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Dr. Annie E. Larson is an investigator at OCHIN. With a doctorate in public health policy, Annie has over 16 years of public health work experience, including policy work in state and local health departments, quantitative and qualitative research, applied epidemiology, and statistical and evaluation consulting for nonprofit organizations. She has extensive experience in analysis and data extraction using electronic health record data, administrative claims and eligibility data, vital statistics data, hospital discharge data, cancer registries, and community-level data. Her research expertise encompasses a range of health policy topics, with a focus on the impact of health system reform on preventive and behavioral health service use and quality of care for underserved populations, with an emphasis on rural populations.
Annie is currently funded by a career development award (K01) from the Agency for Healthcare Research and Quality to evaluate the impact of the wide-scale expansion of telemedicine on the use of preventive health care services and quality of care among rural, low-income patients compared to those residing in more urban areas. These findings will inform efforts to improve health care access and quality of care among low-income, rural patients and ensure disparities in health outcomes do not continue to widen.
Changes in health policy have the potential to impact large populations. In the U.S., health care reform at both the state and national level has been front and center with the potential to improve access to care. Although it is important to measure the impact of these policy changes on the population at large, it is particularly important to pay special attention to those who may not have equal access to health care. While completing her PhD at Oregon State University (OSU), Annie worked as a research analyst on a project examining the impact of Medicaid expansion on low-income women of reproductive age. Since completing her degree, she has continued to collaborate with colleagues at OSU. In her current role, she has served as site PI on multiple NIH-funded studies examining the impact of the Affordable Care Act on chronic conditions among underserved patients seen in community health clinics. Through these studies, we evaluated use of care among patients as well as factors, such as health insurance, that influence use of care. Additionally, she is PI on a K01 funded by AHRQ to examine the impacts of the transition to telemedicine resulting from the COVID-19 pandemic on use of primary care services for rural patients. Although use of care is one important measure of access, it does not ensure quality of care or equity in long-term health outcomes. Annie has contributed to studies that evaluated the impact of policy change on longer term outcomes among both patients and providers. Two of the studies on which she served as site PI at OCHIN have examined the impact of the Affordable Care Act on quality of care among patients receiving care in community health clinics; one focused on hypertension, and the other on evaluating diabetes. Through these studies, she has also begun to examine the impacts of the COVID-19 pandemic on underserved patients. Additionally, during her PhD studies, she led a paper looking at the impact of clean indoor air laws on smoking among individuals with poor mental health. Where someone lives affects their health. Even though rural residents have higher rates of chronic disease, disability, infant mortality, and age-adjusted mortality than their urban counterparts, most health research focuses on urban populations. Annie’s dissertation examined the effect of rurality on use of preventive services among Medicaid enrollees post-ACA and the effect continuity of enrollment and newly enrolling in Medicaid plays in care utilization. As site PI on a study evaluating the impact of the Affordable Care Act on hypertension among community health center patients, she examined how neighborhood and community-level factors affect hypertension control and management. Additionally, through her AHRQ K01 award, she has partnered with a rural health, health services researcher at the University of Iowa to begin examining broadband access in rural communities and explore whether and how telemedicine may improve access to and quality of care for rural, low-income patients. The rapid and wide-scale adoption of telemedicine (TM) resulting from the COVID-19 pandemic provided a unique opportunity to understand if TM can improve utilization or quality of preventive health care for patients. However, the use of TM is inequitable across patients, providers, and clinics. Low-income communities are less likely to use TM than more affluent communities, and rural patients are less likely to use TM for visits than urban patients. Factors including education or digital literacy, economic stability, affordability of devices, trust in technology, and comorbidities may affect a patient’s ability to use TM. Annie currently leads a project examining the impact of TM on access and quality of care among rural, low-income patients. Additionally, she has worked with other study teams to examine how technology is impacting care in community health clinics.
Effect of health policy on health service access and utilization among underserved populations
Effect of health policy on healthcare quality and outcomes among underserved populations
Place matters
Technology and access to and quality of health care
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