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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 11 of 11 Research Studies DisplayedChow JY, Nijhawan AE, Mathews WC
Hospitalization rates among persons with HIV who gained Medicaid or private insurance after the Affordable Care Act in 2014.
The purpose of this study was to investigate whether gaining inpatient healthcare coverage had an effect on hospitalization rates among persons with HIV following implementation of the Affordable Care Act in 2014. Hospitalization data from 2015 were obtained on adults receiving longitudinal care at HIV clinics; all patients were previously uninsured and supported by the Ryan White HIV/AIDS Program (RWHAP) in 2013. Findings showed that acquiring inpatient coverage was not associated with a change in hospitalization rates.
AHRQ-funded; 290201100007C.
Citation: Chow JY, Nijhawan AE, Mathews WC .
Hospitalization rates among persons with HIV who gained Medicaid or private insurance after the Affordable Care Act in 2014.
J Acquir Immune Defic Syndr 2021 Jun 1;87(2):776-80. doi: 10.1097/qai.0000000000002645..
Keywords: Human Immunodeficiency Virus (HIV), Hospitalization, Medicaid, Health Insurance, Access to Care, Policy
McManus KA, McManus K, Dillingham R
National survey of United States human immunodeficiency virus medical providers' knowledge and attitudes about the Affordable Care Act.
The objective of the study was to explore HIV medical providers' knowledge and attitudes about the Affordable Care Act (ACA). The investigators concluded that: medical providers in Medicaid expansion states were more optimistic about the ACA's likelihood to improve their patients' HIV outcomes; there are gaps in HIV medical providers' understanding of the ACA; and education could enhance systems-based practice.
AHRQ-funded; HS024196.
Citation: McManus KA, McManus K, Dillingham R .
National survey of United States human immunodeficiency virus medical providers' knowledge and attitudes about the Affordable Care Act.
Clin Infect Dis 2018 Oct 15;67(9):1403-10. doi: 10.1093/cid/ciy296..
Keywords: Policy, Human Immunodeficiency Virus (HIV), Medicaid, Provider
McManus KA, Rhodes A, Bailey S
Affordable Care Act qualified health plan coverage: association with improved HIV viral suppression for AIDS drug assistance program clients in a Medicaid nonexpansion state.
The objective of this study was to characterize the demographic and healthcare delivery factors associated with Virginia AIDS Drug Assistance Programs (ADAPs) clients' qualified health plan (QHP) enrollment and to assess the relationship between qualified health coverage and human immunodeficiency virus (HIV) viral suppression. It concluded that QHP coverage was associated with viral suppression, an essential outcome for individuals and for public health.
AHRQ-funded; HS024196.
Citation: McManus KA, Rhodes A, Bailey S .
Affordable Care Act qualified health plan coverage: association with improved HIV viral suppression for AIDS drug assistance program clients in a Medicaid nonexpansion state.
Clin Infect Dis 2016 Aug;63(3):396-403. doi: 10.1093/cid/ciw277.
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Keywords: Health Insurance, Human Immunodeficiency Virus (HIV), Medicaid, Medication, Outcomes
Fleishman JA, Monroe AK, Voss CC
AHRQ Author: Fleishman JA
Expenditures for persons living with HIV enrolled in Medicaid, 2006-2010.
The researchers used Medicaid claims data to comprehensively assess payments for care for persons living with HIV between 2006 and 2010. They found that estimated Medicaid payment amounts are higher than some prior estimates. More complete capture of expensive inpatient hospitalizations in Medicaid data may partially explain this finding.
AHRQ-authored.
Citation: Fleishman JA, Monroe AK, Voss CC .
Expenditures for persons living with HIV enrolled in Medicaid, 2006-2010.
J Acquir Immune Defic Syndr 2016 Aug 1;72(4):408-15. doi: 10.1097/qai.0000000000000985.
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Keywords: Human Immunodeficiency Virus (HIV), Medicaid, Healthcare Costs
Berry SA, Fleishman JA, Yehia BR
AHRQ Author: Fleishman JA
Healthcare coverage for HIV provider visits before and after implementation of the Affordable Care Act.
The researchers compared HIV provider coverage pre (2011-2013) versus post (first half of 2014) ACA among a total of 28,374 persons living with HIV (PLWH) followed in 4 sites in Medicaid expansion states (CA, OR, MD), 4 in a state (NY) that expanded Medicaid in 2001, and 2 in non-expansion states (TX, FL). In expansion state sites, half of PLWH relying on Ryan White HIVAIDS Program(RWHAP)/Uncomp shifted to Medicaid, while in NY and non-expansion state sites, reliance on RWHAP/Uncomp remained constant.
AHRQ-authored.
Citation: Berry SA, Fleishman JA, Yehia BR .
Healthcare coverage for HIV provider visits before and after implementation of the Affordable Care Act.
Clin Infect Dis 2016 Aug 1;63(3):387-95. doi: 10.1093/cid/ciw278.
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Keywords: Human Immunodeficiency Virus (HIV), Medicaid, Medicare, Health Insurance
McManus KA, McGonigle KM, Engelhard CL
PPACA and low-income people living with HIV: 2014 qualified health plan enrollment in a Medicaid nonexpansion state.
