele-physiatry program for children living in rural and underserved communities.
This study investigated patient and therapist experience and cost savings from the payer perspective associated with a novel tele-physiatry program for children living in rural and underserved communities. Study setting was four school-based clinics in Northern California with a total of 268 encounters (124 telemedicine and 144 in-person). Parent and therapists reported no difference in experience and perceived quality of care between telemedicine and in-person encounters. For parents whose children received a telemedicine encounter, 54.8% reported no preference for their child’s subsequent encounter, 28.8% preferred a physiatrist telemedicine visit, and 12 preferred a physiatrist in-person visit. There was also an average cost savings of $100 per clinic owing to physician milage for in-person visits.
AHRQ-funded; HS025714.
Citation: Davidson L, Haynes SC, Favila-Meza A .
Parent experience and cost savings associated with a novel tele-physiatry program for children living in rural and underserved communities.
Arch Phys Med Rehabil 2022 Jan;103(1):8-13. doi: 10.1016/j.apmr.2021.07.807..
Keywords: Children/Adolescents, Telehealth, Health Information Technology (HIT), Healthcare Costs, Rural Health, Vulnerable Populations, Disabilities, Rural/Inner-City Residents
Myong C, Hull P, Price M
The impact of funding for federally qualified health centers on utilization and emergency department visits in Massachusetts.
This retrospective study examined the impact of funding for federally qualified health centers (FQHCs) on utilization and emergency department (ED) visits in Massachusetts. The authors theorized that greater funding for FQHCs could increase the local availability of clinic-based care and reduce more costly resource use, such as ED visits. Data from the Massachusetts All Payer Claims Database (APCD) 2010-2013 was used that included enrollees in 559 Massachusetts ZIP codes (2010 numbers 6,173,563). They calculated shift-share predictions of changes in FQHC funding at the ZIP code-level for FQHCs that received Community Health Center funds in any year. They found that a standard deviation increase in prior year FQHC funding (31%) was associated with a 2.3% increase in enrollees with FQHC visits and a 1.3% decrease in enrollees at EDs. However, there were no significant changes in emergent ED visit rates.
AHRQ-funded; HS025378.
Citation: Myong C, Hull P, Price M .
The impact of funding for federally qualified health centers on utilization and emergency department visits in Massachusetts.
PLoS One 2020 Dec 3;15(12):e0243279. doi: 10.1371/journal.pone.0243279..
Keywords: Community-Based Practice, Healthcare Utilization, Emergency Department, Healthcare Costs, Access to Care, Vulnerable Populations, Policy
Sen AP, Chen LM, Wong Samson L
Performance in the Medicare Shared Savings Program by accountable care organizations disproportionately serving dual and disabled populations.
The purpose of this study was to examine performance by accountable care organizations (ACOs) in the top quintile of their proportion of beneficiaries who were dually enrolled in Medicare and Medicaid (high-dual), and the top quintile of disabled beneficiaries (high-disabled). Measures used were quality scores, savings per beneficiary, whether or not the ACO shared savings and the amount of shared savings. The researchers found that high-dual and high-disabled ACOs had similar or higher spending than other ACOs at baseline, but achieved greater savings and were equally or more likely to earn shared savings; alternative payment models can have positive financial outcomes for providers serving vulnerable populations.
AHRQ-funded; HS024698.
Citation: Sen AP, Chen LM, Wong Samson L .
Performance in the Medicare Shared Savings Program by accountable care organizations disproportionately serving dual and disabled populations.
Med Care 2018 Sep;56(9):805-11. doi: 10.1097/mlr.0000000000000968..
Keywords: Disabilities, Medicare, Healthcare Costs, Provider Performance, Payment, Low-Income, Vulnerable Populations
Nguyen KH, Trivedi AN, Shireman TI
Lesbian, gay, and bisexual adults report continued problems affording care despite coverage gains.
