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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 351 Research Studies Displayed
Trent SA, George N, Havranek EP
Established evidence-based treatment guidelines help mitigate disparities in quality of emergency care.
Evidence-based guidelines are often cited as a means of ensuring high-quality care for all patients. The objective of this study was to assess whether emergency department (ED) adherence to core evidence-based guidelines differed by patient sex and race/ethnicity and to assess the effect of ED guideline adherence on patient outcomes by sex and race/ethnicity. The investigators concluded that longstanding, nationally reported evidence-based guidelines can help eliminate sex and race/ethnicity disparities in quality of care.
AHRQ-funded; HS022400.
Citation:
Trent SA, George N, Havranek EP .
Established evidence-based treatment guidelines help mitigate disparities in quality of emergency care.
Acad Emerg Med 2021 Sep;28(9):1051-60. doi: 10.1111/acem.14235..
Keywords:
Evidence-Based Practice, Guidelines, Emergency Department, Disparities, Quality of Care
Markovitz AA, Ayanian JZ, Warrier A
Medicare Advantage plan double bonuses drive racial disparity in payments, yield no quality or enrollment improvements.
Using national data for 2008-18, investigators found that double bonuses were not associated with either improvements in plan quality or increased Medicare Advantage enrollment. Additionally, double bonuses increased payments to plans to care for Black beneficiaries by $60 per year, compared with $91 for White beneficiaries. These findings suggest that double bonuses not only fail to improve quality and enrollment but also foster a racially inequitable distribution of Medicare funds that disfavors Black beneficiaries. This study supports eliminating double bonuses, thereby saving Medicare an estimated $1.8 billion per year.
AHRQ-funded; HS000053.
Citation:
Markovitz AA, Ayanian JZ, Warrier A .
Medicare Advantage plan double bonuses drive racial disparity in payments, yield no quality or enrollment improvements.
Health Aff 2021 Sep;40(9):1411-19. doi: 10.1377/hlthaff.2021.00349..
Keywords:
Medicare, Health Insurance, Payment, Quality Improvement, Quality of Care, Disparities, Racial / Ethnic Minorities
Goyal MK, Chamberlain JM, Webb M
Racial and ethnic disparities in the delayed diagnosis of appendicitis among children.
The objective of this 3-year multicenter retrospective cohort study of children was to determine if there are race/ethnicity differences in rates of appendiceal perforation, delayed diagnosis of appendicitis, and diagnostic imaging during prior visit(s). Delayed diagnosis was defined as having at least one emergency department (ED) visit within 7 days preceding the appendicitis diagnosis. Out of 7,298 patients diagnosed with appendicitis and documented race/ethnicity, 2,567 had appendiceal perforation. Non-Hispanic (NH) Black children had a higher likelihood of perforation (36.5% versus 34.9%) then non-Hispanic whites. They also were over twice as likely to have delayed diagnosis (4.7% versus 2.0%). Eighty-nine patients (43.2%) patients with delayed diagnosis had abdominal imaging during the prior visits. However, NH-Black children were less likely to have any imaging (28.2% versus 46.2%) or definitive imaging (10.3% versus 35.9%).
Acad Emerg Med 2021 Sep;28(9):949-56. doi: 10.1111/acem.14142.
Citation:
Goyal MK, Chamberlain JM, Webb M .
Racial and ethnic disparities in the delayed diagnosis of appendicitis among children.
Acad Emerg Med 2021 Sep;28(9):949-56. doi: 10.1111/acem.14142..
Keywords:
Children/Adolescents, Racial / Ethnic Minorities, Disparities, Diagnostic Safety and Quality, Diagnosis
Schechter SB, Pantell MS, Parikh K
Impact of a national quality collaborative on pediatric asthma care quality by insurance status.
The objective of this study was to assess whether disparities in asthma care and outcomes based on insurance type existed before a national quality improvement (QI) collaborative, and to determine the effects of the collaborative on these disparities. The investigators concluded that at baseline, children with public insurance had higher asthma health care utilization than those with private insurance, despite receiving more evidence-based care.
