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Research Studies is a compilation of published research articles funded by 大象APPor authored by 大象APPresearchers.

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1 to 25 of 29 Research Studies Displayed
Sabik LM, Kwon Y, Drake C
Impact of the Affordable Care Act on access to accredited facilities for cancer treatment.
The objective of this study was to examine differential changes in receipt of surgery at National Cancer Institute-designated comprehensive cancer centers (NCI-CCC) and Commission on Cancer (CoC) accredited hospitals for adult patients with cancer more who might be newly eligible for coverage under Affordable Care Act insurance expansions. Data was taken from the Pennsylvania Cancer Registry. Findings showed a differential increase in receiving care at an NCI-CCC among patients in high baseline uninsurance areas and an estimated positive but not statistically significant differential change in care at the larger set of CoC hospitals.
AHRQ-funded; HS027396.
Citation: Sabik LM, Kwon Y, Drake C . Impact of the Affordable Care Act on access to accredited facilities for cancer treatment. Health Serv Res 2024 Dec; 59(6):e14315. doi: 10.1111/1475-6773.14315.
Keywords: Access to Care, Policy, Cancer
Agarwal SD, Cook BL, Liebman JB
Effect of cash benefits on health care utilization and health: a randomized study.
This paper examined the effects of cash benefits on health care utilization and health using the city of Chelsea, Massachusetts as a case study. This low-income community near Boston randomly assigned individuals by lottery to receive cash benefits of up to $400 per months for 9 months. Primary outcome was emergency department (ED) visits. Secondary outcomes included specific types of ED visits, outpatient use overall and by specialty, COVID-19 vaccination, and biomarkers such as cholesterol levels. The 1746 participants randomized to receive the cash benefits had significantly fewer emergency department visits compared with the control group (217.1 vs 317.5 emergency department visits per 1000 persons). This included reductions in emergency department visits related to behavioral health (-21.6 visits per 1000 persons) and substance use (-12.8 visits per 1000 persons) as well as those that resulted in a hospitalization (-27.3 visits per 1000 persons). The cash benefit had no statistically significant effect on total outpatient visits, visits to primary care, or outpatient behavioral health. Outpatient visits to other subspecialties were higher in the cash benefit group compared with the control group (303.1 visits per 1000 persons), particularly for individuals without a car. There was no statistically significant effect on the secondary outcomes due to the cash benefit.
AHRQ-funded; HS029259.
Citation: Agarwal SD, Cook BL, Liebman JB . Effect of cash benefits on health care utilization and health: a randomized study. JAMA 2024 Nov; 332(17):1455-63. doi: 10.1001/jama.2024.13004.
Keywords: Healthcare Utilization, Low-Income, Emergency Department, Access to Care
Arredondo K, Hughes AM, Lester HF
Churning the tides of care: when nurse turnover makes waves in patient access to primary care.
A study of Veterans Health Administration primary care teams examined how registered nurse (RN) staffing stability affects patient access to care. The research analyzed data from 5,897 Patient Aligned Care Teams across 152 facilities over 24 months. Continuous RN turnover significantly impacted appointment availability, while temporary staffing gaps showed less effect. Team characteristics, including size and overall stability, influenced healthcare access. The findings highlight the importance of RN retention in maintaining effective primary care delivery.
AHRQ-funded; HS025982.
Citation: Arredondo K, Hughes AM, Lester HF . Churning the tides of care: when nurse turnover makes waves in patient access to primary care. BMC Nurs 2024 Oct 10; 23(1):739. doi: 10.1186/s12912-024-02389-8.
Keywords: Access to Care, Primary Care, Provider: Nurse, Workforce
Sandal S, Ahn J, Chen Y
Differences in racial and ethnic disparities between first and repeat kidney transplantation.
