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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 19 of 19 Research Studies DisplayedShover CL, Rosen A, Mata J
Engaging same-day peer ambassadors to increase coronavirus disease 2019 vaccination among people experiencing unsheltered homelessness in Los Angeles County: a hybrid feasibility-evaluation study.
This study’s goal was to evaluate the feasibility and acceptability of engaging unhoused peer ambassadors (PAs) in COVID-19 vaccination efforts to reach people experiencing unsheltered homelessness in Los Angeles County. A total of 117 PAs were enrolled at 103 events, participating for an average of 2 hours. Findings showed that 197 additional people were vaccinated over 167 PA hours, accounting for >25% of all vaccines given at these events, indicating that recruiting same-day unhoused PAs is a feasible, acceptable, and preliminarily effective technique to increase COVID-19 vaccination in unsheltered settings.
AHRQ-funded; HS026407.
Citation: Shover CL, Rosen A, Mata J .
Engaging same-day peer ambassadors to increase coronavirus disease 2019 vaccination among people experiencing unsheltered homelessness in Los Angeles County: a hybrid feasibility-evaluation study.
J Infect Dis 2022 Oct 7;226(suppl 3):S346-s52. doi: 10.1093/infdis/jiac291..
Keywords: COVID-19, Vaccination, Vulnerable Populations, Public Health
Bartsch SM, Wedlock PT, O'Shea KJ
Lives and costs saved by expanding and expediting coronavirus disease 2019 vaccination.
The authors developed a computational model representing the United States population, COVID-19 coronavirus spread (February 2020-December 2022), and vaccination to determine the impact of increasing coverage and expediting time to achieve coverage. They concluded that their study quantified the potential value of decreasing vaccine hesitancy and increasing vaccination coverage and how this value may decrease with the time it takes to achieve coverage, emphasizing the need to reach high coverage levels as soon as possible, especially before the fall/winter.
AHRQ-funded; HS028165.
Citation: Bartsch SM, Wedlock PT, O'Shea KJ .
Lives and costs saved by expanding and expediting coronavirus disease 2019 vaccination.
J Infect Dis 2021 Sep 17;224(6):938-48. doi: 10.1093/infdis/jiab233..
Keywords: COVID-19, Vaccination, Public Health
Hofstetter AM, Schaffer S
Childhood and adolescent vaccination in alternative settings.
This article reviews the unique advantages, challenges, and experiences regarding vaccine delivery in alternative settings, such as schools, emergency rooms, hospitals, and pharmacies. It describes the key components that each setting must possess as well as other important factors to consider when assessing the ability of each to deliver vaccines to the children and adolescents they serve. It is important to emphasize that these settings should not replace the medical home as the primary location for vaccination, but rather serve as a critical safety net for high-risk individuals and communities and in situations where access to traditional locations may be limited, such as during the COVID-19 pandemic.
AHRQ-funded; HS025470.
Citation: Hofstetter AM, Schaffer S .
Childhood and adolescent vaccination in alternative settings.
Acad Pediatr 2021 May-Jun;21(4s):S50-s56. doi: 10.1016/j.acap.2021.02.001..
Keywords: Children/Adolescents, Vaccination, Healthcare Delivery, Public Health
Teixeira da Silva D, Biello K, Lin WY
COVID-19 vaccine acceptance among an online sample of sexual and gender minority men and transgender women.
Sexual and gender minority (SGM) populations are particularly vulnerable to poor COVID-19 outcomes and are more likely to experience stigma and medical mistrust that may impact COVID-19 vaccine acceptance. This study examined the prevalence of COVID testing and diagnosis and assessed COVID-19 vaccine acceptance among a large sample of SGM. The investigators found that black participants were significantly less likely to accept a COVID-19 vaccine, and Asian participants were significantly more likely to accept a vaccine, compared to White peers.
AHRQ-funded; HS0226116.
Citation: Teixeira da Silva D, Biello K, Lin WY .
COVID-19 vaccine acceptance among an online sample of sexual and gender minority men and transgender women.
Vaccines 2021 Mar;9(3). doi: 10.3390/vaccines9030204..
Keywords: Vaccination, COVID-19, Public Health, Racial and Ethnic Minorities, Vulnerable Populations
Fisher KA, Bloomstone SJ, Walder J
Attitudes toward a potential SARS-CoV-2 vaccine: a survey of U.S. adults.
The authors assessed the intent to be vaccinated against COVID-19 among a representative sample of adults in the United States and identified predictors of and reasons for vaccine hesitancy. They found that approximately 3 in 10 adults were not sure they would accept vaccination and 1 in 10 did not intend to be vaccinated against COVID-19. They recommended targeted and multipronged efforts to increase acceptance of a COVID-19 vaccine.
AHRQ-funded; HS024596.
