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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 9378 Research Studies DisplayedKandel ZK, Rittenhouse DR, Bibi S
The CMS State Innovation Models Initiative and improved health information technology and care management capabilities of physician practices.
The Centers for Medicare and Medicaid Services' (CMS) State Innovation Models (SIMs) initiative funded 17 states to implement health care payment and delivery system reforms to improve health system performance. The authors investigated whether SIM improved health information technology (HIT) and care management capabilities of physician practices. They found that the CMS SIM Initiative did not accelerate the adoption of ten foundational physician practice capabilities beyond national trends.
AHRQ-funded; HS024075.
Citation: Kandel ZK, Rittenhouse DR, Bibi S .
The CMS State Innovation Models Initiative and improved health information technology and care management capabilities of physician practices.
Med Care Res Rev 2021 Aug;78(4):350-60. doi: 10.1177/1077558719901217..
Keywords: Health Information Technology (HIT), Healthcare Delivery, Payment, Healthcare Systems, Innovations and Emerging Issues
Borsky AE, Zuvekas SH, Kent EE
Understanding the characteristics of US cancer survivors with informal caregivers.
This AHRQ-authored paper’s purpose is to provide a national representative description of the sociodemographic characteristics of cancer survivors who have or had an informal caregiver. Cross-sectional data from the MEPS Experiences With Cancer Survivorship Supplement survey in 2011, 2016, and 2017 was used. The study population consisted of 720 US adult survivors of cancer other than nonmelanoma skin cancer who were treated for cancer less than 3 years before the survey and were living in the community. A total of 55.2% of cancer survivors reported having an informal caregiving during or after their cancer treatment. Males were more likely to have a spouse as their caregiver and females were more likely to have a child. Cancer survivors who were female, were married, were of a non-White race/ethnicity, or were in poor health were more likely to have an informal caregiver.
AHRQ-authored.
Citation: Borsky AE, Zuvekas SH, Kent EE .
Understanding the characteristics of US cancer survivors with informal caregivers.
Cancer 2021 Aug 1;127(15):2752-61. doi: 10.1002/cncr.33535..
Keywords: Medical Expenditure Panel Survey (MEPS), Cancer, Caregiver
Allen L, Cummings JR, Hockenberry JM
The impact of urgent care centers on nonemergent emergency department visits.
This study looked at the impact of urgent care centers on nonemergency emergency department (ED) use. Secondary data from a novel urgent care center database, linked to the HCUP State Emergency Department Databases (SEDD) from six states was used. Data from ZIP codes with no urgent care centers served as a control group compared to areas with local urgent care centers. Having an open urgent care center in a ZIP code reduced the total number of ED visits by residents by 17.2% largely due to visits for less urgent conditions. The effect was concentrated in areas with hospitals with the longest ED wait times. The total number of uninsured visits to the ED were reduced by 21% and for Medicaid visits by 29.1%.
AHRQ-funded; HS2484501.
Citation: Allen L, Cummings JR, Hockenberry JM .
The impact of urgent care centers on nonemergent emergency department visits.
Health Serv Res 2021 Aug;56(4):721-30. doi: 10.1111/1475-6773.13631..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Healthcare Utilization, Access to Care
Adams LB, Richmond J, Watson SN
Community health worker training curricula and intervention outcomes in African American and Latinx communities: a systematic review.
This systematic review examined research on the relationship between community health worker (CHW) training curricula and intervention outcomes conducted among African American and Latinx populations. Studies included were quantitative, qualitative, and mixed methods studies employed to conduct outcome and process evaluations of CHW-led interventions. Out of 3,295 articles from the extensive literature search, only 36 met the review’s inclusion criteria. Overall, the strength of evidence linking specific CHW training curricula components to primary health interventions in conditions such as hypertension and diabetes was weak, and no studies directly linked outcomes to specific characteristics of CHW training. Studies that discussed training related to didactic sessions or classified as high intensity reported higher percentages of positive outcomes compared to other CHW training methods.
AHRQ-funded; HS000032; HS026122.
Citation: Adams LB, Richmond J, Watson SN .
Community health worker training curricula and intervention outcomes in African American and Latinx communities: a systematic review.