Research examined racial and ethnic disparities in first-time versus repeat kidney transplantation using United States Renal Data System data from 1995-2018. The study analyzed outcomes for over 2.4 million patients, including White, Black, and Hispanic individuals. The investigation revealed that Black patients experienced greater disparities in accessing repeat transplantation compared to first-time procedures. Hispanic patients faced increased barriers to waitlisting for repeat transplantation versus initial transplants. The findings indicate persistent systemic barriers affecting access to repeat kidney transplantation among racial and ethnic minority groups.
AHRQ-funded; HS024600.
Citation: Sandal S, Ahn J, Chen Y . Differences in racial and ethnic disparities between first and repeat kidney transplantation. Transplantation 2024 Oct; 108(10):2144-52. doi: 10.1097/tp.0000000000005051..
Keywords: Transplantation, Kidney Disease and Health, Disparities, Racial and Ethnic Minorities, Access to Care
DiMeo A, Logendran R, Sommers BD
Navigating the labyrinth of pregnancy-related coverage for undocumented immigrants: an assessment of current state and federal policies.
This study assessed current state and federal policies for pregnancy-related coverage for undocumented immigrants. States must provide coverage for labor and delivery through Emergency Medicaid by federal law. The authors searched state Medicaid and federal government websites and found that 27 states and the District of Columbia provide additional coverage for prenatal care, postpartum care, or both, while 23 states do not. Twelve states include any postpartum coverage and 7 provide coverage for 12 months postpartum. Many barriers still exist to access, such as lack of transparency, lack of availability of information in multiple languages, and incorrect information.
AHRQ-funded; HS026370.
Citation: DiMeo A, Logendran R, Sommers BD . Navigating the labyrinth of pregnancy-related coverage for undocumented immigrants: an assessment of current state and federal policies. Am J Public Health 2024 Oct; 114(10):1051-60. doi: 10.2105/ajph.2024.307750..
Keywords: Maternal Health, Women, Health Insurance, Policy, Access to Care
Graetz I, Huang J, Gopalan A
Primary care telemedicine and care continuity: implications for timeliness and short-term follow-up healthcare.
This study鈥檚 objective was to examine the association between primary care visit modality with timeliness and follow-up in-person healthcare, including variation by visits with the patient's own primary care physician (PCP) versus another PCP. This cohort study looked at timeliness (visit completed within 7 days of scheduling) and in-person follow-up (PCP visits, emergency department (ED) visits, hospitalizations) within 7 days of the index PCP visit. Of the 4.817,317 primary care visits, 59% were in-person, 27% audio-only, and 14% video telemedicine with most (71.3%) with the patients鈥 own PCP. Return office visit rates and follow-up ED visits differed. For the patient鈥檚 own PCP, return office visit rates were 1.2% for in-person, 5.3% for video, and 6.1% for audio-only. For a different PCP, rates were 2.2% for in-person, 7.3% for video, and 8.1% for audio. For follow-up ED visits rates ranged from 1.4% (in-person) to 1.6% (audio-only) with own PCP, compared to 1.9% (in-person) to 2.3% (audio-only) with another PCP. Follow-up hospitalizations were rare for both in-person and video visits with the patient鈥檚 own PCP or another PCP.
AHRQ-funded; HS25189.
Citation: Graetz I, Huang J, Gopalan A . Primary care telemedicine and care continuity: implications for timeliness and short-term follow-up healthcare. J Gen Intern Med 2024 Oct; 39(13):2454-60. doi: 10.1007/s11606-024-08914-4..
Keywords: Primary Care, Telehealth, Health Information Technology (HIT), Care Coordination, Access to Care
Borsky AE, Zodet M, Wolf TA
大象APPAuthor: Zodet M, Wolf TA, Bierman AS
Disparities in receipt of high-priority clinical preventive services.