AHRQ-funded; HS026383; HS024554; HS024592.
Citation:
Schechter SB, Pantell MS, Parikh K .
Impact of a national quality collaborative on pediatric asthma care quality by insurance status.
Acad Pediatr 2021 Aug;21(6):1018-24. doi: 10.1016/j.acap.2021.02.009..
Keywords:
Children/Adolescents, Asthma, Chronic Conditions, Disparities, Quality Improvement, Quality of Care, Health Insurance
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 / Ethnic Minorities, Hospitalization, Mortality, Rural Health
Morden NE, Chyn D, Wood A
Racial inequality in prescription opioid receipt - role of individual health systems.
The purpose of this study was to explore the contribution of individual health systems in the receipt of prescription opioids among racial groups in the United States. Medicare claims data for 2016-2017 was used to obtain a random 40% national sample of fee-for-service, Black and White beneficiaries 18 to 64 years of age and identify 310 racially diverse systems. Findings showed that, within individual health systems, Black and White patients received markedly different opioid doses. These system-specific findings could facilitate exploration of the causes and consequences of these differences.
AHRQ-funded; HS024075.
Citation:
Morden NE, Chyn D, Wood A .
Racial inequality in prescription opioid receipt - role of individual health systems.
N Engl J Med 2021 Jul 22;385(4):342-51. doi: 10.1056/NEJMsa2034159..
Keywords:
Opioids, Medication, Racial / Ethnic Minorities, Disparities, Practice Patterns
Cunningham-Erves J, Campbell L, Barlow C
Reducing HPV associated cancers and disparities: engaging African American men to develop a culturally-appropriate program that addresses their needs.
Reducing HPV associated cancers and disparities: engaging African American men to develop a culturally-appropriate program that addresses their needs.
Am J Health Educ 2021;52(4):194-206. doi: 10.1080/19325037.2021.1930614.
This paper discusses the results of the Healthy Men, Healthy Communities program that aims to improve preventive behaviors among African American men to reduce HPV-related cancer disparities. An educational intervention was developed using cultural-targeting strategies such as linguistics, peripherals, evidence, socio-culture, and constituent-involving. Research team members were recruited from community-based (CBO) leaders. Three focus groups, 30 surveys, and a community review and program evaluation with African American men were conducted. The five focus group themes were: 1) The Known and Unknown of Cancer, HPV, and the vaccine; (2) Personal experiences with cancer were commonplace; (3) Barriers to Engaging HPV Cancer Preventive Behaviors; (4) Multi-Modal Strategies are needed to improve preventive behaviors; and (5) Actual versus Preferred Sources of Information. Survey data showed men desired information on penile (52%) and oral cancer (48%). A speaker summit on various topics was the preferred education format (96%). A post-summit evaluation indicated most males intended to get screened (73%), eat healthier (77%), and exercise more (65%). After these interventions the HPV vaccine was administered to about 40% of the men, and their children and grandchildren.
Am J Health Educ 2021;52(4):194-206. doi: 10.1080/19325037.2021.1930614.
This paper discusses the results of the Healthy Men, Healthy Communities program that aims to improve preventive behaviors among African American men to reduce HPV-related cancer disparities. An educational intervention was developed using cultural-targeting strategies such as linguistics, peripherals, evidence, socio-culture, and constituent-involving. Research team members were recruited from community-based (CBO) leaders. Three focus groups, 30 surveys, and a community review and program evaluation with African American men were conducted. The five focus group themes were: 1) The Known and Unknown of Cancer, HPV, and the vaccine; (2) Personal experiences with cancer were commonplace; (3) Barriers to Engaging HPV Cancer Preventive Behaviors; (4) Multi-Modal Strategies are needed to improve preventive behaviors; and (5) Actual versus Preferred Sources of Information. Survey data showed men desired information on penile (52%) and oral cancer (48%). A speaker summit on various topics was the preferred education format (96%). A post-summit evaluation indicated most males intended to get screened (73%), eat healthier (77%), and exercise more (65%). After these interventions the HPV vaccine was administered to about 40% of the men, and their children and grandchildren.
