National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (3)
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- Cultural Competence (1)
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- (-) Diabetes (19)
- (-) Disparities (19)
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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 19 of 19 Research Studies DisplayedTaylor Gangnon, R R, Powell WR
Association of rurality and identifying as Black with receipt of specialty care among patients hospitalized with a diabetic foot ulcer: a Medicare cohort study.
This national retrospective cohort study examined Medicare beneficiaries hospitalized with diabetic foot ulcers. Investigators sought to determine what proportion of rural patients, particularly those identifying as black, received specialty care in comparison with the national proportion. Their findings indicated that a smaller proportion of rural patients, particularly those identified as black, received specialty care compared with the overall cohort. They concluded that this might contribute to disparities in major amputations, but future studies are required to determine causality.
AHRQ-funded; HS026279.
Citation: Taylor Gangnon, R R, Powell WR .
Association of rurality and identifying as Black with receipt of specialty care among patients hospitalized with a diabetic foot ulcer: a Medicare cohort study.
BMJ Open Diabetes Res Care 2023 Apr; 11(2). doi: 10.1136/bmjdrc-2022-003185..
Keywords: Rural Health, Racial and Ethnic Minorities, Diabetes, Chronic Conditions, Disparities
Lock LJ, Channa R, Brennan MB
Effect of health system on the association of rurality and level of disadvantage with receipt of diabetic eye screening.
The goal of this retrospective cohort study was to determine the role of level of disadvantage in diabetic eye screening to explain the effect of health systems on rural and urban disparities. Researchers used an all-payer, statewide claims database to include adult Wisconsin residents with diabetes who had claims billed throughout the baseline and measurement years. Results indicated that patients from urban underserved clinics were more likely to receive screening than those from rural underserved clinics; similar findings emerged for both Medicare and non-Medicare subgroups. The researchers concluded that health systems, especially those that serve urban underserved populations, have an opportunity to increase screening rates by leveraging health system-level interventions and supporting patients in overcoming barriers.
AHRQ-funded; HS026279.
Citation: Lock LJ, Channa R, Brennan MB .
Effect of health system on the association of rurality and level of disadvantage with receipt of diabetic eye screening.
BMJ Open Diabetes Res Care 2022 Dec;10(6):e003174. doi: 10.1136/bmjdrc-2022-003174..
Keywords: Rural Health, Access to Care, Screening, Diabetes, Eye Disease and Health, Disparities, Chronic Conditions, Health Systems
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 and Ethnic Minorities, Disparities, Access to Care, Healthcare Utilization
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
Odlum M, Moise N, Kronish IM
Trends in poor health indicators among Black and Hispanic middle-aged and older adults in the United States, 1999-2018.
This study used records extracted from the Behavioral Risk Factor Surveillance System to determine which health indicators have improved or became worse among Black and Hispanic middle-aged (45 and older) adults compared to Whites from 1999 to 2018. This data is required by the Minority Health and Health Disparities Research and Education Act of 2000. A sample included of 4,856,326 participants, of them 60.9% women, mean age 60.4. During the last 20 years, Black adults showed an overall decrease showing improvement in uninsured status and physical inactivity while showing an overall increase in hypertension, diabetes, asthma, and stroke, and also the same increases and decreases in the Black-White gap. Hispanic adults showed improvement in physical inactivity and perceived poor health, while they showed overall deterioration in hypertension and diabetes. The Hispanic-White gap improved in coronary heart disease, stroke, kidney disease, asthma, arthritis, depression and physical inactivity while it increased for diabetes, hypertension, and uninsured status.
AHRQ-funded; HS025198.
Citation: Odlum M, Moise N, Kronish IM .
Trends in poor health indicators among Black and Hispanic middle-aged and older adults in the United States, 1999-2018.
JAMA Netw Open 2020 Nov 2;3(11):e2025134. doi: 10.1001/jamanetworkopen.2020.25134..
Keywords: Elderly, Racial and Ethnic Minorities, Disparities, Health Status, Health Insurance, Diabetes, Blood Pressure, Chronic Conditions
Sutherland BL, Pecanac K, Bartels CM
Expect delays: poor connections between rural and urban health systems challenge
Rural Americans with diabetic foot ulcers (DFUs) face a 50% increased risk of major amputation compared to their urban counterparts. In this study, the investigators sought to identify health system barriers contributing to this disparity. The investigators concluded that poor connections across rural and urban healthcare systems were described as the primary health system barrier driving the rural disparity in major amputations.
AHRQ-funded; HS026279.
Citation: Sutherland BL, Pecanac K, Bartels CM .
Expect delays: poor connections between rural and urban health systems challenge
J Foot Ankle Res 2020 Jun 16;13(1):32. doi: 10.1186/s13047-020-00395-y..
Keywords: Rural Health, Health Systems, Disparities, Diabetes, Chronic Conditions, Healthcare Delivery
Angier H, Ezekiel-Herera D, Marino M
Racial/ethnic disparities in health insurance and differences in visit type for a population of patients with diabetes after Medicaid Expansion.