This AHRQ-authored paper鈥檚 purpose was to examine potential disparities in the receipt of high-priority, clinical preventive services among adults. This study is based on a cross-sectional survey from the 2018 MEPS and includes non-institutionalized adults age 鈮35 in the United States (n=14,615). Receipt of all recommended prevention services among adults age 35 and older was low (6%). Black adults were 37% less likely than white adults; those with a high school education or less were less than half as likely as college graduates; poor and low-income individuals were much less likely than those with higher incomes; the uninsured were 89% less likely than those with private insurance; and adults who spoke a language other than English had 35% lower odds than those who spoke English to receive all high-priority services.
AHRQ-authored.
Citation: Borsky AE, Zodet M, Wolf TA . Disparities in receipt of high-priority clinical preventive services. Discover Health Systems 2024 Sep 6; 3(76)..
Keywords: Medical Expenditure Panel Survey (MEPS), Disparities, Prevention, Access to Care, Healthcare Utilization
Moon KJ, Linton SL, Kazerouni NJ
Association of economic and racial segregation with restricted buprenorphine dispensing in U.S. community pharmacies.
A nationwide telephone audit investigated buprenorphine dispensing practices at community pharmacies across the United States, examining potential disparities in access to opioid use disorder treatment medication. The study evaluated 858 pharmacies across 473 counties using secret shopper calls to assess prescription filling capabilities. Researchers measured county-level segregation patterns using the Index of Concentration at the Extremes, analyzing racial, ethnic, economic, and combined racial-economic factors. The investigation revealed that pharmacies in areas with high economic deprivation and ethnic segregation demonstrated greater likelihood of restricted buprenorphine dispensing. These dispensing limitations were particularly evident in socially and economically disadvantaged communities.
AHRQ-funded; HS026370.
Citation: Moon KJ, Linton SL, Kazerouni NJ . Association of economic and racial segregation with restricted buprenorphine dispensing in U.S. community pharmacies. Drug Alcohol Depend Rep 2024 Sep; 12:100255. doi: 10.1016/j.dadr.2024.100255..
Keywords: Opioids, Medication, Provider: Pharmacist, Substance Abuse, Behavioral Health, Access to Care, Disparities, Racial and Ethnic Minorities, Vulnerable Populations
Terp S, Ahmed S, Reichert Z
Civil monetary penalties for EMTALA violations involving minors, 2002-2023.
An analysis of Emergency Medical Treatment and Labor Act civil monetary penalties from 2002-2023 revealed that 14.6% of violations involved minors. Among these cases, most infractions concerned failure to provide medical screening exams or stabilizing treatment. Nearly one-fifth involved pregnant minors, while approximately one-third involved inappropriate patient redirection without proper screening. The study highlights the need for enhanced provider education regarding EMTALA requirements, particularly in facilities with limited pediatric services.
AHRQ-funded; HS022402; HS028671.
Citation: Terp S, Ahmed S, Reichert Z . Civil monetary penalties for EMTALA violations involving minors, 2002-2023. Hosp Pediatr 2024 Aug; 14(8):674-81. doi: 10.1542/hpeds.2024-007732..
Keywords: Emergency Department, Access to Care, Policy, Children/Adolescents
Hargraves JL, Cosenza C, Cleary PD
Measuring access to mental health services among primary care patients.
This survey looked at the best ways to measure access to mental health services among primary care patients using new patient survey questions that can be added to CAHPS surveys. The surveys were conducted with a stratified probability sample of patients receiving primary care services in a single state in 2018-2019. The surveys were conducted by mail or telephone using a stratified sample of Medicaid and privately insured patients, with a 14% response rate. The rate of patients getting or trying to get appointments for mental care was more than 10% for privately insured respondents and about 20% for Medicaid respondents. Of those, about 15% of privately insured respondents and 11% of Medicaid respondents reported problems getting appointments with counselors. There was a lower rate for problems to get appointments for prescriptions (8-9%).
AHRQ-funded; HS016978.
