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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
26 to 50 of 322 Research Studies DisplayedMiller MJ, Miller MJ, Pak SS, Keller DR SS, Keller DR
Physical therapist telehealth delivery at 1 year into COVID-19.
This study’s purpose was to examine telehealth physical therapy utilization 1 year into the COVID-19 pandemic and identify factors that influence physical therapists' delivery of telehealth in an urban academic medical center. Data was extracted from electronic medical records from March 22 to May 15, 2021. The proportion of physical therapy sessions delivered via telehealth were identified, and patient characteristics were compared by telehealth volume (0 vs ≥1 session, 1 vs >1 session). Telehealth was used for 3793 of 8038 (47.2%) physical therapist sessions, and 1028 unique patients had at least 2 physical therapist sessions (without telehealth: 6.6%, telehealth once: 39.1%, telehealth more than once: 54.3%). Patients who did not use telehealth were older, non-English speaking, had non-commercial insurance, and had at least 1 chronic health condition. Patients who used telehealth more than once had a neurologic diagnosis and lived farther from the treating clinic. Factors that influenced telehealth delivery were physical therapist clinical skills and knowledge, technical proficiency, telehealth-specific interpersonal skills, and cognitive flexibility. External factors outside of the physical therapist that influenced telehealth delivery included the environment, patient equipment and technology proficiency, physical therapist equipment, clinic factors, and patient and referring provider perspectives.
AHRQ-funded; HS026379.
Citation: Miller MJ, Miller MJ, Pak SS, Keller DR SS, Keller DR .
Physical therapist telehealth delivery at 1 year into COVID-19.
Phys Ther 2022 Nov 6; 102(11). doi: 10.1093/ptj/pzac121..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT)
Daw JR, Yekta S, Jacobson-Davies FE
Consistency and adequacy of public and commercial health insurance for US children, 2016 to 2021.
This study used the 2016 to 2021 National Survey of Children’s Health to compare overall rates, COVID-19 public health emergency-related changes, and child and family characteristics associated with inconsistent and inadequate coverage for publicly and commercially insured children. The authors were looking at inconsistent insurance, defined by failure to meet 3 criteria: (1) benefits usually/always sufficient to meet child's needs; (2) coverage usually/always allows child to access needed health care practitioners; and (3) no or usually/always reasonable annual out-of-pocket payments for child's health care. Of this nationally representative sample of 203,691 insured children, 34.5% were publicly insured (mean age 8.4 [4.1] years; 47.4% female) and 65.5% were commercially insured (mean age, 8.7 [5.6]; 49.1% female). Most publicly insured children were either non-Hispanic Black (20.9%) or Hispanic (36.4%); living with 2 married parents (38.4%) or a single parent (33.1%); and had a household income less than 200% of the federal poverty level (79%); and most commercially insured children were non-Hispanic White (62.8%), living with 2 married parents (79.0%); and had a household income of 400% of the federal poverty level or higher (49.1%). Compared with commercially insured children, publicly insured children had higher rates of inconsistent coverage (4.2% vs 1.4%; difference, 2.7 percentage points [pp]) and lower rates of inadequate coverage (12.2% vs 33.0%; difference). Compared with the period from 2016 to 2019, inconsistent insurance decreased by 42% for publicly insured children and inadequate insurance decreased by 6% for commercially insured children during the COVID-19 public health emergency (PHE) (2020-2021).
AHRQ-funded; HS029159.
Citation: Daw JR, Yekta S, Jacobson-Davies FE .
Consistency and adequacy of public and commercial health insurance for US children, 2016 to 2021.
JAMA Health Forum 2023 Nov; 4(11):e234179. doi: 10.1001/jamahealthforum.2023.4179..
Keywords: Children/Adolescents, Health Insurance, COVID-19
Molloy MJ, Auger KA, Hall M
Epidemiology and severity of illness of MIS-C and Kawasaki Disease during the COVID-19 pandemic.
Researchers sought to understand the illness severity of multisystem inflammatory syndrome in children (MIS-C) compared with Kawasaki disease (KD) and to evaluate changes in MIS-C illness severity over time during the coronavirus pandemic. Data on the hospitalization of children with MIS-C and KD were taken from the Pediatric Health Information System administrative database. The results showed a higher proportion of hospitalizations with shock for MIS-C compared with KD, but a significant decrease in the odds of shock in MIS-C patients was observed over time; MIS-C was a source of lower morbidity than KD as the pandemic progressed. The researchers concluded that their findings provide evidence that MIS-C is a distinct condition from KD.
