National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (5)
- Adverse Events (1)
- Alcohol Use (1)
- Ambulatory Care and Surgery (1)
- Behavioral Health (1)
- Cancer (6)
- Cancer: Breast Cancer (1)
- Cancer: Lung Cancer (1)
- Cancer: Prostate Cancer (3)
- Care Coordination (3)
- Caregiving (2)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (5)
- Chronic Conditions (2)
- Community-Based Practice (1)
- Comparative Effectiveness (1)
- Data (1)
- Dental and Oral Health (1)
- Diabetes (3)
- Diagnostic Safety and Quality (1)
- Dialysis (1)
- Digestive Disease and Health (1)
- Disparities (1)
- Education: Patient and Caregiver (2)
- Elderly (3)
- Falls (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (7)
- (-) Healthcare Costs (77)
- Healthcare Delivery (2)
- Healthcare Utilization (5)
- Health Information Technology (HIT) (2)
- Health Insurance (11)
- Health Promotion (1)
- Health Services Research (HSR) (4)
- Health Status (3)
- Health Systems (1)
- Hepatitis (1)
- Home Healthcare (1)
- Hospital Discharge (2)
- Hospitalization (8)
- Hospital Readmissions (1)
- Hospitals (5)
- Human Immunodeficiency Virus (HIV) (3)
- Imaging (2)
- Infectious Diseases (1)
- Injuries and Wounds (2)
- Inpatient Care (3)
- Intensive Care Unit (ICU) (1)
- Kidney Disease and Health (1)
- Lifestyle Changes (1)
- Long-Term Care (2)
- Low-Income (2)
- Medicaid (8)
- Medical Expenditure Panel Survey (MEPS) (6)
- Medicare (14)
- Medication (5)
- Men's Health (1)
- Mortality (3)
- Neurological Disorders (1)
- Newborns/Infants (1)
- Nursing (2)
- Nutrition (2)
- Organizational Change (1)
- Orthopedics (1)
- Outcomes (3)
- Palliative Care (2)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (1)
- Patient Safety (3)
- Payment (11)
- Policy (9)
- Practice Patterns (1)
- Pregnancy (1)
- Pressure Ulcers (1)
- Prevention (3)
- Primary Care (4)
- Provider: Health Personnel (1)
- Provider Performance (3)
- Public Health (2)
- Quality Improvement (3)
- Quality of Care (3)
- Quality of Life (4)
- Respiratory Conditions (1)
- Risk (1)
- Screening (3)
- Shared Decision Making (2)
- Social Determinants of Health (3)
- Stress (1)
- Surgery (11)
- Trauma (1)
- Treatments (2)
- Vaccination (4)
- Vulnerable Populations (2)
- Women (1)
- Workforce (1)
- Young Adults (1)
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 77 Research Studies DisplayedFitzpatrick MC, Shah HA, Pandey A
One Health approach to cost-effective rabies control in India.
The authors developed a data-driven rabies transmission model fit to human rabies autopsy data and human rabies surveillance data from Tamil Nadu, India. They found that highly feasible strategies focused on stray dogs, vaccinating as few as 7% of dogs annually, could very cost-effectively reduce human rabies deaths by 70% within 5 years, and a modest expansion to vaccinating 13% of stray dogs could cost-effectively reduce human rabies by almost 90%. Futher, if owners are willing to bring dogs to central point campaigns at double the rate that campaign teams can capture strays, expanded annual targets become cost-effective.
AHRQ-funded; HS000055.
Citation: Fitzpatrick MC, Shah HA, Pandey A .
One Health approach to cost-effective rabies control in India.
Proc Natl Acad Sci U S A 2016 Dec 20;113(51):14574-81. doi: 10.1073/pnas.1604975113.
.
.
Keywords: Healthcare Costs, Infectious Diseases, Prevention, Vaccination
Sherry M, Wolff JL, Ballreich J
Bridging the silos of service delivery for high-need, high-cost individuals.