AHRQ-funded; HS022990.
Citation:
Cunningham-Erves J, Campbell L, Barlow C .
Reducing HPV associated cancers and disparities: engaging African American men to develop a culturally-appropriate program that addresses their needs.
Am J Health Educ 2021;52(4):194-206. doi: 10.1080/19325037.2021.1930614..
Keywords:
Sexual Health, Infectious Diseases, Cancer, Disparities, Racial / Ethnic Minorities, Men's Health, Prevention, Health Promotion, Education: Patient and Caregiver
Coley RY, Johnson E, Simon GE
Racial/ethnic disparities in the performance of prediction models for death by suicide after mental health visits.
This study looked at racial/ethnic disparities in the performance of prediction models for death by suicide after mental health visit. The main outcome measured was the suicide rate within 90 days after a mental health visit. The study used a 50% sample of visits from a random set of outpatients at 7 large integrated health care systems by patients 13 years and older (6,984,184 visits). Suicide rates were highest for visits by patients with no race/ethnicity recorded, followed by Asian, White, American Indian/Alaskan Native, Hispanic, and Black. Sensitivity of both models used were high for White, Hispanic, and Asian patients and poor for Black and American Indian/Alaskan Native patients and patients with no race/ethnicity recorded.
AHRQ-funded; HS026369.
Citation:
Coley RY, Johnson E, Simon GE .
Racial/ethnic disparities in the performance of prediction models for death by suicide after mental health visits.
JAMA Psychiatry 2021 Jul;78(7):726-34. doi: 10.1001/jamapsychiatry.2021.0493..
Keywords:
Disparities, Racial / Ethnic Minorities, Behavioral Health, Mortality, Risk
Burris HH, Passarella M, Handley SC
Black-white disparities in maternal in-hospital mortality according to teaching and black-serving hospital status.
This study’s objective was to determine whether black-white disparities in maternal in-hospital mortality during delivery vary across hospital types (black-serving vs non-black and teaching vs non-teaching) and whether overall maternal mortality differs across hospital types. The authors performed a population-based, retrospective cohort study of 5,679,044 deliveries among black (14.2%) and white patients (85.8%) in 3 states (California, Missouri, and Pennsylvania) from 1995 to 2009. Examination of black-white disparities found that after risk adjustment, black patients had significantly greater risk of death and that the disparity was similar within each of the hospital types. At teaching hospitals, mortality was similar in black-serving and nonblack-serving hospitals. Among non-teaching hospitals, mortality was significantly higher in black-serving vs nonblack-serving hospitals. Over half (53%) of black patients delivered in nonteaching black-serving hospitals compared with just 19% of white patients.
AHRQ-funded; HS018661.
Citation:
Burris HH, Passarella M, Handley SC .
Black-white disparities in maternal in-hospital mortality according to teaching and black-serving hospital status.
Am J Obstet Gynecol 2021 Jul;225(1):83.e1-83.e9. doi: 10.1016/j.ajog.2021.01.004..
Keywords:
Maternal Care, Pregnancy, Mortality, Women, Racial / Ethnic Minorities, Disparities, Hospitals
Purnell TS, Simpson DC, Callender CO
Dismantling structural racism as a root cause of racial disparities in COVID-19 and transplantation.
As the United States faces unparalleled challenges due to COVID-19, racial disparities in health and healthcare have once again taken center stage. If effective interventions to address racial disparities in transplantation, including those magnified by COVID-19, are to be designed and implemented at the national level, it is first critical to understand the complex mechanisms by which structural, institutional, interpersonal, and internalized racism influence the presence of racial disparities in healthcare and transplantation. IN this article the authors discuss their viewpoint.