Citation: Hargraves JL, Cosenza C, Cleary PD . Measuring access to mental health services among primary care patients. Med Care 2024 Aug; 62(8):559-66. doi: 10.1097/mlr.0000000000002029..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Behavioral Health, Primary Care, Access to Care
Myong C, Yang Z, Behr C
Mental health care use and quality among Medicaid adults with serious mental illness receiving care at Federally Qualified Health Centers vs. other settings.
This study compared mental health care utilization and acute care events for adult Medicaid enrollees with serious mental illness (SMI) who received care at Federally Qualified Health Centers (FQHCs) vs. other settings. The study used data from the 2015-2016 Massachusetts All-Payer Claims Database to examine outpatient mental health care and acute care events for Medicaid adults, ages 18-64 and with major depressive, bipolar, or schizophrenia spectrum disorders (SSD), who resided in FQHC service areas and received care from FQHCs vs. other settings in 2015. Out of a study population of 32,330 adults, 8,887 (27.5%) had at least one FQHC visit in 2015. Those who received care at FQHCs were more likely to have outpatient mental health visits (73.3% vs. 71.2%) and psychotropic medication fills (73.2% vs. 69.0%), including antidepressants among those with depressive disorders and antipsychotics among those with SSD. They were more likely to have ED visits (74.0% vs. 68.7%), but less likely to be hospitalized (27.8% vs. 31.9%). However, there was no significant difference in the likelihood of having an acute psychiatric hospitalization.
AHRQ-funded; HS025378.
Citation: Myong C, Yang Z, Behr C . Mental health care use and quality among Medicaid adults with serious mental illness receiving care at Federally Qualified Health Centers vs. other settings. BMC Health Serv Res 2024 Jul 17; 24(1):825. doi: 10.1186/s12913-024-11308-1..
Keywords: Behavioral Health, Medicaid, Access to Care
Baker L, Munnich EL, Kranz AM
Medicaid managed care and pediatric dental emergency department visits.
The objective of this cohort study was to estimate the association between adoption of managed care for dental services in Florida's Medicaid program and nontraumatic dental emergency department (ED) visits and associated charges. Subjects were Florida-resident patients aged 17 or younger who had a Florida ED visit 2010-2014 for a nontraumatic dental condition which Medicaid paid for. The results indicated that Florida Medicaid's adoption of managed care for pediatric dental services was associated with increased ED visits for children; this could be associated with decreased access to dental care. The researchers found no evidence that the average charge per visit changed.
AHRQ-funded; HS027994.
Citation: Baker L, Munnich EL, Kranz AM . Medicaid managed care and pediatric dental emergency department visits. JAMA Health Forum 2024 Jun 14; 5(6):e241472. doi: 10.1001/jamahealthforum.2024.1472.
Keywords: Children/Adolescents, Medicaid, Dental and Oral Health, Access to Care
Kahn NF, Kidd KM, Hodax JK
Telemedicine-based provision of adolescent gender-affirming medical care to promote equitable access.
This study explored transgender and nonbinary (TNB) young adults' (1) interest in receiving gender-affirming medications through telemedicine before age 18 years and (2) willingness to initiate this care with primary care providers (PCPs). Data was collected from a survey of TNB young adults who had not received gender-affirming medications before age 18 years. Out of 280 respondents, 82.5% indicated interest in telemedicine and 42.0% were willing to initiate medications with their PCP. Black/African American respondents were more likely to indicate interest in telemedicine than White and multiracial respondents, and respondents from rural areas were more likely to indicate willingness to initiate medications with their PCP than those from urban areas.
AHRQ-funded; HS029028.
Citation: Kahn NF, Kidd KM, Hodax JK . Telemedicine-based provision of adolescent gender-affirming medical care to promote equitable access. Telemed J E Health 2024 Jun; 30(7):1896-900. doi: 10.1089/tmj.2023.0575..
Keywords: Telehealth, Children/Adolescents, Health Information Technology (HIT), Disparities, Access to Care
Liaw W, King B, Olaisen H
大象APPAuthor: Olaisen H
How an academic direct primary care clinic served patients from vulnerable communities.