This study’s investigators used data from three waves of the Behavioral Risk Factor Surveillance System to examine access to a personal doctor, affordability of care, type of health insurance coverage, and self-reported health in LGB adults in the period January 2014-February 2017 in thirty-one states that implemented the Affordable Care Act system's sexual orientation module.
AHRQ-funded; HS000011.
Citation: Nguyen KH, Trivedi AN, Shireman TI .
Lesbian, gay, and bisexual adults report continued problems affording care despite coverage gains.
Health Aff 2018 Aug;37(8):1306-12. doi: 10.1377/hlthaff.2018.0281.
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Keywords: Access to Care, Healthcare Costs, Health Insurance, Uninsured, Vulnerable Populations
Nguyen OK, Higashi RT, Makam AN
The influence of financial strain on health decision-making.
This study sought to explore which unmet social needs are most influential and how these needs affect individuals’ decisions regarding medical treatment and self-management of health needs among community-dwelling low-income adults. It found that financial strain, rather than any single social need, was the most important factor in health decisionmaking among the underserved adults we studied, and may result in non-adherence to medical recommendations.
AHRQ-funded; HS022418.
Citation: Nguyen OK, Higashi RT, Makam AN .
The influence of financial strain on health decision-making.
J Gen Intern Med 2018 Apr;33(4):406-08. doi: 10.1007/s11606-017-4296-3.
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Keywords: Decision Making, Healthcare Costs, Patient Adherence/Compliance, Patient-Centered Healthcare, Vulnerable Populations
Beckman AL, Bilinski A, Boyko R
New hepatitis C drugs are very costly and unavailable to many state prisoners.
This study found that in the forty-one states whose departments of corrections reported data, 106,266 inmates (10 percent of their prisoners) were known to have hepatitis C on or about January 1, 2015. Only 949 of those inmates were being treated. Prices for a twelve-week course of direct-acting antivirals such as sofosbuvir and the combination drug ledipasvir/sofosbuvir varied widely as of September 30, 2015 ($43,418-$84,000 and $44,421-$94,500, respectively).
AHRQ-funded; HS000055.
Citation: Beckman AL, Bilinski A, Boyko R .
New hepatitis C drugs are very costly and unavailable to many state prisoners.
Health Aff 2016 Oct;35(10):1893-901. doi: 10.1377/hlthaff.2016.0296.
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Keywords: Access to Care, Healthcare Costs, Hepatitis, Medication, Vulnerable Populations
Colla CH, Lewis VA, Kao LS
Association between Medicare accountable care organization implementation and spending among clinically vulnerable beneficiaries.
The purpose of this cohort study was to examine the effect of Medicare accountable care organization (ACO) contracts on both spending and high-cost institutional utilization for all Medicare beneficiaries and for clinically vulnerable beneficiaries. The main outcomes and measures for this study were total spending per beneficiary-quarter, spending categories, utilization of hospitals and emergency departments, ambulatory care sensitive admissions, and 30-day readmissions. The study found that total spending decreased by $34 per beneficiary-quarter after implementation of ACO contracts across the overall Medicare population and decreased $114 in clinically vulnerable patients. In the overall Medicare cohort, hospitalizations and emergency department visits decreased by 1.3 and 3.0 events per 1000 beneficiaries per quarter, respectively. Hospitalizations and emergency department visits decreased in the clinically vulnerable cohort by 2.9 and 4.1 events per 1000 beneficiaries per quarter, respectively. Variations in total spending related with ACOs did not differ by clinical condition of beneficiaries.
AHRQ-funded; HS024075.
Citation: Colla CH, Lewis VA, Kao LS .
Association between Medicare accountable care organization implementation and spending among clinically vulnerable beneficiaries.
JAMA Intern Med 2016 Aug;176(8):1167-75. doi: 10.1001/jamainternmed.2016.2827.
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Keywords: Medicare, Policy, Healthcare Costs, Payment, Vulnerable Populations