Health Educ Behav 2021 Aug;48(4):516-31. doi: 10.1177/1090198120959326..
Keywords: Community-Based Practice, Racial / Ethnic Minorities, Training, Outcomes, Provider: Health Personnel
Magee LA, Ranney ML, Fortenberry JD
Identifying nonfatal firearm assault incidents through linking police data and clinical records: cohort study in Indianapolis, Indiana, 2007-2016.
Nonfatal firearm assault incidents are more prevalent than gun homicides, however, little is understood about nonfatal firearm assault incidents due to a lack of accurate data in the United States. This is a descriptive study of all nonfatal firearm assault incidents identified through police and clinical records from 2007 to 2016 in Indianapolis, Indiana.
AHRQ-funded; HS023318.
Citation: Magee LA, Ranney ML, Fortenberry JD .
Identifying nonfatal firearm assault incidents through linking police data and clinical records: cohort study in Indianapolis, Indiana, 2007-2016.
Prev Med 2021 Aug;149:106605. doi: 10.1016/j.ypmed.2021.106605..
Keywords: Injuries and Wounds
Johnson CL, Schwartz H, Greenberg A
Patient perceptions on barriers and facilitators to accessing low-acuity surgery during COVID-19 pandemic.
The onset of the COVID-19 pandemic led to the postponement of low-acuity surgical procedures in an effort to conserve resources and ensure patient safety. This study aimed to characterize patient-reported concerns about undergoing surgical procedures during the pandemic. The investigators concluded that eliciting patients' perspectives, adapting processes to address potential barriers, and effectively educating patients about institutional measures to minimize in-hospital transmission of COVID-19 should be integrated into surgical care.
AHRQ-funded; HS024532.
Citation: Johnson CL, Schwartz H, Greenberg A .
Patient perceptions on barriers and facilitators to accessing low-acuity surgery during COVID-19 pandemic.
J Surg Res 2021 Aug;264:30-36. doi: 10.1016/j.jss.2021.01.028..
Keywords: COVID-19, Surgery, Access to Care, Patient Experience, Public Health
Delaney LD, Kattapuram M, Haidar JA
The impact of surgeon adherence to preoperative optimization of hernia repairs.
This study looked at the ways that surgeon-level adherence to preoperative optimization impacts postoperative outcomes. A cohort of patients receiving hernia repair surgery were studied using data from the Michigan Surgical Quality Collaborative from 2014 to 2018. Adherence to preoperative optimization was defined as operating on patients who were nontobacco users with a body mass index of >18.5 kg/m2 and <40 kg/m2. Risk- and reliability-adjusted adherence rates were used to divide surgeons into tertiles. Across 70 Michigan hospitals, 15,016 patients underwent ventral and incisional hernia repair, cared for by 454 surgeons. Preoperative optimization rates ranged from 51% to 76%. Surgeons in the lowest tertile had higher rates of emergency department visits and serious complications versus any complication than middle and high optimization tertiles.
AHRQ-funded; HS025778.
Citation: Delaney LD, Kattapuram M, Haidar JA .
The impact of surgeon adherence to preoperative optimization of hernia repairs.
J Surg Res 2021 Aug;264:8-15. doi: 10.1016/j.jss.2021.01.044..
Keywords: Surgery, Provider: Physician, Provider, Outcomes
Calabrese SK, Lane SB, Caldwell A
Electronic dissemination of a web-based video promotes PrEP contemplation and conversation among US women engaged in care at Planned Parenthood.
This study evaluated the acceptability and impact of a web-based PrEP educational video among women (n = 126) by comparing two Planned Parenthood centers: one using a Web Video and the other using standard education tools. Most women reported the video helped them understand better what PrEP is (92%), how it works (93%), and how to take PrEP (92%). One month post-intervention, more women in the Web Video group reported a high level of comfort discussing PrEP with a provider (82% vs 48%) and commonly thinking about PrEP (36.% vs. 4%).
AHRQ-funded; HS022242.
Citation: Calabrese SK, Lane SB, Caldwell A .
Electronic dissemination of a web-based video promotes PrEP contemplation and conversation among US women engaged in care at Planned Parenthood.