This AHRQ-authored paper鈥檚 purpose was to describe the demographics and appointments of a now closed, academic direct primary care (DPC) clinic and determine whether there are differences in vulnerability between census tracts with and without any clinic patients. The authors linked geocoded data from the DPC's electronic health record with the social vulnerability index (SVI). They described the users鈥 age, sex, language, membership, diagnoses, and appointments. To determine differences in SVI, they calculated a localized SVI percentile within Harris County. They included 322 patients and 772 appointments, with patients seen an average of 2.4 times and predominantly female (58.4%). More than a third spoke Spanish. Census tracts in which DPC patients lived had significantly higher SVI scores (i.e., more vulnerable) than tracts where no DPC clinic patients resided (median, 0.60 vs 0.47).
AHRQ-authored.
Citation: Liaw W, King B, Olaisen H . How an academic direct primary care clinic served patients from vulnerable communities. J Am Board Fam Med 2024 May-Jun; 37(3):455-65. doi: 10.3122/jabfm.2023.230346R1..
Keywords: Primary Care, Vulnerable Populations, Community-Based Practice, Access to Care
Hughes PM, Graaf G, Gigli KH
Pediatric mental health care and scope-of-practice expansions.
This study investigated the relationship between scope-of-practice (SoP) regulations for psychologists and nurse practitioners and access to pediatric mental health services. The researchers analyzed data from the National Survey of Children's Health spanning 2016 to 2020, focusing on a nationally representative sample of children with mental health needs. The study examined two primary outcomes: unmet mental health care needs and receipt of mental health medication. The analysis revealed that children living in states with expanded psychologist SoP had a 5.4 percentage point lower probability of having unmet mental health needs. Additionally, these children had a 2.0 percentage point higher probability of receiving mental health medication. In contrast, nurse practitioner SoP expansion showed no significant association with unmet mental health needs. However, children in states with expanded nurse practitioner SoP had a 1.5 percentage point lower probability of receiving mental health medication. To assess these associations, the researchers employed logistic regression models, adjusting for multiple covariates. The expanded SoP for both psychologists and nurse practitioners was determined based on the child's state of residence and the year of the survey. The study's findings suggest that expanded SoP for psychologists is associated with improved access to pediatric mental health care, both in terms of addressing unmet needs and increasing medication access. However, the impact of expanded SoP for nurse practitioners appears to be less clear, with no significant effect on unmet needs and a slight decrease in medication receipt.
AHRQ-funded; HS000032.
Citation: Hughes PM, Graaf G, Gigli KH . Pediatric mental health care and scope-of-practice expansions. Adm Policy Ment Health 2024 May; 51(3):384-92. doi: 10.1007/s10488-024-01342-w..
Keywords: Children/Adolescents, Behavioral Health, Access to Care
Amu-Nnadi CN, Ross ES, Garcia NH
Health system integration and cancer center access for rural hospitals.
This study鈥檚 goal was to assess health system integration and cancer center access for rural hospitals. The authors compared health systems with and without cancer centers based on rural hospital presence. They found that 90% of cancer centers are in a health system, and 72% of health systems (434/607) have a cancer center. Larger health systems with more trainees more often have cancer centers but are no more likely to include rural hospitals (11% vs 6%). The minority of cancer centers not in health systems (N = 95) more often serve low complexity patient populations in non-metropolitan areas.
AHRQ-funded; HS013852.
Citation: Amu-Nnadi CN, Ross ES, Garcia NH . Health system integration and cancer center access for rural hospitals. Am Surg 2024 May; 90(5):1023-29. doi: 10.1177/00031348231216497..
Keywords: Health Systems, Cancer, Rural Health, Rural/Inner-City Residents, Access to Care
Adams DR, P茅rez-Flores NJ, Mabrouk F DR, P茅rez-Flores NJ, Mabrouk F
Assessing access to trauma-informed outpatient mental health services for adolescents: a mystery shopper study.