Citation: Fisher KA, Bloomstone SJ, Walder J .
Attitudes toward a potential SARS-CoV-2 vaccine: a survey of U.S. adults.
Ann Intern Med 2020 Dec 15;173(12):964-73. doi: 10.7326/m20-3569..
Keywords: COVID-19, Vaccination, Public Health, Patient Adherence/Compliance
Bartsch SM, O'Shea KJ, Ferguson MC
Vaccine efficacy needed for a COVID-19 coronavirus vaccine to prevent or stop an epidemic as the sole intervention.
This study examined the needed efficacy and coverage of a COVID-19 vaccine to prevent or stop the pandemic. Simulation experiments were conducted at 60-80% efficacy rates. At 60% efficacy, vaccination coverage needs to be 100%. If the coverage rate is reduced to 75%, the efficacy needs to be 70% and up to 80% when coverage drops to 60%. These findings show that the vaccine needs to have at least an efficacy rate of 70% to prevent an epidemic and at least 80% to extinguish an epidemic without any other measures such as social distancing.
AHRQ-funded; HS023317.
Citation: Bartsch SM, O'Shea KJ, Ferguson MC .
Vaccine efficacy needed for a COVID-19 coronavirus vaccine to prevent or stop an epidemic as the sole intervention.
Am J Prev Med 2020 Oct;59(4):493-503. doi: 10.1016/j.amepre.2020.06.011..
Keywords: Vaccination, COVID-19, Public Health, Prevention, Evidence-Based Practice, Infectious Diseases
Bartsch SM, Mitgang EA, Geller G
What if the influenza vaccine did not offer such variable protection?
This study looked at the impact of reducing the variability in responses to the influenza vaccine across the population. Protection from the vaccine can vary significantly from person to person due to differences in immune systems, body types, and other factors. The authors compared the projected cases, direct medical costs, and productivity losses at the 30%, 50%, and 70% efficacy rates.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Mitgang EA, Geller G .
What if the influenza vaccine did not offer such variable protection?
J Infect Dis 2020 Sep 1;222(7):1138-44. doi: 10.1093/infdis/jiaa240..
Keywords: Influenza, Vaccination, Respiratory Conditions, Public Health
Bartsch SM, Asti L, Stokes-Cawley OJ
The potential economic value of a Zika vaccine for a woman of childbearing age.
The authors mapped the Zika vaccine and vaccination characteristic thresholds at which vaccination becomes cost effective, highly cost effective, and cost saving. They developed a Markov model to simulate a woman of childbearing age to follow the potential risk and clinical course of a Zika infection. They found that, in some cases, the vaccine was cost effective when the risk was as low as 0.015%, the cost was as high as $7,500, the efficacy was as low as 25%, and the duration of protection was 1 year. They concluded that the thresholds at which vaccination becomes cost effective and cost saving can provide targets for Zika vaccine development and implementation.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Asti L, Stokes-Cawley OJ .
The potential economic value of a Zika vaccine for a woman of childbearing age.
Am J Prev Med 2020 Mar;58(3):370-77. doi: 10.1016/j.amepre.2019.10.023..
Keywords: Vaccination, Women, Infectious Diseases, Public Health, Healthcare Costs, Prevention
Feldman AG, Hsu EK, Mack CL
The importance of prioritizing pre and posttransplant immunizations in an era of vaccine refusal and epidemic outbreaks.
This paper discusses the prevalence of vaccine-preventable outbreaks occurring both nationally and internationally. Rates of vaccine hesitancy and refusal have been increasing which leads to decreased herd immunity. This poses greater risk to immunosuppressed transplant recipients, and currently 1 in 6 pediatric solid organ transplant recipients are hospitalized with a vaccine-preventable infection in the first 5 years posttransplant. This often results in significant morbidity, mortality, and increased hospitalization costs. Surprisingly, many transplant recipients are not up-to-date on age appropriate immunizations at the time of transplant and thereafter. The authors feel that immunizations must be prioritized in both pre and posttransplant care. They call for more research to understand how to monitor immune response to vaccines in immunosuppressed patients and when to optimally immunize patients posttransplant. They also recommend reexamination of the administration of live vaccines posttransplant.
AHRQ-funded; HS026510.
Citation: Feldman AG, Hsu EK, Mack CL .
The importance of prioritizing pre and posttransplant immunizations in an era of vaccine refusal and epidemic outbreaks.
Transplantation 2020 Jan;104(1):33-38. doi: 10.1097/tp.0000000000002936..
Keywords: Vaccination, Medication, Emergency Preparedness, Public Health, Transplantation
Bartsch SM, Asti L, Cox SN
What is the value of different Zika vaccination strategies to prevent and mitigate Zika outbreaks?