This study examined 5 innovative community-oriented programs that are successfully coordinating medical and nonmedical services to identify factors that stimulate and sustain community-level collaboration and coordinated care across silos of health care, public health, and social services delivery. The authors constructed a conceptual framework depicting community health systems that highlights 4 foundational factors that facilitate community-oriented collaboration.
AHRQ-funded; HS000029.
Citation: Sherry M, Wolff JL, Ballreich J .
Bridging the silos of service delivery for high-need, high-cost individuals.
Popul Health Manag 2016 Dec;19(6):421-28. doi: 10.1089/pop.2015.0147.
.
.
Keywords: Community-Based Practice, Healthcare Costs, Healthcare Delivery, Care Coordination
Nuckols TK, Keeler E, Morton SC
Economic evaluation of quality improvement interventions for bloodstream infections related to central catheters: a systematic review.
The authors systematically reviewed economic evaluations of QI interventions designed to prevent central-line-associated bloodstream infections (CLABSI) and catheter-related bloodstream infections (CRBSI) in acute care hospitals. They concluded that interventions related to central venous catheters were, on average, associated with 57% fewer bloodstream infections and substantial savings to hospitals. Larger initial investments may be associated with greater savings.
AHRQ-funded.
Citation: Nuckols TK, Keeler E, Morton SC .
Economic evaluation of quality improvement interventions for bloodstream infections related to central catheters: a systematic review.
JAMA Intern Med 2016 Dec;176(12):1843-54. doi: 10.1001/jamainternmed.2016.6610.
.
.
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Healthcare Costs, Quality Improvement
Krakovitz PR, Boss EF
Intraoperative nerve monitoring during thyroidectomy-more complex than cost alone.
This brief invited commentary discussed intraoperative nerve monitoring and surgery.
AHRQ-funded; HS022932.
Citation: Krakovitz PR, Boss EF .
Intraoperative nerve monitoring during thyroidectomy-more complex than cost alone.
JAMA Otolaryngol Head Neck Surg 2016 Dec;142(12):1206-07. doi: 10.1001/jamaoto.2016.3116.
.
.
Keywords: Shared Decision Making, Healthcare Costs, Patient-Centered Outcomes Research, Quality of Life, Surgery
Nathan H, Dimick JB
Opportunities for surgical leadership in managing population health costs.
The concept of population health management—long a mainstay in primary care and chronic disease management—is taking root in surgery. The 2010 Affordable Care Act (ACA) ushered in the implementation of several innovative payment models that shift accountability for population costs to health systems and providers. The authors discuss the implications of th trends for the surgical profession.
AHRQ-funded; HS024763.
Citation: Nathan H, Dimick JB .
Opportunities for surgical leadership in managing population health costs.
Ann Surg 2016 Dec;264(6):909-10. doi: 10.1097/sla.0000000000001759.
.
.
Keywords: Healthcare Costs, Payment, Provider: Health Personnel, Surgery
Kirby JB, Davidoff AJ, Basu J
AHRQ Author: Kirby JB, Basu J
The ACA's zero cost-sharing mandate and trends in out-of-pocket expenditures on well-child and screening mammography visits.
This study used a nationally representative sample of ambulatory care visits to estimate the impact of the zero cost-sharing mandate on out-of-pocket expenditures on well-child and screening mammography visits. It concluded that the Affordable Care Act's zero cost-sharing mandate for preventive care has had a large impact on out-of-pocket expenditures for well-child and mammography visits.
AHRQ-authored.
Citation: Kirby JB, Davidoff AJ, Basu J .
The ACA's zero cost-sharing mandate and trends in out-of-pocket expenditures on well-child and screening mammography visits.
Med Care 2016 Dec;54(12):1056-62. doi: 10.1097/mlr.0000000000000610.
.
.