A mystery shopper study examined the accessibility of trauma-informed mental health services for adolescents in Cook County, Illinois safety-net clinics. Posing as mothers of traumatized children, researchers were only able to schedule appointments in 17% of calls to community mental health centers (CMHCs) and federally qualified health centers (FQHCs). Appointment denials were primarily due to capacity constraints at CMHCs (67%) and administrative requirements to switch providers at FQHCs (62%). Notably, non-White callers were less likely to be offered an appointment than White callers, raising concerns about potential racial bias in scheduling practices. Wait times averaged 12 days, with CMHCs offering shorter wait times than FQHCs. Only 38% of schedulers reported offering trauma-informed therapy at their centers. These findings reveal significant disparities and barriers to accessing crucial mental health services for adolescents, particularly those from marginalized backgrounds.
AHRQ-funded; HS000084.
Citation: Adams DR, P茅rez-Flores NJ, Mabrouk F DR, P茅rez-Flores NJ, Mabrouk F . Assessing access to trauma-informed outpatient mental health services for adolescents: a mystery shopper study. Psychiatr Serv 2024 May; 75(5):402-09. doi: 10.1176/appi.ps.20230198..
Keywords: Children/Adolescents, Behavioral Health, Trauma, Access to Care
Nguyen KH, Oronce CIA, Adia AC
Inability to access needed medical care among Asian American, Native Hawaiian, and Pacific Islander Medicaid enrollees.
Researchers examined self-reported inability to access needed medical care and patients鈥 reasons for not accessing medical care among adult Medicaid enrollees, disaggregated across Asian American, Native Hawaiian, and Pacific Islander ethnic groups. Their findings indicated that Chinese, Other Asian, Native Hawaiian enrollees were significantly less likely to report being unable to access needed medical care compared with non-Hispanic White enrollees. The most common reason given was that health plans would not approve, cover, or pay for care. The researchers concluded that different interventions specific to certain ethnic groups may be needed to mitigate inequities.
AHRQ-funded; HS022241.
Citation: Nguyen KH, Oronce CIA, Adia AC . Inability to access needed medical care among Asian American, Native Hawaiian, and Pacific Islander Medicaid enrollees. J Ambul Care Manage 2024 Apr-Jun; 47(2):96-103. doi: 10.1097/jac.0000000000000489..
Keywords: Access to Care, Racial and Ethnic Minorities, Medicaid
Adler JT, Kuk AE, Cron DC
Insurance transitions from employer-based insurance to Medicare and waitlisting for kidney transplantation: placing Marietta v. DaVita in context.
In a retrospective cohort study of incident dialysis patients aged 18-62 with employer-sponsored group health plans (EGHPs), researchers found that 36% switched to Medicare before the end of the 30-month coordination period. Patients residing in counties with higher social vulnerability and those with non-commercial dialysis modalities were more likely to switch early. Early switchers were less likely to be waitlisted for kidney transplantation, even after adjusting for various confounders. This association persisted even among patients who maintained their EGHP for at least one month after starting dialysis. These findings highlight the potential impact of recent legal changes allowing EGHPs to decrease dialysis reimbursements, which may increase early switching to Medicare and consequently affect transplant access.
AHRQ-funded; HS028476.
Citation: Adler JT, Kuk AE, Cron DC . Insurance transitions from employer-based insurance to Medicare and waitlisting for kidney transplantation: placing Marietta v. DaVita in context. J Am Soc Nephrol 2024 Apr; 35(4):495-98. doi: 10.1681/asn.0000000000000298..
Keywords: Transplantation, Kidney Disease and Health, Health Insurance, Access to Care, Medicare
Meille G, Koch T, Wendling B
大象APPAuthor: Meille G, Zuvekas S
The consequences of firm scope and scale on patient access to healthcare.