AHRQ-funded; HS026763; HS028102.
Citation: Molloy MJ, Auger KA, Hall M .
Epidemiology and severity of illness of MIS-C and Kawasaki Disease during the COVID-19 pandemic.
Pediatrics 2023 Nov 1; 152(5). doi: 10.1542/peds.2023-062101..
Keywords: Children/Adolescents, COVID-19
Millman A, Huang J, Graetz I
Patient-reported primary care video and telephone telemedicine preference shifts during the COVID-19 pandemic.
This study used patient surveys to understand the health care experience of patients seeking primary care through telemedicine and how patients expected their preferences to shift as a result of the COVID-19 pandemic. The authors sampled patients monthly and collected 1000 surveys from adults with primary care telemedicine visits scheduled through the online patient portal between 3/16/2020 and 10/31/2020. Participants reported their preferred primary care visit modality (telephone, video, or in-person visits) across 3 time points: before, during and after the COVID-19 pandemic and reported their general assessment of these visits. The majority of participant preferred in-person visits before (69%) and after (57%) the pandemic. During the pandemic most participants reported a preference for telemedicine and continued to prefer telemedicine visits at a 12% higher rate post-pandemic. Most participants (63%) expressed interested in using telemedicine at least some of the time. The majority of participants who reported a recent telemedicine visit (83%) agreed that the visit addressed their health needs.
AHRQ-funded; HS025189.
Citation: Millman A, Huang J, Graetz I .
Patient-reported primary care video and telephone telemedicine preference shifts during the COVID-19 pandemic.
Med Care 2023 Nov; 61(11):772-78. doi: 10.1097/mlr.0000000000001916.
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Primary Care
Fernandez JR, Strassle PD, Richmond J
County-level barriers in the COVID-19 vaccine coverage index and their associations with willingness to receive the COVID-19 vaccine across racial/ethnic groups in the U.S.
This study examined whether county-level vaccination barriers varied across racial/ethnic groups in the U.S., if they were associated with willingness to receive the COVID-19 vaccine, and if they differed across racial/ethnic groups. Data was taken from the REACH-US study. County-level vaccination barriers were measured using the COVID-19 Vaccine Coverage Index. Results showed that American Indian/Alaska Native, African American, Hispanic/Latino, and Multiracial adults were more likely than White adults to live in counties with higher overall county-level vaccination barriers. Higher sociodemographic barriers were associated with less willingness to receive the COVID-19 vaccine. History of low vaccination was associated with less willingness to receive the COVID-19 vaccine among African American adults. The researchers concluded that future vaccination programs should include efforts accounting for structural barriers to preventive healthcare and their intersection with sociodemographic factors.
AHRQ-funded; HS026122.
Citation: Fernandez JR, Strassle PD, Richmond J .
County-level barriers in the COVID-19 vaccine coverage index and their associations with willingness to receive the COVID-19 vaccine across racial/ethnic groups in the U.S.
Front Public Health 2023 Oct 12; 11:1192748. doi: 10.3389/fpubh.2023.1192748..
Keywords: COVID-19, Vaccination, Patient Adherence/Compliance, Racial and Ethnic Minorities
Ahmed N, Sanghavi K, Mathur S
Patient portal use: persistent disparities from pre- to post-onset of the COVID-19 pandemic.
This study examined patient portal usage from pre- to post-onset of the COVID-19 pandemic to determine what impact the pandemic had on portal usage by patient sub-populations. The authors included a total of 153,628 unique patients. They assessed patient portal usage from pre-onset (March 2019-February 2020) to post-onset of the COVID-19 pandemic (March 2020-February 2021). They examined usage by patient sub-populations (age, sex, race, ethnicity), comorbid conditions, and health insurance type. Differences were seen in specific patient portal actions. Increases were seen in immunization views (0.43) and health record views (0.43) from post-onset compared to pre-onset. A decrease was noted in prescription renewal (medication) views (-0.07) from pre- to post-onset There was a decrease in both immunization views and health record views among Black patients (-0.07) in comparison to White patients, but an increase in prescription renewal (medication) views (0.07) amongst Black patients compared to White patients.