The authors developed models of Honduras, Brazil, and Puerto Rico, simulated targeting different populations for Zika vaccination, and then introduced various Zika outbreaks. Their models showed that, when considering transmission, while vaccinating everyone naturally averted the most cases, specifically targeting women of childbearing age or young adults was the most cost-effective.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Asti L, Cox SN .
What is the value of different Zika vaccination strategies to prevent and mitigate Zika outbreaks?
J Infect Dis 2019 Aug 9;220(6):920-31. doi: 10.1093/infdis/jiy688..
Keywords: Healthcare Costs, Vaccination, Public Health, Infectious Diseases
Yoo BK, Schaffer SJ, Humiston SG
Cost effectiveness of school-located influenza vaccination programs for elementary and secondary school children.
This paper describes a clinical trial which created a school-located influenza vaccination (SLIV) program in upstate New York. Researchers wanted to determine if this was a cost-effective alternative to vaccination in primary care practices. Two groups of students were vaccinated – one in an elementary school and the other in a secondary school. Secondary school vaccinations were more cost-effective than elementary schools with a lower median cost per vaccination. The authors concluded that it does raise vaccination rates, but it is not cost-effective due to the higher costs for consent systems and project coordination.
AHRQ-funded; HS021163.
Citation: Yoo BK, Schaffer SJ, Humiston SG .
Cost effectiveness of school-located influenza vaccination programs for elementary and secondary school children.
BMC Health Serv Res 2019 Jun 24;19(1):407. doi: 10.1186/s12913-019-4228-5..
Keywords: Children/Adolescents, Education, Healthcare Costs, Influenza, Public Health, Vaccination
Wedlock PT, Mitgang EA, Oron AP
Modeling the economic impact of different vial-opening thresholds for measles-containing vaccines.
The lack of specific policies on how many children must be present at a vaccinating location before a healthcare worker can open a measles-containing vaccine (MCV) - i.e. the vial-opening threshold - has led to inconsistent practices, which can have wide-ranging systems effects. Using HERMES-generated simulation models of the routine immunization supply chains of Benin, Mozambique and Niger, the investigators evaluated the impact of different vial-opening thresholds (none, 30% of doses must be used, 60%) and MCV presentations (10-dose, 5-dose) on each supply chain.
AHRQ-funded; HS023317.
Citation: Wedlock PT, Mitgang EA, Oron AP .
Modeling the economic impact of different vial-opening thresholds for measles-containing vaccines.
Vaccine 2019 Apr 17;37(17):2356-68. doi: 10.1016/j.vaccine.2019.03.017..
Keywords: Vaccination, Infectious Diseases, Healthcare Costs, Public Health
Bartsch SM, Taitel MS, DePasse JV
Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic.
During an influenza epidemic, where early vaccination is crucial, pharmacies may be a resource to increase vaccine distribution reach and capacity. In this paper, the investigators utilized an agent-based model of the US and a clinical and economics outcomes model to simulate the impact of different influenza epidemics and the impact of utilizing pharmacies in addition to traditional (hospitals, clinic/physician offices, and urgent care centers) locations for vaccination for the year 2017.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Taitel MS, DePasse JV .
Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic.
Vaccine 2018 Nov 12;36(46):7054-63. doi: 10.1016/j.vaccine.2018.09.040..
Keywords: Healthcare Costs, Influenza, Provider: Pharmacist, Public Health, Vaccination
Wedlock PT, Mitgang EA, Siegmund SS
Dual-chamber injection device for measles-rubella vaccine: the potential impact of introducing varying sizes of the devices in 3 countries.
The purpose of this study was to identify the ideal size for dual-chamber injection devices used in routine immunization programs. Vaccine supply chain models of the Republic of Benin, the Republic of Mozambique, and Bihar were generated using the HERMES modeling software to simulate the effects of replacing a 10-dose lyophilized measles-rubella vaccine with single-dose, dual-chamber injection devices of varying sizes and prices. Optimal volume-per-dose was identified as either improving or causing no change in vaccine availability, wastage, or supply-chain costs in comparison to the existing program. The study concludes that a single-dose, dual-chamber measles-rubella injection device would need to be no larger than 5.2cm(3) to not significantly impair the flow of other vaccines.
AHRQ-funded; HS023317.
Citation: Wedlock PT, Mitgang EA, Siegmund SS .
Dual-chamber injection device for measles-rubella vaccine: the potential impact of introducing varying sizes of the devices in 3 countries.
Vaccine 2018 Sep 18;36(39):5879-85. doi: 10.1016/j.vaccine.2018.08.026..
Keywords: Public Health, Vaccination
de Montigny S, Adamson BJS, Masse BR
Projected effectiveness and added value of HIV vaccination campaigns in South Africa: a modeling study.
Sci Rep 2018 Apr 17;8(1):6066. doi: 10.1038/s41598-018-24268-4.