AIDS Behav 2021 Aug;25(8):2483-500. doi: 10.1007/s10461-021-03210-2..
Keywords: Human Immunodeficiency Virus (HIV), Sexual Health, Education: Patient and Caregiver, Health Promotion, Prevention, Health Information Technology (HIT), Communications, Women
Bunting AM, Oser CB, Staton M
Pre-incarceration polysubstance use involving opioids: a unique risk factor of postrelease return to substance use.
This study explored pre-incarceration polysubstance use involving opioids as a unique risk factor for postrelease relapse to substance use. Data from a cohort of 502 justice-involved persons who were enrolled in a therapeutic community treatment program while incarcerated was used. Six unique polysubstance opioid patterns prior to incarceration were found using latent profile validation. Two of these profiles, primarily alcohol and primarily buprenorphine were at increased and accelerated risk for relapse postrelease relative to a lesser polysubstance use profile. Both profiles at increased risk had a pre-incarceration co-use of marijuana and nonmedical use of opioids but were unique in their respective near daily use of alcohol and nonmedical buprenorphine.
AHRQ-funded; HS026120.
Citation: Bunting AM, Oser CB, Staton M .
Pre-incarceration polysubstance use involving opioids: a unique risk factor of postrelease return to substance use.
J Subst Abuse Treat 2021 Aug;127:108354. doi: 10.1016/j.jsat.2021.108354..
Keywords: Opioids, Substance Abuse, Risk
Byhoff E, Paulus JK, Guardado R
Healthcare workers' perspectives on coronavirus testing availability: a cross sectional survey.
This article describes a survey that was conducted during the first wave of the COVID pandemic during March-August 2020 of hospital workers on their perceptions of, access to, and receipt of COVID testing. A survey was given to all hospital employees in a single academic medical center in Boston, Massachusetts. A total of 2543 employees responded to the survey. Respondents were mostly female (76%), white (55%), with the mean age being 40 years. They were nurses (27%), administrators (22%), and patient support roles (22%) of which 56% of respondents wanted COVID testing. Age, full-time status, employment tenure, changes in quality of life, changes in job duties, and worries about enough sick paid leave were associated with testing. Nurses were more likely to want testing than administrators and patient support staff.
AHRQ-funded; HS026008.
Citation: Byhoff E, Paulus JK, Guardado R .
Healthcare workers' perspectives on coronavirus testing availability: a cross sectional survey.
BMC Health Serv Res 2021 Jul 21;21(1):719. doi: 10.1186/s12913-021-06741-5..
Keywords: COVID-19, Diagnosis, Provider: Health Personnel, Public Health
Cunningham-Erves J, Campbell L, Barlow C
Reducing HPV associated cancers and disparities: engaging African American men to develop a culturally-appropriate program that addresses their needs.
Reducing HPV associated cancers and disparities: engaging African American men to develop a culturally-appropriate program that addresses their needs.
Am J Health Educ 2021;52(4):194-206. doi: 10.1080/19325037.2021.1930614.
This paper discusses the results of the Healthy Men, Healthy Communities program that aims to improve preventive behaviors among African American men to reduce HPV-related cancer disparities. An educational intervention was developed using cultural-targeting strategies such as linguistics, peripherals, evidence, socio-culture, and constituent-involving. Research team members were recruited from community-based (CBO) leaders. Three focus groups, 30 surveys, and a community review and program evaluation with African American men were conducted. The five focus group themes were: 1) The Known and Unknown of Cancer, HPV, and the vaccine; (2) Personal experiences with cancer were commonplace; (3) Barriers to Engaging HPV Cancer Preventive Behaviors; (4) Multi-Modal Strategies are needed to improve preventive behaviors; and (5) Actual versus Preferred Sources of Information. Survey data showed men desired information on penile (52%) and oral cancer (48%). A speaker summit on various topics was the preferred education format (96%). A post-summit evaluation indicated most males intended to get screened (73%), eat healthier (77%), and exercise more (65%). After these interventions the HPV vaccine was administered to about 40% of the men, and their children and grandchildren.
Am J Health Educ 2021;52(4):194-206. doi: 10.1080/19325037.2021.1930614.