Racial/ethnic disparities in health insurance and differences in visit type for a population of patients with diabetes after Medicaid Expansion.
AHRQ-funded; HS024270.
Citation: Angier H, Ezekiel-Herera D, Marino M .
Racial/ethnic disparities in health insurance and differences in visit type for a population of patients with diabetes after Medicaid Expansion.
J Health Care Poor Underserved 2019;30(1):116-30. doi: 10.1353/hpu.2019.0011.
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Keywords: Access to Care, Diabetes, Disparities, Health Insurance, Medicaid, Racial and Ethnic Minorities
Wingood GM, Lambert D, Renfro T
A multilevel intervention with African American churches to enhance adoption of point-of-care HIV and diabetes testing, 2014-2018.
This article describes a multilevel intervention to enhance the adoption of point-of-care HIV and diabetes testing at church health fairs in Atlanta, GA. Church leaders viewed a video and subsequently conducted social activities that support testing; a third of the churches involved hosted HIV and diabetes health fairs and resulted in an increase in attendees receiving HIV or diabetes testing. The authors conclude that this implementation science approach could reduce HIV and diabetes disparities among African Americans.
AHRQ-funded; HS022059.
Citation: Wingood GM, Lambert D, Renfro T .
A multilevel intervention with African American churches to enhance adoption of point-of-care HIV and diabetes testing, 2014-2018.
Am J Public Health 2019 Feb;109(S2):S141-s44. doi: 10.2105/ajph.2019.304990..
Keywords: Diabetes, Human Immunodeficiency Virus (HIV), Prevention, Racial and Ethnic Minorities, Disparities, Screening
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
Lobo JM, Anderson R, Stukenborg GJ
Disparities in the use of diabetes screening in Appalachia.
This study examines disparities in the use of diabetes screening in Appalachia. Results showed that at-risk counties had significantly lower screening rates than competitive counties. Recommendations include introducing social policies that improve socioeconomic status and educational attainment, and health policies that reduce barriers to access to care in order to reduce disparities in diabetes screening rates in the less affluent Appalachian counties.
AHRQ-funded; HS018542.
Citation: Lobo JM, Anderson R, Stukenborg GJ .
Disparities in the use of diabetes screening in Appalachia.
J Rural Health 2018 Mar;34(2):173-81. doi: 10.1111/jrh.12247..
Keywords: Diabetes, Rural Health, Disparities, Social Determinants of Health, Screening, Prevention
Leung LB, Vargas-Bustamante A, Martinez AE
Disparities in diabetes care quality by English language preference in community health centers.
Researchers conducted a parallel analysis of disparities in diabetes care quality among Latino and Asian community health center (CHC) patients by English language preference. After adjusting for socioeconomic and health characteristics, disparities in patient experiences by English language preference were found only among Asian patients. There were no significant differences in glycemic control by language for either Latino or Asian patients.
AHRQ-funded; HS020120.
Citation: Leung LB, Vargas-Bustamante A, Martinez AE .
Disparities in diabetes care quality by English language preference in community health centers.
Health Serv Res 2018 Feb;53(1):509-31. doi: 10.1111/1475-6773.12590.
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Keywords: Community-Based Practice, Cultural Competence, Diabetes, Disparities, Racial and Ethnic Minorities
Beckman AL, Herrin J, Nasir K
Trends in cardiovascular health of US adults by income, 2005-2014.
This research letter discusses the trends in cardiovascular health of US adults by income from 2005-2014. The investigators assessed national trends in cardiovascular risk factors by income level among adults aged 25 years and older using data from the National Health and Nutrition Examination Surveys, a nationally representative, multistage probability sample of the US population, across 5 periods: 2005 to 2006, 2007 to 2008, 2009 to 2010, 2011 to 2012, and 2013 to 2014.
AHRQ-funded; HS023000.
Citation: Beckman AL, Herrin J, Nasir K .
Trends in cardiovascular health of US adults by income, 2005-2014.
JAMA Cardiol 2017 Jul;2(7):814-16. doi: 10.1001/jamacardio.2017.1654..
Keywords: Cardiovascular Conditions, Risk, Disparities, Health Status, Blood Pressure, Obesity, Diabetes, Low-Income, Tobacco Use
Tung EL, Baig AA, Huang ES
Racial and ethnic disparities in diabetes screening between asian americans and other adults: BRFSS 2012-2014.
The researchers assessed racial and ethnic disparities in diabetes screening between Asian Americans and other adults. They found that Asian Americans were the least likely racial and ethnic group to receive recommended diabetes screening. Overall, Asian Americans had 34 percent lower adjusted odds of receiving recommended diabetes screening compared to non-Hispanic whites.
AHRQ-funded; HS000078.
Citation: Tung EL, Baig AA, Huang ES .
Racial and ethnic disparities in diabetes screening between asian americans and other adults: BRFSS 2012-2014.