In this paper, the authors estimated the potential epidemiological and economic impact of HIV vaccine campaigns compared to continuous vaccination, assuming that vaccine efficacy was transient and dependent on immune response. The investigators concluded that results suggested a partially effective HIV vaccine would have substantial impact on the HIV epidemic in South Africa and offer good value if priced less than $105 for a five-dose series. They suggested that vaccination campaigns every two years may offer greater value for money than continuous vaccination reaching the same coverage level.
In this paper, the authors estimated the potential epidemiological and economic impact of HIV vaccine campaigns compared to continuous vaccination, assuming that vaccine efficacy was transient and dependent on immune response. The investigators concluded that results suggested a partially effective HIV vaccine would have substantial impact on the HIV epidemic in South Africa and offer good value if priced less than $105 for a five-dose series. They suggested that vaccination campaigns every two years may offer greater value for money than continuous vaccination reaching the same coverage level.
AHRQ-funded; HS013853.
Citation: de Montigny S, Adamson BJS, Masse BR .
Projected effectiveness and added value of HIV vaccination campaigns in South Africa: a modeling study.
Sci Rep 2018 Apr 17;8(1):6066. doi: 10.1038/s41598-018-24268-4..
Keywords: Health Services Research (HSR), Healthcare Costs, Human Immunodeficiency Virus (HIV), Public Health, Vaccination
Szilagyi PG, Schaffer S, Rand CM
School-located influenza vaccinations for adolescents: a randomized controlled trial.
In this study, the investigators aimed to evaluate the effect of school-located influenza vaccination (SLIV) on adolescents' influenza vaccination rates. In 2015-2016, they performed a cluster-randomized trial of adolescent SLIV in middle/high schools. They concluded that SLIV in this community increased influenza vaccination rates among adolescents attending suburban schools.
AHRQ-funded; HS021163.
Citation: Szilagyi PG, Schaffer S, Rand CM .
School-located influenza vaccinations for adolescents: a randomized controlled trial.
J Adolesc Health 2018 Feb;62(2):157-63. doi: 10.1016/j.jadohealth.2017.09.021..
Keywords: Children/Adolescents, Education, Influenza, Prevention, Public Health, Vaccination
Saville AW, Gurfinkel D, Sevick C
Provider preferences and experiences with a countywide centralized collaborative reminder/recall for childhood immunizations.
The researchers assessed among providers in Colorado where a collaborative centralized reminder/recall (CC-R/R) using the Colorado Immunization Information System (CIIS) was performed: 1) preferences about CC-R/R conducted by the public health department (PHD); and 2) experiences with including their name on CC-R/R notices. Most practices are accepting of the PHD centrally conducting R/R, but most prefer collaboration that includes their name.
AHRQ-funded; HS021138.
Citation: Saville AW, Gurfinkel D, Sevick C .
Provider preferences and experiences with a countywide centralized collaborative reminder/recall for childhood immunizations.
Acad Pediatr 2016 Jan-Feb;16(1):50-6. doi: 10.1016/j.acap.2015.09.002.
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Keywords: Public Health, Vaccination, Health Information Technology (HIT), Children/Adolescents, Practice Patterns
Glanz JM, Kraus CR, Daley MF
Addressing parental vaccine concerns: engagement, balance, and timing.
The recent United States measles epidemic has sparked another contentious national discussion about childhood vaccination. Interventions to address this emerging public health issue are needed. The authors describe a framework by which web-based interventions can be used to help parents make evidence-based decisions about childhood vaccinations.
AHRQ-funded; HS021492.
Citation: Glanz JM, Kraus CR, Daley MF .
Addressing parental vaccine concerns: engagement, balance, and timing.
PLoS Biol 2015 Aug;13(8):e1002227. doi: 10.1371/journal.pbio.1002227..
Keywords: Vaccination, Children/Adolescents, Public Health, Education: Patient and Caregiver
Khazeni N, Hutton DW, Collins CI
Health and economic benefits of early vaccination and nonpharmaceutical interventions for a human influenza A (H7N9) pandemic: a modeling study.
In order to determine how quickly vaccination should be completed to reduce infections, deaths, and health care costs in a severe influenza pandemic in a large metropolitan area, researchers used a dynamic transmission model. They found that vaccination in an influenza-A (H7N9) pandemic would need to be completed much faster than in the 2009 pandemic to substantially reduce morbidity, mortality, and health care costs.
AHRQ-funded; HS019816
Citation: Khazeni N, Hutton DW, Collins CI .
Health and economic benefits of early vaccination and nonpharmaceutical interventions for a human influenza A (H7N9) pandemic: a modeling study.
Ann Intern Med. 2014 May 20;160(10):684-94. doi: 10.7326/M13-2071..
Keywords: Vaccination, Influenza, Mortality, Healthcare Costs, Public Health