This paper discusses the results of the Healthy Men, Healthy Communities program that aims to improve preventive behaviors among African American men to reduce HPV-related cancer disparities. An educational intervention was developed using cultural-targeting strategies such as linguistics, peripherals, evidence, socio-culture, and constituent-involving. Research team members were recruited from community-based (CBO) leaders. Three focus groups, 30 surveys, and a community review and program evaluation with African American men were conducted. The five focus group themes were: 1) The Known and Unknown of Cancer, HPV, and the vaccine; (2) Personal experiences with cancer were commonplace; (3) Barriers to Engaging HPV Cancer Preventive Behaviors; (4) Multi-Modal Strategies are needed to improve preventive behaviors; and (5) Actual versus Preferred Sources of Information. Survey data showed men desired information on penile (52%) and oral cancer (48%). A speaker summit on various topics was the preferred education format (96%). A post-summit evaluation indicated most males intended to get screened (73%), eat healthier (77%), and exercise more (65%). After these interventions the HPV vaccine was administered to about 40% of the men, and their children and grandchildren.
AHRQ-funded; HS022990.
Citation: Cunningham-Erves J, Campbell L, Barlow C .
Reducing HPV associated cancers and disparities: engaging African American men to develop a culturally-appropriate program that addresses their needs.
Am J Health Educ 2021;52(4):194-206. doi: 10.1080/19325037.2021.1930614..
Keywords: Sexual Health, Infectious Diseases, Cancer, Disparities, Racial / Ethnic Minorities, Men's Health, Prevention, Health Promotion, Education: Patient and Caregiver
Kutney-Lee A, Brooks Carthon M, Sloane DM
Electronic health record usability: associations with nurse and patient outcomes in hospitals.
Researchers examined associations between electronic health record (EHR) usability and nurse job and surgical patient outcomes. Data from the American Hospital Association, state patient discharges, and nurse surveys were linked in a cross-sectional analysis. The researchers found that employing EHR systems with suboptimal usability was associated with higher odds of adverse nurse job outcomes and surgical patient mortality and readmission.
AHRQ-funded; HS023805.
Citation: Kutney-Lee A, Brooks Carthon M, Sloane DM .
Electronic health record usability: associations with nurse and patient outcomes in hospitals.
Med Care 2021 Jul;59(7):625-31. doi: 10.1097/mlr.0000000000001536..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Surgery, Outcomes, Nursing, Provider: Nurse
Katheria A, Lee HC, Knol R
A review of different resuscitation platforms during delayed cord clamping.
Researchers have brought together an international group that have been intimately involved in the development or use of resuscitation equipment designed to be used with infants while the umbilical cord is still intact. In this review, they presented the benefits and limitations of devices that have been developed or are in use. They also reviewed published trials and ongoing studies using these respective devices.
AHRQ-funded; HS023506.
Citation: Katheria A, Lee HC, Knol R .
A review of different resuscitation platforms during delayed cord clamping.
J Perinatol 2021 Jul;41(7):1540-48. doi: 10.1038/s41372-021-01052-3..
Keywords: Pregnancy, Evidence-based Practice
Jennissen S, Connolly Gibbons MB, Crits-Christoph P
Insight as a mechanism of change in dynamic therapy for major depressive disorder.
This study’s goal was to investigate change in insight into maladaptive interpersonal patterns over the course of psychotherapy, as well as the specificity of insight as a change mechanism in dynamic treatments. Participants received up to 16 sessions of either cognitive or dynamic therapy for major depressive disorder in a randomized clinical trial. Results provided support for insight as a change factor in dynamic therapies. Better self-understanding of dysfunctional interaction patterns could help patients to find more adaptive ways of behaving, to form more satisfying relationships, and to improve their depression.
AHRQ-funded; HS018440.
Citation: Jennissen S, Connolly Gibbons MB, Crits-Christoph P .
Insight as a mechanism of change in dynamic therapy for major depressive disorder.
J Couns Psychol 2021 Jul;68(4):435-45. doi: 10.1037/cou0000554..
Keywords: Depression, Mental Health
Herb JN, Ollila DW, Stitzenberg KB
Use and costs of sentinel lymph node biopsy in non-ulcerated T1b melanoma: analysis of a population-based registry.