AHRQ-funded; HS024600.
Citation:
Purnell TS, Simpson DC, Callender CO .
Dismantling structural racism as a root cause of racial disparities in COVID-19 and transplantation.
Am J Transplant 2021 Jul;21(7):2327-32. doi: 10.1111/ajt.16543..
Keywords:
COVID-19, Racial / Ethnic Minorities, Disparities, Transplantation, Surgery, Access to Care
Lange EMS, Toledo P
Peripartum racial/ethnic disparities.
Addressing disparities has been a focus of the US Department of Health and Human Services Healthy People initiative for decades, with the most recent Healthy People 2020 establishing a need for health equity in the United States. In this article, the investigators presented an overview of peripartum racial/ethnic disparities and address potential structural solutions to improve maternal health equity.
AHRQ-funded; HS025267.
Citation:
Lange EMS, Toledo P .
Peripartum racial/ethnic disparities.
Int Anesthesiol Clin 2021 Jul 1;59(3):1-7. doi: 10.1097/aia.0000000000000326..
Keywords:
Maternal Care, Pregnancy, Disparities, Racial / Ethnic Minorities, Women
Lee K, Gani F, Canner JK
Racial disparities in utilization of palliative care among patients admitted with advanced solid organ malignancies.
The primary objective of this study was to describe racial differences in the use of inpatient palliative care consultations (IPCC) for patients with advanced cancer who are admitted to a hospital in the United States. Hospital admissions of patients with advanced cancers were identified through the National Inpatient Dataset. Findings showed that death during hospitalization was a significant modifier of the relationship between race and receipt of palliative care consultation. There were significant racial disparities in the utilization of IPCC for patients with advanced cancer.
AHRQ-funded; HS024736.
Citation:
Lee K, Gani F, Canner JK .
Racial disparities in utilization of palliative care among patients admitted with advanced solid organ malignancies.
Am J Hosp Palliat Care 2021 Jun;38(6):539-46. doi: 10.1177/1049909120922779..
Keywords:
Healthcare Cost and Utilization Project (HCUP), Palliative Care, Cancer, Disparities, Racial / Ethnic Minorities, Healthcare Utilization, Inpatient Care, Chronic Conditions
Lacson R, Shi J, Kapoor N
Exacerbation of inequities in use of diagnostic radiology during the early stages of reopening after COVID-19.
Researchers assessed diagnostic radiology examination utilization and associated social determinants of health during the early stages of reopening after state-mandated shutdown of nonurgent services because of COVID-19. They found that, despite resumption of nonurgent services, a marked decrease in radiology examination utilization persisted in all care settings post-shutdown, with more significantly decreased odds ratios for having examinations in inpatient and outpatient settings versus in the emergency department. Inequities worsened, with patients from communities with high rates of poverty, unemployment, and chronic disease having significantly lower odds of undergoing radiology examinations post-shutdown. Patients of Asian race and Hispanic ethnicity had significantly lower odds ratios for having examinations post-shutdown compared with White and non-Hispanic patients, respectively.
AHRQ-funded; HS024722.
Citation:
Lacson R, Shi J, Kapoor N .
Exacerbation of inequities in use of diagnostic radiology during the early stages of reopening after COVID-19.
J Am Coll Radiol 2021 May;18(5):696-703. doi: 10.1016/j.jacr.2020.12.009..
Keywords:
COVID-19, Disparities, Diagnostic Safety and Quality, Racial / Ethnic Minorities, Social Determinants of Health
Kim D, Lee Y, Thorsness R
Racial and ethnic disparities in excess deaths among persons with kidney failure during the COVID-19 pandemic, March-July 2020.
