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Topics
- Anxiety (1)
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- (-) Trauma (10)
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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 10 of 10 Research Studies DisplayedAghaei P, Bayramzadeh S
Clinicians’ experience with technology within the physical environment of trauma rooms: a focus group study.
This study’s objective was to investigate how trauma team members perceive technological equipment and tools in the trauma room (TR) environment and to identify how the technological equipment could be optimized in relation to the TR’s space. The authors conducted a total of 21 focus group sessions with 69 trauma team members, all of whom worked in Level I TRs from six teaching hospitals in the USA. Findings were analyzed and categorized into three parent themes: imaging equipment, assistive devices, and room features. The results suggest that trauma team members place high importance on the availability and versatility of the technological equipment in the TR environment. CT-scanners were not usually optimized for easy access to the TR. Other suggestions included the implementation of cameras and screens to accommodate situation awareness, and the rapid sharing of data such as imaging results. This study will inform health-care designers with the knowledge they need to make informed decisions when designing TRs. It covers key considerations such as room layout, equipment selection, lighting and controls.
AHRQ-funded; HS027261.
Citation: Aghaei P, Bayramzadeh S .
Clinicians’ experience with technology within the physical environment of trauma rooms: a focus group study.
Facilities 2024 Mar 12. 2024/02/14..
Keywords: Workflow, Teams, Emergency Department, Trauma
Scaife JH, Bryce JR, Iantorno SE
Secondary undertriage of pediatric trauma patients across the United States emergency departments.
The term “Undertriage” refers to the treatment of patients at facilities lacking in the equipment needed to treat the patient's injuries appropriately. The purpose of this retrospective cohort study was to assess the relationship between patient and hospital characteristics and secondary undertriage in children after major trauma. The researchers utilized the 2019 Nationwide Emergency Department Sample and included patients aged less than 18 years of age if they presented to a Level 3 or non-trauma center (NTC) and were diagnosed with a traumatic injury with an injury severity score of greater than 15 based on International Classification of Diseases 10 codes. The study found that of 6,572 weighted patients, 15% were undertriaged. Undertriage was significantly associated with older age, metropolitan location, and major abdominal injuries. After multivariable adjustment, secondary undertriage was significantly associated with patients aged 6-10 years of age compared to patients aged 15-17 years, penetrating injury, major chest injury, and presentation at a teaching hospital.
AHRQ-funded; HS025776.
Citation: Scaife JH, Bryce JR, Iantorno SE .
Secondary undertriage of pediatric trauma patients across the United States emergency departments.
J Surg Res 2024 Jan; 293:37-45. doi: 10.1016/j.jss.2023.07.054..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Trauma, Injuries and Wounds
Scott JW, Scott KW, Moniz M
Financial outcomes after traumatic injury among working-age US adults with commercial insurance.
This cross-sectional study linked insurance claims and consumer credit report data to evaluate the experience of financial distress in commercially insured adults after traumatic injury. Data from Blue Cross Blue Shield of Michigan’s preferred provider organization insurance claims from 2019 through 2021 were included. The authors identified working-age adults aged 21 to 64 whose January 2021 credit reports occurred more than 6 months after hospital admission for traumatic injury. This cohort of 3164 adults was compared demographically to 2223 patients in the comparison cohort. Relative to the comparison cohort, the post injury cohort had a 23% higher likelihood of having medical debt in collections, a 70% higher amount of medical debt in collections, and a 110% higher bankruptcy rate. For many commercially insured patients, the burden of out-of-pocket costs after hospitalization exceeded their ability to pay and could be associated with bankruptcy risk.
AHRQ-funded; HS028672; HS025465; HS028817.
Citation: Scott JW, Scott KW, Moniz M .
Financial outcomes after traumatic injury among working-age US adults with commercial insurance.
JAMA Health Forum 2022 Nov;3(11):e224105. doi: 10.1001/jamahealthforum.2022.4105..