This review examined qualified heallth plan enrollment of AIDS Drug Assistance Programs clients in Virginia, a Medicaid nonexpansion state, and explored some issues that affect people living with HIV in other Medicaid nonexpansion states. The authors recommend that as healthcare delivery models shift, the effects on patients and health outcomes achieved should be monitored, particularly for chronic diseases such as HIV.
AHRQ-funded; HS024196.
Citation: McManus KA, McGonigle KM, Engelhard CL .
PPACA and low-income people living with HIV: 2014 qualified health plan enrollment in a Medicaid nonexpansion state.
South Med J 2016 Jun;109(6):371-7. doi: 10.14423/smj.0000000000000469.
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Keywords: Medicaid, Low-Income, Human Immunodeficiency Virus (HIV), Health Insurance, Policy
Berry SA, Fleishman JA, Moore RD
AHRQ Author: Fleishman JA
Thirty-day hospital readmissions for adults with and without HIV infection.
This study compared 30-day readmission rates by HIV status in a multi-state sample with planned subgroup comparisons by insurance and diagnostic categories. After adjustment for age, gender, race, insurance, and diagnostic category, HIV infection was associated with 1.5 times higher odds of readmission. Predicted, adjusted readmission rates were higher for persons living with HIV within every insurance category, including Medicaid.
AHRQ-authored.
Citation: Berry SA, Fleishman JA, Moore RD .
Thirty-day hospital readmissions for adults with and without HIV infection.
HIV Med 2016 Mar;17(3):167-77. doi: 10.1111/hiv.12287.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Human Immunodeficiency Virus (HIV), Hospital Readmissions, Medicaid, Medicare
Hellinger FJ
AHRQ Author: Hellinger FJ
In four ACA expansion states, the percentage of uninsured hospitalizations for people with HIV declined, 2012-14.
This study examines the influence of the Affordable Care Act's optional state Medicaid expansion on insurance coverage and health outcomes for hospitalized patients with HIV. It found that the percentage of hospitalizations of uninsured people with HIV in the four expansion states fell from 13.7 percent to 5.5 percent in the study period, while the percentage in the two nonexpanding states increased from 14.5 percent to 15.7 percent.
AHRQ-authored.
Citation: Hellinger FJ .
In four ACA expansion states, the percentage of uninsured hospitalizations for people with HIV declined, 2012-14.
Health Aff 2015 Dec;34(12):2061-8. doi: 10.1377/hlthaff.2015.0718..
Keywords: Policy, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Human Immunodeficiency Virus (HIV), Medicaid, Uninsured
Brouwer ES, Napravnik S, Eron JJ, Jr.
Validation of Medicaid claims-based diagnosis of myocardial infarction using an HIV clinical cohort.
The investigators aimed to validate claims-based myocardial infarction (MI) algorithms in a Medicaid population using an HIV clinical cohort as the gold standard. Studying 1063 individuals over 2.5 years, 17 had an MI. Specificity ranged from 0.979 to 0.993 with the highest specificity obtained using the ICD-9 code 410.xx in the primary or secondary position and a length of stay greater than 3 days. Sensitivity of MI ascertainment varied from 0.588 to 0.824 depending on algorithm. They recommended that the type of algorithm used be prioritized based on study question and maximization of specific validation parameters that will minimize bias while also considering precision.
AHRQ-funded; HS018731.
Citation: Brouwer ES, Napravnik S, Eron JJ, Jr. .
Validation of Medicaid claims-based diagnosis of myocardial infarction using an HIV clinical cohort.
Med Care 2015 Jun;53(6):e41-8. doi: 10.1097/MLR.0b013e318287d6fd.
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Keywords: Comparative Effectiveness, Human Immunodeficiency Virus (HIV), Medicaid, Heart Disease and Health, Research Methodologies
Brouwer ES, Moga DC, Eron JJ
Evaluating the incident user design in the HIV population: incident use versus naive?
Through linkage to a comprehensive HIV clinical cohort, the researchers aimed to quantify and describe the truly naïve patients in an incident use population identified in Medicaid administrative claims. In their sample, they found that 34 percent of the Medicaid incident users were naïve based on medical record abstraction of antiretroviral use.
AHRQ-funded; HS018731.
Citation: Brouwer ES, Moga DC, Eron JJ .
Evaluating the incident user design in the HIV population: incident use versus naive?
Pharmacoepidemiol Drug Saf 2015 Mar;24(3):297-300. doi: 10.1002/pds.3705..
Keywords: Human Immunodeficiency Virus (HIV), Research Methodologies, Comparative Effectiveness, Data, Medicaid
Zhang SM, McGoy SL, Dawes D
The potential for elimination of racial-ethnic disparities in HIV treatment initiation in the Medicaid population among 14 southern states.
This study explored racial/ethnic disparities in the initiation of antiretroviral treatment among HIV-infected Medicaid enrollees in 14 Southern States. It found no significant differences between blacks and non-Hispanic whites but Hispanic/Latino persons were significantly less likely to receive antiretroviral treatment.
AHRQ-funded; HS022444; HS019470
Citation: Zhang SM, McGoy SL, Dawes D .
The potential for elimination of racial-ethnic disparities in HIV treatment initiation in the Medicaid population among 14 southern states.
PLoS One. 2014 Apr 25;9(4):e96148. doi: 10.1371/journal.pone.0096148..
Keywords: Human Immunodeficiency Virus (HIV), Disparities, Racial and Ethnic Minorities, Medicaid