This national study estimated excess deaths for the kidney failure population by race and ethnicity from March 1 through August 1, 2020. Findings showed that, among the US kidney failure population, the number of excess deaths was 16% higher than expected, similar to reports for the general population. However, results showed that the relative increase in deaths among Black and Hispanic patients was more than 4-fold higher than that observed among White patients. The magnitude of these disparities was larger than corresponding relative ratios reported among COVID-19–associated deaths in the general population.
AHRQ-funded; HS028285.
Citation:
Kim D, Lee Y, Thorsness R .
Racial and ethnic disparities in excess deaths among persons with kidney failure during the COVID-19 pandemic, March-July 2020.
Am J Kidney Dis 2021 May;77(5):827-29. doi: 10.1053/j.ajkd.2021.02.003..
Keywords:
COVID-19, Racial / Ethnic Minorities, Disparities, Mortality, Kidney Disease and Health, Chronic Conditions, Social Determinants of Health
Javalkar K, Robson VK, Gaffney L
Socioeconomic and racial and/or ethnic disparities in multisystem inflammatory syndrome.
Researchers characterized the socioeconomic and racial and/or ethnic disparities impacting the diagnosis and outcomes of multisystem inflammatory syndrome in children (MIS-C). They found that lower socioeconomic status or higher social vulnerability index, Hispanic ethnicity, and Black race independently increased risk for MIS-C. They recommended additional studies to target interventions to improve health equity for children.
AHRQ-funded; HS000063.
Citation:
Javalkar K, Robson VK, Gaffney L .
Socioeconomic and racial and/or ethnic disparities in multisystem inflammatory syndrome.
Pediatrics 2021 May;147(5). doi: 10.1542/peds.2020-039933..
Keywords:
Children/Adolescents, Social Determinants of Health, Socioeconomic Factors, Disparities, Racial / Ethnic Minorities, Risk
Malhotra NA, Nevar A, Yearby R
Medicaid's EPSDT benefit: an opportunity to improve pediatric screening for social determinants of health.
This paper discusses the Early and Periodic Screening, Diagnostic, and Treatment (EPDST) benefit which is a key component of Medicaid policy intended to define an essential set of services provided to patients age 21 and younger. This qualitative review examines the extent to which EPSDT might be used to implement structured screening to identify environmental and social factors affecting children’s health. Semistructured interviews conducted in 2017 were triangulated with a review of the recent literature to describe how states currently consider the EPSDT benefit with respect to social determinants of health (SDOH) screening. Findings suggest that with sufficient stakeholder advocacy given the evidence supporting social determinants of health as “medically necessary”, EPSDT benefits could be considered as a funding source to incentivize the incorporation of SDOH screening into the basic package of well-child care.
AHRQ-funded; 233201600221A.
Citation:
Malhotra NA, Nevar A, Yearby R .
Medicaid's EPSDT benefit: an opportunity to improve pediatric screening for social determinants of health.
Med Care Res Rev 2021 Apr;78(2):87-102. doi: 10.1177/1077558719874211..
Keywords:
Children/Adolescents, Medicaid, Social Determinants of Health, Screening, Disparities, Policy
Costello WG, Zhang L, Schnipper J
Post-discharge adverse events among African American and Caucasian patients of an urban community hospital.
This study compared post-discharge adverse events (AEs) among African American and Caucasian patients at an urban community hospital. This prospective cohort study was conducted from December 2011 to October 2012. The cohort included 589 English-speaking patients who were discharged home and could be contacted after discharge for evaluation. Two nurses performed 30-day post-discharge telephone interviews, and two physicians reviewed health records to determine AEs using a previous methodology. African Americans had a slightly higher incidence of post-discharge AEs than Caucasian patients (30.6 vs. 29.9%) but it was not statistically significant.
AHRQ-funded; HS018694.
Citation:
Costello WG, Zhang L, Schnipper J .
Post-discharge adverse events among African American and Caucasian patients of an urban community hospital.
J Racial Ethn Health Disparities 2021 Apr;8(2):439-47. doi: 10.1007/s40615-020-00800-z..