J Gen Intern Med 2017 Apr;32(4):423-29. doi: 10.1007/s11606-016-3913-x.
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Keywords: Racial and Ethnic Minorities, Diabetes, Screening, Disparities, Prevention
Sohn MW, Kang H, Park JS
Disparities in recommended preventive care usage among persons living with diabetes in the Appalachian region.
This study examined disparities in the receipt of preventive care recommended by the American Diabetes Association (ADA) between Appalachian and non-Appalachian counties and within Appalachian counties. It concluded that there are significant disparities in the uptake of many recommended preventive services between less and more affluent counties in the Appalachian region.
AHRQ-funded; HS018542.
Citation: Sohn MW, Kang H, Park JS .
Disparities in recommended preventive care usage among persons living with diabetes in the Appalachian region.
BMJ Open Diabetes Res Care 2016 Dec;4(1):e000284. doi: 10.1136/bmjdrc-2016-000284.
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Keywords: Diabetes, Disparities, Prevention, Chronic Conditions, Social Determinants of Health
Adedinsewo D, Taka N, Agasthi P
Prevalence and factors associated with statin use among a nationally representative sample of US Adults: National Health and Nutrition Examination Survey, 2011-2012.
The researchers estimated the prevalence and likelihood of statin use among a statin benefit group with diabetes and a second group with arteriosclerosis. In adjusted models, uninsured and Hispanic adults were less likely to be on a statin compared with white adults; 59.5 percent of all adults in the diabetes statin benefit group, and 63.5 percent of all adults in the srteriosclerosis group were on a statin.
AHRQ-funded; HS022444.
Citation: Adedinsewo D, Taka N, Agasthi P .
Prevalence and factors associated with statin use among a nationally representative sample of US Adults: National Health and Nutrition Examination Survey, 2011-2012.
Clin Cardiol 2016 Sep;39(9):491-6. doi: 10.1002/clc.22577.
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Keywords: Cardiovascular Conditions, Diabetes, Medication, Disparities, Racial and Ethnic Minorities
Adams AS, Soumerai SB, Zhang F
Effects of eliminating drug caps on racial differences in antidepressant use among dual enrollees with diabetes and depression.
This study aimed to evaluate the impact of removing a significant financial barrier to prescription medications (drug caps) on existing black-white disparities in antidepressant treatment rates among patients with diabetes and comorbid depression. It found that policies that remove financial barriers to medications may increase depression treatment rates among patients with diabetes overall while exacerbating treatment disparities.
AHRQ-funded; HS018577; HS018072.
Citation: Adams AS, Soumerai SB, Zhang F .
Effects of eliminating drug caps on racial differences in antidepressant use among dual enrollees with diabetes and depression.
Clin Ther 2015 Mar;37(3):597-609. doi: 10.1016/j.clinthera.2014.12.011..
Keywords: Medication, Disparities, Depression, Diabetes, Healthcare Costs
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
Chen R, Cheadle A, Johnson D
US trends in receipt of appropriate diabetes clinical and self-care from 2001 to 2010 and racial/ethnic disparities in care.
The purpose of this study was to examine trends in the receipt of 8 recommended diabetes clinical and self-care indicators from 2001 to 2010 and assess racial/ethnic disparities in care. There were significant increases from 2001 to 2010 in A1C tests, annual foot exams, flu shots, diabetes self-management education and self management of blood glucose but declines in eye and self feet exams.
AHRQ-funded; HS013853.
Citation: Chen R, Cheadle A, Johnson D .
US trends in receipt of appropriate diabetes clinical and self-care from 2001 to 2010 and racial/ethnic disparities in care.
Diabetes Educ 2014 Nov-Dec;40(6):756-66. doi: 10.1177/0145721714546721..
Keywords: Diabetes, Patient Self-Management, Disparities, Racial and Ethnic Minorities, Racial and Ethnic Minorities
Zhang R, Lee JY, Jean-Jacques M
Factors influencing the increasing disparity in LDL cholesterol control between white and black patients with diabetes in a context of active quality improvement.
The authors conducted a retrospective analysis of black and white patients treated continuously between 2008 and 2010 in order to examine possible causes of an increased disparity in low-density lipoprotein (LDL) cholesterol control following a multifaceted physician-directed quality improvement (QI) initiative. They found that physician-facing, general QI interventions may be insufficient to produce equity in LDL cholesterol control, and that helping patients maintain prior success controlling cholesterol appears as important in addressing this disparity as is helping uncontrolled patients achieve control.
AHRQ-funded; HS021141.
Citation: Zhang R, Lee JY, Jean-Jacques M .
Factors influencing the increasing disparity in LDL cholesterol control between white and black patients with diabetes in a context of active quality improvement.
Am J Med Qual 2014 Jul-Aug;29(4):308-14. doi: 10.1177/1062860613498112.
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Keywords: Heart Disease and Health, Diabetes, Disparities, Quality Improvement, Racial and Ethnic Minorities