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Screening, Women, Policy, Prevention
Abdus S, Selden TM, Keenan P
AHRQ Author: Abdus S, Selden TM, Keenan P
The financial burdens of high-deductible plans.
The increased prevalence of high-deductible health plans raises concerns regarding high financial burdens from health care, particularly for low-income adults.
AHRQ-authored.
Citation: Abdus S, Selden TM, Keenan P .
The financial burdens of high-deductible plans.
Health Aff 2016 Dec;35(12):2297-301. doi: 10.1377/hlthaff.2016.0842.
.
.
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Healthcare Costs, Social Determinants of Health
. .
Why did the Affordable Care Act raise coverage?
This article discusses NBER Working Paper No. 22213 on Premium Subsidies, the Mandate,and Medicaid Expansion: Coverage Effects of the Affordable Care Act by researchers Molly Frean, Jonathan Gruber, and Benjamin Sommers. The study’s key result is that the ACA’s premium subsidies led to a 0.85 percentage point increase in coverage, while the expansion of Medicaid to newly eligible individuals led to a 0.44 point increase.
AHRQ-funded; HS021291.
Citation: . . .
Why did the Affordable Care Act raise coverage?
Natl Bur Econ Res Bull Aging Health 2016(2):3.
.
.
Keywords: Medicaid, Health Insurance, Policy, Healthcare Costs
Giordano SH, Niu J, Chavez-MacGregor M
Estimating regimen-specific costs of chemotherapy for breast cancer: observational cohort study.
The objective of the current study was to generate cost estimates for guideline-concordant adjuvant chemotherapy regimens from payers' and patients' perspectives in a large, insured US population. It concluded that the costs of breast cancer chemotherapy vary widely across regimens, and patients bear a substantial out-of-pocket burden.
AHRQ-funded; HS020263.
Citation: Giordano SH, Niu J, Chavez-MacGregor M .
Estimating regimen-specific costs of chemotherapy for breast cancer: observational cohort study.
Cancer 2016 Nov 15; 122(2):3447-3455. doi: 10.1002/cncr.30274.
.
.
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Healthcare Costs
O'Shea L, Bindman AB
AHRQ Author: Bindman AB
Personal health budgets for patients with complex needs.
Some of the highest cost patients have functional impairments and social needs that necessitate long-term services and supports. One approach from England entails the creation of “personal health budgets,” a model for self-directed support that may be worth considering in the United States. The authors discuss this approach and conclude that the evidence from England suggests that patients themselves can help to design higher-value care.
AHRQ-authored.
Citation: O'Shea L, Bindman AB .
Personal health budgets for patients with complex needs.
N Engl J Med 2016 Nov 10;375(19):1815-17. doi: 10.1056/NEJMp1606040.
.
.
Keywords: Healthcare Costs, Policy, Policy
Michaelidis CI, Fine MJ, Lin CJ
The hidden societal cost of antibiotic resistance per antibiotic prescribed in the United States: an exploratory analysis.
This study estimated the hidden societal cost of antibiotic resistance per antibiotic prescribed in the United States. It concluded that each ambulatory antibiotic prescription is associated with a hidden societal cost of antibiotic resistance (SCAR) that substantially increases the cost of an antibiotic prescription in the United States. This finding raises concerns regarding the magnitude of misalignment between individual and societal antibiotic costs.
AHRQ-funded; HS024930.
Citation: Michaelidis CI, Fine MJ, Lin CJ .
The hidden societal cost of antibiotic resistance per antibiotic prescribed in the United States: an exploratory analysis.
BMC Infect Dis 2016 Nov 8;16(1):655. doi: 10.1186/s12879-016-1990-4.
.
.
Keywords: Medication, Primary Care, Hospitalization, Healthcare Costs, Ambulatory Care and Surgery
Nocon RS, Lee SM, Sharma R
AHRQ Author: Ngo-Metzger Q
Health care use and spending for medicaid enrollees in federally qualified health centers versus other primary care settings.