This study looked at the utility of sentinel lymph node biopsy (SLNB) for non-ulcerated T1b melanoma. The aim of the study was to estimate SLNB use, positivity, prevalence, and procedural costs in patients with non-ulcerated T1b melanoma using a population-based registry. Patients with clinically node-negative, non-ulcerated T1b melanoma were identified in the SEER database from 2010 to 2016. Among 7245 included patients, 53% underwent SLNB of which 156 (4.1%) had a positive SLNB. Higher odds of positivity were associated with younger age, >1 mitosis per mm2, female sex, and truncal tumor location. Estimated SLNB costs to identify one patient with Stage II disease was $71,700. Out-of-pocket expenses for a Medicare patient was estimated to be $652 for a wide local excision (WLE) and SLNB and $79 for WLE alone.
AHRQ-funded; HS000032.
Citation: Herb JN, Ollila DW, Stitzenberg KB .
Use and costs of sentinel lymph node biopsy in non-ulcerated T1b melanoma: analysis of a population-based registry.
Ann Surg Oncol 2021 Jul;28(7):3470-78. doi: 10.1245/s10434-021-09998-6..
Keywords: Cancer: Skin Cancer, Cancer, Surgery, Healthcare Costs, Skin Conditions
Coley RY, Johnson E, Simon GE
Racial/ethnic disparities in the performance of prediction models for death by suicide after mental health visits.
This study looked at racial/ethnic disparities in the performance of prediction models for death by suicide after mental health visit. The main outcome measured was the suicide rate within 90 days after a mental health visit. The study used a 50% sample of visits from a random set of outpatients at 7 large integrated health care systems by patients 13 years and older (6,984,184 visits). Suicide rates were highest for visits by patients with no race/ethnicity recorded, followed by Asian, White, American Indian/Alaskan Native, Hispanic, and Black. Sensitivity of both models used were high for White, Hispanic, and Asian patients and poor for Black and American Indian/Alaskan Native patients and patients with no race/ethnicity recorded.
AHRQ-funded; HS026369.
Citation: Coley RY, Johnson E, Simon GE .
Racial/ethnic disparities in the performance of prediction models for death by suicide after mental health visits.
JAMA Psychiatry 2021 Jul;78(7):726-34. doi: 10.1001/jamapsychiatry.2021.0493..
Keywords: Disparities, Racial / Ethnic Minorities, Mental Health, Mortality, Risk
Chao GF, Li KY, Zhu Z
Use of telehealth by surgical specialties during the COVID-19 pandemic.
This study’s objective was to determine telehealth use by surgical specialty before and during the pandemic period starting in March 2020. Insurance claims from a Michigan statewide commercial payer for new patient visits with a surgeon from 1 of 9 surgical specialties during one of the following periods: prior to the COVID-19 pandemic (period 1: January 5 to March 7, 2020), early pandemic (period 2: March 8 to June 6, 2020), and late pandemic (period 3: June 7 to September 5, 2020) were analyzed. For new patient visits, 1182 surgeons (26.8%) in any patient context used telehealth. Telehealth use peaked in April 2020 and facilitated 34.6% of all new patient visits during that week. Urology was the specialty with the highest telehealth conversion rate (14.3%).
AHRQ-funded; HS027632.
Citation: Chao GF, Li KY, Zhu Z .
Use of telehealth by surgical specialties during the COVID-19 pandemic.
JAMA Surg 2021 Jul;156(7):620-26. doi: 10.1001/jamasurg.2021.0979..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Access to Care, Practice Patterns, Surgery
Caram MEV, Burns J, Kumbier K
Factors influencing treatment of veterans with advanced prostate cancer.
This study examined factors influencing treatment of veterans with metastatic castration-resistant prostate cancer (CRPC). Clinician and nonclinical factors associated with the first-line treatment for CPRC using data from the Veterans Health Administration was used. Almost 5000 patients who received abiraterone, enzalutamide, docetaxel, or ketoconazole from 2010 through 2017 were identified. Increasing age was associated with receipt of abiraterone or enzalutamide versus docetaxel. Greater preexisting comorbidity was associated with enzalutamide versus abiraterone. Patients with higher PSA values at the start of treatment were more likely to receive docetaxel than the other three treatments. African American men were more likely to receive ketoconazole.