AHRQ-funded; HS026298.
Citation: Ahmed N, Sanghavi K, Mathur S .
Patient portal use: persistent disparities from pre- to post-onset of the COVID-19 pandemic.
Int J Med Inform 2023 Oct; 178:105204. doi: 10.1016/j.ijmedinf.2023.105204..
Keywords: COVID-19, Disparities, Electronic Health Records (EHRs), Health Information Technology (HIT)
Ferranna M, Robinson LA, Cadarette D
The benefits and costs of U.S. employer COVID-19 vaccine mandates.
This study examined the benefits and costs of U.S. employer COVID-19 mandates for federal employees and contractors and for some healthcare and private sector workers if there had not been major challenges in court that halted or delayed the mandates. The authors estimated the direct costs and health-related benefits that would have accrued if these vaccination requirements had been implemented as intended. Compared with the January 2022 vaccination rates, they found that the mandates could have led to 15 million additional vaccinated individuals, increasing the overall proportion of the fully vaccinated U.S. population from 64% to 68%. They examined scenarios involving the emergence of a novel, more transmissible variant, against which vaccination and previous infection offer moderate protection, and found that the estimated net benefits are potentially large. They estimated that they reach almost $20,000 per additional vaccinated individual, with more than 20,000 total deaths averted over the 6-month period assessed. For other scenarios involving a fading pandemic, existing vaccination-acquired or infection-acquired immunity provides sufficient protection, and the mandates' benefits are unlikely to exceed their costs. They believe that mandates may be most useful when the consequences of inaction are catastrophic. However, they did not compare the effects of mandates with alternative policies for increasing vaccination rates or for promoting other protective measures, which may receive stronger public support and be less likely to be overturned by litigation.
AHRQ-funded; HS000055.
Citation: Ferranna M, Robinson LA, Cadarette D .
The benefits and costs of U.S. employer COVID-19 vaccine mandates.
Risk Anal 2023 Oct; 43(10):2053-68. doi: 10.1111/risa.14090..
Keywords: COVID-19, Vaccination, Healthcare Costs
Oke I, Hunter DG, Mantagos IS
The impact of the COVID-19 pandemic on the surgical volume of pediatric ophthalmology and strabismus fellows.
This article described a study that used data from the annual fellowship survey to describe trends in surgical experience for pediatric ophthalmology and strabismus fellows, and to quantify the impact of the COVID-19 pandemic on trainee surgical volume. The findings showed that the overall number of procedures performed by fellows in the primary surgeon role declined during the first academic year of the pandemic but recovered in the second year. The number of intraocular cases performed per year increased during the study’s 7-year interval.
AHRQ-funded; HS000063.
Citation: Oke I, Hunter DG, Mantagos IS .
The impact of the COVID-19 pandemic on the surgical volume of pediatric ophthalmology and strabismus fellows.
J AAPOS 2023 Oct; 27(5):305-07. doi: 10.1016/j.jaapos.2023.06.006..
Keywords: COVID-19, Children/Adolescents, Surgery
Hooper M, Reinhart M, Dusetzina SB
Trends in U.S. self-reported health and self-care behaviors during the COVID-19 pandemic.
The purpose of this study was to evaluate changes in self-reported health outcomes during the COVID-19 pandemic, and to examine trends in health-related behaviors that may be associated with the observed health changes. The researchers utilized an interrupted time series design stratified by age, gender, race/ethnicity, educational attainment, household income, and employment status. Health outcomes were self-reported by participants and included the number of days per month that respondents spent in poor mental health, physical health, or when poor health prevented their usual activities of daily living. The study found that the national rate of days spent in poor physical health decreased. The researchers also witnessed overall increases in average sleep hours per day, the percentage of adults who report any exercise activity, increased alcohol consumption days, and decreased prevalence of smoking.
AHRQ-funded; HS026395.
Citation: Hooper M, Reinhart M, Dusetzina SB .
Trends in U.S. self-reported health and self-care behaviors during the COVID-19 pandemic.
PLoS One 2023 Sep 19; 18(9):e0291667. doi: 10.1371/journal.pone.0291667..