This study compared health care use and spending of Medicaid enrollees seen at federally qualified health centers versus non-health center settings in a context of significant growth. It found that health center patients had lower use and spending than did non-health center patients across all services, with 22 percent fewer visits and 33 percent lower spending on specialty.
AHRQ-authored.
Citation: Nocon RS, Lee SM, Sharma R .
Health care use and spending for medicaid enrollees in federally qualified health centers versus other primary care settings.
Am J Public Health 2016 Nov;106(11):1981-89. doi: 10.2105/ajph.2016.303341.
.
.
Keywords: Medicaid, Healthcare Costs, Primary Care, Healthcare Utilization
Pradarelli JC, Healy MA, Osborne NH
Variation in Medicare expenditures for treating perioperative complications: the cost of rescue.
The researchers evaluated differences across hospitals in the costs of care for patients surviving perioperative complications after major inpatient surgery. After 4 selected inpatient operations, substantial variation was observed across hospitals regarding Medicare episode payments for patients rescued from perioperative complications. Notably, higher Medicare payments were not associated with improved clinical performance.
AHRQ-funded; HS017765.
Citation: Pradarelli JC, Healy MA, Osborne NH .
Variation in Medicare expenditures for treating perioperative complications: the cost of rescue.
JAMA Surg 2016 Oct 5:e163340. doi: 10.1001/jamasurg.2016.3340.
.
.
Keywords: Medicare, Adverse Events, Surgery, Healthcare Costs, Patient Safety
Peiris D, Phipps-Taylor MC, Stachowski CA
ACOs holding commercial contracts are larger and more efficient than noncommercial ACOs.
The researchers examined differences between commercial accountable care organizations (ACOs) and noncommercial ACOs. They found that among all ACOs, there was low uptake of quality and efficiency activities; commercial ACOs reported more use of disease monitoring tools, patient satisfaction data, and quality improvement methods; and about two-thirds of the ACOs had established processes for distributing any savings accrued. They concluded that ACO delivery systems remain at a nascent stage.
AHRQ-funded; HS024075.
Citation: Peiris D, Phipps-Taylor MC, Stachowski CA .
ACOs holding commercial contracts are larger and more efficient than noncommercial ACOs.
Health Aff 2016 Oct;35(10):1849-56. doi: 10.1377/hlthaff.2016.0387.
.
.
Keywords: Healthcare Costs, Payment, Health Systems, Medicaid, Medicare
Schulz R, Beach SR, Matthews JT
Caregivers' willingness to pay for technologies to support caregiving.
The authors reported the results of a study designed to assess whether and how much informal caregivers are willing to pay for technologies designed to help monitor and support care recipients (CRs) in performing kitchen and personal care tasks. By web survey, they found that about 20% of caregivers were not willing to pay anything for kitchen and self-care technologies. Among those willing to pay, the mean amount was approximately $50 per month for monitoring technologies and $70 per month for technologies that both monitored and provided some assistance. Younger caregivers, those caring for a person with Alzheimer's disease, and caregivers with more positive attitudes toward and experience with technology were willing to pay more. Most caregivers felt that the government or private insurance should help pay for these technologies.
AHRQ-funded; HS022889.
Citation: Schulz R, Beach SR, Matthews JT .
Caregivers' willingness to pay for technologies to support caregiving.
Gerontologist 2016 Oct;56(5):817-29. doi: 10.1093/geront/gnv033.
.
.
Keywords: Caregiving, Healthcare Costs, Health Information Technology (HIT)
Murray MT, Heitkempber E, Jackson O
Direct costs of acute respiratory infections in a pediatric long-term care facility.
Acute respiratory tract infections (ARI) are a major burden in pediatric long-term care. The researchers analyzed the financial impact of ARI in 2012-2013. Costs associated with ARI during the respiratory viral season were ten times greater than during the non-respiratory viral season, $31,224 and $3,242 per 1000 patient-days, respectively.