The objective of this study was to quantify changes in the market structure of primary care physicians and to examine its relationship with access to care. Researchers created measures of market structure from a 5% sample of Medicare fee-for-service claims and examined access to care using MEPS data. The findings showed that respondents in highly concentrated ZIP codes were less likely to report having access to immediate care than respondents in unconcentrated ZIP codes; the association was largest among Medicaid beneficiaries. No association between HHI and indicators for having a usual source of care and annual checkups were found. Multispecialty market share was negatively associated with checkups, but not other measures of access.
AHRQ-authored.
Citation: Meille G, Koch T, Wendling B . The consequences of firm scope and scale on patient access to healthcare. Health Serv Res 2024 Apr; 59(2):e14228. doi: 10.1111/1475-6773.14228..
Keywords: Medical Expenditure Panel Survey (MEPS), Access to Care, Healthcare Delivery, Medicare
Daw JR, MacCallum-Bridges CL, Kozhimannil KB
Continuous Medicaid eligibility during the COVID-19 pandemic and postpartum coverage, health care, and outcomes.
This study鈥檚 objective was to evaluate the association of continuous Medicaid eligibility due to the Families First Coronavirus Response Act (FFCRA) during the COVID-19 public health emergency (PHE) with postpartum health insurance, health care use, breastfeeding, and depressive symptoms. This cohort study included 47,716 respondents from the Pregnancy Risk Assessment Monitoring System (PRAMS) comparing 21 states with continuous prepolicy (2017-2019) and postpolicy (2020-2021) participation. Based on adjusted estimates, a 100% federal poverty level (FPL) increase in postpartum Medicaid eligibility was associated with a 5.1 percentage point (pp) increase in reported postpartum Medicaid enrollment, no change in commercial coverage, and a 6.6 pp decline in uninsurance, which represents a 40% reduction in postpartum uninsurance after a Medicaid-paid birth compared with the prepolicy baseline of 16.7%. Continuous Medicaid eligibility during the COVID-19 PHE was associated with significantly reduced postpartum uninsurance for people with Medicaid-paid births, but was not associated with postpartum visit attendance, contraception use, breastfeeding, or depressive symptoms at approximately 4 months postpartum. Uninsurance reductions were observed only among White and Black non-Hispanic individuals and Hispanic individuals had no change with no policy-associated changes in other outcomes.
AHRQ-funded; HS029159.
Citation: Daw JR, MacCallum-Bridges CL, Kozhimannil KB . Continuous Medicaid eligibility during the COVID-19 pandemic and postpartum coverage, health care, and outcomes. JAMA Health Forum 2024 Mar; 5(3):e240004. doi: 10.1001/jamahealthforum.2024.0004..
Keywords: COVID-19, Medicaid, Maternal Health, Women, Access to Care
Feinberg E, Eilenberg JS
Role of community health workers in promoting health equity in pediatrics.
This progress report describes 2 pilot RCTs that examined the feasibility and acceptability of using a community health worker (CHW) implemented intervention as a strategy to improve timely completion of autism diagnostic evaluations among young children from historically marginalized communities. The authors describe the research that has been published on the topic since they submitted their original study report on November 17, 2019. Their team conducted a subsequent large multisite RCT (鈥淧roject EARLY鈥) as part of National Institute of Mental Health鈥檚 Autism Spectrum Disorder Pediatric Early Detection, Engagement and Services Network, whose aim was to develop and test interventions that coordinate early autism screening, evaluation, and engagement in services. Their findings confirmed the efficacy of family navigation to reduce time to autism diagnostic resolution while also uncovering family navigation鈥檚 differential impact by ethnicity. Positive effects of using a CHW were significantly greater for Hispanic families compared to non-Hispanic families, suggesting that the intervention may be an effective strategy to reduce disparities by minoritized subgroups. The authors also discussed recent funding through grants, and the fact that Medicaid reimburses CHWs for patient education and health care navigation in 29 US states. They also discuss future directions for investigating the impact of CHWs on autism outcomes specifically, and child well-being more generally.