Keywords:
Adverse Events, Racial / Ethnic Minorities, Urban Health, Disparities, Hospital Discharge
Moriya AS, Xu L
The complex relationships among race/ethnicity, social determinants, and opioid utilization.
The objective of this study was to examine individual- and community-level factors associated with racial/ethnic differences in individuals' opioid prescription use. The investigators found that the average annual rate of any outpatient opioid prescription use was higher for non-Hispanic whites than for non-Hispanic blacks and Hispanics. The smaller difference between non-Hispanic blacks and whites was not explained by the differences in the risk factors, while almost all the difference between Hispanics and non-Hispanic whites could be explained by the differences in the means of the risk factors.
AHRQ-authored.
Citation:
Moriya AS, Xu L .
The complex relationships among race/ethnicity, social determinants, and opioid utilization.
Health Serv Res 2021 Apr;56(2):310-22. doi: 10.1111/1475-6773.13619..
Keywords:
Medical Expenditure Panel Survey (MEPS), Racial / Ethnic Minorities, Social Determinants of Health, Opioids, Medication, Disparities
Dos Santos Marques IC, Theiss LM, Wood LN
Racial disparities exist in surgical outcomes for patients with inflammatory bowel disease.
The authors hypothesized that racial disparities exist for Hispanic and Asian patients undergoing surgery for inflammatory bowel disease (IBD). Data from the American College of Surgeons National Surgical Quality Improvement Program (ACS- NSQIP) was used. They found that racial disparities do exist among IBD patients undergoing surgery. Black, Hispanic, and Asian IBD patients experience major disparities in post-operative complications, readmissions, and length of stay, respectively, when compared to White patients with IBD. They recommended future research to better understand the mechanisms of these disparities including evaluation of social determinants of health.
AHRQ-funded; HS023009.
Citation:
Dos Santos Marques IC, Theiss LM, Wood LN .
Racial disparities exist in surgical outcomes for patients with inflammatory bowel disease.
Am J Surg 2021 Apr;221(4):668-74. doi: 10.1016/j.amjsurg.2020.12.010..
Keywords:
Disparities, Racial / Ethnic Minorities, Surgery, Digestive Disease and Health, Outcomes
Fraiman YS, Litt JS, Davis JM
Racial and ethnic disparities in adult COVID-19 and the future impact on child health.
This article discusses the impact of the COVID-19 pandemic on children who are racial and ethnic minorities and the disproportionate harm to them. The authors urge that COVID-19-focused research consider racial and ethnic disparity. The paper discusses the lasting and intergenerational impact of COVID-19 on communities of color, especially children, due to increase in stress, material hardship, food insecurity, and long-term school readiness.
AHRQ-funded; HS000063.
Citation:
Fraiman YS, Litt JS, Davis JM .
Racial and ethnic disparities in adult COVID-19 and the future impact on child health.
Pediatr Res 2021 Apr;89(5):1052-54. doi: 10.1038/s41390-021-01377-x..
Keywords:
COVID-19, Children/Adolescents, Racial / Ethnic Minorities, Disparities, Health Status, Social Determinants of Health
Smith JM, Jarrín OF, Lin H
Racial disparities in post-acute home health care referral and utilization among older adults with diabetes.
The purpose of this study was to examine the association between race/ethnicity and hospital discharge to home health care and subsequent utilization of home health care among a cohort of adults (age 50 and older) who experienced a diabetes-related hospitalization. The investigators found that among those discharged to home health care, all non-white racial/ethnic minority patients were less likely to receive services within 14-days.
AHRQ-funded; HS022406.
Citation:
Smith JM, Jarrín OF, Lin H .
Racial disparities in post-acute home health care referral and utilization among older adults with diabetes.
Int J Environ Res Public Health 2021 Mar 19;18(6):3196. doi: 10.3390/ijerph18063196..