AHRQ-funded; HS021470.
Citation: Murray MT, Heitkempber E, Jackson O .
Direct costs of acute respiratory infections in a pediatric long-term care facility.
Influenza Other Respir Viruses 2016 Jan;10(1):34-6. doi: 10.1111/irv.12350.
.
.
Keywords: Children/Adolescents, Respiratory Conditions, Long-Term Care, Healthcare Costs, Children/Adolescents
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.
.
.
Keywords: Access to Care, Healthcare Costs, Hepatitis, Medication, Vulnerable Populations
Eaton EF, Tamhane A, Saag M
Cost considerations in the current antiretroviral era.
The authors analyzed the relative cost-effectiveness of contemporary antiretroviral therapy in real-world clinical settings. They found that, among the participants studied, raltegravir and efavirenz-based regimens were the most cost-effective options for treatment-naive patients. They suggested that these findings are relevant given changes in recommended regimens for treatment-naive persons. The authors recommended that further data on the comparative effectiveness of efavirenz and rilpivirine are needed.
AHRQ-funded; HS013852.
Citation: Eaton EF, Tamhane A, Saag M .
Cost considerations in the current antiretroviral era.
AIDS 2016 Sep 10;30(14):2115-9. doi: 10.1097/qad.0000000000001120.
.
.
Keywords: Healthcare Costs, Human Immunodeficiency Virus (HIV), Medication
Grundy Q
"Whether something cool is good enough": the role of evidence, sales representatives and nurses' expertise in hospital purchasing decisions.
The author analyzed the ways that committee members constructed and evaluated a case for a product's value, concluding that purchasing committees need unique support that emphasizes local contexts and expertise, while maintaining rigor and minimizing bias. Grundy proposed a guiding framework to support this decision-making.
AHRQ-funded; HS022383.
Citation: Grundy Q .
"Whether something cool is good enough": the role of evidence, sales representatives and nurses' expertise in hospital purchasing decisions.
Soc Sci Med 2016 Sep;165:82-91. doi: 10.1016/j.socscimed.2016.07.042.
.
.
Keywords: Shared Decision Making, Healthcare Costs, Hospitals, Nursing
Breitenstein SM, Schoeny M, Risser H
A study protocol testing the implementation, efficacy, and cost effectiveness of the ezParent program in pediatric primary care.
The purpose of this paper is to describe the study protocol evaluating the implementation, efficacy, and cost-effectiveness of implementing the tablet-based ezParent program in pediatric primary care settings. Data on parenting and child behavior outcomes will be obtained at baseline, and at 3, 6, and 12 months post baseline. The authors suggest that the implementation of the ezParent is an innovative opportunity to promote positive parenting with potential for universal access to the preschool population and for low cost by building on existing infrastructure in pediatric primary care settings.
AHRQ-funded; HS024273.
Citation: Breitenstein SM, Schoeny M, Risser H .
A study protocol testing the implementation, efficacy, and cost effectiveness of the ezParent program in pediatric primary care.
Contemp Clin Trials 2016 Sep;50:229-37. doi: 10.1016/j.cct.2016.08.017.
.
.
Keywords: Children/Adolescents, Healthcare Costs, Primary Care, Education: Patient and Caregiver, Caregiving
Shao H, Brown L, Diana ML
Estimating the costs of supporting safety-net transformation into patient-centered medical homes in post-Katrina New Orleans.
The authors aimed to understand the characteristics of clinics that transformed into patient-centered medical homes and the incremental cost for transformation. The estimated incremental cost for clinics that underwent transformation was $37.61 per visit per 6 months, and overall it cost $24.86 per visit per 6 months in grant funds to support a clinic's transformation.
AHRQ-funded; HS022624.
Citation: Shao H, Brown L, Diana ML .
Estimating the costs of supporting safety-net transformation into patient-centered medical homes in post-Katrina New Orleans.