AHRQ-funded; HS025707.
Citation: Caram MEV, Burns J, Kumbier K .
Factors influencing treatment of veterans with advanced prostate cancer.
Cancer 2021 Jul 1;127(13). doi: 10.1002/cncr.33485..
Keywords: Cancer: Prostate Cancer, Cancer, Veterans, Men's Health, Treatments
Bushnell GA, Crystal S, Olfson M
Trends in antipsychotic medication use in young privately insured children.
This study’s objective was to estimate trends in annual antipsychotic medication use by privately insured young children (aged 2-7 years) in the United States and to describe the clinical and treatment characteristics of these children. Young children from a nationwide commercial claims database from 2007-2017 was used to estimate annual antipsychotic use by age and sex. Annual antipsychotic use decreased over the time period, from a peak of 0.29% in 2009 and significantly declined to 0.17% in 2017. Antipsychotic use was higher in boys than in girls with a greater proportion receiving a mental disorder diagnosis in 2017 than in 2009. The most common clinical diagnoses were pervasive development disorder, conduct or disruptive behavior disorder, and attention-deficit/hyperactivity disorder. In 2017, 32% had 4+ psychotherapy claims, 43% had a psychiatrist visit, and the majority used another psychotropic medication, most commonly a stimulant.
AHRQ-funded; HS023258; HS026001.
Citation: Bushnell GA, Crystal S, Olfson M .
Trends in antipsychotic medication use in young privately insured children.
J Am Acad Child Adolesc Psychiatry 2021 Jul;60(7):877-86. doi: 10.1016/j.jaac.2020.09.023..
Keywords: Children/Adolescents, Medication, Mental Health
Burris HH, Passarella M, Handley SC
Black-white disparities in maternal in-hospital mortality according to teaching and black-serving hospital status.
This study’s objective was to determine whether black-white disparities in maternal in-hospital mortality during delivery vary across hospital types (black-serving vs non-black and teaching vs non-teaching) and whether overall maternal mortality differs across hospital types. The authors performed a population-based, retrospective cohort study of 5,679,044 deliveries among black (14.2%) and white patients (85.8%) in 3 states (California, Missouri, and Pennsylvania) from 1995 to 2009. Examination of black-white disparities found that after risk adjustment, black patients had significantly greater risk of death and that the disparity was similar within each of the hospital types. At teaching hospitals, mortality was similar in black-serving and nonblack-serving hospitals. Among non-teaching hospitals, mortality was significantly higher in black-serving vs nonblack-serving hospitals. Over half (53%) of black patients delivered in nonteaching black-serving hospitals compared with just 19% of white patients.
AHRQ-funded; HS018661.
Citation: Burris HH, Passarella M, Handley SC .
Black-white disparities in maternal in-hospital mortality according to teaching and black-serving hospital status.
Am J Obstet Gynecol 2021 Jul;225(1):83.e1-83.e9. doi: 10.1016/j.ajog.2021.01.004..
Keywords: Maternal Care, Pregnancy, Mortality, Women, Racial / Ethnic Minorities, Disparities, Hospitals
Brei BK, Sawyer T, Umoren R
Associations between family presence and neonatal intubation outcomes: a report from the National Emergency Airway Registry for Neonates: NEAR4NEOS.
This study looked at whether the presence of family members had an impact on neonatal tracheal intubation (TI) outcomes. This retrospective analysis looked at TIs performed in NICUs participating in the National Emergency Airway Registry for Neonates (NEAR4NEOS) at 13 academic NICUS from October 2014 to December 2017. Family members were present in less than 10% of TIs, but this varied by site. Success rates were not significantly different, with the first attempt success rate at 55% with family present versus 49% and success within 2 attempts was 74% versus 66%. Adverse TI-associated events (TIAEs) were 17% versus 20% and severe oxygen desaturation was 49% versus 52%. No independent association between any of these outcomes was found with family presence.
AHRQ-funded; HS027259; HS024511.
Citation: Brei BK, Sawyer T, Umoren R .