Keywords: COVID-19, Patient Self-Management
Kilaru AS, Scheulen JJ, Harbertson CA
Boarding in US academic emergency departments during the COVID-19 pandemic.
The purpose of this retrospective study was to characterize changes in emergency department (ED) boarding among U.S. academic EDs across the duration of the COVID-19 pandemic. From January 2019 to December 2021 the researchers utilized a convenience sample of academic departments of emergency medicine to conduct an analysis of monthly data. The primary outcome was total boarding hours, and secondary outcomes included patient volume stratified by ED disposition. Of the 73 academic departments of emergency medicine contacted, 46.6% participated, a total of 43 individual EDs in 25 states. The study found that the adjusted mean total boarding hours per month were significantly lower during the second quarter of 2020 compared to the first quarter of 2019. Beginning in the second quarter of 2021, total boarding hours were significantly higher than pre-pandemic levels, peaking during the fourth quarter of 2021.
AHRQ-funded; HS026372.
Citation: Kilaru AS, Scheulen JJ, Harbertson CA .
Boarding in US academic emergency departments during the COVID-19 pandemic.
Ann Emerg Med 2023 Sep; 82(3):247-54. doi: 10.1016/j.annemergmed.2022.12.004..
Keywords: COVID-19, Emergency Department, Public Health
Menez S, Coca Moledina, Moledina DG
Evaluation of plasma biomarkers to predict major adverse kidney events in hospitalized patients with COVID-19.
There is an increased risk for major adverse kidney events (MAKE) in patients hospitalized with COVID-19. The purpose of this prospective cohort study was to identify plasma biomarkers predictive of MAKE in patients hospitalized with COVID-19. The study found that in total, 95 patients (16%) experienced MAKE. Each 1 SD increase in soluble tumor necrosis factor receptor 1 (sTNFR1) and sTNFR2 was significantly associated with an increased risk of MAKE. A limitation of the study was a lack of control group of hospitalized patients without COVID-19.
AHRQ-funded; HS027626.
Citation: Menez S, Coca Moledina, Moledina DG .
Evaluation of plasma biomarkers to predict major adverse kidney events in hospitalized patients with COVID-19.
Am J Kidney Dis 2023 Sep; 82(3):322-32.e1. doi: 10.1053/j.ajkd.2023.03.010..
Keywords: COVID-19, Kidney Disease and Health, Inpatient Care
Chen JT, Mehrizi R, Aasman B
Long short-term memory model identifies ARDS and in-hospital mortality in both non-COVID-19 and COVID-19 cohort.
The objective of this study was to identify risk of acute respiratory distress syndrome (ARDS) and in-hospital mortality using a long short-term memory (LSTM) framework in mechanically ventilated (MV) COVID-19 and non-COVID-19 cohorts. The results indicated that the LSTM algorithm accurately identified the risk of ARDS or death in both non-COVID-19 and COVID MV patients. The researchers concluded that a tool that alerts to the risk of ARDS or death can improve the implementation of evidence-based ARDS management and facilitate goals-of-care discussions involving high-risk patients.
AHRQ-funded; HS026188.
Citation: Chen JT, Mehrizi R, Aasman B .
Long short-term memory model identifies ARDS and in-hospital mortality in both non-COVID-19 and COVID-19 cohort.
BMJ Health Care Inform 2023 Sep; 30(1). doi: 10.1136/bmjhci-2023-100782..
Keywords: COVID-19, Mortality, Hospitals, Inpatient Care
Kim D, Swaminathan S, Lee Y
Racial and ethnic disparities in excess deaths after COVID-19 vaccine deployment among persons with kidney failure.
COVID-19 resulted in clear racial/ethnic disparities in excess deaths among persons with kidney failure. It is not clear whether or how these disparities changed throughout the pandemic, especially after the deployment of COVID-19 vaccines. The purpose of this study was to examine disparities in excess mortality for the Medicare population with kidney failure from March 2020, through December 2021. The study found that there were 686,719 patients with kidney failure in January 2020. Researchers reported an increase in excess deaths beginning March 1, 2020, with a peak in January 2021. From March 1, 2020, through January 30, 2021, and there were substantial disparities in excess deaths across racial/ethnic groups. The number of excess deaths was 5582, 4303, and 2679 for non-Hispanic White, non-Hispanic Black, and Hispanic patients, respectively. The percent excess deaths was 31.9% for Hispanic patients, 27.5% for non-Hispanic Black patients, and 16.4% for non-Hispanic White patients. After the wide distribution of COVID-19 vaccines since the end of January 2021, the lowest percent excess deaths was observed among Hispanic patients, followed by Black patients, and White patients.