AHRQ-funded; HS022155.
Citation: Feinberg E, Eilenberg JS . Role of community health workers in promoting health equity in pediatrics. Acad Pediatr 2024 Mar; 24(2):199-200. doi: 10.1016/j.acap.2023.09.005..
Keywords: Children/Adolescents, Disparities, Access to Care
Mullens Hernandez, JA JA, Murthy J
Understanding the impacts of rural hospital closures: a scoping review.
Researchers conducted a scoping literature review to understand the impact of rural hospital closure in order to inform ongoing federal policy debates and research. Key categories of adverse impacts that emerged included: emergency medical service transport; availability of emergency care, hospital services, and outpatient services; changes in quality of care: effects on workforce and community members and the local economy. The researchers concluded that a synthesis of their findings will permit policymakers and researchers to understand, and mitigate, the harms of rural hospital closure. They also recommended a tailored approach and discussed crucial knowledge gaps in the evidence base.
AHRQ-funded; HS028672; HS027788; HS028606; HS028963.
Citation: Mullens Hernandez, JA JA, Murthy J . Understanding the impacts of rural hospital closures: a scoping review. J Rural Health 2024 Mar; 40(2):227-37. doi: 10.1111/jrh.12801..
Keywords: Rural Health, Rural/Inner-City Residents, Hospitals, Access to Care
King CA, Beetham T, Smith N
Adolescent residential addiction treatment in the US: uneven access, waitlists, and high costs.
This study examined adolescent residential addiction treatment facilities in the United States, and their accessibility and cost. The authors used the Substance Abuse and Mental Health Services Administration's treatment locator and search engine advertising data to identify 160 residential addiction treatment facilities that treated adolescents with opioid use disorder as of December 2022. They called facilities while role-playing as the aunt or uncle of a sixteen-year-old child with a recent nonfatal overdose to inquire about policies and costs. A little over half (54.5%) had a bed immediately available. The mean wait time for a bed was 28.4 days among sites with a waitlist. Of the facilities that provided cost information, the mean cost of treatment per day was $878, with daily costs among for-profit facilities triple of nonprofit facilities. Half of facilities required up-front payments by noninsured patients, with a mean up-front cost of $28,731. They were unable to identify any facilities for adolescents in ten states or Washington, D.C.
AHRQ-funded; HS017589.
Citation: King CA, Beetham T, Smith N . Adolescent residential addiction treatment in the US: uneven access, waitlists, and high costs. Health Aff 2024 Jan; 43(1):64-71. doi: 10.1377/hlthaff.2023.00777..
Keywords: Children/Adolescents, Substance Abuse, Healthcare Costs, Access to Care
Adams DR
Availability and accessibility of mental health services for youth: a descriptive survey of safety-net health centers during the COVID-19 pandemic.
The goal of this study was to assess the availability of outpatient mental health services for children and adolescents at safety-net health centers in a large metropolitan county. A comprehensive sample of Community Mental Health Centers (CMHCs) and Federally Qualified Health Centers (FQHCs) received a 5-minute survey approximately one year after the beginning of the COVID-19 pandemic. The response indicated that 10% of health centers had closed and 20% reported that they were not offering outpatient mental health services. Reported wait times were longer at CMHCs than FQHCs. The author concluded that these findings suggested that online directories such as the SAMHSA Treatment Locator are often inaccurate or out-of-date.
AHRQ-funded; HS000084.
Citation: Adams DR . Availability and accessibility of mental health services for youth: a descriptive survey of safety-net health centers during the COVID-19 pandemic. Community Ment Health J 2024 Jan; 60(1):88-97. doi: 10.1007/s10597-023-01127-9..
Keywords: Children/Adolescents, Behavioral Health, Access to Care, COVID-19, Public Health

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