Associations between family presence and neonatal intubation outcomes: a report from the National Emergency Airway Registry for Neonates: NEAR4NEOS.
Arch Dis Child Fetal Neonatal Ed 2021 Jul;106(4):392-97. doi: 10.1136/archdischild-2020-319709..
Keywords: Newborns, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Registries, Patient Safety
Bogetz JF, Revette A, DeCourcey DD
Clinical care strategies that support parents of children with complex chronic conditions.
This paper examines the best clinical care strategies that support parents of children with complex chronic conditions facing inpatient and end-of-life care in the ICU. Qualitative analysis of 21 open-response items from the cross-sectional “Survey of Caring for Children with Complex Chronic Conditions” was done. Open-ended responses from 110 of 114 survey respondents who were parents of children who received care at a large academic institution and died between 2006 and 2015 were analyzed. Most of the children had congenital/chromosomal complex chronic conditions and had died an average of 3.9 years prior to their parents’ study participation. The respondents emphasized the relational aspects of clinical care including inclusivity of their expertise on their child’s needs, recognition of their unique experiences as parents, and maintenance of connection with clinicians through bereavement.
AHRQ-funded; HS022986.
Citation: Bogetz JF, Revette A, DeCourcey DD .
Clinical care strategies that support parents of children with complex chronic conditions.
Pediatr Crit Care Med 2021 Jul;22(7):595-602. doi: 10.1097/pcc.0000000000002726..
Keywords: Children/Adolescents, Chronic Conditions, Palliative Care, Inpatient Care
Bishop JR, Huang RS, Brown JT
Pharmacogenomics education, research and clinical implementation in the state of Minnesota.
This article looks at the development and implementation of formal pharmacogenomic (PGx) clinical programs at several healthcare organizations across Minnesota. These programs increase drug safety and effectiveness. The article reviews the state of PGx activities in the state of Minnesota including educational programs, research, national consortia involvement, technology, clinical implementation and utilization and reimbursement, and outlines the challenges and opportunities in equitable implementation of these activities.
AHRQ-funded; HS026379.
Citation: Bishop JR, Huang RS, Brown JT .
Pharmacogenomics education, research and clinical implementation in the state of Minnesota.
Pharmacogenomics 2021 Jul;22(11):681-91. doi: 10.2217/pgs-2021-0058..
Keywords: Medication, Implementation, Learning Health Systems, Evidence-based Practice, Patient-Centered Outcomes Research
Berdahl TA, Moriya AS
Insurance coverage for non-standard workers: experiences of temporary workers, freelancers, and part-time workers in the USA, 2010-2017.
This AHRQ-authored paper estimates insurance disparities across non-standard employment categories and determines how coverage disparities shifted following health reform in 2014. Data on working-age adults was analyzed from the 2010-2012 and 2015-2017 MEPS. Uninsurance decreased after health reform for all groups of nonstandard workers with a 10-14% point decline. Uninsurance remained high for all freelance workers at 30.8%, full-time temporary workers (25.1%) and part-time workers (17.9%) compared to full-time workers (11.9%). Lower uninsurance in a Medicaid expansion state was found for all categories of workers.
AHRQ-authored.
Citation: Berdahl TA, Moriya AS .
Insurance coverage for non-standard workers: experiences of temporary workers, freelancers, and part-time workers in the USA, 2010-2017.
J Gen Intern Med 2021 Jul;36(7):1997-2003. doi: 10.1007/s11606-021-06700-0..
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Policy, Uninsured, Medicaid, Low-Income
Lange EMS, Toledo P
Peripartum racial/ethnic disparities.
Addressing disparities has been a focus of the US Department of Health and Human Services Healthy People initiative for decades, with the most recent Healthy People 2020 establishing a need for health equity in the United States. In this article, the investigators presented an overview of peripartum racial/ethnic disparities and address potential structural solutions to improve maternal health equity.
AHRQ-funded; HS025267.
Citation: Lange EMS, Toledo P .
Peripartum racial/ethnic disparities.
Int Anesthesiol Clin 2021 Jul 1;59(3):1-7. doi: 10.1097/aia.0000000000000326..
Keywords: Maternal Care, Pregnancy, Disparities, Racial / Ethnic Minorities, Women