AHRQ-funded; HS028285.
Citation: Kim D, Swaminathan S, Lee Y .
Racial and ethnic disparities in excess deaths after COVID-19 vaccine deployment among persons with kidney failure.
Clin J Am Soc Nephrol 2023 Sep; 18(9):1207-09. doi: 10.2215/cjn.0000000000000226..
Keywords: COVID-19, Racial and Ethnic Minorities, Disparities, Vaccination, Kidney Disease and Health, Mortality
Rao S, Armistead I, Tyler A
Respiratory syncytial virus, influenza, and coronavirus disease 2019 hospitalizations in children in Colorado during the 2021-2022 respiratory virus season.
This study compared demographic characteristics, clinical features, and outcomes of children hospitalized with respiratory syncytial virus (RSV), influenza, or severe acute respiratory syndrome coronavirus 2 during their cocirculation 2021-2022 respiratory virus season. The authors conducted a retrospective cohort study using Colorado's hospital respiratory surveillance data comparing coronavirus disease 2019 (COVID-19)-, influenza-, and RSV-hospitalized cases < 18 years of age admitted and undergoing standardized molecular testing between October 1, 2021, and April 30, 2022. The cohort consisted of 847 hospitalized cases, of which 490 (57.9%) were RSV associated, 306 (36.1%) were COVID-19 associated, and 51 (6%) were influenza associated. Most RSV cases were children less than 4 years of age (92.9%), whereas influenza hospitalizations were observed in older children. RSV cases were more likely to require oxygen support higher than nasal cannula compared with COVID-19 and influenza cases, although COVID-19 cases were more likely to require invasive mechanical ventilation than influenza and RSV cases. Compared with children with COVID-19, the risk of intensive care unit admission was highest among children with influenza, whereas the risk of pneumonia, bronchiolitis, longer hospital length of stay, and need for oxygen were more likely among children with RSV.
AHRQ-funded; HS026512.
Citation: Rao S, Armistead I, Tyler A .
Respiratory syncytial virus, influenza, and coronavirus disease 2019 hospitalizations in children in Colorado during the 2021-2022 respiratory virus season.
J Pediatr 2023 Sep; 260:113491. doi: 10.1016/j.jpeds.2023.113491..
Keywords: Children/Adolescents, COVID-19, Respiratory Conditions, Influenza, Hospitalization, Infectious Diseases
Osmanlliu E, Kalwani NM, Parameswaran V
Sociodemographic disparities in the use of cardiovascular ambulatory care and telemedicine during the COVID-19 pandemic.
Researchers examined adult cardiology visits at an academic and affiliated community practice in Northern California to assess the persistence sociodemographic disparities in telemedicine use before and during the COVID pandemic. Results indicated that sociodemographic characteristics of patients receiving cardiovascular care remained stable during both periods, but the modality of care diverged across groups. Observed disparities in the use of video-based telemedicine were greatest for patients 80 years or older, Black, with limited English proficiency, or on Medicaid. The researchers recommended that future studies examine barriers and outcomes in digital healthcare access across diverse patient groups.
AHRQ-funded; HS026128.
Citation: Osmanlliu E, Kalwani NM, Parameswaran V .
Sociodemographic disparities in the use of cardiovascular ambulatory care and telemedicine during the COVID-19 pandemic.
Am Heart J 2023 Sep; 263:169-76. doi: 10.1016/j.ahj.2023.06.011..
Keywords: COVID-19, Cardiovascular Conditions, Telehealth, Health Information Technology (HIT), Disparities, Ambulatory Care and Surgery
Feldman AG, Beaty B, Everitt M
Survey of pediatric transplant center practices regarding COVID-19 vaccine mandates for transplant candidates and living donors and use of COVID-19-positive deceased organs.