Keywords: Trauma, Healthcare Costs, Health Insurance
Bowden CF, Simmel C, Mendez A
The complexity of psychotropic medication prescription and treating trauma among youth in foster care: perspectives from the lived experience.
The purpose of this study was to examine stakeholders' perspectives of the relationship between psychotropic medications and trauma informed care (TIC) for youth in foster care. The researchers recruited foster caseworkers, prescribing clinicians, caregivers, and alumni of the foster care system and conducted semi-structured individual and group interviews. Data were recorded and transcribed verbatim and analyzed using a directed content analysis approach. Five themes emerged across the recorded and transcribed data within stakeholder groups: 1) acknowledging trauma; 2) role of psychotropic medication; 3) psychosocial resources; 4) additional supports; and, 5) training and education. Stakeholders identified TIC as an important component of mental health services for youth in foster care. Most stakeholders felt that psychotropic medication was overused in treating trauma. Respondents suggested including additional supportive team members to help guide youth through the mental health treatment system and stated the importance of support from individuals with common lived experiences. The study concluded that there is a need for: improved training and education for stakeholders, additional sources of support for youth in foster care, and an overall system that emphasizes trauma-sensitive clinical interactions and psychosocial supports.
AHRQ-funded; HS02600101A1.
Citation: Bowden CF, Simmel C, Mendez A .
The complexity of psychotropic medication prescription and treating trauma among youth in foster care: perspectives from the lived experience.
Adm Policy Ment Health 2022 Sep;49(5):821-33. doi: 10.1007/s10488-022-01203-4..
Keywords: Children/Adolescents, Vulnerable Populations, Behavioral Health, Trauma, Medication
Henkhaus LE
The lasting consequences of childhood sexual abuse on human capital and economic well-being.
The objective of this study was to examine impacts on human capital and economic well-being of childhood sexual abuse by estimating likely ranges around causal effects, using a nationally representative U.S. sample. Findings suggested that childhood sexual abuse led to lower educational attainment and worse labor market outcomes. Further, childhood sexual abuse by someone other than a caregiver was as influential or more so than caregiver sexual abuse in predicting worse outcomes.
AHRQ-funded; HS026444.
Citation: Henkhaus LE .
The lasting consequences of childhood sexual abuse on human capital and economic well-being.
Health Econ 2022 Sep;31(9):1954-72. doi: 10.1002/hec.4557..
Keywords: Children/Adolescents, Trauma
Marks MR, Dux MC, Rao V
Treatment patterns of anxiety and posttraumatic stress disorder following traumatic brain injury.
Investigators examined psychotropic medication use and psychotherapy patterns among individuals diagnosed with anxiety disorders and PTSD post-traumatic brain injury (TBI). They found that receipt of pharmacotherapy pre- and post-TBI was considerably more common than receipt of psychotherapy. Individuals diagnosed with anxiety were 66% less likely to receive psychotherapy compared with individuals diagnosed with PTSD. Overall, psychotropic medication use and rates of antidepressant prescription use in the anxiety group were higher compared to those in the PTSD group.
AHRQ-funded; HS024560.
Citation: Marks MR, Dux MC, Rao V .
Treatment patterns of anxiety and posttraumatic stress disorder following traumatic brain injury.
J Neuropsychiatry Clin Neurosci 2022 Summer;34(3):247-53. doi: 10.1176/appi.neuropsych.21040104..
Keywords: Anxiety, Behavioral Health, Trauma, Brain Injury, Treatments, Practice Patterns, Medication
Danan ER, Brunner J, Bergman A
The relationship between sexual assault history and cervical cancer screening completion among women veterans in the Veterans Health Administration.