Medicine 2016 Sep;95(39):e4990. doi: 10.1097/md.0000000000004990.
.
.
Keywords: Patient-Centered Healthcare, Healthcare Costs, Access to Care, Organizational Change
Spector WD, Limcangco R, Owens PL
AHRQ Author: Spector WD, Limcangco R, Owens PL, Steiner CA
Marginal hospital cost of surgery-related hospital-acquired pressure ulcers.
The researchers estimated the hospital marginal cost of a hospital-acquired pressure ulcer (HAPU) for adults patients who were hospitalized for major surgeries, adjusted for patient characteristics, comorbidities, procedures, and hospital characteristics. They found that 3.5 percent of major surgical patients developed HAPUs and that the HAPUs added approximately $8,200 to the cost of a surgical stay after adjusting for comorbidities, patient characteristics, procedures, and hospital characteristics.
AHRQ-authored.
Citation: Spector WD, Limcangco R, Owens PL .
Marginal hospital cost of surgery-related hospital-acquired pressure ulcers.
Med Care 2016 Sep;54(9):845-51. doi: 10.1097/mlr.0000000000000558.
.
.
Keywords: Pressure Ulcers, Surgery, Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Patient Safety
Ellimoottil C, Ryan AM, Hou H
Medicare's new bundled payment for joint replacement may penalize hospitals that treat medically complex patients.
Using Medicare claims for patients in Michigan who underwent lower extremity joint replacement in the period 2011-13, the researchers applied payment methods analogous to those CMS intends to use in determining annual bonuses or penalties (reconciliation payments) to hospitals. Their findings suggest that CMS should include risk adjustment in the Comprehensive Care for Joint Replacement program and in future bundled payment programs.
AHRQ-funded; HS024193; HS018546.
Citation: Ellimoottil C, Ryan AM, Hou H .
Medicare's new bundled payment for joint replacement may penalize hospitals that treat medically complex patients.
Health Aff 2016 Sep;35(9):1651-7. doi: 10.1377/hlthaff.2016.0263.
.
.
Keywords: Medicare, Payment, Healthcare Costs, Orthopedics, Provider Performance
Adrion ER, Ryan AM, Seltzer AC
Out-of-pocket spending for hospitalizations among nonelderly adults.
The researchers evaluated out-of-pocket spending associated with hospitalizations in order to assess how this spending varied over time and by patient characteristics, region, and type of insurance. They found that from 2009 to 2013, total cost sharing per inpatient hospitalization increased by 37 percent, from $738 in 2009 to $1013 in 2013 after adjusting for inflation and case-mix differences.
AHRQ-funded; HS000053.
Citation: Adrion ER, Ryan AM, Seltzer AC .
Out-of-pocket spending for hospitalizations among nonelderly adults.
JAMA Intern Med 2016 Sep;176(9):1325-32. doi: 10.1001/jamainternmed.2016.3663.
.
.
Keywords: Hospitalization, Healthcare Costs, Health Insurance
Ali MM, Chen J, Mutter R
AHRQ Author: Novak P
The ACA's dependent coverage expansion and out-of-pocket spending by young adults with behavioral health conditions.
The authors analyzed out-of-pocket spending as a share of total health care expenditures for young adults with behavioral health conditions before and after the implementation of the ACA dependent care provision. They found that the extension of health insurance coverage to young adults with behavioral health disorders has provided them with additional financial protection, which can be important given the low incomes and high debt burden that characterize the age group.
AHRQ-authored.
Citation: Ali MM, Chen J, Mutter R .
The ACA's dependent coverage expansion and out-of-pocket spending by young adults with behavioral health conditions.
Psychiatr Serv 2016 Sep;67(9):977-82. doi: 10.1176/appi.ps.201500346.
.
.
Keywords: Behavioral Health, Healthcare Costs, Health Insurance, Medical Expenditure Panel Survey (MEPS), Young Adults