This study’s objective was to assess COVID-19 policies at US pediatric solid organ transplant centers. A 79-item survey was created and emailed between March and April 2022 to 200 UNOS Medical Directors detailing center COVID-19 vaccine policies for transplant candidates and living donors and use of grafts from COVID-19-positive deceased donors. The response rate was 77%. For children aged 5-15 years, 23% of centers have a COVID-19 vaccine mandate, 27% anticipate implementing a future mandate, and 47% have not considered or do not anticipate implementing a mandate. For children ≥16 years, 32% of centers have a COVID-19 vaccine mandate, 25% anticipate implementing a future mandate, and 40% have not considered or do not anticipate implementing a mandate. The top two reasons provided for not implementing a COVID-19 vaccine mandate were concerns about penalizing a child for their parent's decision and worsening inequities in transplant. Almost a third of 85 (27/85) kidney and liver living donor centers require vaccinations of donors. Twenty percent of centers accept organs from COVID-19-positive deceased donors.
AHRQ-funded; HS026510.
Citation: Feldman AG, Beaty B, Everitt M .
Survey of pediatric transplant center practices regarding COVID-19 vaccine mandates for transplant candidates and living donors and use of COVID-19-positive deceased organs.
Pediatr Transplant 2023 Sep; 27(6):e14513. doi: 10.1111/petr.14513..
Keywords: COVID-19, Children/Adolescents, Transplantation
Overhage L, Hailu R, Busch AB
Trends in acute care use for mental health conditions among youth during the COVID-19 pandemic.
This study’s objective was to examine youth acute mental health care use (emergency department [ED], boarding, and subsequent inpatient care) during the second year of the COVID-19 pandemic. This cross-sectional analysis used data from national, deidentified commercial health insurance claims of youth mental health ED and hospital care that took place between March 2019 and February 2022. Among 4.1 million commercial insurance enrollees aged 5 to 17 years, 17,614 in the baseline year (March 2019-February 2020) and 16,815 youth in pandemic year 2 (March 2021-February 2022) had at least 1 mental health ED visit. Comparing baseline to pandemic year 2, there was a 6.7% increase in youth with any mental health ED visits. Among adolescent females, there was a larger increase (22.1%). The fraction of ED visits that resulted in a psychiatric admission increased by 8.4%. Mean length of inpatient psychiatric stay increased 3.8%. The fraction of episodes with prolonged boarding increased 76.4%.
AHRQ-funded; HS026503.
Citation: Overhage L, Hailu R, Busch AB .
Trends in acute care use for mental health conditions among youth during the COVID-19 pandemic.
JAMA Psychiatry 2023 Sep; 80(9):924-32. doi: 10.1001/jamapsychiatry.2023.2195..
Keywords: COVID-19, Behavioral Health, Children/Adolescents
Hua Y, Temkin-Greener H, Cai S
Primary care telemedicine use among assisted living residents with dementia during COVID-19: race and dual enrollment status.
The purpose of this study was to explore primary care telemedicine use among Medicare beneficiaries with Alzheimer’s disease and related dementias (ADRD) who resided in Assisted Living Facilities (Als) during the early stage of the COVID-19 pandemic, with a focus on possible racial and socioeconomic differences. The study found that at the start of the pandemic in quarter 2 of 2020, Black residents were less likely to have telemedicine visits than their White counterparts. In the following two quarters, Black residents were more likely to receive primary care via telemedicine than White residents; a similar difference was observed between Hispanic and White residents, but with smaller effect sizes. Compared with nondual residents, dual residents were more likely to receive primary care via telemedicine in Q3. In addition, residents in AL communities with a higher proportion of dual residents, compared with those in low-dual ALs, were less likely to receive primary care via telemedicine throughout the study period. However, the difference in telemedicine use between higher vs lower dual ALs narrowed over time.
AHRQ-funded; HS026893.
Citation: Hua Y, Temkin-Greener H, Cai S .
Primary care telemedicine use among assisted living residents with dementia during COVID-19: race and dual enrollment status.
J Am Med Dir Assoc 2023 Aug; 24(8):1157-58.e3. doi: 10.1016/j.jamda.2023.05.005..
Keywords: COVID-19, Primary Care, Telehealth, Health Information Technology (HIT), Nursing Homes, Long-Term Care, Dementia, Neurological Disorders, Racial and Ethnic Minorities, Elderly
Eliason E, Admon LK, Steenland MW
Late postpartum coverage loss before COVID-19: implications for Medicaid unwinding.