Keywords:
Elderly, Home Healthcare, Diabetes, Chronic Conditions, Racial / Ethnic Minorities, Disparities, Access to Care, Healthcare Utilization
Sinclair KA, Muller C, Noonan C
Increasing health equity through biospecimen research: Identification of factors that influence willingness of Native Americans to donate biospecimens.
American Indian and Alaska Native (AI/AN) people are underrepresented in biomedical research, particularly in biospecimen research, yet little research has been conducted to assess AI/AN attitudes about biospecimen donation. In this study, the researchers identified factors that influence willingness of Native Americans to donate biospecimens. Their results highlighted areas in which interventions could be developed to increase AI/AN donation of biospecimens for research with the ultimate goal of reducing health disparities.
AHRQ-funded; HS023576.
Citation:
Sinclair KA, Muller C, Noonan C .
Increasing health equity through biospecimen research: Identification of factors that influence willingness of Native Americans to donate biospecimens.
Prev Med Rep 2021 Mar;21:101311. doi: 10.1016/j.pmedr.2021.101311..
Keywords:
Disparities, Racial / Ethnic Minorities, Research Methodologies
Han B, Chen PG, Yu H
Access to after-hours primary care: a key determinant of children's medical home status.
Researchers sought to identify individual survey items or domains that best predict medical home (MH) status for children and use them to develop brief markers of MH status. Using MEPS data, they found that accessibility, especially the ability to access health care after regular office hours, appeared to be the major predictor of having a MH among children. They recommended that the ongoing efforts to promote the MH model target improving accessibility of health care after regular hours for children overall and especially for Latino children.
AHRQ-funded; HS023336.
Citation:
Han B, Chen PG, Yu H .
Access to after-hours primary care: a key determinant of children's medical home status.
BMC Health Serv Res 2021 Feb 27;21(1):185. doi: 10.1186/s12913-021-06192-y..
Keywords:
Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare, Access to Care, Healthcare Delivery, Disparities, Racial / Ethnic Minorities
Safon CB, Heeren TC, Kerr SM
Disparities in breastfeeding among U.S. Black mothers: identification of mechanisms.
Disparities in U.S. breastfeeding rates persist among Black mothers according to birth country and between Black and White mothers, necessitating further investigation of modifiable mediating factors to inform interventions. This study sought to examine the extent that social, maternal, infant factors and Theory of Planned Behavior (TPB) domains (attitudes, perceived control, and subjective norms) mediated the association of maternal race/birth country and breastfeeding continuation.
AHRQ-funded; HS022242.
Citation:
Safon CB, Heeren TC, Kerr SM .
Disparities in breastfeeding among U.S. Black mothers: identification of mechanisms.
Breastfeed Med 2021 Feb;16(2):140-49. doi: 10.1089/bfm.2020.0310..
Keywords:
Breast Feeding, Racial / Ethnic Minorities, Disparities, Maternal Care, Women
McCoy RG, Van Houten HK, Deng Y
Comparison of diabetes medications used by adults with commercial insurance vs Medicare Advantage, 2016 to 2019.
Investigators sought to compare trends in initiation of treatment with GLP-1RA, SGLT2i, and DPP-4i by older adults with type 2 diabetes insured by Medicare Advantage vs commercial health plans. They found that Medicare Advantage beneficiaries may be less likely than commercially insured beneficiaries to be treated with newer medications to lower glucose levels, with greater disparities among lower-income patients. They recommended further investigation of nonclinical factors contributing to treatment decisions and efforts to promote greater equity in diabetes management.
AHRQ-funded; HS025164.
Citation:
McCoy RG, Van Houten HK, Deng Y .
Comparison of diabetes medications used by adults with commercial insurance vs Medicare Advantage, 2016 to 2019.
JAMA Netw Open 2021 Feb;4(2):e2035792. doi: 10.1001/jamanetworkopen.2020.35792..
Keywords:
Elderly, Diabetes, Chronic Conditions, Medication, Medicare, Health Insurance, Disparities, Low-Income
