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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 9402 Research Studies DisplayedMcInerney M, Mellor JM, Sabik LM. M, Mellor JM, Sabik LM
Welcome mats and on-ramps for older adults: the impact of the Affordable Care Act's Medicaid Expansions on Dual Enrollment in Medicare and Medicaid.
The authors examined whether Medicaid participation by low-income adults age 65 and up increased as a result of Medicaid expansions to working-age adults under the Affordable Care Act (ACA). Using American Community Survey data and state variation in ACA Medicaid expansions, they found that Medicaid expansions to working-age adults increased Medicaid participation among low-income older adults by 4.4 percent. They also found evidence of an “on-ramp” effect, which is an important mechanism behind welcome mat effects among some older adults.
AHRQ-funded; HS025422.
Citation: McInerney M, Mellor JM, Sabik LM. M, Mellor JM, Sabik LM .
Welcome mats and on-ramps for older adults: the impact of the Affordable Care Act's Medicaid Expansions on Dual Enrollment in Medicare and Medicaid.
J Policy Anal Manage 2021 Win;40(1):12-41. doi: 10.1002/pam.22259..
Keywords: Elderly, Medicaid, Medicare, Low-Income, Health Insurance, Policy
McCoy RG, Van Houten HK, Dunlay SM
Race and sex differences in the initiation of diabetes drugs by privately insured US adults.
The authors examined the differences in the use of three glucose-lowering medications as a function of both sex and race. They found that, compared to white men, GLP-1RA were 43% more likely to be started by White women, 12% more likely to be started by non-White men, and 21% less likely to be started by non-White women. SGLT2i were at least 10% less likely to be started by all groups compared to White men, and DPP4i were used more often by non-White than White patients of both sexes.
AHRQ-funded; HS024075.
Citation: McCoy RG, Van Houten HK, Dunlay SM .
Race and sex differences in the initiation of diabetes drugs by privately insured US adults.
Race and sex differences in the initiation of diabetes drugs by privately insured US adults..
Keywords: Diabetes, Chronic Conditions, Medication, Sex Factors, Racial / Ethnic Minorities
Kandel 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
Morden NE, Chyn D, Wood A
Racial inequality in prescription opioid receipt - role of individual health systems.
The purpose of this study was to explore the contribution of individual health systems in the receipt of prescription opioids among racial groups in the United States. Medicare claims data for 2016-2017 was used to obtain a random 40% national sample of fee-for-service, Black and White beneficiaries 18 to 64 years of age and identify 310 racially diverse systems. Findings showed that, within individual health systems, Black and White patients received markedly different opioid doses. These system-specific findings could facilitate exploration of the causes and consequences of these differences.
AHRQ-funded; HS024075.
Citation: Morden NE, Chyn D, Wood A .
Racial inequality in prescription opioid receipt - role of individual health systems.
N Engl J Med 2021 Jul 22;385(4):342-51. doi: 10.1056/NEJMsa2034159..
Keywords: Opioids, Medication, Racial / Ethnic Minorities, Disparities, Practice Patterns
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
Murad MH, Chang SM, Fiordalisi CV
Improving the utility of evidence synthesis for decision makers in the face of insufficient evidence.
The authors identified and suggested strategies to make insufficient evidence ratings in systematic reviews more actionable. A workgroup comprising members from AHRQ’s Evidence-Based Practice Program convened throughout 2020. They identified five strategies for supplementing systematic review findings when evidence on benefits or harms is expected to be, or found to be, insufficient: 1) reconsider eligible study designs, 2) summarize indirect evidence, 3) summarize contextual and implementation evidence, 4) consider modelling, and 5) incorporate unpublished health system data in the evidence synthesis. While these strategies may not increase the strength of evidence, they may improve the utility of reports for decision makers.
AHRQ-authored; AHRQ-funded; 290201700003C; 290201500013I; 290201500008I; 290201500007I; 290201500011I; 290201500010I; 290201500002I; 290201500005I; 290201500012I; 290201500006I.
Citation: Murad MH, Chang SM, Fiordalisi CV .
Improving the utility of evidence synthesis for decision makers in the face of insufficient evidence.
J Clin Epidemiol 2021 Jul;135:170-75. doi: 10.1016/j.jclinepi.2021.02.028..
Keywords: Evidence-based Practice, Decision Making, Patient-Centered Outcomes Research
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
Orenstein EW, ElSayed-Ali O, Kandaswamy S
Evaluation of a clinical decision support strategy to increase seasonal influenza vaccination among hospitalized children before inpatient discharge.
The authors’ goal was to design and evaluate a clinical decision support (CDS) strategy to increase the proportion of eligible hospitalized children who receive a seasonal influenza vaccine prior to inpatient discharge. They found that a user-centered CDS may be associated with significantly improved influenza vaccination rates among hospitalized children.
AHRQ-funded; HS027689.
Citation: Orenstein EW, ElSayed-Ali O, Kandaswamy S .
Evaluation of a clinical decision support strategy to increase seasonal influenza vaccination among hospitalized children before inpatient discharge.
JAMA Netw Open 2021 Jul;4(7):e2117809. doi: 10.1001/jamanetworkopen.2021.17809..
Keywords: Children/Adolescents, Influenza, Vaccination, Clinical Decision Support (CDS), Health Information Technology (HIT), Hospital Discharge
Moza R, Truong DT, Lambert LM
Poor weight recovery between stage 1 palliation and hospital discharge for infants with single ventricle physiology: an analysis of the NPC-QIC Phase II dataset.
The purpose of this study was to investigate change in weight-for-age z-scores (WAZ) and risk factors for impaired weight gain between stage 1 palliation (S1P) for single ventricle physiology and discharge. Data from the National Pediatric Cardiology Quality Improvement Collaborative Phase II database was analysed. Findings showed that nearly all infants lost weight after S1P, with little recovery by hospital discharge. At discharge, three-quarters of the infants were at-risk for impaired weight gain or had failure to thrive. Most risk factors associated with change in WAZ were unmodifiable or surrogates of disease severity.
AHRQ-funded; HS021114.
Citation: Moza R, Truong DT, Lambert LM .
Poor weight recovery between stage 1 palliation and hospital discharge for infants with single ventricle physiology: an analysis of the NPC-QIC Phase II dataset.
J Pediatr 2021 Jul;234:20-26.e2. doi: 10.1016/j.jpeds.2021.03.035..
Keywords: Newborns, Centers for Education and Research on Therapeutics (CERTs), Heart Disease and Health, Cardiovascular Conditions, Health Status, Risk
Magee LA, Fortenberry JD, Nelson T
Sexually transmitted infections in association with area-level prostitution and drug-related arrests.
Using justice and public health sexually transmitted infections (STIs) /HIV data in Marion County (Indianapolis), Indiana, during an 18-year period, the authors assessed the overall association of area-level prostitution and drug-related arrests and STI/HIV, and mediators and moderators of the relationship. Results indicated a positive relationship between numbers of prostitution arrests and area-level STI rates. There was a dose-response relationship between prostitution arrests and STI rates when accounting for drug-related arrests. The authors stated that these findings inform public health agencies and community-based organizations that conduct outreach in these areas to expand their efforts to include harm reduction and HIV/STI testing for both sex workers and individuals experiencing substance use disorder.
AHRQ-funded; HS023318.
Citation: Magee LA, Fortenberry JD, Nelson T .
Sexually transmitted infections in association with area-level prostitution and drug-related arrests.
Sex Transm Dis 2021 Jul;48(7):508-14. doi: 10.1097/olq.0000000000001345..
Keywords: Sexual Health, Human Immunodeficiency Virus (HIV), Infectious Diseases
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