The purpose of this study was to explore the loss of Medicaid coverage in toward the end of the postpartum period prior to COVID-19 and describe the implications for Medicaid unwinding. The researchers utilized unique Pregnancy Risk Assessment Monitoring System follow-up data from prior to the COVID-19 pandemic. The study found that only 68% of enrollees in prenatal Medicaid maintained continuous Medicaid coverage through 9 or 10 months postpartum. Of the total prenatal Medicaid enrollees who lost their coverage in the early postpartum period, two-thirds continued to be uninsured 9 to 10 months postpartum. The researchers concluded that extensions to state postpartum Medicaid could prevent a return to postpartum coverage loss rates similar to the level in the prepandemic period.
AHRQ-funded; HS027464; HS000011.
Citation: Eliason E, Admon LK, Steenland MW .
Late postpartum coverage loss before COVID-19: implications for Medicaid unwinding.
Health Aff 2023 Jul; 42(7):966-72. doi: 10.1377/hlthaff.2022.01659..
Keywords: COVID-19, Maternal Care, Medicaid, Women, Access to Care, Uninsured, Health Insurance
Titus AR, Mezuk B, Hirschtick JL
Patterns and predictors of depressive and anxiety symptoms within a population-based sample of adults diagnosed with COVID-19 in Michigan.
Researchers examined the intersection of demographic, economic, and illness-related predictors of depressive and anxiety symptoms within a population-based sample of adults diagnosed with COVID-19 in Michigan. Data were taken from a population-based survey of Michigan adults who experienced a COVID-19 diagnosis prior to August 2020. Results indicated that relative risks for experiencing poor mental health outcomes varied by race/ethnicity, sex, age, and income. Symptom severity was associated with a higher burden of comorbid depressive/anxiety symptoms. "Long COVID" was associated with all outcomes. The researchers concluded that because of overlapping risk factors, integrated approaches to treating depressive/anxiety symptoms among COVID-19 survivors is warranted.
AHRQ-funded; HS026120.
Citation: Titus AR, Mezuk B, Hirschtick JL .
Patterns and predictors of depressive and anxiety symptoms within a population-based sample of adults diagnosed with COVID-19 in Michigan.
Soc Psychiatry Psychiatr Epidemiol 2023 Jul; 58(7):1099-108. doi: 10.1007/s00127-023-02453-9..
Keywords: COVID-19, Depression, Anxiety, Behavioral Health
Amaefule AQ, Litvintchouk A, de Cordova P
Reevaluating the significance of infection preventionists and infection prevention and control departments in the post-COVID-19 era.
Infection preventionists are specialized health care professionals responsible for infection control policy development and implementation, prevention education for staff and patients, and investigation of outbreaks. The role of infection preventionists in creating effective methods for infection prevention and control became even more critical during the COVID-19 pandemic. The purpose of this paper was to increase awareness of the importance for health care systems and health care institutions to integrate lessons learned, improve infection prevention and control resources, and increase the workforce of infection preventionists to better prepare for pandemic events in the future.
AHRQ-funded; HS029023.
Citation: Amaefule AQ, Litvintchouk A, de Cordova P .
Reevaluating the significance of infection preventionists and infection prevention and control departments in the post-COVID-19 era.
Am J Med Qual 2023 Jul-Aug; 38(4):206-08. doi: 10.1097/jmq.0000000000000132..
Keywords: COVID-19, Infectious Diseases, Public Health
Hatch BA, Kenzie E, Ramalingam N
Impact of the COVID-19 vaccination mandate on the primary care workforce and differences between rural and urban settings to inform future policy decision-making.
The purpose of this cross-sectional study was to determine how vaccine mandates affect the healthcare workforce. Between October 28, 2021- November 18, 2021, following implementation of a COVID-19 vaccination mandate for healthcare personnel, the researchers conducted a survey of Oregon primary care clinic staff. The survey included 19 questions that assessed the clinic-level effects of the vaccination mandate. Study outcomes included job loss among staff, receipt of an approved vaccination waiver, new vaccination among staff, and the perceived significance of the policy on clinic staffing. Staff from 80 clinics across 28 counties completed surveys, representing 38 rural and 42 urban clinics. The study found that clinics reported job loss (46%), use of vaccination waivers (51%), and newly vaccinated staff (60%). Significantly more rural clinics (compared to urban) used medical and/or religious vaccination waivers (71% vs 33%) and reported significant impact on clinic staffing (45% vs 21%). There was also a non-significant trend toward more job loss for rural compared to urban clinics (53% vs. 41%). Qualitative analysis revealed a decrease in clinic morale and mixed opinions of the vaccination mandate.