The purpose of this study was to determine whether a history of sexual assault in women Veterans is associated with decreased cervical cancer screening completion. The researchers analyzed data from a 2015 survey of 1049 women Veterans who accessed primary care services at 12 Veterans health administration facilities (VA’s) in nine states, and linked responses with electronic health data from the VA system. Fifty-seven percent (616) of women Veterans reported lifetime sexual assault, and those who did so had a greater likelihood of reporting a high level of distress associated with pelvic examinations and delaying a gynecologic exam due to distress. However, in the final adjusted model, there was not a significant association between lifetime sexual assault and reduced odds of cervical cancer screening completion. The study concluded that there was no significant association between sexual assault and gaps in cervical cancer screening completion.
AHRQ-funded; HS026379.
Citation: Danan ER, Brunner J, Bergman A .
The relationship between sexual assault history and cervical cancer screening completion among women veterans in the Veterans Health Administration.
J Womens Health 2022 Jul;31(7):1040-47. doi: 10.1089/jwh.2021.0237.AHRQ-funded; HS026379..
Keywords: Women, Cancer: Cervical Cancer, Cancer, Screening, Trauma
Neiman PU, Flaherty MM, Salim A
Evaluating the complex association between social vulnerability index and trauma mortality.
Researchers merged CDC Social Vulnerability Index (SVI) data with a statewide trauma registry and employed three analytic models to evaluate the association between SVI quartile and inpatient trauma mortality. Results showed that, while higher SVI was associated with worse mortality in the unadjusted model, there was no significant association between SVI and inpatient mortality after adjusting for covariates common to trauma. Higher SVI was associated with a higher likelihood of presenting with penetrating injuries. These findings suggested that the burden of trauma mortality is not driven by variation in quality of treatment, but by lethality of injuries. The researchers concluded that improvement in trauma survival among high-risk communities will require interventions and policies which target social and structural inequities upstream of trauma center admission.
AHRQ-funded; HS028672; HS027788.
Citation: Neiman PU, Flaherty MM, Salim A .
Evaluating the complex association between social vulnerability index and trauma mortality.
J Trauma Acute Care Surg 2022 May; 92(5):821-30. doi: 10.1097/ta.0000000000003514..
Keywords: Social Determinants of Health, Trauma, Mortality
Maughan BC, Lin A, Caughey AB
Field trauma triage among older adults: a cost-effectiveness analysis.
The authors evaluated the cost-effectiveness of a high-sensitivity triage strategy for older adults. They used a microsimulation model with a retrospective cohort of community-dwelling Medicare beneficiaries transported by emergency medical services after an acute injury. They found that high-sensitivity trauma field triage is not cost-effective among older adults.
AHRQ-funded; HS023796.
Citation: Maughan BC, Lin A, Caughey AB .
Field trauma triage among older adults: a cost-effectiveness analysis.
J Am Coll Surg 2022 Feb 1;234(2):139-54. doi: 10.1097/xcs.0000000000000025..
Keywords: Elderly, Trauma, Healthcare Costs
Hoonakker PLT, Hose BZ, Carayon P
Scenario-based evaluation of team health information technology to support pediatric trauma care transitions.
This study’s objective was to examine if the Teamwork Transition Technology (T(3)) supports teams and team cognition. Using a scenario-based mock-up methodology with 36 clinicians and staff from the different units and departments who are involved in pediatric trauma to examine T(3), results showed that most participants agreed that the technology helped to achieve the goals set out in the design phase. Respondents thought that T(3) organized and presented information in a different way that was helpful to them. The authors concluded that the results of their evaluation showed that participants agreed that T(3) does support them in their work and increases their situation awareness.
AHRQ-funded; HS023837.
Citation: Hoonakker PLT, Hose BZ, Carayon P .
Scenario-based evaluation of team health information technology to support pediatric trauma care transitions.
Appl Clin Inform 2022 Jan;13(1):218-29. doi: 10.1055/s-0042-1742368.
AHRQ-funded; HS023837..
AHRQ-funded; HS023837..
Keywords: Children/Adolescents, Transitions of Care, Health Information Technology (HIT), Teams, Trauma