National Healthcare Quality and Disparities Report
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- Access to Care (1)
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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 4 of 4 Research Studies DisplayedMcDaniel CE, Leyenaar JK, Bryan MA
Urban-rural disparities in interfacility transfers for children during COVID-19.
This study’s goal was to identify temporal trends and differences in urban and rural pediatric interfacility transfers (IFTs) before and during the COVID-19 pandemic. The authors conducted a cross-sectional analysis of IFT among children <18 years from January 2019 to June 2022 using the Pediatric Health Information System. They calculated observed-to-expected (O-E) ratios of pre-pandemic (March 2019-Feb 2020) transfers compared to pandemic year 1 (March 2020-Feb 2021) and year 2 (March 2021-February 2022) using Poisson modeling. The O-E ratio of IFT in year 1 for urban children was 14.0% and 14.8% for rural children compared to pre-pandemic. In year 2, transfers rebounded with IFTs for rural-residing children increasing more than urban-residing children (101.7%) compared to 90.7%. For mental-health indications in year 2, rural transfer ratios were higher than urban, 126% compared to 113.7%.
AHRQ-funded; HS028683.
Citation: McDaniel CE, Leyenaar JK, Bryan MA .
Urban-rural disparities in interfacility transfers for children during COVID-19.
J Rural Health 2023 Jun; 39(3):611-16. doi: 10.1111/jrh.12746..
Keywords: COVID-19, Children/Adolescents, Disparities, Rural Health, Urban Health, Rural/Inner-City Residents
Encinosa W, Moon K, Figueroa J
AHRQ Author: Encinosa W
Complications, adverse drug events, high costs, and disparities in multisystem inflammatory syndrome in children vs COVID-19.
This cross-sectional study’s goal was to determine outcomes from multisystem inflammatory syndrome in children (MIS-C) after COVID-19. Outcomes examined were 50 complications, adverse medication events, costs, and the Social Vulnerability Index. An analysis was conducted using data from the 2021 HCUP in individuals younger than 21 years from 31 states. There were 4107 individuals hospitalized with MIS-C (median age 9 years, 59.5% male, 38.1% White) and 23,686 hospitalizations for COVID-19 without MIS-C (median age 15 years, 54.5% female, 44.1% White). Hospitalization rate for MIS-C was 1.48 per 100,000 children, ranging from 0.97 hospitalizations per 100 for White and 1.99 hospitalizations per 100 for Black children. Outcomes were worse when organ dysfunction increased from 2 to 8 organs, with deaths increasing from less than 1% to 5.8% for MIS-C, and 1% to 17.2% for COVID-19. Median length of stay increased from 4 to 8 days for MIS-C, and 3 to 16 days for COVID-19. Median costs for MIS-C increased from $16,225 to $53 359 and from $6474 to $98,643 for COVID-19. The percentage of MIS-C cases in Black children doubled from 16.2% to 31.7% as organ dysfunction increased, remaining unchanged with COVID-19.
AHRQ-authored.
Citation: Encinosa W, Moon K, Figueroa J .
Complications, adverse drug events, high costs, and disparities in multisystem inflammatory syndrome in children vs COVID-19.
JAMA Netw Open 2023 Jan;6(1):e2244975. doi: 10.1001/jamanetworkopen.2022.44975..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, COVID-19, Medication, Adverse Drug Events (ADE), Adverse Events, Healthcare Costs, Disparities, Racial and Ethnic Minorities
Kemme S, Yoeli D, Sundaram SS
Decreased access to pediatric liver transplantation during the COVID-19 pandemic.
The purpose of the study was to explore and understand the impact of the COVID-19 pandemic on nationwide pediatric liver transplants. The researchers compared data for transplant waiting list additions, removals, and liver transplants during pre-COVID-19 (March-November 2016-2019), early COVID-19 (March-May 2020), and late COVID-19 (June-November 2020). The study results showed a 38% decrease in liver transplantations during early COVID-19, recovering to pre-pandemic rates during late COVID-19. White children had a 30% decrease in overall liver transplantation, while non-White children had a 44% decrease in overall liver transplantation. Additions to the waiting list decreased 25% during COVID-19, with Black transplant candidates the most affected, and children spent longer on the waiting list during early COVID-19 compared to pre-COVID-19 (140 vs. 96 days). The study concluded that the COVID-19 pandemic decreased access to pediatric liver transplants, especially during early COVID-19. The researchers discussed that although the rate of pediatric liver transplants has resumed to pre-COVID-19 levels, racial disparities must be addressed.
AHRQ-funded; HS026510.
Citation: Kemme S, Yoeli D, Sundaram SS .
Decreased access to pediatric liver transplantation during the COVID-19 pandemic.
Pediatr Transplant 2022 Mar;26(2):e14162. doi: 10.1111/petr.14162..
Keywords: Children/Adolescents, COVID-19, Transplantation, Access to Care, Disparities
Fraiman YS, Litt JS, Davis JM
Racial and ethnic disparities in adult COVID-19 and the future impact on child health.
This article discusses the impact of the COVID-19 pandemic on children who are racial and ethnic minorities and the disproportionate harm to them. The authors urge that COVID-19-focused research consider racial and ethnic disparity. The paper discusses the lasting and intergenerational impact of COVID-19 on communities of color, especially children, due to increase in stress, material hardship, food insecurity, and long-term school readiness.
AHRQ-funded; HS000063.
Citation: Fraiman YS, Litt JS, Davis JM .
Racial and ethnic disparities in adult COVID-19 and the future impact on child health.
Pediatr Res 2021 Apr;89(5):1052-54. doi: 10.1038/s41390-021-01377-x..
Keywords: COVID-19, Children/Adolescents, Racial and Ethnic Minorities, Disparities, Health Status, Social Determinants of Health