AHRQ-funded; HS027080.
Citation: Hatch BA, Kenzie E, Ramalingam N .
Impact of the COVID-19 vaccination mandate on the primary care workforce and differences between rural and urban settings to inform future policy decision-making.
PLoS One 2023 Jun 27; 18(6):e0287553. doi: 10.1371/journal.pone.0287553..
Keywords: COVID-19, Vaccination, Primary Care, Policy, Rural Health, Urban Health, Rural/Inner-City Residents
Patel M, Berlin H, Rajkumar A
Barriers to telemedicine use: qualitative analysis of provider perspectives during the COVID-19 pandemic.
The objective of this study was to describe perceived barriers and facilitators to the use of web-based visits to inform quality improvement efforts and promote sustainability. Medical providers at a large, midwestern academic institution were surveyed. Four overarching categories of provider experience with web-based visits emerged: quality of care, patient rapport, visit flow, and equity. The authors concluded that their findings demonstrated key barriers to the maintenance of telemedicine services following the COVID pandemic, and that these findings might help to prioritize impactful methods of sustaining and expanding telemedicine availability for patients.
AHRQ-funded; HS027632.
Citation: Patel M, Berlin H, Rajkumar A .
Barriers to telemedicine use: qualitative analysis of provider perspectives during the COVID-19 pandemic.
JMIR Hum Factors 2023 Jun 26; 10:e39249. doi: 10.2196/39249..
Keywords: Telehealth, COVID-19, Public Health, Health Information Technology (HIT), Provider: Health Personnel
Paglino E, Lundberg, DJ, Zhou Z
Monthly excess mortality across counties in the United States during the COVID-19 pandemic, March 2020 to February 2022.
Researchers estimated all-cause excess mortality for the US by county and month by using a Bayesian hierarchical model focused on data from 2015-2019. Overall, excess mortality decreased in large metropolitan counties but increased in nonmetropolitan counties. Nonmetropolitan Southern counties had the highest cumulative relative excess mortality by July 2021. The researchers concluded that their results highlight the need for investments in rural health as the pandemic's rural impact increases.
AHRQ-funded; HS013853.
Citation: Paglino E, Lundberg, DJ, Zhou Z .
Monthly excess mortality across counties in the United States during the COVID-19 pandemic, March 2020 to February 2022.
Sci Adv 2023 Jun 23; 9(25):eadf9742. doi: 10.1126/sciadv.adf9742..
Keywords: COVID-19, Mortality
Mahmud A, Cushing-Haugen K, Wellman R
Understanding the relationship between social risk factors and COVID-19 contacts.
The purpose of this study was to facilitate researchers’ understanding of the prevalence of patients' social risk factors during the pandemic and recognize how social risks may intensify COVID-19. Between January and September 2020, the researchers conducted a national survey of Kaiser Permanente members and analyzed only the data from those who responded to a set of COVID-19 survey items. The survey included questions on their experiences with social risks, whether they knew of people with COVID-19, if COVID-19 affected their emotional and mental health, and their preferred type of assistance. The study found that 62% of respondents reported social risks, with 38% reporting having 2 or more social risks. The most common response was financial strain (45%). One third of respondents reported one or more contact types with COVID-19. respondents with 2 or more COVID-19 contact types reported higher rates of housing instability, financial strain, food insecurity, and social isolation than those with fewer contacts. Fifty percent of respondents reported that COVID-19 affected their emotional, mental health negatively, and 19% of respondents noted that it affected their ability to maintain a job.
AHRQ-funded; HS013853.
Citation: Mahmud A, Cushing-Haugen K, Wellman R .
Understanding the relationship between social risk factors and COVID-19 contacts.
Perm J 2023 Jun 15; 27(2):18-22. doi: 10.7812/tpp/22.146..
Keywords: COVID-19, Risk, Public Health, Infectious Diseases